Background: In the global burden of non-communicable diseases, the top slot among them all is occupied by various cardiovascular diseases (CVD), which also claim primacy in mortality rates. Generally speaking, the pat...Background: In the global burden of non-communicable diseases, the top slot among them all is occupied by various cardiovascular diseases (CVD), which also claim primacy in mortality rates. Generally speaking, the pathophysiological pathway frequently involves either (or a combination of) elevated serum cholesterol levels, predominantly attributed to dietary patterns characterized by extremely high levels of saturated and trans-fat consumption. Day-to-day nutritional epidemiology among university students suggests that they represent a crucial demographic for the study of preventive interventions. Objective: This in-depth study and investigation were specifically aimed to quantitatively assess and compare prevailing patterns of dietary fat consumption between female students enrolled in health sciences and non-health sciences programs at major universities in Riyadh, Saudi Arabia. Methodology: This cross-sectional study was comprised of 434 Saudi female university students (age range: 18 - 25 years), utilizing a validated Block Dietary Fat Screener accompanied by anthropometric measurements and comprehensive demographic data collection. The sampling methodology consisted of a snowball technique that was spread across three major academic institutions in Riyadh. Results: Statistical analysis revealed a significant association between academic specialization and patterns of dietary fat consumption (p = 0.012). Paradoxically, students of health science exhibited a higher prevalence of very high fat intake (41.9%) compared with their non-health sciences counterparts (27.6%). Surprisingly, anthropometric stratification revealed that it was the underweight students who demonstrated very high levels of fat consumption. A notable socioeconomic gradient was observed, with students from households earning 15,000 - 20,000 SR monthly showing the highest prevalence of very high-fat consumption (47.1%), although this association did not achieve statistical significance (p = 0.104). Conclusion: These findings challenge the conventional assumption that health sciences education correlates with superior dietary behaviors. The data suggests a critical need for enhanced education in nutrition, as well as intervention using various behavioral programs across all academic disciplines, particularly those addressing the disconnect between nutritional knowledge and dietary practices among students of health sciences. Future longitudinal studies are warranted in order to elucidate the temporal relationship between academic specialization and dietary behaviors.展开更多
Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This stu...Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This study aimed to examine the factors related to nutritional literacy for oral health among VHVs.Methods:This was a mixed-methods study employing an explanatory sequential design.The quantitative data were gathered through questionnaires distributed to a cohort of 10,514 VHVs registered in Health Region 1.A stratified random sampling technique was used to ensure adequate representation of various subgroups within the VHV population,considering factors such as age,education level,and geographical distribution across the region.This approach allowed for a more representative sample that accurately reflects the diversity of the VHV population.Qualitative data were obtained through semi-structured interviews with a purposive sampling of 20 participants based on specific criteria.Quantitative data were analyzed using descriptive statistics and biserial correlation techniques,while qualitative data were analyzed using content analysis.Results:The study found that the sample group possessed a moderate level of knowledge of health literacy principles and nutrition for oral health.However,their self-assessed skills in nutritional literacy for oral health were rated as high.A statistically significant negative correlation was found between knowledge of nutrition for oral health and skills in nutritional literacy for oral health.VHVs equated health literacy with knowledge because their public health training had focused more on imparting knowledge rather than developing skills based on health literacy principles.Conclusion:There is a need to emphasize skill-based health literacy training and to use effective skill development techniques that are tailored to the specific roles and responsibilities of health volunteers.It is also recommended to continuously monitor and evaluate the outcomes of these efforts.展开更多
The pandemic highlighted significant gaps in the public health infrastructure impacted by shortages of public health workers, an undertrained workforce, and years of disinvestment. These gaps required innovative probl...The pandemic highlighted significant gaps in the public health infrastructure impacted by shortages of public health workers, an undertrained workforce, and years of disinvestment. These gaps required innovative problem-solving by public health agencies (PHAs), including local health departments (LHDs), to respond to rapidly changing community conditions during and after the pandemic. Many schools and programs of public health (SPPH) worked with PHAs to mobilize public health (PH) students through practice-based teaching (PBT). Current research indicates PBT benefits all stakeholders—PHAs, students, faculty, SPPH, and ultimately the community served. However, more research is needed on the utility of PBT in addressing a community’s systemic public health issues, the extent to which the academic-community collaboration enhances a PHA’s capacity, and the impact of the pedagogy on preparing the workforce for an evolving PH landscape. This paper examines the process of a semester-long PBT course, guided by the PBT STEPS framework, which includes five steps from collaboration to implementation to evaluation of a PBT course. The collaborating PHA and its student group addressed community trauma and resilience issues during the semester. Additionally, it examines the longer-term impacts after the semester for the PHA, community, and the workforce by 1) conducting a formative evaluation to understand needs and gaps in the community;2) redesigning an intervention that merged the results of the formative evaluation with the intervention developed during the semester;and 3) securing funding and resources for intervention sustainability. Through the documentation of a post-course partnership between an LHD and faculty at a large school of public health, this case study illustrates the potential for PBT to lay the foundation for ongoing research that supports more impactful interventions for PHAs while bolstering the workforce abilities of students as future practitioners.展开更多
Background:It has been broadly witnessed that a large number of adolescents are suffering emotional and mental health problems after COVID-19,and such adverse experiences in early life often extend into adulthood,resu...Background:It has been broadly witnessed that a large number of adolescents are suffering emotional and mental health problems after COVID-19,and such adverse experiences in early life often extend into adulthood,resulting in serious long-term implications.However,it is accepted that the literature examining the relationship between mental health problems in adolescents and their underlying psychological factors is limited.The purposes of the current study were to identify mental health problems of Korean adolescents and to investigate the possible influence of self-esteem,self-efficacy,and health locus of control on mental health problems.Methods:A total of 2104 Korean adolescents were randomly recruited from junior high and high schools located in Seoul,Korea.The Korean Symptom Checklist,and Self-esteem Scale,Health Locus of Control Scale,Self-efficacy Scale were applied to identify mental health problems and psychological factors among adolescents.Frequency analysis,independent t-tests,one-way ANOVA,correlation analysis,and multiple regression analysis were performed to test the study hypothesis.Results:Korean adolescents showed a high prevalence of depression(61.4%),anxiety(44.7%),interpersonal sensitivity(76.1%),and hostility(40.3%).In addition,the findings indicated significant gender and age differences in adolescent mental health problems.Moreover,results reported that the adolescents’mental health problems were significantly associated with psychological factors(R^(2)=0.51 for depression,0.38 for anxiety,0.33 for interpersonal sensitivity,and 0.23 for hostility).Conclusions:The current findings highlight the need for comprehensive,culturally relevant mental health strategies for Korean adolescents.The interventions that foster psychological resilience,promote positive self-concept,and encourage internal control beliefs may be effective in mitigating mental health challenges.展开更多
Objectives:Population aging is occurring at a rapid speed all over the world,bringing considerable public health challenges,including for the mental health of older adults.Considering that older populations are prone ...Objectives:Population aging is occurring at a rapid speed all over the world,bringing considerable public health challenges,including for the mental health of older adults.Considering that older populations are prone to depression and stress,the need for effective preventive interventions is critical.Thus,we conducted a study aimed at exploring the preventive impact of a community-based Tai Chi program over 8 weeks on depression and perceived stress in healthy older adults in South Korea.Methods:A quasi-experimental design was utilized,with 63 older adults participating(31 individuals in the Tai Chi group and 32 in the control group).The Tai Chi intervention was a supervised session 3 times per week.Data were obtained anonymously at baseline and post-intervention(week 8),with validated measures,including the Geriatric Depression Scale and the Korean version of the Brief Encounter Psychosocial Instrument.Data analysis included frequency distributions,descriptive statistics,and repeated measures analysis of variance to examine group×time interaction effects.Results:Baseline characteristics were comparable between groups.A repeated measures analysis of variance revealed significant group×time interaction effects for depression(Wilks’Lambda=0.868,F1,57=8.63,p=0.005,partialη^(2)=0.13)and perceived stress(Wilks’Lambda=0.831,F1,57=11.62,p=0.001,partialη^(2)=0.17).In particular,participants in the Tai Chi group had significantly greater reductions in depression and perceived stress than participants in the control group.Conclusions:These results suggest that Tai Chi may contribute to more favorable changes in depression and perceived stress among healthy older adults compared to no intervention,suggesting its usefulness as a culturally appropriate intervention for sustainable enhancement of mental health and successful aging in rapidly aging societies,including South Korea.展开更多
BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)is a recently proposed term that highlights the role of metabolic dysfunction in hepatic steatosis.It currently affects more than one-third of adul...BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)is a recently proposed term that highlights the role of metabolic dysfunction in hepatic steatosis.It currently affects more than one-third of adults worldwide and is associated with liver fibrosis,hepatocellular carcinoma,cardiovascular disease,and chronic kidney disease.Given its high prevalence,asymptomatic progression,and revised definition,evaluating its epidemiology and risk profile remains an important public health priority.AIM To assess the prevalence and characteristics of MAFLD among Vietnamese individuals undergoing health check-ups.METHODS This retrospective study included 331 adults undergoing routine health check-ups at The Health Evaluation and Promotion Center,International University of Health and Welfare Center,Cho Ray Hospital,from June to October 2023.MAFLD was diagnosed based on the 2020 international expert consensus.Data collected included demographic,clinical,laboratory information,and metabolic risk factors from routine health check-up records.Descriptive statistics,χ^(2) tests,and ttests/Mann-Whitney tests were applied as appropriate.Significance was defined as P<0.05.RESULTS MAFLD was identified in 97 of 331 individuals(29.31%).Prevalence was significantly higher in men than women(44.51%vs 14.37%;P<0.001).In females,prevalence increased sharply after age 50(P=0.008).According to body mass index groups,prevalence was 0%(underweight),9.27%(normal),and 48.26%(overweight/obese).The MAFLD group had significantly higher rates of hypertension(19.59%vs 2.99%),dyslipidemia(98.96%vs 89.32%),prediabetes/diabetes(65.98%vs 28.20%),hyperuricemia(64.95%vs 31.19%),and metabolic syndrome(54.64%vs 7.69%)compared to the non-MAFLD group(all P<0.001).CONCLUSION MAFLD is prevalent in Vietnamese adults undergoing health screening.It is strongly associated with sex,age,body mass index,and metabolic disorders,indicating the importance of early detection and integrated management.展开更多
Objectives Few studies have investigated longitudinal associations of loneliness with health outcomes in Africa.This study aimed to assess the longitudinal associations between loneliness and mental and physical healt...Objectives Few studies have investigated longitudinal associations of loneliness with health outcomes in Africa.This study aimed to assess the longitudinal associations between loneliness and mental and physical health among aging adults in South Africa.Methods Data from the 7-year longitudinal Health and Ageing in Africa(HAALSI)study conducted in South Africa were used in the analysis(analytic sample:n=3707,aged 40 years and older).Loneliness was measured with one question.Longitudinal relationships between loneliness and each health outcome were estimated using Generalized Estimating Equations analysis(GEE),hazard ratios(HRs)(95%CI)were used to determine the relationship between loneliness and 7-year mortality in the entire sample,and correlations between incident health outcomes and loneliness were evaluated using logistic regressions.Results The prevalence of loneliness was 12.1%in 2015,16.9%in 2019,and 16.3%in 2022.Multivariable analysis showed that loneliness was positively associated with the prevalence and/or incidence of four poor mental health indicators(e.g.,poor sleep quality,AOR=1.53,95%CI:1.30–1.80),four physical ill-health indicators(e.g.,incident kidney disease,AOR=2.50,95%CI:1.41–4.42),mortality(Hazard Ratio=1.20,95%CI=1.04–1.39),and three poor behavioral health indicators(e.g.,current tobacco use,AOR=1.21,95%CI=1.04–1.42).Conclusion The study discovered that several outcomes related to mental,physical,and behavioral health were associated with loneliness.Enhancing the detection and management of loneliness could lower mental and physical illness in aging adults in South Africa.展开更多
This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technol...This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technology deployment relevant to disease management,healthcare delivery,epidemiology,and policy-making.However,its AI is culturally sensitive and ethically grounded in Islam.Based on the PRISMA framework,an SLR evaluated primary academic literature,cases,and practices of Saudi Arabia’s AI implementation in the public healthcare sector.Instead,it categorizes prior research based on how AI can work,the issues it poses,and its implications for the Kingdom’s healthcare system.The Saudi Arabian context analyses show that AI has increased the discreet prediction of diseases,resource management,and monitoring outbreaks during mass congregations such as hajj.Therefore,the study outlines critical areas for defining the potential for artificial intelligence and areas for enhancing digital development to support global healthcare progress.The key themes emerging from the review include Saudi Arabia:(i)the effectiveness of AI with human interaction for sustainable health services;(ii)conditions and quality control to enhance the quality of health care services using AI;(iii)environmental factors as influencing factors for public health care;(iv)Artificial Intelligence,and advanced decision-making technology for Middle Eastern health care systems.For policymakers,healthcare managers,and researchers who will engage with AI innovation,the review proclaims that AI applications should respect the country’s socio-cultural and ethical practices and pave the way for sustainable healthcare provision.More empirical research is needed on the implementation issues with AI,creating culturally appropriate models of AI,and finding new applications of AI to address the increasing demand for healthcare services in Saudi Arabia.展开更多
Irrational drug use and prescription safety are pressing global concerns.The World Health Organization estimated that over half of all prescriptions worldwide contain errors,leading to substantial harm[1,2].In China,p...Irrational drug use and prescription safety are pressing global concerns.The World Health Organization estimated that over half of all prescriptions worldwide contain errors,leading to substantial harm[1,2].In China,prescription errors occur at a rate of 32%,and improper medication use is reported in over 70%of households[3,4].Vulnerable populations,including children(16.7%)and older adults(30.4%),are particularly affected[5].展开更多
The rapid evolution of digital health technologies has sparked transformative changes across the healthcare landscape.These advancements were at the heart of discussions during the recent academic conference co-organi...The rapid evolution of digital health technologies has sparked transformative changes across the healthcare landscape.These advancements were at the heart of discussions during the recent academic conference co-organized by The First Affiliated Hospital,Sun Yat-sen University(FAH-SYSU)and University of California at Berkeley,the Pacific-Rim Conference on Healthcare Innovation(PRC-HI 2024),convening under the theme“The Future of Medicine:Integrating Robotics,AI and Healthcare.”This article distills the key developments and their implications for the future of healthcare,focusing on innovations in robotic surgery,health data science,and AI for medicine.展开更多
Background:In recent years,there has been a growing trend in the utilization of observational studies that make use of routinely collected healthcare data(RCD).These studies rely on algorithms to identify specific hea...Background:In recent years,there has been a growing trend in the utilization of observational studies that make use of routinely collected healthcare data(RCD).These studies rely on algorithms to identify specific health conditions(e.g.,diabetes or sepsis)for statistical analyses.However,there has been substantial variation in the algorithm development and validation,leading to frequently suboptimal performance and posing a significant threat to the validity of study findings.Unfortunately,these issues are often overlooked.Methods:We systematically developed guidance for the development,validation,and evaluation of algorithms designed to identify health status(DEVELOP-RCD).Our initial efforts involved conducting both a narrative review and a systematic review of published studies on the concepts and methodological issues related to algorithm development,validation,and evaluation.Subsequently,we conducted an empirical study on an algorithm for identifying sepsis.Based on these findings,we formulated specific workflow and recommendations for algorithm development,validation,and evaluation within the guidance.Finally,the guidance underwent independent review by a panel of 20 external experts who then convened a consensus meeting to finalize it.Results:A standardized workflow for algorithm development,validation,and evaluation was established.Guided by specific health status considerations,the workflow comprises four integrated steps:assessing an existing algorithm’s suitability for the target health status;developing a new algorithm using recommended methods;validating the algorithm using prescribed performance measures;and evaluating the impact of the algorithm on study results.Additionally,13 good practice recommendations were formulated with detailed explanations.Furthermore,a practical study on sepsis identification was included to demonstrate the application of this guidance.Conclusions:The establishment of guidance is intended to aid researchers and clinicians in the appropriate and accurate development and application of algorithms for identifying health status from RCD.This guidance has the potential to enhance the credibility of findings from observational studies involving RCD.展开更多
The exposure patterns of pest control and disinfection workers have changed after the coronavirus disease 2019(COVID-19)outbreak,but the health risks of chemical exposure have not been assessed.We identified these wor...The exposure patterns of pest control and disinfection workers have changed after the coronavirus disease 2019(COVID-19)outbreak,but the health risks of chemical exposure have not been assessed.We identified these workers’chemical exposure patterns and risks before and after the COVID-19 outbreak.We used data conducted between 2018(pre-pandemic)and 2021(post-pandemic)from three-year cross-sectional surveys on pest control and disinfection workers.Inhalation and dermal exposure concentrations were estimated using equations based on a biocidal product risk assessment model from the Korean National Institute of Environmental Research.The non-carcinogenic and carcinogenic risks of chemicals were calculated using the United States Environmental Protection Agency risk assessment model.We found that the annual work frequency(50^(th)percentile)of foggers using disinfectants increased the most among all the work types,from 140 uses/year to 176 uses/year after the COVID-19 outbreak.Moreover,all chemicals’non-carcinogenic and carcinogenic risks increased regardless of exposure routes.In the worst scenario(95^(th)percentile),the margin of exposure for citric acid,benzethonium chloride,benzyl-C12-16-alkyldimethyl chlorides,and sodium chlorite of inhalation exposure,and isopropyl alcohol and benzyl-C12-16-alkyldimethyl chlorides of dermal exposure were acceptable(>100)before the COVID-19outbreak but became unacceptable(<100)after the COVID-19 outbreak.Carcinogenic risks of dichlorvos from inhalation and dermal exposure were above acceptable levels(>10^(-6))before and after the COVID-19 outbreak but comparatively high after the COVID-19 outbreak.Additionally,significantly more workers experienced health symptoms after the COVID-19outbreak(p<0.05),with the most common being muscle lethargy(31%),skin/face stinging(28.7%),and breath shortness/neck pain(24.1%).展开更多
Understanding the neural underpinning of human gait and balance is one of the most pertinent challenges for 21st-century translational neuroscience due to the profound impact that falls and mobility disturbances have ...Understanding the neural underpinning of human gait and balance is one of the most pertinent challenges for 21st-century translational neuroscience due to the profound impact that falls and mobility disturbances have on our aging population.Posture and gait control does not happen automatically,as previously believed,but rather requires continuous involvement of central nervous mechanisms.To effectively exert control over the body,the brain must integrate multiple streams of sensory information,including visual,vestibular,and somatosensory signals.The mechanisms which underpin the integration of these multisensory signals are the principal topic of the present work.Existing multisensory integration theories focus on how failure of cognitive processes thought to be involved in multisensory integration leads to falls in older adults.Insufficient emphasis,however,has been placed on specific contributions of individual sensory modalities to multisensory integration processes and cross-modal interactions that occur between the sensory modalities in relation to gait and balance.In the present work,we review the contributions of somatosensory,visual,and vestibular modalities,along with their multisensory intersections to gait and balance in older adults and patients with Parkinson’s disease.We also review evidence of vestibular contributions to multisensory temporal binding windows,previously shown to be highly pertinent to fall risk in older adults.Lastly,we relate multisensory vestibular mechanisms to potential neural substrates,both at the level of neurobiology(concerning positron emission tomography imaging)and at the level of electrophysiology(concerning electroencephalography).We hope that this integrative review,drawing influence across multiple subdisciplines of neuroscience,paves the way for novel research directions and therapeutic neuromodulatory approaches,to improve the lives of older adults and patients with neurodegenerative diseases.展开更多
1 Background Congenital heart disease(CHD)is the most common major congenital anomaly,affecting approximately one in every 100 live births[1].Among congenital anomalies,66%of preventable deaths are due to CHD,and 58%o...1 Background Congenital heart disease(CHD)is the most common major congenital anomaly,affecting approximately one in every 100 live births[1].Among congenital anomalies,66%of preventable deaths are due to CHD,and 58%of the avertable morbidity and mortality due to congenital anomalies would result from scaling congenital heart surgery services[2].Every year,nearly 300,000 children and adults die from CHD,the majority of whom live in low-and middle-income countries(LMICs)[3].Approximately 49%of all individuals with CHD will require surgical or interventional care at some point in their lifetime[4];as a result of advances in access to and the delivery of such services,over 95%of children born with CHD in high-income countries now live into adulthood[3].Here,adults have surpassed children in the number of CHD cases at a ratio of 2:1[5].展开更多
Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for...Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.展开更多
Research on the use of EHR is contradictory since it presents contradicting results regarding the time spent documenting. There is research that supports the use of electronic records as a tool to speed documentation;...Research on the use of EHR is contradictory since it presents contradicting results regarding the time spent documenting. There is research that supports the use of electronic records as a tool to speed documentation;and research that found that it is time consuming. The purpose of this quantitative retrospective before-after project was to measure the impact of using the laboratory value flowsheet within the EHR on documentation time. The research question was: “Does the use of a laboratory value flowsheet in the EHR impact documentation time by primary care providers (PCPs)?” The theoretical framework utilized in this project was the Donabedian Model. The population in this research was the two PCPs in a small primary care clinic in the northwest of Puerto Rico. The sample was composed of all the encounters during the months of October 2019 and December 2019. The data was obtained through data mining and analyzed using SPSS 27. The evaluative outcome of this project is that there is a decrease in documentation time after implementation of the use of the laboratory value flowsheet in the EHR. However, patients per day increase therefore having an impact on the number of patients seen per day/week/month. The implications for clinical practice include the use of templates to improve workflow and documentation as well as decreasing documentation time while also increasing the number of patients seen per day. .展开更多
The ongoing revolution in information technology is reshaping human life. In the realm of health behavior, wearable technology emerges as a leading digital solution,capturing physical behaviors (i.e., physical activit...The ongoing revolution in information technology is reshaping human life. In the realm of health behavior, wearable technology emerges as a leading digital solution,capturing physical behaviors (i.e., physical activity, sedentary habits, sleep patterns) within the 24-h cycle of daily life. Wearables are applied in research, clinical practice, and as lifestyle devices;most obvious, they promise to be a key element for increasing human physical activity, one of the biggest health challenges nowadays.展开更多
BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread ...BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.展开更多
BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad factors.The creation of a reliable prog-nostic model for the overall survival(OS)of EC patie...BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad factors.The creation of a reliable prog-nostic model for the overall survival(OS)of EC patients promises to greatly advance the customization of treatment approaches.AIM To create a more systematic and practical model that incorporates clinically significant indicators to support decision-making in clinical settings.METHODS This study utilized data from a prospective longitudinal cohort of 3127 EC patients treated at Chongqing University Cancer Hospital between January 1,2018,and December 12,2020.Utilizing the least absolute shrinkage and selection operator regression alongside multivariate Cox regression analyses helped pinpoint pertinent variables for constructing the model.Its efficacy was assessed by concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curves,and decision curve analysis(DCA).RESULTS Nine variables were determined to be significant predictors of OS in EC patients:Body mass index(BMI),Karnofsky performance status,TNM stage,surgery,radiotherapy,chemotherapy,immunotherapy,platelet-to-lymphocyte ratio,and albumin-to-globulin ratio(ALB/GLB).The model demonstrated a C-index of 0.715(95%CI:0.701-0.729)in the training cohort and 0.711(95%CI:0.689-0.732)in the validation cohort.In the training cohort,AUCs for 1-year,3-year,and 5-year OS predictions were 0.773,0.787,and 0.750,respectively;in the validation cohort,they were 0.772,0.768,and 0.723,respectively,illustrating the model's precision.Calibration curves and DCA verified the model's predictive accuracy and net benefit.CONCLUSION A novel prognostic model for determining the OS of EC patients was successfully developed and validated to help clinicians in devising individualized treatment schemes for EC patients.展开更多
BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis ...BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis in the treatment of type 2 diabetes,the report is as follows.AIM To investigate the effect of jejunoileal side-to-side anastomosis on metabolic parameters in patients with type 2 diabetes mellitus(T2DM).METHODS We retrospectively analyzed the clinical data of 78 patients with T2DM who were treated via jejunoileal lateral anastomosis.Metabolic indicators were collected preoperatively,as well as at 3 and 6 months postoperative.The metabolic indicators analyzed included body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),2-hour blood glucose(PBG),glycated hemoglobin(HbA1c),fasting C-peptide,2-hour C-peptide(PCP),fasting insulin(Fins),2-hour insulin(Pins),insulin resistance index(HOMA-IR),βCellular function index(HOMA-β),alanine aminotransferase,aspartate aminotransferase,serum total cholesterol(TC),low-density lipoprotein cholesterol(L DL-C),triglycerides(TG),high-density lipoprotein,and uric acid(UA)levels.RESULTS SBP,DBP,PBG,HbA1c,LDL-C,and TG were all significantly lower 3 months postoperative vs preoperative values;body weight,BMI,SBP,DBP,FBG,PBG,HbA1c,TC,TG,UA,and HOMA-IR values were all significantly lower 6 months postoperative vs at 3 months;and PCP,Fins,Pins,and HOMA-βwere all significantly higher 6 months postoperative vs at 3 months(all P<0.05).CONCLUSION Side-to-side anastomosis of the jejunum and ileum can effectively treat T2DM and improve the metabolic index levels associated with it.展开更多
文摘Background: In the global burden of non-communicable diseases, the top slot among them all is occupied by various cardiovascular diseases (CVD), which also claim primacy in mortality rates. Generally speaking, the pathophysiological pathway frequently involves either (or a combination of) elevated serum cholesterol levels, predominantly attributed to dietary patterns characterized by extremely high levels of saturated and trans-fat consumption. Day-to-day nutritional epidemiology among university students suggests that they represent a crucial demographic for the study of preventive interventions. Objective: This in-depth study and investigation were specifically aimed to quantitatively assess and compare prevailing patterns of dietary fat consumption between female students enrolled in health sciences and non-health sciences programs at major universities in Riyadh, Saudi Arabia. Methodology: This cross-sectional study was comprised of 434 Saudi female university students (age range: 18 - 25 years), utilizing a validated Block Dietary Fat Screener accompanied by anthropometric measurements and comprehensive demographic data collection. The sampling methodology consisted of a snowball technique that was spread across three major academic institutions in Riyadh. Results: Statistical analysis revealed a significant association between academic specialization and patterns of dietary fat consumption (p = 0.012). Paradoxically, students of health science exhibited a higher prevalence of very high fat intake (41.9%) compared with their non-health sciences counterparts (27.6%). Surprisingly, anthropometric stratification revealed that it was the underweight students who demonstrated very high levels of fat consumption. A notable socioeconomic gradient was observed, with students from households earning 15,000 - 20,000 SR monthly showing the highest prevalence of very high-fat consumption (47.1%), although this association did not achieve statistical significance (p = 0.104). Conclusion: These findings challenge the conventional assumption that health sciences education correlates with superior dietary behaviors. The data suggests a critical need for enhanced education in nutrition, as well as intervention using various behavioral programs across all academic disciplines, particularly those addressing the disconnect between nutritional knowledge and dietary practices among students of health sciences. Future longitudinal studies are warranted in order to elucidate the temporal relationship between academic specialization and dietary behaviors.
文摘Background:Oral health issues persistently affect the overall health and well-being of rural populations.Village health volunteers(VHVs)play a crucial role in advancing oral health literacy in their community.This study aimed to examine the factors related to nutritional literacy for oral health among VHVs.Methods:This was a mixed-methods study employing an explanatory sequential design.The quantitative data were gathered through questionnaires distributed to a cohort of 10,514 VHVs registered in Health Region 1.A stratified random sampling technique was used to ensure adequate representation of various subgroups within the VHV population,considering factors such as age,education level,and geographical distribution across the region.This approach allowed for a more representative sample that accurately reflects the diversity of the VHV population.Qualitative data were obtained through semi-structured interviews with a purposive sampling of 20 participants based on specific criteria.Quantitative data were analyzed using descriptive statistics and biserial correlation techniques,while qualitative data were analyzed using content analysis.Results:The study found that the sample group possessed a moderate level of knowledge of health literacy principles and nutrition for oral health.However,their self-assessed skills in nutritional literacy for oral health were rated as high.A statistically significant negative correlation was found between knowledge of nutrition for oral health and skills in nutritional literacy for oral health.VHVs equated health literacy with knowledge because their public health training had focused more on imparting knowledge rather than developing skills based on health literacy principles.Conclusion:There is a need to emphasize skill-based health literacy training and to use effective skill development techniques that are tailored to the specific roles and responsibilities of health volunteers.It is also recommended to continuously monitor and evaluate the outcomes of these efforts.
文摘The pandemic highlighted significant gaps in the public health infrastructure impacted by shortages of public health workers, an undertrained workforce, and years of disinvestment. These gaps required innovative problem-solving by public health agencies (PHAs), including local health departments (LHDs), to respond to rapidly changing community conditions during and after the pandemic. Many schools and programs of public health (SPPH) worked with PHAs to mobilize public health (PH) students through practice-based teaching (PBT). Current research indicates PBT benefits all stakeholders—PHAs, students, faculty, SPPH, and ultimately the community served. However, more research is needed on the utility of PBT in addressing a community’s systemic public health issues, the extent to which the academic-community collaboration enhances a PHA’s capacity, and the impact of the pedagogy on preparing the workforce for an evolving PH landscape. This paper examines the process of a semester-long PBT course, guided by the PBT STEPS framework, which includes five steps from collaboration to implementation to evaluation of a PBT course. The collaborating PHA and its student group addressed community trauma and resilience issues during the semester. Additionally, it examines the longer-term impacts after the semester for the PHA, community, and the workforce by 1) conducting a formative evaluation to understand needs and gaps in the community;2) redesigning an intervention that merged the results of the formative evaluation with the intervention developed during the semester;and 3) securing funding and resources for intervention sustainability. Through the documentation of a post-course partnership between an LHD and faculty at a large school of public health, this case study illustrates the potential for PBT to lay the foundation for ongoing research that supports more impactful interventions for PHAs while bolstering the workforce abilities of students as future practitioners.
基金supported by Seoul National University of Science and Technology.
文摘Background:It has been broadly witnessed that a large number of adolescents are suffering emotional and mental health problems after COVID-19,and such adverse experiences in early life often extend into adulthood,resulting in serious long-term implications.However,it is accepted that the literature examining the relationship between mental health problems in adolescents and their underlying psychological factors is limited.The purposes of the current study were to identify mental health problems of Korean adolescents and to investigate the possible influence of self-esteem,self-efficacy,and health locus of control on mental health problems.Methods:A total of 2104 Korean adolescents were randomly recruited from junior high and high schools located in Seoul,Korea.The Korean Symptom Checklist,and Self-esteem Scale,Health Locus of Control Scale,Self-efficacy Scale were applied to identify mental health problems and psychological factors among adolescents.Frequency analysis,independent t-tests,one-way ANOVA,correlation analysis,and multiple regression analysis were performed to test the study hypothesis.Results:Korean adolescents showed a high prevalence of depression(61.4%),anxiety(44.7%),interpersonal sensitivity(76.1%),and hostility(40.3%).In addition,the findings indicated significant gender and age differences in adolescent mental health problems.Moreover,results reported that the adolescents’mental health problems were significantly associated with psychological factors(R^(2)=0.51 for depression,0.38 for anxiety,0.33 for interpersonal sensitivity,and 0.23 for hostility).Conclusions:The current findings highlight the need for comprehensive,culturally relevant mental health strategies for Korean adolescents.The interventions that foster psychological resilience,promote positive self-concept,and encourage internal control beliefs may be effective in mitigating mental health challenges.
基金supported by the Bio&Medical Technology Development Program of the National Research Foundation(NRF)&funded by the Korean government(MSIT)(NRF-2021M3A9E4080780)Hankuk University of Foreign Studies(2024).
文摘Objectives:Population aging is occurring at a rapid speed all over the world,bringing considerable public health challenges,including for the mental health of older adults.Considering that older populations are prone to depression and stress,the need for effective preventive interventions is critical.Thus,we conducted a study aimed at exploring the preventive impact of a community-based Tai Chi program over 8 weeks on depression and perceived stress in healthy older adults in South Korea.Methods:A quasi-experimental design was utilized,with 63 older adults participating(31 individuals in the Tai Chi group and 32 in the control group).The Tai Chi intervention was a supervised session 3 times per week.Data were obtained anonymously at baseline and post-intervention(week 8),with validated measures,including the Geriatric Depression Scale and the Korean version of the Brief Encounter Psychosocial Instrument.Data analysis included frequency distributions,descriptive statistics,and repeated measures analysis of variance to examine group×time interaction effects.Results:Baseline characteristics were comparable between groups.A repeated measures analysis of variance revealed significant group×time interaction effects for depression(Wilks’Lambda=0.868,F1,57=8.63,p=0.005,partialη^(2)=0.13)and perceived stress(Wilks’Lambda=0.831,F1,57=11.62,p=0.001,partialη^(2)=0.17).In particular,participants in the Tai Chi group had significantly greater reductions in depression and perceived stress than participants in the control group.Conclusions:These results suggest that Tai Chi may contribute to more favorable changes in depression and perceived stress among healthy older adults compared to no intervention,suggesting its usefulness as a culturally appropriate intervention for sustainable enhancement of mental health and successful aging in rapidly aging societies,including South Korea.
文摘BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)is a recently proposed term that highlights the role of metabolic dysfunction in hepatic steatosis.It currently affects more than one-third of adults worldwide and is associated with liver fibrosis,hepatocellular carcinoma,cardiovascular disease,and chronic kidney disease.Given its high prevalence,asymptomatic progression,and revised definition,evaluating its epidemiology and risk profile remains an important public health priority.AIM To assess the prevalence and characteristics of MAFLD among Vietnamese individuals undergoing health check-ups.METHODS This retrospective study included 331 adults undergoing routine health check-ups at The Health Evaluation and Promotion Center,International University of Health and Welfare Center,Cho Ray Hospital,from June to October 2023.MAFLD was diagnosed based on the 2020 international expert consensus.Data collected included demographic,clinical,laboratory information,and metabolic risk factors from routine health check-up records.Descriptive statistics,χ^(2) tests,and ttests/Mann-Whitney tests were applied as appropriate.Significance was defined as P<0.05.RESULTS MAFLD was identified in 97 of 331 individuals(29.31%).Prevalence was significantly higher in men than women(44.51%vs 14.37%;P<0.001).In females,prevalence increased sharply after age 50(P=0.008).According to body mass index groups,prevalence was 0%(underweight),9.27%(normal),and 48.26%(overweight/obese).The MAFLD group had significantly higher rates of hypertension(19.59%vs 2.99%),dyslipidemia(98.96%vs 89.32%),prediabetes/diabetes(65.98%vs 28.20%),hyperuricemia(64.95%vs 31.19%),and metabolic syndrome(54.64%vs 7.69%)compared to the non-MAFLD group(all P<0.001).CONCLUSION MAFLD is prevalent in Vietnamese adults undergoing health screening.It is strongly associated with sex,age,body mass index,and metabolic disorders,indicating the importance of early detection and integrated management.
基金HAALSI(Health and Aging in Africa:A Longitudinal Study of an INDEPTH Community in South Africa)is sponsored by the National Institute on Aging(grant number 5P01AG041710-05)and is conducted by the Harvard Center for Population and Development Studies in Partnership with Witwatersrand UniversityThe Agincourt HDSS was supported by the Wellcome Trust,UK(058893/Z/99/A,069683/Z/02/Z,085477/Z/08/Z and085477/B/08/Z),the University of the Witwatersrand and South African Medical Research Council.
文摘Objectives Few studies have investigated longitudinal associations of loneliness with health outcomes in Africa.This study aimed to assess the longitudinal associations between loneliness and mental and physical health among aging adults in South Africa.Methods Data from the 7-year longitudinal Health and Ageing in Africa(HAALSI)study conducted in South Africa were used in the analysis(analytic sample:n=3707,aged 40 years and older).Loneliness was measured with one question.Longitudinal relationships between loneliness and each health outcome were estimated using Generalized Estimating Equations analysis(GEE),hazard ratios(HRs)(95%CI)were used to determine the relationship between loneliness and 7-year mortality in the entire sample,and correlations between incident health outcomes and loneliness were evaluated using logistic regressions.Results The prevalence of loneliness was 12.1%in 2015,16.9%in 2019,and 16.3%in 2022.Multivariable analysis showed that loneliness was positively associated with the prevalence and/or incidence of four poor mental health indicators(e.g.,poor sleep quality,AOR=1.53,95%CI:1.30–1.80),four physical ill-health indicators(e.g.,incident kidney disease,AOR=2.50,95%CI:1.41–4.42),mortality(Hazard Ratio=1.20,95%CI=1.04–1.39),and three poor behavioral health indicators(e.g.,current tobacco use,AOR=1.21,95%CI=1.04–1.42).Conclusion The study discovered that several outcomes related to mental,physical,and behavioral health were associated with loneliness.Enhancing the detection and management of loneliness could lower mental and physical illness in aging adults in South Africa.
基金funded by the Scientific ResearchDeanship at theUniversity ofHa’il-Saudi Arabia through project number-RG-23251.
文摘This review aims to analyze the development and impact of Artificial Intelligence(AI)in the context of Saudi Arabia’s public healthcare system to fulfill Vision 2030 objectives.It is extensively devoted to AI technology deployment relevant to disease management,healthcare delivery,epidemiology,and policy-making.However,its AI is culturally sensitive and ethically grounded in Islam.Based on the PRISMA framework,an SLR evaluated primary academic literature,cases,and practices of Saudi Arabia’s AI implementation in the public healthcare sector.Instead,it categorizes prior research based on how AI can work,the issues it poses,and its implications for the Kingdom’s healthcare system.The Saudi Arabian context analyses show that AI has increased the discreet prediction of diseases,resource management,and monitoring outbreaks during mass congregations such as hajj.Therefore,the study outlines critical areas for defining the potential for artificial intelligence and areas for enhancing digital development to support global healthcare progress.The key themes emerging from the review include Saudi Arabia:(i)the effectiveness of AI with human interaction for sustainable health services;(ii)conditions and quality control to enhance the quality of health care services using AI;(iii)environmental factors as influencing factors for public health care;(iv)Artificial Intelligence,and advanced decision-making technology for Middle Eastern health care systems.For policymakers,healthcare managers,and researchers who will engage with AI innovation,the review proclaims that AI applications should respect the country’s socio-cultural and ethical practices and pave the way for sustainable healthcare provision.More empirical research is needed on the implementation issues with AI,creating culturally appropriate models of AI,and finding new applications of AI to address the increasing demand for healthcare services in Saudi Arabia.
基金supported by the Ministry of Science and Technology of the People’s Republic of China under the“New Generation Artificial Intelligence”Major Project of Science and Technology Innovation 2030(2020AAA0105002).
文摘Irrational drug use and prescription safety are pressing global concerns.The World Health Organization estimated that over half of all prescriptions worldwide contain errors,leading to substantial harm[1,2].In China,prescription errors occur at a rate of 32%,and improper medication use is reported in over 70%of households[3,4].Vulnerable populations,including children(16.7%)and older adults(30.4%),are particularly affected[5].
文摘The rapid evolution of digital health technologies has sparked transformative changes across the healthcare landscape.These advancements were at the heart of discussions during the recent academic conference co-organized by The First Affiliated Hospital,Sun Yat-sen University(FAH-SYSU)and University of California at Berkeley,the Pacific-Rim Conference on Healthcare Innovation(PRC-HI 2024),convening under the theme“The Future of Medicine:Integrating Robotics,AI and Healthcare.”This article distills the key developments and their implications for the future of healthcare,focusing on innovations in robotic surgery,health data science,and AI for medicine.
基金supported by the National Natural Science Foundation of China(82225049,72104155)the Sichuan Provincial Central Government Guides Local Science and Technology Development Special Project(2022ZYD0127)the 1·3·5 Project for Disciplines of Excellence,West China Hospital,Sichuan University(ZYGD23004).
文摘Background:In recent years,there has been a growing trend in the utilization of observational studies that make use of routinely collected healthcare data(RCD).These studies rely on algorithms to identify specific health conditions(e.g.,diabetes or sepsis)for statistical analyses.However,there has been substantial variation in the algorithm development and validation,leading to frequently suboptimal performance and posing a significant threat to the validity of study findings.Unfortunately,these issues are often overlooked.Methods:We systematically developed guidance for the development,validation,and evaluation of algorithms designed to identify health status(DEVELOP-RCD).Our initial efforts involved conducting both a narrative review and a systematic review of published studies on the concepts and methodological issues related to algorithm development,validation,and evaluation.Subsequently,we conducted an empirical study on an algorithm for identifying sepsis.Based on these findings,we formulated specific workflow and recommendations for algorithm development,validation,and evaluation within the guidance.Finally,the guidance underwent independent review by a panel of 20 external experts who then convened a consensus meeting to finalize it.Results:A standardized workflow for algorithm development,validation,and evaluation was established.Guided by specific health status considerations,the workflow comprises four integrated steps:assessing an existing algorithm’s suitability for the target health status;developing a new algorithm using recommended methods;validating the algorithm using prescribed performance measures;and evaluating the impact of the algorithm on study results.Additionally,13 good practice recommendations were formulated with detailed explanations.Furthermore,a practical study on sepsis identification was included to demonstrate the application of this guidance.Conclusions:The establishment of guidance is intended to aid researchers and clinicians in the appropriate and accurate development and application of algorithms for identifying health status from RCD.This guidance has the potential to enhance the credibility of findings from observational studies involving RCD.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT)(No.NRF-2021R1F1A1063967)。
文摘The exposure patterns of pest control and disinfection workers have changed after the coronavirus disease 2019(COVID-19)outbreak,but the health risks of chemical exposure have not been assessed.We identified these workers’chemical exposure patterns and risks before and after the COVID-19 outbreak.We used data conducted between 2018(pre-pandemic)and 2021(post-pandemic)from three-year cross-sectional surveys on pest control and disinfection workers.Inhalation and dermal exposure concentrations were estimated using equations based on a biocidal product risk assessment model from the Korean National Institute of Environmental Research.The non-carcinogenic and carcinogenic risks of chemicals were calculated using the United States Environmental Protection Agency risk assessment model.We found that the annual work frequency(50^(th)percentile)of foggers using disinfectants increased the most among all the work types,from 140 uses/year to 176 uses/year after the COVID-19 outbreak.Moreover,all chemicals’non-carcinogenic and carcinogenic risks increased regardless of exposure routes.In the worst scenario(95^(th)percentile),the margin of exposure for citric acid,benzethonium chloride,benzyl-C12-16-alkyldimethyl chlorides,and sodium chlorite of inhalation exposure,and isopropyl alcohol and benzyl-C12-16-alkyldimethyl chlorides of dermal exposure were acceptable(>100)before the COVID-19outbreak but became unacceptable(<100)after the COVID-19 outbreak.Carcinogenic risks of dichlorvos from inhalation and dermal exposure were above acceptable levels(>10^(-6))before and after the COVID-19 outbreak but comparatively high after the COVID-19 outbreak.Additionally,significantly more workers experienced health symptoms after the COVID-19outbreak(p<0.05),with the most common being muscle lethargy(31%),skin/face stinging(28.7%),and breath shortness/neck pain(24.1%).
文摘Understanding the neural underpinning of human gait and balance is one of the most pertinent challenges for 21st-century translational neuroscience due to the profound impact that falls and mobility disturbances have on our aging population.Posture and gait control does not happen automatically,as previously believed,but rather requires continuous involvement of central nervous mechanisms.To effectively exert control over the body,the brain must integrate multiple streams of sensory information,including visual,vestibular,and somatosensory signals.The mechanisms which underpin the integration of these multisensory signals are the principal topic of the present work.Existing multisensory integration theories focus on how failure of cognitive processes thought to be involved in multisensory integration leads to falls in older adults.Insufficient emphasis,however,has been placed on specific contributions of individual sensory modalities to multisensory integration processes and cross-modal interactions that occur between the sensory modalities in relation to gait and balance.In the present work,we review the contributions of somatosensory,visual,and vestibular modalities,along with their multisensory intersections to gait and balance in older adults and patients with Parkinson’s disease.We also review evidence of vestibular contributions to multisensory temporal binding windows,previously shown to be highly pertinent to fall risk in older adults.Lastly,we relate multisensory vestibular mechanisms to potential neural substrates,both at the level of neurobiology(concerning positron emission tomography imaging)and at the level of electrophysiology(concerning electroencephalography).We hope that this integrative review,drawing influence across multiple subdisciplines of neuroscience,paves the way for novel research directions and therapeutic neuromodulatory approaches,to improve the lives of older adults and patients with neurodegenerative diseases.
文摘1 Background Congenital heart disease(CHD)is the most common major congenital anomaly,affecting approximately one in every 100 live births[1].Among congenital anomalies,66%of preventable deaths are due to CHD,and 58%of the avertable morbidity and mortality due to congenital anomalies would result from scaling congenital heart surgery services[2].Every year,nearly 300,000 children and adults die from CHD,the majority of whom live in low-and middle-income countries(LMICs)[3].Approximately 49%of all individuals with CHD will require surgical or interventional care at some point in their lifetime[4];as a result of advances in access to and the delivery of such services,over 95%of children born with CHD in high-income countries now live into adulthood[3].Here,adults have surpassed children in the number of CHD cases at a ratio of 2:1[5].
文摘Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.
文摘Research on the use of EHR is contradictory since it presents contradicting results regarding the time spent documenting. There is research that supports the use of electronic records as a tool to speed documentation;and research that found that it is time consuming. The purpose of this quantitative retrospective before-after project was to measure the impact of using the laboratory value flowsheet within the EHR on documentation time. The research question was: “Does the use of a laboratory value flowsheet in the EHR impact documentation time by primary care providers (PCPs)?” The theoretical framework utilized in this project was the Donabedian Model. The population in this research was the two PCPs in a small primary care clinic in the northwest of Puerto Rico. The sample was composed of all the encounters during the months of October 2019 and December 2019. The data was obtained through data mining and analyzed using SPSS 27. The evaluative outcome of this project is that there is a decrease in documentation time after implementation of the use of the laboratory value flowsheet in the EHR. However, patients per day increase therefore having an impact on the number of patients seen per day/week/month. The implications for clinical practice include the use of templates to improve workflow and documentation as well as decreasing documentation time while also increasing the number of patients seen per day. .
基金funded in part by the German Research Foundation(Grant reference:496846758).
文摘The ongoing revolution in information technology is reshaping human life. In the realm of health behavior, wearable technology emerges as a leading digital solution,capturing physical behaviors (i.e., physical activity, sedentary habits, sleep patterns) within the 24-h cycle of daily life. Wearables are applied in research, clinical practice, and as lifestyle devices;most obvious, they promise to be a key element for increasing human physical activity, one of the biggest health challenges nowadays.
基金Huxiang TCM Physique Intervention Clinical Research Center,No.2023SK4061Traditional Chinese Medicine Research Project of Hunan Province,No.B2023065+4 种基金Hunan Province"14th Five-Year Plan"key specialty of TCM,No.[2023]4Hunan University of Chinese Medicine and Hospital Joint Foundation,No.2023XYLH019 and 2024XYLH365R&D Plan for Key Areas of Hunan Provincial Department of Science and Technology,No.2019SK2321Excellent Youth Program of Hunan Education Department,No.24B0346Hunan Provincial Natural Science Foundation for Young Scientists,No.2025JJ60626.
文摘BACKGROUND Anxiety and depression are prevalent among patients with chronic heart failure(CHF)and can adversely contribute to treatment adherence and clinical outcomes.Poor fluid restriction adherence is a widespread challenge in the management of CHF.To effectively manage disease progression and alleviate symptoms,it is crucial to identify key influencing factors to facilitate the implementation of targeted interventions.AIM To investigate the status of anxiety and depression among patients with CHF and determine the factors contributing to poor fluid restriction adherence.METHODS Three hundred CHF patients seeking medical treatment at The First Hospital of Hunan University of Traditional Chinese Medicine between June 2021 and June 2023 were included in the study.Questionnaires,including the Psychosomatic Symptom Scale,Self-Rating Anxiety Scale,Self-Rating Depression Scale,and Fluid Restriction Adherence Questionnaire were administered to patients.Based on their anxiety and depression scores,patients were categorized into anxiety/depression and non-anxiety/depression groups,as well as fluid restriction adherence and fluid restriction non-adherence groups.General patient data were collected,and univariate and logistic regression analyses were conducted to determine the occurrence of depression and anxiety.Logistic regression analysis was used to identify independent factors influencing fluid restriction adherence.RESULTS Statistically significant differences in age,New York Heart Association(NYHA)grading,marital status,educational attainment,and family support were observed between depressed and non-depressed CHF patients(P<0.05).Age,NYHA grading,marital status,educational attainment,and family support were identified as factors influencing the development of depression.The anxiety and non-anxiety groups differed statistically in terms of gender,age,NYHA grading,smoking history,alcohol consumption history,monthly income,educational attainment,and family support(P<0.05).Gender,smoking,alcohol consumption,monthly income,and educational attainment affected anxiety in these patients.The fluid restriction adherence rate was 28.0%,and thirst sensation,anxiety,and depression were identified as independent influencing factors.CONCLUSION CHF patients are susceptible to anxiety and depression,with multiple associated influencing factors.Moreover,anxiety and depression are independent factors that can influence fluid restriction adherence in these patients.
文摘BACKGROUND Esophageal carcinoma(EC)presents a significant public health issue in China,with its prognosis impacted by myriad factors.The creation of a reliable prog-nostic model for the overall survival(OS)of EC patients promises to greatly advance the customization of treatment approaches.AIM To create a more systematic and practical model that incorporates clinically significant indicators to support decision-making in clinical settings.METHODS This study utilized data from a prospective longitudinal cohort of 3127 EC patients treated at Chongqing University Cancer Hospital between January 1,2018,and December 12,2020.Utilizing the least absolute shrinkage and selection operator regression alongside multivariate Cox regression analyses helped pinpoint pertinent variables for constructing the model.Its efficacy was assessed by concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curves,and decision curve analysis(DCA).RESULTS Nine variables were determined to be significant predictors of OS in EC patients:Body mass index(BMI),Karnofsky performance status,TNM stage,surgery,radiotherapy,chemotherapy,immunotherapy,platelet-to-lymphocyte ratio,and albumin-to-globulin ratio(ALB/GLB).The model demonstrated a C-index of 0.715(95%CI:0.701-0.729)in the training cohort and 0.711(95%CI:0.689-0.732)in the validation cohort.In the training cohort,AUCs for 1-year,3-year,and 5-year OS predictions were 0.773,0.787,and 0.750,respectively;in the validation cohort,they were 0.772,0.768,and 0.723,respectively,illustrating the model's precision.Calibration curves and DCA verified the model's predictive accuracy and net benefit.CONCLUSION A novel prognostic model for determining the OS of EC patients was successfully developed and validated to help clinicians in devising individualized treatment schemes for EC patients.
文摘BACKGROUND At present,the existing internal medicine drug treatment can alleviate the high glucose toxicity of patients to a certain extent,to explore the efficacy of laparoscopic jejunoileal side to side anastomosis in the treatment of type 2 diabetes,the report is as follows.AIM To investigate the effect of jejunoileal side-to-side anastomosis on metabolic parameters in patients with type 2 diabetes mellitus(T2DM).METHODS We retrospectively analyzed the clinical data of 78 patients with T2DM who were treated via jejunoileal lateral anastomosis.Metabolic indicators were collected preoperatively,as well as at 3 and 6 months postoperative.The metabolic indicators analyzed included body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(DBP),fasting blood glucose(FBG),2-hour blood glucose(PBG),glycated hemoglobin(HbA1c),fasting C-peptide,2-hour C-peptide(PCP),fasting insulin(Fins),2-hour insulin(Pins),insulin resistance index(HOMA-IR),βCellular function index(HOMA-β),alanine aminotransferase,aspartate aminotransferase,serum total cholesterol(TC),low-density lipoprotein cholesterol(L DL-C),triglycerides(TG),high-density lipoprotein,and uric acid(UA)levels.RESULTS SBP,DBP,PBG,HbA1c,LDL-C,and TG were all significantly lower 3 months postoperative vs preoperative values;body weight,BMI,SBP,DBP,FBG,PBG,HbA1c,TC,TG,UA,and HOMA-IR values were all significantly lower 6 months postoperative vs at 3 months;and PCP,Fins,Pins,and HOMA-βwere all significantly higher 6 months postoperative vs at 3 months(all P<0.05).CONCLUSION Side-to-side anastomosis of the jejunum and ileum can effectively treat T2DM and improve the metabolic index levels associated with it.
