Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the...Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the past decades worldwide[1],but the growth in healthy life expectancy has generally lagged behind[2].China has made substantial strides in enhancing both life expectancy and healthy life expectancy.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
Background:Low awareness of common pediatric eye conditions,such as amblyopia,conjunctivitis,and myopia in rural Chiang Rai,Thailand,prompted the development of a specialized curriculum.This curriculum aimed to provid...Background:Low awareness of common pediatric eye conditions,such as amblyopia,conjunctivitis,and myopia in rural Chiang Rai,Thailand,prompted the development of a specialized curriculum.This curriculum aimed to provide individuals serving these areas with resources to educate and disseminate information within their communities.Methods:A one-hour curriculum covering the causes,signs,diagnosis,treatment,and prevention of amblyopia,conjunctivitis,and myopia was delivered virtually to public health students at a Thai university and in-person to students at this university and rural community members.The in-person seminar included hands-on activities and simulations of these eye conditions.Knowledge acquisition and retention were assessed using pre-tests,immediate post-tests,and one-month post-tests.Results:The seminar was attended by 87 virtual public health students,111 in-person public health students,and 40 in-person rural community members.All groups showed significant improvement in test scores from pre-test to immediate post-test(P<0.001).In-person students had 1.57 times the odds of answering correctly on the immediate post-test compared to virtual students,despite no significant difference in baseline knowledge.However,the subset of in-person students who did not receive bilingual materials showed no significant difference in immediate post-test performance compared to virtual students(P>0.05).Although public health students had more than twice the odds of answering correctly at pre-test compared to rural community members,there were no significant differences between groups on the immediate post-test(P>0.05).Conclusion:A brief seminar significantly improved understanding and retention of pediatric eye conditions,achieving similar levels of understanding among public health students and rural community members,regardless of initial knowledge on this topic.In-person,hands-on seminars with educational materials in participants'preferred language proved more effective than virtual ones in achieving these improvements.展开更多
Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interv...Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interventions have been shown to help students develop healthy stress coping strategies.The purpose of this systematic review and meta-analysis was to examine the diverse array of coping interventions and what characteristics of coping interventions were most effective at decreasing stress among healthcare students.Methods:Any intervention designed to address coping for academic stress was included among medical,dental,nursing,physician assistant,allied health,veterinary,psychology,etc.students.A comprehensive literature search was completed to include multiple databases,Ancestry,and hand-searching from EBSCO and Google Scholar articles.A final total of 17 studies were included.Standardized mean difference effect sizes(ES)were synthesized across studies using a random-effects model in the Comprehensive Meta-Analysis Software for changes in coping levels in healthcare students.Moderator analyses were performed to explore the study,intervention,and participants’characteristics.The risk of bias was assessed by RoB2 and ROBINS-I.Results:Coping interventions significantly reduced stress outcomes among healthcare students(d=0.74;95%CI[0.48–1.01],95%PI[−0.41–1.90],p<0.001,Q=228.49,I^(2)=93.0%,T=0.52,T^(2)=0.28,p<0.001).Moderator analysis showed that interventions with stress education,established professional guidance,and fewer hours led to better stress management outcomes.Conclusions:This study demonstrates that coping interventions produce an overall moderate-to-large effect on stress reduction.Future research investigating coping interventions on academic and long-term outcomes would be beneficial.展开更多
It is well recognized that Structural Health Monitoring(SHM)reliability evaluation is a key aspect that needs to be urgently addressed to promote the wide application of SHM methods.However,the existing studies typica...It is well recognized that Structural Health Monitoring(SHM)reliability evaluation is a key aspect that needs to be urgently addressed to promote the wide application of SHM methods.However,the existing studies typically transfer the Non-Destructive Testing/Evaluation(NDT/E)reliability metrics to SHM without a systematic analysis of where these metrics originated.Seldom attentions are paid to the evaluation conditions which are very important to apply these metrics.Aimed at this issue,a new condition control-based Dual-Reliability Evaluation(Dual-RE)method for SHM is proposed.This new method is proposed based on a systematic analysis of the whole framework of reliability evaluation from instrument to NDT,and emphasis is paid to the evaluation condition control.Based on these analyses,considering the special online application scenario of SHM,the proposed Dual-RE method contains two key components:Integrated Sensor-based SHM-RE(IS-SHM-RE)and Critical Service Condition-based SHM-RE(CSC-SHM-RE).ISSHM-RE evaluates the reliability of integrated SHM sensor and system themselves under approximate repeatability conditions,while CSC-SHM-RE assesses SHM reliability under the dominant uncertainties during service,namely intermediate conditions.To demonstrate the Dual-RE,crack monitoring by using the Guided Wave-based-SHM(GW-SHM)on aircraft lug structures is taken as a case study.Both the crack detection and sizing performance are evaluated from accuracy and uncertainty.展开更多
Against the backdrop of the Healthy China strategy and the vigorous development of the cultural tourism industry,the integration of healthcare and cultural tourism has emerged as a highly promising direction for innov...Against the backdrop of the Healthy China strategy and the vigorous development of the cultural tourism industry,the integration of healthcare and cultural tourism has emerged as a highly promising direction for innovation.This paper takes the Dap eng Hospital of the Shenzhen Second People's Hospital as the research object,and analyzes how to organically combine medical academic activities,clinical medical services with the cultural and tourism resources of Dapeng New District in Shenzhen within the policy fr amework.By constructing a compliance-oriented,professional,and distinctive integr ation standards system,this paper explores an innovative development path that integrates academic exchanges,medical services,spiritual healing,and cultural experiences,providing a practical example and theoretical support for the integration of healthcare and cultural tourism nationwide.展开更多
Overweight and obesity are significant public health concerns worldwide due to their association with many chronic health conditions.This has resulted in the development of various interventions focused on weight loss...Overweight and obesity are significant public health concerns worldwide due to their association with many chronic health conditions.This has resulted in the development of various interventions focused on weight loss to reduce the associated health burden.Physical activity is an important lifestyle behavior associated with enhanced health.Evidence supports that many of the benefits of physical activity are realized independent of initial weight status or whether weight loss is achieved,with some benefits additive to what is achieved with weight loss alone.These benefits include enhanced cardiometabolic,brain,cognitive and psychological health,and others.Moreover,in adults with overweight or obesity,physical activity has independent effects on cardiorespiratory fitness,muscular strength,physical function,and mobility.There are also benefits to body composition,with physical activity improving the quality of key tissues,such as skeletal muscle,which may not occur with diet-induced weight loss.Therefore,physical activity is an important public health target for adults with overweight or obesity to provide a wide range of health benefits that extend beyond those of weight loss alone.However,physical activity recommendations and programming efforts should consider the unique characteristics of adults with overweight or obesity to be most effective,and should support a focus on mobility,physical function,and other health outcomes.展开更多
There have been an increasing number of studies on climate change and population health over the past 20 years,with most focusing on health risk assessment,targeting different locations and populations with various di...There have been an increasing number of studies on climate change and population health over the past 20 years,with most focusing on health risk assessment,targeting different locations and populations with various diseases[1−2].While these studies have provided the necessary epidemiological evidence for health authorities in policymaking,it is time to develop and implement tailored health interventions to protect the health and well-being of communities,and particularly that of vulnerable groups.展开更多
Objective:This scoping review explores digital health interventions used to improve maternal health and the health of children under-5-year-olds in rural areas of low-and middle-income countries(LMICs),identifying cur...Objective:This scoping review explores digital health interventions used to improve maternal health and the health of children under-5-year-olds in rural areas of low-and middle-income countries(LMICs),identifying current practices and research gaps.Methods:Guided by PRISMA Extension for Scoping Reviews,a comprehensive search was conducted across PubMed,Web of Science,and grey literature search with Google Scholar,and the South African National Elec-tronic Theses and Dissertations Portal.MeSH terms and Boolean operators were used.Studies were screened using the Population,Concept,and Context framework,and data were extracted systematically.Results:Of 5,114 records,63 met inclusion criteria.Digital health interventions,particularly mobile health,were found to enhance service delivery,education,and support for maternal and child health in LMICs.However,challenges such as limited access to technology,digital literacy,and cultural barriers persist.Contextual factors,including geography and sociocultural norms,significantly influenced implementation success.Conclusion:Digital health interventions show promise in improving maternal and child health in LMICs.How-ever,regional disparities,technological limitations,and cultural misalignment hinder scalability.Future research should focus on culturally adaptive,community-engaged approaches and long-term impact assessments to sup-port sustainable health promotion in low-resource settings.展开更多
Objectives:24-h movement behaviors(24-HMB),encompassing physical activity,sedentary behavior,and sleep duration,are increasingly regarded as interrelated and important factors for mental health.However,evidence on the...Objectives:24-h movement behaviors(24-HMB),encompassing physical activity,sedentary behavior,and sleep duration,are increasingly regarded as interrelated and important factors for mental health.However,evidence on the comprehensive association of these behaviors with mental health in adults with diabetes in developing countries remains scarce.This study examined the association between 24-HMB guidelines and psychological health among adults with diabetes in developing countries.Methods:Data were retrieved from the World Health Organization’s study on Global Aging and Adult Health Survey dataset.Adults(N=1905)diagnosed with diabetes from five low-and middle-income countries were included.The exposure of interest was adherence to 24-HMB guidelines,depression,cognition,and quality of life(QoL).Multiple logistic and multiple linear regression analyses were used to examine the association between meeting 24-HMB guidelines and depression,cognition,and QoL,respectively.Results:This cross-sectional study revealed that 28.61%complied with all three 24-HMB guidelines.Diabetic patients who met more numbers of 24-HMB guidelines had lower depression risk(OR=0.74,95%CI:0.61 to 0.91,p=0.004),greater cognition(β=0.42,95%CI:0.25 to 0.60,p<0.001),and QoL(β=1.30,95%CI:1.04 to 1.55,p<0.001)with the non-compliant population.For specific combinations,meeting all three guidelines were significantly associated with lower odds of depression,improved cognitive function,and enhanced QoL(all p<0.001).Conclusion:These findings support that meeting 24-HMB guidelines in a single or combined movement behaviors was significantly related to reduced risk of depression,enhanced cognitive function,and improved QoL among individuals with diabetes.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)disrupted healthcare and led to increased telehealth use.We explored the impact of COVID-19 on liver transplant evaluation(LTE).AIM To understand the impact of telehealth o...BACKGROUND Coronavirus disease 2019(COVID-19)disrupted healthcare and led to increased telehealth use.We explored the impact of COVID-19 on liver transplant evaluation(LTE).AIM To understand the impact of telehealth on LTE during COVID-19 and to identify disparities in outcomes disaggregated by sociodemographic factors.METHODS This was a retrospective study of patients who initiated LTE at our center from 3/16/20-3/16/21(“COVID-19 era”)and the year prior(3/16/19-3/15/20,“pre-COVID-19 era”).We compared LTE duration times between eras and explored the effects of telehealth and inpatient evaluations on LTE duration,listing,and pretransplant mortality.RESULTS One hundred and seventy-eight patients were included in the pre-COVID-19 era cohort and one hundred and ninety-nine in the COVID-19 era cohort.Twentynine percent(58/199)of COVID-19 era initial LTE were telehealth,compared to 0%(0/178)pre-COVID-19.There were more inpatient evaluations during COVID-19 era(40%vs 28%,P<0.01).Among outpatient encounters,telehealth use for initial LTE during COVID-19 era did not impact likelihood of listing,pretransplant mortality,or time to LTE and listing.Median times to LTE and listing during COVID-19 were shorter than pre-COVID-19,driven by increased inpatient evaluations.Sociodemographic factors were not predictive of telehealth.CONCLUSION COVID-19 demonstrates a shift to telehealth and inpatient LTE.Telehealth does not impact LTE or listing duration,likelihood of listing,or mortality,suggesting telehealth may facilitate LTE without negative outcomes.展开更多
The contemporary smart cities,smart homes,smart buildings,and smart health care systems are the results of the explosive growth of Internet of Things(IoT)devices and deep learning.Yet the centralized training paradigm...The contemporary smart cities,smart homes,smart buildings,and smart health care systems are the results of the explosive growth of Internet of Things(IoT)devices and deep learning.Yet the centralized training paradigms have fundamental issues in data privacy,regulatory compliance,and ownership silo alongside the scaled limitations of the real-life application.The concept of Federated Deep Learning(FDL)is a privacy-by-design method that will enable the distributed training of machine learning models among distributed clients without sharing raw data and is suitable in heterogeneous urban settings.It is an overview of the privacy-preserving developments in FDL as of 2018-2025 with a narrow scope on its usage in smart cities(traffic prediction,environmental monitoring,energy grids),smart homes/buildings/IoT(non-intrusive load monitoring,HVAC optimization,anomaly detection)and the healthcare application(medical imaging,Electronic Health Records(EHR)analysis,remote monitoring).It gives coherent taxonomy,domain pipelines,comparative analyses of privacy mechanisms(differential privacy,secure aggregation,Homomorphic Encryption(HE),Trusted Execution Environments(TEEs),blockchain enhanced and hybrids),system structures,security/robustness defense,deployment/Machine Learning Operation(MLOps)issues,and the longstanding challenges(non-IID heterogeneity,communication efficiency,fairness,and sustainability).Some of the contributions made are structured comparisons of privacy threats,practical design advice on urban areas,recognition of open problems,and a research roadmap into the future up to 2035.The paper brings out the transformational worth of FDL in building credible,scalable,and sustainable intelligent urban ecosystems and the need to do further interdisciplinary research in standardization,real-world testbeds,and ethical governance.展开更多
Dear Editor,The National Health Commission(NHC)of China has championed the creation of weight management clinics to confront the growing crisis of overweight and obesity.Forecasts indicate that by 2030,the prevalence ...Dear Editor,The National Health Commission(NHC)of China has championed the creation of weight management clinics to confront the growing crisis of overweight and obesity.Forecasts indicate that by 2030,the prevalence of these conditions among Chinese adults and children could climb to 70.5%and 31.8%,respectively[1].This troubling trajectory,alongside an increasing burden of chronic illnesses such as diabetes,hypertension,and cardiovascular diseases,underscores the need for immediate action.Instead of focusing solely on weight management clinics,we propose that medical institutions prioritize the establishment of comprehensive chronic disease management clinics,building upon the foundation of weight management clinics to holistically address obesity,aging,and healthcare system challenges.展开更多
BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remain...BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remains limited.We hypothesized that IPV survivors would have elevated risks of psychiatric disorders and stressrelated physical conditions.AIM To assess psychiatric and physical health risks following IPV exposure in Taiwan.METHODS We conducted a nationwide,registry-based case control study using data from Taiwan’s Health and Welfare Data Science Center.Adults aged 18-64 years with a first IPV report in 2019(n=43393)were matched 1:1 by sex and age to controls.Incident diagnoses within 1 year were identified from claims data.Conditional logistic regression was used to estimate adjusted odds ratios(AORs).RESULTS Compared to controls,IPV survivors had higher risks of depressive disorders[AOR=4.18,95%confidence interval(CI):3.78-4.60,P<0.001],bipolar disorder(AOR=4.81,95%CI:3.83-6.10,P<0.001),schizophrenia(AOR=1.75,95%CI:1.46-2.10,P<0.001),and alcohol/substance use disorders(AOR=5.98,95%CI:2.21-8.50,P<0.001).The risk of asthma was modestly elevated(AOR=1.31,95%CI:1.08-1.60,P=0.006).No significant association was observed for irritable bowel syndrome(P=0.94).CONCLUSION IPV survivors in Taiwan face substantially increased psychiatric risk and a modestly elevated risk of asthma,warranting early screening and integrated mental and physical health care.展开更多
Objective: The health-related quality of life (HRQoL) theory was used to assess the health quality of elderly residents in Southwest China. This was done by using the European Five-Dimensional Health Scale in a compre...Objective: The health-related quality of life (HRQoL) theory was used to assess the health quality of elderly residents in Southwest China. This was done by using the European Five-Dimensional Health Scale in a comprehensive manner and by analysing the factors influencing it. The findings will provide new perspectives and ideas for improving the health-related quality of life of the elderly population and enhancing the precise health management of elderly residents. Methods: The response data of 1892 elderly residents in southwestern China were included in the analysis based on the CLHLS data. The factors influencing the occurrence of problems, EQ-VAS scores and health utility values were analysed by logistic regression, multiple linear regression and Tobit regression, respectively. Results: The primary health concerns among the elderly population in the Southwest region were limited ability to perform daily activities and pain or discomfort. These individuals exhibited an EQ-VAS self-assessment score of 66.51 ± 14.87 and a health utility value of 0.87 (0.70, 1.00). Gender, age, regular medical check-ups, exercise habits and the prevalence of chronic diseases are the main influencing factors. Conclusions: The health quality of elderly people in Southwest China needs to be improved, and a comprehensive management strategy can be adopted in terms of lifestyle management, health needs management and disease management to improve the quality of their healthy lives and promote the development of healthy ageing.展开更多
1|Introduction The Federal Republic of Somalia,often perceived as linguistically homogeneous,is home to a rich tapestry of dialects and minority languages that reflect its diverse cultural heritage.While Somali is the...1|Introduction The Federal Republic of Somalia,often perceived as linguistically homogeneous,is home to a rich tapestry of dialects and minority languages that reflect its diverse cultural heritage.While Somali is the official medium of communication,it is divided into two major dialects:Maxaa Tiri(spoken by approximately 60%of the population)and Maay(spoken by approximately 20%of the population)[1].Minority languages such as Bravanese(also known as Chimwiini or Chimbalazi),Mushunguli,Benadiri Somali,and Kibajuni are spoken by smaller communities,particularly in the southern and coastal regions[1].展开更多
Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at t...Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at the grassroots level. Methods: A total of 300 elderly individuals who underwent health examinations at our center from January 2024 to December 2024 were selected as the study subjects. They were randomly divided into a control group and an observation group, with 150 cases in each group. The control group underwent the conventional health examination nursing process, while the observation group adopted an optimized community nursing model, which included stratified education and appointment scheduling before the examination, full-time accompaniment and safety care during the examination, and the establishment of electronic medical records and continuous follow-up after the examination. Differences in health management awareness rates and satisfaction with health examination services between the two groups of elderly individuals were compared. Results: The health management awareness rate in the observation group was 94.67%, significantly higher than that in the control group (78.00%;p < 0.001). The satisfaction rate with health examination services in the observation group was 96.00%, also significantly higher than that in the control group (82.00%;p < 0.001). Conclusion: The optimized community nursing model can effectively enhance the health awareness level and service satisfaction of elderly individuals during health examinations, demonstrating strong practicality and promotion value. It contributes to achieving continuity and precision in grassroots elderly health management.展开更多
Background:Telehealth has emerged as a powerful tool for managing chronic diseases and mental health conditions,offering increased access to care and improved patient outcomes.However,inequities in digital connectivit...Background:Telehealth has emerged as a powerful tool for managing chronic diseases and mental health conditions,offering increased access to care and improved patient outcomes.However,inequities in digital connectivity and technological resources have created significant disparities in access to these potentially life-changing services,disproportionately impacting marginalized and minoritized communities across the globe.Methods:Data on 473,716 telehealth encounters occurring between January 1,2022,and June 30,2023 were retrieved from the electronic health records(EHR)system used by University Hospitals.These encounters were classified into three groups:attended,canceled,and no-show.Relative risk was calculated based on age,sex,and race,and a multivariate linear regression was performed with age,sex,and race as inputs,to determine their effect on the encounter outcome.Results:Our analysis identified significant differences in relative risk between demographic groups.Patients 20-39 years of age had a high relative risk of cancellation and no-show,and Black patients demonstrated the highest relative risk for cancellation and no-show.The regression analysis illustrated a statistically significant link between no-shows and patients with a cellular plan with no other internet subscription(p<0.001),smartphone ownership(p<0.001),and not having a computer(p<0.05).Conclusions:This study highlights the clinical repercussions of the digital divide,as patients relying on a mobile phone and data plan to attend telehealth visits were more likely to no-show.Current disparities in digital connectivity for historically marginalized populations heightens the risk of creating a digital underclass.There is evidence this study may be applicable in multiple countries across the world.Further research on the causes of the observed no-shows is necessary to ensure equitable delivery of digital healthcare services.展开更多
Background:The World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0)is a popular tool for eval-uating functioning and disability in a range of population demographics and medical situations.However,...Background:The World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0)is a popular tool for eval-uating functioning and disability in a range of population demographics and medical situations.However,very little is known about the WHODAS 2.0's validity and reliability,particularly when dealing with potentially life-threatening maternal condi-tions(PLTCs).The aim of this study was to evaluate the validity of the WHODAS 2.0 Tigrigna version.Methods:This cross-sectional study was conducted in Tigray,northern Ethiopia,from December 15 to 20,2023.Following translation and back translation,women who had experienced PLTCs during a recent pregnancy,childbirth,or postpartum period were administered the 36-item WHODAS 2.0 in Tigrigna version 6 months after the childbirth.In total,121 women with a history of PLTCs participated.Cronbach′sαwas used to evaluate internal consistency in all six WHODAS 2.0 domains,while Spearman′s correlation coefficient was used to evaluate convergent validity.With confirmatory factor analysis,construct validity was also examined.Results:All domain scores of the Tigrigna version of the WHODAS 2.0 indicated excellent internal consistency(α=0.917-0.978 for 36 items andα=0.874-0.940 for 12 items),while the Cronbach′sαcoefficients for the summary score were 0.981 and 0.952 for 36 and 12 items,respectively.The convergent validity between the 36-item and 12-item WHODAS 2.0 showed a strong correlation between similar constructs(r=0.909-0.981).Conclusion:Despite the small sample limitation,the WHODAS 2.0 tool adapted to the Tigrigna version indicated an acceptable reliability and validity and therefore could be applied to women with a history of PLTCs at 6 months postpartum.展开更多
INTRODUCTION China is facing an increasingly urgent demand for children's mental health services.According to a nationwide epidemiological survey conducted by our team,the prevalence of mental health disorders amo...INTRODUCTION China is facing an increasingly urgent demand for children's mental health services.According to a nationwide epidemiological survey conducted by our team,the prevalence of mental health disorders among children aged 6-16 years in China is 17.5%,with attention-deficit hyperactivity disorder(6.4%),oppositional defiant disorder(3.6%)and major depressive disorder(2.0%)being the most common diagnoses.展开更多
文摘Healthy life expectancy is a pivotal measure of population health by integrating both life expectancy and the quality of years lived.A significant increase in life expectancy was evident in most populations during the past decades worldwide[1],but the growth in healthy life expectancy has generally lagged behind[2].China has made substantial strides in enhancing both life expectancy and healthy life expectancy.
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.
基金supported by the National Institutes of Health(Bethesda,MD)through the P30 EY010572 core grantthe Malcolm M.Marquis,MD Endowed Fund for Innovation+1 种基金an unrestricted grant from Research to Prevent Blindness(New York,NY)to the Casey Eye Institute,Oregon Health&Science UniversityAdditional support was provided by Oregon Health&Science University Global Health。
文摘Background:Low awareness of common pediatric eye conditions,such as amblyopia,conjunctivitis,and myopia in rural Chiang Rai,Thailand,prompted the development of a specialized curriculum.This curriculum aimed to provide individuals serving these areas with resources to educate and disseminate information within their communities.Methods:A one-hour curriculum covering the causes,signs,diagnosis,treatment,and prevention of amblyopia,conjunctivitis,and myopia was delivered virtually to public health students at a Thai university and in-person to students at this university and rural community members.The in-person seminar included hands-on activities and simulations of these eye conditions.Knowledge acquisition and retention were assessed using pre-tests,immediate post-tests,and one-month post-tests.Results:The seminar was attended by 87 virtual public health students,111 in-person public health students,and 40 in-person rural community members.All groups showed significant improvement in test scores from pre-test to immediate post-test(P<0.001).In-person students had 1.57 times the odds of answering correctly on the immediate post-test compared to virtual students,despite no significant difference in baseline knowledge.However,the subset of in-person students who did not receive bilingual materials showed no significant difference in immediate post-test performance compared to virtual students(P>0.05).Although public health students had more than twice the odds of answering correctly at pre-test compared to rural community members,there were no significant differences between groups on the immediate post-test(P>0.05).Conclusion:A brief seminar significantly improved understanding and retention of pediatric eye conditions,achieving similar levels of understanding among public health students and rural community members,regardless of initial knowledge on this topic.In-person,hands-on seminars with educational materials in participants'preferred language proved more effective than virtual ones in achieving these improvements.
文摘Objectives:Healthcare students experience significant stress due to their rigorous graduate school curricula.These levels of stress are associated with higher risks of depression,self-harm,and exhaustion.Coping interventions have been shown to help students develop healthy stress coping strategies.The purpose of this systematic review and meta-analysis was to examine the diverse array of coping interventions and what characteristics of coping interventions were most effective at decreasing stress among healthcare students.Methods:Any intervention designed to address coping for academic stress was included among medical,dental,nursing,physician assistant,allied health,veterinary,psychology,etc.students.A comprehensive literature search was completed to include multiple databases,Ancestry,and hand-searching from EBSCO and Google Scholar articles.A final total of 17 studies were included.Standardized mean difference effect sizes(ES)were synthesized across studies using a random-effects model in the Comprehensive Meta-Analysis Software for changes in coping levels in healthcare students.Moderator analyses were performed to explore the study,intervention,and participants’characteristics.The risk of bias was assessed by RoB2 and ROBINS-I.Results:Coping interventions significantly reduced stress outcomes among healthcare students(d=0.74;95%CI[0.48–1.01],95%PI[−0.41–1.90],p<0.001,Q=228.49,I^(2)=93.0%,T=0.52,T^(2)=0.28,p<0.001).Moderator analysis showed that interventions with stress education,established professional guidance,and fewer hours led to better stress management outcomes.Conclusions:This study demonstrates that coping interventions produce an overall moderate-to-large effect on stress reduction.Future research investigating coping interventions on academic and long-term outcomes would be beneficial.
基金the support from National Natural Science Foundation of China(No.52275153)the Frontier Technologies R&D Program of Jiangsu,China(No.BF2024068)+1 种基金The Fund of Prospective Layout of Scientific Research for Nanjing University of Aeronautics and Astronautics,ChinaResearch Fund of State Key Laboratory of Mechanics and Control for Aerospace Structures(Nanjing University of Aeronautics and Astronautics),China(Nos.MCAS-I-0425K01,MCAS-I-0423G01)。
文摘It is well recognized that Structural Health Monitoring(SHM)reliability evaluation is a key aspect that needs to be urgently addressed to promote the wide application of SHM methods.However,the existing studies typically transfer the Non-Destructive Testing/Evaluation(NDT/E)reliability metrics to SHM without a systematic analysis of where these metrics originated.Seldom attentions are paid to the evaluation conditions which are very important to apply these metrics.Aimed at this issue,a new condition control-based Dual-Reliability Evaluation(Dual-RE)method for SHM is proposed.This new method is proposed based on a systematic analysis of the whole framework of reliability evaluation from instrument to NDT,and emphasis is paid to the evaluation condition control.Based on these analyses,considering the special online application scenario of SHM,the proposed Dual-RE method contains two key components:Integrated Sensor-based SHM-RE(IS-SHM-RE)and Critical Service Condition-based SHM-RE(CSC-SHM-RE).ISSHM-RE evaluates the reliability of integrated SHM sensor and system themselves under approximate repeatability conditions,while CSC-SHM-RE assesses SHM reliability under the dominant uncertainties during service,namely intermediate conditions.To demonstrate the Dual-RE,crack monitoring by using the Guided Wave-based-SHM(GW-SHM)on aircraft lug structures is taken as a case study.Both the crack detection and sizing performance are evaluated from accuracy and uncertainty.
基金funded by the Guangdong Provincial Science and Technology Program Project(2023B0101200003)the National Health Commission Hospital Management Research Institute Project(JCWJ2024ZD01)+2 种基金the Guangxi Graduate Education Innovation Program Project(JGY2023168)the Shenzhen Philosophy and Social Sciences Planning 2025 Annual Research Topic(SZ2025D040)the 2025 Shenzhen Health Economics Society Project(202506)。
文摘Against the backdrop of the Healthy China strategy and the vigorous development of the cultural tourism industry,the integration of healthcare and cultural tourism has emerged as a highly promising direction for innovation.This paper takes the Dap eng Hospital of the Shenzhen Second People's Hospital as the research object,and analyzes how to organically combine medical academic activities,clinical medical services with the cultural and tourism resources of Dapeng New District in Shenzhen within the policy fr amework.By constructing a compliance-oriented,professional,and distinctive integr ation standards system,this paper explores an innovative development path that integrates academic exchanges,medical services,spiritual healing,and cultural experiences,providing a practical example and theoretical support for the integration of healthcare and cultural tourism nationwide.
基金supported by the National Institutes of Health for the Kansas Center for Metabolism and Obesity Research(award No.P20GM144269)support from the Center for Advancing Translational Sciences of the National Institutes of Health(award No.KL2TR002367)supported by the National Center for Advancing Translational Sciences of the National Institutes of Health(award No.TL1TR002368)。
文摘Overweight and obesity are significant public health concerns worldwide due to their association with many chronic health conditions.This has resulted in the development of various interventions focused on weight loss to reduce the associated health burden.Physical activity is an important lifestyle behavior associated with enhanced health.Evidence supports that many of the benefits of physical activity are realized independent of initial weight status or whether weight loss is achieved,with some benefits additive to what is achieved with weight loss alone.These benefits include enhanced cardiometabolic,brain,cognitive and psychological health,and others.Moreover,in adults with overweight or obesity,physical activity has independent effects on cardiorespiratory fitness,muscular strength,physical function,and mobility.There are also benefits to body composition,with physical activity improving the quality of key tissues,such as skeletal muscle,which may not occur with diet-induced weight loss.Therefore,physical activity is an important public health target for adults with overweight or obesity to provide a wide range of health benefits that extend beyond those of weight loss alone.However,physical activity recommendations and programming efforts should consider the unique characteristics of adults with overweight or obesity to be most effective,and should support a focus on mobility,physical function,and other health outcomes.
文摘There have been an increasing number of studies on climate change and population health over the past 20 years,with most focusing on health risk assessment,targeting different locations and populations with various diseases[1−2].While these studies have provided the necessary epidemiological evidence for health authorities in policymaking,it is time to develop and implement tailored health interventions to protect the health and well-being of communities,and particularly that of vulnerable groups.
文摘Objective:This scoping review explores digital health interventions used to improve maternal health and the health of children under-5-year-olds in rural areas of low-and middle-income countries(LMICs),identifying current practices and research gaps.Methods:Guided by PRISMA Extension for Scoping Reviews,a comprehensive search was conducted across PubMed,Web of Science,and grey literature search with Google Scholar,and the South African National Elec-tronic Theses and Dissertations Portal.MeSH terms and Boolean operators were used.Studies were screened using the Population,Concept,and Context framework,and data were extracted systematically.Results:Of 5,114 records,63 met inclusion criteria.Digital health interventions,particularly mobile health,were found to enhance service delivery,education,and support for maternal and child health in LMICs.However,challenges such as limited access to technology,digital literacy,and cultural barriers persist.Contextual factors,including geography and sociocultural norms,significantly influenced implementation success.Conclusion:Digital health interventions show promise in improving maternal and child health in LMICs.How-ever,regional disparities,technological limitations,and cultural misalignment hinder scalability.Future research should focus on culturally adaptive,community-engaged approaches and long-term impact assessments to sup-port sustainable health promotion in low-resource settings.
文摘Objectives:24-h movement behaviors(24-HMB),encompassing physical activity,sedentary behavior,and sleep duration,are increasingly regarded as interrelated and important factors for mental health.However,evidence on the comprehensive association of these behaviors with mental health in adults with diabetes in developing countries remains scarce.This study examined the association between 24-HMB guidelines and psychological health among adults with diabetes in developing countries.Methods:Data were retrieved from the World Health Organization’s study on Global Aging and Adult Health Survey dataset.Adults(N=1905)diagnosed with diabetes from five low-and middle-income countries were included.The exposure of interest was adherence to 24-HMB guidelines,depression,cognition,and quality of life(QoL).Multiple logistic and multiple linear regression analyses were used to examine the association between meeting 24-HMB guidelines and depression,cognition,and QoL,respectively.Results:This cross-sectional study revealed that 28.61%complied with all three 24-HMB guidelines.Diabetic patients who met more numbers of 24-HMB guidelines had lower depression risk(OR=0.74,95%CI:0.61 to 0.91,p=0.004),greater cognition(β=0.42,95%CI:0.25 to 0.60,p<0.001),and QoL(β=1.30,95%CI:1.04 to 1.55,p<0.001)with the non-compliant population.For specific combinations,meeting all three guidelines were significantly associated with lower odds of depression,improved cognitive function,and enhanced QoL(all p<0.001).Conclusion:These findings support that meeting 24-HMB guidelines in a single or combined movement behaviors was significantly related to reduced risk of depression,enhanced cognitive function,and improved QoL among individuals with diabetes.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)disrupted healthcare and led to increased telehealth use.We explored the impact of COVID-19 on liver transplant evaluation(LTE).AIM To understand the impact of telehealth on LTE during COVID-19 and to identify disparities in outcomes disaggregated by sociodemographic factors.METHODS This was a retrospective study of patients who initiated LTE at our center from 3/16/20-3/16/21(“COVID-19 era”)and the year prior(3/16/19-3/15/20,“pre-COVID-19 era”).We compared LTE duration times between eras and explored the effects of telehealth and inpatient evaluations on LTE duration,listing,and pretransplant mortality.RESULTS One hundred and seventy-eight patients were included in the pre-COVID-19 era cohort and one hundred and ninety-nine in the COVID-19 era cohort.Twentynine percent(58/199)of COVID-19 era initial LTE were telehealth,compared to 0%(0/178)pre-COVID-19.There were more inpatient evaluations during COVID-19 era(40%vs 28%,P<0.01).Among outpatient encounters,telehealth use for initial LTE during COVID-19 era did not impact likelihood of listing,pretransplant mortality,or time to LTE and listing.Median times to LTE and listing during COVID-19 were shorter than pre-COVID-19,driven by increased inpatient evaluations.Sociodemographic factors were not predictive of telehealth.CONCLUSION COVID-19 demonstrates a shift to telehealth and inpatient LTE.Telehealth does not impact LTE or listing duration,likelihood of listing,or mortality,suggesting telehealth may facilitate LTE without negative outcomes.
文摘The contemporary smart cities,smart homes,smart buildings,and smart health care systems are the results of the explosive growth of Internet of Things(IoT)devices and deep learning.Yet the centralized training paradigms have fundamental issues in data privacy,regulatory compliance,and ownership silo alongside the scaled limitations of the real-life application.The concept of Federated Deep Learning(FDL)is a privacy-by-design method that will enable the distributed training of machine learning models among distributed clients without sharing raw data and is suitable in heterogeneous urban settings.It is an overview of the privacy-preserving developments in FDL as of 2018-2025 with a narrow scope on its usage in smart cities(traffic prediction,environmental monitoring,energy grids),smart homes/buildings/IoT(non-intrusive load monitoring,HVAC optimization,anomaly detection)and the healthcare application(medical imaging,Electronic Health Records(EHR)analysis,remote monitoring).It gives coherent taxonomy,domain pipelines,comparative analyses of privacy mechanisms(differential privacy,secure aggregation,Homomorphic Encryption(HE),Trusted Execution Environments(TEEs),blockchain enhanced and hybrids),system structures,security/robustness defense,deployment/Machine Learning Operation(MLOps)issues,and the longstanding challenges(non-IID heterogeneity,communication efficiency,fairness,and sustainability).Some of the contributions made are structured comparisons of privacy threats,practical design advice on urban areas,recognition of open problems,and a research roadmap into the future up to 2035.The paper brings out the transformational worth of FDL in building credible,scalable,and sustainable intelligent urban ecosystems and the need to do further interdisciplinary research in standardization,real-world testbeds,and ethical governance.
基金supported by the Beijing Natural Science Foundation-Xiaomi Innovation Joint Fund(L233009).
文摘Dear Editor,The National Health Commission(NHC)of China has championed the creation of weight management clinics to confront the growing crisis of overweight and obesity.Forecasts indicate that by 2030,the prevalence of these conditions among Chinese adults and children could climb to 70.5%and 31.8%,respectively[1].This troubling trajectory,alongside an increasing burden of chronic illnesses such as diabetes,hypertension,and cardiovascular diseases,underscores the need for immediate action.Instead of focusing solely on weight management clinics,we propose that medical institutions prioritize the establishment of comprehensive chronic disease management clinics,building upon the foundation of weight management clinics to holistically address obesity,aging,and healthcare system challenges.
文摘BACKGROUND Intimate partner violence(IPV)is a major public health concern linked to psychiatric and physical morbidity.However,evidence from East Asia,particularly from registry-based and sex-inclusive analyses,remains limited.We hypothesized that IPV survivors would have elevated risks of psychiatric disorders and stressrelated physical conditions.AIM To assess psychiatric and physical health risks following IPV exposure in Taiwan.METHODS We conducted a nationwide,registry-based case control study using data from Taiwan’s Health and Welfare Data Science Center.Adults aged 18-64 years with a first IPV report in 2019(n=43393)were matched 1:1 by sex and age to controls.Incident diagnoses within 1 year were identified from claims data.Conditional logistic regression was used to estimate adjusted odds ratios(AORs).RESULTS Compared to controls,IPV survivors had higher risks of depressive disorders[AOR=4.18,95%confidence interval(CI):3.78-4.60,P<0.001],bipolar disorder(AOR=4.81,95%CI:3.83-6.10,P<0.001),schizophrenia(AOR=1.75,95%CI:1.46-2.10,P<0.001),and alcohol/substance use disorders(AOR=5.98,95%CI:2.21-8.50,P<0.001).The risk of asthma was modestly elevated(AOR=1.31,95%CI:1.08-1.60,P=0.006).No significant association was observed for irritable bowel syndrome(P=0.94).CONCLUSION IPV survivors in Taiwan face substantially increased psychiatric risk and a modestly elevated risk of asthma,warranting early screening and integrated mental and physical health care.
文摘Objective: The health-related quality of life (HRQoL) theory was used to assess the health quality of elderly residents in Southwest China. This was done by using the European Five-Dimensional Health Scale in a comprehensive manner and by analysing the factors influencing it. The findings will provide new perspectives and ideas for improving the health-related quality of life of the elderly population and enhancing the precise health management of elderly residents. Methods: The response data of 1892 elderly residents in southwestern China were included in the analysis based on the CLHLS data. The factors influencing the occurrence of problems, EQ-VAS scores and health utility values were analysed by logistic regression, multiple linear regression and Tobit regression, respectively. Results: The primary health concerns among the elderly population in the Southwest region were limited ability to perform daily activities and pain or discomfort. These individuals exhibited an EQ-VAS self-assessment score of 66.51 ± 14.87 and a health utility value of 0.87 (0.70, 1.00). Gender, age, regular medical check-ups, exercise habits and the prevalence of chronic diseases are the main influencing factors. Conclusions: The health quality of elderly people in Southwest China needs to be improved, and a comprehensive management strategy can be adopted in terms of lifestyle management, health needs management and disease management to improve the quality of their healthy lives and promote the development of healthy ageing.
文摘1|Introduction The Federal Republic of Somalia,often perceived as linguistically homogeneous,is home to a rich tapestry of dialects and minority languages that reflect its diverse cultural heritage.While Somali is the official medium of communication,it is divided into two major dialects:Maxaa Tiri(spoken by approximately 60%of the population)and Maay(spoken by approximately 20%of the population)[1].Minority languages such as Bravanese(also known as Chimwiini or Chimbalazi),Mushunguli,Benadiri Somali,and Kibajuni are spoken by smaller communities,particularly in the southern and coastal regions[1].
文摘Objective: To explore the application effect of optimizing the nursing model in community health centers for elderly health examinations, providing a reference for enhancing the management level of elderly health at the grassroots level. Methods: A total of 300 elderly individuals who underwent health examinations at our center from January 2024 to December 2024 were selected as the study subjects. They were randomly divided into a control group and an observation group, with 150 cases in each group. The control group underwent the conventional health examination nursing process, while the observation group adopted an optimized community nursing model, which included stratified education and appointment scheduling before the examination, full-time accompaniment and safety care during the examination, and the establishment of electronic medical records and continuous follow-up after the examination. Differences in health management awareness rates and satisfaction with health examination services between the two groups of elderly individuals were compared. Results: The health management awareness rate in the observation group was 94.67%, significantly higher than that in the control group (78.00%;p < 0.001). The satisfaction rate with health examination services in the observation group was 96.00%, also significantly higher than that in the control group (82.00%;p < 0.001). Conclusion: The optimized community nursing model can effectively enhance the health awareness level and service satisfaction of elderly individuals during health examinations, demonstrating strong practicality and promotion value. It contributes to achieving continuity and precision in grassroots elderly health management.
文摘Background:Telehealth has emerged as a powerful tool for managing chronic diseases and mental health conditions,offering increased access to care and improved patient outcomes.However,inequities in digital connectivity and technological resources have created significant disparities in access to these potentially life-changing services,disproportionately impacting marginalized and minoritized communities across the globe.Methods:Data on 473,716 telehealth encounters occurring between January 1,2022,and June 30,2023 were retrieved from the electronic health records(EHR)system used by University Hospitals.These encounters were classified into three groups:attended,canceled,and no-show.Relative risk was calculated based on age,sex,and race,and a multivariate linear regression was performed with age,sex,and race as inputs,to determine their effect on the encounter outcome.Results:Our analysis identified significant differences in relative risk between demographic groups.Patients 20-39 years of age had a high relative risk of cancellation and no-show,and Black patients demonstrated the highest relative risk for cancellation and no-show.The regression analysis illustrated a statistically significant link between no-shows and patients with a cellular plan with no other internet subscription(p<0.001),smartphone ownership(p<0.001),and not having a computer(p<0.05).Conclusions:This study highlights the clinical repercussions of the digital divide,as patients relying on a mobile phone and data plan to attend telehealth visits were more likely to no-show.Current disparities in digital connectivity for historically marginalized populations heightens the risk of creating a digital underclass.There is evidence this study may be applicable in multiple countries across the world.Further research on the causes of the observed no-shows is necessary to ensure equitable delivery of digital healthcare services.
文摘Background:The World Health Organization Disability Assessment Schedule 2.0(WHODAS 2.0)is a popular tool for eval-uating functioning and disability in a range of population demographics and medical situations.However,very little is known about the WHODAS 2.0's validity and reliability,particularly when dealing with potentially life-threatening maternal condi-tions(PLTCs).The aim of this study was to evaluate the validity of the WHODAS 2.0 Tigrigna version.Methods:This cross-sectional study was conducted in Tigray,northern Ethiopia,from December 15 to 20,2023.Following translation and back translation,women who had experienced PLTCs during a recent pregnancy,childbirth,or postpartum period were administered the 36-item WHODAS 2.0 in Tigrigna version 6 months after the childbirth.In total,121 women with a history of PLTCs participated.Cronbach′sαwas used to evaluate internal consistency in all six WHODAS 2.0 domains,while Spearman′s correlation coefficient was used to evaluate convergent validity.With confirmatory factor analysis,construct validity was also examined.Results:All domain scores of the Tigrigna version of the WHODAS 2.0 indicated excellent internal consistency(α=0.917-0.978 for 36 items andα=0.874-0.940 for 12 items),while the Cronbach′sαcoefficients for the summary score were 0.981 and 0.952 for 36 and 12 items,respectively.The convergent validity between the 36-item and 12-item WHODAS 2.0 showed a strong correlation between similar constructs(r=0.909-0.981).Conclusion:Despite the small sample limitation,the WHODAS 2.0 tool adapted to the Tigrigna version indicated an acceptable reliability and validity and therefore could be applied to women with a history of PLTCs at 6 months postpartum.
基金supported by a grant from the National Natural Science Foundation of China(grant no.82171538)the Beijing High-level Public Health Technology Talent Construction Project(grant no.2022-2-007)the Joint Basic—Clinical Laboratory of Paediatric Epilepsy and Cognitive Development(grant no.3-1-013-03).
文摘INTRODUCTION China is facing an increasingly urgent demand for children's mental health services.According to a nationwide epidemiological survey conducted by our team,the prevalence of mental health disorders among children aged 6-16 years in China is 17.5%,with attention-deficit hyperactivity disorder(6.4%),oppositional defiant disorder(3.6%)and major depressive disorder(2.0%)being the most common diagnoses.
