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
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
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
Liberia holds 44.5% of the remaining portion of the Upper Guinean Rainforest in West Africa,which is home to critically endangered forest elephants and western chimpanzees.The forests are of vital importance for the l...Liberia holds 44.5% of the remaining portion of the Upper Guinean Rainforest in West Africa,which is home to critically endangered forest elephants and western chimpanzees.The forests are of vital importance for the livelihoods of millions of West Africans and provide key ecosystem services of local and global importance for food systems transformation and agroecology.Liberia’s efforts toward land reform through legislation and policies recognise communities’rights to own and manage their customary lands and resources.These include the National Forestry Reform Law of 2006,the Community Rights Law Concerning Forest Lands of 2009,and the Land Rights Act of 2018,and more.In May 2022,a program team from the Sustainable Development Institute(SDI)-Friends of the Earth Liberia researched the social and environmental impacts of Maryland Oil Palm Plantations(MOPPs)in Liberia.Twenty-three(23)key informant interviews(KIIs)and 10 focus group discussions(FGDs)were conducted in seven communities in and around the MOPP.They included farmers,contract workers,MOPP staff,local authorities,women and youth leaders,the Environmental Protection Agency(EPA)Inspector,the Civil Society Head,and the Gender Coordinator of Maryland County.The team cross-checked information with formal documents as much as possible and took photographs and global positioning system(GPS)locations of areas of deforestation,pollution,and conflict.The team also used observation to monitor environmental pollution,such as affluent into water bodies and planting oil palm in wetlands.The team used narrative analysis and geospatial landscape analysis to analyze the data.The research finds that land conflict and deforestation have several negative impacts on communities.MOPP has not respected land tenure rights or followed Free Prior and Informed Consent(FPIC)standards,including resettlement without reparation and destruction of farms and old towns without(sufficient)compensation or restitution.During MOPP land acquisition and clearance,communities experienced the loss of their farms and the identification of villages as“village de squatters”,leading to restricted access to farmland,heightened food insecurity,and reduced income from cash crops to support families.MOPP destroyed high conservation value areas and destroyed secondary forest regrowth,which affected important biodiversity areas.MOPP is one of the four large-scale industrial palm oil plantations in Liberia in Maryland County.It has a palm oil mill in a joint venture with Golden Veroleum Liberia(GVL).Its 2011 concession agreement includes 8,800 hectares for industrial palm oil plantations.展开更多
Chronic hepatitis B (CHB) disproportionately affects minority groups in the US, particularly Asian Americans, with numerous factors contributing to this disparity. Of the 2.4 million people living with chronic HBV in ...Chronic hepatitis B (CHB) disproportionately affects minority groups in the US, particularly Asian Americans, with numerous factors contributing to this disparity. Of the 2.4 million people living with chronic HBV in the US, 60% are Asian American. Many are unaware of their status and lack access to proper clinical care, with less than ten percent receiving necessary antiviral treatment. Barriers to screening and care include lack of disease awareness, language and cultural barriers, and financial constraints. Additionally, healthcare providers and systems in the US often overlook the importance of CHB, leading to inadequate care. In response, the Center for Viral Hepatitis (CVH) has implemented a community-based outreach program over the past sixteen years, employing a multifaceted approach involving all sectors of society and various organizations to combat health disparities in CHB. This grassroots campaign has proven highly effective, leveraging CVH’s leadership in spearheading numerous collaborative activities with community members, healthcare professionals, and policymakers. We have summarized the key points of CVH's efforts and their significance in combating CHB-related health disparities. The CHB Screening and Awareness Campaign, tailored to the Asian American community, serves as a successful model for increasing CHB screening, linkage-to-care, and addressing socio-cultural barriers and health literacy. Insights from these outreach programs have guided the development of culturally relevant resources and education initiatives. These findings suggest that such community-driven approaches are essential for addressing health disparities. The strategies and outcomes of CVH’s efforts can inform future health initiatives for other minority communities in the US and globally.展开更多
Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear ...Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.展开更多
Background:China is rapidly aging,increasing the burden on families,society,and public health services.The health of elderly individuals tends to deteriorate with age,and chronic conditions like frailty become more pr...Background:China is rapidly aging,increasing the burden on families,society,and public health services.The health of elderly individuals tends to deteriorate with age,and chronic conditions like frailty become more prevalent,driving up the use of healthcare services.Early screening and intervention for frailty are crucial in managing this demographic shift.While tools like the Fried Frailty Phenotype and Frailty Index assess frailty in communities,they are resource-intensive and only indicate frailty status without predicting risk or providing management recommendations.This study aims to develop a risk prediction model for frailty using real-world data,which can support the early detection of high-risk individuals in community settings.Objectives:To analyze the prevalence of frailty and its influencing factors in community-dwelling elderly,to construct a frailty risk prediction model and develop a nomogram,and to validate the model and assess its clinical utility.Methods:A cross-sectional survey of 420 elderly individuals in a Shanghai community health center was conducted(August 2022–March 2023).Data from various assessment tools were used to build a frailty prediction model through logistic regression,with validation conducted on 180 additional participants.The model’s predictive performance was evaluated using the ROC,AUC,calibration curves,and decision curve analysis(DCA).Results:The frailty prevalence was 7.4%.Independent risk factors included social support,malnutrition,fatigue,sarcopenia,reduced grip strength,and sleep duration.The prediction model achieved an AUC of 0.968 in the training set and 0.939 in the validation set,indicating high discrimination and calibration.DCA confirmed the model’s clinical utility.Conclusion:This study highlights a frailty prevalence rate of 7.4%among elderly individuals in Shanghai,with key risk factors identified.The validated frailty risk prediction model provides accurate and clinically effective frailty risk assessment,supporting targeted early interventions to prevent frailty in community settings.展开更多
Objective: The purpose of this study was to clarify the collaborative activities and mutual recognition between community comprehensive care unit nurses (Ns) and care managers (CM) in supporting the discharge of the e...Objective: The purpose of this study was to clarify the collaborative activities and mutual recognition between community comprehensive care unit nurses (Ns) and care managers (CM) in supporting the discharge of the elderly from the hospital. Methods: A total of 300 nurses working in community comprehensive care wards and 360 care managers working in B City in A Prefecture were surveyed using an anonymous self-administered questionnaire. Results: The highest percentage of responses regarding necessary collaborative activities with multiple professions in supporting hospital discharge were the same for Ns and CMs. The items regarding practice with the highest percentages were “relationship as a team” for Ns, and “user-centered awareness” for CM. While these professionals were willing to share information about their patients’ lives after discharge, the percentage of those explaining their expertise was low. It is thought that collaborative activities focusing on these aspects would lead to more appropriate discharge support.展开更多
BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a cert...BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.展开更多
Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhu...Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhur,Chennai.Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling.Pregnant women,postnatal and postmenopausal women were excluded from the study.Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge,attitude,and practices.Data analysis was done using IBM SPSS version 22.Analytical test like Chi square and odds ratio(OR)were used to identify association between knowledge,attitude,and behavior of contraception with the associated variables and enter method of logistic regression analysis was done.Results:Out of the 360 respondents,228 were females,with a mean age of(34±5)years.Approximately 43%demonstrated adequate knowledge of contraception use,and 91%were aware of at least one contraceptive method.Notably,72%exhibited a positive attitude towards contraceptive use.Nevertheless,43%(155 individuals)did not utilize any contraceptive method.Among contraceptive users,intrauterine devices were the most commonly adopted,followed by barrier methods and female sterilization.There was significant association between knowledge of contraception and education(aOR 7.29,95%CI 2.93-18.10,P<0.05),age(aOR 2.04,95%CI 1.19-3.50,P<0.05)and socioeconomic class(aOR 3.66,95%CI 1.71-7.85,P<0.05;aOR 3.97,95%CI 2.12-7.49,P<0.05).Regarding attitude towards contraception use,education(aOR 8.54,95%CI 2.35-31.03,P<0.05),sex(aOR 0.15,95%CI 0.06-0.37,P<0.05),age(aOR 0.53,95%CI 0.28-0.99,P<0.05),socio-economic class(aOR 4.42,95%CI 1.97-9.92,P<0.05;aOR 9.83,95%CI 3.63-26.58,P<0.05)and number of children(aOR 10.04,95%CI 4.26-23.66,P<0.05)were the variables that had a significant association.Conclusions:These findings underscore the imperative for enhanced dissemination of health education pertaining to contraception use within the slum population.The health sectors of the area and other stakeholders need to make sure to extend penetration of family planning related services to the urban slum population.展开更多
Knee osteoarthritis(KOA)is a common progressive joint disease with chronic pain and movement disorders as the main clinical features.It is a major public health problem worldwide and it imposes serious medical and eco...Knee osteoarthritis(KOA)is a common progressive joint disease with chronic pain and movement disorders as the main clinical features.It is a major public health problem worldwide and it imposes serious medical and economic burdens.KOA accounts for nearly four-fifths of the global Osteoarthritis burden and increases with rising obesity and age[1].There are many reasons for the change in disease prevalence and risk factors,such as urbanization,lifestyle changes,population aging,and sex imbalances.展开更多
Eating disorders(EDs)like anorexia nervosa(AN)and bulimia nervosa(BN)are conditions characterised by severe and persistent disruptions in eating behaviours.Nutritional rehabilitation is the main goal of many therapies...Eating disorders(EDs)like anorexia nervosa(AN)and bulimia nervosa(BN)are conditions characterised by severe and persistent disruptions in eating behaviours.Nutritional rehabilitation is the main goal of many therapies,for example,family therapy for AN,enhancedcognitive-behavioural’therapy and the Maudsley Model of AN Treatment for Adults.展开更多
Introduction: Postpartum mental disorders are psychopathological states that affect women after childbirth. These disorders often negatively impact a child’s mental health and the mother-child bond. The objective of ...Introduction: Postpartum mental disorders are psychopathological states that affect women after childbirth. These disorders often negatively impact a child’s mental health and the mother-child bond. The objective of this work was to determine the frequency of mental disorders during the postpartum period at the University Community Health Center of Konobougou in Mali. Methods: This descriptive cross-sectional study took place from March 1 to July 31, 2022, for four months. Results: The study involved 201 immediate postpartum women at the Konobougou Community and University Health Center. The 20-35 age group accounted for 70.00% of the population;the average age was 24 years ± 5.95 years, with a range of 15 to 45 years. Married women made up 96.00% of the sample. The overall frequency of mental disorders was 15.92%. The mental disorders recorded were postpartum depression (5.47%), anxiety disorders (3.98%), postpartum blues (5.47%), and posttraumatic stress disorder (0.50%). Puerperal psychosis was found in 0.50% of the participants. Conclusion: This study revealed a high prevalence of mental disorders among postpartum women in Konobougou, Mali. During postnatal consultations, health workers should prioritize screening for mental health disorders.展开更多
Introduction: Fetal macrosomia is a birth weight greater than or equal to 4000 grams. The aim of this study is to determine the frequency of macrosomia, to identify the risk factors, and to evaluate the maternal and p...Introduction: Fetal macrosomia is a birth weight greater than or equal to 4000 grams. The aim of this study is to determine the frequency of macrosomia, to identify the risk factors, and to evaluate the maternal and perinatal prognosis in the obstetrics and gynaecology department of the Community University Hospital Centre (CHUC). Methodology: This was a retrospective case-control study over a period of 24 months in the maternity ward of the CHUC. Results: The frequency of delivery of macrosomic fetuses was 4.1%, and the average age of women with large fetuses was 29.5 years. In 65.7% of cases, they were not engaged in any income-generating activity. Most of them had at least secondary education (65.7%) and were mainly multiparous (78.8%). The risk factors found were maternal age greater than or equal to 35 years, multiparity, previous large fœtus, gestational diabetes, obesity and male sex. Maternal complications were dominated by uterine atony (52.2%), perineal tear (31.9%), and cervical tear (15.9%). In our series, macrosomic newborns were three times more likely to present with a neonatal complication than normal-weight newborns. Neonatal mortality was 2.1%. Conclusion: Reducing macrosomia requires a better understanding of the risk factors, early detection, correct management during vaginal delivery and close monitoring of labour with good control of obstetric manoeuvres.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.”
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.
文摘Liberia holds 44.5% of the remaining portion of the Upper Guinean Rainforest in West Africa,which is home to critically endangered forest elephants and western chimpanzees.The forests are of vital importance for the livelihoods of millions of West Africans and provide key ecosystem services of local and global importance for food systems transformation and agroecology.Liberia’s efforts toward land reform through legislation and policies recognise communities’rights to own and manage their customary lands and resources.These include the National Forestry Reform Law of 2006,the Community Rights Law Concerning Forest Lands of 2009,and the Land Rights Act of 2018,and more.In May 2022,a program team from the Sustainable Development Institute(SDI)-Friends of the Earth Liberia researched the social and environmental impacts of Maryland Oil Palm Plantations(MOPPs)in Liberia.Twenty-three(23)key informant interviews(KIIs)and 10 focus group discussions(FGDs)were conducted in seven communities in and around the MOPP.They included farmers,contract workers,MOPP staff,local authorities,women and youth leaders,the Environmental Protection Agency(EPA)Inspector,the Civil Society Head,and the Gender Coordinator of Maryland County.The team cross-checked information with formal documents as much as possible and took photographs and global positioning system(GPS)locations of areas of deforestation,pollution,and conflict.The team also used observation to monitor environmental pollution,such as affluent into water bodies and planting oil palm in wetlands.The team used narrative analysis and geospatial landscape analysis to analyze the data.The research finds that land conflict and deforestation have several negative impacts on communities.MOPP has not respected land tenure rights or followed Free Prior and Informed Consent(FPIC)standards,including resettlement without reparation and destruction of farms and old towns without(sufficient)compensation or restitution.During MOPP land acquisition and clearance,communities experienced the loss of their farms and the identification of villages as“village de squatters”,leading to restricted access to farmland,heightened food insecurity,and reduced income from cash crops to support families.MOPP destroyed high conservation value areas and destroyed secondary forest regrowth,which affected important biodiversity areas.MOPP is one of the four large-scale industrial palm oil plantations in Liberia in Maryland County.It has a palm oil mill in a joint venture with Golden Veroleum Liberia(GVL).Its 2011 concession agreement includes 8,800 hectares for industrial palm oil plantations.
文摘Chronic hepatitis B (CHB) disproportionately affects minority groups in the US, particularly Asian Americans, with numerous factors contributing to this disparity. Of the 2.4 million people living with chronic HBV in the US, 60% are Asian American. Many are unaware of their status and lack access to proper clinical care, with less than ten percent receiving necessary antiviral treatment. Barriers to screening and care include lack of disease awareness, language and cultural barriers, and financial constraints. Additionally, healthcare providers and systems in the US often overlook the importance of CHB, leading to inadequate care. In response, the Center for Viral Hepatitis (CVH) has implemented a community-based outreach program over the past sixteen years, employing a multifaceted approach involving all sectors of society and various organizations to combat health disparities in CHB. This grassroots campaign has proven highly effective, leveraging CVH’s leadership in spearheading numerous collaborative activities with community members, healthcare professionals, and policymakers. We have summarized the key points of CVH's efforts and their significance in combating CHB-related health disparities. The CHB Screening and Awareness Campaign, tailored to the Asian American community, serves as a successful model for increasing CHB screening, linkage-to-care, and addressing socio-cultural barriers and health literacy. Insights from these outreach programs have guided the development of culturally relevant resources and education initiatives. These findings suggest that such community-driven approaches are essential for addressing health disparities. The strategies and outcomes of CVH’s efforts can inform future health initiatives for other minority communities in the US and globally.
文摘Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.
文摘Background:China is rapidly aging,increasing the burden on families,society,and public health services.The health of elderly individuals tends to deteriorate with age,and chronic conditions like frailty become more prevalent,driving up the use of healthcare services.Early screening and intervention for frailty are crucial in managing this demographic shift.While tools like the Fried Frailty Phenotype and Frailty Index assess frailty in communities,they are resource-intensive and only indicate frailty status without predicting risk or providing management recommendations.This study aims to develop a risk prediction model for frailty using real-world data,which can support the early detection of high-risk individuals in community settings.Objectives:To analyze the prevalence of frailty and its influencing factors in community-dwelling elderly,to construct a frailty risk prediction model and develop a nomogram,and to validate the model and assess its clinical utility.Methods:A cross-sectional survey of 420 elderly individuals in a Shanghai community health center was conducted(August 2022–March 2023).Data from various assessment tools were used to build a frailty prediction model through logistic regression,with validation conducted on 180 additional participants.The model’s predictive performance was evaluated using the ROC,AUC,calibration curves,and decision curve analysis(DCA).Results:The frailty prevalence was 7.4%.Independent risk factors included social support,malnutrition,fatigue,sarcopenia,reduced grip strength,and sleep duration.The prediction model achieved an AUC of 0.968 in the training set and 0.939 in the validation set,indicating high discrimination and calibration.DCA confirmed the model’s clinical utility.Conclusion:This study highlights a frailty prevalence rate of 7.4%among elderly individuals in Shanghai,with key risk factors identified.The validated frailty risk prediction model provides accurate and clinically effective frailty risk assessment,supporting targeted early interventions to prevent frailty in community settings.
文摘Objective: The purpose of this study was to clarify the collaborative activities and mutual recognition between community comprehensive care unit nurses (Ns) and care managers (CM) in supporting the discharge of the elderly from the hospital. Methods: A total of 300 nurses working in community comprehensive care wards and 360 care managers working in B City in A Prefecture were surveyed using an anonymous self-administered questionnaire. Results: The highest percentage of responses regarding necessary collaborative activities with multiple professions in supporting hospital discharge were the same for Ns and CMs. The items regarding practice with the highest percentages were “relationship as a team” for Ns, and “user-centered awareness” for CM. While these professionals were willing to share information about their patients’ lives after discharge, the percentage of those explaining their expertise was low. It is thought that collaborative activities focusing on these aspects would lead to more appropriate discharge support.
基金Supported by the Capital’s Funds for Health Improvement and Research,No.2023-3S-002.
文摘BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.
文摘Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhur,Chennai.Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling.Pregnant women,postnatal and postmenopausal women were excluded from the study.Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge,attitude,and practices.Data analysis was done using IBM SPSS version 22.Analytical test like Chi square and odds ratio(OR)were used to identify association between knowledge,attitude,and behavior of contraception with the associated variables and enter method of logistic regression analysis was done.Results:Out of the 360 respondents,228 were females,with a mean age of(34±5)years.Approximately 43%demonstrated adequate knowledge of contraception use,and 91%were aware of at least one contraceptive method.Notably,72%exhibited a positive attitude towards contraceptive use.Nevertheless,43%(155 individuals)did not utilize any contraceptive method.Among contraceptive users,intrauterine devices were the most commonly adopted,followed by barrier methods and female sterilization.There was significant association between knowledge of contraception and education(aOR 7.29,95%CI 2.93-18.10,P<0.05),age(aOR 2.04,95%CI 1.19-3.50,P<0.05)and socioeconomic class(aOR 3.66,95%CI 1.71-7.85,P<0.05;aOR 3.97,95%CI 2.12-7.49,P<0.05).Regarding attitude towards contraception use,education(aOR 8.54,95%CI 2.35-31.03,P<0.05),sex(aOR 0.15,95%CI 0.06-0.37,P<0.05),age(aOR 0.53,95%CI 0.28-0.99,P<0.05),socio-economic class(aOR 4.42,95%CI 1.97-9.92,P<0.05;aOR 9.83,95%CI 3.63-26.58,P<0.05)and number of children(aOR 10.04,95%CI 4.26-23.66,P<0.05)were the variables that had a significant association.Conclusions:These findings underscore the imperative for enhanced dissemination of health education pertaining to contraception use within the slum population.The health sectors of the area and other stakeholders need to make sure to extend penetration of family planning related services to the urban slum population.
基金funded by the Capital Health Research and Development of Special Funds(NO:2022-1-7032)the High-level Talent Research Project of Beijing University of Chinese Medicine(NO2021-XJ-KYQD-001).
文摘Knee osteoarthritis(KOA)is a common progressive joint disease with chronic pain and movement disorders as the main clinical features.It is a major public health problem worldwide and it imposes serious medical and economic burdens.KOA accounts for nearly four-fifths of the global Osteoarthritis burden and increases with rising obesity and age[1].There are many reasons for the change in disease prevalence and risk factors,such as urbanization,lifestyle changes,population aging,and sex imbalances.
文摘Eating disorders(EDs)like anorexia nervosa(AN)and bulimia nervosa(BN)are conditions characterised by severe and persistent disruptions in eating behaviours.Nutritional rehabilitation is the main goal of many therapies,for example,family therapy for AN,enhancedcognitive-behavioural’therapy and the Maudsley Model of AN Treatment for Adults.
文摘Introduction: Postpartum mental disorders are psychopathological states that affect women after childbirth. These disorders often negatively impact a child’s mental health and the mother-child bond. The objective of this work was to determine the frequency of mental disorders during the postpartum period at the University Community Health Center of Konobougou in Mali. Methods: This descriptive cross-sectional study took place from March 1 to July 31, 2022, for four months. Results: The study involved 201 immediate postpartum women at the Konobougou Community and University Health Center. The 20-35 age group accounted for 70.00% of the population;the average age was 24 years ± 5.95 years, with a range of 15 to 45 years. Married women made up 96.00% of the sample. The overall frequency of mental disorders was 15.92%. The mental disorders recorded were postpartum depression (5.47%), anxiety disorders (3.98%), postpartum blues (5.47%), and posttraumatic stress disorder (0.50%). Puerperal psychosis was found in 0.50% of the participants. Conclusion: This study revealed a high prevalence of mental disorders among postpartum women in Konobougou, Mali. During postnatal consultations, health workers should prioritize screening for mental health disorders.
文摘Introduction: Fetal macrosomia is a birth weight greater than or equal to 4000 grams. The aim of this study is to determine the frequency of macrosomia, to identify the risk factors, and to evaluate the maternal and perinatal prognosis in the obstetrics and gynaecology department of the Community University Hospital Centre (CHUC). Methodology: This was a retrospective case-control study over a period of 24 months in the maternity ward of the CHUC. Results: The frequency of delivery of macrosomic fetuses was 4.1%, and the average age of women with large fetuses was 29.5 years. In 65.7% of cases, they were not engaged in any income-generating activity. Most of them had at least secondary education (65.7%) and were mainly multiparous (78.8%). The risk factors found were maternal age greater than or equal to 35 years, multiparity, previous large fœtus, gestational diabetes, obesity and male sex. Maternal complications were dominated by uterine atony (52.2%), perineal tear (31.9%), and cervical tear (15.9%). In our series, macrosomic newborns were three times more likely to present with a neonatal complication than normal-weight newborns. Neonatal mortality was 2.1%. Conclusion: Reducing macrosomia requires a better understanding of the risk factors, early detection, correct management during vaginal delivery and close monitoring of labour with good control of obstetric manoeuvres.
