BACKGROUND The prevalence of metabolic-associated fatty liver disease(MAFLD)is a growing public health issue in people living with human immunodeficiency virus(PLWH).However,the pathophysiology of MAFLD is still unkno...BACKGROUND The prevalence of metabolic-associated fatty liver disease(MAFLD)is a growing public health issue in people living with human immunodeficiency virus(PLWH).However,the pathophysiology of MAFLD is still unknown,and the role of genetic variables is only now becoming evident.AIM To evaluate the associations of gene-polymorphism-related MAFLD in PLWH.METHODS The study employed transient elastography with a controlled attenuation parameter≥248 dB/m to identify MAFLD in patients from a Super Tertiary Hospital in central Thailand.Candidate single-nucleotide polymorphisms(SNPs)were genotyped using TaqMan®MGB probe 5'nuclease assays for seven MAFLD-related genes.Statistical analyses included SNP frequency analysis,Fisher's Exact and Chi-square tests,odds ratio calculations,and multivariable logistic regression.RESULTS The G-allele carriers of PNPLA3(rs738409)exhibited a two-fold rise in MAFLD,increasing by 2.5 times in MAFLD with human immunodeficiency virus infection.The clinical features and genetic patterns imply that LEP rs7799039 A-allele carriers had a nine times(P=0.001)more significant chance of developing aberrant triglyceride among PLWH.CONCLUSION The current study shows an association between PNPLA3 rs738409 and LEP rs7799039 with MAFLD in PLWH.展开更多
Introduction: Lower extremity artery disease (LEAD) is a serious cardiovascular disease. People living with the human immunodeficiency virus (HIV) are at risk. The aim of the study was to determine the prevalence of L...Introduction: Lower extremity artery disease (LEAD) is a serious cardiovascular disease. People living with the human immunodeficiency virus (HIV) are at risk. The aim of the study was to determine the prevalence of LEAD and identify the associated factors among people living with HIV who were followed at the departmental university hospital Ouémé-Plateau in Benin. Methods: This was a cross-sectional study. It included all HIV-infected people who were monitored at the department of medicine of the target hospital during the study period and met the inclusion criteria (followed for at least three months, aged at least 25 years, and having given their written consent to participate). Data were collected during an individual interview, followed by the measurement of parameters. The ankle brachial index ≤ 0.9 was used for the diagnosis of LEAD. Associated factors were searched through a multivariable logistic regression. Results: The prevalence of LEAD was 34.2% among 222 respondents having a mean age was 42.9 ± 10.8 years and a female predominance (77.5%). No significant association was found between the presence of LEAD and sociodemographic factors. The presence of LEAD was significantly associated with hypertension and antiretroviral therapy. Hypertensive patients had a higher risk of LEAD compared to non-hypertensive patients (OR = 1.98, 95% CI [1.04-3.83], p = 0.037). Those who were receiving second-line therapy also had a higher risk of LEAD compared to those on first-line therapy (OR = 2.95, 95% CI [1.14-7.60], p = 0.025). Conclusion: This study showed a high prevalence of LEAD especially among hypertensive patients and those who were receiving second-line antiretroviral therapy. LEAD diagnosis and management should be included in the routine care of people living with HIV in Benin.展开更多
Hepatitis C virus(HCV)/human immunodeficiency virus(HIV)co-infection still involves 2.3 million patients worldwide of the estimated 37.7 million living with HIV,according to World Health Organization.People living wit...Hepatitis C virus(HCV)/human immunodeficiency virus(HIV)co-infection still involves 2.3 million patients worldwide of the estimated 37.7 million living with HIV,according to World Health Organization.People living with HIV(PLWH)are six times greater affected by HCV,compared to HIV negative ones;the greater prevalence is encountered among people who inject drugs and men who have sex with men:the risk of HCV transmission through sexual contact in this setting can be increased by HIV infection.These patients experience a high rate of chronic hepatitis,which if left untreated progresses to end-stage liver disease and hepato-cellular carcinoma(HCC)HIV infection increases the risk of mother to child vertical transmission of HCV.No vaccination against both infections is still available.There is an interplay between HIV and HCV infections.Treatment of HCV is nowadays based on direct acting antivirals(DAAs),HCV treatment plays a key role in limiting the progression of liver disease and reducing the risk of HCC development in mono-and coinfected individuals,especially when used at an early stage of fibrosis,reducing liver disease mortality and morbidity.Since the sustained virological response at week 12 rates were observed in PLWH after HCV eradication,the AASLD has revised its simplified HCV treatment algorithm to also include individuals living with HIV.HCV eradication can determine dyslipidemia,since HCV promotes changes in serum lipid profiles and may influence lipid metabolism.In addition to these apparent detrimental effects on the lipid profile,the efficacy of DAA in HCV/HIV patients needs to be considered in light of its effects on glucose metabolism mediated by improvements in liver function.The aim of the present editorial is to describe the advancement in HCV treatment among PLWH.展开更多
This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are present...This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.展开更多
By employing the information-reshufflingmethod that integrates census data, precipitation dataand inquiry data of water consumption, this paperdiscusses 5 (water consumption coefficient of people’sliving) in allusion...By employing the information-reshufflingmethod that integrates census data, precipitation dataand inquiry data of water consumption, this paperdiscusses 5 (water consumption coefficient of people’sliving) in allusion to different precipitation zones anddifferent periods of time. The study shows that 5-(water consumption coefficient of urban people’sliving), 5. (water consumption coefficient of ruralpeople’s living) and increase with time passing, andthe increasing extent of 5 is 1.84, 2.62, 2.84 and 2.68times respectively from the west to the east, whichresults from the total quantity of water resources andthe speed of urbanization. 5- and 5. of eachprecipitation zone increased with 5- increasing morequickly than 5., and the difference between the twoalso increased when time passed. In the past fifty years(1950-2000), the increasing extent of 5- was 1.71,2.96, 2.41 and 2.33 times respectively from the westto the east, in which 200-400mm precipitation zoneincreased more than others. Meanwhile the increasingextent of 5. is 1.55, 1.60, 1.53 and 1.64 timesrespectively from the west to the east with eachprecipitation zone increasing similarly. The change of5-is due to the speed of urbanization and the stabilityof water resources. This study provides basis forcalculating the water demand of people’s living andrevealing the impact of water demand of people’s livingon ecological drought in different zones.展开更多
Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to asse...Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to assess the level of knowledge, attitude and practice with regard to care of PLHIV among nursing and midwifery students in Fako division of Cameroon. A survey was performed between May and July 2015, among 227 nursing and midwifery students (in their second to final year of study), selected from 8 government accredited training institutions in Fako division of Cameroon. An anonymous self-administered semi-structured questionnaire was used to collect data. The Pearson’s chi-square test, univariate and multivariate logistic regression analyses adjusting for possible confounders were all performed as part of the statistical analyses. The cutoff of statistical significance was set at p ≤ 0.05. Nursing and midwifery students had a moderate level of HIV/AIDS knowledge (average score of 7.02 on a scale of 11). Attitude towards PLHIV was generally positive (68.7%) but there were some misconceptions and prejudice about PLHIV, with considerable stigmatization (31.3%), unwillingness to share a room with someone infected with HIV (27.7%), and unwillingness to work on PLHIV (23.8%). Good HIV/AIDS knowledge was observed to be the sole independent predictor (p = 0.004) of positive attitude towards PLHIV. Fur-thermore the confidence of the respondents regarding care of PLHIV was generally moderate. Our results suggest the need for the development of a more appropriate education program in nursing and midwifery institutions in Fako division to reduce the discrepancies between the general knowledge, attitude and practice regarding care of PLHIV.展开更多
Background: Among elderly people, rehabilitation is important for reducing the risk of falls and hospitalization and to maintain an independent life for longer. Motivation is a factor for elderly people to lead an act...Background: Among elderly people, rehabilitation is important for reducing the risk of falls and hospitalization and to maintain an independent life for longer. Motivation is a factor for elderly people to lead an active daily life and leave home more frequently. Purpose: The purposes of this study were to determine the optimal cut-off point in the Scale for Achievement Motive in Geriatrics (SAMG) that could identify individuals as inactive or active, based on the Frenchay Activities Index (FAI), and to compare characteristics between active and inactive groups classified by the cut-off point. Methods: A cross-sectional study of 285 community-dwelling elderly people measured SAMG and FAI and physical function. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) that was the optimal cut-off point for the SAMG total score, with the associated sensitivity and 1-specificity when compared with the FAI results. Demographic parameters and physical function were compared between two groups defined by cut-off point. Results: The AUC was 0.78, the optimal cut-off for SAMG total score for indicating inactivity was ≤48, the sensitivity was 77.98% and the 1-specificity was 75.00%. The group with SAMG score >48 was characterized by a significantly higher proportion of women, fewer people sharing a house, and participation in more hobbies. Discussion: A cut-off point of 48 in the SAMG could be a predictive index of motivation toward goals for individuals with inactive daily activities. The group with score higher than the cut-off was characterized by more women, fewer people living together, and more hobbies than the group with lower scores.展开更多
BACKGROUND As people living with human immunodeficiency virus(HIV)(PLWH)enjoy longer life expectancy with highly effective antiretroviral therapy,they are encountering challenging cardiovascular health risks.AIM To re...BACKGROUND As people living with human immunodeficiency virus(HIV)(PLWH)enjoy longer life expectancy with highly effective antiretroviral therapy,they are encountering challenging cardiovascular health risks.AIM To retrospectively examine the increasing burden of cardiovascular diseases in PLWH over the past decade.METHODS All hospitalizations for heart failure(HF),ischemic heart disease(IHD),and cerebrovascular disease(CeVD)in PLWH were identified using the International Classification of Diseases,Ninth Revision,Clinical Modification(ICD-9-CM)and ICD-10-CM codes in the National Inpatient Sample from 2008 to 2018.Outcomes included number of hospitalizations,in-hospital mortality,length of stay,and total hospital charge.Trend of the outcomes from 2008 to 2018 were analyzed using Cochran-Armitage_(trend)test and simple linear regression.RESULTS The number of hospitalizations for HF in PLWH increased from 4212 in 2008 to 6700 in 2018(P_(trend)<0.01).Similar increasing_(trend)was seen with those for IHD and CeVD over the decade(P_(trend)<0.01).A decreasing_(trend)of in-hospital mortality was observed in all hospitalizations of PLWH(P_(trend)<0.01)and CeVD in PLWH(P_(trend)<0.01),but not in those for HF(P_(trend)=0.67)and IHD(P_(trend)=0.13).The_(trend)of length of stay was decreasing in all hospitalizations of PLWH(P_(trend)<0.01),but increasing in those for HF in PLWH(P_(trend)<0.01).An increasing_(trend)of total hospital charge was observed in hospitalizations for HF,IHD,and CeVD(P_(trend)<0.01).CONCLUSION The burden of cardiovascular diseases has significantly increased in hospitalizations of PLWH from 2008 to 2018.Continued efforts are needed to address the additional cardiovascular risks in this vulnerable population.展开更多
China Society for Human Rights Studies, I would like to extend my warm greetings to the launch of your Human Rights magazine. Enjoying human rights fully is a lofty goal long pursued after by human race. Over the year...China Society for Human Rights Studies, I would like to extend my warm greetings to the launch of your Human Rights magazine. Enjoying human rights fully is a lofty goal long pursued after by human race. Over the years when they carried out revolution, construction and reforms, the Chinese people have struggled indomitably and strived incessantly to achieve this goal. Progress made in this regard has caught worldwide attention. When struggling for, safeguarding, promoting and developing human rights, the Chinese people have always combined the universality prin-展开更多
Tuberculosis (TB) is a chronic disease caused by mycobacterium tuberculosis and transmitted from person to person, through inhalation of droplet nuclei aerosolized by coughing of an infected person. It reach...Tuberculosis (TB) is a chronic disease caused by mycobacterium tuberculosis and transmitted from person to person, through inhalation of droplet nuclei aerosolized by coughing of an infected person. It reached epidemic proportions in Europe and North America during the 18th and 19th centuries. The incubation period is 2 - 6 weeks and the control has been complicated with emergence of HIV and drug-resistant TB. In 1993, World Health Organization (WHO) declared TB a global emergency. However, despite the concerted effort of National TB control programs, adoption and implementation of Stop TB strategy, TB has remained a major public health challenge with high mortality rate, especially in developing countries. Methodology: This is a descriptive study, evaluated using the positivist/quantitative approach. The study was conducted at FederalMedical Centre Umuahia, a tertiary specialist hospital with comprehensive TB/HIV treatment services. All the presumptive drug-resistant TB cases and symptomatic PLHIV were screened for HIV and their sputum specimens were tested for tuberculosis using the Gene xpert and the Ziehl- Neelsen technique for detecting Acid Fast bacilli. A pretested structured questionnaire was used tocollect the demographic data and other essential data from the presumptive TB and laboratory registers such as total number of TB presumptive cases registered HIV status, AFB status and rifampicin status within the study period. Result: A total of 493 presumptive TB cases were screened in the study, 49.9% were HIV positive while 50.05% were HIV negative. More so, 77.85% of thescreened cases were AFB negative and 22.15% were AFB positive. Moreover, 11% of the TB/HIV co-infected patients were rifampicin positive. Interestingly among the 493 cases screened with gene xpert machine, 3.6% were rifampicin positive. Furthermore, 3.6% of the HIV negative cases were rifampicin positive while 1.6% of the HIV positive cases were rifampicin positive. Discussion: The data depict lower rifampicin resistance among HIV positive cases than HIV negative cases. The implication for public health professionals is to intensify equitable and unbiased search for resistant TB cases among smear negative and positive cases.展开更多
Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection amon...Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection among people who living with HIV (PLHIV) in the infectious and tropical diseases department of the Centre Hospitalier Universitaire de lAmiti Sino-Centrafricaine in Bangui. Methods: A retrospective study was carried out from January 1, 2010 to December 31, 2021 in the Infectious and Tropical Diseases Department at the Amiti Sino-Centrafricaine University Hospital. It included the files of all PLHIV, which included the results of HBV serology. A standardized form was used to collect socio-demographic and professional data by documentary review. Data was analysed using Epi-Info 7 software. Means, proportions were calculated as well as Chi square witch was significant if p-value was below 0.05. Results: The study included 265 patients, 188 were women (70.1%) and 77 men (29.1%), giving a sex ratio of 0.45. Mean age was 35.8 years, higher in men (40 years) than in women (35.8 years) (p 0.0001). The age groups 25 to 34 (37.7%) and 35 to 44 (33.6%) were in the majority (71.3%). The majority of PLHIV were unemployed (57.1%), including housewives (43.0%). HBV prevalence was 14.3%, including 7.2% among the unemployed, who account for half of all co-infections. The search for associations between HIV-HBV co-infection and all socio-demographic characteristics (age, sex, marital status) and socio-professional categories showed no significant difference (p 0.05). Conclusion: PLHIV were predominantly young adults, female, and unemployed;no occupation was significantly associated with co-infection. The vast majority of co-infected people were not covered by the occupational health system (unemployed or informal sector). Urgent action is needed to improve workers access to occupational medicine in CAR.展开更多
Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)interventio...Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.展开更多
The paper combs the problems about living difficulties of farmers and marketing economy in the risk society and puts forward another point of view that with the theory of risk society,reconsider the dilemma of living ...The paper combs the problems about living difficulties of farmers and marketing economy in the risk society and puts forward another point of view that with the theory of risk society,reconsider the dilemma of living choices of farmers under the background of marketing economy.On the basis of the statistics,the paper discloses the trend of larger and larger disparities of incomes between urban and rural areas;the paper explains the risks and uncertainties of life choices with the background of deepening marketing economy.In order to understand the life dilemma of farmers and marketing economy in the risk society,the paper makes an analysis from perspectives of the relationships between risk society and markets,the risks of farmers' living choices.The results show that in the risk society,because of the division space from time,the personal farmers are devoid of the safe environment.Then the situation deepens to worse.In addition to the organization which is not in charge results in a situation that the personal farmers would take all risks by themselves.展开更多
The study evaluated the quality of healthcare services given to PLWHA (people living with HIV/AIDS) in different communities of Enugu State of Nigeria. Descriptive cross sectional survey design was employed for the ...The study evaluated the quality of healthcare services given to PLWHA (people living with HIV/AIDS) in different communities of Enugu State of Nigeria. Descriptive cross sectional survey design was employed for the study. The participants were PLWHA attending health facilities in different communities in the state. A sample of 180 PLWHA who participated in the study were selected using a multi-stage sampling procedure and were interviewed at community level. The data were analyzed using descriptive statistics. The results showed that 82.2% of the respondents were cared for by government health facilities, 75% were of the opinion that the health workers in those places do not discriminate against them, 81.7% felt that they were being given high quality healthcare, 82.8% stated that their drugs were readily available, 75% were of the opinion that the physical facilities in their care centers were adequate, 84.4% felt that grievance redressing were good while 90% felt that their healthcare providers maintain confidentiality about their conditions. It was concluded from the findings that quality of care provided to PLWHA in communities was of good quality as perceived by PLWHA and that the national antiretroviral programmes are making drugs available and affordable in the state. It was then recommended that all levels of government in the nation should strengthen the programmes on HIV prevention and control to maintain the continuity of care to PLWHA.展开更多
The paper presents an analytical study on the American society through a popular American drama series "the Desperate House Wives". Typical American values can be found everywhere on the show as they have be...The paper presents an analytical study on the American society through a popular American drama series "the Desperate House Wives". Typical American values can be found everywhere on the show as they have been ingrained in the soul of the American people. As a nation with not very long history but great achievements, its people are the one that should be highlighted. Unlike China, the nation of which have formed since thousands of years ago, so has its culture, America's history is an immigration history. People started migrating from other parts of the world since the 17 thcentury and gathered at the land of America to build up their new homes and realize their dreams. They influence each other and fuse with each other. America is one of the countries in the world that plural cultures successfully mix together.The paper focuses on the American people's daily life to explain to the readers the American traits and values prevailing in their society. Except the Foreword which is the general introduction to the paper, this paper is presented in five parts. The first part to the forth part are the emphasis of the paper which respectively analyze the American traits and values. A series of vivid examples are provided with a wide range of study objects, man and woman, kids to elders, in hope of making the paper understandable and persuasive. It is expected that the study can offer a general idea to the people who are interested in the American society and its people.展开更多
The human motion data collected using wearables like smartwatches can be used for activity recognition and emergency event detection.This is especially applicable in the case of elderly or disabled people who live sel...The human motion data collected using wearables like smartwatches can be used for activity recognition and emergency event detection.This is especially applicable in the case of elderly or disabled people who live self-reliantly in their homes.These sensors produce a huge volume of physical activity data that necessitates real-time recognition,especially during emergencies.Falling is one of the most important problems confronted by older people and people with movement disabilities.Numerous previous techniques were introduced and a few used webcam to monitor the activity of elderly or disabled people.But,the costs incurred upon installation and operation are high,whereas the technology is relevant only for indoor environments.Currently,commercial wearables use a wireless emergency transmitter that produces a number of false alarms and restricts a user’s movements.Against this background,the current study develops an Improved WhaleOptimizationwithDeep Learning-Enabled Fall Detection for Disabled People(IWODL-FDDP)model.The presented IWODL-FDDP model aims to identify the fall events to assist disabled people.The presented IWODLFDDP model applies an image filtering approach to pre-process the image.Besides,the EfficientNet-B0 model is utilized to generate valuable feature vector sets.Next,the Bidirectional Long Short Term Memory(BiLSTM)model is used for the recognition and classification of fall events.Finally,the IWO method is leveraged to fine-tune the hyperparameters related to the BiLSTM method,which shows the novelty of the work.The experimental analysis outcomes established the superior performance of the proposed IWODL-FDDP method with a maximum accuracy of 97.02%.展开更多
Objective China began providing antiretroviral therapy to people living with HIV/AIDS (PLWHA) in 2003. This study was to investigate the living conditions, including quality of life and happiness, and need for palli...Objective China began providing antiretroviral therapy to people living with HIV/AIDS (PLWHA) in 2003. This study was to investigate the living conditions, including quality of life and happiness, and need for palliative care of end-of-life PLWHA in rural Henan. Methods One hundred end-of-life AIDS patients were selected from Weishi, Zhenping and Tanghe counties in Henan, using convenience sampling. The World Health Organization Quality of Life for HIV (WHOQOL-HIV) BREF Chinese Version was used to measure the quality of life and the Memorial University of Newfoundland Scale of Happiness (MUNSH) was employed to measure subjective welfare. Qualitative interviews and focus group discussions were undertaken to learn about the palliative care provided and the specific needs of the end-of-life patients. Results Patients’ overall quality of life was moderate (12.62±1.97). Highest scores were in the spirituality/religion/personal beliefs, higher than the average scores in the Chinese population (P0.01), while psychological (13.58±2.06) and environment (12.50±3.28) domain scores were similar to the latter (P0.05). Both independence (12.15±2.15) and physiological (14.04±3.16) domain scores were lower than the average of the people living with HIV/AIDS in other studies (P0.01); however, all were in the moderate range. The average MUNSH score was 21.00±6.20, which was also moderate. The in-depth interviews indicated that the Henan Provincial Government’s policy of treatment and care had a beneficial impact on end-of-life AIDS patients, although the care components could be improved. Conclusions Living conditions of the end-of-life AIDS patients were moderate, and the HIV/AIDS palliative care model used was beneficial to them. Care could be improved by assisting the family unit as a whole.展开更多
Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospita...Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospitals who also live with elderly adults at home. Method: The study used the questionnaire method with an independently prepared questionnaire. Participants: The objective of the study was explained to the persons in charge of nursing in the selected 17 hospitals, and 1929. Finally, this study of participants were 524 female nurses working in general 54 wards (excluding the emergency wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms, and intensive care units) at community hospitals who also live with elderly adults at home. Results and conclusions: Cronbach’s overall coefficient for the 20 items of dilemma was high (0.78) and the factor analysis extracted four dilemma factors as having a characteristic value of 1 (Kaiser-Meyer-Olkin measure value = 0.81) with a cumulative contribution ratio of 64.5%. The high Cronbach’s for these items (0.86, 0.88, 0.87 and 0.81) confirmed the internal consistencies. With respect to the dilemma where nurses working in general wards at community hospitals who also live with elderly adults at home are faced with the physical restraint of elderly persons, four factors in the clarification of the dilemma were extracted: accomplishment of medical-treatment and accident prevention, characteristic features in nursing for elderly patients with dementia, healthcare professional relationship in nursing for elderly patients with dementia, and priorities on the accident prevention for elderly patients with dementia. Therefore, the construction of four systems to cope with these dilemmas is suggested. These systems would enable practising nurses to: (i) institution of policies to encourage discussion between nurses and other medical staff to reach consensus on treatment;(ii) allocating elderly care specialists to wards to promote alternatives to restraints;(iii) establishment of safety standards to define nurses’ responsibilities;and (iv) institution of continuous ethical education for nurses.展开更多
HIV remains a global health challenge,and research efforts directed towards a functional cure require people living with HIV(PLHIV)in-volvement in clinical trials.Our study assessed willingness to participate in HIV f...HIV remains a global health challenge,and research efforts directed towards a functional cure require people living with HIV(PLHIV)in-volvement in clinical trials.Our study assessed willingness to participate in HIV functional cure–related clinical trials and associated factors among PLHIV in Guangzhou,China,using a questionnaire survey approach.We analyzed responses from 718 questionnaires,finding that 71.2%were willing to participate in Phase Ⅲtrials,while 51.7%were willing to participate in Phase I trials and 42.9%expressed acceptability for analytic treatment interruption.Multivariate logistic regression demonstrated that male PLHIV,those with awareness of functional cure,and PLHIV,who had been on antiretroviral therapy(ART)for less than 1 year,were more willing to partic-ipate in Phase Ⅲtrials.Those with a body mass index greater than 24,and those without resistance to ART drug were more willing to participate in Phase I trials.The major motivations for participation in Phase Ⅲtrials were access to cutting-edge treatments(62.6%)and supporting research(55.3%).Safety was the main concern contributing to hesitancy.Our study revealed a high willingness to participate in HIV functional cure–related trials among PLHIV in Guangzhou,China,and willingness varied across different trial phases and was influenced by multiple factors.This study provides valuable references for future clinical trial recruitment strategies and public health policy formulation.展开更多
基金Supported by the Faculty of Medicine,Ramathibodi Hospital,Mahidol University。
文摘BACKGROUND The prevalence of metabolic-associated fatty liver disease(MAFLD)is a growing public health issue in people living with human immunodeficiency virus(PLWH).However,the pathophysiology of MAFLD is still unknown,and the role of genetic variables is only now becoming evident.AIM To evaluate the associations of gene-polymorphism-related MAFLD in PLWH.METHODS The study employed transient elastography with a controlled attenuation parameter≥248 dB/m to identify MAFLD in patients from a Super Tertiary Hospital in central Thailand.Candidate single-nucleotide polymorphisms(SNPs)were genotyped using TaqMan®MGB probe 5'nuclease assays for seven MAFLD-related genes.Statistical analyses included SNP frequency analysis,Fisher's Exact and Chi-square tests,odds ratio calculations,and multivariable logistic regression.RESULTS The G-allele carriers of PNPLA3(rs738409)exhibited a two-fold rise in MAFLD,increasing by 2.5 times in MAFLD with human immunodeficiency virus infection.The clinical features and genetic patterns imply that LEP rs7799039 A-allele carriers had a nine times(P=0.001)more significant chance of developing aberrant triglyceride among PLWH.CONCLUSION The current study shows an association between PNPLA3 rs738409 and LEP rs7799039 with MAFLD in PLWH.
文摘Introduction: Lower extremity artery disease (LEAD) is a serious cardiovascular disease. People living with the human immunodeficiency virus (HIV) are at risk. The aim of the study was to determine the prevalence of LEAD and identify the associated factors among people living with HIV who were followed at the departmental university hospital Ouémé-Plateau in Benin. Methods: This was a cross-sectional study. It included all HIV-infected people who were monitored at the department of medicine of the target hospital during the study period and met the inclusion criteria (followed for at least three months, aged at least 25 years, and having given their written consent to participate). Data were collected during an individual interview, followed by the measurement of parameters. The ankle brachial index ≤ 0.9 was used for the diagnosis of LEAD. Associated factors were searched through a multivariable logistic regression. Results: The prevalence of LEAD was 34.2% among 222 respondents having a mean age was 42.9 ± 10.8 years and a female predominance (77.5%). No significant association was found between the presence of LEAD and sociodemographic factors. The presence of LEAD was significantly associated with hypertension and antiretroviral therapy. Hypertensive patients had a higher risk of LEAD compared to non-hypertensive patients (OR = 1.98, 95% CI [1.04-3.83], p = 0.037). Those who were receiving second-line therapy also had a higher risk of LEAD compared to those on first-line therapy (OR = 2.95, 95% CI [1.14-7.60], p = 0.025). Conclusion: This study showed a high prevalence of LEAD especially among hypertensive patients and those who were receiving second-line antiretroviral therapy. LEAD diagnosis and management should be included in the routine care of people living with HIV in Benin.
文摘Hepatitis C virus(HCV)/human immunodeficiency virus(HIV)co-infection still involves 2.3 million patients worldwide of the estimated 37.7 million living with HIV,according to World Health Organization.People living with HIV(PLWH)are six times greater affected by HCV,compared to HIV negative ones;the greater prevalence is encountered among people who inject drugs and men who have sex with men:the risk of HCV transmission through sexual contact in this setting can be increased by HIV infection.These patients experience a high rate of chronic hepatitis,which if left untreated progresses to end-stage liver disease and hepato-cellular carcinoma(HCC)HIV infection increases the risk of mother to child vertical transmission of HCV.No vaccination against both infections is still available.There is an interplay between HIV and HCV infections.Treatment of HCV is nowadays based on direct acting antivirals(DAAs),HCV treatment plays a key role in limiting the progression of liver disease and reducing the risk of HCC development in mono-and coinfected individuals,especially when used at an early stage of fibrosis,reducing liver disease mortality and morbidity.Since the sustained virological response at week 12 rates were observed in PLWH after HCV eradication,the AASLD has revised its simplified HCV treatment algorithm to also include individuals living with HIV.HCV eradication can determine dyslipidemia,since HCV promotes changes in serum lipid profiles and may influence lipid metabolism.In addition to these apparent detrimental effects on the lipid profile,the efficacy of DAA in HCV/HIV patients needs to be considered in light of its effects on glucose metabolism mediated by improvements in liver function.The aim of the present editorial is to describe the advancement in HCV treatment among PLWH.
文摘This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.
文摘By employing the information-reshufflingmethod that integrates census data, precipitation dataand inquiry data of water consumption, this paperdiscusses 5 (water consumption coefficient of people’sliving) in allusion to different precipitation zones anddifferent periods of time. The study shows that 5-(water consumption coefficient of urban people’sliving), 5. (water consumption coefficient of ruralpeople’s living) and increase with time passing, andthe increasing extent of 5 is 1.84, 2.62, 2.84 and 2.68times respectively from the west to the east, whichresults from the total quantity of water resources andthe speed of urbanization. 5- and 5. of eachprecipitation zone increased with 5- increasing morequickly than 5., and the difference between the twoalso increased when time passed. In the past fifty years(1950-2000), the increasing extent of 5- was 1.71,2.96, 2.41 and 2.33 times respectively from the westto the east, in which 200-400mm precipitation zoneincreased more than others. Meanwhile the increasingextent of 5. is 1.55, 1.60, 1.53 and 1.64 timesrespectively from the west to the east with eachprecipitation zone increasing similarly. The change of5-is due to the speed of urbanization and the stabilityof water resources. This study provides basis forcalculating the water demand of people’s living andrevealing the impact of water demand of people’s livingon ecological drought in different zones.
文摘Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to assess the level of knowledge, attitude and practice with regard to care of PLHIV among nursing and midwifery students in Fako division of Cameroon. A survey was performed between May and July 2015, among 227 nursing and midwifery students (in their second to final year of study), selected from 8 government accredited training institutions in Fako division of Cameroon. An anonymous self-administered semi-structured questionnaire was used to collect data. The Pearson’s chi-square test, univariate and multivariate logistic regression analyses adjusting for possible confounders were all performed as part of the statistical analyses. The cutoff of statistical significance was set at p ≤ 0.05. Nursing and midwifery students had a moderate level of HIV/AIDS knowledge (average score of 7.02 on a scale of 11). Attitude towards PLHIV was generally positive (68.7%) but there were some misconceptions and prejudice about PLHIV, with considerable stigmatization (31.3%), unwillingness to share a room with someone infected with HIV (27.7%), and unwillingness to work on PLHIV (23.8%). Good HIV/AIDS knowledge was observed to be the sole independent predictor (p = 0.004) of positive attitude towards PLHIV. Fur-thermore the confidence of the respondents regarding care of PLHIV was generally moderate. Our results suggest the need for the development of a more appropriate education program in nursing and midwifery institutions in Fako division to reduce the discrepancies between the general knowledge, attitude and practice regarding care of PLHIV.
文摘Background: Among elderly people, rehabilitation is important for reducing the risk of falls and hospitalization and to maintain an independent life for longer. Motivation is a factor for elderly people to lead an active daily life and leave home more frequently. Purpose: The purposes of this study were to determine the optimal cut-off point in the Scale for Achievement Motive in Geriatrics (SAMG) that could identify individuals as inactive or active, based on the Frenchay Activities Index (FAI), and to compare characteristics between active and inactive groups classified by the cut-off point. Methods: A cross-sectional study of 285 community-dwelling elderly people measured SAMG and FAI and physical function. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) that was the optimal cut-off point for the SAMG total score, with the associated sensitivity and 1-specificity when compared with the FAI results. Demographic parameters and physical function were compared between two groups defined by cut-off point. Results: The AUC was 0.78, the optimal cut-off for SAMG total score for indicating inactivity was ≤48, the sensitivity was 77.98% and the 1-specificity was 75.00%. The group with SAMG score >48 was characterized by a significantly higher proportion of women, fewer people sharing a house, and participation in more hobbies. Discussion: A cut-off point of 48 in the SAMG could be a predictive index of motivation toward goals for individuals with inactive daily activities. The group with score higher than the cut-off was characterized by more women, fewer people living together, and more hobbies than the group with lower scores.
文摘BACKGROUND As people living with human immunodeficiency virus(HIV)(PLWH)enjoy longer life expectancy with highly effective antiretroviral therapy,they are encountering challenging cardiovascular health risks.AIM To retrospectively examine the increasing burden of cardiovascular diseases in PLWH over the past decade.METHODS All hospitalizations for heart failure(HF),ischemic heart disease(IHD),and cerebrovascular disease(CeVD)in PLWH were identified using the International Classification of Diseases,Ninth Revision,Clinical Modification(ICD-9-CM)and ICD-10-CM codes in the National Inpatient Sample from 2008 to 2018.Outcomes included number of hospitalizations,in-hospital mortality,length of stay,and total hospital charge.Trend of the outcomes from 2008 to 2018 were analyzed using Cochran-Armitage_(trend)test and simple linear regression.RESULTS The number of hospitalizations for HF in PLWH increased from 4212 in 2008 to 6700 in 2018(P_(trend)<0.01).Similar increasing_(trend)was seen with those for IHD and CeVD over the decade(P_(trend)<0.01).A decreasing_(trend)of in-hospital mortality was observed in all hospitalizations of PLWH(P_(trend)<0.01)and CeVD in PLWH(P_(trend)<0.01),but not in those for HF(P_(trend)=0.67)and IHD(P_(trend)=0.13).The_(trend)of length of stay was decreasing in all hospitalizations of PLWH(P_(trend)<0.01),but increasing in those for HF in PLWH(P_(trend)<0.01).An increasing_(trend)of total hospital charge was observed in hospitalizations for HF,IHD,and CeVD(P_(trend)<0.01).CONCLUSION The burden of cardiovascular diseases has significantly increased in hospitalizations of PLWH from 2008 to 2018.Continued efforts are needed to address the additional cardiovascular risks in this vulnerable population.
文摘China Society for Human Rights Studies, I would like to extend my warm greetings to the launch of your Human Rights magazine. Enjoying human rights fully is a lofty goal long pursued after by human race. Over the years when they carried out revolution, construction and reforms, the Chinese people have struggled indomitably and strived incessantly to achieve this goal. Progress made in this regard has caught worldwide attention. When struggling for, safeguarding, promoting and developing human rights, the Chinese people have always combined the universality prin-
文摘Tuberculosis (TB) is a chronic disease caused by mycobacterium tuberculosis and transmitted from person to person, through inhalation of droplet nuclei aerosolized by coughing of an infected person. It reached epidemic proportions in Europe and North America during the 18th and 19th centuries. The incubation period is 2 - 6 weeks and the control has been complicated with emergence of HIV and drug-resistant TB. In 1993, World Health Organization (WHO) declared TB a global emergency. However, despite the concerted effort of National TB control programs, adoption and implementation of Stop TB strategy, TB has remained a major public health challenge with high mortality rate, especially in developing countries. Methodology: This is a descriptive study, evaluated using the positivist/quantitative approach. The study was conducted at FederalMedical Centre Umuahia, a tertiary specialist hospital with comprehensive TB/HIV treatment services. All the presumptive drug-resistant TB cases and symptomatic PLHIV were screened for HIV and their sputum specimens were tested for tuberculosis using the Gene xpert and the Ziehl- Neelsen technique for detecting Acid Fast bacilli. A pretested structured questionnaire was used tocollect the demographic data and other essential data from the presumptive TB and laboratory registers such as total number of TB presumptive cases registered HIV status, AFB status and rifampicin status within the study period. Result: A total of 493 presumptive TB cases were screened in the study, 49.9% were HIV positive while 50.05% were HIV negative. More so, 77.85% of thescreened cases were AFB negative and 22.15% were AFB positive. Moreover, 11% of the TB/HIV co-infected patients were rifampicin positive. Interestingly among the 493 cases screened with gene xpert machine, 3.6% were rifampicin positive. Furthermore, 3.6% of the HIV negative cases were rifampicin positive while 1.6% of the HIV positive cases were rifampicin positive. Discussion: The data depict lower rifampicin resistance among HIV positive cases than HIV negative cases. The implication for public health professionals is to intensify equitable and unbiased search for resistant TB cases among smear negative and positive cases.
文摘Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection among people who living with HIV (PLHIV) in the infectious and tropical diseases department of the Centre Hospitalier Universitaire de lAmiti Sino-Centrafricaine in Bangui. Methods: A retrospective study was carried out from January 1, 2010 to December 31, 2021 in the Infectious and Tropical Diseases Department at the Amiti Sino-Centrafricaine University Hospital. It included the files of all PLHIV, which included the results of HBV serology. A standardized form was used to collect socio-demographic and professional data by documentary review. Data was analysed using Epi-Info 7 software. Means, proportions were calculated as well as Chi square witch was significant if p-value was below 0.05. Results: The study included 265 patients, 188 were women (70.1%) and 77 men (29.1%), giving a sex ratio of 0.45. Mean age was 35.8 years, higher in men (40 years) than in women (35.8 years) (p 0.0001). The age groups 25 to 34 (37.7%) and 35 to 44 (33.6%) were in the majority (71.3%). The majority of PLHIV were unemployed (57.1%), including housewives (43.0%). HBV prevalence was 14.3%, including 7.2% among the unemployed, who account for half of all co-infections. The search for associations between HIV-HBV co-infection and all socio-demographic characteristics (age, sex, marital status) and socio-professional categories showed no significant difference (p 0.05). Conclusion: PLHIV were predominantly young adults, female, and unemployed;no occupation was significantly associated with co-infection. The vast majority of co-infected people were not covered by the occupational health system (unemployed or informal sector). Urgent action is needed to improve workers access to occupational medicine in CAR.
文摘Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.
文摘The paper combs the problems about living difficulties of farmers and marketing economy in the risk society and puts forward another point of view that with the theory of risk society,reconsider the dilemma of living choices of farmers under the background of marketing economy.On the basis of the statistics,the paper discloses the trend of larger and larger disparities of incomes between urban and rural areas;the paper explains the risks and uncertainties of life choices with the background of deepening marketing economy.In order to understand the life dilemma of farmers and marketing economy in the risk society,the paper makes an analysis from perspectives of the relationships between risk society and markets,the risks of farmers' living choices.The results show that in the risk society,because of the division space from time,the personal farmers are devoid of the safe environment.Then the situation deepens to worse.In addition to the organization which is not in charge results in a situation that the personal farmers would take all risks by themselves.
文摘The study evaluated the quality of healthcare services given to PLWHA (people living with HIV/AIDS) in different communities of Enugu State of Nigeria. Descriptive cross sectional survey design was employed for the study. The participants were PLWHA attending health facilities in different communities in the state. A sample of 180 PLWHA who participated in the study were selected using a multi-stage sampling procedure and were interviewed at community level. The data were analyzed using descriptive statistics. The results showed that 82.2% of the respondents were cared for by government health facilities, 75% were of the opinion that the health workers in those places do not discriminate against them, 81.7% felt that they were being given high quality healthcare, 82.8% stated that their drugs were readily available, 75% were of the opinion that the physical facilities in their care centers were adequate, 84.4% felt that grievance redressing were good while 90% felt that their healthcare providers maintain confidentiality about their conditions. It was concluded from the findings that quality of care provided to PLWHA in communities was of good quality as perceived by PLWHA and that the national antiretroviral programmes are making drugs available and affordable in the state. It was then recommended that all levels of government in the nation should strengthen the programmes on HIV prevention and control to maintain the continuity of care to PLWHA.
文摘The paper presents an analytical study on the American society through a popular American drama series "the Desperate House Wives". Typical American values can be found everywhere on the show as they have been ingrained in the soul of the American people. As a nation with not very long history but great achievements, its people are the one that should be highlighted. Unlike China, the nation of which have formed since thousands of years ago, so has its culture, America's history is an immigration history. People started migrating from other parts of the world since the 17 thcentury and gathered at the land of America to build up their new homes and realize their dreams. They influence each other and fuse with each other. America is one of the countries in the world that plural cultures successfully mix together.The paper focuses on the American people's daily life to explain to the readers the American traits and values prevailing in their society. Except the Foreword which is the general introduction to the paper, this paper is presented in five parts. The first part to the forth part are the emphasis of the paper which respectively analyze the American traits and values. A series of vivid examples are provided with a wide range of study objects, man and woman, kids to elders, in hope of making the paper understandable and persuasive. It is expected that the study can offer a general idea to the people who are interested in the American society and its people.
基金The authors extend their appreciation to the Deanship of Scientific Research at King Khalid University for funding this work through Large Groups Project under grant number(158/43)Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2022R77)+1 种基金Princess Nourah bint Abdulrahman University,Riyadh,Saudi ArabiaThe authors would like to thank the Deanship of Scientific Research at Umm Al-Qura University for supporting this work by Grant Code:(22UQU4310373DSR52).
文摘The human motion data collected using wearables like smartwatches can be used for activity recognition and emergency event detection.This is especially applicable in the case of elderly or disabled people who live self-reliantly in their homes.These sensors produce a huge volume of physical activity data that necessitates real-time recognition,especially during emergencies.Falling is one of the most important problems confronted by older people and people with movement disabilities.Numerous previous techniques were introduced and a few used webcam to monitor the activity of elderly or disabled people.But,the costs incurred upon installation and operation are high,whereas the technology is relevant only for indoor environments.Currently,commercial wearables use a wireless emergency transmitter that produces a number of false alarms and restricts a user’s movements.Against this background,the current study develops an Improved WhaleOptimizationwithDeep Learning-Enabled Fall Detection for Disabled People(IWODL-FDDP)model.The presented IWODL-FDDP model aims to identify the fall events to assist disabled people.The presented IWODLFDDP model applies an image filtering approach to pre-process the image.Besides,the EfficientNet-B0 model is utilized to generate valuable feature vector sets.Next,the Bidirectional Long Short Term Memory(BiLSTM)model is used for the recognition and classification of fall events.Finally,the IWO method is leveraged to fine-tune the hyperparameters related to the BiLSTM method,which shows the novelty of the work.The experimental analysis outcomes established the superior performance of the proposed IWODL-FDDP method with a maximum accuracy of 97.02%.
基金supported by the China Global Fund Round 3 and the China Multidisciplinary AIDS Prevention Training Program with NIH Research Grant #U2R TW06918-01funded by the Fogarty International Centre,the National Institute on Drug Abuse and the National Institute of Mental Health (China ICOHRTA, with Principal Investigator being Zun-You WU)
文摘Objective China began providing antiretroviral therapy to people living with HIV/AIDS (PLWHA) in 2003. This study was to investigate the living conditions, including quality of life and happiness, and need for palliative care of end-of-life PLWHA in rural Henan. Methods One hundred end-of-life AIDS patients were selected from Weishi, Zhenping and Tanghe counties in Henan, using convenience sampling. The World Health Organization Quality of Life for HIV (WHOQOL-HIV) BREF Chinese Version was used to measure the quality of life and the Memorial University of Newfoundland Scale of Happiness (MUNSH) was employed to measure subjective welfare. Qualitative interviews and focus group discussions were undertaken to learn about the palliative care provided and the specific needs of the end-of-life patients. Results Patients’ overall quality of life was moderate (12.62±1.97). Highest scores were in the spirituality/religion/personal beliefs, higher than the average scores in the Chinese population (P0.01), while psychological (13.58±2.06) and environment (12.50±3.28) domain scores were similar to the latter (P0.05). Both independence (12.15±2.15) and physiological (14.04±3.16) domain scores were lower than the average of the people living with HIV/AIDS in other studies (P0.01); however, all were in the moderate range. The average MUNSH score was 21.00±6.20, which was also moderate. The in-depth interviews indicated that the Henan Provincial Government’s policy of treatment and care had a beneficial impact on end-of-life AIDS patients, although the care components could be improved. Conclusions Living conditions of the end-of-life AIDS patients were moderate, and the HIV/AIDS palliative care model used was beneficial to them. Care could be improved by assisting the family unit as a whole.
文摘Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospitals who also live with elderly adults at home. Method: The study used the questionnaire method with an independently prepared questionnaire. Participants: The objective of the study was explained to the persons in charge of nursing in the selected 17 hospitals, and 1929. Finally, this study of participants were 524 female nurses working in general 54 wards (excluding the emergency wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms, and intensive care units) at community hospitals who also live with elderly adults at home. Results and conclusions: Cronbach’s overall coefficient for the 20 items of dilemma was high (0.78) and the factor analysis extracted four dilemma factors as having a characteristic value of 1 (Kaiser-Meyer-Olkin measure value = 0.81) with a cumulative contribution ratio of 64.5%. The high Cronbach’s for these items (0.86, 0.88, 0.87 and 0.81) confirmed the internal consistencies. With respect to the dilemma where nurses working in general wards at community hospitals who also live with elderly adults at home are faced with the physical restraint of elderly persons, four factors in the clarification of the dilemma were extracted: accomplishment of medical-treatment and accident prevention, characteristic features in nursing for elderly patients with dementia, healthcare professional relationship in nursing for elderly patients with dementia, and priorities on the accident prevention for elderly patients with dementia. Therefore, the construction of four systems to cope with these dilemmas is suggested. These systems would enable practising nurses to: (i) institution of policies to encourage discussion between nurses and other medical staff to reach consensus on treatment;(ii) allocating elderly care specialists to wards to promote alternatives to restraints;(iii) establishment of safety standards to define nurses’ responsibilities;and (iv) institution of continuous ethical education for nurses.
基金supported by the National Natural Science Foundation of China(82271786 and 81971927)the Science and Technology Planning Project of Shenzhen City(JSGG20200225152008136 and JCYJ20190807155009482)+2 种基金the Science and Technology Planning Project of Guangdong Province(2021B1212040017)Sanming Project of Medicine in Shenzhen Nanshan(SZSM202103008)the Key Subject of Nanshan district of Shenzhen for AIDS surveillance and prevention.
文摘HIV remains a global health challenge,and research efforts directed towards a functional cure require people living with HIV(PLHIV)in-volvement in clinical trials.Our study assessed willingness to participate in HIV functional cure–related clinical trials and associated factors among PLHIV in Guangzhou,China,using a questionnaire survey approach.We analyzed responses from 718 questionnaires,finding that 71.2%were willing to participate in Phase Ⅲtrials,while 51.7%were willing to participate in Phase I trials and 42.9%expressed acceptability for analytic treatment interruption.Multivariate logistic regression demonstrated that male PLHIV,those with awareness of functional cure,and PLHIV,who had been on antiretroviral therapy(ART)for less than 1 year,were more willing to partic-ipate in Phase Ⅲtrials.Those with a body mass index greater than 24,and those without resistance to ART drug were more willing to participate in Phase I trials.The major motivations for participation in Phase Ⅲtrials were access to cutting-edge treatments(62.6%)and supporting research(55.3%).Safety was the main concern contributing to hesitancy.Our study revealed a high willingness to participate in HIV functional cure–related trials among PLHIV in Guangzhou,China,and willingness varied across different trial phases and was influenced by multiple factors.This study provides valuable references for future clinical trial recruitment strategies and public health policy formulation.