Mental health in a Canadian Old Order Mennonite community

This paper presents the results of a 2010 survey exploring the determinants of rural mental health in two farming groups in Waterloo, Ontario, Canada: Old Order Mennonites (OOMs) and non-OOM farmers. Comparing these two groups reduces the likely impact of many contextual features impacting both groups, such as local economic conditions. We explore a comprehensive list of health determinants to assess their relative importance and thus enable policy action to focus on those having the greatest impact. The mental component summary (MCS) of the short- form health survey (SF-12) was used to measure mental health. We compare mental health in the two populations and use multiple regression to determine the relative importance of the determinants in explaining mental health. The results show that OOMs experience better mental health than non-OOMs, in part due to the strong mental health of OOM women. Coping, stress and social interaction shape mental health in both groups, reflecting the broader determinants literature and suggesting these are important across many populations with different life circumstances. Other determinants are important for one group but not the other, underscoring the diversity of rural populations. For example, different social capital measures shape mental health in the two groups, and sense-of-place is associated with mental health in only one group (OOMs). The results are discussed in terms of their implications for future health determinants research and policy action to address rural mental health.

Quantities of comorbidities affects physical, but not mental health related quality of life in type 1 diabetes with confirmed polyneuropathy

BACKGROUND A large number of adults with long-term type 1 diabetes are affected by symmetrical peripheral neuropathy.These complications increase socioeconomic expenses and diminish the individual quality of life.The 36-Item Short Form Health Survey(SF-36)is a generic patient reported questionnaire,measuring mental and physical health related quality of life.We hypothesized that diabetic neuropathy would decrease physical and mental quality of life measured with SF-36,and that clinical appearance may be associated with the decline.AIM To investigate if diabetic neuropathy would decrease physical and mental quality of life measured with SF-36,and if clinical appearance may be associated with the decline.METHODS Forty-eight adults[age 50±9 years,10 females,disease duration 32(14-51)years]with verified diabetic symmetrical peripheral neuropathy and 21 healthy participants(age 51±6 years,6 females)underwent standardised nerve conduction testing and completed the SF-36 questionnaire.Furthermore,disease duration,number of comorbidities,both diabetes related and nondiabetes related,vibration perception threshold,number of hypoglycaemic events,HbA1c and administration way of insulin was notified.RESULTS In comparison to healthy subjects,patients’mental composite score was not significantly diminished(51.9±8.9 vs 53.1±5.5,P=0.558),while the physical composite score was(46.3±11.7 vs 54.6±3.3,P=0.002).As expected,the overall physical health related symptoms in patients were associated to total number of comorbidities(P<0.0001),comorbidities relation to diabetes(P=0.0002)and HbA1c(P=0.005)as well as comorbidities not related to diabetes(P=0.0006).CONCLUSION The finding of this study emphasises the importance of focusing on quality of life in adults with diabetes and especially in those with multiple comorbidities as well as the possibility of HbA1c as a biomarker for severe complication.

Impact of Post Hepatitis C Chronic Liver Disease and Hepatocellular Carcinoma on Health Related Quality of Life

Background: Post hepatitis C virus chronic liver disease (CLD) is prevalent among the Egyptian population with a bad impact upon their quality of life (QOL). Hepatocellular carcinoma (HCC) is one of the long term and fatal complications of CLD and it also has its negative impact on patient’s quality of life. Aim: To assess impact of CLD and HCC on the quality of life of group of hospitalized elderly patients. Methodology: Ninety elderly patients were divided into three groups: 30 elderly with post hepatitis C virus CLD, 30 elderly with HCC and 30 others free of liver disease as control group (Cn), all were recruited from the in-patient ward and the outpatient clinic of the Geriatric Department, Ain-Shams University Hospital. After giving consent, comprehensive geriatric assessment was done with assessment of their quality of life by using the Short Form-36 health survey (SF-36). Investigations including liver enzymes, serum albumin, serum bilirubin and abdominal ultrasound were done. Results: All QOL domains were the highest among control group, followed by HCC group and the least among CLD group. The differences were statistically significant in most subscales and total score [Mean of Cn = 81.9 ± 12.4, Mean of CLD = 47.5 ± 21.9, Mean of HCC = 62.3 ± 16.1;P Cn/CLD ≤ 0.001, P Cn/HCC ≤ 0.001, P CLD/HCC = 0.004]. Albumin was the only biochemical marker correlated positively with total SF score and two subscales (PF and EF) [r = 0.408;P = 0.025]. Conclusion & Recommendation: Our study showed a decrease in the QOL of Egyptian post hepatitis C virus CLD and HCC patients compared with Egyptian population norms. The results showed that CLD were more affected than HCC patients. This had a particularly serious negative impact on their life. The findings indicate a need for updated counseling and educational materials designed to provide adequate information and consistent healthcare service to this patient setting.

碳中和目标下运动康养形态和业态研究

随着全球气候变化问题的日益严峻,碳中和成为各国共同追求的目标。在这个背景下,运动康养作为绿色、低碳、健康的生活方式,受到了广泛的关注。该文旨在探讨碳中和目标下运动康养的形态和业态发展,分析其对社会、经济和环境的影响,并提出相应的政策建议。同时,该文还就如何进一步推动运动康养事业的可持续发展,提出了具有针对性的政策建议。

Health Related Quality of Life among Osteoarthritis Patients: A Comparison of Traditional Non-Steroidal Anti-Inflammatory Drugs and Selective COX-2 Inhibitors in the United Arab Emirates Using the SF-36

Objectives: Osteoarthritis (OA) has a dramatic impact on patients’ health related quality of life (HRQoL). Chronic use of analgesics and anti-inflammatory medications for pain management may improve symptoms but on long term may affect HRQoL negatively. The objective of the present study was to compare the impact of two different classes of analgesics, traditional non-steroidal anti-inflammatory drugs (NSAIDs) and selective cyclo-oxygenase-2 (COX-2) inhibitors on HRQoL among osteoarthritis patients using the SF-36 questionnaire. Methods: Clinic based cross-sectional study conducted at Al-Qassimi Hospital, Sharjah, United Arab Emirates (UAE), over a period of six months. Ethical Approval was obtained from the ethics committee at Al-Qassimi Clinical Research Center. Total of 200 osteoarthritis patients fulfilling the inclusion and exclusion criteria were involved in the study. Patients’ demographics were collected from their medical records. The Medical Outcome Study Short-Form 36 (SF-36) questionnaire was used to measure patients’ HRQoL. SF-36 data were scored using health outcomes scoring software 4.5. Results: Mean age of the subjects was 62.19 ± 9.81 years with females constituting 151 (75.5%) of the patients. In general, females scored lower in most of the HRQoL domains compared to males and there was significant difference between the two groups in the mental health (p = 0.005) & mental component (p = 0.042) domains. Compared to selective COX-2 inhibitors, patients on NSAIDs scored higher on all domains of SF-36 except physical functioning. There was significant difference in mental health domain for patients treated with NSAIDs (p = 0.02). Celecoxib was only better than NSAIDs in osteoarthritis patients with more than one musculoskeletal disorders in the domain of bodily pain (p = 0.009). Conclusion: NSAIDs-treated patients did not differ significantly from celecoxib-treated patients in all domains of the SF-36 except for the mental health domain.

简版健康素养量表的开发:基于经典测量理论和项目反应理论

背景健康素养与健康状况密切相关,目前国内研究多倾向于运用多维度、多条目的健康素养测评工具,尚缺少简便且有效的健康素养测评工具。目的简化健康素养量表并在中国人群中进行心理测量学检验。方法从“中国家庭健康指数调查(2021年)”数据中选择18岁及以上人群作为本研究的调查对象,依据纳入与排除标准,最终纳入7449份数据,并随机分为2个样本集,其中样本集1共3680份,样本集2共3769份。对调查对象进行一般资料问卷、12条目健康素养量表(HLS-SF12)、领悟社会支持量表(PSSS)、家庭健康量表(FHS-SF)调查。应用经典测量理论以及项目反应理论中的Mokken模型对HLS-SF12原条目进行筛选,并对精简后的量表进行信效度等验证性分析。结果使用经典测量理论和Mokken模型分别简化出1个9条目版本的量表(HLS-SF9)和1个4条目版本的量表(HLS-SF4)。HLS-SF9与HLS-SF4均无天花板效应、地板效应,二者的Cronbach'sα系数分别为0.913和0.842,折半信度分别为0.871和0.815。HLS-SF4经探索性因子分析提取出1个公因子,累积方差贡献率为67.813%,各条目的因子载荷量均>0.81。HLS-SF9经验证性因子分析结果显示χ^(2)/df=10.844、拟合优度指数(GFI)=0.985、调整拟合优度指数(AGFI)=0.971、规范拟合指数(NFI)=0.986、比较拟合指数(CFI)=0.987和近似误差均方根(RMSEA)=0.051。相关性分析结果显示,HLS-SF9、HLS-SF4与PSSS呈正相关(r=0.367、0.292,P<0.001),与FHS-SF呈正相关(r=0.340、0.237,P<0.001)。HLS-SF9对HLS-SF12的效标效度的一致性水平(ICC)(95%CI)为0.989(0.988~0.999),HLS-SF4效标效度的ICC(95%CI)为0.892(0.886~0.899)。结论简化后的健康素养量表具有良好的信效度,是能够快速测评中国人群健康素养的有效工具,研究者可根据研究精度(HLS-SF9)或测评时间(HLS-SF4)的需求采取针对性选择。

基于数据整合模式的基层医疗卫生机构智能报表填写模型构建路径研究

目的/意义探索面向基层医疗卫生机构的智能自动化模型构建路径,解决报表重复上报问题。方法/过程运用现场调研和专家咨询等方法,在北京市东城区基层医疗卫生机构开展实地调研,通过信息资源规划方法、数据整合与映射技术等,梳理基层医疗卫生机构业务交互与信息流动情况,研究自动化报表模型的构建路径。结果/结论建模梳理业务流、数据流,整理报表相关指标库,构建多源数据自动映射模型与规则,为实现基层医疗卫生机构智能报表提供具有可行性的参考路径。

东海三门湾主要海产品中典型重金属累积状况

为探究我国东海三门湾主要养殖海产品重金属累积状况,评估当地沿海居民因海产品摄入导致的重金属健康风险,并以此了解海产品中重金属的累积特异性,本研究于2022年10月—12月选取三门湾养殖场进行取样,共取76份样本,包含10个品种,分析样品中总砷、无机砷、总镉、总铅和总汞这几种典型重金属含量,采用单因子污染指数评估这10种海产品受重金属污染的情况,应用目标危害系数及复合危害系数评估当地沿海居民长期食用海产品的健康风险,同时对海产品中无机砷的赋存形态展开讨论。结果表明仅部分虾蛄、梭子蟹中镉含量高于限量值(3.0 mg·kg^(-1)),所有样品中的无机砷、铅和汞的含量均低于限量值。不同种类的海产品对重金属累积存在显著差异,这10种海产品除受到镉不同程度的污染外,另外3种重金属污染均处于正常水平,当地沿海居民长期摄入这10种海产品由重金属引起的健康风险属于低关注级别。每种海产品中的无机砷含量低于总砷含量的5%,且与总砷含量之间表现出弱相关性。本研究可为了解三门湾养殖海产品的重金属污染状况及为评价当地沿海居民食用三门湾养殖海产品引起的重金属暴露风险提供科学依据,同时也可为了解海产品中重金属累积特异性和重金属安全限量值的研究提供基础科学信息。

基于微信公众平台开展医学微生物学课程思政与健康融合教育的实践意义

研究表明微信公众平台能显著提高大学生健康教育和课程思政教育的效果。通过医学微生物学课程思政与健康融合教育微信公众平台,将课程思政与校园健康教育有机统一起来,以提高医学生的健康、人文素养和医学微生物学课程的学习效果。微信公众平台作为校园思政、健康与课程融合教育创新模式,对完善课程思政与健康的融合、协同式教育的长效机制,形成人人都积极参与建设“健康中国”的校园和社会合力,共同促进新时代医学教育事业的改革与创新,建设中国特色社会主义和实现中华民族伟大复兴的目标等都具有重要实践意义。

轮班对地铁职工健康相关生命质量的影响

目的探究轮班对地铁职工健康相关生命质量的影响,为提高该职业人群的健康素养提供科学依据。方法2019年对武汉市地铁集团职工进行研究,使用调查问卷收集人口学特征和职业史等信息。用生活质量评价量表(the Mos 36-item Short Form Health Survey,SF-36)测定其健康相关生命质量;按照性别分层,采用单因素和多因素Logistic回归模型分析轮班对该职业人群量表各维度得分的影响。结果9960名职工中有68.6%从事轮班工作。不同性别、工种、被动吸烟状况、锻炼习惯、睡眠状况、个人疾病史亚组人群的SF-36量表得分有显著差异(P<0.05)。与不轮班者相比,不同轮班制职工的一般健康状况、健康变化和社会功能等维度得分为差的风险均较高。并且随着轮班年限的增加,轮班者在身体机能、生理职能、一般健康状况、健康变化、精力、社会功能和精神健康维度得分为差的风险呈现为先升高再趋于平缓甚至下降的趋势。在男职工中,轮班制影响其SF-36量表各维度得分,但在女职工中未见此影响。结论轮班工作可能是影响地铁职工健康相关生命质量的重要危险因素之一,尤以男职工为甚。

人类文明新形态视域下人类卫生健康共同体的伦理意蕴

“人类卫生健康共同体”理念来源于国际国内突发公共卫生事件的治理实践,是经过实践证明的中国方案,也是全球合作应对公共卫生伦理困境的有效路径。面对国际突发公共卫生事件对人类健康的威胁,“人类卫生健康共同体”理念能够超越文明隔阂,构建人类文明新形态,有效解决个人权利与公共善、平等主义正义观与自由主义正义观的伦理困境,具有高度的实践价值。为应对全球健康危机、加强全球合作治理、共创人类可持续发展的美好未来指明方向并提供伦理路径。

某退役铀矿山地下水中铀空间分布特征及其健康风险评价

以南方某退役铀矿山为对象,分别在平、丰、枯水期对铀矿山尾矿库下游地下水进行采样分析,查明地下水中典型放射性核素铀的时空分布特征;探究铀存在形式与地下水环境参数间的相关关系;使用健康风险评价模型对不同人群的致癌风险进行分类评估,为铀矿山退役后的地下水环境质量评估提供依据。研究结果表明:尾矿库下游平水期地下水中铀的平均含量最高,为0.14 mg/L,丰水期和枯水期地下水中铀含量较低,浓度在0.017~0.049 mg/L;地下水中铀的主要存在形式有UO_(2)(CO_(3))_(3)^(4-)、UO_(2)(CO_(3))_(2)^(2-),存在形式受水文地球化学参数pH、Eh以及主成分Cl^(-)、HCO_(3)^(-)影响显著;不同水文期地下水中铀的致癌风险值均未超过规定阈值,对成人和幼儿暂无健康威胁,但仍应加强该区域地下水质量监测,以保障周边环境安全。

对症下药还是面面俱到:健康辟谣中信息呈现对说服效果的影响研究

社交媒体中传统“把关人”机制失效,健康谣言“被辟谣-再出现”现象频发,愈加凸显辟谣信息设计策略的重要性。围绕健康谣言真假参半、情绪鲜明的信息呈现特征来探究健康辟谣信息说服效果,能更好地理解辟谣信息设计机理,为优化谣言治理策略提供有益借鉴。聚焦信息呈现的二维分类框架,设计2(内容呈现:单面内容vs.双面内容)×2(形式呈现:严肃形式vs.幽默形式)×2谣言类型(恐惧谣言vs.希望谣言)的控制实验,进而分析其与健康辟谣信息说服效果间的相关关系。研究结果显示,内容呈现对健康辟谣信息说服效果具有显著影响,双面(vs.单面)的健康辟谣信息有更好的说服效果;内容呈现和形式呈现的交互效应对说服效果的影响受到谣言类型的调节;对于希望谣言,采用单面幽默的辟谣信息与双面严肃的辟谣信息均能实现更好的说服效果。

Application of psychological intervention in intensive care unit nursing for patients with severe acute pancreatitis

BACKGROUND Severe acute pancreatitis(SAP)is a familiar critical disease in the intensive care unit(ICU)patients.Nursing staff are important spiritual pillars during the treatment of patients,and in addition to routine nursing,more attention needs be paid to the patient’s psychological changes.AIM To investigate the effects of psychological intervention in ICU patients with SAP.METHODS One hundred ICU patients with SAP were hospitalized in the authors’hospital between 2020 and 2023 were selected,and divided into observation and control groups per the hospitalization order.The control and observation groups received routine nursing and psychological interventions,respectively.Two groups are being compared,using the Self-rating Anxiety Scale(SAS),Self-Determination Scale(SDS),Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ,and 36-item Short Form Health Survey(SF-36)scores;nursing satisfaction of patients;ICU care duration;length of stay;hospitalization expenses;and the incidence of complications.RESULTS After nursing,the SDS,SAS,and APACHEⅡ scores in the experimental group were significantly lower than in the control group(P<0.05).The SF-36 scores in the observation group were significantly higher than those in the control group(P<0.05).The nursing satisfaction of patients in the experimental group was 94.5%,considerably higher than that of 75.6% in the control group(P<0.05).The ICU care duration,length of stay,and hospitalization expenses in the observation group were significantly lower than those in the control group,and the incidence of complications was lower(P<0.05).CONCLUSION For patients with SAP,the implementation of standardized psychological intervention measures can effectively alleviate adverse psychological conditions.

肠道菌群介导谷物阿魏酸代谢及其生理功效的研究进展

阿魏酸是谷物中含量最丰富的酚酸,常以游离态和结合态两种形式广泛存在于谷物、豆类等植物基食品当中。阿魏酸具有抗氧化、抗炎、抗菌等多种功能活性,其在食品、医药方面具有较高的应用价值。尽管已有大量体内外实验结果表明谷物阿魏酸对维持肠道健康有重要意义,但对其肠道菌群代谢机制尚不明确。本文对近些年有关阿魏酸的肠道菌群代谢文献进行系统整理,从谷物阿魏酸的存在形式、其肠道释放与代谢及产生的生理健康效应3个方面详细总结了其进展情况,旨在为明确阿魏酸发挥肠道调控作用的分子机制提供新见解,为更好地开发利用谷物阿魏酸及其代谢物提供理论参考。

综合干预改善肺癌晚期患者疼痛及睡眠质量的价值研究

目的:探讨综合干预对肺癌晚期患者疼痛及睡眠质量的改善价值。方法:选取2023年2月至2024年2月厦门大学附属第一医院收治的肺癌晚期患者80例作为研究对象,按照随机数字表法分为对照组和观察组,每组40例。对照组进行常规护理干预,观察组进行综合护理干预。对比2组疼痛、睡眠改善效果、睡眠质量、生命质量评分。结果:干预前,2组患者在视觉模拟量表(VAS)评分、睡眠改善效果(睡眠时长、睡眠效率、入睡时间、觉醒次数)、匹兹堡睡眠质量指数(PSQI)评分,以及36条目简明健康量表(SF-36)评分的数据比较,差异无统计学意义(P>0.05);干预后,在疼痛VAS评分、睡眠改善效果(睡眠时长、睡眠效率、入睡时间、觉醒次数)、睡眠质量PSQI评分,以及SF-36评分的数据上观察组均显著优于对照组,差异有统计学意义(P<0.05)。结论:对肺癌晚期患者采取综合干预能够有效缓解患者疼痛情况,改善患者的睡眠质量和生命质量,值得推广。

基于全健康理念重构人体寄生虫学教学模式初探

临床医学专业定向生是我国医疗卫生服务体系基层医疗保障的守护人,承担着社区居民疾病健康和预防宣传的重任。围绕“健康中国”的战略规划,全健康即人、动物和环境的整体健康理念在我国多部门、多学科、多领域迅速推进。人体寄生虫学作为一门研究与人体健康有关的寄生虫以及寄生虫与人体和外界因素(动物、环境等)相互关系的学科,是践行和宣传全健康理念的重要课程。徐州医科大学病原生物学与免疫学教研室依托人体寄生虫学课程,积极开展教育教学改革,将全健康理念渗透到课程教学的全过程,帮助学生建立疾病的整体观,夯实课程知识体系,培养临床思维能力,锻炼实践技能,提高医学人文素养,培养一批服务生命全周期、健康全过程的基层医疗卫生人才。

校园春花、春叶植物景观对大学生身心健康的影响研究

为了研究大学生易接触的校园春季植物景观对其情绪恢复的影响,定量分析了大学生对校园春季花、叶两类植物景观观赏前后的生理状态指标(血压、心率、血样饱和浓度)和心理状态指标(总体情绪紊乱程度)变化值。结果表明:在生理指标方面,同一指标的各试验组的测试结果不同,但对于大学生身心状态的恢复有正向效应;观察不同春季植物景观对血压收缩压、血氧饱和浓度的恢复性效果与其他指标比较恢复性效果不明显,总体呈现出春季观花植物对各指标的恢复性效果最好。在心理指标上,大学生的总体情绪紊乱程度值(TMD)与室内TMD相比都有明显下降;不同试验组的总体情绪紊乱程度之间存在差异性,对压力的缓解程度存在差异性。

长期使用不同给药方式的雌激素对绝经泌尿生殖道综合征的疗效及安全性分析

目的 探讨长期使用不同给药方式的雌激素对绝经泌尿生殖道综合征的疗效及安全性情况。方法 选取北京市顺义区妇幼保健院2019年2月至2022年1月收治的绝经泌尿生殖道综合征患者95例为研究对象,采用随机纸片法分为两组,治疗A组45例,经口服给药雌激素治疗,治疗B组50例,经阴道给予结合雌激素乳膏治疗。比较两组患者治疗前、治疗6个月后阴道症状评分、性交痛症状评分、女性性功能量表(FSFI)、阴道健康指数评分(VHIS)、尿失禁影响程度(IIQ-7)评分。比较两组患者临床症状加重、泌尿生殖道出血、泌尿生殖道感染、乳腺胀痛发生情况。结果 治疗前,两组患者阴道症状评分、性交痛症状评分、FSFI、VHIS、IIQ-7比较,差异均无统计学意义(P> 0.05);治疗6个月后,两组患者阴道症状评分、性交痛症状评分均低于同组治疗前,治疗B组IIQ-7低于同组治疗前,FSFI、VHIS均高于同组治疗6个月后,治疗B组阴道症状评分、性交痛症状评分、IIQ-7均低于治疗A组,FSFI、VHIS均高于治疗A组,差异有统计学意义(P <0.05)。两组患者临床症状加重、泌尿生殖道感染发生率比较,差异无统计学意义(P> 0.05);治疗B组患者泌尿生殖道出血、乳腺胀痛发生率低于治疗A组,差异有统计学意义(P <0.05)。结论 经阴道给予结合雌激素乳膏治疗绝经泌尿生殖道综合征患者,可以改善患者临床症状、提高性功能,安全性高,值得临床推广应用。

江苏省社区卫生服务内容和方式现况调查

目的 了解江苏省社区卫生服务的内容和方式。方法 采取多阶段分层整群随机抽样 ,对江苏省南京市、无锡市、泰州市、淮安市、徐州市的 80个社区卫生服务机构进行调查。结果 在 80个社区卫生服务机构中 ,10 0 %的开展了医疗服务工作 ,73 8%的开展了社区预防 ,75 0 %的开展了社区保健 ,并为 4 9 3%的慢性病人建立了档案 ,6 5 0 %的开展了社区康复 ,90 0 %的开展了健康教育。结论 江苏省社区卫生服务工作内容全面、方便群众、节省费用 ,但“六位一体”功能发展不平衡 ,一体化整合不到位。