Background There have been numerous intervention studies focusing on the development of preterm infants,but there has been limited investigation into the home environment as a determinant of developmental outcomes in ...Background There have been numerous intervention studies focusing on the development of preterm infants,but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants.The aspects and extent to which the home environment affects the early(18 months corrected age)neuropsychological development of preterm infants are still unclear.Aims This study aimed to analyse the effect of the home environment on the neuropsychiatric development of preterm infants at 18 months corrected age after discharge from the neonatal intensive care unit(NICU).It also sought to provide a basis for promoting neuropsychiatric development among preterm infants by improving the home environment.Methods In this retrospective cross-sectional study,275 preterm infants born between January 2019 and January 2022 were followed up for systematic management after discharge from the NICU at Shanghai Children's Hospital.The Home Nurture Environment Questionnaire was used to assess the home environment of the infants and analyse its impact on the developmental quotient(evaluated by the Gesell Developmental Scale)and the rate of developmental delays at 18 months corrected age.Results A total of 41.454%of the infants were extremely preterm.The developmental quotient scores at 18 months corrected age were in the middle of the scale.The language domain had the highest rate of developmental delay(46.182%),followed by the adaptive domain(37.091%).Multiple logistic regression analyses showed that compared with infants in supportive home environments,infants with moderate/unsupportive home environments had significantly elevated risks of development delay:2.162-fold for global(odds ratio(OR)2.162,95% confidence interval(Cl)1.274 to 3.665,p=0.004),2.193-fold for fine motor(OR 2.193,95%CI 1.161 to 4.140,p=0.016),2.249-fold for language(0R 2.249,95%CI 1.336 to 3.786,p=0.002)and 2.042-fold for personal-social(OR 2.042,95%CI 1.149 to 3.628,p=0.015).Conclusions A supportive home environment is a crucial protective factor for the neuropsychological development of preterm infants.It is associated with higher developmental quotient scores and protects against neuropsychiatric delays.Incorporating evaluation and continuous improvement of the home environment into the management framework for preterm infants to promote optimal neurodevelopment is essential.展开更多
OBJECTIVE： In spite of the World Health Organization＇s recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary m...OBJECTIVE： In spite of the World Health Organization＇s recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individuallevel involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework. This paper explores the health care users, and providers＇ experiences and attitudes towards the implementation of intercultural health care policy in Ghana. METHODS： In-depth interviews, augmented with informal conversations, were conducted with 16 health service users, 7 traditional healers and 6 health professionals in the Sekyere South District and Kumasi Metropolis in the Ashanti Region of Ghana. Data were thematically analysed and presented based on the a posteriori inductive reduction approach. RESULTS： Findings reveal a widespread positive attitude to, and support for integrative medical care in Ghana. However, inter-provider communication in a form of cross-referrals and collaborative mechanisms between healers and health professionals seldom occurs and remains unofficially sanctioned. Traditional healers and health care professionals are skeptical about intercultural health care policy mainly due to inadequate political commitment for provider education. The medical practitioners have limited opportunity to undergo training for integrative medical practice. We also find a serious mistrust between the practitioners due to the ＂diversity of healing approaches and techniques.＂ Weak institutional support, lack of training to meet standards of practice, poor registration and regulatory measures as well as negative perception of the integrative medical policy inhibit its implementation in Ghana. CONCLUSION： In order to advance any useful intercultural health care policy in Ghana, the government＇s total commitment in informed training and provider education, enforcement of regulatoryinstrument and improved community engagement is needed. Evidence-based incorporation of traditional medical therapies into clinical practice will provide safer, faster and more effective health care for the underserved and resource-poor, particularly in the rural areas.展开更多
Individuals who are unable to walk independently spend most of the day in a wheelchair.This population is at high risk for developing pressure injuries caused by sitting.However,early diagnosis and prevention of these...Individuals who are unable to walk independently spend most of the day in a wheelchair.This population is at high risk for developing pressure injuries caused by sitting.However,early diagnosis and prevention of these injuries still remain challenging.Herein,we introduce battery-free,wireless,multimodal sensors and a movable system for continuous measurement of pressure,temperature,and hydration at skin interfaces.The device design includes a crack-activated pressure sensor with nanoscale encapsulations for enhanced sensitivity,a temperature sensor for measuring skin temperature,and a galvanic skin response sensor for measuring skin hydration levels.The movable system enables power harvesting,and data communication to multiple wireless devices mounted at skin-cushion interfaces of wheelchair users over full body coverage.Experimental evaluations and numerical simulations of the devices,together with clinical trials for wheelchair patients,demonstrate the feasibility and stability of the sensor system for preventing pressure injuries caused by sitting.展开更多
Global land cover maps are important sources of information for a wide range of studies including land change analysis and climate change research.While the global land cover maps attempt to present a consistent and h...Global land cover maps are important sources of information for a wide range of studies including land change analysis and climate change research.While the global land cover maps attempt to present a consistent and homogenous data in terms of the production process,the existing datasets offer coarse resolution data,e.g.1000 m for IGBP DISCover and 300 m for GlobeCover 2009 that is oftentimes challenging.Recently,GlobeLand30 data based on Landsat archive for two timestamps of 2000 and 2010 has been released.It presents a finer spatial resolution of 30 m,which provides numerous opportunities for a wide range of studies.The main objective of this study is to use this dataset for characterizing global land cover patterns,monitoring,and identifying extreme land change cases with their types and magnitude.The findings reveal massive land change patterns including deforestation,desertification,shrinkage of water bodies,and urbanization across the globe.The results and discussions of this research can help policy-makers,environmental planners,ecosystem services providers and climate change researchers to gain finer insights about the forms of global land change.Future research calls for further investigation of the underlying causes of the massive changes and their consequences on our ecosystems and human populations.展开更多
基金funded by Shanghai Municipal Health and Wellness Commission Health Industry Clinical Research Special Project(202140299).
文摘Background There have been numerous intervention studies focusing on the development of preterm infants,but there has been limited investigation into the home environment as a determinant of developmental outcomes in preterm infants.The aspects and extent to which the home environment affects the early(18 months corrected age)neuropsychological development of preterm infants are still unclear.Aims This study aimed to analyse the effect of the home environment on the neuropsychiatric development of preterm infants at 18 months corrected age after discharge from the neonatal intensive care unit(NICU).It also sought to provide a basis for promoting neuropsychiatric development among preterm infants by improving the home environment.Methods In this retrospective cross-sectional study,275 preterm infants born between January 2019 and January 2022 were followed up for systematic management after discharge from the NICU at Shanghai Children's Hospital.The Home Nurture Environment Questionnaire was used to assess the home environment of the infants and analyse its impact on the developmental quotient(evaluated by the Gesell Developmental Scale)and the rate of developmental delays at 18 months corrected age.Results A total of 41.454%of the infants were extremely preterm.The developmental quotient scores at 18 months corrected age were in the middle of the scale.The language domain had the highest rate of developmental delay(46.182%),followed by the adaptive domain(37.091%).Multiple logistic regression analyses showed that compared with infants in supportive home environments,infants with moderate/unsupportive home environments had significantly elevated risks of development delay:2.162-fold for global(odds ratio(OR)2.162,95% confidence interval(Cl)1.274 to 3.665,p=0.004),2.193-fold for fine motor(OR 2.193,95%CI 1.161 to 4.140,p=0.016),2.249-fold for language(0R 2.249,95%CI 1.336 to 3.786,p=0.002)and 2.042-fold for personal-social(OR 2.042,95%CI 1.149 to 3.628,p=0.015).Conclusions A supportive home environment is a crucial protective factor for the neuropsychological development of preterm infants.It is associated with higher developmental quotient scores and protects against neuropsychiatric delays.Incorporating evaluation and continuous improvement of the home environment into the management framework for preterm infants to promote optimal neurodevelopment is essential.
基金the Council for the Development of Social Science Research in Africa (Grant number.SGRT.46/T12)the Institute for Research in Africa (IFRA-Nigeria)the French Embassy in Ghana for providing financial support for the study (these scholarships were offered to the first author)
文摘OBJECTIVE： In spite of the World Health Organization＇s recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individuallevel involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework. This paper explores the health care users, and providers＇ experiences and attitudes towards the implementation of intercultural health care policy in Ghana. METHODS： In-depth interviews, augmented with informal conversations, were conducted with 16 health service users, 7 traditional healers and 6 health professionals in the Sekyere South District and Kumasi Metropolis in the Ashanti Region of Ghana. Data were thematically analysed and presented based on the a posteriori inductive reduction approach. RESULTS： Findings reveal a widespread positive attitude to, and support for integrative medical care in Ghana. However, inter-provider communication in a form of cross-referrals and collaborative mechanisms between healers and health professionals seldom occurs and remains unofficially sanctioned. Traditional healers and health care professionals are skeptical about intercultural health care policy mainly due to inadequate political commitment for provider education. The medical practitioners have limited opportunity to undergo training for integrative medical practice. We also find a serious mistrust between the practitioners due to the ＂diversity of healing approaches and techniques.＂ Weak institutional support, lack of training to meet standards of practice, poor registration and regulatory measures as well as negative perception of the integrative medical policy inhibit its implementation in Ghana. CONCLUSION： In order to advance any useful intercultural health care policy in Ghana, the government＇s total commitment in informed training and provider education, enforcement of regulatoryinstrument and improved community engagement is needed. Evidence-based incorporation of traditional medical therapies into clinical practice will provide safer, faster and more effective health care for the underserved and resource-poor, particularly in the rural areas.
基金supported by the Technology Innovation Program(00144157,Development of Heterogeneous Multi-Sensor Micro-System Platform)funded By the Ministry of Trade,Industry&Energy(MOTIE,korea)and the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT)(no.2021R1A2C3008742)supported by the MSIT(Ministry of Science and ICT),Korea,under the Grand Information Technology Research Center support program(IITP-2022-2016-0-00318)supervised by the IITP(Institute for Information&communications Technology Planning&Evaluation)Z.X.acknowledges the support from the National Natural Science Foundation of China(Grant No.12072057).
文摘Individuals who are unable to walk independently spend most of the day in a wheelchair.This population is at high risk for developing pressure injuries caused by sitting.However,early diagnosis and prevention of these injuries still remain challenging.Herein,we introduce battery-free,wireless,multimodal sensors and a movable system for continuous measurement of pressure,temperature,and hydration at skin interfaces.The device design includes a crack-activated pressure sensor with nanoscale encapsulations for enhanced sensitivity,a temperature sensor for measuring skin temperature,and a galvanic skin response sensor for measuring skin hydration levels.The movable system enables power harvesting,and data communication to multiple wireless devices mounted at skin-cushion interfaces of wheelchair users over full body coverage.Experimental evaluations and numerical simulations of the devices,together with clinical trials for wheelchair patients,demonstrate the feasibility and stability of the sensor system for preventing pressure injuries caused by sitting.
文摘Global land cover maps are important sources of information for a wide range of studies including land change analysis and climate change research.While the global land cover maps attempt to present a consistent and homogenous data in terms of the production process,the existing datasets offer coarse resolution data,e.g.1000 m for IGBP DISCover and 300 m for GlobeCover 2009 that is oftentimes challenging.Recently,GlobeLand30 data based on Landsat archive for two timestamps of 2000 and 2010 has been released.It presents a finer spatial resolution of 30 m,which provides numerous opportunities for a wide range of studies.The main objective of this study is to use this dataset for characterizing global land cover patterns,monitoring,and identifying extreme land change cases with their types and magnitude.The findings reveal massive land change patterns including deforestation,desertification,shrinkage of water bodies,and urbanization across the globe.The results and discussions of this research can help policy-makers,environmental planners,ecosystem services providers and climate change researchers to gain finer insights about the forms of global land change.Future research calls for further investigation of the underlying causes of the massive changes and their consequences on our ecosystems and human populations.
