In recent years,the prevalence of diabetes in China has increased significantly,and approximately 11.9%of Chinese adults had diabetes in 2020.Moreover,there are several rigorous challenges in diabetes prevention and g...In recent years,the prevalence of diabetes in China has increased significantly,and approximately 11.9%of Chinese adults had diabetes in 2020.Moreover,there are several rigorous challenges in diabetes prevention and glycaemic control,especially at the primary medical care level.In order to guide primary healthcare providers in providing comprehensive and continuous care to affected patients,the Office for Primary Diabetes Care of the National Basic Public Health Service Program and the Chinese Diabetes Society issued national guidelines for the prevention and control of diabetes at the primary care level in 2025.The management objects were adults with type 2 diabetes aged≥18 years.The main contents include basic requirements for management,health management process,diagnosis,screening,evaluation,treatment,recognition and management of acute complications,traditional Chinese medicine,referral and health management and education.展开更多
Background:Social media addiction,one of the behavioural addictions,is a significant predictor of job performance.It has also been posited that individuals whose fundamental requirements(e.g.,sleep)are not sufficientl...Background:Social media addiction,one of the behavioural addictions,is a significant predictor of job performance.It has also been posited that individuals whose fundamental requirements(e.g.,sleep)are not sufficiently met andwho lack adequate support(e.g.,perceived social support)are incapable of effectivelyharnessing theirpotential.The primary objective of this study is to examine themediating effects of sleep disorder and perceived social support on the relationship between social media addiction and job performance.Furthermore,it seeks to explore the moderating effects of perceived social support on sleep disorders and job performance.Methods:The data were collected through the questionnairemethod,and data analysis was performed using SPSS 26.0.Moreover,statistical analysis encompasses correlation analysis,mediation,and moderation analysis.The data were gathered from 488 healthcare professionals(57.2%female),whose ages ranged from 24 to 56 years(Meanage±SD=37.86±6.71),using a convenience sample approach.Results:The results revealed significant relationships between social media addiction,job performance,perceived social support,and sleep disorder.The findings indicate that social media addiction negatively predicts job performance(β=−0.11,p<0.05).Sleep disorder(effect size=−0.02,95%CI=[−0.04,−0.00])and perceived social support(effect size=−0.01,95%CI=[−0.02,−0.00])mediate this relationship.Furthermore,perceived social supportmoderates the pathway between sleep disorder and job performance(index ofmoderatedmediation:−0.0040,95%CI=[−0.0070,−0.0010]).Conclusions:This study suggests that social media addiction negatively affects job performance through sleep disorders and perceived social support among healthcare professionals.The study’s findings are significant,as they suggest that treatments aimed at alleviating sleep disorders and enhancing perceived social support among medical workers may improve their job performance.展开更多
Stroke induces profound neuroinflammation and systemic immune dysregulation,including disturbances in gut homeostasis.Experimental evidence suggests that intestinal barrier permeability(IBP)and bacterial translocation...Stroke induces profound neuroinflammation and systemic immune dysregulation,including disturbances in gut homeostasis.Experimental evidence suggests that intestinal barrier permeability(IBP)and bacterial translocation(BT)critically influence stroke outcomes.However,biological variability among commonly used rodent substrains has received limited attention.In this pilot study,we compared poststroke immune responses in two Wistar rat substrains obtained from different suppliers:RccHan(Envigo)and RjHan(Janvier).Naive animals(n=4)and rats subjected to permanent cerebral ischemia(n=8 per substrain)were evaluated 72 h after middle cerebral artery occlusion and stratified according to the presence or absence of BT.Immune cell populations in blood and bone marrow were analyzed using flow cytometry,and leukocyte infiltration into ischemic brain tissue was quantified using immunohisto-chemistry.Differences were considered statistically significant when p<0.05.Both substrains developed significant infarcts and neurological deficits.RccHan rats exhibited larger infarct volumes and more extensive BT across multiple organs.In contrast,RjHan rats exhibited BT mainly confined to mesenteric lymph nodes but exhibited greater IBP.Although dissemination was broader in RccHan rats,overall bacterial burden was slightly lower compared with RjHan,and extraintestinal bacterial composition differed between groups.Particularly,RjHan rats exhibited stronger systemic and central immune activation,with significant alterations in lymphocyte and monocyte populations and enhanced granulocyte and T-cell infiltration within ischemic lesions.These findings demonstrate that substrain origin profoundly influences poststroke intestinal barrier integrity,bacterial dissemination,and immune responses considering substrain-related variability is essential to improve reproducibility and translational relevance in preclinical stroke research.展开更多
We conducted a review of the peer-reviewed literature focused on conducting community health needs assessments and highlighted the necessary steps to conduct a community health needs assessment in a rural community. F...We conducted a review of the peer-reviewed literature focused on conducting community health needs assessments and highlighted the necessary steps to conduct a community health needs assessment in a rural community. From the literature review, we identified three steps necessary— establishing partnerships, using a mixed methods approach, and disseminating results—to successfully conduct a needs assessment that fitted the definition of the Affordable Care Act. These three steps have been used as a guide for developing a protocol for conducting a community health needs assessment in Meadville, PA. We detail our preliminary project protocol here.展开更多
Unipolar depressive disorder(UDD)affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted...Unipolar depressive disorder(UDD)affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted life years lost in 2030.It is imperative for leading economies to implement preventive strategies targeted towards UDD,given consistent policies are currently lacking.Recently established similarities between the aetiological hypotheses of depression and cardiometabolic diseases are shifting paradigms within this field.It is believed that dietary practices could potentially reduce the incidence of depression;similar to their effects on metabolism.Thus,the aim of this review was to compile current evidence on healthy dietary patterns as suitable contributors towards primary prevention strategies against UDD.Most of the well-known biological mechanisms behind depression have been positively associated with healthful diets and dietary patterns to varying degrees.Interestingly,a common factor of UDD is the production and overall effects of inflammatory cytokines,such as interleukin-6,tumor necrosis factor-α,and Creactive protein.These compounds have been associated with depressive symptoms,disturbances in neuroendocrine function,leaky gut,monoamine activity and brain function,while also being key factors in the development of cardiometabolic diseases.The Mediterranean diet(MD)in particular,is well supported by first-level evidence regarding its preventive qualities against metabolic and cardiovascular diseases and thus considered a model for healthy eating by various organizations.In one of the few clinical trials investigating these associations,the PREDIMED trial,individuals with diabetes assigned to a MD supplemented with mixed tree nuts experienced a 41%relative risk reduction for developing depression.Lastly,there is a need to include health related quality of life as an indicator of physical and mental well-being,considering its putative associations with depression and suicide risk.Going forward,focusing on clinical trials,using precise nutritional assessments,and identifying nutritional biomarkers which may be related to depression are needed to fully support the implementation of dietary recommendations in the field of psychiatry.展开更多
The use of educational technology focused on child health promotion requires theoretical-methodological foundations to support aspects related to the growth and psychomotor development stage, articulating knowledge an...The use of educational technology focused on child health promotion requires theoretical-methodological foundations to support aspects related to the growth and psychomotor development stage, articulating knowledge and healthy habits as early as possible. This article is an integrative review to investigate the educational technologies used in health education actions to promote child health. The databases LILACS, MEDLINE, BDENF, PUBMED, CINAHL, and in the Virtual library Cochrane Library and SciELO were consulted. Thirteen articles were analyzed. The educational technologies have been employed to promote child health promotion actions and have contributed to the achievement of long-lasting results. The actions happen predominantly in the school context and light, light-hard and hard technologies are used. The association between light and hard technology obtained better results.展开更多
Despite many decades of researches and large numbers of clinical trials, there remain no effective treatments for Alzheimer’s disease, a major degenerative ageing brain disorder. The potential treatments have focused...Despite many decades of researches and large numbers of clinical trials, there remain no effective treatments for Alzheimer’s disease, a major degenerative ageing brain disorder. The potential treatments have focused on targeting the accumulation of amyloid beta-peptide in the brains of patients, but without success in slowing the disease. Many studies have now identified a large range of pathological changes (<em>i.e.</em> altered immune activity, mitochondrial impairment, abnormal microbiome), and links to the external environment (<em>i.e.</em> associations with infections, the influence of air pollution). While the concept of One Health (which considers links between the environment and human disease) has traditionally been applied to the understanding of the human infectious disease, it is argued here that the One Health approach should be adopted for Alzheimer’s disease. This would provide a far more holistic understanding of the disease, and its relationship to a growing number of exogenous factors, as well as could potentially lead to new treatment options targeted at the confluence of external influences, and internal molecular pathways.展开更多
Background Mental health problems are prevalent among patients seeking primary healthcare.However,traditional patient interviews often fail to identify and manage these problems.Therefore,an improved patient interview...Background Mental health problems are prevalent among patients seeking primary healthcare.However,traditional patient interviews often fail to identify and manage these problems.Therefore,an improved patient interview process is needed to assess and treat mental health problems in primary care settings.Aims To assess the validity,reliability,sensitivity and specificity of a 5-Step Patient Interview approach for the screening,diagnosis and treatment of mental health problems.Design and setting This study compared a 5-Step Patient Interview approach(AlKhathami approach)with expert psychiatric interviews based on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders,fifth edition,the Patient Health Questionnaire-9(PHQ-9)and the Generalised Anxiety Disorder-7(GAD-7)questionnaire from 1 January 2020 to 30 April 2020 in family practice or primary healthcare centres.Methods A total of 760 participants from five Saudi Arabian regions were selected using a multiclustered random sample of every third patient aged≥18 years,drawn from the clinics’patient list.Results A total of 732 patients agreed to participate,with a response rate of 96.3%;396(54.1%)were women;the mean(Standard Deviation)age was 41.28(14.30)years(ranging from 18 to 84 years).Mental health problems were suspected in 40%of the participants.The 5-Step Patient Interview approach was shown to be comparable to an expert interview by a psychiatrist.Moreover,it was more accurate than the PHQ-9 and GAD-7 self-administered questionnaires in screening for stress and classifying it as mild,moderate to severe or severe.Additionally,the 5-Step Patient Interview approach improved physician-patient communication by encouraging the exploration of patients’perspectives.Conclusions The 5-Step Patient Interview approach is a valid,reliable tool that can aid the integration of mental healthcare into primary healthcare and family practice.Future studies should evaluate the implementation outcomes of the 5-Step Patient Interview approach.展开更多
Cardiovascular disease remains a leading cause of morbidity and mortality,a fact that is commonly associated with co-morbidities such as clinical depression.While phase II cardiac rehabilitation is an established inte...Cardiovascular disease remains a leading cause of morbidity and mortality,a fact that is commonly associated with co-morbidities such as clinical depression.While phase II cardiac rehabilitation is an established intervention for those with cardiovascular disease,its effect on patients who also suffer from depression are under studied.Aim:To quantify Pre-and Post-cardiac rehabilitation questionnaire scores collected from a large patient data registry.For this investigation,27670 patients completed Patient Health Questionnaire-9 questionnaires both Pre-and Post-rehabilitation(averaging[28.08.7]phase II sessions).Findings reveal that questionnaire scores decreased by 40%–48%across all groups,a finding that was independent of assigned sex,race,and ethnicity.Moreover,when data were stratified for questionnaire scores that may indicate major and minor depressive disorder,phase II cardiac rehabilitation outcomes were lower by 61%and 49%respectively.While all groups exhibited lower questionnaire scores following cardiac rehabilitation participation,numerical differences at Preand Post-rehabilitation time points indicate that males and White patients have more favorable scores.This latter observation,while not confirmed currently,appears to be linked to referral rates to phase II cardiac rehabilitation,which remain poor for females,racial and ethnic minorities.展开更多
<strong>Background: </strong>The Sustainable Development Goals commitment to Ending HIV/AIDS by 2030 requires sustained adequate investment. This study sought to examine the association between HIV/AIDS sp...<strong>Background: </strong>The Sustainable Development Goals commitment to Ending HIV/AIDS by 2030 requires sustained adequate investment. This study sought to examine the association between HIV/AIDS spending and outcomes in Thailand between 2008 and 2019. <strong>Methods: </strong>A quantitative secondary data analysis with time-series was conducted using a retrospective dataset of HIV spending and some selected outcomes including the number of people living with HIV (PLHIV), incidence and prevalence of HIV/AIDS, the prevention of mother-to-child transmission (PMTCT) and AIDS-related deaths. Data were obtained from a diverse set of sources. Descriptive statistics and univariate regression model were used to analyze HIV expenditure and outcomes. <strong>Results: </strong>HIV spending per PLHIV rose by two folds from $347 in 2008 to more than $600 in 2019, mostly financed by domestic sources. This increase of domestic resources per PLHIV was significantly associated with better HIV-related outcomes especially in the reduction of PLHIV and AIDS-related deaths through increased number of people receiving antiretroviral therapy (ART). However, the spending per PLHIV varied across the three public health insurance schemes. Comparison of HIV expenditure and health outcomes across upper-middle-income countries shows Thailand is not highly ranked in terms of spending efficiency despite having made good progress. <strong>Conclusion: </strong>Domestic financing for HIV programs is indispensable for achieving the goal of ending AIDS. Despite significant improvement in HIV-related outcomes, challenges remain in achieving the 90-90-90 goal. The redesigning of payment methods should be considered to increase the efficiency of HIV financing. Other factors related to strengthening the health system should not be overlooked.展开更多
Background: Ethiopia is one of the countries with the highest Human Immune-deficiency Virus (HIV) and Tuberculosis (TB) infection rates in the world. To improve TB/HIV Programs outcomes through Public Private Partners...Background: Ethiopia is one of the countries with the highest Human Immune-deficiency Virus (HIV) and Tuberculosis (TB) infection rates in the world. To improve TB/HIV Programs outcomes through Public Private Partnership Mix (PPM) approach was in place since 2006. But the status of its implementation has never been assessed. Methods: In this cross sectional study we employed mixed methods;we interviewed 272 tuberculosis patients, reviewed their records, and facilitated six in-depth interviews and four focus group discussions. The survey was conducted from January through March 2014 in Addis Ababa. Result: Among the interviewees 51.5% were males and the mean age was (32.7 ± SD 12.4) years. PPM facilities were offering HIV counseling for all TB patients;whereas 87.5% of TB patients have received HIV testing services. The TB/HIV co-infection rate was 45.4%. And only 72.2% TB/HIV patients were enrolled into chronic disease care services, 64.8% were put on Cotrimoxazol Preventive Therapy (CPT) and 50% were put on standard highly active anti-retro viral therapy (HAART) services. All PPM facilities don’t have IPT (Isoniazid Prophylaxis Therapy). The TB/HIV collaborative services strongly linked with the public health sector which was documented by developing inclusive work plan which create access to supplies and conducting joint supportive supervisions. However, the majorities of PPM facilities don’t have Multi-Disciplinary Team and lacks some essential supplies. The predictor for uptake of CPT were: being females TB patients was 86% lower than their counter part males (AOR = 0.14;95% CI = 0.04 - 0.92 P = 0.002), patients who has attended their TB/HIV care at private for the profit facilities were 84% lower than those attend in private not for profit facilities (AOR = 0.16;95% CI = 0.49 - 0.55, P = 0.003). Conclusions: The TB/HIV collaborative services at program level are stronger but only half of patients didn’t get the comprehensive TB/HIV collaborative services to achieve recommended quality of care. Strengthening the services and ensuring the availability of essential supplies was highly recommended.展开更多
Introduction: The authors wanted to study the prevalence of ocular trauma in the ophthalmology unit of the CSREF of Kati. Patients and method: This is a retrospective study, covering the period from January to Decembe...Introduction: The authors wanted to study the prevalence of ocular trauma in the ophthalmology unit of the CSREF of Kati. Patients and method: This is a retrospective study, covering the period from January to December 2015, carried out in the ophthalmology unit of the CSREF in Kati. Results: The sample consisted of 568 patients, or 6.82% of ophthalmological consultations. Children aged 0 to 14 years accounted for 154 (27.11%) of the trauma cases. Bruises constitute the main circumstance (58.1%) of eye trauma, followed by domestic accidents (15.6%). Closed globe ocular trauma was the main type of trauma (61.6%), followed by ocular adnexal trauma (30.1%) and open globe trauma (8.3%) in which the penetrating wound was the lesion, the least common (2.6%) but the most serious. Medical treatment was the most used therapeutic modality in 82.4% of cases, followed by surgery with 17.6% of cases. The evolution of the lesions after treatment was favorable in 85.6% of cases and unfavorable in 14.4% of cases. Complications were observed in 5.8% of cases and sequelae in 8.6% of cases. Conclusion: Ocular trauma constitutes an important reason for ophthalmological consultation at the CSREF of Kati. The severity of some of these lesions requires frequent recourse to surgery. The complexity of the treatment should encourage us to favor preventive measures.展开更多
Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national ...Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national challenges with poor viral suppression. The OTZ program aligns with the UNAIDS 95-95-95 goals. It seeks to empower AYPLHIV to be in charge of their treatment and commit to triple zero outcomeszero missed appointments, zero missed drugs, and zero viral loads. The purpose of the study was to assess the impact of the OTZ program on viral load suppression among members of the adolescent club in 68 NARHY, Lagos. Method: A cross-sectional retrospective study to evaluate the impact of the OTZ program on the viral load of 53 AYP enrolled in the OTZ program between March 2019 to December 2019 was analyzed. The Percentage of viral load suppression before enrollment compared with 6 and 12 months after enrollment into the OTZ program. The AYP is grouped into 10 - 14, 15 - 19, and 20 - 24 years. Activities conducted were peer driven monthly meetings with the AYP during which the adolescents interacted on issues relating to improving their treatment outcomes, healthcare workers reviewed their clinical status, viral load result, provider peer counseling, and caregivers engagement to support adherence to medication and ARV refills. Results: Before OTZ, 81% aged 10 - 14 years, 75% aged 15 - 19 years, and 25% aged 20 - 24 years were virally suppressed (VL less than 1000 copies/ml). Six months after enrollment, 94% were virally suppressed95% aged 10 - 14 years, 96% aged 15 - 19 years, and 66% aged 20-24 years. Twelve months after enrollment, 96% of AYP were virally suppressed100% aged 10-14 years, 93% aged 15 - 19 years, and 100% aged 20 - 24 years. Males viral load (VL) suppression improved from 79% to 96% and 92%, while females VL suppression improved from 69% to 93% and 100% at 6 and 12 months respectively. Conclusion: The OTZ activities contributed to improved viral load suppression in the AYP of the facility.展开更多
Autism is a neurodevelopmental condition with associated difficulties that present differently across individuals.One such difficulty is recognizing basic and complex facial expressions.Research has previously found t...Autism is a neurodevelopmental condition with associated difficulties that present differently across individuals.One such difficulty is recognizing basic and complex facial expressions.Research has previously found that there are many evidence-based support programs available for building non-verbal communication skills.These programs are frequently administered with a therapist or in a group setting,making them inflexible in nature.Programs hosted on e-technology are becoming increasingly popular,with many parents supportive of them.Applications(apps)that are hosted on technology such as iPads or mobile phones allow users to engage in building skills in real-time social settings and own what they are learning.These technologies are frequently used by autistic children,with apps typically focusing on identifying facial features.Yet at this current time,there are mixed reviews of how to design such programs and what their theoretical backing is,with many studies using a mix of observation and psychological assessments as outcome measures.Eye-tracking and electroencephalography are established methodologies that measure neural processing and gaze behaviors while viewing faces.To better support the field moving forward,objective measures such as these are a way to measure outcomes of apps that are designed for helping children on the spectrum build skills in understanding facial expressions.展开更多
The horticultural sector has undergone tremendous growth in Kenya and is now the second largest foreign income earning sector in the country. Lake Naivasha is the hub of large scale horticultural farming in Kenya. Thi...The horticultural sector has undergone tremendous growth in Kenya and is now the second largest foreign income earning sector in the country. Lake Naivasha is the hub of large scale horticultural farming in Kenya. This growth coupled with increased use of pesticides, may increase the possibility of pesticide exposure and its associated risks to workers and residents of the region. The purpose of this study was to assess the symptoms commonly experienced by residents of Naivasha town and their possible association to pesticide exposure. Purposive sampling of residents from Kamere, Kwa Muia, Kioto and Karagita was performed, as these residential areas have significant numbers of flower farm workers. By random selection, a total of 801 community members were recruited to participate in the study and data was collected by completing the prepared questionnaire and from clinical examinations. Results indicate that several residents exhibited respiratory;skin, joints and bones;and nervous system symptoms. We found a higher frequency of symptoms among planters, weeders, harvesters than in sprayers working in horticultural farms. We recommend training to planters, weeders, harvesters who are mainly women (61.6%) in this study concerning pesticide use as do sprayers;and second, longer reentry times between the last spraying of pesticide and entry of these workers is warranted, particularly in greenhouses. In this regard, reentry times for greenhouses and fields established for specific pesticides in Europe, North America, Japan or Australia should be adapted by Kenya, and these guidelines enforced by the Government of Kenya to reduce exposure to pesticides within this vulnerable work group. These workers should also use protective clothing including gloves and masks at all times while handling chemicals or recently sprayed plants or flowers. It would also be prudent for flower farm owners to introduce an integrated pest management regime to reduce pesticide use andworker exposures. Further research is required both to identify validated biomarkers that can reliably be used to identify pesticide exposure prior to the occurrence of acute toxicity;and to follow up individual cases of known exposures for chronic health effects.展开更多
Axonal regeneration following surgical nerve repair is slow and often incomplete,resulting in poor functional recovery which sometimes contributes to lifelong disability.Currently,there are no FDA-approved therapies a...Axonal regeneration following surgical nerve repair is slow and often incomplete,resulting in poor functional recovery which sometimes contributes to lifelong disability.Currently,there are no FDA-approved therapies available to promote nerve regeneration.Tacrolimus accelerates axonal regeneration,but systemic side effects presently outweigh its potential benefits for peripheral nerve surgery.The authors describe herein a biodegradable polyurethane-based drug delivery system for the sustained local release of tacrolimus at the nerve repair site,with suitable properties for scalable production and clinical application,aiming to promote nerve regeneration and functional recovery with minimal systemic drug exposure.Tacrolimus is encapsulated into co-axially electrospun polycarbonate-urethane nanofibers to generate an implantable nerve wrap that releases therapeutic doses of bioactive tacrolimus over 31 days.Size and drug loading are adjustable for applications in small and large caliber nerves,and the wrap degrades within 120 days into biocompatible byproducts.Tacrolimus released from the nerve wrap promotes axon elongation in vitro and accelerates nerve regeneration and functional recovery in preclinical nerve repair models while off-target systemic drug exposure is reduced by 80%compared with systemic delivery.Given its surgical suitability and preclinical efficacy and safety,this system may provide a readily translatable approach to support axonal regeneration and recovery in patients undergoing nerve surgery.展开更多
基金funded by the Noncommunicable Chronic Diseases-National Science and Technology Major Project(2024ZD0523300)the National Key Clinical Specialty Capacity Building for Endocrine and Metabolic Diseases(Z155080000004)+1 种基金the Shanghai Key Laboratory of Diabetes Mellitus(20DZ2270300)the Sanming Project of Medicine in Shenzhen(SZSM202311019).
文摘In recent years,the prevalence of diabetes in China has increased significantly,and approximately 11.9%of Chinese adults had diabetes in 2020.Moreover,there are several rigorous challenges in diabetes prevention and glycaemic control,especially at the primary medical care level.In order to guide primary healthcare providers in providing comprehensive and continuous care to affected patients,the Office for Primary Diabetes Care of the National Basic Public Health Service Program and the Chinese Diabetes Society issued national guidelines for the prevention and control of diabetes at the primary care level in 2025.The management objects were adults with type 2 diabetes aged≥18 years.The main contents include basic requirements for management,health management process,diagnosis,screening,evaluation,treatment,recognition and management of acute complications,traditional Chinese medicine,referral and health management and education.
文摘Background:Social media addiction,one of the behavioural addictions,is a significant predictor of job performance.It has also been posited that individuals whose fundamental requirements(e.g.,sleep)are not sufficiently met andwho lack adequate support(e.g.,perceived social support)are incapable of effectivelyharnessing theirpotential.The primary objective of this study is to examine themediating effects of sleep disorder and perceived social support on the relationship between social media addiction and job performance.Furthermore,it seeks to explore the moderating effects of perceived social support on sleep disorders and job performance.Methods:The data were collected through the questionnairemethod,and data analysis was performed using SPSS 26.0.Moreover,statistical analysis encompasses correlation analysis,mediation,and moderation analysis.The data were gathered from 488 healthcare professionals(57.2%female),whose ages ranged from 24 to 56 years(Meanage±SD=37.86±6.71),using a convenience sample approach.Results:The results revealed significant relationships between social media addiction,job performance,perceived social support,and sleep disorder.The findings indicate that social media addiction negatively predicts job performance(β=−0.11,p<0.05).Sleep disorder(effect size=−0.02,95%CI=[−0.04,−0.00])and perceived social support(effect size=−0.01,95%CI=[−0.02,−0.00])mediate this relationship.Furthermore,perceived social supportmoderates the pathway between sleep disorder and job performance(index ofmoderatedmediation:−0.0040,95%CI=[−0.0070,−0.0010]).Conclusions:This study suggests that social media addiction negatively affects job performance through sleep disorders and perceived social support among healthcare professionals.The study’s findings are significant,as they suggest that treatments aimed at alleviating sleep disorders and enhancing perceived social support among medical workers may improve their job performance.
基金Leducq Trans-Atlantic Network of Excellence,Grant/Award Number:TNE-21CVD04Spanish Ministry of Science and Innovation,Grant/Award Number:PID2020-117765RB-I00 and PID2022-140616OB-I00+1 种基金Instituto de Salud Carlos III,European Development Regional Fund,RICORS-ICTUS Grant/Award Number:RD21/0006/0001the FORTALECE program.Grant/Award Number:FORT23/00023。
文摘Stroke induces profound neuroinflammation and systemic immune dysregulation,including disturbances in gut homeostasis.Experimental evidence suggests that intestinal barrier permeability(IBP)and bacterial translocation(BT)critically influence stroke outcomes.However,biological variability among commonly used rodent substrains has received limited attention.In this pilot study,we compared poststroke immune responses in two Wistar rat substrains obtained from different suppliers:RccHan(Envigo)and RjHan(Janvier).Naive animals(n=4)and rats subjected to permanent cerebral ischemia(n=8 per substrain)were evaluated 72 h after middle cerebral artery occlusion and stratified according to the presence or absence of BT.Immune cell populations in blood and bone marrow were analyzed using flow cytometry,and leukocyte infiltration into ischemic brain tissue was quantified using immunohisto-chemistry.Differences were considered statistically significant when p<0.05.Both substrains developed significant infarcts and neurological deficits.RccHan rats exhibited larger infarct volumes and more extensive BT across multiple organs.In contrast,RjHan rats exhibited BT mainly confined to mesenteric lymph nodes but exhibited greater IBP.Although dissemination was broader in RccHan rats,overall bacterial burden was slightly lower compared with RjHan,and extraintestinal bacterial composition differed between groups.Particularly,RjHan rats exhibited stronger systemic and central immune activation,with significant alterations in lymphocyte and monocyte populations and enhanced granulocyte and T-cell infiltration within ischemic lesions.These findings demonstrate that substrain origin profoundly influences poststroke intestinal barrier integrity,bacterial dissemination,and immune responses considering substrain-related variability is essential to improve reproducibility and translational relevance in preclinical stroke research.
文摘We conducted a review of the peer-reviewed literature focused on conducting community health needs assessments and highlighted the necessary steps to conduct a community health needs assessment in a rural community. From the literature review, we identified three steps necessary— establishing partnerships, using a mixed methods approach, and disseminating results—to successfully conduct a needs assessment that fitted the definition of the Affordable Care Act. These three steps have been used as a guide for developing a protocol for conducting a community health needs assessment in Meadville, PA. We detail our preliminary project protocol here.
文摘Unipolar depressive disorder(UDD)affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted life years lost in 2030.It is imperative for leading economies to implement preventive strategies targeted towards UDD,given consistent policies are currently lacking.Recently established similarities between the aetiological hypotheses of depression and cardiometabolic diseases are shifting paradigms within this field.It is believed that dietary practices could potentially reduce the incidence of depression;similar to their effects on metabolism.Thus,the aim of this review was to compile current evidence on healthy dietary patterns as suitable contributors towards primary prevention strategies against UDD.Most of the well-known biological mechanisms behind depression have been positively associated with healthful diets and dietary patterns to varying degrees.Interestingly,a common factor of UDD is the production and overall effects of inflammatory cytokines,such as interleukin-6,tumor necrosis factor-α,and Creactive protein.These compounds have been associated with depressive symptoms,disturbances in neuroendocrine function,leaky gut,monoamine activity and brain function,while also being key factors in the development of cardiometabolic diseases.The Mediterranean diet(MD)in particular,is well supported by first-level evidence regarding its preventive qualities against metabolic and cardiovascular diseases and thus considered a model for healthy eating by various organizations.In one of the few clinical trials investigating these associations,the PREDIMED trial,individuals with diabetes assigned to a MD supplemented with mixed tree nuts experienced a 41%relative risk reduction for developing depression.Lastly,there is a need to include health related quality of life as an indicator of physical and mental well-being,considering its putative associations with depression and suicide risk.Going forward,focusing on clinical trials,using precise nutritional assessments,and identifying nutritional biomarkers which may be related to depression are needed to fully support the implementation of dietary recommendations in the field of psychiatry.
文摘The use of educational technology focused on child health promotion requires theoretical-methodological foundations to support aspects related to the growth and psychomotor development stage, articulating knowledge and healthy habits as early as possible. This article is an integrative review to investigate the educational technologies used in health education actions to promote child health. The databases LILACS, MEDLINE, BDENF, PUBMED, CINAHL, and in the Virtual library Cochrane Library and SciELO were consulted. Thirteen articles were analyzed. The educational technologies have been employed to promote child health promotion actions and have contributed to the achievement of long-lasting results. The actions happen predominantly in the school context and light, light-hard and hard technologies are used. The association between light and hard technology obtained better results.
文摘Despite many decades of researches and large numbers of clinical trials, there remain no effective treatments for Alzheimer’s disease, a major degenerative ageing brain disorder. The potential treatments have focused on targeting the accumulation of amyloid beta-peptide in the brains of patients, but without success in slowing the disease. Many studies have now identified a large range of pathological changes (<em>i.e.</em> altered immune activity, mitochondrial impairment, abnormal microbiome), and links to the external environment (<em>i.e.</em> associations with infections, the influence of air pollution). While the concept of One Health (which considers links between the environment and human disease) has traditionally been applied to the understanding of the human infectious disease, it is argued here that the One Health approach should be adopted for Alzheimer’s disease. This would provide a far more holistic understanding of the disease, and its relationship to a growing number of exogenous factors, as well as could potentially lead to new treatment options targeted at the confluence of external influences, and internal molecular pathways.
文摘Background Mental health problems are prevalent among patients seeking primary healthcare.However,traditional patient interviews often fail to identify and manage these problems.Therefore,an improved patient interview process is needed to assess and treat mental health problems in primary care settings.Aims To assess the validity,reliability,sensitivity and specificity of a 5-Step Patient Interview approach for the screening,diagnosis and treatment of mental health problems.Design and setting This study compared a 5-Step Patient Interview approach(AlKhathami approach)with expert psychiatric interviews based on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders,fifth edition,the Patient Health Questionnaire-9(PHQ-9)and the Generalised Anxiety Disorder-7(GAD-7)questionnaire from 1 January 2020 to 30 April 2020 in family practice or primary healthcare centres.Methods A total of 760 participants from five Saudi Arabian regions were selected using a multiclustered random sample of every third patient aged≥18 years,drawn from the clinics’patient list.Results A total of 732 patients agreed to participate,with a response rate of 96.3%;396(54.1%)were women;the mean(Standard Deviation)age was 41.28(14.30)years(ranging from 18 to 84 years).Mental health problems were suspected in 40%of the participants.The 5-Step Patient Interview approach was shown to be comparable to an expert interview by a psychiatrist.Moreover,it was more accurate than the PHQ-9 and GAD-7 self-administered questionnaires in screening for stress and classifying it as mild,moderate to severe or severe.Additionally,the 5-Step Patient Interview approach improved physician-patient communication by encouraging the exploration of patients’perspectives.Conclusions The 5-Step Patient Interview approach is a valid,reliable tool that can aid the integration of mental healthcare into primary healthcare and family practice.Future studies should evaluate the implementation outcomes of the 5-Step Patient Interview approach.
文摘Cardiovascular disease remains a leading cause of morbidity and mortality,a fact that is commonly associated with co-morbidities such as clinical depression.While phase II cardiac rehabilitation is an established intervention for those with cardiovascular disease,its effect on patients who also suffer from depression are under studied.Aim:To quantify Pre-and Post-cardiac rehabilitation questionnaire scores collected from a large patient data registry.For this investigation,27670 patients completed Patient Health Questionnaire-9 questionnaires both Pre-and Post-rehabilitation(averaging[28.08.7]phase II sessions).Findings reveal that questionnaire scores decreased by 40%–48%across all groups,a finding that was independent of assigned sex,race,and ethnicity.Moreover,when data were stratified for questionnaire scores that may indicate major and minor depressive disorder,phase II cardiac rehabilitation outcomes were lower by 61%and 49%respectively.While all groups exhibited lower questionnaire scores following cardiac rehabilitation participation,numerical differences at Preand Post-rehabilitation time points indicate that males and White patients have more favorable scores.This latter observation,while not confirmed currently,appears to be linked to referral rates to phase II cardiac rehabilitation,which remain poor for females,racial and ethnic minorities.
文摘<strong>Background: </strong>The Sustainable Development Goals commitment to Ending HIV/AIDS by 2030 requires sustained adequate investment. This study sought to examine the association between HIV/AIDS spending and outcomes in Thailand between 2008 and 2019. <strong>Methods: </strong>A quantitative secondary data analysis with time-series was conducted using a retrospective dataset of HIV spending and some selected outcomes including the number of people living with HIV (PLHIV), incidence and prevalence of HIV/AIDS, the prevention of mother-to-child transmission (PMTCT) and AIDS-related deaths. Data were obtained from a diverse set of sources. Descriptive statistics and univariate regression model were used to analyze HIV expenditure and outcomes. <strong>Results: </strong>HIV spending per PLHIV rose by two folds from $347 in 2008 to more than $600 in 2019, mostly financed by domestic sources. This increase of domestic resources per PLHIV was significantly associated with better HIV-related outcomes especially in the reduction of PLHIV and AIDS-related deaths through increased number of people receiving antiretroviral therapy (ART). However, the spending per PLHIV varied across the three public health insurance schemes. Comparison of HIV expenditure and health outcomes across upper-middle-income countries shows Thailand is not highly ranked in terms of spending efficiency despite having made good progress. <strong>Conclusion: </strong>Domestic financing for HIV programs is indispensable for achieving the goal of ending AIDS. Despite significant improvement in HIV-related outcomes, challenges remain in achieving the 90-90-90 goal. The redesigning of payment methods should be considered to increase the efficiency of HIV financing. Other factors related to strengthening the health system should not be overlooked.
文摘Background: Ethiopia is one of the countries with the highest Human Immune-deficiency Virus (HIV) and Tuberculosis (TB) infection rates in the world. To improve TB/HIV Programs outcomes through Public Private Partnership Mix (PPM) approach was in place since 2006. But the status of its implementation has never been assessed. Methods: In this cross sectional study we employed mixed methods;we interviewed 272 tuberculosis patients, reviewed their records, and facilitated six in-depth interviews and four focus group discussions. The survey was conducted from January through March 2014 in Addis Ababa. Result: Among the interviewees 51.5% were males and the mean age was (32.7 ± SD 12.4) years. PPM facilities were offering HIV counseling for all TB patients;whereas 87.5% of TB patients have received HIV testing services. The TB/HIV co-infection rate was 45.4%. And only 72.2% TB/HIV patients were enrolled into chronic disease care services, 64.8% were put on Cotrimoxazol Preventive Therapy (CPT) and 50% were put on standard highly active anti-retro viral therapy (HAART) services. All PPM facilities don’t have IPT (Isoniazid Prophylaxis Therapy). The TB/HIV collaborative services strongly linked with the public health sector which was documented by developing inclusive work plan which create access to supplies and conducting joint supportive supervisions. However, the majorities of PPM facilities don’t have Multi-Disciplinary Team and lacks some essential supplies. The predictor for uptake of CPT were: being females TB patients was 86% lower than their counter part males (AOR = 0.14;95% CI = 0.04 - 0.92 P = 0.002), patients who has attended their TB/HIV care at private for the profit facilities were 84% lower than those attend in private not for profit facilities (AOR = 0.16;95% CI = 0.49 - 0.55, P = 0.003). Conclusions: The TB/HIV collaborative services at program level are stronger but only half of patients didn’t get the comprehensive TB/HIV collaborative services to achieve recommended quality of care. Strengthening the services and ensuring the availability of essential supplies was highly recommended.
文摘Introduction: The authors wanted to study the prevalence of ocular trauma in the ophthalmology unit of the CSREF of Kati. Patients and method: This is a retrospective study, covering the period from January to December 2015, carried out in the ophthalmology unit of the CSREF in Kati. Results: The sample consisted of 568 patients, or 6.82% of ophthalmological consultations. Children aged 0 to 14 years accounted for 154 (27.11%) of the trauma cases. Bruises constitute the main circumstance (58.1%) of eye trauma, followed by domestic accidents (15.6%). Closed globe ocular trauma was the main type of trauma (61.6%), followed by ocular adnexal trauma (30.1%) and open globe trauma (8.3%) in which the penetrating wound was the lesion, the least common (2.6%) but the most serious. Medical treatment was the most used therapeutic modality in 82.4% of cases, followed by surgery with 17.6% of cases. The evolution of the lesions after treatment was favorable in 85.6% of cases and unfavorable in 14.4% of cases. Complications were observed in 5.8% of cases and sequelae in 8.6% of cases. Conclusion: Ocular trauma constitutes an important reason for ophthalmological consultation at the CSREF of Kati. The severity of some of these lesions requires frequent recourse to surgery. The complexity of the treatment should encourage us to favor preventive measures.
文摘Background: In Nigeria, adolescents and young people (AYP) aged 10 - 24, comprise 22.3% of the population and with HIV prevalence of 3.5%. The AYP living with HIV enrolled at the 68 NARHY, Lagos reflects the national challenges with poor viral suppression. The OTZ program aligns with the UNAIDS 95-95-95 goals. It seeks to empower AYPLHIV to be in charge of their treatment and commit to triple zero outcomeszero missed appointments, zero missed drugs, and zero viral loads. The purpose of the study was to assess the impact of the OTZ program on viral load suppression among members of the adolescent club in 68 NARHY, Lagos. Method: A cross-sectional retrospective study to evaluate the impact of the OTZ program on the viral load of 53 AYP enrolled in the OTZ program between March 2019 to December 2019 was analyzed. The Percentage of viral load suppression before enrollment compared with 6 and 12 months after enrollment into the OTZ program. The AYP is grouped into 10 - 14, 15 - 19, and 20 - 24 years. Activities conducted were peer driven monthly meetings with the AYP during which the adolescents interacted on issues relating to improving their treatment outcomes, healthcare workers reviewed their clinical status, viral load result, provider peer counseling, and caregivers engagement to support adherence to medication and ARV refills. Results: Before OTZ, 81% aged 10 - 14 years, 75% aged 15 - 19 years, and 25% aged 20 - 24 years were virally suppressed (VL less than 1000 copies/ml). Six months after enrollment, 94% were virally suppressed95% aged 10 - 14 years, 96% aged 15 - 19 years, and 66% aged 20-24 years. Twelve months after enrollment, 96% of AYP were virally suppressed100% aged 10-14 years, 93% aged 15 - 19 years, and 100% aged 20 - 24 years. Males viral load (VL) suppression improved from 79% to 96% and 92%, while females VL suppression improved from 69% to 93% and 100% at 6 and 12 months respectively. Conclusion: The OTZ activities contributed to improved viral load suppression in the AYP of the facility.
基金Hunter Medical Research Institute(Happy,Healthy Kids),No.G1801008an Australian Government Research Training Program Fee Offset and Scholarship.
文摘Autism is a neurodevelopmental condition with associated difficulties that present differently across individuals.One such difficulty is recognizing basic and complex facial expressions.Research has previously found that there are many evidence-based support programs available for building non-verbal communication skills.These programs are frequently administered with a therapist or in a group setting,making them inflexible in nature.Programs hosted on e-technology are becoming increasingly popular,with many parents supportive of them.Applications(apps)that are hosted on technology such as iPads or mobile phones allow users to engage in building skills in real-time social settings and own what they are learning.These technologies are frequently used by autistic children,with apps typically focusing on identifying facial features.Yet at this current time,there are mixed reviews of how to design such programs and what their theoretical backing is,with many studies using a mix of observation and psychological assessments as outcome measures.Eye-tracking and electroencephalography are established methodologies that measure neural processing and gaze behaviors while viewing faces.To better support the field moving forward,objective measures such as these are a way to measure outcomes of apps that are designed for helping children on the spectrum build skills in understanding facial expressions.
文摘The horticultural sector has undergone tremendous growth in Kenya and is now the second largest foreign income earning sector in the country. Lake Naivasha is the hub of large scale horticultural farming in Kenya. This growth coupled with increased use of pesticides, may increase the possibility of pesticide exposure and its associated risks to workers and residents of the region. The purpose of this study was to assess the symptoms commonly experienced by residents of Naivasha town and their possible association to pesticide exposure. Purposive sampling of residents from Kamere, Kwa Muia, Kioto and Karagita was performed, as these residential areas have significant numbers of flower farm workers. By random selection, a total of 801 community members were recruited to participate in the study and data was collected by completing the prepared questionnaire and from clinical examinations. Results indicate that several residents exhibited respiratory;skin, joints and bones;and nervous system symptoms. We found a higher frequency of symptoms among planters, weeders, harvesters than in sprayers working in horticultural farms. We recommend training to planters, weeders, harvesters who are mainly women (61.6%) in this study concerning pesticide use as do sprayers;and second, longer reentry times between the last spraying of pesticide and entry of these workers is warranted, particularly in greenhouses. In this regard, reentry times for greenhouses and fields established for specific pesticides in Europe, North America, Japan or Australia should be adapted by Kenya, and these guidelines enforced by the Government of Kenya to reduce exposure to pesticides within this vulnerable work group. These workers should also use protective clothing including gloves and masks at all times while handling chemicals or recently sprayed plants or flowers. It would also be prudent for flower farm owners to introduce an integrated pest management regime to reduce pesticide use andworker exposures. Further research is required both to identify validated biomarkers that can reliably be used to identify pesticide exposure prior to the occurrence of acute toxicity;and to follow up individual cases of known exposures for chronic health effects.
基金supported by the German Research Foundation(DA 2255/1-1to SCD)+4 种基金a SickKids Research Training Competition(RESTRACOMP)Graduate Scholarship(to KJWS)an Ontario Graduate Scholarship(to KJWS)a grant from Natural Sciences and Engineering Research Council of Canada(NSERC)(to KJWS)a Kickstarter grant from the Institute of Biomedical Engineering(BME)at the University of Toronto(to KJWS)the Abe Frank Fund from the Riley’s Children Foundation(GHB)。
文摘Axonal regeneration following surgical nerve repair is slow and often incomplete,resulting in poor functional recovery which sometimes contributes to lifelong disability.Currently,there are no FDA-approved therapies available to promote nerve regeneration.Tacrolimus accelerates axonal regeneration,but systemic side effects presently outweigh its potential benefits for peripheral nerve surgery.The authors describe herein a biodegradable polyurethane-based drug delivery system for the sustained local release of tacrolimus at the nerve repair site,with suitable properties for scalable production and clinical application,aiming to promote nerve regeneration and functional recovery with minimal systemic drug exposure.Tacrolimus is encapsulated into co-axially electrospun polycarbonate-urethane nanofibers to generate an implantable nerve wrap that releases therapeutic doses of bioactive tacrolimus over 31 days.Size and drug loading are adjustable for applications in small and large caliber nerves,and the wrap degrades within 120 days into biocompatible byproducts.Tacrolimus released from the nerve wrap promotes axon elongation in vitro and accelerates nerve regeneration and functional recovery in preclinical nerve repair models while off-target systemic drug exposure is reduced by 80%compared with systemic delivery.Given its surgical suitability and preclinical efficacy and safety,this system may provide a readily translatable approach to support axonal regeneration and recovery in patients undergoing nerve surgery.
