Current rates of mental illness are worrisome.Mental illness mainly affects females and younger age groups.The use of the internet to deliver mental health care has been growing since 2020 and includes the implementat...Current rates of mental illness are worrisome.Mental illness mainly affects females and younger age groups.The use of the internet to deliver mental health care has been growing since 2020 and includes the implementation of novel mental health treatments using virtual reality,augmented reality,and artificial intelligence.A new three dimensional digital environment,known as the metaverse,has emerged as the next version of the Internet.Artificial intelligence,augmented reality,and virtual reality will create fully immersive,experiential,and interactive online environments in the metaverse.People will use a unique avatar to do anything they do in their“real”lives,including seeking and receiving mental health care.In this opinion review,we reflect on how the metaverse could reshape how we deliver mental health treatment,its opportunities,and its challenges.展开更多
Objective: To give an historical record of the research of the World Health Organization (WHO) Task Force to develop methods of male contraception; to examine the social, political, medical, pharmaceutical, funding, a...Objective: To give an historical record of the research of the World Health Organization (WHO) Task Force to develop methods of male contraception; to examine the social, political, medical, pharmaceutical, funding, and other factors that influenced progress; and to suggest reasons why such methods are only now becoming available. Design: Review of basic and clinical research over 30 years. Setting: Task force of a multinational agency and collaborating agencies. Conclusion(s): Through the involvement of many international scientists, the WHO Task Force has uniquely contributed to the exploratory phases of the research in male contraception and by its multicenter contraceptive efficacy studies has accelerated progress towards the ideal hormonal method. Despite an adverse climate involving social and political attitudes, funding constraints, and pharmaceutical industry hesitations, WHO formed coalitions with governments and international agencies to sustain research with results that apply to men in culturally diverse populations and thereby to influence activities across the whole range of global reproductive health and family planning.展开更多
Due to the increasing prevalence of clarithromycin resistance, future of management of Helicobacter pylori(H. pylori) infections need to be recognized. To now, clarithromycin was the best effective, well-tolerated and...Due to the increasing prevalence of clarithromycin resistance, future of management of Helicobacter pylori(H. pylori) infections need to be recognized. To now, clarithromycin was the best effective, well-tolerated and safe antibiotic used in treatment of the bacterium, but, increasing trend of resistance reduced efficacy of recommended regimens. Indeed, gastroenterologists are mostly unable to start appropriate therapyaccording to the sensitivity profile-due to the certain difficulties in routine H. pylori culture procedure and being time consuming method. This announcement by World Health Organization(WHO) was an onset to reconsider current challenging dilemma about H. pylori clarithromycin resistant isolates. Therefore, investigating of various factors affecting this nomination by WHO is highly welcomed. In fact, WHO enumerated more than 16 pathogens which seriously threats human life and public health, thus better management or effective guidelines are necessary. Here for the first time, we nominated this phenomenon as ‘‘gastroenterologist's persistence'' which should be equally investigated as antibiotic resistance. The ability of gastroenterologists to win the game against H. pylori infections is highly influenced by their collaboration with diagnostic laboratories to apply susceptibility patterns before any prescription. In conclusion, closer collaboration between two important partners(gastroenterologists and microbiologists) in management of H. pylori infection may hopefully trigger an era to remedy current crisis in clarithromycin resistance, a later gastric cancer can be practically preventable.展开更多
The classification of central nervous system(CNS)glioma went through a sequence of developments,between 2006 and 2021,started with only histological approach then has been aided with a major emphasis on molecular sign...The classification of central nervous system(CNS)glioma went through a sequence of developments,between 2006 and 2021,started with only histological approach then has been aided with a major emphasis on molecular signatures in the 4^(th) and 5^(th) editions of the World Health Organization(WHO).The recent reformation in the 5th edition of the WHO classification has focused more on the molecularly defined entities with better characterized natural histories as well as new tumor types and subtypes in the adult and pediatric populations.These new subclassified entities have been incorporated in the 5^(th) edition after the continuous exploration of new genomic,epigenomic and transcriptomic discovery.Indeed,the current guidelines of 2021 WHO classification of CNS tumors and European Association of Neuro-Oncology(EANO)exploited the molecular signatures in the diagnostic approach of CNS gliomas.Our current review presents a practical diagnostic approach for diffuse CNS gliomas and circumscribed astrocytomas using histomolecular criteria adopted by the recent WHO classification.We also describe the treatment strategies for these tumors based on EANO guidelines.展开更多
The accelerated population growth of the elderly(individuals aged 60 years or more)across the globe has many indications,including changes in demography,health,the psycho-social milieu,and economic security.This trans...The accelerated population growth of the elderly(individuals aged 60 years or more)across the globe has many indications,including changes in demography,health,the psycho-social milieu,and economic security.This transition has given rise to varied challenges;significant changes have been observed in regard to developing strategies for health care systems across the globe.The World Health Organization(WHO)is also engaging in initiatives and mediating processes.Furthermore,advocacy is being conducted regarding a shift toward the salutogenic model from the pathogenic model.The concept behind this move was to shift from disablement to enablement and from illness to wellness,with the notion of mental health promotion(MHP)being promoted.This article attempts to discuss the MHP of elderly individuals,with special reference to the need to disseminate knowledge and awareness in the community by utilizing the resources of the health sector available in the WHO South-East Asia Region countries.We have tried to present the current knowledge gap by exploring the existing infrastructure,human resources,and financial resources.There is much to do to promote the mental health of the elderly,but inadequate facilities are available.Based on available resources,a roadmap for MHP in elderly individuals is discussed.展开更多
November 1,2023 marks the 6th"World Flu Day".The theme is"Preventing Influenza,Protecting Health"in this year.According to data from the World Health Organization,influenza infects approximately 5%...November 1,2023 marks the 6th"World Flu Day".The theme is"Preventing Influenza,Protecting Health"in this year.According to data from the World Health Organization,influenza infects approximately 5%-10%of adults and 20%-30%of children worldwide each year,resulting in up to 5million severe cases and 650,000 deaths.A recent study showed that about 88,000 people in China died from respiratory diseases caused by influenza each year,accounting for 8.2%of total respiratory disease deaths,making influenza a serious threat to public health.展开更多
A descriptive study on assessment of medicines cold chain storage conformity with World Health Organization (WHO) requirements in public health facilities was carried out in Dar es Salaam and Dodoma regions. Storage c...A descriptive study on assessment of medicines cold chain storage conformity with World Health Organization (WHO) requirements in public health facilities was carried out in Dar es Salaam and Dodoma regions. Storage conformity in selected health facilities was assessed by monitoring temperature using temperature data loggers mounted in the refrigerators for a period of 30 days. Results indicated almost half of the health facilities 48.5% visited, did not significantly (P = 0.031) comply with storage temperature (+2°C to +8°C) as per WHO requirement because all recorded Mean Kinetic temperature (MKT) > 8°C. In rural areas, 59.2% of visited health facilities adhered to the WHO recommended storage temperature while in urban areas only 31.6% complied. The study has established electricity failure in urban and lack of gas in rural areas coupled with absence of contingency plan as major challenges to WHO temperature conformity in storage of cold chain medicines in health facilities in Tanzania.展开更多
The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular ...The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular updates in this classification accommodate emerging molecular discoveries,advances in immunohistochemical techniques,and evolving clinical insights.The 5th edition of the WHO/IARC classification of head and neck tumors refines the'Oral Cavity and Mobile Tongue'chapter,including sections for non-neoplastic lesions,epithelial tumors,and tumors of uncertain histogenesis.Notably,the epithelial tumors section is rearranged by tumor behavior,starting with benign squamous papillomas and progressing through potentially malignant oral disorders to oral squamous cell carcinoma(OSCC).The section on OSCC reflects recent information on epidemiology,pathogenesis,and histological prognostic factors.Noteworthy is the specific categorization of verrucous carcinoma(VC)and carcinoma cuniculatum(CC),both associated with the oral cavity and distinct in clinical and histologic characteristics.This classification adjustment emphasizes the oral cavity as their predominant site in the head and neck.Designating specific sections for VC and CC aims to provide comprehensive insights into these unique subtypes,elucidating their clinical features,distinct histological characteristics,prevalence,significance,and clinical relevance.By categorizing these subtypes into specific sections,the 5th edition of the WHO classification aims to provide a more nuanced and detailed account,enhancing our understanding of these specific variants within the broader spectrum of head and neck tumors.展开更多
While mental health issues are increasingly gaining attention in Ghana, little is known about the situation among deaf people. This study assessed the mental health care needs of deaf people in Ghana. A descriptive de...While mental health issues are increasingly gaining attention in Ghana, little is known about the situation among deaf people. This study assessed the mental health care needs of deaf people in Ghana. A descriptive design, consisting of interviews and focus group discussions, was used to collect data from 97 participants. Findings indicated that participants had limited knowledge on mental health issues. Mental health stigma, inaccessible mental health information and exclusion from mental health programmes were the major barriers hindering access to mental health care services. This study bridges the knowledge gap and provides evidence for the implementation of deaf-friendly services.展开更多
Background: The incidence of in-hospital adverse events is about 10%, with a majority of these related to surgery, and nearly half considered preventable events. In attempts to improve patient safety, the World Health...Background: The incidence of in-hospital adverse events is about 10%, with a majority of these related to surgery, and nearly half considered preventable events. In attempts to improve patient safety, the World Health Organization (WHO) developed a checklist to be used at critical perioperative moments. This meta-analysis examines the impact of the WHO surgical safety checklist (SSC) on various patient outcomes. Methods: A comprehensive search of all published studies assessing the use of the WHO SSC in patients undergoing surgery was conducted. Studies using the WHO SSC in any surgical setting, with pre-implementation and post-implementation outcome data were included. The incidence of patient outcomes (total complications, surgical site infections, unplanned return to the operating room (OR) within 30 days, and overall mortality) and adherence to safety measures were analyzed. Results: 10 studies involving 51,125 patients (27,490 prior to implementation and 23,635 after implementation of the WHO SSC) were analyzed. The implementation of the WHO SSC significantly reduced the risk of total complications by 37.9%, surgical site infections by 45.5%, unplanned return to OR by 32.1%, and mortality by 15.3%. Increased adherence to safety measures including airway evaluation, use of pulse oximetry, prophylactic antibiotics when necessary, confirmation of patient name and surgical site, and sponge count was also observed. Conclusions: The use of the WHO SSC is associated with a significant reduction in post-operative complication rates and mortality. The WHO SSC is a valuable tool that should be universally implemented in all surgical centers and utilized in all surgical patients.展开更多
Journal of Sport and Health Science《运动与健康科学》(英文版),简称JSHS,是我国内地地区第一本英文体育学术期刊,深入分析和全面认识JSHS的期刊画像特征,对我国体育学术英文期刊国际化发展实践和建设世界一流期刊均具有重要现实意...Journal of Sport and Health Science《运动与健康科学》(英文版),简称JSHS,是我国内地地区第一本英文体育学术期刊,深入分析和全面认识JSHS的期刊画像特征,对我国体育学术英文期刊国际化发展实践和建设世界一流期刊均具有重要现实意义。采集Web of Science数据库中2012-2022年755篇JSHS论文,基于科学计量的方法,系统挖掘了JSHS在时间产出、作者合作、机构分布、刊文热点与趋势等特征,还从影响因子、即年指标、被引半衰期等指标,对标对表British Journal of Sports Medicine(简称BJSM,英国运动医学杂志)进行深入分析。研究发现:JSHS作为新创的体育科学期刊和我国建设世界一流期刊的代表,总体发展势头良好。年载文量稳步增长,期刊影响因子、论文影响力显著提升。论文高产机构来自上海体育学院、北卡罗莱纳大学、卡尔加里大学等,高产作者有Walter Herzog、刘宇、于冰、陈佩杰等,作者队伍越来越壮大,且呈团队合作趋势。JSHS在不断发展中形成6大主题群,包括儿童青少年运动与健康促进、老年人群运动与健康、运动表现分析、运动损伤、运动与疾病风险以及运动与认知功能。对标对表BJSM分析,JSHS在出版周期、年发文量、论文影响力等方面亟需提升。展开更多
目的基于世界卫生组织国际分类家族(WHO-FICs)构建作业治疗改善脑卒中上肢功能的PICO架构,并分析主要作业疗法改善脑卒中患者上肢功能的效果。方法运用WHO-FICs框架,检索Web of Science、PubMed、CNKI、SinoMed等数据库,收集建库至2022...目的基于世界卫生组织国际分类家族(WHO-FICs)构建作业治疗改善脑卒中上肢功能的PICO架构,并分析主要作业疗法改善脑卒中患者上肢功能的效果。方法运用WHO-FICs框架,检索Web of Science、PubMed、CNKI、SinoMed等数据库,收集建库至2022年10月关于作业治疗干预脑卒中上肢功能的相关文献,并进行系统综述。结果最终纳入10项随机对照试验,382例参与者(≥18岁),来自6个国家,主要来源于康复医学、物理和康复医学、神经科学、生物工程医学、作业治疗等研究领域,发表年限集中于2013年以后。纳入文献物理治疗证据数据库(PEDro)量表评分平均7.5分。基于WHO-FICs框架,纳入文献中涉及的疾病类型涵盖脑出血(8B00)、缺血性脑卒中(8B11)、蛛网膜下腔出血(8B01)、肌张力和异常反射(MB47)、偏瘫(MB53)。主要功能障碍包括关节活动功能(b710)、关节稳定性功能(b715)、肌肉力量功能(b730)、肌张力功能(b735)、运动反射功能(b750)、随意运动控制功能(b760)、不随意运动功能(b765)。主要活动受限和参与局限包括上肢的活动和参与,如举起和搬运物体(d430),手和手臂的使用(d445),精巧手的使用(d440);以及日常生活活动和社会参与能力,如自理(d510-d570),家庭生活(d610-d660),主要生活领域(d810-d879),社区、社会和公民生活(d910-d950)。涉及身体功能的治疗类干预措施有肌肉功能电刺激(MU2.SC.BP)、协助和指导运动功能训练(MV2.PG.ZZ);涉及活动和参与的治疗类干预措施有举起和搬运物体训练(SIA.PH.ZZ)、使用精巧手的训练(SIG.PH.ZZ)、使用上肢和手的训练(SIJ.PH.ZZ)、自理的干预措施(SM1-SMH)、主要生活领域的干预措施(SO2-SOD)、游戏训练(SXD.PH.ZZ)。每次干预15~60 min,每周3~10次,持续3~8周。干预场所一般为医院或居家。干预效果分为3个层面:身体功能层面,涉及神经运动传导功能、反射功能、随意运动控制能力、协调性与速度改善,关节活动度和握力增加;活动和参与层面,涉及上肢活动能力和速度、手的精细功能和速度、上肢活动参与的频率和质量,日常生活活动能力提高,参与日常活动任务的困难程度降低;生活质量和福祉层面,涉及获得愉悦感和成就感,生活质量提高。结论基于WHO-FICs构建了作业治疗改善脑卒中上肢功能效果的PICO架构。涉及的疾病类型涵盖脑出血、缺血性脑卒中、蛛网膜下腔出血、肌张力和异常反射以及偏瘫。上肢运动功能障碍主要有随意运动控制功能障碍,运动反射功能减弱或亢进,肌张力异常,肌肉协调障碍,关节活动稳定性差,肌力减退等,活动受限和参与局限性表现为手臂和手的活动参与功能障碍,手的精细活动功能障碍,影响日常生活活动和社会参与能力。涉及身体功能的治疗类干预措施有基于脑机接口的神经肌肉电刺激治疗、单上肢镜像训练;涉及活动和参与的治疗类干预措施有动作观察训练、双上肢镜像训练、任务导向训练、双上肢训练及上肢机器人训练。健康和功能效益主要表现为上肢运动功能、上肢的活动和参与水平、日常生活活动能力和社会参与能力提高,生活质量与福祉改善。展开更多
According to global annual estimates hunger/malnutrition is the major cause of death(36 of 62 million). Cardiovascular diseases and cancer(5.44 of 13.43 million) are the major causes of death in developed countries, w...According to global annual estimates hunger/malnutrition is the major cause of death(36 of 62 million). Cardiovascular diseases and cancer(5.44 of 13.43 million) are the major causes of death in developed countries, while lower respiratory tract infections, human immunodeficiency virus infection/acquired immunodeficiency syndrome, diarrhoeal disease, malaria and tuberculosis(10.88 of 27.12 million) are the major causes of death in developing countries with more than 70% of deaths occurring in children. The majority of approximately 800 million people with other rare diseases, including 100000 children born with thalassaemia annually receive no treatment. There are major ethical dilemmas in dealing with global health issues such as poverty and the treatment of orphan and rare diseases. Of approximately 50000 drugs about 10% are orphan drugs, with annual sales of the latter approaching 100 billion USD. In comparison, the annual revenue in 2009 from the top 12 pharmaceutical companies in Western countrieswas 445 billion USD and the top drug, atorvastatin, reached 100 billion USD. In the same year, the total government expenditure for health in the developing countries was 410 billion USD with only 6%-7% having been received as aid from developed countries. Drugs cost the National Health Service in the United Kingdom more than 20 billion USD or 10% of the annual health budget. Uncontrollable drug prices and marketing policies affect global health budgets, clinical practice, patient safety and survival. Fines of 5.3 billion USD were imposed on two pharmaceutical companies in the United States, the regulatory authority in France was replaced and clinicians were charged with bribery in order to overcome recent illegal practises affecting patient care. High expenditure for drug development is mainly related to marketing costs. However, only 2 million USD was spent developing the drug deferiprone(L1) for thalassaemia up to the stage of multicentre clinical trials. The criteria for drug development, price levels and use needs to be readdressed to improve drug safety and minimise costs. New global health policies based on cheaper drugs can help the treatment of many categories of orphan and rare diseases and millions of orphan patients in developing and developed countries.展开更多
基金Supported by Instituto de Salud CarlosⅢ(ISCⅢ),with group funds the Research Network on Chronicity,Primary Care and Health Promotion(RICAPPS,RD21/0016/0005)that is part of the Results-Oriented Cooperative Research Networks in Health(RICORS)(CarlosⅢHealth Institute),co-funded by the European Union“NextGeneration EU/PRTR”funds and with group funds Mental health research group in Primary Care(B17_23R),which is part of the Department of Innovation,Research,and University in the Government of Aragón(Spain).
文摘Current rates of mental illness are worrisome.Mental illness mainly affects females and younger age groups.The use of the internet to deliver mental health care has been growing since 2020 and includes the implementation of novel mental health treatments using virtual reality,augmented reality,and artificial intelligence.A new three dimensional digital environment,known as the metaverse,has emerged as the next version of the Internet.Artificial intelligence,augmented reality,and virtual reality will create fully immersive,experiential,and interactive online environments in the metaverse.People will use a unique avatar to do anything they do in their“real”lives,including seeking and receiving mental health care.In this opinion review,we reflect on how the metaverse could reshape how we deliver mental health treatment,its opportunities,and its challenges.
文摘Objective: To give an historical record of the research of the World Health Organization (WHO) Task Force to develop methods of male contraception; to examine the social, political, medical, pharmaceutical, funding, and other factors that influenced progress; and to suggest reasons why such methods are only now becoming available. Design: Review of basic and clinical research over 30 years. Setting: Task force of a multinational agency and collaborating agencies. Conclusion(s): Through the involvement of many international scientists, the WHO Task Force has uniquely contributed to the exploratory phases of the research in male contraception and by its multicenter contraceptive efficacy studies has accelerated progress towards the ideal hormonal method. Despite an adverse climate involving social and political attitudes, funding constraints, and pharmaceutical industry hesitations, WHO formed coalitions with governments and international agencies to sustain research with results that apply to men in culturally diverse populations and thereby to influence activities across the whole range of global reproductive health and family planning.
文摘Due to the increasing prevalence of clarithromycin resistance, future of management of Helicobacter pylori(H. pylori) infections need to be recognized. To now, clarithromycin was the best effective, well-tolerated and safe antibiotic used in treatment of the bacterium, but, increasing trend of resistance reduced efficacy of recommended regimens. Indeed, gastroenterologists are mostly unable to start appropriate therapyaccording to the sensitivity profile-due to the certain difficulties in routine H. pylori culture procedure and being time consuming method. This announcement by World Health Organization(WHO) was an onset to reconsider current challenging dilemma about H. pylori clarithromycin resistant isolates. Therefore, investigating of various factors affecting this nomination by WHO is highly welcomed. In fact, WHO enumerated more than 16 pathogens which seriously threats human life and public health, thus better management or effective guidelines are necessary. Here for the first time, we nominated this phenomenon as ‘‘gastroenterologist's persistence'' which should be equally investigated as antibiotic resistance. The ability of gastroenterologists to win the game against H. pylori infections is highly influenced by their collaboration with diagnostic laboratories to apply susceptibility patterns before any prescription. In conclusion, closer collaboration between two important partners(gastroenterologists and microbiologists) in management of H. pylori infection may hopefully trigger an era to remedy current crisis in clarithromycin resistance, a later gastric cancer can be practically preventable.
文摘The classification of central nervous system(CNS)glioma went through a sequence of developments,between 2006 and 2021,started with only histological approach then has been aided with a major emphasis on molecular signatures in the 4^(th) and 5^(th) editions of the World Health Organization(WHO).The recent reformation in the 5th edition of the WHO classification has focused more on the molecularly defined entities with better characterized natural histories as well as new tumor types and subtypes in the adult and pediatric populations.These new subclassified entities have been incorporated in the 5^(th) edition after the continuous exploration of new genomic,epigenomic and transcriptomic discovery.Indeed,the current guidelines of 2021 WHO classification of CNS tumors and European Association of Neuro-Oncology(EANO)exploited the molecular signatures in the diagnostic approach of CNS gliomas.Our current review presents a practical diagnostic approach for diffuse CNS gliomas and circumscribed astrocytomas using histomolecular criteria adopted by the recent WHO classification.We also describe the treatment strategies for these tumors based on EANO guidelines.
文摘The accelerated population growth of the elderly(individuals aged 60 years or more)across the globe has many indications,including changes in demography,health,the psycho-social milieu,and economic security.This transition has given rise to varied challenges;significant changes have been observed in regard to developing strategies for health care systems across the globe.The World Health Organization(WHO)is also engaging in initiatives and mediating processes.Furthermore,advocacy is being conducted regarding a shift toward the salutogenic model from the pathogenic model.The concept behind this move was to shift from disablement to enablement and from illness to wellness,with the notion of mental health promotion(MHP)being promoted.This article attempts to discuss the MHP of elderly individuals,with special reference to the need to disseminate knowledge and awareness in the community by utilizing the resources of the health sector available in the WHO South-East Asia Region countries.We have tried to present the current knowledge gap by exploring the existing infrastructure,human resources,and financial resources.There is much to do to promote the mental health of the elderly,but inadequate facilities are available.Based on available resources,a roadmap for MHP in elderly individuals is discussed.
文摘November 1,2023 marks the 6th"World Flu Day".The theme is"Preventing Influenza,Protecting Health"in this year.According to data from the World Health Organization,influenza infects approximately 5%-10%of adults and 20%-30%of children worldwide each year,resulting in up to 5million severe cases and 650,000 deaths.A recent study showed that about 88,000 people in China died from respiratory diseases caused by influenza each year,accounting for 8.2%of total respiratory disease deaths,making influenza a serious threat to public health.
文摘A descriptive study on assessment of medicines cold chain storage conformity with World Health Organization (WHO) requirements in public health facilities was carried out in Dar es Salaam and Dodoma regions. Storage conformity in selected health facilities was assessed by monitoring temperature using temperature data loggers mounted in the refrigerators for a period of 30 days. Results indicated almost half of the health facilities 48.5% visited, did not significantly (P = 0.031) comply with storage temperature (+2°C to +8°C) as per WHO requirement because all recorded Mean Kinetic temperature (MKT) > 8°C. In rural areas, 59.2% of visited health facilities adhered to the WHO recommended storage temperature while in urban areas only 31.6% complied. The study has established electricity failure in urban and lack of gas in rural areas coupled with absence of contingency plan as major challenges to WHO temperature conformity in storage of cold chain medicines in health facilities in Tanzania.
文摘The International Agency for Research on Cancer(IARC)and World Health Organization(WHO)collaboratively produce the'WHO Blue Books'essential tools standardizing the diagnostic process for human cancers.Regular updates in this classification accommodate emerging molecular discoveries,advances in immunohistochemical techniques,and evolving clinical insights.The 5th edition of the WHO/IARC classification of head and neck tumors refines the'Oral Cavity and Mobile Tongue'chapter,including sections for non-neoplastic lesions,epithelial tumors,and tumors of uncertain histogenesis.Notably,the epithelial tumors section is rearranged by tumor behavior,starting with benign squamous papillomas and progressing through potentially malignant oral disorders to oral squamous cell carcinoma(OSCC).The section on OSCC reflects recent information on epidemiology,pathogenesis,and histological prognostic factors.Noteworthy is the specific categorization of verrucous carcinoma(VC)and carcinoma cuniculatum(CC),both associated with the oral cavity and distinct in clinical and histologic characteristics.This classification adjustment emphasizes the oral cavity as their predominant site in the head and neck.Designating specific sections for VC and CC aims to provide comprehensive insights into these unique subtypes,elucidating their clinical features,distinct histological characteristics,prevalence,significance,and clinical relevance.By categorizing these subtypes into specific sections,the 5th edition of the WHO classification aims to provide a more nuanced and detailed account,enhancing our understanding of these specific variants within the broader spectrum of head and neck tumors.
文摘While mental health issues are increasingly gaining attention in Ghana, little is known about the situation among deaf people. This study assessed the mental health care needs of deaf people in Ghana. A descriptive design, consisting of interviews and focus group discussions, was used to collect data from 97 participants. Findings indicated that participants had limited knowledge on mental health issues. Mental health stigma, inaccessible mental health information and exclusion from mental health programmes were the major barriers hindering access to mental health care services. This study bridges the knowledge gap and provides evidence for the implementation of deaf-friendly services.
文摘Background: The incidence of in-hospital adverse events is about 10%, with a majority of these related to surgery, and nearly half considered preventable events. In attempts to improve patient safety, the World Health Organization (WHO) developed a checklist to be used at critical perioperative moments. This meta-analysis examines the impact of the WHO surgical safety checklist (SSC) on various patient outcomes. Methods: A comprehensive search of all published studies assessing the use of the WHO SSC in patients undergoing surgery was conducted. Studies using the WHO SSC in any surgical setting, with pre-implementation and post-implementation outcome data were included. The incidence of patient outcomes (total complications, surgical site infections, unplanned return to the operating room (OR) within 30 days, and overall mortality) and adherence to safety measures were analyzed. Results: 10 studies involving 51,125 patients (27,490 prior to implementation and 23,635 after implementation of the WHO SSC) were analyzed. The implementation of the WHO SSC significantly reduced the risk of total complications by 37.9%, surgical site infections by 45.5%, unplanned return to OR by 32.1%, and mortality by 15.3%. Increased adherence to safety measures including airway evaluation, use of pulse oximetry, prophylactic antibiotics when necessary, confirmation of patient name and surgical site, and sponge count was also observed. Conclusions: The use of the WHO SSC is associated with a significant reduction in post-operative complication rates and mortality. The WHO SSC is a valuable tool that should be universally implemented in all surgical centers and utilized in all surgical patients.
文摘Journal of Sport and Health Science《运动与健康科学》(英文版),简称JSHS,是我国内地地区第一本英文体育学术期刊,深入分析和全面认识JSHS的期刊画像特征,对我国体育学术英文期刊国际化发展实践和建设世界一流期刊均具有重要现实意义。采集Web of Science数据库中2012-2022年755篇JSHS论文,基于科学计量的方法,系统挖掘了JSHS在时间产出、作者合作、机构分布、刊文热点与趋势等特征,还从影响因子、即年指标、被引半衰期等指标,对标对表British Journal of Sports Medicine(简称BJSM,英国运动医学杂志)进行深入分析。研究发现:JSHS作为新创的体育科学期刊和我国建设世界一流期刊的代表,总体发展势头良好。年载文量稳步增长,期刊影响因子、论文影响力显著提升。论文高产机构来自上海体育学院、北卡罗莱纳大学、卡尔加里大学等,高产作者有Walter Herzog、刘宇、于冰、陈佩杰等,作者队伍越来越壮大,且呈团队合作趋势。JSHS在不断发展中形成6大主题群,包括儿童青少年运动与健康促进、老年人群运动与健康、运动表现分析、运动损伤、运动与疾病风险以及运动与认知功能。对标对表BJSM分析,JSHS在出版周期、年发文量、论文影响力等方面亟需提升。
文摘目的基于世界卫生组织国际分类家族(WHO-FICs)构建作业治疗改善脑卒中上肢功能的PICO架构,并分析主要作业疗法改善脑卒中患者上肢功能的效果。方法运用WHO-FICs框架,检索Web of Science、PubMed、CNKI、SinoMed等数据库,收集建库至2022年10月关于作业治疗干预脑卒中上肢功能的相关文献,并进行系统综述。结果最终纳入10项随机对照试验,382例参与者(≥18岁),来自6个国家,主要来源于康复医学、物理和康复医学、神经科学、生物工程医学、作业治疗等研究领域,发表年限集中于2013年以后。纳入文献物理治疗证据数据库(PEDro)量表评分平均7.5分。基于WHO-FICs框架,纳入文献中涉及的疾病类型涵盖脑出血(8B00)、缺血性脑卒中(8B11)、蛛网膜下腔出血(8B01)、肌张力和异常反射(MB47)、偏瘫(MB53)。主要功能障碍包括关节活动功能(b710)、关节稳定性功能(b715)、肌肉力量功能(b730)、肌张力功能(b735)、运动反射功能(b750)、随意运动控制功能(b760)、不随意运动功能(b765)。主要活动受限和参与局限包括上肢的活动和参与,如举起和搬运物体(d430),手和手臂的使用(d445),精巧手的使用(d440);以及日常生活活动和社会参与能力,如自理(d510-d570),家庭生活(d610-d660),主要生活领域(d810-d879),社区、社会和公民生活(d910-d950)。涉及身体功能的治疗类干预措施有肌肉功能电刺激(MU2.SC.BP)、协助和指导运动功能训练(MV2.PG.ZZ);涉及活动和参与的治疗类干预措施有举起和搬运物体训练(SIA.PH.ZZ)、使用精巧手的训练(SIG.PH.ZZ)、使用上肢和手的训练(SIJ.PH.ZZ)、自理的干预措施(SM1-SMH)、主要生活领域的干预措施(SO2-SOD)、游戏训练(SXD.PH.ZZ)。每次干预15~60 min,每周3~10次,持续3~8周。干预场所一般为医院或居家。干预效果分为3个层面:身体功能层面,涉及神经运动传导功能、反射功能、随意运动控制能力、协调性与速度改善,关节活动度和握力增加;活动和参与层面,涉及上肢活动能力和速度、手的精细功能和速度、上肢活动参与的频率和质量,日常生活活动能力提高,参与日常活动任务的困难程度降低;生活质量和福祉层面,涉及获得愉悦感和成就感,生活质量提高。结论基于WHO-FICs构建了作业治疗改善脑卒中上肢功能效果的PICO架构。涉及的疾病类型涵盖脑出血、缺血性脑卒中、蛛网膜下腔出血、肌张力和异常反射以及偏瘫。上肢运动功能障碍主要有随意运动控制功能障碍,运动反射功能减弱或亢进,肌张力异常,肌肉协调障碍,关节活动稳定性差,肌力减退等,活动受限和参与局限性表现为手臂和手的活动参与功能障碍,手的精细活动功能障碍,影响日常生活活动和社会参与能力。涉及身体功能的治疗类干预措施有基于脑机接口的神经肌肉电刺激治疗、单上肢镜像训练;涉及活动和参与的治疗类干预措施有动作观察训练、双上肢镜像训练、任务导向训练、双上肢训练及上肢机器人训练。健康和功能效益主要表现为上肢运动功能、上肢的活动和参与水平、日常生活活动能力和社会参与能力提高,生活质量与福祉改善。
文摘According to global annual estimates hunger/malnutrition is the major cause of death(36 of 62 million). Cardiovascular diseases and cancer(5.44 of 13.43 million) are the major causes of death in developed countries, while lower respiratory tract infections, human immunodeficiency virus infection/acquired immunodeficiency syndrome, diarrhoeal disease, malaria and tuberculosis(10.88 of 27.12 million) are the major causes of death in developing countries with more than 70% of deaths occurring in children. The majority of approximately 800 million people with other rare diseases, including 100000 children born with thalassaemia annually receive no treatment. There are major ethical dilemmas in dealing with global health issues such as poverty and the treatment of orphan and rare diseases. Of approximately 50000 drugs about 10% are orphan drugs, with annual sales of the latter approaching 100 billion USD. In comparison, the annual revenue in 2009 from the top 12 pharmaceutical companies in Western countrieswas 445 billion USD and the top drug, atorvastatin, reached 100 billion USD. In the same year, the total government expenditure for health in the developing countries was 410 billion USD with only 6%-7% having been received as aid from developed countries. Drugs cost the National Health Service in the United Kingdom more than 20 billion USD or 10% of the annual health budget. Uncontrollable drug prices and marketing policies affect global health budgets, clinical practice, patient safety and survival. Fines of 5.3 billion USD were imposed on two pharmaceutical companies in the United States, the regulatory authority in France was replaced and clinicians were charged with bribery in order to overcome recent illegal practises affecting patient care. High expenditure for drug development is mainly related to marketing costs. However, only 2 million USD was spent developing the drug deferiprone(L1) for thalassaemia up to the stage of multicentre clinical trials. The criteria for drug development, price levels and use needs to be readdressed to improve drug safety and minimise costs. New global health policies based on cheaper drugs can help the treatment of many categories of orphan and rare diseases and millions of orphan patients in developing and developed countries.
