Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Met...Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Methods:Applying the evidence-based nursing model and nursing intervention theory based on the survey research by searching China Knowledge Network,Wanfang Database and Wipro Chinese Science and Technology Journal Database,the study collected the literature on the health prescription intervention research in children’s Tourette’s disorders health education in children’s health education of specialized nursing outpatient clinic for review and combined with the specialty characteristics to formulate“Children’s Tourette’s Disorder Health Education Prescription.”Results:Tourette’s syndrome in children is a common pediatric neurological disorder,mainly manifested as involuntary,rapid and repeated muscle twitching and vocal tics,which brings serious psychological pressure and life disturbance to the affected children.Conclusion:For children with Tourette’s syndrome,healthcare professionals should give enough care and understanding to the children and their parents,provide timely and effective health education to them,help them improve their bad behavioral habits,establish correct cognitive attitudes,enhance self-confidence,improve patient compliance,reduce the frequency of recurrence,reduce the incidence of complications and promote children’s physical and mental health development.展开更多
This study was carried out in order to investigate the professionals’ feelings concerning the care in the Center for Children and Youth Psychosocial Care, as well as to evidence the advantages and difficulties of thi...This study was carried out in order to investigate the professionals’ feelings concerning the care in the Center for Children and Youth Psychosocial Care, as well as to evidence the advantages and difficulties of this work. This was a qualitative research guided by the social phenomenology of Al-fred Schütz. 13 health professionals from CAPSi between November 2008 and January 2009 were interviewed. We identified three categories: First feelings, difficulties of care and motivation for the care. The first category, awakened feelings, relates to the beginning of work with children and adolescents in CAPSi. The second motivation for the care, relates to the points highlighted as conducive to work. The third, difficulties in Caring for expressing the difficulties encountered in mental health of children and adolescents in CAPSi. We concluded that the care depends of knowledge, experience and service conditions in order to attend the needs of children and adolescents in CAPSi.展开更多
This study aims to identify the actions performed by nurses of the Family Health Strategy with the pregnancy cycle of adolescents and analyze if the actions developed by these nurses are focused on risk prevention in ...This study aims to identify the actions performed by nurses of the Family Health Strategy with the pregnancy cycle of adolescents and analyze if the actions developed by these nurses are focused on risk prevention in pregnancy and childbirth. It is a qualitative and exploratory research in basic health units with 12 nurses. A semi-structured interview technique was applied, and the speeches were analyzed using content analysis. In the analysis of the results, it was identified two thematic categories in which it was noted that nurses during the prenatal make the reception of pregnant adolescents differently and conduct guidelines on examination, signs and symptoms of possible complications during the pregnancy and still emphasize the importance of educational activities as groups of pregnant women to be a chance of coexistence and exchange of experiences, doubts, and anxieties among themselves. It is concluded that the care provided by nurses is fundamental for the pregnant adolescents having prenatal with more quality.展开更多
Objective:This study aims to examine the effects of a community-based friendly health clinic(CFHC)program that adopts manual participatory learning(MPL)intervention on the adolescents living in the rural and urban are...Objective:This study aims to examine the effects of a community-based friendly health clinic(CFHC)program that adopts manual participatory learning(MPL)intervention on the adolescents living in the rural and urban areas of Indonesia to gain further insights into their knowledge,attitudes,and skills related to adolescent reproductive health(ARH).Methods:A quasi-experimental design was used to obtain information on the ARH knowledge,attitudes,and skills of adolescents.Two intervention studies that used similar protocols and measures were conducted.A total of 192 adolescents(96 adolescents from urban and rural areas)participated in the project,and the participants from each area were divided into eight groups.A questionairre was adopted to measure the ARH knowledge,attitudes,and skills of these participants.A content analysis of the logbook entries of these respondents was conducted to identify their ARH-related problems.The questionnairre and self-reported ARH data were collected before and after the eight-week program.Results:The CFHC program significantly increased the ARH attitudes(p=0.045)and skills(p=0.009)of adolescents in the rural area,but only improved the ARH knowledge(p<0.001)of adolescents in both rural and urban areas.Fourteen themes were identified in three dominant categories,namely,schools,families,and communities.Conclusions:The CFHC with MPL intervention can improve the ARH knowledge,attitudes,and skills of adolescents in the rural area,but can only improve the ARH knowledge of adolescents in the urban area.The ARH program must be designed based on the characterictics of these adolescents to improve their life skills during puberty.展开更多
Background: Ministry of Health, Government of India developed the Adolescent Reproductive and Sexual Health (ARSH) strategy and operationalized adolescent health services up to district and sub-district hospital level...Background: Ministry of Health, Government of India developed the Adolescent Reproductive and Sexual Health (ARSH) strategy and operationalized adolescent health services up to district and sub-district hospital level. Objectives: To operationalize adolescent health services at primary health care level in a block of Maharashtra;assess impact of need based interventions on quality of services;and understand potential for scalability in the state. Methods: Adolescent and Youth friendly centers were established at primary health care settings and interventions such as health system strengthening, sensitizing gatekeepers, involving Accredited Social Health Activist (ASHAs), developing inter and intra-sectoral linkages, improving monitoring and evaluation were tested. Results: Over a period of 2009-2014, there was a steady increase in the number of clients attending the Adolescent and Youth Friendly Health Centers (A&YFHCs). Attitude of providers to address adolescents’ needs improved significantly. Successful interventions were networking with schools, colleges and Non Government Organization (NGOs), linkages with HIV program and Integrated Child Development Services (ICDS), and involvement of ASHAs. Conclusions: The study demonstrates that although health system has the primary responsibility of addressing health issues among adolescents;it has limitations in terms of its reach to adolescents and generating demand for services. There is a need to network with education sector, ICDS, NGOs working for adolescent health and development to work as a team and address the multifaceted needs of the adolescents. Such a strategy will be crucial while implementing the recently launched Rashtriya Kishor Swasthya Karyakram— the new national adolescent health programme in India.展开更多
The objective of this study was to evaluate the performance of oral functions and oral conditions in children and adolescents with overweight or obesity, investigating possible associations with treatment for weight r...The objective of this study was to evaluate the performance of oral functions and oral conditions in children and adolescents with overweight or obesity, investigating possible associations with treatment for weight reduction. Developing a cross-sectional research and quantitative approach with inductive and descriptive and critical analysis of data, such as from a range of 95%, the universe was represented by children and adolescents who were overweight or obese, in both sexes, treated at reference centers for the treatment of obesity by the National Health System, in Campina Grande, Paraíba, 2010-2012. As the control group considered subjects of the same age, in the process of screening for attention in the places listed, but without the condition of overweight or obese, the research was started after the approval by the Ethics Resarch Committee of the UEPB under the protocol number 0513.0.133.000-09. As instruments for data collection were used in the questionnaire and clinical examination, of the 70 surveyed, most were female, ranging in age from 3 to 17 years, overweight, without comorbidities and carriers of deleterious oral habits;especially the nail biting, significantly associated with female sex p < 0.05. Consistency was the preferred food paste and chewing quickly, unilaterally, without discomfort or gagging constant. There was a significant difference between the values of the DMFT index, the presence of visible biofilm and the frequency of halitosis, for groups with overweight or obesity, with association between time of treatment and medications.展开更多
The health and mental well-being of children and adolescents in general is good.Most are satisfied with their lives,perceive their health to be good,and do not regularly suffer from health complaints.The main problems...The health and mental well-being of children and adolescents in general is good.Most are satisfied with their lives,perceive their health to be good,and do not regularly suffer from health complaints.The main problems of the first half of the 20th century,such as acute infections and high infant mortality,have diminished in importance.Instead of physical disorders,mental illness accounts for a large and growing share of ill health among children and adolescents in Europe.Including emotional problems,this may conduct problems and learning disabilities came to the fore in the middle of the last century.Currently,the frame of mental health and socio-economic influences on health has risen to achieve importance within child and adolescent health.World Health Organization(WHO)declared that young people’s mental health is a key area of concern to which professionals and policy-makers must direct their attention.Focusing only on mental health disorders does not give the whole picture of the state of mental health among young people.A general problem is the predominant understanding of mental health as the absence of mental disorder.Risk factor research has focused on mental health problems rather than strengths and positive outcomes.Consideration of resilience has emerged from research indicating that a proportion of young people had a positive life trajectory despite having faced diverse potentially harmful life experiences.Worldwide up to 20%of children and adolescents suffer from disabling mental health problems:Mental health of adolescents and youth,it is a very problematic issue that is not expressed only with elements.This required a lot of analysis and statistic to arrive for a result which serves to us for knowing and preventive the problem.As an issue,we must identify two major part of this:What is mental health(definition,cause,diffusion,ages,and preventive)?And what can we do to improve the mental health of Adolescents and Youth(family,society,hospitals,school,and public places)?The estimates of psychological problems and disorders may therefore be higher than is reported in studies.On an individual level,mental health problems can have deteriorating effects on young people’s social,intellectual,and emotional development and consequently on their future.At its worst,they can lead to loss of life.Suicide is one of the three leading causes of death in young people and a public health concern in many European countries.Besides the negative effects on an individual level,mental illness affects also many other spheres of life―family,friends,and society at large―causing costs not only in health care system.Furthermore,there are close links between child and adult mental illness―the presence of mental illness during childhood may lead to up to 10 times higher costs during adulthood.Children are our future.Through well-conceived policy and planning,government can promote the mental health of children,for the benefit of the child,the family,the community,and society.展开更多
Objective:To investigate the status quo of spiritual care competence and assocaited influencing factors among clinical nurses in China,and examine the relationships among spiritual care perceptions,spiritual health an...Objective:To investigate the status quo of spiritual care competence and assocaited influencing factors among clinical nurses in China,and examine the relationships among spiritual care perceptions,spiritual health and spiritual care competence,and the mediating role of spiritual health between spiritual care competence and spiritual care perceptions,in order to provide reference for the construction of spiritual care education intervention program to improve the spiritual care competence of clinical nurses in China.Methods:A total of 1454 clinical nurses from 17 hospitals in Tianjin were selected by convenience sampling method,and were investigated with sociodemographic characteristics questionnaire,the Chinese version of Spiritual Care Competence Scale(C-SCCS),the Chinese Version of the Spiritual Care-Giving Scale(C-SCGS)and the Spiritual Health Scale Short Form(SHS-SF).Results:The scores of spiritual care competence of nurses was(57.52±16.02).The results of multiple linear regression showed that nurses'spiritual care competence was influenced by 9 sociodemographic characteristics such as educational background and nursing age,as well as spiritual care perceptions and spiritual health factors,which accounted for 67.2%of the total variation.And spiritual care competence was positively correlated with spiritual care perceptions(r=0.639,P<0.01)and spiritual health(r=0.596,P<0.01).Besides,spiritual health played a mediating role between between other two variables,accounting for 27.5%of the indirect effect.Conclusions:The scores of spiritual care competence of clinical nurses was in the lower middle level,which needs to be further improved.It is recommended that nurse managers and educators should pay attention to the spiritual care education of nurses,and improve spiritual care perceptions and spiritual health level of nurses in multiple ways,at multiple levels,so as to improve their spiritual care competence and to maximize the satisfy spiritual care needs of patients.展开更多
Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread...Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread press coverage of ensuing chaos in clinical administration. We wanted to know how this new electronic system impacted on our working patterns in outpatient clinics and – more specifically – on the time actually spent with the patients. Material & methods: This study was performed 4 and 12 months after implementation of CRS to assess its impact on the time distribution in clinic. Senior doctors were monitored with a stop clock during consultations. Timings for pre- and post-consultation administration, and the actual consultation with the patient were recorded. A total of 170 consultations were evaluated in this way. Results: The key findings were that the total time needed to spend on a urological outpatient of 16 minutes remains unchanged from the pre-CRS era, but a majority (57%) of this time is spent in administration on the computer without the patient involved. Conclusion: No more than 15 patients should be seen in a 4 hour outpatient clinic per doctor. This recommendation drawn up by BAUS before CRS remains still valid. Patient administration related to the consultation that has previously been done by administrative aides is now to be done by the doctors on the computer in the same consultation session. Intended to streamline patient pathways, this does reduce the quality interaction-time between doctor and patients significantly.展开更多
‘Neurodevelopmental disorders’comprise a group of congenital or acquired longterm conditions that are attributed to disturbance of the brain and or neuromuscular system and create functional limitations,including au...‘Neurodevelopmental disorders’comprise a group of congenital or acquired longterm conditions that are attributed to disturbance of the brain and or neuromuscular system and create functional limitations,including autism spectrum disorder,attention deficit/hyperactivity disorder,tic disorder/Tourette’s syndrome,developmental language disorders and intellectual disability.Cerebral palsy and epilepsy are often associated with these conditions within the broader framework of paediatric neurodisability.Co-occurrence with each other and with other mental health disorders including anxiety and mood disorders and behavioural disturbance is often the norm.Together these are referred to as neurodevelopmental,emotional,behavioural,and intellectual disorders(NDEBIDs)in this paper.Varying prevalence rates for NDEBID have been reported in developed countries,up to 15%,based on varying methodologies and definitions.NDEBIDs are commonly managed by either child health paediatricians or child/adolescent mental health(CAMH)professionals,working within multidisciplinary teams alongside social care,education,allied healthcare practitioners and voluntary sector.Fragmented services are common problems for children and young people with multi-morbidity,and often complicated by subthreshold diagnoses.Despite repeated reviews,limited consensus among clinicians about classification of the various NDEBIDs may hamper service improvement based upon research.The recently developed“Mental,Behavioural and Neurodevelopmental disorder”chapter of the International Classification of Diseases-11 offers a way forward.In this narrative review we search the extant literature and discussed a brief overview of the aetiology and prevalence of NDEBID,enumerate common problems associated with current classification systems and provide recommendations for a more integrated approach to the nosology and clinical care of these related conditions.展开更多
Aim: To explore family responsibility dynamics, metabolic control, clinic attendance, and emergency admissions when young adults (YA) with type 1 diabetes transition to an adult hospital. Method: A longitudinal mixed ...Aim: To explore family responsibility dynamics, metabolic control, clinic attendance, and emergency admissions when young adults (YA) with type 1 diabetes transition to an adult hospital. Method: A longitudinal mixed method design with two study groups (parents, n = 28;YA intervention group, n = 23) and a YA comparison group (n = 20). Sample recruited from an outpatient diabetes centre. Demographic, clinic attendance, emergency admissions, biodata, and the Diabetes Family Responsibility Questionnaire (DFRQ) were completed on entry and sixmonths later as part of an 18-month trial of a diabetes transition coordinator (DTC). The selfreport DFRQ were analyzed using derived parent-child dyadic variables to explore differences at baseline and end of study using Wilcoxon Signed Rank Test. The relationship between metabolic control and the DFRQ patterns was explored using Spearman’s rho. Results: On completion of the study, the change in HBA1Cfor both adolescent groups was not significant but was less than ideal for 25% of adolescents in the study. The YA intervention group had significantly fewer missed appointments between them compared to the comparison group. The DFRQ indicated that the derived parent-child dyadic variable of task-discordance increased during the study. Conclusion: The clinically relevant diabetes-task dissonance between parents and young adults offers a challenge and a diagnostic opportunity for diabetes educators.展开更多
BACKGROUND Non-invasive tests,such as Fibrosis-4 index and transient elastography(com-monly FibroScan),are utilized in clinical pathways to risk stratify and diagnose non-alcoholic fatty liver disease(NAFLD).In 2018,a...BACKGROUND Non-invasive tests,such as Fibrosis-4 index and transient elastography(com-monly FibroScan),are utilized in clinical pathways to risk stratify and diagnose non-alcoholic fatty liver disease(NAFLD).In 2018,a clinical decision support tool(CDST)was implemented to guide primary care providers(PCPs)on use of FibroScan for NAFLD.AIM To analyze how this CDST impacted health care utilization and patient outcomes.METHODS We performed a retrospective review of adults who had FibroScan for NAFLD indication from January 2015 to December 2017(pre-CDST)or January 2018 to December 2020(post-CDST).Outcomes included FibroScan result,laboratory tests,imaging studies,specialty referral,patient morbidity and mortality.RESULTS We identified 958 patients who had FibroScan,115 before and 843 after the CDST was implemented.The percentage of FibroScans ordered by PCPs increased from 33%to 67.1%.The percentage of patients diagnosed with early F1 fibrosis,on a scale from F0 to F4,increased from 7.8%to 14.2%.Those diagnosed with ad-vanced F4 fibrosis decreased from 28.7%to 16.5%.There were fewer laboratory tests,imaging studies and biopsy after the CDST was implemented.Though there were more specialty referrals placed after the CDST was implemented,multivariate analysis revealed that healthcare utilization aligned with fibrosis score,whereby patients with more advanced disease had more referrals.Very few patients were hospitalized or died.CONCLUSION This CDST empowered PCPs to diagnose and manage patients with NAFLD with appropriate allocation of care towards patients with more advanced disease.展开更多
Purpose: Carrying out a scoping review to fill gaps in current knowledge regarding comfort needs in the care provided by nurses to girls/women who experience puerperium. Methods: The procedures guided by the Joanna Br...Purpose: Carrying out a scoping review to fill gaps in current knowledge regarding comfort needs in the care provided by nurses to girls/women who experience puerperium. Methods: The procedures guided by the Joanna Briggs Institute will be applied. The searches will be carried out in the Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Nursing Database, Scientific Electronic Library databases. Studies which are available in full and published in English, Spanish or Portuguese will be selected. There will be no restrictions to the study design or time frame. Two reviewers will independently screen all citations with the aid of software. The degree of agreement between the researchers will be verified by statistics that measure reliability. Through narrative descriptions, charts, and tables, we will present the results obtained. Data analysis will involve descriptive statistics, and qualitative evaluation. We will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist to review and write this review. Conclusion: We will summarize the main information available in the literature on the subject, aiming to obtain an overview of the practices employed, and the gaps present in knowledge that require greater attention from the scientific community.展开更多
目的梳理人工智能在中医药临床研究中的应用现状,为充分发挥人工智能在中医药研究领域的作用提供参考依据。方法检索中国知网、万方、中国科技期刊数据库、PubMed和Web of Science核心数据库,收集公开发表的针对人工智能在中医药临床研...目的梳理人工智能在中医药临床研究中的应用现状,为充分发挥人工智能在中医药研究领域的作用提供参考依据。方法检索中国知网、万方、中国科技期刊数据库、PubMed和Web of Science核心数据库,收集公开发表的针对人工智能在中医药临床研究中应用的文献,进行分析。结果最终纳入32篇文献,均来自中国,发文年限在2014—2023年。研究主要来自高校和医疗机构。纳入的文献均为观察性研究,共包含病例47564例。人工智能在中医药临床研究中的应用包含10个方面,排名前三的分别为:(1)根据中医证型预测疾病发生风险,预测准确率均在80%以上;(2)预测疾病的中医证型,预测准确率高达99.16%;(3)利用人工智能探索疾病的中医证型与理化指标的关联,准确率最高达96.4%。其余7个分别为利用人工智能挖掘并构建了舌图像与疾病的关联模型、辅助诊断、根据中医人格及体质预测疾病发生风险、预测疾病预后、根据中医脉象信号预测疾病发生风险、预测中成药不良反应发生率。结论人工智能在中医药临床研究中赋能效果明显,可有效提高患者的诊疗质量,避免医疗资源的浪费。展开更多
Conventional dentistry or periodontal research often ignores the human component in favor of clinical outcomes and biological causes.Clinical research is driven by the statistical significance of outcome parameters ra...Conventional dentistry or periodontal research often ignores the human component in favor of clinical outcomes and biological causes.Clinical research is driven by the statistical significance of outcome parameters rather than the satisfaction level of the patient.In this context,patient-centric periodontal research(PCPR)is an approach that considers the patient´s feedback concerning their functional status,experience,clinical outcomes,and accessibility to their treatments.It is argued that data self-reported by the patient might have low reliability owing to the confounding effect of their personal belief,cultural background,and social and economic factors.However,literature has shown that the incorporation of“patient-centric outcome”components considerably enhances the validity and applicability of research findings.Variations in the results of different studies might be due to the use of different and non-standardized assessment tools.To overcome this problem,this editorial enlists various reliable tools available in the literature.In conclusion,we advocate that the focus of researchers should shift from mere periodontal research to PCPR so that the results can be effectively applied in clinical settings and the therapeutic strategy can also change from mere periodontal therapy to patient-centric periodontal therapy.展开更多
文摘Objective:This study designs and implements the health prescription of children’s health education specialized nursing clinic based on the physical and mental characteristics of children with Tourette’s syndrome.Methods:Applying the evidence-based nursing model and nursing intervention theory based on the survey research by searching China Knowledge Network,Wanfang Database and Wipro Chinese Science and Technology Journal Database,the study collected the literature on the health prescription intervention research in children’s Tourette’s disorders health education in children’s health education of specialized nursing outpatient clinic for review and combined with the specialty characteristics to formulate“Children’s Tourette’s Disorder Health Education Prescription.”Results:Tourette’s syndrome in children is a common pediatric neurological disorder,mainly manifested as involuntary,rapid and repeated muscle twitching and vocal tics,which brings serious psychological pressure and life disturbance to the affected children.Conclusion:For children with Tourette’s syndrome,healthcare professionals should give enough care and understanding to the children and their parents,provide timely and effective health education to them,help them improve their bad behavioral habits,establish correct cognitive attitudes,enhance self-confidence,improve patient compliance,reduce the frequency of recurrence,reduce the incidence of complications and promote children’s physical and mental health development.
文摘This study was carried out in order to investigate the professionals’ feelings concerning the care in the Center for Children and Youth Psychosocial Care, as well as to evidence the advantages and difficulties of this work. This was a qualitative research guided by the social phenomenology of Al-fred Schütz. 13 health professionals from CAPSi between November 2008 and January 2009 were interviewed. We identified three categories: First feelings, difficulties of care and motivation for the care. The first category, awakened feelings, relates to the beginning of work with children and adolescents in CAPSi. The second motivation for the care, relates to the points highlighted as conducive to work. The third, difficulties in Caring for expressing the difficulties encountered in mental health of children and adolescents in CAPSi. We concluded that the care depends of knowledge, experience and service conditions in order to attend the needs of children and adolescents in CAPSi.
文摘This study aims to identify the actions performed by nurses of the Family Health Strategy with the pregnancy cycle of adolescents and analyze if the actions developed by these nurses are focused on risk prevention in pregnancy and childbirth. It is a qualitative and exploratory research in basic health units with 12 nurses. A semi-structured interview technique was applied, and the speeches were analyzed using content analysis. In the analysis of the results, it was identified two thematic categories in which it was noted that nurses during the prenatal make the reception of pregnant adolescents differently and conduct guidelines on examination, signs and symptoms of possible complications during the pregnancy and still emphasize the importance of educational activities as groups of pregnant women to be a chance of coexistence and exchange of experiences, doubts, and anxieties among themselves. It is concluded that the care provided by nurses is fundamental for the pregnant adolescents having prenatal with more quality.
基金The author(s)would like to thank the grant is provided by the Ministry of Research,Technology,and Higher Education,Directorate General of Resources for Research,Technology and Higher Education of Indonesia for providing this research,School of Nursing,University of Jember,and Research Center Department(Lembaga Penelitian)of University of Jember.
文摘Objective:This study aims to examine the effects of a community-based friendly health clinic(CFHC)program that adopts manual participatory learning(MPL)intervention on the adolescents living in the rural and urban areas of Indonesia to gain further insights into their knowledge,attitudes,and skills related to adolescent reproductive health(ARH).Methods:A quasi-experimental design was used to obtain information on the ARH knowledge,attitudes,and skills of adolescents.Two intervention studies that used similar protocols and measures were conducted.A total of 192 adolescents(96 adolescents from urban and rural areas)participated in the project,and the participants from each area were divided into eight groups.A questionairre was adopted to measure the ARH knowledge,attitudes,and skills of these participants.A content analysis of the logbook entries of these respondents was conducted to identify their ARH-related problems.The questionnairre and self-reported ARH data were collected before and after the eight-week program.Results:The CFHC program significantly increased the ARH attitudes(p=0.045)and skills(p=0.009)of adolescents in the rural area,but only improved the ARH knowledge(p<0.001)of adolescents in both rural and urban areas.Fourteen themes were identified in three dominant categories,namely,schools,families,and communities.Conclusions:The CFHC with MPL intervention can improve the ARH knowledge,attitudes,and skills of adolescents in the rural area,but can only improve the ARH knowledge of adolescents in the urban area.The ARH program must be designed based on the characterictics of these adolescents to improve their life skills during puberty.
文摘Background: Ministry of Health, Government of India developed the Adolescent Reproductive and Sexual Health (ARSH) strategy and operationalized adolescent health services up to district and sub-district hospital level. Objectives: To operationalize adolescent health services at primary health care level in a block of Maharashtra;assess impact of need based interventions on quality of services;and understand potential for scalability in the state. Methods: Adolescent and Youth friendly centers were established at primary health care settings and interventions such as health system strengthening, sensitizing gatekeepers, involving Accredited Social Health Activist (ASHAs), developing inter and intra-sectoral linkages, improving monitoring and evaluation were tested. Results: Over a period of 2009-2014, there was a steady increase in the number of clients attending the Adolescent and Youth Friendly Health Centers (A&YFHCs). Attitude of providers to address adolescents’ needs improved significantly. Successful interventions were networking with schools, colleges and Non Government Organization (NGOs), linkages with HIV program and Integrated Child Development Services (ICDS), and involvement of ASHAs. Conclusions: The study demonstrates that although health system has the primary responsibility of addressing health issues among adolescents;it has limitations in terms of its reach to adolescents and generating demand for services. There is a need to network with education sector, ICDS, NGOs working for adolescent health and development to work as a team and address the multifaceted needs of the adolescents. Such a strategy will be crucial while implementing the recently launched Rashtriya Kishor Swasthya Karyakram— the new national adolescent health programme in India.
文摘The objective of this study was to evaluate the performance of oral functions and oral conditions in children and adolescents with overweight or obesity, investigating possible associations with treatment for weight reduction. Developing a cross-sectional research and quantitative approach with inductive and descriptive and critical analysis of data, such as from a range of 95%, the universe was represented by children and adolescents who were overweight or obese, in both sexes, treated at reference centers for the treatment of obesity by the National Health System, in Campina Grande, Paraíba, 2010-2012. As the control group considered subjects of the same age, in the process of screening for attention in the places listed, but without the condition of overweight or obese, the research was started after the approval by the Ethics Resarch Committee of the UEPB under the protocol number 0513.0.133.000-09. As instruments for data collection were used in the questionnaire and clinical examination, of the 70 surveyed, most were female, ranging in age from 3 to 17 years, overweight, without comorbidities and carriers of deleterious oral habits;especially the nail biting, significantly associated with female sex p < 0.05. Consistency was the preferred food paste and chewing quickly, unilaterally, without discomfort or gagging constant. There was a significant difference between the values of the DMFT index, the presence of visible biofilm and the frequency of halitosis, for groups with overweight or obesity, with association between time of treatment and medications.
文摘The health and mental well-being of children and adolescents in general is good.Most are satisfied with their lives,perceive their health to be good,and do not regularly suffer from health complaints.The main problems of the first half of the 20th century,such as acute infections and high infant mortality,have diminished in importance.Instead of physical disorders,mental illness accounts for a large and growing share of ill health among children and adolescents in Europe.Including emotional problems,this may conduct problems and learning disabilities came to the fore in the middle of the last century.Currently,the frame of mental health and socio-economic influences on health has risen to achieve importance within child and adolescent health.World Health Organization(WHO)declared that young people’s mental health is a key area of concern to which professionals and policy-makers must direct their attention.Focusing only on mental health disorders does not give the whole picture of the state of mental health among young people.A general problem is the predominant understanding of mental health as the absence of mental disorder.Risk factor research has focused on mental health problems rather than strengths and positive outcomes.Consideration of resilience has emerged from research indicating that a proportion of young people had a positive life trajectory despite having faced diverse potentially harmful life experiences.Worldwide up to 20%of children and adolescents suffer from disabling mental health problems:Mental health of adolescents and youth,it is a very problematic issue that is not expressed only with elements.This required a lot of analysis and statistic to arrive for a result which serves to us for knowing and preventive the problem.As an issue,we must identify two major part of this:What is mental health(definition,cause,diffusion,ages,and preventive)?And what can we do to improve the mental health of Adolescents and Youth(family,society,hospitals,school,and public places)?The estimates of psychological problems and disorders may therefore be higher than is reported in studies.On an individual level,mental health problems can have deteriorating effects on young people’s social,intellectual,and emotional development and consequently on their future.At its worst,they can lead to loss of life.Suicide is one of the three leading causes of death in young people and a public health concern in many European countries.Besides the negative effects on an individual level,mental illness affects also many other spheres of life―family,friends,and society at large―causing costs not only in health care system.Furthermore,there are close links between child and adult mental illness―the presence of mental illness during childhood may lead to up to 10 times higher costs during adulthood.Children are our future.Through well-conceived policy and planning,government can promote the mental health of children,for the benefit of the child,the family,the community,and society.
文摘Objective:To investigate the status quo of spiritual care competence and assocaited influencing factors among clinical nurses in China,and examine the relationships among spiritual care perceptions,spiritual health and spiritual care competence,and the mediating role of spiritual health between spiritual care competence and spiritual care perceptions,in order to provide reference for the construction of spiritual care education intervention program to improve the spiritual care competence of clinical nurses in China.Methods:A total of 1454 clinical nurses from 17 hospitals in Tianjin were selected by convenience sampling method,and were investigated with sociodemographic characteristics questionnaire,the Chinese version of Spiritual Care Competence Scale(C-SCCS),the Chinese Version of the Spiritual Care-Giving Scale(C-SCGS)and the Spiritual Health Scale Short Form(SHS-SF).Results:The scores of spiritual care competence of nurses was(57.52±16.02).The results of multiple linear regression showed that nurses'spiritual care competence was influenced by 9 sociodemographic characteristics such as educational background and nursing age,as well as spiritual care perceptions and spiritual health factors,which accounted for 67.2%of the total variation.And spiritual care competence was positively correlated with spiritual care perceptions(r=0.639,P<0.01)and spiritual health(r=0.596,P<0.01).Besides,spiritual health played a mediating role between between other two variables,accounting for 27.5%of the indirect effect.Conclusions:The scores of spiritual care competence of clinical nurses was in the lower middle level,which needs to be further improved.It is recommended that nurse managers and educators should pay attention to the spiritual care education of nurses,and improve spiritual care perceptions and spiritual health level of nurses in multiple ways,at multiple levels,so as to improve their spiritual care competence and to maximize the satisfy spiritual care needs of patients.
文摘Objective: Government targets to reduce waiting times are putting enormous pressures on outpatient services. The implementation of an electronic care records service (CRS) at our hospital in 2008 has led to widespread press coverage of ensuing chaos in clinical administration. We wanted to know how this new electronic system impacted on our working patterns in outpatient clinics and – more specifically – on the time actually spent with the patients. Material & methods: This study was performed 4 and 12 months after implementation of CRS to assess its impact on the time distribution in clinic. Senior doctors were monitored with a stop clock during consultations. Timings for pre- and post-consultation administration, and the actual consultation with the patient were recorded. A total of 170 consultations were evaluated in this way. Results: The key findings were that the total time needed to spend on a urological outpatient of 16 minutes remains unchanged from the pre-CRS era, but a majority (57%) of this time is spent in administration on the computer without the patient involved. Conclusion: No more than 15 patients should be seen in a 4 hour outpatient clinic per doctor. This recommendation drawn up by BAUS before CRS remains still valid. Patient administration related to the consultation that has previously been done by administrative aides is now to be done by the doctors on the computer in the same consultation session. Intended to streamline patient pathways, this does reduce the quality interaction-time between doctor and patients significantly.
文摘‘Neurodevelopmental disorders’comprise a group of congenital or acquired longterm conditions that are attributed to disturbance of the brain and or neuromuscular system and create functional limitations,including autism spectrum disorder,attention deficit/hyperactivity disorder,tic disorder/Tourette’s syndrome,developmental language disorders and intellectual disability.Cerebral palsy and epilepsy are often associated with these conditions within the broader framework of paediatric neurodisability.Co-occurrence with each other and with other mental health disorders including anxiety and mood disorders and behavioural disturbance is often the norm.Together these are referred to as neurodevelopmental,emotional,behavioural,and intellectual disorders(NDEBIDs)in this paper.Varying prevalence rates for NDEBID have been reported in developed countries,up to 15%,based on varying methodologies and definitions.NDEBIDs are commonly managed by either child health paediatricians or child/adolescent mental health(CAMH)professionals,working within multidisciplinary teams alongside social care,education,allied healthcare practitioners and voluntary sector.Fragmented services are common problems for children and young people with multi-morbidity,and often complicated by subthreshold diagnoses.Despite repeated reviews,limited consensus among clinicians about classification of the various NDEBIDs may hamper service improvement based upon research.The recently developed“Mental,Behavioural and Neurodevelopmental disorder”chapter of the International Classification of Diseases-11 offers a way forward.In this narrative review we search the extant literature and discussed a brief overview of the aetiology and prevalence of NDEBID,enumerate common problems associated with current classification systems and provide recommendations for a more integrated approach to the nosology and clinical care of these related conditions.
文摘Aim: To explore family responsibility dynamics, metabolic control, clinic attendance, and emergency admissions when young adults (YA) with type 1 diabetes transition to an adult hospital. Method: A longitudinal mixed method design with two study groups (parents, n = 28;YA intervention group, n = 23) and a YA comparison group (n = 20). Sample recruited from an outpatient diabetes centre. Demographic, clinic attendance, emergency admissions, biodata, and the Diabetes Family Responsibility Questionnaire (DFRQ) were completed on entry and sixmonths later as part of an 18-month trial of a diabetes transition coordinator (DTC). The selfreport DFRQ were analyzed using derived parent-child dyadic variables to explore differences at baseline and end of study using Wilcoxon Signed Rank Test. The relationship between metabolic control and the DFRQ patterns was explored using Spearman’s rho. Results: On completion of the study, the change in HBA1Cfor both adolescent groups was not significant but was less than ideal for 25% of adolescents in the study. The YA intervention group had significantly fewer missed appointments between them compared to the comparison group. The DFRQ indicated that the derived parent-child dyadic variable of task-discordance increased during the study. Conclusion: The clinically relevant diabetes-task dissonance between parents and young adults offers a challenge and a diagnostic opportunity for diabetes educators.
文摘BACKGROUND Non-invasive tests,such as Fibrosis-4 index and transient elastography(com-monly FibroScan),are utilized in clinical pathways to risk stratify and diagnose non-alcoholic fatty liver disease(NAFLD).In 2018,a clinical decision support tool(CDST)was implemented to guide primary care providers(PCPs)on use of FibroScan for NAFLD.AIM To analyze how this CDST impacted health care utilization and patient outcomes.METHODS We performed a retrospective review of adults who had FibroScan for NAFLD indication from January 2015 to December 2017(pre-CDST)or January 2018 to December 2020(post-CDST).Outcomes included FibroScan result,laboratory tests,imaging studies,specialty referral,patient morbidity and mortality.RESULTS We identified 958 patients who had FibroScan,115 before and 843 after the CDST was implemented.The percentage of FibroScans ordered by PCPs increased from 33%to 67.1%.The percentage of patients diagnosed with early F1 fibrosis,on a scale from F0 to F4,increased from 7.8%to 14.2%.Those diagnosed with ad-vanced F4 fibrosis decreased from 28.7%to 16.5%.There were fewer laboratory tests,imaging studies and biopsy after the CDST was implemented.Though there were more specialty referrals placed after the CDST was implemented,multivariate analysis revealed that healthcare utilization aligned with fibrosis score,whereby patients with more advanced disease had more referrals.Very few patients were hospitalized or died.CONCLUSION This CDST empowered PCPs to diagnose and manage patients with NAFLD with appropriate allocation of care towards patients with more advanced disease.
文摘Purpose: Carrying out a scoping review to fill gaps in current knowledge regarding comfort needs in the care provided by nurses to girls/women who experience puerperium. Methods: The procedures guided by the Joanna Briggs Institute will be applied. The searches will be carried out in the Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Nursing Database, Scientific Electronic Library databases. Studies which are available in full and published in English, Spanish or Portuguese will be selected. There will be no restrictions to the study design or time frame. Two reviewers will independently screen all citations with the aid of software. The degree of agreement between the researchers will be verified by statistics that measure reliability. Through narrative descriptions, charts, and tables, we will present the results obtained. Data analysis will involve descriptive statistics, and qualitative evaluation. We will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist to review and write this review. Conclusion: We will summarize the main information available in the literature on the subject, aiming to obtain an overview of the practices employed, and the gaps present in knowledge that require greater attention from the scientific community.
文摘目的梳理人工智能在中医药临床研究中的应用现状,为充分发挥人工智能在中医药研究领域的作用提供参考依据。方法检索中国知网、万方、中国科技期刊数据库、PubMed和Web of Science核心数据库,收集公开发表的针对人工智能在中医药临床研究中应用的文献,进行分析。结果最终纳入32篇文献,均来自中国,发文年限在2014—2023年。研究主要来自高校和医疗机构。纳入的文献均为观察性研究,共包含病例47564例。人工智能在中医药临床研究中的应用包含10个方面,排名前三的分别为:(1)根据中医证型预测疾病发生风险,预测准确率均在80%以上;(2)预测疾病的中医证型,预测准确率高达99.16%;(3)利用人工智能探索疾病的中医证型与理化指标的关联,准确率最高达96.4%。其余7个分别为利用人工智能挖掘并构建了舌图像与疾病的关联模型、辅助诊断、根据中医人格及体质预测疾病发生风险、预测疾病预后、根据中医脉象信号预测疾病发生风险、预测中成药不良反应发生率。结论人工智能在中医药临床研究中赋能效果明显,可有效提高患者的诊疗质量,避免医疗资源的浪费。
文摘Conventional dentistry or periodontal research often ignores the human component in favor of clinical outcomes and biological causes.Clinical research is driven by the statistical significance of outcome parameters rather than the satisfaction level of the patient.In this context,patient-centric periodontal research(PCPR)is an approach that considers the patient´s feedback concerning their functional status,experience,clinical outcomes,and accessibility to their treatments.It is argued that data self-reported by the patient might have low reliability owing to the confounding effect of their personal belief,cultural background,and social and economic factors.However,literature has shown that the incorporation of“patient-centric outcome”components considerably enhances the validity and applicability of research findings.Variations in the results of different studies might be due to the use of different and non-standardized assessment tools.To overcome this problem,this editorial enlists various reliable tools available in the literature.In conclusion,we advocate that the focus of researchers should shift from mere periodontal research to PCPR so that the results can be effectively applied in clinical settings and the therapeutic strategy can also change from mere periodontal therapy to patient-centric periodontal therapy.