Association of spiritual well-being with quality of life among undergraduate nursing students

Objective:The study was conducted with the aim of determining the spiritual well-being(SWB)of nursing students and its association with quality of life(QOL).Materials and Methods:A cross-sectional analytical study was conducted with a sample size of 504 nursing students collected from January 2023 to March 2023 in the nursing institutes of Khyber Pakhtunkhwa,Pakistan,using convenient sampling techniques.A Spiritual Health and Life-Orientation Measure(SHALOM)questionnaire for SWB and K-27 QOL(K-27 QOL)instrument were used for data collection that contains three parts.Results:The number of female participants was in the majority(50.4%)compared to male nurses(49.6%).The overall mean score of SWB of the students was 3.79±0.48,while the mean K-27 QOL score was 3.73±0.57.There were significant differences between the groups of gender(P=0.001),while no significant difference within the groups of semester(P=0.061)and college status(0.285).In QOL,there were significant differences within the groups of semester(P=0.000)and college status(P=0.036)while no significant difference in gender category(P=0.480).SHALOM score is positively and moderately correlated with QOL score(r=0.597,P<0.05).Conclusion:Spiritual practices are one of the important factors that are associated positively with QOL,therefore to enhance the QOL,it will require spiritual practices.

Comparative efficacy of various exercise interventions on cognitive function in patients with mild cognitive impairment or dementia:A systematic review and network meta-analysis

Background:Exercise is a promising nonpharmacological therapy for cognitive dysfunction,but it is unclear which type of exercise is most effective.The objective of this study was to compare and rank the effectiveness of various exercise interventions on cognitive function in patients with mild cognitive impairment(MCI)or dementia and to examine the effects of exercise on the symptoms relevant to cognitive impairment.Methods:We searched PubMed,Web of Science,Embase,Cochrane Central Register of Controlled Trials,SPORTDiscus,and PsycInfo through September 2019 and included randomized controlled trials that examined the effectiveness of exercise interventions in patients with MCI or dementia.Primary outcomes included global cognition,executive cognition,and memory cognition.Secondary outcomes included activities of daily living,neuropsychiatric symptoms,and quality of life.Pairwise analyses and network meta-analyses were performed using a random effects model.Results:A total of 73 articles from 71 trials with 5606 participants were included.All types of exercise were effective in increasing or maintaining global cognition,and resistance exercise had the highest probability of being the most effective intervention in slowing the decrease in global cognition(standard mean difference(SMD)=1.05,95%confidence interval(95%CI):0.56-1.54),executive function(SMD=0.85,95%CI:0.21-1.49),and memory function(SMD=0.32,95%CI:0.01-0.63)in patients with cognitive dysfunction.Subgroup analyses for patients with MCI revealed different effects,and multicomponent exercise was most likely to be the optimal exercise therapy for preventing the decline of global cognition(SMD=0.99,95%CI:0.44-1.54)and executive function(SMD=0.72,95%CI:0.06-1.38).However,only resistance exercise showed significant effects on memory function for patients with MCI(SMD=0.35,95%CI:0.01-0.69).Exercise interventions also showed various effects on the secondary outcomes.Conclusion:Resistance exercise has the highest probability of being the optimal exercise type for slowing cognitive declin e in patients withcognitive dysfunction,especially in patients with dementia.Multicomponent exercise tends to be most effective in protecting global cognition and executive function in patients with MCI.

Examining perception of job satisfaction and intention to leave among ICU nurses in China

Objectives:Previous studies in China's Mainland found ICU nurses to be less satisfied with their jobs and more inclined to leave them than are nurses in other hospital units.We aimed to determine ICU nurses'perspectives on the factors that influence job satisfaction and whether or not to continue working in the ICU.Methods:Nine ICU nurses were asked five open-ended questions to elicit the nurses'perspectives on job satisfaction and intentions to leave.Data were analyzed according to the process described by Knafl and Webster(1988).Core concepts were identified using the constant comparative method.Results:Two themes emerged as major influences on job dissatisfaction:1)stress experienced from excessive workload demands and the ICU work environment,and 2)a lack of respect and recognition for the nurses'work.Two themes emerged as major influences on job satisfaction:1)recognition of work,and 2)professional opportunities and relationships with coworkers.The effects of job satisfaction or dissatisfaction on the nurses'intentions to leave their jobs varied,although three categories were identified.Conclusions:For ICU nurses in China,sources of job dissatisfaction are potentially remedied with simple interventions.Adequate staffing is necessary but not sufficient for a positive work environment.Administrators should address the factors that directly affect their nurses'levels of job satisfaction,as it will ultimately result in less staff turnover and greater patient care.

Development and Validation of a Simplified Chinese Version of the Assessment Tool for Students' Perceptions of Medical Professionalism

Professionalism is crucial in all professions and is particularly important in the medical field.Measuring students' perceptions of professionalism can help to form education targeting the enhancement of professionalism.This study aimed to validate an effective assessment tool for the measurement of medical students5 perceptions of medical professionalism in China's Mainland.The cross-sectional survey was conducted in three medical colleges in Guangdong,China.Of the 2103 eligible medical students,1976 responded,and 1856 questionnaires were deemed valid.Students from clinical medicine in these three medical colleges were randomly selected by cluster sampling.First,a Simplified Chinese Version questionnaire to measure Student's Perception of Medical Professionalism (SCV-SPMP) was constructed.Second,questionnaires from 1856 students majoring in clinical medicine at three medical colleges were included in the analysis.Third,exploratory factor analysis,Cronbach's alpha,item-subscale correlation,and confirmatory factor analysis were conducted to test the validity and reliability of the SCV-SPMP.Nine items were eliminated following exploratory factor analysis,and four subscales were extracted from the analysis.All internal consistency reliability exceeded the minimum standard.The overall Cronbach's alpha was 0.94,and four subscales' alphas were 0.82 (Accountability and excellence),0.81 (Duty),0.89 (Honor and integrity),and 0.85 (Practice habits and respect for others),respectively.The model fit was good.The convergent validity and discriminant validity were acceptable.The modified SCVSPMP was found to be a valid and reliable tool to capture the main features of Chinese students' perceptions of medical professionalism in four dimensions,and it provides a quantitative method for the measurement of the students' perceptions in China's Mainland..

Utilising digital health to improve medication-related quality of care for hypertensive patients:An integrative literature review

BACKGROUND Hypertension or high blood pressure is considered as a significant contributor and risk factor to many serious conditions,approximately 1.13 billion people have hypertension globally.However,the integrated technologies can upscale health provisions and improve the effectiveness of the healthcare system.WHO has recommended that the digital health interventions(DHIs)and the Health System Challenges should be used in tandem in addressing health.AIM To summarise the outcomes from a range of research which investigated the use of DHI to improve the medication-related quality of care(MRQOC)for hypertensive patients.METHODS An integrative literature review was undertaken in October 2019 using the Medline,Cumulative Index of Nursing and Allied Health Literature,and Scopus databases for publications in English with no date limit.RESULTS In total,18433 participants were included in this review from 28 studies meeting the eligibility criteria.There were 19 DHI identified within eight countries:Australia,Canada,India,South Korea,Lebanon,Pakistan,the United Kingdom,and the United States of America.The DHI were provided as community-based,clinical-based and home-based program through mobile phone,mobile health system,short message service,and telehealth,digital medicine,and online healthcare(web-based).The mean age of participants was 59 ranging from 42 to 81 years with an average mean systolic blood pressure of 143.3 mmHg at baseline,ranging from 129.0 mmHg to 159.0 mmHg.The proportion of male participants ranged from 13.9%to 92.0%.Eighteen interventions showed evidence of reduction in blood pressure and improvement of self-management in relation to medication adherence and blood pressure control.The reduction of systolic blood pressure ranged between 1.9 mmHg and 26.0 mmHg,with a mean of 10.8 mmHg.The digital health was found positively associated with the MRQOC for hypertensive patients such as improvement in medication adherence and medication management;better blood pressure control;maintaining followups appointment and self-management;increasing access to healthcare particularly among patients living in rural area;and reducing adverse events.However,some interventions found no significant effect on hypertensive care.The follow up duration varied between 2 mo and 18 mo with an average attrition rate of 10.1%,ranging from 0.0%to 17.4%.CONCLUSION Utilising digital health innovation for hypertensive care in different settings with tailored interventions positively impacted on MRQOC leading to an improvement of patient outcomes and their quality of life.Nevertheless,inconclusive findings were found in some interventions,and inconsistent outcomes between DHI were noted.A future research and evidence-based DHI for hypertension or chronic diseases should be developed through the evidenceto-decision framework and guidelines.

Regulatory role of sphingosine kinase and sphingosine-1-phosphate receptor signaling in progenitor/stem cells

Balanced sphingolipid signaling is important for the maintenance of homeostasis. Sphingolipids were demonstrated to function as structural components, second messengers, and regulators of cell growth and survival in normal and disease-affected tissues. Particularly, sphingosine kinase 1 (SphK1) and its product sphingosine-1-phosphate (S1P) operate as mediators and facilitators of proliferation-linked signaling. Unlimited proliferation (selfrenewal) within the regulated environment is a hallmark of progenitor/stem cells that was recently associated with the S1P signaling network in vasculature, nervous,muscular, and immune systems. S1P was shown to regulate progenitor-related characteristics in normal and cancerstemcells(CSCs) viaG-protein coupled receptorsS1Pn(n=1 to 5). The SphK/S1P axis is crucially involved in the regulation of embryonic development of vasculature and the nervous system, hematopoietic stem cell migration, regeneration of skeletal muscle, and development of multiple sclerosis. The ratio of the S1P receptor expression, localization, and specific S1P receptoractivated downstream effectors influenced the rate of selfrenewal and should be further explored as regeneration related targets. Considering malignant transformation,it is essential to control the level of self-renewal capacity.Proliferation of the progenitor cell should be synchronized with differentiation to provide healthy lifelong function of blood, immune systems, and replacement of damaged ordead cells. The differentiation-related role of SphK/S1P remains poorly assessed. A few pioneering investigations exploredpharmacologicaltoolsthattargetsphingolipid signaling and can potentially confine and direct self-renewal towards normal differentiation. Further investigation is required to test the role of the SphK/S1P axis in regulation of self-renewal and differentiation.

Facilitators of and barriers to emergency medical service use by acute ischemic stroke patients: A retrospective survey

Objective: The objective of the study was to identify facilitators and barriers to emergency medical service use among acute ischemic stroke patients in Korea.Methods: This paper presents a secondary analysis of a retrospective survey that collected data from questionnaires and medical records.Among 233 acute ischemic stroke patients enrolled in a large-scale study,160 patients who had arrived at a hospital within 72 h after symptom onset were included in the data analysis.Results: Users of emergency medical services needed a shorter time than non-users to arrive at hospital (140 min vs.625 min.,p =0.001) and were more likely to arrive at hospital within 3 h of symptom onset (51.9% vs.31.5%,p =0.013).For those who first contacted emergency medical service,the facilitators of emergency medical service use were the presence of hemiparesis (p =0.003),bilateral paralysis (p =0.040),and loss of balance (p =0.021).The predominant barrier was the failure to recognize the urgency of symptoms (p 0.006).Conclusions: The use of emergency medical services reduced prehospital delay and increased the likelihood of patient arrival at hospital within 3 h.Given that experiencing typical stroke symptoms was a facilitator of emergency medical service use yet failure to recognize the urgency of symptoms was a barrier,public awareness should be raised as regards stroke symptoms and the benefits of using emergency medical services.

The Impact of Fidget Spinners on Fine Motor Skills in Individuals with and without ADHD: An Exploratory Analysis

Fidget spinners have been marketed as repetitive motion devices that improve attention and motor performance, and as such, they have become quite appealing to individuals with Attention Deficit Hyperactive Disorder (ADHD). To date, no studies have explored changes in brain activity that may occur due to fidgeting in ADHD. Our aim was to use functional Near-Infrared Spectroscopy (fNIRS) to examine the prefrontal cortex (PFC) during the performance of a standardized fine motor skills test after using a fidget spinner. Eight right-handed adults with ADHD and eight age and gender matched adults without ADHD (4F/4M, 4 control/4 fidget) performed the Purdue Pegboard Test (PPT) while their brain oxygenation was monitored using fNIRS. Relative neural efficiency (RNE) and involvement (RNI) were calculated and analyzed for all subtasks of PPT including the less cognitively demanding fine motor subtasks and more complex assembly tasks. The fidget spinner improved both task performance and RNE in the ADHD group but not the non-ADHD group for the less cognitively demanding subtasks. Our results indicate Fidget spinners may improve both relative neural efficiency and fine motor performance in adults with ADHD for less cognitively demanding tasks.

Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline(updated version)

The novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the cause of a rapidly spreading illness,coronavirus disease 2019(COVID-19),affecting more than seventeen million people around the world.Diagnosis and treatment guidelines for clinicians caring for patients are needed.In the early stage,we have issued"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infected pneumonia(standard version)";now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline.We formed a working group of clinical experts and methodologists.The steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas:chemoprophylaxis,diagnosis,treatments,and discharge management.We searched the literature for direct evidence on the management of COVID-19,and assessed its certainty generated recommendations using the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)approach.Recommendations were either strong or weak,or in the form of ungraded consensus-based statement.Finally,we issued 34 statements.Among them,6 were strong recommendations for,14 were weak recommendations for,3 were weak recommendations against and 11 were ungraded consensus-based statement.They covered topics of chemoprophylaxis(including agents and Traditional Chinese Medicine(TCM)agents),diagnosis(including clinical manifestations,reverse transcription-polymerase chain reaction(RT-PCR),respiratory tract specimens,IgM and IgG antibody tests,chest computed tomography,chest X-ray,and CT features of asymptomatic infections),treatments(including lopinavirritonavir,umifenovir,favipiravir,interferon,remdesivir,combination of antiviral drugs,hydroxychloroquine/chloroquine,interleukin-6 inhibitors,interleukin-1 inhibitors,glucocorticoid,qingfei paidu decoction,lianhua qingwen granules/capsules,convalescent plasma,lung transplantation,invasive or noninvasive ventilation,and extracorporeal membrane oxygenation(ECMO)),and discharge management(including discharge criteria and management plan in patients whose RT-PCR retesting shows SARS-CoV-2 positive after discharge).We also created two figures of these recommendations for the implementation purpose.We hope these recommendations can help support healthcare workers caring for COVID-19 patients.

Clinical practice guidelines for traditional Chinese medicine and integrated traditional Chinese and western medicine:a cross-sectional study of data analysis from 2010 to 2020

Objective With the increasing publication of clinical practice guidelines(CPG)for Traditional Chinese Medicine(TCM)and Integrated Traditional Chinese and Western Medicine(IM),the standardization and scientifiction of its formulation have gradually attracted many people’s attention.To offer an overview of TCM and IM CPGs published over the past decade and analyze their general characteristics and methodological quality.Methods The China National Knowledge Infrastructure(CNKI)and WANFANG databases were searched for clinical practice guidelines and expert consensus papers from January 2010 to June 2021.Two researchers independently completed the literature screening and cross-checking according to the inclusion and exclusion criteria of CPGs and extracted information on general characteristics and methodological quality of CPGs.Results According to the selection criteria,231 CPGs(EB-CPGs=119,CBCPGs=112)were selected and the number of CPGs published in the 11 years showed an overall upward trend.The vast majority of CPGs used the Western naming system for the diseases,and only 11 CPGs were named of TCM diseases or symptoms.TCM treatments were recommended in 223 CPGs.There were 156 ancient Chinese Medicine literature sources cited in 231 CPGs and opinions and experiences of 62 TCM experts cited in 37 CPGs.The methodological quality of EB-CPGs for TCM and IM were significantly better than CB-CPGs in 11 items.Only 60 EB-CPGs and 7 CB-CPGs designated clear criteria for grading quality of evidence and strength of the recommendations and 74 CPGs presented both the level of evidence and the strength of recommendations.We classified all CPGs according to whether or not they used GRADE,and the results showed that the CPGs using GRADE had higher methodological quality and more standardized reports.Conclusion This research has shown that the quantity and quality of CPGs in both TCM and IM have improved over the time span,but the methodological quality,especially evidence citation,and the use of criteria for grading quality of evidence and strength of the recommendations,still needs to further improvement in the future.

Framing Cuisine with Food Loss and Waste as a Combined Nutrition Public Health Priority and Climate Change Mitigation Action

This paper proposes that fortifying honored traditional recipes with natural foods in tandem with preventing food loss and waste adds a new dimension to sustainable food management—nutrient recovery and bioavailability—while reducing the global prevalence of anemia and other diet-induced maladies. Using the complementarity of iron and Vitamin C as an example, this paper demonstrates that we can recover bioavailable nutrients to ensure recovery is efficient. The authors show by example that returning food loss and waste into a healthy food environment can meet the daily and monthly needs of iron-deficiency in substantial portions of the populations with significant need and in all countries. Further, maximizing the availability of key nutrients, like iron, will reduce the stress of animal husbandry on the environment, reduce greenhouse gas emissions;and thereby, reduce agriculture impacts to climate change and global warming. Considering the quality, quantity, and convenience of food recovery, from farm—and beyond fork—to gut, is key for global policy development in nutrition public health and actions that are ready to implement today.

The Prevalence of Psychosomatic Symptoms and Spirituality Levels among University Students in South Jordan

Psychosomatic symptoms are present in various stages of life. University students have also manifested such symptoms, which were also found to be linked to the level of spirituality affecting physical and psychological well-being. This study aims to examine whether spirituality can predict the presence of psychosomatic symptoms by investigating the relationship between the prevalence of psychosomatic symptoms and the level of spirituality among university students in South Jordan. An exploratory cross-sectional design involving convenience samples and self-administered questionnaires using the twelveitem general health questionnaire including spirituality-based items were used to collect data for this study. A total of 1269 completed the study questionnaire. Students’ responses indicated various psychosomatic symptoms causing issues to better academic achievement, including students’ feeling of uselessness, followed by their lack of happiness, inability to make decisions and solve problems, and lack of concentration on what they are doing. They considered spirituality as an important part of their life. Lower scores on general health questionnaire were observed to have higher scores on spirituality items indicating that students with better spirituality practices have less psychological symptoms. Based on the findings of this study, the level of spirituality influences the prevalence of psychosomatic symptoms. Conducting educational programs to improve the spiritual well-being of students could be beneficial. Further, it is important that students’ affairs board at the university perform proper assessment and interventions to improve the spirituality level to decrease the impact of psychosomatic symptoms among students.

Influence of childhood trauma on adolescent internet addiction: The mediating roles of loneliness and negative coping styles

BACKGROUND In the information age,the use of the internet and multimedia tools has large effects on the life of middle school students.Improper use of the internet may result in internet addiction(IA).Thus,actively exploring the factors influencing adolescent and the mechanism of addiction as well as promoting adolescent physical and mental health and academic development are priorities that families,schools,and society urgently need to address.AIM To explore the effect of childhood trauma on adolescent IA and to consider the roles of loneliness and negative coping styles.METHODS A total of 11310 students from six junior high schools in Henan,China,completed the child trauma questionnaire,IA test,loneliness scale,and simple coping style questionnaire.In addition,data were collected from 1044 adolescents with child-hood trauma for analysis with IBM SPSS 26.0 and AMOS 28.0;we examined the relationships among childhood trauma,IA,loneliness,and negative coping styles.RESULTS We found that childhood trauma not only directly affected adolescents’IA but also affected IA through loneliness and negative coping styles.CONCLUSION Therefore,this study has theoretical implications regarding adolescent mental health and may inform interventions for IA.

Incorporating HPS Model into Lebanese Public Schools: Comparison of Adolescents’ Smoking, Alcohol and Drug Use Behavior in HPS versus Other Public and Private Schools in Lebanon

In 2010, the World Health Organization supported the Lebanese Ministry of Education and Higher Education to establish a network of 10 Health Promoting Schools (HPS). This study was undertaken to address the extent to which the HPS model was able to produce changes in the risk behaviors of adolescents (Smoking, Drinking, and Drug Use) and prepare them to respond to evolving health challenges. A cross-sectional survey was carried out during 2011-2012 and compared Grade 6 - 9 students in HPS, and 10 other public and private schools. The Youth Risk Behavior Survey [1], and Carbon Monoxide measurements in adolescent breaths were used for data collection. Findings revealed that the current School Health Program failed to address issues of concern to adolescents with no significant differences in risk behaviors: smoking, alcohol and drug use. The HPS network needs reassessment to upgrade the outcomes of health education curricula. Expected learning outcomes and healthy practices must be designed to match students’ age, grade level, and developmental milestones.

Something’s Got to Give: A Description of Contemporary Nursing Students

Objective: The purpose of this study was to explore and describe the socio-demographic profiles, academic habits, and lived experiences of baccalaureate nursing students at a private university in Hawaii. Methods: A mixed method design of descriptive statistics and analysis was used. For this study, a semi-structured, twenty-five item survey was developed by the researchers and reviewed by other faculty for veracity. A convenience sample included level one (LV1) students (n = 91) and level five (LV5) students (n = 64) attending class on the day of the survey. Results: Analysis revealed that contemporary students have complex lives with multiple work, family, financial, program, and health challenges that impact their lives as students. The majority of students in this sample were identified as Asian or Pacific Islander. Fifty percent of students in both levels worked 20 hours per week and about 1/4 in both levels had children. About 25% spent more than 15 hours per week on social media and studied 1-2 hours per day. Fourteen percent of both levels reported getting less than five hours of sleep. Beginning students identified time management and work as the top two barriers to success. Those completing the program identified issues with the nursing program and family obligations. Conclusions: Factors identified in this study not only impact students’ performance in the classroom but also have implications for performance in the clinical areas. These factors suggest that nursing faculty take into consideration the perceived needs of students while maintaining ethics and high academic standards. The understanding gained from this study will inform curriculum revision and program development.

Using Geographic Information Systems (GIS) for Targeted National Recruitment of Community-Dwelling Caregivers Managing Dementia-Related Behavioral and Psychological Symptoms: A Recruitment Approach for a Randomized Clinical Trial

Over 16 million caregivers of people living with dementia require support in a range of issues, including self-care, disease education, and guidance for how to manage behavioral and psychological symptoms of dementia (BPSD). Non-pharmacological interventions are needed to address these areas, and online applications have been shown to be safe and effective. To ensure the efficacy of such interventions, racially, ethnically, geographically, and socioeconomically diverse participants must be recruited to increase the generalizability of study outcomes. This protocol paper describes a recruitment plan using Geographic Information Systems (GIS) to reach a representative sample of caregivers across the United States for a national Phase III clinical study. Using publicly available census data from the American Community Survey (ACS), combined with location data for local aging resources such as Area Agencies on Aging (AAA), recruitment will be derived from data analysis conducted in ESRI ArcGIS v10.7.1. Datasets including age, gender, income, and education will be assessed nationally at the county and census tract spatial scale in a nine-step process to develop recruitment priority areas containing high concentrations of eligible participants living in the community. Overall, the current protocol will demonstrate the value of GIS in tailoring targeted outreach strategies to recruit community-dwelling populations through local resource institutions. This novel approach may have far-reaching implications in future recruitment initiatives and help to secure racially/ethnically diverse samples.

Assessment of Maternal Readiness for Childbirth and Childrearing among Adolescent Mothers in Ghana

Background: Adolescent pregnancy is a public health problem of concern in developed, developing and underdeveloped countries. Trends in developing and underdeveloped countries are higher and account for most adverse pregnancy outcomes. Adolescence is a period of transition between childhood and adulthood. The burden of coping with changes with this transition and at the same time preparing for childbirth puts pregnant adolescent girls on edge. Childbirth and childrearing are critical moments that require support and specialized skills to nurture healthy infants. Aim: This study aims to assess the readiness of adolescent expectant mothers towards childbirth and childrearing in the Komenda/Edina/Eguafo/Abirem (KEEA) district of the central region of Ghana. Methods: This study utilized the total population sampling technique to collect data from three sites that offer specialized adolescent antenatal services within the KEEA district of the central region of Ghana. Data were analyzed using SPSS version 22.0 and results presented as descriptive statistics. Results: This study assessed maternal readiness for childbirth and childrearing among 98 pregnant adolescent girls. The study was dominated by late adolescents who made up 86.7% of study participants. Regarding readiness for childrearing, the majority (74.5%) said they could not independently cater for their children and will require some support. The majority (52.0%) have had some form of counseling with a greater number (41.2%) coming from parents. Regarding readiness to embrace childbirth, the majority (82.4%) of respondents said they had companions who were willing to support them during childbirth. The majority (57.1%) of respondents have packed their delivery items although only 13.3% of them knew their expected dates of delivery. About 37.8% of respondents had knowledge of the possibility of having blood transfusion during delivery. Conclusion: Adolescent pregnancy is pervasive, and adolescent mothers require optimal support to ensure safe motherhood. Health promotion activities must be streamlined to meet their specific needs. Their significant others must actively be involved in their perinatal counseling to enhance compliance with health and wellbeing programs.

Knowledge and Perceived Barriers towards Intermittent Prevention of Malaria in Pregnancy: A Cross-Sectional Study

Background: Intermittent prevention of malaria is a key strategy adopted globally to ensure the wellbeing of pregnant women. By extension, these strategies enhance the healthy development of the fetus. This study assesses the knowledge and practices of pregnant women towards intermittent malaria prevention strategies in the Juaben Government Hospital of Ghana. Methods: A cross-sectional, quantitative, descriptive survey was conducted among 120 pregnant women at the antenatal clinic of the Juaben Government hospital in the Ashanti region of Ghana using a simple random sampling technique in selecting the study participants. The participant response rate was 94.5%. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22.0. Results: Majority (54.2%) of respondents were between 20 - 29 years of age. Majority of study respondents attended Antenatal visits in their first trimester of pregnancy. Majority (69.2%) have knowledge of malaria preventive strategies in pregnancy, with about 70% of respondents stating these strategies were designed only for pregnant women. Only 37.5% of study respondents could rightly identify the chemoprophylaxis indicated for malaria prevention in pregnancy. Whereas majority (93.3%) of respondents owned insecticide-treated mosquito nets, only 63.3% utilized these nets for their purpose. Barriers to utilization of insecticide-treated nets include difficulty in setting up the nets (26.7%), using mosquito coils (10.8%), and feeling uncomfortable sleeping in the nets (36.7%). Barriers to taking malaria prophylaxis include distance to health facilities (28.3%), thoughts of not being sick with malaria (55.8%), using herbs (10.0%), and not being aware of the essence of prophylaxis (7.5%). Conclusion: Knowledge of malaria preventive strategies in pregnancy is high. However, utilization of these strategies is low due to perceived human and institutional barriers. A comprehensive community-wide approach is required to improve the utilization of these services among pregnant women.

Multilevel Modeling of PM2.5 and Risk of Cardiovascular Disease and Diabetes Mellitus in Adults Aged 65 and Older

We aimed to test a hypothesis that elevated ambient particulate matter (PM) 2.5 concentrations are significantly associated with risk of coronary heart disease (CHD), stroke, and diabetes mellitus (DM) in adults aged 65 and older. We analyzed data (2010-2013) from U.S. 1118 counties to examine the association between PM2.5 concentrations and risk of prevalent CHD, stroke, and DM, and mortality from cardiovascular disease (CVD), CHD, stroke, and DM in adults aged ≥ 65. Multilevel regression analysis technique was applied to test these associations. The results show that the annual mean of PM2.5 concentration was 8.7 μg/m3 in the total study sample. Significant differences in mean PM2.5 concentrations were observed across counties and states in the U.S. Multilevel regression analysis indicates that an average annual concentration of 1 μg/m3 increase in PM2.5 concentration was significantly associated with an increased prevalence of CHD, stroke, and DM by 4.9‰ (95% CI: 3.1‰ - 6.7‰), 0.8‰ (0.5‰ - 1.1‰), and 3.3‰ (2.9‰ - 4.4‰), respectively. State-level correlation analyses indicate that increased PM2.5 concentrations were significantly associated with increased age-adjusted mortality from CVD (r = 0.76, p < 0.001), CHD (r = 0.0.40, p = 0.004), stroke (r = 0.60, p p = 0.02). In conclusion, Elevated PM2.5 concentrations were significantly associated with an increased risk of the prevalence and mortality from CVD, CHD, stroke, and DM. Continued effort to control ambient PM2.5 concentrations could play an important role in risk reduction of cardiovascular disease and diabetes in the elderly.

Development of a Total Flavonoids Extract of Artemisia Rupestris L.via Nanotechnology and Its Antiviral Effect In Vitro

Objective:We aimed to develop a novel Artemisia rupestris L.flavonoid nano-encapsulation(AFN)preparation and evaulate its anti-hepatitis B virus(HBV)activityin vitro.Methods:First,the AFN was prepared using polylactic-co-glycolic acid(PLGA).Then,after verification of the AFN,in vitro anti-virus assays were conducted by:(1)assessing the inhibitory effect of AFN on the secretion of hepatitis B surface antigens(HBsAg),hepatitis B e-antigens(HBeAg),and the replication of HBV DNAin HepG2.2.15 cells;(2)analyzing the influence of AFN on the activation rate of NF-κB positive cells;and(3)evaluating the effect of AFN on the function of glutathione peroxidase(GSH-PX)enzymes located onthe HepG2.2.15 cell membrane.Results:Compared to the original total flavonoids extract of Artemisia rupestris L.(withoutnano-encapsulation),AFN preparation under the maximum nontoxic concentration effectively inhibited the secretion of HBsAg,HBeAg,and HBV DNA from HepG2.2.15 cells.At the same time,AFN preparation promoted not only the activation rate of NF-κB positive cells,but also antiviral GSH-PX enzyme function.In conclusion,nano-encapsulation of the flavonoids extract of Artemisia rupestris L.showed an enhanced anti-HBV effect in vitro compared to the original total flavonoids extract(without nanoencapsulation);therefore,nano-encapsulation has great potential for the development of a novel antiviral herbal medicine preparation with improved efficacy.