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
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
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
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
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
Climate change poses a significant threat to global health.It exacerbates existing health challenges and generates new ones.Therefore,innovative solutions to mitigate and adapt to its adverse effects are urgently requ...Climate change poses a significant threat to global health.It exacerbates existing health challenges and generates new ones.Therefore,innovative solutions to mitigate and adapt to its adverse effects are urgently required.This article explores the potential of digital health technologies to address the challenge posed by climate change-related health issues.It discusses their dual functionality of diminishing the carbon footprint of healthcare services and increasing understanding and governance of climate-sensitive diseases.Notably,with advanced technologies such as Generative medical AI(GMAI)presenting environmental concerns like substantial energy consumption during data processing and the generation of electronic waste,it is essential to underscore the significance of their responsible development and implementation of these technologies.This will ensure that the benefits of digital health technologies can be maximized while minimizing their ecological drawbacks.This study,therefore propose,a framework for leveraging digital health technologies to support climate change adaptation,including disease surveillance,telemedicine,patient support systems,and public awareness campaigns.展开更多
Objectives This study aimed to quantify the impact of major chronic diseases on changes in healthy life expectancy(HLE)from 2011 to 2020 in China using an age-specific disability weights(DW)estimation method.Methods H...Objectives This study aimed to quantify the impact of major chronic diseases on changes in healthy life expectancy(HLE)from 2011 to 2020 in China using an age-specific disability weights(DW)estimation method.Methods HLE at age 60(HLE_(60))was used as the indicator of HLE in China.Cause-specific mortality rates were obtained from the cause-of-death database of the National Health Commission.Selfreported disease and disability status were derived from the China Health and Retirement Longitudinal Study.A total of 55,861 participants were included for DW estimation.Rates of disability,which was assessed using the Activities of Daily Living questionnaires,were estimated using data from 5,465 participants in 2011 and 9,910 participants in 2020.Age-specific DWs were calculated using a Bayesian logistic regression model.Changes in HLE_(60) were decomposed into mortality and disability effects by cause,based on the estimated DWs.Results HLE_(60) in China increased by 0.83 years from 2011 to 2020.Ischemic heart disease(IHD)contributed the most to the decline in HLE_(60),remaining the leading cause of reduction in terms of mortality effects.Diabetes showed the greatest impact on HLE_(60) due to disability,followed by stroke.The largest sex disparities in HLE_(60) were associated with disability from arthritis.Conclusion HLE_(60) in China improved from 2011 to 2020 and IHD remained the leading contributor to its decline,particularly through increased mortality.Disabilities related to diabetes,stroke,and arthritis had significant negative impacts.These findings highlight the need to strengthen integrated chronic disease prevention and rehabilitation services at community health centers.展开更多
While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the assoc...While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the association between combined lifestyle factors and stroke incidence.Using data from 51929 participants free of major cardiovascular diseases or cancer at baseline,we employed structural equation modeling to assess the mediating effects of systolic(SBP)and diastolic(DBP)blood pressure.During the follow-up,2811 incident stroke cases were identified.A healthy lifestyle was significantly associated with a reduced risk of stroke,with SBP mediating 44.70%(β=-0.0014,95%confidence interval[CI]:-0.0016 to-0.0012)and DBP mediating 37.81%(β=-0.0012,95%CI:-0.0015 to-0.0009)of this association.The mediating effects were attenuated but remained significant for ischemic stroke(SBP:33.21%;DBP:27.24%).In conclusion,approximately two-fifths of the protective association between a healthy lifestyle and stroke may be mediated by BP.These findings suggest that BP control may serve as an important early indicator for evaluating the effectiveness of lifestyle interventions in reducing stroke risk.展开更多
Rehabilitation for patients with chronic physical conditions,such as stroke,spinal cord injury,and fibromyalgia,is predominantly focused on physical recovery,often neglecting the affective and social dimensions crucia...Rehabilitation for patients with chronic physical conditions,such as stroke,spinal cord injury,and fibromyalgia,is predominantly focused on physical recovery,often neglecting the affective and social dimensions crucial for comprehensive health outcomes.This oversight contributes to a significant mental health burden,with up to40%of rehabilitating patients experiencing depression or anxiety.This perspective article reviews evidence from social and affective neuroscience to highlight the urgent need to integrate well-being as a central component of rehabilitation.We propose a holistic rehabilitation model that includes psychological,affective,and social interventions alongside physical therapies.This model draws on existing studies demonstrating that emotional resilience and social support are key predictors of successful rehabilitation outcomes.Patients with strong social and affective well-being are more likely to adhere to treatment protocols and achieve better physical recovery.Conversely,neglecting these dimensions can exacerbate mental health conditions,leading to what we identify as a"second wave"of health crises—mental health conditions triggered by chronic physical ailments.By adopting this holistic approach,healthcare systems can improve immediate rehabilitation outcomes,prevent the long-term escalation of mental health issues,and reduce the overall burden on global mental health services,ultimately enhancing the quality of life for patients worldwide.展开更多
BACKGROUND Effective health management for high-risk stroke populations is essential.The hospital-community-home(HCH)collaborative health management(CHM)model leverages resources from hospitals,communities,and familie...BACKGROUND Effective health management for high-risk stroke populations is essential.The hospital-community-home(HCH)collaborative health management(CHM)model leverages resources from hospitals,communities,and families.By integrating patient information across these three domains,it facilitates the delivery of tailored guidance,health risk assessments,and three-in-one health education.AIM To explore the effects of the HCH-CHM model on stroke risk reduction in highrisk populations.METHODS In total,110 high-risk stroke patients screened in the community from January 2019 to January 2023 were enrolled,with 52 patients in the control group receiving routine health education and 58 in the observation group receiving HCH-CHM model interventions based on routine health education.Stroke awareness scores,health behavior levels,medication adherence,blood pressure,serum biochemical markers(systolic/diastolic blood pressure,total cholesterol,and triglyceride),and psychological measures(self-rating anxiety/depression scale)were evaluated and compared between groups.RESULTS The observation group showed statistically significant improvements in stroke awareness scores and health behavior levels compared to the control group(P<0.05),with notable enhancements in lifestyle and dietary habits(P<0.05)and reductions in postintervention systolic blood pressure,diastolic blood pressure,total cholesterol,triglyceride,self-rating anxiety scale,and self-rating depression scale scores(P<0.05).CONCLUSION The HCH-CHM model had a significant positive effect on high-risk stroke populations,effectively increasing disease awareness,improving health behavior and medication adherence,and appropriately ameliorating blood pressure,serum biochemical marker levels,and negative psychological symptoms.展开更多
Mobile health apps (MHAs) and medical apps (MAs) are becoming increasinglypopular as digital interventions in a wide range of health-related applications inalmost all sectors of healthcare. The surge in demand for dig...Mobile health apps (MHAs) and medical apps (MAs) are becoming increasinglypopular as digital interventions in a wide range of health-related applications inalmost all sectors of healthcare. The surge in demand for digital medical solutionshas been accelerated by the need for new diagnostic and therapeutic methods inthe current coronavirus disease 2019 pandemic. This also applies to clinicalpractice in gastroenterology, which has, in many respects, undergone a recentdigital transformation with numerous consequences that will impact patients andhealth care professionals in the near future. MHAs and MAs are considered tohave great potential, especially for chronic diseases, as they can support the selfmanagementof patients in many ways. Despite the great potential associated withthe application of MHAs and MAs in gastroenterology and health care in general,there are numerous challenges to be met in the future, including both the ethicaland legal aspects of applying this technology. The aim of this article is to providean overview of the current status of MHA and MA use in the field ofgastroenterology, describe the future perspectives in this field and point out someof the challenges that need to be addressed.展开更多
This study addressed the critical need for an integrated,personalized approach to perimenopausal mental health,addressing both biological and psychosocial fac-tors.Current research highlighted the influence of hormona...This study addressed the critical need for an integrated,personalized approach to perimenopausal mental health,addressing both biological and psychosocial fac-tors.Current research highlighted the influence of hormonal fluctuations,genetic predispositions,and lifestyle factors in shaping perimenopausal mental health outcomes.This transitional period is marked by significant hormonal fluctuations contributing to heightened anxiety,depression,and sleep disturbances,affecting the women’s quality of life.Traditional pharmacological treatments,including selective serotonin reuptake inhibitors and hormone replacement therapy,have limitations due to variable efficacy and side effects,emphasizing the need for precision medicine.Advancements in pharmacogenomics and metabolomics provide new avenues for individualized treatments,with genetic markers(e.g.,Solute carrier organic anion transporter family member 1B1,estrogen receptor 1/estrogen receptor 2,and tachykinin receptor 3)guiding hormone therapy resp-onses.Emerging digital health technologies,such as artificial intelligence-driven diagnostics,wearable monitoring,and telehealth platforms,offer scalable,real-time mental health support,though regulatory and clinical validation challenges remain.Furthermore,integrative treatment models combining hormone-based therapy with non-pharmacological interventions demonstrate significant efficacy in alleviating perimenopausal symptoms.Future directions should prioritize the clinical validation and ethical implementation of digital health solutions,ensuring safety,efficacy,and user accessibility.A multidisciplinary,patient-centric model,incorporating genetics,endocrinology,digital health,and psychosocial interventions,is essential for optimizing perimenopausal mental health outcomes.展开更多
AIM:To evaluate the differences in near point of convergence(NPC),fusional vergence,saccadic eye movements,versional eye movements,and heterophoria between patients diagnosed with Parkinson’s disease(PD)and healthy s...AIM:To evaluate the differences in near point of convergence(NPC),fusional vergence,saccadic eye movements,versional eye movements,and heterophoria between patients diagnosed with Parkinson’s disease(PD)and healthy subjects.METHODS:A cross-sectional comparative study was conducted,enrolling two cohorts:a PD group and a healthy control group.The PD group was recruited via non-random convenience sampling,while the control group was selected randomly from individuals without PD.All participants were screened according to predefined inclusion and exclusion criteria before undergoing a comprehensive optometric assessment,which included measurements of uncorrected visual acuity,corrected visual acuity,and objective and subjective refraction.Subsequently,binocular vision function evaluations were performed,covering NPC measurement,fusional vergence reserve assessment at both distance and near,saccadic eye movement testing,and versional eye movement and heterophoria assessment.RESULTS:A total of 42 PD patients and 41 healthy controls were included in the final analysis.The two groups were well-matched in terms of sex distribution[29 males(69.0%)in the PD group vs 29 males(70.7%)in the control group,P=0.867]and mean age(55.3±9.6y in the PD group vs 54.9±9.8y in the control group,P=0.866).The prevalence of abnormal versional eye movements was significantly higher in the PD group than in the control group(23.81%,95%CI:12.05%-39.45%vs 7.32%,95%CI:1.54%-19.92%;P=0.025).Near exophoria was more prevalent in PD patients(61.90%,95%CI:45.64%-76.43%)than in controls(17.07%,95%CI:7.15%-32.06%),with a significant difference[odds ratio(OR)=7.99;95%CI:2.83-21.99;P<0.001].The mean NPC was significantly greater(more receded)in the PD group than in the control group(9.01±3.74 cm vs 7.20±2.15 cm;P=0.007).A statistically significant positive correlation was observed between PD severity and NPC values(Pearson’s correlation coefficient=0.309;P=0.046).Except for distance baseout break and distance base-out recovery values,all other fusional vergence parameters were significantly lower in the PD group than in the control group(P<0.05).The mean saccadic test score was significantly lower in PD patients than in controls(3.29±0.57 vs 3.78±0.42;P<0.001).Among all fusional vergence indices,near base-in blur yielded the highest area under the curve(AUC=0.877),with a sensitivity of 69%and specificity of 90%,followed by distance base-out blur(AUC=0.824,sensitivity=97.6%,specificity=66.7%),near base-out blur(AUC=0.814,sensitivity=76.2%,specificity=72.7%),near base-out break(AUC=0.749,sensitivity=78.6%,specificity=67.6%),and near base-out recovery(AUC=0.749,sensitivity=95.2%,specificity=50%).CONCLUSION:PD is associated with significant binocular vision function impairment,with receded NPC and reduced near fusional vergence reserves being the most prominent disorders.These findings highlight the potential value of binocular vision assessment as a non-invasive biomarker for the early detection and clinical monitoring of PD.展开更多
This article addresses the important role school health education program can play in reducing youth risky behaviors that lead to incarceration, diseases and fatalities or that impact their academic performance in sch...This article addresses the important role school health education program can play in reducing youth risky behaviors that lead to incarceration, diseases and fatalities or that impact their academic performance in school. Children growing up are at risks of exposure to different behaviors and common social influences which if unchecked result in unexpected health consequences common among youth in America today. According to US Centers for Disease Control & Prevention, the six leading behaviors that cause death, disability, and social problems among American children are: unintentional injuries and violence, alcohol and drug use, tobacco use, unhealthy diets, inadequate physical activities, and sexual behaviors and diseases. This article shows that school health program: 1) can provide the foundation for children to learn desired healthy behaviors in order to preserve life, 2) protects the future of children and that of the nation, 3) can teach students skills to recognize risky behaviors and resist them, 4) can boost community efforts to achieve desired health behaviors, 5) closes socio-economic gaps that interfere with basic nurturing of children, and 6) finally links local stakeholders as partners in promoting community safety. Through review of literature, the authors found that it costs ($588) daily or (214,620) annually to incarcerate a juvenile and only $75 daily for the cost of individualized community-based services. The cost to New York is over $900,000, yet does not address the causative issues. The authors recommend that schools teach comprehensive school health from kindergarten to grade 12 and employ health educators to support teachers teach health promotion and education.展开更多
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.
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.
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.
基金supported by the Science and Technology Innovation 2030 Major Project(2023ZD0508506)National Key Research and Development Program of China(2022YFC2305104).
文摘Climate change poses a significant threat to global health.It exacerbates existing health challenges and generates new ones.Therefore,innovative solutions to mitigate and adapt to its adverse effects are urgently required.This article explores the potential of digital health technologies to address the challenge posed by climate change-related health issues.It discusses their dual functionality of diminishing the carbon footprint of healthcare services and increasing understanding and governance of climate-sensitive diseases.Notably,with advanced technologies such as Generative medical AI(GMAI)presenting environmental concerns like substantial energy consumption during data processing and the generation of electronic waste,it is essential to underscore the significance of their responsible development and implementation of these technologies.This will ensure that the benefits of digital health technologies can be maximized while minimizing their ecological drawbacks.This study,therefore propose,a framework for leveraging digital health technologies to support climate change adaptation,including disease surveillance,telemedicine,patient support systems,and public awareness campaigns.
基金National Key Research and Development Plan of China(2022YFC3600800)Shenzhen Medical Academy of Research and Translation(Grants C2302001)。
文摘Objectives This study aimed to quantify the impact of major chronic diseases on changes in healthy life expectancy(HLE)from 2011 to 2020 in China using an age-specific disability weights(DW)estimation method.Methods HLE at age 60(HLE_(60))was used as the indicator of HLE in China.Cause-specific mortality rates were obtained from the cause-of-death database of the National Health Commission.Selfreported disease and disability status were derived from the China Health and Retirement Longitudinal Study.A total of 55,861 participants were included for DW estimation.Rates of disability,which was assessed using the Activities of Daily Living questionnaires,were estimated using data from 5,465 participants in 2011 and 9,910 participants in 2020.Age-specific DWs were calculated using a Bayesian logistic regression model.Changes in HLE_(60) were decomposed into mortality and disability effects by cause,based on the estimated DWs.Results HLE_(60) in China increased by 0.83 years from 2011 to 2020.Ischemic heart disease(IHD)contributed the most to the decline in HLE_(60),remaining the leading cause of reduction in terms of mortality effects.Diabetes showed the greatest impact on HLE_(60) due to disability,followed by stroke.The largest sex disparities in HLE_(60) were associated with disability from arthritis.Conclusion HLE_(60) in China improved from 2011 to 2020 and IHD remained the leading contributor to its decline,particularly through increased mortality.Disabilities related to diabetes,stroke,and arthritis had significant negative impacts.These findings highlight the need to strengthen integrated chronic disease prevention and rehabilitation services at community health centers.
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82192900,82192901,82192904,81390540,and 91846303 to L.L.)the National Key Research and Development Program of China(Grant No.2016YFC0900500 to Y.G.)the Kadoorie Charitable Foundation in Hong Kong,and the Wellcome Trust in the UK(Grant/Award Nos.088158/Z/09/Z,104085/Z/14/Z,and 202922/Z/16/Z to Z.C.).
文摘While a healthy lifestyle is known to reduce the risk of stroke,the extent to which blood pressure(BP)mediates this association remains unclear.The present study aimed to quantify the mediating role of BP in the association between combined lifestyle factors and stroke incidence.Using data from 51929 participants free of major cardiovascular diseases or cancer at baseline,we employed structural equation modeling to assess the mediating effects of systolic(SBP)and diastolic(DBP)blood pressure.During the follow-up,2811 incident stroke cases were identified.A healthy lifestyle was significantly associated with a reduced risk of stroke,with SBP mediating 44.70%(β=-0.0014,95%confidence interval[CI]:-0.0016 to-0.0012)and DBP mediating 37.81%(β=-0.0012,95%CI:-0.0015 to-0.0009)of this association.The mediating effects were attenuated but remained significant for ischemic stroke(SBP:33.21%;DBP:27.24%).In conclusion,approximately two-fifths of the protective association between a healthy lifestyle and stroke may be mediated by BP.These findings suggest that BP control may serve as an important early indicator for evaluating the effectiveness of lifestyle interventions in reducing stroke risk.
文摘Rehabilitation for patients with chronic physical conditions,such as stroke,spinal cord injury,and fibromyalgia,is predominantly focused on physical recovery,often neglecting the affective and social dimensions crucial for comprehensive health outcomes.This oversight contributes to a significant mental health burden,with up to40%of rehabilitating patients experiencing depression or anxiety.This perspective article reviews evidence from social and affective neuroscience to highlight the urgent need to integrate well-being as a central component of rehabilitation.We propose a holistic rehabilitation model that includes psychological,affective,and social interventions alongside physical therapies.This model draws on existing studies demonstrating that emotional resilience and social support are key predictors of successful rehabilitation outcomes.Patients with strong social and affective well-being are more likely to adhere to treatment protocols and achieve better physical recovery.Conversely,neglecting these dimensions can exacerbate mental health conditions,leading to what we identify as a"second wave"of health crises—mental health conditions triggered by chronic physical ailments.By adopting this holistic approach,healthcare systems can improve immediate rehabilitation outcomes,prevent the long-term escalation of mental health issues,and reduce the overall burden on global mental health services,ultimately enhancing the quality of life for patients worldwide.
基金Supported by Guiding Project of Hebei Provincial Health Commission,No.20201190 and 20180220.
文摘BACKGROUND Effective health management for high-risk stroke populations is essential.The hospital-community-home(HCH)collaborative health management(CHM)model leverages resources from hospitals,communities,and families.By integrating patient information across these three domains,it facilitates the delivery of tailored guidance,health risk assessments,and three-in-one health education.AIM To explore the effects of the HCH-CHM model on stroke risk reduction in highrisk populations.METHODS In total,110 high-risk stroke patients screened in the community from January 2019 to January 2023 were enrolled,with 52 patients in the control group receiving routine health education and 58 in the observation group receiving HCH-CHM model interventions based on routine health education.Stroke awareness scores,health behavior levels,medication adherence,blood pressure,serum biochemical markers(systolic/diastolic blood pressure,total cholesterol,and triglyceride),and psychological measures(self-rating anxiety/depression scale)were evaluated and compared between groups.RESULTS The observation group showed statistically significant improvements in stroke awareness scores and health behavior levels compared to the control group(P<0.05),with notable enhancements in lifestyle and dietary habits(P<0.05)and reductions in postintervention systolic blood pressure,diastolic blood pressure,total cholesterol,triglyceride,self-rating anxiety scale,and self-rating depression scale scores(P<0.05).CONCLUSION The HCH-CHM model had a significant positive effect on high-risk stroke populations,effectively increasing disease awareness,improving health behavior and medication adherence,and appropriately ameliorating blood pressure,serum biochemical marker levels,and negative psychological symptoms.
文摘Mobile health apps (MHAs) and medical apps (MAs) are becoming increasinglypopular as digital interventions in a wide range of health-related applications inalmost all sectors of healthcare. The surge in demand for digital medical solutionshas been accelerated by the need for new diagnostic and therapeutic methods inthe current coronavirus disease 2019 pandemic. This also applies to clinicalpractice in gastroenterology, which has, in many respects, undergone a recentdigital transformation with numerous consequences that will impact patients andhealth care professionals in the near future. MHAs and MAs are considered tohave great potential, especially for chronic diseases, as they can support the selfmanagementof patients in many ways. Despite the great potential associated withthe application of MHAs and MAs in gastroenterology and health care in general,there are numerous challenges to be met in the future, including both the ethicaland legal aspects of applying this technology. The aim of this article is to providean overview of the current status of MHA and MA use in the field ofgastroenterology, describe the future perspectives in this field and point out someof the challenges that need to be addressed.
基金Supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education,No.RS-2023-00237287。
文摘This study addressed the critical need for an integrated,personalized approach to perimenopausal mental health,addressing both biological and psychosocial fac-tors.Current research highlighted the influence of hormonal fluctuations,genetic predispositions,and lifestyle factors in shaping perimenopausal mental health outcomes.This transitional period is marked by significant hormonal fluctuations contributing to heightened anxiety,depression,and sleep disturbances,affecting the women’s quality of life.Traditional pharmacological treatments,including selective serotonin reuptake inhibitors and hormone replacement therapy,have limitations due to variable efficacy and side effects,emphasizing the need for precision medicine.Advancements in pharmacogenomics and metabolomics provide new avenues for individualized treatments,with genetic markers(e.g.,Solute carrier organic anion transporter family member 1B1,estrogen receptor 1/estrogen receptor 2,and tachykinin receptor 3)guiding hormone therapy resp-onses.Emerging digital health technologies,such as artificial intelligence-driven diagnostics,wearable monitoring,and telehealth platforms,offer scalable,real-time mental health support,though regulatory and clinical validation challenges remain.Furthermore,integrative treatment models combining hormone-based therapy with non-pharmacological interventions demonstrate significant efficacy in alleviating perimenopausal symptoms.Future directions should prioritize the clinical validation and ethical implementation of digital health solutions,ensuring safety,efficacy,and user accessibility.A multidisciplinary,patient-centric model,incorporating genetics,endocrinology,digital health,and psychosocial interventions,is essential for optimizing perimenopausal mental health outcomes.
基金Supported by Mashhad University of Medical Sciences.
文摘AIM:To evaluate the differences in near point of convergence(NPC),fusional vergence,saccadic eye movements,versional eye movements,and heterophoria between patients diagnosed with Parkinson’s disease(PD)and healthy subjects.METHODS:A cross-sectional comparative study was conducted,enrolling two cohorts:a PD group and a healthy control group.The PD group was recruited via non-random convenience sampling,while the control group was selected randomly from individuals without PD.All participants were screened according to predefined inclusion and exclusion criteria before undergoing a comprehensive optometric assessment,which included measurements of uncorrected visual acuity,corrected visual acuity,and objective and subjective refraction.Subsequently,binocular vision function evaluations were performed,covering NPC measurement,fusional vergence reserve assessment at both distance and near,saccadic eye movement testing,and versional eye movement and heterophoria assessment.RESULTS:A total of 42 PD patients and 41 healthy controls were included in the final analysis.The two groups were well-matched in terms of sex distribution[29 males(69.0%)in the PD group vs 29 males(70.7%)in the control group,P=0.867]and mean age(55.3±9.6y in the PD group vs 54.9±9.8y in the control group,P=0.866).The prevalence of abnormal versional eye movements was significantly higher in the PD group than in the control group(23.81%,95%CI:12.05%-39.45%vs 7.32%,95%CI:1.54%-19.92%;P=0.025).Near exophoria was more prevalent in PD patients(61.90%,95%CI:45.64%-76.43%)than in controls(17.07%,95%CI:7.15%-32.06%),with a significant difference[odds ratio(OR)=7.99;95%CI:2.83-21.99;P<0.001].The mean NPC was significantly greater(more receded)in the PD group than in the control group(9.01±3.74 cm vs 7.20±2.15 cm;P=0.007).A statistically significant positive correlation was observed between PD severity and NPC values(Pearson’s correlation coefficient=0.309;P=0.046).Except for distance baseout break and distance base-out recovery values,all other fusional vergence parameters were significantly lower in the PD group than in the control group(P<0.05).The mean saccadic test score was significantly lower in PD patients than in controls(3.29±0.57 vs 3.78±0.42;P<0.001).Among all fusional vergence indices,near base-in blur yielded the highest area under the curve(AUC=0.877),with a sensitivity of 69%and specificity of 90%,followed by distance base-out blur(AUC=0.824,sensitivity=97.6%,specificity=66.7%),near base-out blur(AUC=0.814,sensitivity=76.2%,specificity=72.7%),near base-out break(AUC=0.749,sensitivity=78.6%,specificity=67.6%),and near base-out recovery(AUC=0.749,sensitivity=95.2%,specificity=50%).CONCLUSION:PD is associated with significant binocular vision function impairment,with receded NPC and reduced near fusional vergence reserves being the most prominent disorders.These findings highlight the potential value of binocular vision assessment as a non-invasive biomarker for the early detection and clinical monitoring of PD.
文摘This article addresses the important role school health education program can play in reducing youth risky behaviors that lead to incarceration, diseases and fatalities or that impact their academic performance in school. Children growing up are at risks of exposure to different behaviors and common social influences which if unchecked result in unexpected health consequences common among youth in America today. According to US Centers for Disease Control & Prevention, the six leading behaviors that cause death, disability, and social problems among American children are: unintentional injuries and violence, alcohol and drug use, tobacco use, unhealthy diets, inadequate physical activities, and sexual behaviors and diseases. This article shows that school health program: 1) can provide the foundation for children to learn desired healthy behaviors in order to preserve life, 2) protects the future of children and that of the nation, 3) can teach students skills to recognize risky behaviors and resist them, 4) can boost community efforts to achieve desired health behaviors, 5) closes socio-economic gaps that interfere with basic nurturing of children, and 6) finally links local stakeholders as partners in promoting community safety. Through review of literature, the authors found that it costs ($588) daily or (214,620) annually to incarcerate a juvenile and only $75 daily for the cost of individualized community-based services. The cost to New York is over $900,000, yet does not address the causative issues. The authors recommend that schools teach comprehensive school health from kindergarten to grade 12 and employ health educators to support teachers teach health promotion and education.
