健康信念模式下危害高校教师的健康行为成因探析

健康信念模式已成为人们用以解释和干预健康相关行为的重要理论模式，文章在分析该理论模式的基础上，探究了高校教师危害谜康行为形成的内在原因，明确指出提高高校教师对健康行为与疾病关系的认识、为高校教师合理平衡事业与健康创造支持性的工作环境、充分发挥高校健康中心与医疗卫生机构的作用等是切实可行的干预策略。     

新冠肺炎疫情期间临床医学专业线上教学面临的问题及其应对策略

新冠肺炎疫情导致教育行业发生前所未有的变化,其中最重要和关键的一个方面是专业教学模式的转变,即由原来传统面对面的教学,转变为网络依赖的线上教学模式。本研究发现新冠疫情下临床医学线上教学存在授课软件操作不熟练、网络设施不完善和教学过程缺乏直观性等多种问题,并结合线上教学实际,提出有效的应对策略,为保障疫情环境下医学生的教育教学质量提供依据。     

Life in a New Normal with a Self-Care Routine: A Cross-Sectional Study of Older Adults’ Daily Health Behaviors (DHB) Performance during the Initial Outbreak of COVID-19 in China

For older adults, self-care begins with daily health behaviors (DHB), which refers to a series of basic behaviors beneficial to health in daily life; it is the foundation for promoting health, preventing disease, and maintaining health with or without the support of a healthcare provider. Thus, this study aimed to observe the changes in DHB among older adults when the COVID-19 pan-demic first erupted in China (at the beginning of 2020) and explore the impact factors on self-care routines in daily life. We applied a cross-sectional study among 1256 (83.7%) valid older Chinese from 19 February 2020 to 19 March 2020, the score of DHB changes (mean ± SD, 14.70 ± 2.140; range, 8–18) presented a significant growth (t₁₂₅₆ = 44.636, p < 0.001) during COVID-19. From 3 hierarchical linear regression models, the older Chinese who received a higher education include high school (β = 0.403, 95% CI [0.009, 0.797], p = 0.045) and college degree and above (β = 0.488, 95% CI [0.034, 0.943], p = 0.035), and lived in the eastern China (β = 0.771, 95% CI [0.392, 1.151], p < 0.001) took DHB more frequently. However, the high-risk infection (β = −0.740, 95% CI [−1.248, −0.231], p = 0.004), overweight/obese character (β = −0.265, 95% CI [−0.526, −0.004], p = 0.047), and alcohol consumption (β = −0.350, 95% CI [−0.634, −0.065], p = 0.016) are significant factors in decreasing a senior’s DHB performance. For China, self-care offers a straightforward strategy among the range of measures required to combat COVID-19 and future health threats. In summary, findings in this study can build a foundation for developing healthcare policy and services for the relevant government and departments on prompting DHB and the importance of self-care among the older population.     

Improving the health equity and the human rights of Canadians with dementia through a social determinants approach: a call to action in the COVID-19 pandemic

In 2019, the Canadian Government released a national dementia strategy that identified the need to address the health inequity (e.g., avoidable, unfair, and unjust differences in health outcomes) and improve the human rights of people living with dementia. However, the novel coronavirus disease 2019 (COVID-19) pandemic is having an inequitable impact on people with dementia in terms of mortality and human rights violations. As the new Omicron COVID-19 variant approaches its peak, our commentary highlights the need for urgent action to support people living with dementia and their care partners. More specifically, we argue that reducing COVID-19 inequities requires addressing underlying population-level factors known as the social determinants of health. Health disparities cannot be rectified merely by looking at mortality rates of people with dementia. Thus, we believe that improving the COVID-19 outcomes of people with dementia requires addressing key determinants such as where people live, their social supports, and having equitable access to healthcare services. Drawing on Canadian-based examples, we conclude that COVID-19 policy responses to the pandemic must be informed by evidence-informed research and collaborative partnerships that embrace the lived experience of diverse people living with dementia and their care partners.     

应用健康信念模型分析社会心理因素与手足口病预防行为的关系

目的应用健康信念模型（HBM）分析社会心理因素与手足口病预防行为的关系。方法采用分层抽样方法对天津市塘沽地区幼儿园中530名婴幼儿家长进行问卷调查,采用SPSS13．0进行统计分析,对原有的HBM进行校正,应用结构方程方法进行分析。结果对手足口病知觉到严重性和到易感性有较强信念的人为46．92％和30．82％。手足口病相关知识得分低的人群的预防行为得分低于手足口病相关知识得分高的人群,差异有统计学意义（x2=8．24,P〈0．05）。结构方程分析结果显示,户籍（t=-1．962）、手足I：1病相关知识（t=2．020）和知觉到障碍（t=-22．220）对预防手足口病预防行为有直接效应;家庭月收入（t=2．872）和手足口病相关知识（t=1．990）对预防行为有间接效应;手足口病相关知识（t=2．866）和知觉到障碍（t=-22．220）对预防行为有总效应,均有统计学意义（P〈0．05）。结论校正后的健康信念模型能够成功地解释社会心理因素与手足口病预防行为的关系。良好的个人预防行为可以通过健康教育的形式,建立健康信念来实现。     

Impacts of routine varicella vaccination program and COVID-19 pandemic on varicella and herpes zoster incidence and health resource use among children in Japan

PurposeTo determine the epidemiological trends in pediatric varicella and herpes zoster incidence and changes in healthcare resource use from 2005 to 2022 using a nationally representative database in Japan.Materials and methodsWe conducted a retrospective observational study consisting of 3.5 million children with 177 million person-months during 2005–2022 using Japan Medical Data Center (JMDC) claims database in Japan. We investigated trends in incidence rates of varicella and herpes zoster and changes in healthcare resource use (e.g., antiviral use, office visits, and healthcare costs) over 18 years. Interrupted time-series analyses were used to investigate the impact of the routine varicella vaccination program in 2014 and infection prevention measures against COVID-19 on incidence rates of varicella and herpes zoster and related healthcare utilization.ResultsAfter the introduction of the routine immunization program in 2014, we observed level changes in incidence rates (45.6 % reduction [95 %CI, 32.9–56.0] of varicella cases, antiviral use (40.9 % reduction [95 %CI, 25.1–53.3]), and relevant healthcare costs (48.7 % reduction [95 %CI, 38.2–57.3]). Furthermore, infection prevention measures against COVID-19 were associated with additional level changes in varicella rates (57.2 % reduction [95 %CI, 44.5–67.1]), antiviral use (65.7 % reduction [59.7–70.8]), and healthcare costs (49.1 % [95 %CI, 32.7–61.6]). In contrast, the changes in incidence and healthcare costs for herpes zoster were relatively small, which showed 9.4 % elevated level change with a decreasing trend and 8.7 % reduced level change with a decreasing trend after the vaccine program and the COVID-19 pandemic. The cumulative incidence of herpes zoster in children born after 2014 was lower than that before 2014.ConclusionsVaricella incidence and healthcare resource use were largely affected by the routine immunization program and infection prevention measures against COVID-19, while these impacts on herpes zoster were relatively small. Our study indicates that immunization and infection prevention measures largely changed pediatric infectious disease practices.     

Indicators of poor mental health and stressors during the COVID-19 pandemic,by disability status: A cross-sectional analysis

BackgroundEvidence from previous public health emergencies indicates that adults with disabilities have higher risk for morbidity (physical and mental) and mortality than adults without disabilities.ObjectiveTo provide estimates of mental health indicators and stressors for US adults by disability status during April and May 2020, shortly following the emergence of the COVID-19 pandemic.MethodsWe analyzed data from Porter Novelli View 360 opt-in Internet panel survey conducted during the weeks of April 20th and May 18th^, 2020 among 1004 English-speaking adults aged ≥18 years without and with disabilities (serious difficulty with hearing, vision, cognition, or mobility; any difficulty with self-care or independent living). Weighted logistic regression was used to test for significant differences between calculated prevalence estimates at the P ≤ .05 level.ResultsOne in four adults reported any disability. Adults with any disability were significantly more likely than adults without disability to report current depressive symptoms, frequent mental distress, suicidal ideation, and COVID-19-related initiated or increased substance use (all p values < .0001). Adults with disabilities also reported significantly higher levels of stressors, such as access to health care services (p < .0001), difficulty caring for their own (or another’s) chronic condition (p < .0001), emotional or physical abuse from others (p < .001), and not having enough food (p < .01).ConclusionsThe disproportionately high levels of poor mental health indicators among adults with disabilities as compared to those without highlight the importance of delivering timely mental health screening and treatment/intervention during and after the COVID-19 pandemic to persons with disabilities.     

新冠肺炎疫情下武汉方舱医院实施协同管理机制实践探索

方舱医院是我国应对新冠肺炎疫情的重要之举,如何使其迅速实现高效、有序、安全的运转,完成好轻症患者集中收治的任务,是疫情防控的焦点和重点.从分析合作需求、建立合作关系、合作执行与控制、合作评价与改进4个维度,介绍了在新冠肺炎疫情下江汉方舱医院实施协同管理机制的实践探索,并就进一步完善应急救治体系提出建议,为今后的应急医疗...     

Worldwide prevalence of fungal coinfections among COVID-19 patients: a comprehensive systematic review and meta-analysis

Microbial coinfections can increase the morbidity and mortality rates of viral respiratory diseases. Therefore, this study aimed to determine the pooled prevalence of fungal coinfections in coronavirus disease 2019 (COVID-19) patients. Web of Science, Medline, Scopus, and Embase were searched without language restrictions to identify the related research on COVID-19 patients with fungal coinfections from December 1, 2019, to December 30, 2020. A random-effects model was used for analysis. The sample size included 2,246 patients from 8 studies. The pooled prevalence of fungal coinfections was 12.60%. The frequency of fungal subtype coinfections was 3.71% for Aspergillus, 2.39% for Candida, and 0.39% for other. The World Health Organization’s Regional Office for Europe and Regional Office for Southeast Asia had the highest (23.28%) and lowest (4.53%) estimated prevalence of fungal coinfection, respectively. Our findings showed a high prevalence of fungal coinfections in COVID-19 cases, which is a likely contributor to mortality in COVID-19 patients. Early identification of fungal pathogens in the laboratory for COVID-19 patients can lead to timely treatment and prevention of further damage by this hidden infection.     

Effect of educating mothers on injury prevention among children aged <5 years using the Health Belief Model: a randomized controlled trial

Objectives

To assess the effect of the Health Belief Model (HBM) on the education of mothers for promoting safety and preventing injury among children aged <5 years.

Study design

Randomized controlled trial.

Methods

This study was conducted in Hamadan City, West Iran in 2012. One hundred and twenty mothers participated in this study, divided into intervention and control groups (60 mothers in each group). The intervention group participated in an educational programme consisting of four 1-hour sessions twice per week. The education programme was based on the HBM. The participants of both groups were evaluated before the intervention and two months after the intervention using a questionnaire. The validity and reliability of the questionnaire were tested with a pilot study. The questionnaire consisted of three parts: demographic characteristics; knowledge, practices and HBM constructs (perceived sensitivity, perceived severity, perceived benefits, perceived barriers, cues to action and self-efficacy); and history of recent injuries to the child. Student's t-test was used to compare the mean differences, and P < 0.05 was considered to indicate significance.

Results

None of the 120 participants dropped out of the study. The mean differences in knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy and practices after the intervention, between the two groups, were 3.98, 3.57, 3.97, 1.57, −7.08, 0.82, 2.95 and 2.47, respectively. All differences were statistically significant (P = 0.001).

Conclusions

Educational programmes based on the HBM can be used as an effective approach in planning and developing preventive programmes for injury prevention and safety promotion in children aged <5 years.     

濮阳市新型冠状病毒肺炎疫情一级、二级响应期间其他法定传染病流行特征分析

目的 了解新型冠状病毒肺炎(简称新冠肺炎)疫情一级、二级响应期间,濮阳市除新冠肺炎以外的其他法定传染病(简称其他法定传染病)的流行特征变化。 方法 通过中国疾病预防控制信息系统收集相关数据,采用描述流行病学对应急响应期间濮阳市其他法定传染病进行分析,并与2019年同期发病情况进行比较。 结果 一级响应期间报告的乙类(除新冠肺炎外)、丙类传染病较2019年同期分别下降74.39%、12.43%,二级响应期间分别下降28.26%、85.35%;应急响应期间报告的其他法定传染病病种病例数较2019年同期均有不同程度下降,下降幅度较大的病种有手足口病、猩红热、流行性感冒(流感)、流行性腮腺炎、病毒性肝炎、梅毒、肺结核。手足口病、流行性感冒、流行性腮腺炎的季节性流行特征均有变化。 结论 新冠肺炎疫情应急响应期间濮阳市其他法定传染病的发病数明显减少,特别是丙类传染病发病数下降明显,提示所采取的防控措施有效,可为今后常态下的传染病防控工作提供借鉴。     

Factors Influencing Healthy Eating Habits Among College Students: An Application of the Health Belief Model

Poor eating habits are an important public health issue that has large health and economic implications. Many food preferences are established early, but because people make more and more independent eating decisions as they move through adolescence, the transition to independent living during the university days is an important event. To study the phenomenon of food selection, the heath belief model was applied to predict the likelihood of healthy eating among university students. Structural equation modeling was used to investigate the validity of the health belief model (HBM) among 194 students, followed by gender-based analyses. The data strongly supported the HBM. Social change campaign implications are discussed.     

Trends and disparities in the utilization of influenza vaccines among commercially insured US adults during the COVID-19 pandemic

ObjectivesLittle is known about how the coronavirus disease 2019 (COVID-19) pandemic affected influenza vaccine utilization and disparities. We sought to estimate changes in the likelihood of receiving an influenza vaccine across different demographic subgroups during the COVID-19 pandemic.MethodsIn this cohort study, we analyzed influenza vaccine uptake from 2019 to 2020 using Optum commercial insurance claims data. Eligible individuals were aged 18 or above in 2018 and continuously enrolled from 08/01/2018 through 12/31/2020. Multivariable logistic regressions were fitted for the individual-level influenza vaccine uptake. Adjusting for demographic factors and medical histories, we estimated probabilities of receiving influenza vaccines before and after the COVID-19 pandemic across demographic subgroups.ResultsFrom August to December 2019, unadjusted influenza vaccination rate was 42.3%, while in the same period of 2020, the vaccination rate increased to 45.9%. Females had a higher vaccination rate in 2019 (OR: 1.16, 95% CI 1.15–1.16), but the increase was larger for males. Blacks and Hispanics had lower vaccination rates relative to whites in both flu seasons. Hispanics showed a greater increase in vaccination rate, increasing by 7.8 percentage points (p < .001) compared to 4.4 (p < .001) for whites. The vaccination rate for Blacks increased by 5.2 percentage points (p < .001). All income groups experienced vaccination improvements, but poorer individuals had lower vaccination rates in both seasons. The most profound disparities occurred when educational cohort were considered. The vaccination rate increased among college-educated enrollees by 8.8 percentage points (p < .001) during the pandemic compared to an increase of 2.8 percentage points (p < .001) for enrollees with less than a 12th grade education. Past influenza infections or vaccination increased the likelihood of vaccination (p < .001).ConclusionsThe COVID-19 pandemic was associated with increased influenza vaccine utilization. Disparities persisted but narrowed with respect to gender and race but worsened with respect to income and educational attainment.     

Prevalence and factors of influenza vaccination during the COVID-19 pandemic among university students in China

BackgroundPrevious outbreaks of emerging infectious diseases (e.g., SARS) had increased the uptake of influenza vaccination (IV). It is uncertain whether such was also true for COVID-19. This study hence investigated prevalence of IV behavior/intention prior to and during the COVID-19 pandemic and associated cognitive factors.MethodsA self-administered, online, and anonymous cross-sectional survey was conducted among 6,922 university students of five provinces in China during November 1–28, 2020 (response rate: 72.3%).ResultsOf all the participants, 35.1% self-reported behavioral intention of IV (next 12 months), while 62.9% reported an increased intention of IV due to COVID-19. However, only 4.7% and 2.9% had taken up IV during the 12-month period prior to the outbreak (1/2019–12/2019) and during the COVID-19 outbreak (1–11/2020), respectively. Adjusted for the background factors, the multivariable logistic regression analysis showed that in general the COVID-19 related perceptions (perceived susceptibility, perceived severity, and perceived chance of having another wave of COVID-19 outbreak) were significantly and positively associated the IV behavior (during the COVID-19 outbreak) and intention of IV uptake in the next 12 months.ConclusionsThe COVID-19 pandemic may have influenced actual behavior and intention of IV uptake among university students during the pandemic. Efforts are warranted to reduce the intention-behavior gap of IV uptake; modification of perceived susceptibility and perceived severity regarding COVID-19 may help. Future longitudinal and intervention studies are needed to confirm the findings of this study and explore other factors affecting IV uptake during the COVID-19 period.     

新型冠状病毒肺炎疫情期间广东省大学生电子健康素养状况及影响因素

目的 了解新型冠状病毒（新冠）肺炎疫情期间广东省大学生电子健康素养状况,探讨其影响因素,为进一步提高大学生电子健康素养水平提供依据。方法 采用网络问卷对广东省的高校大学生进行调查。结果 共收集16 497份有效问卷,女生为11 268人（68.3%）,大一至大四分别为7 241人（43.9%）、4 467人（27.1%）、 2 842人（17.2%）、1 947人（11.8%）,各学科中文科人数最多,为5 769人（35.0%）。电子健康素养平均总分为（29.62±6.74）分,合格率为23.6%。多因素分析显示医科（β’=0.053）、当前所在地为广州或深圳地区（β’=0.030）、消息来源途径数目越多（β’=0.037）、网络信息可靠性的判断方法数目越多（β’=0.034）、对新冠肺炎的关注程度越高（β’=0.118）、信息了解程度越高（β’=0.233）的大学生电子健康素养得分也越高;而女生（β’=-0.039）、疫情相关信息导致的困扰程度越高（β’=-0.069）的大学生得分越低。结论 广东省大学生电子健康素养水平较低,提高电子健康素养能力,有助于提高大学生对健康信息的判断、获取能力和对疫情的关注度与了解程度。     

The role of resilience and coping among Italian healthcare workers during the COVID-19 pandemic

Objective:To evaluate the psychological state of healthcare workers (HCWs) in the field of rehabilitation during the COVID-19 pandemic.Methods:Cross-sectional observational study. Sample of 334 HCWs including: nurses, medical doctors, therapists, scientists, and clerical workers working at the IRCCS San Raffaele Roma rehabilitation hospital during the second wave of the COVID-19 pandemic. Anonymous web-based questionnaire included 14-item Resilience Scale, Brief-COPE, Hospital Anxiety Depression Scale, Fear of COVID-19 Scale. Occupational and sociodemographic characteristics.Results:High levels of resilience, low levels of anxiety, depression, and fear were observed in the study population; the most frequently used coping strategies in the Brief-COPE were acceptance, planning, and active coping. Specifically, 87% of the participants reported a moderate to high level of resilience, with the highest level observed in nurses while physicians show the lowest level. HCWs showed symptoms of anxiety (29%), depressive symptoms (10%), and fear caused by the COVID-19 pandemic (44%). Statistically significant differences were observed between different occupations for fear (p <0.05) and resilience (p <0.01). Levels of anxiety and fear appeared to be higher in female and younger workers. The latter group - who also reported higher levels of depression - showed lower levels of resilience.Conclusions:In our study hospital and non-hospital workers show different emotional, cognitive, and behavioural resources when facing stressful situations, like in the case of the SARS-CoV-2 pandemics. Our results support the role of resilience and the proper use of problem-focused and emotion-focused coping strategies as protective factors from psychological distress.