Objectives:Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals.This study aimed to explore the challenges that community health workers...Objectives:Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals.This study aimed to explore the challenges that community health workers(CHWs)encounter while providing mental health services in the community.Methods:Forty CHWs were selected to participate in the study by purposive sampling method from July to August 2023 in seven primary health centers(PHCs)among three cites of Indonesia.Focus group discussions were used to collect data.All of data were analyzed using the interpretive phenomenological analysis method.Results:Considering the participants’voluntary CHW role,the results were organized into five themes.These comprised two themes of challengesdfamily stigma and limited understanding of mental disorders,and three themes regarding efforts to overcome the challengesdmaintaining self-motivation,fostering self-efficacy,and using communication skills when approaching families and patients.Conclusions:Upskilling and empowering CHWs helps to enhance community mental health.Thus,it is crucial to support CHWs through training programs that aim to improve mental health literacy and communication skills and diminish family stigma.展开更多
BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T...BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.展开更多
This article examines the progress in the prevention and treatment of Alzheimer’s disease among elderly individuals in communities from the perspective of traditional Chinese medicine(TCM).Through a systematic review...This article examines the progress in the prevention and treatment of Alzheimer’s disease among elderly individuals in communities from the perspective of traditional Chinese medicine(TCM).Through a systematic review of recent related studies,it analyzes new insights into the etiology and pathogenesis of Alzheimer’s disease within TCM and summarizes novel methods and achievements in the prevention and treatment of the disease using TCM.Based on the TCM principles of“preventive treatment”and holistic health,innovative intervention models with Chinese characteristics,such as the“brain-heart-kidney axis”and“brain-gut connection,”have shown new breakthroughs in improving cognitive function and slowing disease progression.The article also explores the benefits of shifting preventive and therapeutic measures to earlier stages,contributing to the establishment of an integrated community prevention model of“prevention-intervention-rehabilitation.”展开更多
Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at t...Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at the grassroots level. Methods: A total of 300 elderly individuals who underwent health examinations at our center from January 2024 to December 2024 were selected as the study subjects. They were randomly divided into a control group and an observation group, with 150 cases in each group. The control group underwent the conventional health examination nursing process, while the observation group adopted an optimized community nursing model, which included stratified education and appointment scheduling before the examination, full-time accompaniment and safety care during the examination, and the establishment of electronic medical records and continuous follow-up after the examination. Differences in health management awareness rates and satisfaction with health examination services between the two groups of elderly individuals were compared. Results: The health management awareness rate in the observation group was 94.67%, significantly higher than that in the control group (78.00%;p < 0.001). The satisfaction rate with health examination services in the observation group was 96.00%, also significantly higher than that in the control group (82.00%;p < 0.001). Conclusion: The optimized community nursing model can effectively enhance the health awareness level and service satisfaction of elderly individuals during health examinations, demonstrating strong practicality and promotion value. It contributes to achieving continuity and precision in grassroots elderly health management.展开更多
According to the data from the 7th national population census,the population aged 65 and above in China has reached 13.50%,indicating that the country has entered a deeply aging society.The health issues of the elderl...According to the data from the 7th national population census,the population aged 65 and above in China has reached 13.50%,indicating that the country has entered a deeply aging society.The health issues of the elderly have become a significant concern for society.Common brain diseases among the elderly,including cerebrovascular diseases,genetic factors,or long-term solitary living,can all lead to dementia,with Alzheimer’s disease(AD)being the most common.Early symptoms of AD mainly include memory loss and difficulty concentrating,which are often mistaken for normal aging or stress-related issues and thus overlooked.AD lacks specific biomarkers and effective auxiliary diagnostic methods,making it difficult to accurately diagnose with existing imaging and neuroprotein indicators.Therefore,early detection of AD is very challenging.This article explores community-based early detection and intervention strategies from the perspectives of existing mechanism research,clinical manifestations,modern drug treatments,innovative explorations in traditional medicine,and community-appropriate technologies,aiming to construct an ecological management strategy.展开更多
Objectives:This study aimed to evaluate attitudes toward caring for terminally ill patients and identify the associated factors among community nurses in Shanghai.Methods:The study was conducted among community nurses...Objectives:This study aimed to evaluate attitudes toward caring for terminally ill patients and identify the associated factors among community nurses in Shanghai.Methods:The study was conducted among community nurses using convenience sampling in Shanghai between August and November 2023.The demographic questionnaire,the Frommelt Attitude Toward Care of the Dying Scale-B(FATCOD-B),and the Coping with Death Scale(CDS)were used for data collection.Data analysis was conducted using independent sample t-test,one-way analysis of variance,and multiple linear regression analysis.Results:A total of 1,396 community nurses participated in this study.The overall FATCOD-B score among community nurses was 102.27±10.23,the attitude toward caring for the dying person’s family dimension scored the highest(4.03±0.53),whereas the attitude toward the communication dimension scored the lowest(2.86±0.52).The overall CDS score was 130.78±20.25.Multiple linear regression analysis showed that death coping ability and blended death education accounted for 13.7%of the variance in community nurses’attitudes toward caring for terminally ill patients.Conclusions:Community nurses in Shanghai exhibit moderate attitudes toward caring for terminally ill patients.Nurses with greater death coping ability and those who participated in blended death education tended to have more positive attitudes toward terminally ill patients.These findingsunderscore the potential of blended death education as a practical strategy to enhance hospice care quality in community health service centers.展开更多
BACKGROUND Motoric cognitive risk(MCR)syndrome represents an“ultra-early”stage of dementia prevention,highlighting the need for effective screening tools.AIM To develop and validate a novel tool for MCR identificati...BACKGROUND Motoric cognitive risk(MCR)syndrome represents an“ultra-early”stage of dementia prevention,highlighting the need for effective screening tools.AIM To develop and validate a novel tool for MCR identification,comparing its effectiveness with existing methods.METHODS As part of a community study on healthy aging,a cross-sectional study recruited 1189 Chinese participants aged 50 years and older between May 1,2022,and March 15,2023.The cohort was randomly split into training(70%)and testing(30%)datasets.Relevant features were selected for logistic regression(LR)and decision tree(DT)models using the training dataset,and their performance was subsequently assessed using the testing dataset to validate reliability and generalizability.RESULTS The prevalence of MCR was 13.12%among 1189 participants.DT models had the area under the curves(AUCs)of 0.834 and 0.821 for training and testing datasets,respectively,while LR models indicated AUCs of 0.840 and 0.859.Non-inferiority tests confirmed the DT model’s comparable effectiveness to the LR models in predicting MCR.Both models demonstrated good calibration and clinical utility.Seven modifiable risk factors were identified:Age,education level,social engagement,physical activity,nutritional status,depressive symptoms,and purpose in life.Notably,social engagement emerged as a novel factor compared to those previously identified.Both models are integrated into an easy-to-use,interpretable web-based user interface.CONCLUSION The interactive,web-based user interface of both models effectively identifies MCR,with the DT model recommended for its simplicity and interpretability,supporting community nurses and clinicians in triaging MCR.展开更多
From the establishment of dialogue relations between China and ASEAN in 1991 to the 30th anniversary of their dialogue relations in 2021,bilateral ties have been continuously elevated to a comprehensive strategic part...From the establishment of dialogue relations between China and ASEAN in 1991 to the 30th anniversary of their dialogue relations in 2021,bilateral ties have been continuously elevated to a comprehensive strategic partnership.We have witnessed relentless enhancement of political mutual trust,deepening economic cooperation,and closer people-to-people exchanges.The sustained development of the China-ASEAN bilateral partnership is precisely what has generated significant positive spillover e!ects,driving profound changes in China’s relations with neighboring countries.The various levels of partnerships China has established with neighboring countries will play an important role in shaping a networked,non-hierarchical regional order in the future,and such relationships have already become a key pathway for China and its neighbors to jointly build a community with a shared future in the region.展开更多
BACKGROUND Older adults with mild cognitive impairment(MCI)often show motor dysfunction,including slower gait and impaired handwriting.While gait and handwriting parameters are promising for MCI screening,their combin...BACKGROUND Older adults with mild cognitive impairment(MCI)often show motor dysfunction,including slower gait and impaired handwriting.While gait and handwriting parameters are promising for MCI screening,their combined potential to distinguish MCI from cognitively normal adults is unclear.AIM To assess gait and handwriting differences and their potential for screening MCI in older adults.METHODS Ninety-five participants,including 34 with MCI and 61 cognitively normal controls,were assessed for gait using the GAITRite^(R)system and handwriting with a dot-matrix pen.Five machine learning models were developed to assess the discriminative power of gait and handwriting data for MCI screening.RESULTS Compared to the cognitively normal group,the MCI group had slower gait velocity(Z=-2.911,P=0.004),shorter stride and step lengths(t=-3.005,P=0.003;t=2.863,P=0.005),and longer cycle,standing,and double support times(t=-2.274,P=0.025;t=-2.376,P=0.018;t=-2.717,P=0.007).They also had reduced cadence(t=2.060,P=0.042)and increased double support time variability(Z=-2.614,P=0.009).In handwriting,the MCI group showed lower average pressure(all tasks:Z=-2.135,P=0.033)and decreased accuracy(graphic task:Z=-2.447,P=0.014;Chinese character task:Z=-3.078,P=0.002).In the graphic task,they demonstrated longer time in air(Z=-2.865,P=0.004),reduced X-axis maximum velocities(Z=-3.237,P=0.001),and lower accelerations(X-axis:Z=-2.880,P=0.004;Y-axis:Z=-1.987,P=0.047)and maximum accelerations(X-axis:Z=-3.998,P<0.001;Y-axis:Z=-2.050,P=0.040).The multimodal analysis achieved the highest accuracy(74.4%)with the Gradient Boosting Classifier.CONCLUSION Integrating gait and handwriting kinematics parameters provides a viable method for distinguishing MCI,potentially supporting large-scale screening,especially in resource-limited settings.展开更多
This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of soci...This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of social welfare services provision among others for the citizens of a country over time, with particular emphasis on medical care component of such index aimed at reduction in diseases and poverty in the population. The objective of the review work is to determine the extent to which Community Health Practice, particularly by Community Health Practitioners is capable of ensuring National Development in democratic governance or otherwise, in the context of our country, Nigeria. The methodology applied was traditional review of published literatures concerning the subject and findings of operational research of programme implemented by Community Health Practitioners at the Primary Health Care facilities and household level in the communities. This paper emphasizes on Primary Health Care services delivery contribution to National Development, since it is the level where Community Health Practitioners are mainly commissioned to render their services. Home-Based Care Strategy for Integrated Maternal, Newborn and Child Health piloted in three (3) local government areas (Ahoada West, Etche and Oyigbo) in Rivers State, Nigeria, in 2012 and implemented by Community Health Practitioners, aimed at reducing maternal, newborn and child morbidity and mortality by 20% by 2015 in line with the United Nations (UN) Millennium Development Goals 4 and 5, had been shown to achieve an average of 26% improvement in utilization of maternal and newborn health services, an average of 27% overall reduction in maternal malnutrition status, an average of 14% overall improvement in under 5 years malnutrition status among others in 2013 on comparing with baseline indicators. Nigeria also attained 80% coverage in routine immunization in most vaccine preventable diseases except Tetanus Toxiod (TT) 2 (54%) in 2013 to achieve herd immunity of the community to prevent transmission of disease pathogen to cause a disease. Community Health Practitioners are the frontline Primary Health Care Professionals charged with the responsibility of implementation of immunization programmes in Nigeria and therefore contributing significantly to the prevention and control of targeted vaccine preventable diseases in Nigeria Health System. Our findings on factors militating against Community Health Practitioners’ Roles in National Development as elicited in this paper may form basis for empirical studies to determine the level of significance of each of these factors. In conclusion, it is when the Community Health parameters are adequately addressed that we can ensure sustainable National Development and we can say we have succeeded in our various strategic agenda of government at whatever level that makes up the complex whole. This brings to fore, the importance of the roles of Community Health Practitioners in health care delivery to National Development in the context of our country, Nigeria.展开更多
Background:Soil fungi play crucial roles in ecosystem functions.However,how snow cover change associated with winter warming affects soil fungal communities remains unclear in the Tibetan forest.Methods:We conducted a...Background:Soil fungi play crucial roles in ecosystem functions.However,how snow cover change associated with winter warming affects soil fungal communities remains unclear in the Tibetan forest.Methods:We conducted a snow manipulation experiment to explore immediate and legacy effects of snow exclusion on soil fungal community diversity and composition in a spruce forest on the eastern Tibetan Plateau.Soil fungal communities were performed by the high throughput sequencing of gene-fragments.Results:Ascomycota and Basidiomycota were the two dominant fungal phyla and Archaeorhizomyces,Aspergillus and Amanita were the three most common genera across seasons and snow manipulations.Snow exclusion did not affect the diversity and structure of soil fungal community in both snow-covered and snow-free seasons.However,the relative abundance of some fungal communities was different among seasons.Soil fungal groups were correlated with environmental factors(i.e.,temperature and moisture)and soil biochemical variables(i.e.,ammonium and enzyme).Conclusions:These results suggest that the season-driven variations had stronger impacts on soil fungal community than short-term snow cover change.Such findings may have important implications for soil microbial processes in Tibetan forests experiencing significant decreases in snowfall.展开更多
Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in Myanmar.Methods:A total of 30 CHNs from t...Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in Myanmar.Methods:A total of 30 CHNs from township health centers in the northeastern,southern,and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews.Quantitative data were processed using Microsoft Excel software,and qualitative data were analyzed using thematic analysis.This study is registered with researchregistry6201.Results:Around the country,30 CHNs uncovered their hardships in implementing primary health care to achieve UHC.Over 90%of the participants agreed to the problem of inadequate health infrastructure,while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion.Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services.Complications are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidencebased practices.Insecure work and living conditions,unsupportive community relationships,and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC.Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs.Conclusion:Myanmar’s CHNs face many challenges in achieving UHC.These challenges are not confined to the health sector.Some situations,such as geographical barriers and transportation problems,remain persistent challenges for healthcare providers.This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure.Meanwhile,public empowerment plays a critical role in promoting health development.展开更多
In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical...In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available con-cerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based rec-ommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.展开更多
Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CH...Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CHWs)in Indonesia’s rural areas.Methods:A cohor t retrospective study evaluated 577 par ticipants from Posbindu-NCD in 7 public health centers(PHCs)in 2019.Activities of intervention of CDM for Posbindu-NCD was included,identified risk factors to NCDs,and provided counselling education and other follow-ups based on interviews and measurement results from the five Desk systems that recorded in a medical record as a form of the monthly activity report each the first month,the 6 months,and the 12th month.Results:There were statistically significant differences for alcohol consumed and diabetes mellites(χ^(2)=10.455;P=0.001).There were significant differences on gender(χ^(2)=3.963;P=0.047),on ethnicity(χ^(2)=19.873;P<0.001),and hypertension.In addition,there were also significant differences on ethnicity(χ^(2)=15.307;P<0.001),vegetable consumption(χ^(2)=4.435;P=0.035),physical exercise(χ^(2)=6.328;P=0.012),and the current diseases of hypercholesterolemia of par ticipants.Fur thermore,the survival rate among patients who have overweight,abdominal overweight,hyper tension,diabetes mellitus,and hypercholesterolemia increased among par ticipants who regularly visited Posbindu-NCD compared with the non-regularly one.Conclusions:The CDM program’s community-based intervention through Posbindu-NCD conducted by CHWs improved survival rates in Indonesia’s rural areas.Therefore,this program can be fur ther developed in conducting CDM in the community with the active involvement of CHWs so that the community becomes active regularly in par ticipating in Posbindu-NCD activities in rural areas of Indonesia.展开更多
Objectives:To examine the relationship between cardiovascular disease risk factors and frailty in a sample of older Chinese adults.Methods:A total of 458 community-dwelling older adults(>65 years)in Lanzhou,Gansu P...Objectives:To examine the relationship between cardiovascular disease risk factors and frailty in a sample of older Chinese adults.Methods:A total of 458 community-dwelling older adults(>65 years)in Lanzhou,Gansu Province of China participated in a cross-sectional survey.Their status was evaluated in terms of frailty phenotype(unintentional weight loss,exhaustion,low activity levels,slowness and weakness).Participants were categorized as not frail,prefrail or frail.Cardiovascular disease risk factors that were assessed included:blood pressure,body mass index,waist circumference,blood glucose,total cholesterol,triglycerides,lowdensity lipoproteins and high-density lipoproteins.Results:Individuals with obesity had an increased risk of prefrailty(OR:2.26;95%CI:1.05,4.84).Hypertension was inversely associated with frailtyamong the participants(OR:0.31;95%CI:0.11,0.87)after adjusting for covariates.Conclusions:The findings suggest that much more attention should be paid to weight control of the elderly in the community for preventing them from transition to prefrailty or frailty.Active prevention and control of cardiovascular diseases among the community-dwelling elder are still of great importance.展开更多
AIM: To explore the association of serum insulin, insulin resistance, and β-cell dysfunction with gallstone disease (GSD) in type 2 diabetics. METHODS: We used a community-based study conducted between 1991 and 1993 ...AIM: To explore the association of serum insulin, insulin resistance, and β-cell dysfunction with gallstone disease (GSD) in type 2 diabetics. METHODS: We used a community-based study conducted between 1991 and 1993 in Kinmen, Taiwan to identify type 2 diabetics. A screening program for GSD was performed in 2001 by a panel of specialists who employed real-time ultrasound sonography to examine the abdominal region after the patient had fasted for at least 8 h. Screening was conducted in 2001 on 848 patients diagnosed with type 2 diabetes. The HOMA method was used to compare the profile differences for insulin resistance (HOMA IR) and β-cell dysfunction (HOMA β-cell). RESULTS: We studied 440 type 2 diabetics who attended sonography check-ups. After excluding eight insulin-treated diabetics, the prevalence of GSD among the remaining 432 was 13.9% (26/187) among males and 14.7% (36/245) among females. After adjustment for other GSD-associated risk factors in addition to age and obesity, GSD risk increased among females with levels of serum insulin [4th vs 1st quartile odds ratios (OR) = 4.46 (95%CI: 1.71-11.66)] and HOMA IR [4th vs 1st quartile OR = 4.46 (95%CI: 1.71-11.66)]. Better HOMA β-cell function was significantly related to decreased risk of GSD [4th vs 1st quartile OR = 0.16 (95%CI: 0.03-1.70)]. Among males, age and central obesity were the most significant risk factors for GSD. No association of GSD with serum insulin, HOMA IR, and HOMA β-cell was observed among males. CONCLUSION: Serum insulin, insulin resistance, and β-cell dysfunction are risk factors for GSD in females, but not males with type 2 diabetes.展开更多
Objective:This study aims to examine the effects of a community-based friendly health clinic(CFHC)program that adopts manual participatory learning(MPL)intervention on the adolescents living in the rural and urban are...Objective:This study aims to examine the effects of a community-based friendly health clinic(CFHC)program that adopts manual participatory learning(MPL)intervention on the adolescents living in the rural and urban areas of Indonesia to gain further insights into their knowledge,attitudes,and skills related to adolescent reproductive health(ARH).Methods:A quasi-experimental design was used to obtain information on the ARH knowledge,attitudes,and skills of adolescents.Two intervention studies that used similar protocols and measures were conducted.A total of 192 adolescents(96 adolescents from urban and rural areas)participated in the project,and the participants from each area were divided into eight groups.A questionairre was adopted to measure the ARH knowledge,attitudes,and skills of these participants.A content analysis of the logbook entries of these respondents was conducted to identify their ARH-related problems.The questionnairre and self-reported ARH data were collected before and after the eight-week program.Results:The CFHC program significantly increased the ARH attitudes(p=0.045)and skills(p=0.009)of adolescents in the rural area,but only improved the ARH knowledge(p<0.001)of adolescents in both rural and urban areas.Fourteen themes were identified in three dominant categories,namely,schools,families,and communities.Conclusions:The CFHC with MPL intervention can improve the ARH knowledge,attitudes,and skills of adolescents in the rural area,but can only improve the ARH knowledge of adolescents in the urban area.The ARH program must be designed based on the characterictics of these adolescents to improve their life skills during puberty.展开更多
BACKGROUND While Singapore attains good health outcomes,Singapore’s healthcare system is confronted with bed shortages and prolonged stays for elderly people recovering from surgery in acute hospitals.An Acute Hospit...BACKGROUND While Singapore attains good health outcomes,Singapore’s healthcare system is confronted with bed shortages and prolonged stays for elderly people recovering from surgery in acute hospitals.An Acute Hospital-Community Hospital(AHCH)care bundle has been developed to assist patients in postoperative rehabilitation.The core concept is to transfer patients out of AHs when clinically recommended and into CHs,where they can receive more beneficial dedicated care to aid in their recovery,while freeing up bed capacities in AHs.AIM To analyze the AH length of stay(LOS),costs,and savings associated with the AH-CH care bundle intervention initiated and implemented in elderly patients aged 75 years and above undergoing elective orthopedic surgery.METHODS A total of 8621:1 propensity score-matched patients aged 75 years and above who underwent elective orthopedic surgery in Singapore General Hospital(SGH)before(2017-2018)and after(2019-2021)the care bundle intervention period was analyzed.Outcome measures were AH LOS,CH LOS,hospitalization metrics,postoperative 30-d mortality,and modified Barthel Index(MBI)scores.The costs of AH inpatient hospital stay in the matched cohorts were compared using cost data in Singapore dollars.RESULTS Of the 862 matched elderly patients undergoing elective orthopedic surgery before and after the care bundle intervention,the age distribution,sex,American Society of Anesthesiologists classification,Charlson Comorbidity Index,and surgical approach were comparable between both groups.Patients transferred to CHs after the surgery had a shorter median AH LOS(7 d vs 9 d,P<0.001).The mean total AH inpatient cost per patient was 14.9%less for the elderly group transferred to CHs(S$24497.3 vs S$28772.8,P<0.001).The overall AH U-turn rates for elderly patients within the care bundle were low,with a 0%mortality rate following orthopedic surgery.When elderly patients were discharged from CHs,their MBI scores increased significantly(50.9 vs 71.9,P<0.001).CONCLUSION The AH-CH care bundle initiated and implemented in the Department of Orthopedic Surgery appears to be effective and cost-saving for SGH.Our results indicate that transitioning care between acute and community hospitals using this care bundle effectively reduces AH LOS in elderly patients receiving orthopedic surgery.Collaboration between acute and community care providers can assist in closing the care delivery gap and enhancing service quality.展开更多
Purpose:To study the level and influencing factors of gerotranscendence in communitydwelling older adults.Methods:We investigated 772 community-dwelling older adults in Hengyang in the Hunan Province of the People'...Purpose:To study the level and influencing factors of gerotranscendence in communitydwelling older adults.Methods:We investigated 772 community-dwelling older adults in Hengyang in the Hunan Province of the People's Republic of China using a translated Gerotranscendence Scale and demographic information.Results:The community-dwelling older adults had an overall intermediate level of gerotranscendence.One-way analysis of variance and multiple linear regression analysis showed that sex,living arrangements,regular activities,and religious affiliation influenced the gerotranscendence perspective of the community-dwelling older adults(p<0.05),but that living arrangement and gerotranscendence perspective were not significantly correlated.The covariates clarified about 38.8%of the variation in gerotranscendence perspective.Conclusions:Our findings suggest that sex,regular activities,religious affiliation,and living arrangement influence gerotranscendence.These findings can guide the planning and implementation of better practices in elderly care by nurses and other healthcare professionals.展开更多
Objective:To analyze the combined therapeutic effect of clopidogrel(CLO)and aspirin(ASP)on coronary heart disease(CHD)in community-dwelling elderly.Methods:Thirty elderly patients with CHD who were admitted to the Xin...Objective:To analyze the combined therapeutic effect of clopidogrel(CLO)and aspirin(ASP)on coronary heart disease(CHD)in community-dwelling elderly.Methods:Thirty elderly patients with CHD who were admitted to the Xinxin Community Health Service Station,Pangzhuang Street,Quanshan District,Xuzhou City,from November 2020 to November 2022 were selected and randomly grouped into an observation group and a control group,with 15 cases in each group.The observation group was given the combination of CLO and ASP and the reference group was given only ASP.The total effective rate and other treatment indicators between the two groups were compared.Results:The total effective rate of the observation group(93.33%)was higher than that of the reference group(60.00%)(P<0.05).The adverse drug reaction rate(13.33%)and long-term cardiovascular adverse event rate(6.67%)of the observation group were lower than those of the reference group at 46.67%and 40.00%respectively,(P<0.05).Before treatment,the two groups had no difference in the quality-of-life scores(P>0.05).After treatment,the quality-of-life scores of the observation group were higher than those of the reference group(P<0.05).Conclusion:CLO combined with ASP improved the therapeutic effect of community-dwelling elderly patients with CHD,reduced adverse reactions during medication,prevented adverse cardiovascular events,and comprehensively improved the patient’s quality of life.展开更多
基金This research(study design,data collection and analysis)was funded by Program Riset Kolaborasi Indonesia(RKI)-World Class University(WCU)Lembaga Penelitian dan Pengabdian Masyarakat Universitas Airlangga Indonesia in 2023 with the number:974/UN3.LPPM/PT.01.03/2023.
文摘Objectives:Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals.This study aimed to explore the challenges that community health workers(CHWs)encounter while providing mental health services in the community.Methods:Forty CHWs were selected to participate in the study by purposive sampling method from July to August 2023 in seven primary health centers(PHCs)among three cites of Indonesia.Focus group discussions were used to collect data.All of data were analyzed using the interpretive phenomenological analysis method.Results:Considering the participants’voluntary CHW role,the results were organized into five themes.These comprised two themes of challengesdfamily stigma and limited understanding of mental disorders,and three themes regarding efforts to overcome the challengesdmaintaining self-motivation,fostering self-efficacy,and using communication skills when approaching families and patients.Conclusions:Upskilling and empowering CHWs helps to enhance community mental health.Thus,it is crucial to support CHWs through training programs that aim to improve mental health literacy and communication skills and diminish family stigma.
文摘BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability.
基金Shanghai Pudong New District“National Traditional Chinese Medicine Development Comprehensive Reform Experimental Zone”Construction Project(Project No.:PDZY-2024-1003)Shanghai Pudong New District“National Traditional Chinese Medicine Heritage and Innovation Experimental Zone”Project(Project No.:PDZY-2025-0804)。
文摘This article examines the progress in the prevention and treatment of Alzheimer’s disease among elderly individuals in communities from the perspective of traditional Chinese medicine(TCM).Through a systematic review of recent related studies,it analyzes new insights into the etiology and pathogenesis of Alzheimer’s disease within TCM and summarizes novel methods and achievements in the prevention and treatment of the disease using TCM.Based on the TCM principles of“preventive treatment”and holistic health,innovative intervention models with Chinese characteristics,such as the“brain-heart-kidney axis”and“brain-gut connection,”have shown new breakthroughs in improving cognitive function and slowing disease progression.The article also explores the benefits of shifting preventive and therapeutic measures to earlier stages,contributing to the establishment of an integrated community prevention model of“prevention-intervention-rehabilitation.”
文摘Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at the grassroots level. Methods: A total of 300 elderly individuals who underwent health examinations at our center from January 2024 to December 2024 were selected as the study subjects. They were randomly divided into a control group and an observation group, with 150 cases in each group. The control group underwent the conventional health examination nursing process, while the observation group adopted an optimized community nursing model, which included stratified education and appointment scheduling before the examination, full-time accompaniment and safety care during the examination, and the establishment of electronic medical records and continuous follow-up after the examination. Differences in health management awareness rates and satisfaction with health examination services between the two groups of elderly individuals were compared. Results: The health management awareness rate in the observation group was 94.67%, significantly higher than that in the control group (78.00%;p < 0.001). The satisfaction rate with health examination services in the observation group was 96.00%, also significantly higher than that in the control group (82.00%;p < 0.001). Conclusion: The optimized community nursing model can effectively enhance the health awareness level and service satisfaction of elderly individuals during health examinations, demonstrating strong practicality and promotion value. It contributes to achieving continuity and precision in grassroots elderly health management.
基金Pudong New District“National Comprehensive Reform Experimental Zone for Traditional Chinese Medicine Development”Construction Project(Project No.:PDZY-2024-1003)。
文摘According to the data from the 7th national population census,the population aged 65 and above in China has reached 13.50%,indicating that the country has entered a deeply aging society.The health issues of the elderly have become a significant concern for society.Common brain diseases among the elderly,including cerebrovascular diseases,genetic factors,or long-term solitary living,can all lead to dementia,with Alzheimer’s disease(AD)being the most common.Early symptoms of AD mainly include memory loss and difficulty concentrating,which are often mistaken for normal aging or stress-related issues and thus overlooked.AD lacks specific biomarkers and effective auxiliary diagnostic methods,making it difficult to accurately diagnose with existing imaging and neuroprotein indicators.Therefore,early detection of AD is very challenging.This article explores community-based early detection and intervention strategies from the perspectives of existing mechanism research,clinical manifestations,modern drug treatments,innovative explorations in traditional medicine,and community-appropriate technologies,aiming to construct an ecological management strategy.
基金supported by the“Climbing Plan”for Outstanding Young Teachers at Shanghai University of Medicine&Health Sciences(A3-0200-21-311008)Ministry of Education of Humanities and Social Science Project(23YJC630002).
文摘Objectives:This study aimed to evaluate attitudes toward caring for terminally ill patients and identify the associated factors among community nurses in Shanghai.Methods:The study was conducted among community nurses using convenience sampling in Shanghai between August and November 2023.The demographic questionnaire,the Frommelt Attitude Toward Care of the Dying Scale-B(FATCOD-B),and the Coping with Death Scale(CDS)were used for data collection.Data analysis was conducted using independent sample t-test,one-way analysis of variance,and multiple linear regression analysis.Results:A total of 1,396 community nurses participated in this study.The overall FATCOD-B score among community nurses was 102.27±10.23,the attitude toward caring for the dying person’s family dimension scored the highest(4.03±0.53),whereas the attitude toward the communication dimension scored the lowest(2.86±0.52).The overall CDS score was 130.78±20.25.Multiple linear regression analysis showed that death coping ability and blended death education accounted for 13.7%of the variance in community nurses’attitudes toward caring for terminally ill patients.Conclusions:Community nurses in Shanghai exhibit moderate attitudes toward caring for terminally ill patients.Nurses with greater death coping ability and those who participated in blended death education tended to have more positive attitudes toward terminally ill patients.These findingsunderscore the potential of blended death education as a practical strategy to enhance hospice care quality in community health service centers.
基金Supported by the National Natural Science Foundation of China,No.72174061 and No.71704053China Scholarship Council Foundation,No.202308330251Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2022KY370 and No.2023KY1186.
文摘BACKGROUND Motoric cognitive risk(MCR)syndrome represents an“ultra-early”stage of dementia prevention,highlighting the need for effective screening tools.AIM To develop and validate a novel tool for MCR identification,comparing its effectiveness with existing methods.METHODS As part of a community study on healthy aging,a cross-sectional study recruited 1189 Chinese participants aged 50 years and older between May 1,2022,and March 15,2023.The cohort was randomly split into training(70%)and testing(30%)datasets.Relevant features were selected for logistic regression(LR)and decision tree(DT)models using the training dataset,and their performance was subsequently assessed using the testing dataset to validate reliability and generalizability.RESULTS The prevalence of MCR was 13.12%among 1189 participants.DT models had the area under the curves(AUCs)of 0.834 and 0.821 for training and testing datasets,respectively,while LR models indicated AUCs of 0.840 and 0.859.Non-inferiority tests confirmed the DT model’s comparable effectiveness to the LR models in predicting MCR.Both models demonstrated good calibration and clinical utility.Seven modifiable risk factors were identified:Age,education level,social engagement,physical activity,nutritional status,depressive symptoms,and purpose in life.Notably,social engagement emerged as a novel factor compared to those previously identified.Both models are integrated into an easy-to-use,interpretable web-based user interface.CONCLUSION The interactive,web-based user interface of both models effectively identifies MCR,with the DT model recommended for its simplicity and interpretability,supporting community nurses and clinicians in triaging MCR.
文摘From the establishment of dialogue relations between China and ASEAN in 1991 to the 30th anniversary of their dialogue relations in 2021,bilateral ties have been continuously elevated to a comprehensive strategic partnership.We have witnessed relentless enhancement of political mutual trust,deepening economic cooperation,and closer people-to-people exchanges.The sustained development of the China-ASEAN bilateral partnership is precisely what has generated significant positive spillover e!ects,driving profound changes in China’s relations with neighboring countries.The various levels of partnerships China has established with neighboring countries will play an important role in shaping a networked,non-hierarchical regional order in the future,and such relationships have already become a key pathway for China and its neighbors to jointly build a community with a shared future in the region.
基金Supported by National Natural Science Foundation of China,No.72174061 and No.71704053Key Research and Development Program of Zhejiang Province,No.2025C02106+1 种基金China Scholarship Council Foundation,No.202308330251Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2022KY370。
文摘BACKGROUND Older adults with mild cognitive impairment(MCI)often show motor dysfunction,including slower gait and impaired handwriting.While gait and handwriting parameters are promising for MCI screening,their combined potential to distinguish MCI from cognitively normal adults is unclear.AIM To assess gait and handwriting differences and their potential for screening MCI in older adults.METHODS Ninety-five participants,including 34 with MCI and 61 cognitively normal controls,were assessed for gait using the GAITRite^(R)system and handwriting with a dot-matrix pen.Five machine learning models were developed to assess the discriminative power of gait and handwriting data for MCI screening.RESULTS Compared to the cognitively normal group,the MCI group had slower gait velocity(Z=-2.911,P=0.004),shorter stride and step lengths(t=-3.005,P=0.003;t=2.863,P=0.005),and longer cycle,standing,and double support times(t=-2.274,P=0.025;t=-2.376,P=0.018;t=-2.717,P=0.007).They also had reduced cadence(t=2.060,P=0.042)and increased double support time variability(Z=-2.614,P=0.009).In handwriting,the MCI group showed lower average pressure(all tasks:Z=-2.135,P=0.033)and decreased accuracy(graphic task:Z=-2.447,P=0.014;Chinese character task:Z=-3.078,P=0.002).In the graphic task,they demonstrated longer time in air(Z=-2.865,P=0.004),reduced X-axis maximum velocities(Z=-3.237,P=0.001),and lower accelerations(X-axis:Z=-2.880,P=0.004;Y-axis:Z=-1.987,P=0.047)and maximum accelerations(X-axis:Z=-3.998,P<0.001;Y-axis:Z=-2.050,P=0.040).The multimodal analysis achieved the highest accuracy(74.4%)with the Gradient Boosting Classifier.CONCLUSION Integrating gait and handwriting kinematics parameters provides a viable method for distinguishing MCI,potentially supporting large-scale screening,especially in resource-limited settings.
文摘This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of social welfare services provision among others for the citizens of a country over time, with particular emphasis on medical care component of such index aimed at reduction in diseases and poverty in the population. The objective of the review work is to determine the extent to which Community Health Practice, particularly by Community Health Practitioners is capable of ensuring National Development in democratic governance or otherwise, in the context of our country, Nigeria. The methodology applied was traditional review of published literatures concerning the subject and findings of operational research of programme implemented by Community Health Practitioners at the Primary Health Care facilities and household level in the communities. This paper emphasizes on Primary Health Care services delivery contribution to National Development, since it is the level where Community Health Practitioners are mainly commissioned to render their services. Home-Based Care Strategy for Integrated Maternal, Newborn and Child Health piloted in three (3) local government areas (Ahoada West, Etche and Oyigbo) in Rivers State, Nigeria, in 2012 and implemented by Community Health Practitioners, aimed at reducing maternal, newborn and child morbidity and mortality by 20% by 2015 in line with the United Nations (UN) Millennium Development Goals 4 and 5, had been shown to achieve an average of 26% improvement in utilization of maternal and newborn health services, an average of 27% overall reduction in maternal malnutrition status, an average of 14% overall improvement in under 5 years malnutrition status among others in 2013 on comparing with baseline indicators. Nigeria also attained 80% coverage in routine immunization in most vaccine preventable diseases except Tetanus Toxiod (TT) 2 (54%) in 2013 to achieve herd immunity of the community to prevent transmission of disease pathogen to cause a disease. Community Health Practitioners are the frontline Primary Health Care Professionals charged with the responsibility of implementation of immunization programmes in Nigeria and therefore contributing significantly to the prevention and control of targeted vaccine preventable diseases in Nigeria Health System. Our findings on factors militating against Community Health Practitioners’ Roles in National Development as elicited in this paper may form basis for empirical studies to determine the level of significance of each of these factors. In conclusion, it is when the Community Health parameters are adequately addressed that we can ensure sustainable National Development and we can say we have succeeded in our various strategic agenda of government at whatever level that makes up the complex whole. This brings to fore, the importance of the roles of Community Health Practitioners in health care delivery to National Development in the context of our country, Nigeria.
基金funded by the National Natural Science Foundation of China(Nos.31700542,32071745,31870602,31800519 and 31901295)Program of Sichuan Excellent Youth Sci-Tech Foundation(No.2020JDJQ0052)the National Key Research and Development Program of China(Nos.2016YFC0502505 and 2017YFC0505003)。
文摘Background:Soil fungi play crucial roles in ecosystem functions.However,how snow cover change associated with winter warming affects soil fungal communities remains unclear in the Tibetan forest.Methods:We conducted a snow manipulation experiment to explore immediate and legacy effects of snow exclusion on soil fungal community diversity and composition in a spruce forest on the eastern Tibetan Plateau.Soil fungal communities were performed by the high throughput sequencing of gene-fragments.Results:Ascomycota and Basidiomycota were the two dominant fungal phyla and Archaeorhizomyces,Aspergillus and Amanita were the three most common genera across seasons and snow manipulations.Snow exclusion did not affect the diversity and structure of soil fungal community in both snow-covered and snow-free seasons.However,the relative abundance of some fungal communities was different among seasons.Soil fungal groups were correlated with environmental factors(i.e.,temperature and moisture)and soil biochemical variables(i.e.,ammonium and enzyme).Conclusions:These results suggest that the season-driven variations had stronger impacts on soil fungal community than short-term snow cover change.Such findings may have important implications for soil microbial processes in Tibetan forests experiencing significant decreases in snowfall.
基金This work was supported by the Ministry of Health and Sports,Republic of the Union of Myanmar(MOHS IR Grant 2019,Research ID No.501).
文摘Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in Myanmar.Methods:A total of 30 CHNs from township health centers in the northeastern,southern,and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews.Quantitative data were processed using Microsoft Excel software,and qualitative data were analyzed using thematic analysis.This study is registered with researchregistry6201.Results:Around the country,30 CHNs uncovered their hardships in implementing primary health care to achieve UHC.Over 90%of the participants agreed to the problem of inadequate health infrastructure,while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion.Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services.Complications are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidencebased practices.Insecure work and living conditions,unsupportive community relationships,and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC.Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs.Conclusion:Myanmar’s CHNs face many challenges in achieving UHC.These challenges are not confined to the health sector.Some situations,such as geographical barriers and transportation problems,remain persistent challenges for healthcare providers.This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure.Meanwhile,public empowerment plays a critical role in promoting health development.
基金supported by agrant from"The National Urban Community Health Service System Building Project"of the Ministry of Health of China(No.)
文摘In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available con-cerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based rec-ommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.
基金supported by the University of Jember for funding IDB grand research No.2589/UN25.3.1/LT/2020。
文摘Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CHWs)in Indonesia’s rural areas.Methods:A cohor t retrospective study evaluated 577 par ticipants from Posbindu-NCD in 7 public health centers(PHCs)in 2019.Activities of intervention of CDM for Posbindu-NCD was included,identified risk factors to NCDs,and provided counselling education and other follow-ups based on interviews and measurement results from the five Desk systems that recorded in a medical record as a form of the monthly activity report each the first month,the 6 months,and the 12th month.Results:There were statistically significant differences for alcohol consumed and diabetes mellites(χ^(2)=10.455;P=0.001).There were significant differences on gender(χ^(2)=3.963;P=0.047),on ethnicity(χ^(2)=19.873;P<0.001),and hypertension.In addition,there were also significant differences on ethnicity(χ^(2)=15.307;P<0.001),vegetable consumption(χ^(2)=4.435;P=0.035),physical exercise(χ^(2)=6.328;P=0.012),and the current diseases of hypercholesterolemia of par ticipants.Fur thermore,the survival rate among patients who have overweight,abdominal overweight,hyper tension,diabetes mellitus,and hypercholesterolemia increased among par ticipants who regularly visited Posbindu-NCD compared with the non-regularly one.Conclusions:The CDM program’s community-based intervention through Posbindu-NCD conducted by CHWs improved survival rates in Indonesia’s rural areas.Therefore,this program can be fur ther developed in conducting CDM in the community with the active involvement of CHWs so that the community becomes active regularly in par ticipating in Posbindu-NCD activities in rural areas of Indonesia.
基金supported by the National Natural Science Foundation of China[grant number 71804064].
文摘Objectives:To examine the relationship between cardiovascular disease risk factors and frailty in a sample of older Chinese adults.Methods:A total of 458 community-dwelling older adults(>65 years)in Lanzhou,Gansu Province of China participated in a cross-sectional survey.Their status was evaluated in terms of frailty phenotype(unintentional weight loss,exhaustion,low activity levels,slowness and weakness).Participants were categorized as not frail,prefrail or frail.Cardiovascular disease risk factors that were assessed included:blood pressure,body mass index,waist circumference,blood glucose,total cholesterol,triglycerides,lowdensity lipoproteins and high-density lipoproteins.Results:Individuals with obesity had an increased risk of prefrailty(OR:2.26;95%CI:1.05,4.84).Hypertension was inversely associated with frailtyamong the participants(OR:0.31;95%CI:0.11,0.87)after adjusting for covariates.Conclusions:The findings suggest that much more attention should be paid to weight control of the elderly in the community for preventing them from transition to prefrailty or frailty.Active prevention and control of cardiovascular diseases among the community-dwelling elder are still of great importance.
基金Supported by the grants from the National Science Council, Nos.NSC-91-2320-B-010-102 and NSC-92-2320-B-010-102
文摘AIM: To explore the association of serum insulin, insulin resistance, and β-cell dysfunction with gallstone disease (GSD) in type 2 diabetics. METHODS: We used a community-based study conducted between 1991 and 1993 in Kinmen, Taiwan to identify type 2 diabetics. A screening program for GSD was performed in 2001 by a panel of specialists who employed real-time ultrasound sonography to examine the abdominal region after the patient had fasted for at least 8 h. Screening was conducted in 2001 on 848 patients diagnosed with type 2 diabetes. The HOMA method was used to compare the profile differences for insulin resistance (HOMA IR) and β-cell dysfunction (HOMA β-cell). RESULTS: We studied 440 type 2 diabetics who attended sonography check-ups. After excluding eight insulin-treated diabetics, the prevalence of GSD among the remaining 432 was 13.9% (26/187) among males and 14.7% (36/245) among females. After adjustment for other GSD-associated risk factors in addition to age and obesity, GSD risk increased among females with levels of serum insulin [4th vs 1st quartile odds ratios (OR) = 4.46 (95%CI: 1.71-11.66)] and HOMA IR [4th vs 1st quartile OR = 4.46 (95%CI: 1.71-11.66)]. Better HOMA β-cell function was significantly related to decreased risk of GSD [4th vs 1st quartile OR = 0.16 (95%CI: 0.03-1.70)]. Among males, age and central obesity were the most significant risk factors for GSD. No association of GSD with serum insulin, HOMA IR, and HOMA β-cell was observed among males. CONCLUSION: Serum insulin, insulin resistance, and β-cell dysfunction are risk factors for GSD in females, but not males with type 2 diabetes.
基金The author(s)would like to thank the grant is provided by the Ministry of Research,Technology,and Higher Education,Directorate General of Resources for Research,Technology and Higher Education of Indonesia for providing this research,School of Nursing,University of Jember,and Research Center Department(Lembaga Penelitian)of University of Jember.
文摘Objective:This study aims to examine the effects of a community-based friendly health clinic(CFHC)program that adopts manual participatory learning(MPL)intervention on the adolescents living in the rural and urban areas of Indonesia to gain further insights into their knowledge,attitudes,and skills related to adolescent reproductive health(ARH).Methods:A quasi-experimental design was used to obtain information on the ARH knowledge,attitudes,and skills of adolescents.Two intervention studies that used similar protocols and measures were conducted.A total of 192 adolescents(96 adolescents from urban and rural areas)participated in the project,and the participants from each area were divided into eight groups.A questionairre was adopted to measure the ARH knowledge,attitudes,and skills of these participants.A content analysis of the logbook entries of these respondents was conducted to identify their ARH-related problems.The questionnairre and self-reported ARH data were collected before and after the eight-week program.Results:The CFHC program significantly increased the ARH attitudes(p=0.045)and skills(p=0.009)of adolescents in the rural area,but only improved the ARH knowledge(p<0.001)of adolescents in both rural and urban areas.Fourteen themes were identified in three dominant categories,namely,schools,families,and communities.Conclusions:The CFHC with MPL intervention can improve the ARH knowledge,attitudes,and skills of adolescents in the rural area,but can only improve the ARH knowledge of adolescents in the urban area.The ARH program must be designed based on the characterictics of these adolescents to improve their life skills during puberty.
文摘BACKGROUND While Singapore attains good health outcomes,Singapore’s healthcare system is confronted with bed shortages and prolonged stays for elderly people recovering from surgery in acute hospitals.An Acute Hospital-Community Hospital(AHCH)care bundle has been developed to assist patients in postoperative rehabilitation.The core concept is to transfer patients out of AHs when clinically recommended and into CHs,where they can receive more beneficial dedicated care to aid in their recovery,while freeing up bed capacities in AHs.AIM To analyze the AH length of stay(LOS),costs,and savings associated with the AH-CH care bundle intervention initiated and implemented in elderly patients aged 75 years and above undergoing elective orthopedic surgery.METHODS A total of 8621:1 propensity score-matched patients aged 75 years and above who underwent elective orthopedic surgery in Singapore General Hospital(SGH)before(2017-2018)and after(2019-2021)the care bundle intervention period was analyzed.Outcome measures were AH LOS,CH LOS,hospitalization metrics,postoperative 30-d mortality,and modified Barthel Index(MBI)scores.The costs of AH inpatient hospital stay in the matched cohorts were compared using cost data in Singapore dollars.RESULTS Of the 862 matched elderly patients undergoing elective orthopedic surgery before and after the care bundle intervention,the age distribution,sex,American Society of Anesthesiologists classification,Charlson Comorbidity Index,and surgical approach were comparable between both groups.Patients transferred to CHs after the surgery had a shorter median AH LOS(7 d vs 9 d,P<0.001).The mean total AH inpatient cost per patient was 14.9%less for the elderly group transferred to CHs(S$24497.3 vs S$28772.8,P<0.001).The overall AH U-turn rates for elderly patients within the care bundle were low,with a 0%mortality rate following orthopedic surgery.When elderly patients were discharged from CHs,their MBI scores increased significantly(50.9 vs 71.9,P<0.001).CONCLUSION The AH-CH care bundle initiated and implemented in the Department of Orthopedic Surgery appears to be effective and cost-saving for SGH.Our results indicate that transitioning care between acute and community hospitals using this care bundle effectively reduces AH LOS in elderly patients receiving orthopedic surgery.Collaboration between acute and community care providers can assist in closing the care delivery gap and enhancing service quality.
基金This research was supported by Hunan Province Department of Education Fund(No.:14C0984).
文摘Purpose:To study the level and influencing factors of gerotranscendence in communitydwelling older adults.Methods:We investigated 772 community-dwelling older adults in Hengyang in the Hunan Province of the People's Republic of China using a translated Gerotranscendence Scale and demographic information.Results:The community-dwelling older adults had an overall intermediate level of gerotranscendence.One-way analysis of variance and multiple linear regression analysis showed that sex,living arrangements,regular activities,and religious affiliation influenced the gerotranscendence perspective of the community-dwelling older adults(p<0.05),but that living arrangement and gerotranscendence perspective were not significantly correlated.The covariates clarified about 38.8%of the variation in gerotranscendence perspective.Conclusions:Our findings suggest that sex,regular activities,religious affiliation,and living arrangement influence gerotranscendence.These findings can guide the planning and implementation of better practices in elderly care by nurses and other healthcare professionals.
文摘Objective:To analyze the combined therapeutic effect of clopidogrel(CLO)and aspirin(ASP)on coronary heart disease(CHD)in community-dwelling elderly.Methods:Thirty elderly patients with CHD who were admitted to the Xinxin Community Health Service Station,Pangzhuang Street,Quanshan District,Xuzhou City,from November 2020 to November 2022 were selected and randomly grouped into an observation group and a control group,with 15 cases in each group.The observation group was given the combination of CLO and ASP and the reference group was given only ASP.The total effective rate and other treatment indicators between the two groups were compared.Results:The total effective rate of the observation group(93.33%)was higher than that of the reference group(60.00%)(P<0.05).The adverse drug reaction rate(13.33%)and long-term cardiovascular adverse event rate(6.67%)of the observation group were lower than those of the reference group at 46.67%and 40.00%respectively,(P<0.05).Before treatment,the two groups had no difference in the quality-of-life scores(P>0.05).After treatment,the quality-of-life scores of the observation group were higher than those of the reference group(P<0.05).Conclusion:CLO combined with ASP improved the therapeutic effect of community-dwelling elderly patients with CHD,reduced adverse reactions during medication,prevented adverse cardiovascular events,and comprehensively improved the patient’s quality of life.
