形象化健康教育联合护理干预在慢阻肺患者中的应用

目的探讨形象化健康教育联合护理干预在慢阻肺患者中的应用效果。方法选取2019年2月至2020年1月我院收治的93例慢阻肺患者,依据干预方式的不同分为两组。对照组46例采用护理干预,观察组47例在对照组基础上采用形象化健康教育。比较两组干预前后的肺通气功能及自我护理能力。结果干预前,两组的FEV1、FEV1%水平及自我护理能力评分比较,差异无统计学意义(P>0.05);干预后,两组的FEV1、FEV1%水平及自我护理能力评分均显著高于干预前,且观察组的各指标均显著高于对照组(P<0.05)。结论形象化健康教育联合护理干预能够有效改善慢阻肺患者的肺通气功能,提高其自我护理能力。     

长效可逆避孕措施在人工流产后即刻实施的效果评价

目的探究长效可逆避孕措施在人工流产后即刻实施的效果。方法从2017年7月-2018年7月,抽选在广州市增城区妇幼保健院行人工流产女性1200例,按照随机数字表法分为常规组(612例)和强化干预组(588例)。常规组给予常规流产后关爱(PAC)服务,强化干预组在常规PAC服务的基础上采用长效可逆避孕措施。对比两组长效可逆避孕措施使用情况、重复人工流产率以及避孕措施的持续时间情况。结果强化干预组的高效避孕措施使用率比常规组更高,同时重复人工流产率比常规组低,差异有统计学意义(P<0.05);强化干预组长效可逆避孕措施LARC(IUS/IUD)避孕术后6个月、1年使用率明显高于常规组,差异有统计学意义(P<0.05);复方口服避孕药优思悦(COC)避孕术后3个月、6个月、1年的使用率比常规组高,差异有统计学意义(P<0.05)。结论人工流产后即刻实施长效可逆避孕措施,可提升高效避孕措施的使用率,减少意外妊娠及再次人工流产的几率,值得推广。     

不同浓度地佐辛联合丙泊酚麻醉对无痛肠镜患者的临床研究

目的研究分析不同浓度地佐辛加丙泊酚麻醉对行无痛肠镜治疗患者苏醒质量的影响。方法选择2019年1月—2020年1月于我院行无痛肠镜治疗的80例患者为本次研究对象,将其按照随机分组的方式分为甲组和乙组,各40例,甲组予以0.05 mg/kg地佐辛+丙泊酚麻醉,乙组予以0.1 mg/kg地佐辛+丙泊酚麻醉,观察两组丙泊酚用量、苏醒时间和术中不良反应发生情况,并对数据进行分析统计。结果乙组丙泊酚用量低于甲组,且乙组苏醒时间短于甲组,差异具有统计学意义(P<0.05),乙组术中不良反应发生率为7.50%低于甲组25.00%,差异具有统计学意义(P<0.05)。结论地佐辛联合丙泊酚在无痛肠镜治疗患者的麻醉中效果显著,但0.1 mg/kg地佐辛+丙泊酚安全性更高,可有效降低丙泊酚用量,缩短苏醒时间,并降低不良反应发生率,可满足临床麻醉需求,有较高的临床应用价值。     

The Effects of Sleep Quality and Resilience on Perceived Stress,Dietary Behaviors,and Alcohol Misuse: A Mediation-Moderation Analysis of Higher Education Students from Asia,Europe, and North America during the COVID-19 Pandemic

Background: The coronavirus disease 2019 (COVID-19) pandemic has increased the already high levels of stress that higher education students experience. Stress influences health behaviors, including those related to dietary behaviors, alcohol, and sleep; yet the effects of stress can be mitigated by resilience. To date, past research studying the connections between dietary behaviors, alcohol misuse, sleep, and resilience commonly investigated singular relationships between two of the constructs. The aim of the current study was to explore the relationships between these constructs in a more holistic manner using mediation and moderation analyses. Methods: Higher education students from China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands, and the United States were enrolled in a cross-sectional study from April to May 2020, which was during the beginning of the COVID-19 pandemic for most participants. An online survey, using validated tools, was distributed to assess perceived stress, dietary behaviors, alcohol misuse, sleep quality and duration, and resilience. Results: 2254 students completed the study. Results indicated that sleep quality mediated the relationship between perceived stress and dietary behaviors as well as the relationship between perceived stress and alcohol misuse. Further, increased resilience reduced the strength of the relationship between perceived stress and dietary behaviors but not alcohol misuse. Conclusion: Based on these results, higher education students are likely to benefit from sleep education and resilience training, especially during stressful events.     

Effect of Heat-Killed Lactobacillus casei DKGF7 on a Rat Model of Irritable Bowel Syndrome

Non-viable bacteria, referred to as “paraprobiotics,” have attracted attention as potentially safer alternatives to probiotics. The aim of this study was to investigate the efficacy of heat-killed Lactobacillus casei DKGF7 on the symptomatic improvement of irritable bowel syndrome (IBS) in a rat disease model and to elucidate the underlying mechanisms that contribute to the beneficial effects of heat-killed probiotics. Seven male Wistar rats were induced with IBS by restraint stress and administered heat-killed L. casei DKGF7 for four weeks and then compared with seven rats in the control group. Stool consistency measured four weeks after initial treatment was the primary outcome measure. To investigate the mechanism of action of the heat-killed bacteria on IBS, we measured serum corticosterone levels, inflammatory cytokines in colon tissue, and expression of tight junction proteins (TJPs) in the epithelium. The treatment group showed significantly better stool consistency scores than the control group at week 4, as well as at every measured time point (all p values < 0.05). The treatment group showed lower serum corticosterone levels, lower colonic inflammatory cytokine levels, and higher expression of TJPs compared with the control group. Paraprobiotics such as heat-killed L. casei DKGF7 can improve stool consistency in a rat IBS model, which may indicate a potential therapeutic strategy for IBS treatment.     

In Vivo Evaluation of Dendropanax morbifera Leaf Extract for Anti-Obesity and Cholesterol-Lowering Activity in Mice

Metabolic syndrome is a worldwide health problem, and obesity is closely related to type 2 diabetes, cardiovascular disease, hypertension, and cancer. According to WHO in 2018, the prevalence of obesity in 2016 tripled compared to 1975. D. morbifera reduces bad cholesterol and triglycerides levels in the blood and provides various antioxidant nutrients and germicidal sub-stances, as well as selenium, which helps to remove active oxygen. Moreover, D. morbifera is useful for treating cardiovascular diseases, hypertension, hyperlipidemia, and diabetes. Therefore, we study in vivo efficacy of D. morbifera to investigate the prevention effect of obesity and cholesterol. The weight and body fat were effectively reduced by D. morbifera water (DLW) extract administration to high-fat diet-fed C57BL/6 mice compared to those of control mice. The group treated with DLW 500 mg∙kg⁻¹∙d⁻¹ had significantly lower body weights compared to the control group. In addition, High-density lipoprotein (HDL) cholesterol increased in the group treated with DLW 500 mg∙kg⁻¹∙d⁻¹. The effect of DLW on the serum lipid profile could be helpful to prevent obesity. DLW suppresses lipid formation in adipocytes and decreases body fat. In conclusion, DLW can be applied to develop anti-obesity functional foods and other products to reduce body fat.     

Veridical causal inference using propensity score methods for comparative effectiveness research with medical claims

Health Services and Outcomes Research Methodology - Medical insurance claims are becoming increasingly common data sources to answer a variety of questions in biomedical research. Although...     

Prevalence and Associated Factors of Sarcopenia in Singaporean Adults—The Yishun Study

ObjectivesTo describe the normative values of sarcopenia among community-dwelling adults (≥21 years of age); compare the prevalence of sarcopenia using Asian Working Group for Sarcopenia criteria, 2014 (AWGS2014), Asian Working Group for Sarcopenia criteria, 2019 (AWGS2019), and European Working Group on Sarcopenia in Older People criteria, 2018 (EWGSOP2) guidelines; and identify factors associated with sarcopenia.DesignParticipants were recruited through random sampling. Sarcopenia assessments were performed using a dual-energy x-ray absorptiometry scan (muscle mass), handgrip test (muscle strength), and usual walking test (physical performance). Questionnaires were administered to evaluate lifestyle and cognition.Setting and ParticipantsIn total, 542 community-dwelling Singaporeans were recruited (21?90 years old, 57.9% women).MethodsWe assessed anthropometry, body composition, and questionnaire-based physical and cognitive factors, and estimated sarcopenia prevalence according to the AWGS2014, AWGS2019, and EWGSOP2 recommendations, and examined associations using logistic regression.ResultsAccording to AWGS2019, the Singapore population-adjusted sarcopenia prevalence was 13.6% (men 13.0%; women 14.2%) overall, and 32.2% (men 33.7%, women 30.9%) in those aged 60 years and above. The cut-offs derived from young adult reference group for low appendicular lean mass index were 5.28 kg/m2 for men and 3.69 kg/m2 for women (lower than AWGS recommended cut-off); for gait speed it was 0.82 m/s, (AWGS2019 recommended cut-off 1.0 m/s, AWGS2014 cut-off was 0.8 m/s); and for handgrip strength it was 27.9 kg/m2 for men and 16.7 kg/m2 for women (close to AWGS2019 recommendation). Age, sex, marital status, alcoholism, physical activity, body mass index, waist circumference, and global cognition were associated with sarcopenia (P < .05).Conclusions and ImplicationsThis is the first study to provide reference values of muscle mass, strength, and gait speed across the adult lifespan of Singaporeans. Using AWGS2019 criteria, sarcopenia is prominent in older age (32.2% in ≥60 years old), but it is already nontrivial (6.9%) among young and middle-age persons. Multidomain lifestyle modifications addressing muscle strength, cognition, and nutrition over the adult lifespan are important to delay the development of sarcopenia.     

广东省21个地级市医师人力供需分析与趋势预测

目的 分析广东省21个地市的医师人力供需情况,并预测2022年的供需变化趋势。方法 基于卫生服务需求法与Holt指数平滑法,拟合广东省各个地市2009—2019年的住院与门诊服务数据,对2022年医师供需变化进行预测。结果 预测2022年广东省医师需求为322 290人,执业（助理）医师配置总数为331 806人,全省医师供给状况较充足。2019年供需比最高的3个地市分别是珠海市（1.33）、汕头市（1.31）、汕尾市（1.31）;医师供需比最低的3个地市分别是茂名市（0.55）、中山市（0.76）、江门市（0.76）。预测到2022年,医师供需比最高的3个地市分别是汕尾市（1.64）、珠海市（1.34）、深圳市（1.28）;医师供需比最低的3个地市分别是茂名市（0.58）、江门市（0.79）、云浮市（0.90）。结论 2022年广东省医师供需情况良好,医师配置数将超过医师需求数,大部分地市的医师供需情况得到改善。