General Practice/Family Medicine Portuguese doctors: “technicists” or “systemics”?

To study if the consultation''s problems classification of a fictitious case by General and Family Medicine doctors, showed the characteristics of being a mechanistic or a systemic approach. Exploratory cross-sectional observational study in a convenience sample of the General Practice/Family Medicine population, internees included, in April 2020, applying a modified real world clinical case. Central Portugal and the Autonomous Region of Azores. General Practice/Family Medicine specialists and internees. Electronic Doctors invitation to participate, anonymously, in specific doctor''s social networks. A self-fulfilling questionnaire was used to verify the classification of a clinical case in Subjective, Assessment and Plan (from the SOAP methodology) with the response options of the International Classification of Primary Health Care (ICPC2) in chapters P (Psychological) and Z (Social) possible for this case. “Technicists” doctors, only classifying “P” codes and “Systemics” classifying “P + Z” or only “Z” ICPC2 codes were defined. Differences between genders, work place, being an internee or specialist and being a tutor in specialized formation were studied. A sample of 227 30% (n = 68) males, specialists represented 66% (n = 149), of whom 49% (n = 73) were internee''s tutors and 34% (n = 78) were internees, was studied. In the Subjective chapter of the SOAP methodology, 44.1% (n = 100) were “technicists”, for Assessment n = 93 (40.8%) were “technicists” and for P chapter classification 56.8% were “technicists”. For S, A and P chapters classification there was no significant difference between the considered variables. In this sample General Practice/Family Medicine Portuguese doctors were more “systemic” for the S and A chapters of the SOAP model, And “technicists” in the P chapter.     

COVID-19出院患者“复阳”情况及原因分析

国内新型冠状病毒肺炎（COVID-19）疫情虽已得到基本控制,但有部分患者在出院后康复隔离观察期核酸检测再次呈阳性,即出现“复阳”现象,具体原因尚不明确。可能由新型冠状病毒（SARS-CoV-2）的病原学特点决定,也可能与病毒入侵后产生的机体免疫反应、患者的病程和病情以及样本采样部位、处理方式、检测等一系列因素相关,因此对出院患者的核酸检测仍需重视。本文就COVID-19出院患者核酸检测复查阳性情况及其可能存在的原因进行综述,为后续复阳患者的防控工作和科学研究提供理论支持。     

德阳地区妇女“两癌”防治知识知晓现状及影响因素分析

目的 调查德阳地区妇女乳腺癌和宫颈癌（简称“两癌”）防治知识的掌握情况,探讨影响女性“两癌”防治知识认知的相关因素,为更好地开展 “两癌”筛查工作提供参考依据。方法 采用分层整群抽样方法于2019年6—9月抽取德阳市妇女作为研究对象进行“两癌”防治知识知晓情况现场问卷调查,采用描述流行病学分析方法进行分析,并采用单、多因素分析方法对“两癌”防治知识知晓影响因素进行分析。结果 共对1 835名德阳市女性居民进行分析,年龄20~69岁,平均（42.36±5.22）岁。文化程度以初中（653人,35.59%）和高中（634人,34.55%）为主。城镇居民占60.60%。职业以企事业职工为主（594人,32.37%）。“两癌”防治知识的总均分为（23.6±5.3）分,总知晓率为49.30%。答对“两癌”防治知识问卷60%以上题的有878人,了解率为47.85%。年龄越大（OR=0.730）的女性居民“两癌”防治知识了解的可能性较小,文化程度越高（OR=2.787）、居住地在城镇（OR=5.512）、职业为企事业单位职工或个体户（OR=5.124、1.713）、家庭人均月收入越高（OR=2.298）、乳腺疾病史（OR=1.775）和妇科疾病史（OR=1.320）是女性“两癌”防治知识了解率的促进因素。结论 德阳市适龄妇女“两癌”防治知识的掌握情况不佳,应重点针对高龄、文化程度低、农村地区的低收入女性人群加强“两癌”健康知识宣传教育工作。     

承德市健康体检女性“两癌”筛查意愿及影响因素分析

目的 探讨承德市普通体检女性“两癌”筛查意愿及影响因素。方法 以2020年7月至2021年6月在承德市某医院进行普通体检的成年女性作为调查对象进行“两癌”筛查意愿问卷调查,采用描述性分析方法对“两癌”筛查意愿进行分析,并对其影响因素进行分析。结果 最终有效调查承德市健康女性3 150人,30~60岁1 752人,占55.62%,已婚2 159人,占68.54%,有筛查意愿970人,占30.79%。个人月收入>8 000元（OR=3.025）、居住地为城市（OR=3.154）、31~60岁（OR=1.335）、文化程度为硕士及以上（OR=2.331）的健康体检女性“两癌”筛查意愿较高。结论 承德市普通体检女性“两癌”筛查意愿较低,需引起重视,需要加强“两癌”筛查相关认知宣传,需制定综合措施增加女性“两癌”筛查积极性。     

基于“治未病”理念综合干预老年骨质疏松高危人群效果观察

目的 基于“治未病”理念观察的社区综合干预方法对老年骨质疏松高危人群的效果。方法 基于 “治未病”理念的综合方法对上海市浦东新区社区老年骨质疏松高危人群进行干预,干预组实施中医“治未病”综合管理方案,对照组接受常规骨质疏松症健康教育,时间6个月,采用t检验、卡方检验分析干预前后骨质疏松症知识问卷、健康信念量表和自我效能量表的分值变化以及跌倒或骨折发生情况的差异。结果 共纳入200例研究对象,干预组100例（男9例,女91例）,年龄66~84岁,平均BMI（26.1 ± 2.2）;对照组100例（男13例,女87例）,年龄65~85岁,平均BMI（26.8 ± 2.5）;2组研究对象性别、年龄及BMI值差异均无统计学意义 （均P>0.05）。干预后,干预组知识问卷、健康信念量表和自我效能量表分值增值均高于对照组（P<0.05）;干预组跌倒或骨折事件的发生率13%（13/100）,对照组24%（24/100）,干预组与对照组跌倒或骨折事件发生不同次数的人数分布差异有统计学意义（P<0.05）。结论 基于“治未病”理念的社区综合干预方法可以提高社区老年骨质疏松高危人群相关知识水平、增强自信、提高健康信念及自我效能感、提升自我管理水平、减少不良事件的发生以及降低跌倒或骨折发生风险。     

海南省“营养改善计划”某试点地区中小学生贫血状况及影响因素分析

目的 分析海南省“农村义务教育学生营养改善计划”（简称“计划”）某试点地区中小学生贫血的变化趋势及影响因素。方法 2014—2017年采用分层整群随机抽样法,在实施“计划”的重点监测县抽取中小学生进行血红蛋白等生化指标检测及问卷调查。多组均值间比较采用方差分析,率的比较采用χ²检验,贫血影响因素分析采用二分类Logistic回归。结果 2014—2017年共抽取学生2 590人,各年血红蛋白平均水平分别为（138.1±12.0）、（136.4±13.4）、（138.1±12.4）、（138.1±15.4）g/L,差异无统计学意义（P>0.05）。4年来各年贫血率分别为5.4%、5.4%、4.5%、6.7%,变化趋势无统计学意义（P>0.05）;其中2015年初中生贫血率高于小学生（P<0.05）,其余年度小学、初中生间,男、女生间贫血率差异均无统计学意义（均P>0.05）。Logistic回归分析结果显示,少数民族学生（OR=6.947）和维生素A亚临床缺乏/缺乏学生（OR=2.030）发生贫血的风险更高。结论 该地区中小学生贫血状况改善不明显,少数民族和维生素A亚临床缺乏/缺乏学生是需改善贫血的重点人群。     

How the “Are We Drinking Ourselves Sick?” Communication Campaign Built Support for Policy Action on Sugary Drinks in Jamaica

Background: This study assesses the effectiveness of a campaign “Are We Drinking Ourselves Sick?” that ran nationally in Jamaica in four phases from 2017 to 2019 to increase knowledge about the harms of sugary drinks, shift attitudes, and build support for policy actions to address sugary drink consumption, including a tax and a ban in schools. Methods: Campaign impact was measured in representative cross-sectional household surveys of adults ages 18 to 55. A baseline survey was conducted before the launch of the campaign (n = 1430). Evaluation surveys were conducted mid-campaign (n = 1571) and post-campaign (n = 1500). Campaign impact was assessed by comparing changes across survey periods on key knowledge, attitudinal and policy support outcome indicators. The independent association between campaign awareness and outcomes was analyzed using logistic regression analyses. Results: The campaign was recalled by more than 80% of respondents and was well-received with 90% or more respondents describing it as believable and relevant. There was a decline in knowledge on the harms of sugary drinks from the baseline to post-campaign period, notably on risks of diabetes (adjusted odds ratio or AOR = 0.62, p < 0.001), overweight and obesity (AOR = 0.58, p < 0.001), and heart disease (AOR = 0.79, p < 0.003). However, post-campaign awareness was independently associated in logistic regression analysis with improved knowledge of the harms of sugary drinks, including risks of diabetes (AOR = 1.45, p = 0.019), overweight or obesity (AOR = 1.65, p = 0.001), and heart disease (AOR = 1.44, p = 0.011). Support for government action remained high across survey waves (≥90%), and campaign awareness was independently associated with increased policy support for sugary drinks taxes (Mid-campaign: AOR = 1.43, p = 0.019; post-campaign: AOR = 1.46, p = 0.01) and restrictions on sugary drinks in schools (AOR = 1.55, p = 0.01). Conclusion: This study demonstrates the role that media campaigns can play in maintaining knowledge and concern about the health harms of sugary drinks and increasing support for policy passage.     

“Leisure Life Satisfaction:” Will It Have a Beneficial Impact on Depression Among Older Adults in Community Care Settings in Korea?

ObjectivesWhile the risk of depression is expected to substantially increase among older adults receiving community care, leisure life satisfaction can be regarded as a key component in enhancing the mental health of those receiving community care. However, it is not yet known whether community care utilization increases the risk of depression, or what role is played by leisure life satisfaction in these settings. This study investigated the relationship between community care utilization and depression, as well as the main effect and the moderating role of leisure life satisfaction on the link between community care utilization and depression among older adults.MethodsThis study, using the 2019 Korean Welfare Panel Survey, conducted multiple regression analysis on data from 4494 elderly people aged 65 years or older.ResultsAfter controlling for potential covariates, older community care recipients were more likely to report symptoms of depression than those who did not receive community care. Meanwhile, leisure life satisfaction was negatively associated with depression in older adults. The test for interaction between community care utilization and leisure life satisfaction revealed that leisure life satisfaction significantly attenuated the link between depression and community care utilization.ConclusionsThe findings of this study imply that leisure life satisfaction could play a meaningful role in improving the mental health of older adults receiving community care. Welfare policies affecting older adults should consider leisure life satisfaction as an important resource for reducing depression in community care settings.     

The Role of Bovine and Non-Bovine Milk in Cardiometabolic Health: Should We Raise the “Baa”?

Although causality is yet to be confirmed, a considerable volume of research has explored the relationships between cow milk consumption, type II diabetes, and cardiovascular disease. Contrastingly, it has not been comprehensively examined whether milk of non-bovine origin can provide cardiometabolic protection. This narrative review outlines the marked differences in macronutrient composition, particularly protein and lipid content, and discusses how whole milk product (and individual milk ingredients) from different species could impact cardiometabolic health. There is some data, although primarily from compositional analyses, animal studies, and acute clinical trials, that non-bovine milk (notably sheep and goat milk) could be a viable substitute to cow milk for the maintenance, or enhancement, of cardiometabolic health. With a high content of medium-chain triglycerides, conjugated linoleic acid, leucine, and essential minerals, sheep milk could assist in the prevention of metabolic-related disorders. Similarly, albeit with a lower content of such functional compounds relative to sheep milk, goat and buffalo milk could be plausible counterparts to cow milk. However, the evidence required to generate nutritional recommendations for ‘non-bovine milk’ is currently lacking. Longer-term randomised controlled trials must assess how the bioactive ingredients of different species’ milks collectively influence biomarkers of, and subsequently incidence of, cardiometabolic health.