Medical services for sports injuries and illnesses in the Beijing 2022 Olympic Winter Games

BACKGROUND:Beijing 2022 Olympic Winter Games was the second Games held amid the COVID-19 pandemic.To a certain extent,it has altered the way sporting activities operate.There is a lack of knowledge on injury risk and illness occurrence in elite winter sport athletes amid the COVID-19 pandemic.This study aimed to describe the incidence of injuries and illnesses sustained during the XXIV Olympic Winter Games in Beijing from February 4 to 20,2022.METHODS:We recorded the daily number of injuries and illnesses among athletes reported by Beijing 2022 medical staff in the polyclinic,medical venues,and ambulance.We calculated injury and illness incidence as the number of injuries or illnesses occurring during competition or training,respectively,with incidence presented as injuries/illnesses per 100 athlete-days.RESULTS:In total,2,897 athletes from 91 nations experienced injury or illness.Beijing 2022 medical staff reported 326 injuries and 80 illnesses,equaling 11.3 injuries and 2.8 illnesses per 100 athletes over the 17-day period.Altogether,11%of the athletes incurred at least one injury and nearly 3%incurred at least one illness.The number of injured athletes was highest in the skating sports(n=104),followed by alpine skiing(n=53),ice track(n=37),freestyle skiing(n=36),and ice hockey(n=35),and was the lowest in the Nordic skiing disciplines(n=20).Of the 326 injuries,14(4.3%)led to an estimated absence from training or competition of more than 1 week.A total of 52 injured athletes were transferred to hospitals for further care.The number of athletes with illness(n=80)was the highest for skating(n=33)and Nordic skiing(n=22).A total of 50 illnesses(62.5%)were admitted to the department of dentistry/ophthalmology/otolaryngology,and the most common cause of illness was other causes,including preexisting illness and medicine(n=52,65%).CONCLUSION:Overall,11%of athletes incurred at least one injury during the Games,which is similar to the findings during the Olympic Winter Games in 2014 and 2018.Regarding illness,2%of athletes were affected,which is approximately one-third of the number affected in the 2018 Olympic Winter Games.

Insomnia in Patients Suffering from Chronic Medical Illnesses: Prevalence and Impact of IAYT

Background: Sleep is an important lifestyle factor to be addressed in patients having chronic non-communicable diseases. Data revealing prevalence of insomnia in chronic medical illnesses (CMIs) in Indian population are lacking. Yoga has been found effective in improving sleep quality in patients with chronic medical illnesses (CMIs). Aim: To find the prevalence of insomnia in major chronic medical illnesses and to assess the effect of Integrated Approach of Yoga Therapy (IAYT) on them. Methods and Material: From the outpatients and inpatients of our integrative therapy clinics, 200 patients (116 males;84 females) in the age range 49.57 ± 11.71 years, who satisfied the inclusion criteria and were diagnosed by the physician with any of the four major categories of CMIs: cardio-pulmonary, diabetes, musculoskeletal, and psychiatric were screened for insomnia using Insomnia Severity Index (ISI) scale. Those found suffering from clinically significant insomnia (ISI score > 14) were admitted and a residential IAYT intervention was given for a week. Before and after the intervention, ISI and Pittsburg insomnia rating scale (PIRS) were administered to assess extent of insomnia. Data was analyzed before and after the intervention using paired t-test. Results: Taking all patients of CMIs together, we found that 35% suffered from clinical insomnia, out of which, 12.5% had severe and 22.5% had moderate insomnia. We also found that prevalence of clinical insomnia was highest among those suffering from psychiatric illnesses (62.07%) and minimum in those having musculoskeletal disorders (28.05%). Those suffering from diabetes mellitus and cardio-pulmonary disorders reported prevalence of 32.25% and 31.94% respectively. After IAYT intervention of one week, extent of clinical insomnia reduced from 35% at the baseline to 8.5% in all patients of CMIs taken together. Following changes were observed in percentage of patients suffering from clinical insomnia in different CMIs before and after one week of IAYT intervention: 1) In psychiatric patients, the percentage reduced from 62.07% to 24.13%;2) In diabetic patients, the percentage reduced from 32.27% to 3.0%;3) In patients having musculoskeletal disorders, the percentage reduced from 28.05% to 8.53%;and 4) In patients having cardio-pulmonary illnesses, the percentage reduced from 31.94% to 2.7%. Conclusion: Prevalence of insomnia is higher in patients suffering from chronic medical illnesses. IAYT intervention of one week may be helpful in reducing extent of insomnia in this population.

Determinants of inequality in health care seeking for childhood illnesses:insights from Nairobi informal settlements

Background:An in-depth understanding of patterns of inequities in healthcare seeking among the urban residents is critical in identifying appropriate interventions strategies.The study evaluates determinants of inequality in health care seeking for childhood illnesses among informal settlement residents in Nairobi,Kenya.Methods:Data from the second Nairobi Cross-Sectional Slum Survey(NCSS 2012)was examined.The inequality in seeking health care for childhood diarrhea as the prototype illness was assessed using concentration index(CI).The wealth index based on the household possessions and amenities was used as a measure for socioeconomic status.Results:A total of 2027 qualified women were included in this study.About 16.6% of children born of younger mothers aged<20 years had diarrhea and a similar proportion of children(16.3%)was observed among mothers who were unemployed.The CI of-0.026 on health care seeking for diarrhea among children points to significant inequality among the urban poor(95% confidence interval:-0.028 to-0.023).Conclusion:Occupation of parents,age of mothers,ethnicity,marital status and children's age were major deter-minants with regard to disease outcome and to a broader extent inequality in health care seeking for childhood illnesses.Enhanced bottom top community health invigoration strategies in health information awareness and services access would be instrumental.

Sexually Transmitted Illnesses in Masvingo Province, 2012-2015: A Secondary Data Analysis

Background: Masvingo province is among the top three provinces with high Genital Ulcer Disease incidence rates in Zimbabwe. There has been no documented evidence to establish the burden and epidemiology of STIs in Masvingo province. We analysed these data to describe trends in STIs from 2012 - 2015. Methods: A retrospective records review of Masvingo STI data set was conducted. We assessed trends in STIs from 2012-2015. Microsoft Excel 2010 software was used to generate bar and linear graphs. Epi info 7TM was used to calculate Chi-square for trends and p values. Results: Most affected age group was 25 - 49 years (incidence rate of 73.9 cases per 1000). The 50 and above age group had a higher incidence rate than the 10 - 24 year age group (27.5 compared to 15.5 cases per 1000). STI incidence was higher in females (31.9 cases per 1000) than in males (20.6 cases per 1000). The most prevalent STIs were vaginal discharge 48,972 (30.7%) and other forms of STIs 35,777 (22.3%). Masvingo district recorded the highest STI incidence rate (34.1 cases per 1000). There was a decline in HIV testing rates from 36 (100%) to 12,190 (64.4%) (p Conclusion: There was a general decline in the STI trends for all age groups. Age group most affected by STIs was the 25 - 49 years with females being more affected. HIV testing services among STI clients declined. We recommend advocacy on safe sexual practices and further research to identify reasons for low uptake of HIV testing services among STI clients.

Psychosocial Health Status of Patients Diagnosed with Chronic Illnesses in Jordan

Background: The comorbidity between chronic physical conditions and psychosocial health consequences is becoming a research interest for researchers in the field. The purpose of this study was to investigate the psychosocial health status of patients diagnosed with chronic illnesses in Jordan. Methods: A cross sectional survey using 806 patients diagnosed with chronic illnesses has been used to collect data in regards to depressive symptoms, psychological distress, coping, optimism, life satisfaction, and perceive social support. Results: 17.5% of the patients reported that they had moderate to severe depressive symptoms, and about 50% of them had high level of optimism and life satisfaction, moderate level of effectiveness of coping skills, psychological distress, and perceived social support from family, friends and others. There were significant association between patients’ age and their scores on perception of social support from family, friends and others, life satisfaction, and psychological distress (p > 0.05). While, male and female patients were different in their depressive symptoms (t = -2.57, p = 0.01), perceived social support from others (t = -2.06, p = 0.04), and optimism (t = 2.29, p = 0.02). Also, patients had differences in their depressive symptoms, perceived social support from friends, others and friends, optimism, life satisfaction, and psychological distress related to their medical diagnoses (p < 0.05). Conclusion: Patients with chronic illness are in need for psychological care, and periodic psychological screening is one step toward maintaining their psychological wellbeing.

Original Research: Treating Sleep Disorders Has Positive Outcomes in Psychiatric Illnesses

Introduction: Sleep and psychiatric disorders are common, and often co-morbid. Sleep disorders may predispose to development or exacerbation of psychiatric disorders. Authors hypothesized that treatment of sleep disorders improve outcomes in psychiatric illnesses. Methods: Charts of patients diagnosed with sleep disorders from October 2007 to December 2007 were reviewed. Outcomes in patients with co-morbid psychiatric disorders were recorded at 6, 12 and 24 months after initiation of sleep disorder treatment. These patients received a baseline psychiatric status score of 0. Change in status at each subsequent time point was scored as: ?2 (marked worsening), ?1 (mild worsening), 0 (no change), +1 (mild improvement) or +2 (marked improvement). We individually compared change in average score at each time point to baseline using the signed rank test. We compared provider documented compliance to sleep therapies between patients with and without psychiatric disorders using Fisher’s exact test. Results: Of 127 charts reviewed, 10 were excluded as patients died within follow-up period. No death was reported as suicide. Of 117 patients, 97.64% were men, 2.36% were women. Age range: 21 - 40: 7.69%, 41 - 60: 42.74%, 61 - 80: 47.87%, >81: 1.70%. 58 patients (45.67%) had coexistent psychiatric diagnoses. There was no difference in provider documented compliance rate to sleep therapies between patients with and without psychiatric disorders at 6, 12 and 24 months, (Fisher’s p value 0.1031, 0.2290 and 0.2248 respectively). Psychiatric status progressively improved compared to baseline (Change in average score by +0.45, +0.56, and +0.79 at 6, 12, and 24 months, respectively, p < 0.0001). Conclusion: Psychiatric disorders did not affect compliance to sleep related treatment. Treatment of co-morbid sleep disorders is associated with improvement in psychiatric disorders. Authors recommend need for prospective study with more subjects.

Medicinal Plants Used in Management of Various Mental Illnesses in Goma City, Democratic Republic of Congo

Many mentally ill people in Goma city, Democratic Republic of Congo (DRC), seek treatment from Traditional Health Practitioners (THPs) that utilize medicinal plants (MPs) in management of various ailments. The study aimed to document the MPs used locally to manage mental illnesses (MIs). An in-depth ethnobotanical survey including 43 respondents selected using snow ball method and interviewed using semi-structured questionnaires was conducted in Goma city, in DRC, from May to September 2021. Voucher specimens were collected from the study area and identified at Makerere University Herbarium (MHU). Data were analyzed using ethnobotanical parameters, frequency index, Rahman’s similarity index (RSI) and non-parametric tests as well as Spearman correlation coefficient. A total of 30 plant species, represented amongst 29 genera and 19 families were reportedly used to treat MIs. Of these 63.33% were reported for anxiety, 36.67% for psychosis and 30% for depression. Most abundant taxa were reported for three families including Asteraceae, Lamiaceae and Solanaceae. Among MPs used in Goma city, the two priority plant species for anxiety were Euphorbia abyssinica and Cleome gynandra L. While, the two priority plant species for depression were Conyza sumatrensis and Emilia coccinea. High similarity (RSI = 77.42%) was observed in the use of common species for MIs between THPs from both Goma and Karisimbi communes. Results prove that local people of Goma city use MPs species against MIs that could be further studied for pharmacological effectiveness and safety.

Correlates of Depression among Patients Diagnosed with Chronic Illnesses in Saudi Arabia

Background: Depression contributes to an increased medical morbidity and mortality among patients with chronic medical illnesses. The purpose of this study was to investigate correlates of depression among patients diagnosed with chronic illnesses in Saudi Arabia. Methods: A cross sectional survey using 412 patients diagnosed with chronic illnesses has been used to collected data in regards to depressive symptoms, psychological distress, coping, and life satisfaction. Results: 25.2% of the patients reported that they had moderate to severe depressive symptoms, and about 13.8% of them had mild level of depression. Psychological distress and life satisfaction were significant correlates with depressive symptoms (r = 0.33, 0.54, p < 0.001), while coping strategies is not. The results also showed that there is a significant and negative correlation between patients’ age and depression score (r = 0.17, p ≤ 0.001). Regarding gender differences, the analysis showed that there was no significant difference between male and female patients in their depressive symptoms (t = ﹣0.69, p = 0.488). Conclusion: implication for clinical practice and research discussed.

Effect of Social Media Used by Medical Professionals in Facilitating the Treatment of Chronic Illnesses

The objective of this research is to describe the effect of social media use by medical professionals in facilitating the treatment of chronic illnesses in chronically ill individuals. This study focuses on the prominent social media used by medical professionals and the way it is used to manage health conditions of chronically ill individuals.

Psychological Health of Wives’of Patients with Chronic Illnesses

Objectives:Chronic illnesses are more prevalent in males.The expectations of caregiving,thus falls on the women.Role expectations from women,increases stress,strain and the possibility of Psychological health concerns.In this paper,we explore the psychological health,as well as the levels of marital and sexual satisfaction of women caregivers.Method:The sample consisted of 35 women,whose husbands were diagnosed with,and undergoing treatment for a chronic illness(Coronary Heart Disease(CHD);Diabetes;or Cancer).Three standardized questionnaires,the Index of Marital Satisfaction(IMS),Index of Sexual Satisfaction(ISS)and the Depression Anxiety Stress Scale 21(DASS 21)were used.Results:Correlational and predictive analysis were conducted on the data.Clinically significant marital and sexual dissatisfaction were found.Wives’also reported moderate levels of depression and anxiety,but severe levels of stress.Depression and Sexual satisfaction were found to be significant predictors of marital satisfaction.Discussion:Women caregiver are impacted by the illness status of their spouse.The additional stress of caregiving,along with societally ascribed roles and responsibilities on women creates a more difficult,stressful environment,which affects psychological health and well-being.

Injury and illness in short-course triathletes:A systematic review

Background:Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies.This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes.Methods:This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Studies reporting health problems(injury and illness)in triathletes(all sexes,ages,and experience levels)training and/or competing in short-course distances were included.Six electronic databases(Cochrane Central Register of Controlled Trials,MEDLINE,Embase,APA PsychINFO,Web of Science Core Collection,and SPORTDiscus)were searched.Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale.Two authors independently completed data extraction.Results:The search yielded 7998 studies,with 42 studies eligible for inclusion.Twenty-three studies investigated injuries,24 studies investigated illnesses,and 5 studies investigated both injuries and illnesses.The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures,and the illness incidence rate ranged 1.8-13.1 per 1000 athlete days.Injury and illness prevalence ranged between 2%-15%and 6%-84%,respectively.Most injuries reported occurred during running(45%-92%),and the most frequently reported illnesses affected the gastrointestinal(7%-70%),cardiovascular(14%-59%),and respiratory systems(5%-60%).Conclusion:The most frequently reported health problems in short-course triathletes were:overuse and lower limb injuries associated with running;gastrointestinal illnesses and altered cardiac function,primarily attributable to environmental factors;and respiratory illness mostly caused by infection.

Controversies regarding transplantation of mesenchymal stem cells

Mesenchymal stem cells(MSCs)have tantalized regenerative medicine with their therapeutic potential,yet a cloud of controversies looms over their clinical tran-splantation.This comprehensive review navigates the intricate landscape of MSC controversies,drawing upon 15 years of clinical experience and research.We delve into the fundamental properties of MSCs,exploring their unique immuno-modulatory capabilities and surface markers.The heart of our inquiry lies in the controversial applications of MSC transplantation,including the perennial debate between autologous and allogeneic sources,concerns about efficacy,and lingering safety apprehensions.Moreover,we unravel the enigmatic mechanisms surro-unding MSC transplantation,such as homing,integration,and the delicate balance between differentiation and paracrine effects.We also assess the current status of clinical trials and the ever-evolving regulatory landscape.As we peer into the future,we examine emerging trends,envisioning personalized medicine and innovative delivery methods.Our review provides a balanced and informed perspective on the controversies,offering readers a clear understanding of the complexities,challenges,and potential solutions in MSC transplantation.

Adverse effects of early-life stress:focus on the rodent neuroendocrine system

Early-life stress is associated with a high prevalence of mental illnesses such as post-traumatic stress disorders,attention-deficit/hyperactivity disorder,schizophrenia,and anxiety or depressive behavior,which constitute major public health problems.In the early stages of brain development after birth,events such as synaptogenesis,neuron maturation,and glial differentiation occur in a highly orchestrated manner,and external stress can cause adverse long-term effects throughout life.Our body utilizes multifaceted mechanisms,including neuroendocrine and neurotransmitter signaling pathways,to appropriately process external stress.Newborn individuals first exposed to early-life stress deploy neurogenesis as a stress-defense mechanism;however,in adulthood,early-life stress induces apoptosis of mature neurons,activation of immune responses,and reduction of neurotrophic factors,leading to anxiety,depression,and cognitive and memory dysfunction.This process involves the hypothalamus-pituitary-adrenal axis and neurotransmitters secreted by the central nervous system,including norepinephrine,dopamine,and serotonin.The rodent early-life stress model is generally used to experimentally assess the effects of stress during neurodevelopment.This paper reviews the use of the early-life stress model and stress response mechanisms of the body and discusses the experimental results regarding how early-life stress mediates stress-related pathways at a high vulnerability of psychiatric disorder in adulthood.

Irrigation regimes modulate non-structural carbohydrate remobilization and improve grain filling in rice(Oryza sativa L.)by regulating starch metabolism

Recently developed ‘super’ rice cultivars with greater yield potentials often suffer from the problem of poor grain filling, especially in inferior spikelets. Here, we studied the activities of enzymes related to starch metabolism in rice stems and grains, and the microstructures related to carbohydrate accumulation and transportation to investigate the effects of different water regimes on grain filling. Two ‘super’ rice cultivars were grown under two irrigation regimes of well-watered(WW) and alternate wetting and moderate soil drying(AWMD). Compared with the WW treatment,the activities of ADP glucose pyrophosphorylase(AGPase), starch synthase(StSase) and starch branching enzyme(SBE), and the accumulation of non-structural carbohydrates(NSCs) in the stems before heading were significantly improved, and more starch granules were stored in the stems in the AWMD treatment. After heading, the activities of α-amylase, β-amylase, sucrose phosphate synthase(SPS) and sucrose synthase in the synthetic direction(SSs)were increased in the stems to promote the remobilization of NSCs for grain filling under AWMD. During grain filling, the enzymatic activities of sucrose synthase in the cleavage direction(SSc), AGPase, StSase and SBE in the inferior spikelets were increased, which promoted grain filling, especially for the inferior spikelets under AWMD.However, there were no significant differences in vascular microstructures. The grain yield and grain weight could be improved by 13.1 and 7.5%, respectively, by optimizing of the irrigation regime. We concluded that the low activities of key enzymes in carbon metabolism is the key limitation for the poor grain filling, as opposed to the vascular microstructures, and AWMD can increase the amount of NSC accumulation in the stems before heading, improve the utilization rate of NSCs after heading, and increase the grain filling, especially in the inferior spikelets, by altering the activities of key enzymes in carbon metabolism.

Mental health status among COVID-19 patients survivors of critical illness in Saudi Arabia:A 6-month follow-up questionnaire study

BACKGROUND Psychological assessment after intensive care unit(ICU)discharge is increasingly used to assess patients'cognitive and psychological well-being.However,few studies have examined those who recovered from coronavirus disease 2019(COVID-19).There is a paucity of data from the Middle East assessing the post-ICU discharge mental health status of patients who had COVID-19.AIM To evaluate anxiety and depression among patients who had severe COVID-19.METHODS This is a prospective single-center follow-up questionnaire-based study of adults who were admitted to the ICU or under ICU consultation for>24 h for COVID-19.Eligible patients were contacted via telephone.The patient’s anxiety and depression six months after ICU discharge were assessed using the Hospital Anxiety and Depression Scale(HADS).The primary outcome was the mean HADS score.The secondary outcomes were risk factors of anxiety and/or depression.RESULTS Patients who were admitted to the ICU because of COVID-19 were screened(n=518).Of these,48 completed the questionnaires.The mean age was 56.3±17.2 years.Thirty patients(62.5%)were male.The main comorbidities were endocrine(n=24,50%)and cardiovascular(n=21,43.8%)diseases.The mean overall HADS score for anxiety and depression at 6 months post-ICU discharge was 11.4(SD±8.5).A HADS score of>7 for anxiety and depression was detected in 15 patients(30%)and 18 patients(36%),respectively.Results from the multivariable ordered logistic regression demonstrated that vasopressor use was associated with the development of anxiety and depression[odds ratio(OR)39.06,95% confidence interval:1.309-1165.8;P<0.05].CONCLUSION Six months after ICU discharge,30% of patients who had COVID-19 demonstrated a HADS score that confirmed anxiety and depression.To compare the psychological status of patients following an ICU admission(with vs without COVID-19),further studies are warranted.

Iron and ferritin effects on intensive care unit mortality:A metaanalysis

BACKGROUND The effect of serum iron or ferritin parameters on mortality among critically ill patients is not well characterized.AIM To determine the association between serum iron or ferritin parameters and mortality among critically ill patients.METHODS Web of Science,Embase,PubMed,and Cochrane Library databases were searched for studies on serum iron or ferritin parameters and mortality among critically ill patients.Two reviewers independently assessed,selected,and abstracted data from studies reporting on serum iron or ferritin parameters and mortality among critically ill patients.Data on serum iron or ferritin levels,mortality,and demographics were extracted.RESULTS Nineteen studies comprising 125490 patients were eligible for inclusion.We observed a slight negative effect of serum ferritin on mortality in the United States population[relative risk(RR)1.002;95%CI:1.002-1.004].In patients with sepsis,serum iron had a significant negative effect on mortality(RR=1.567;95%CI:1.208-1.925).CONCLUSION This systematic review presents evidence of a negative correlation between serum iron levels and mortality among patients with sepsis.Furthermore,it reveals a minor yet adverse impact of serum ferritin on mortality among the United States population.

Intensive care unit-acquired weakness and mechanical ventilation:A reciprocal relationship

Intensive care unit-acquired weakness(ICU-AW;ICD-10 Code:G72.81)is a syndrome of generalized weakness described as clinically detectable weakness in critically ill patients with no other credible cause.The risk factors for ICU-AW include hyperglycemia,parenteral nutrition,vasoactive drugs,neuromuscular blocking agents,corticosteroids,sedatives,some antibiotics,immobilization,the disease severity,septicemia and systemic inflammatory response syndrome,multiorgan failure,prolonged mechanical ventilation(MV),high lactate levels,older age,female sex,and pre-existing systemic morbidities.There is a definite association between the duration of ICU stay and MV with ICU-AW.However,the interpretation that these are modifiable risk factors influencing ICU-AW,appears to be flawed,because the relationship between longer ICU stays and MV with ICU-AW is reciprocal and cannot yield clinically meaningful strategies for the prevention of ICU-AW.Prevention strategies must be based on other risk factors.Large multicentric randomized controlled trials as well as meta-analysis of such studies can be a more useful approach towards determining the influence of these risk factors on the occurrence of ICU-AW in different populations.

Cardiovascular mechanisms of thyroid hormones and heart failure:Current knowledge and perspectives

A multiple hormonal imbalance that accompanies heart failure(HF)may have a significant impact on the clinical course in such patients.The non-thyroidal illness syndrome(NTIS),also referred to as euthyroid sick syndrome or low triiodothyronine syndrome,can be found in about 30%of patients with HF.NTIS represents a systemic adaptation to chronic illness that is associated with increased cardiac and overall mortality in patients with HF.While conclusions on thyroid-stimulating hormone,free triiodothyronine,total and free thyroxine are currently unresolved,serum total triiodothyronine levels and the ratio of free triiodothyronine to free thyroxine seem to provide the best correlates to the echocardiographic,laboratory and clinical parameters of disease severity.HF patients with either hyper-or hypothyroidism should be treated according to the appropriate guidelines,but the therapeutic approach to NTIS,with or without HF,is still a matter of debate.Possible treatment options include better individual titration of levothyroxine therapy,combined triiodothyronine plus thyroxine therapy and natural measures to increase triiodothyronine.Future research should further examine the cellular and tissue mechanisms of NTIS as well as new therapeutic avenues in patients with HF.

Facilitating and hindering factors of community nurses'emergency and critical care treatment abilities:A qualitative study

BACKGROUND This study adopts a descriptive phenomenological approach to investigate the facilitators and barriers of community nurses'abilities in managing critical and emergency conditions.With the transition of healthcare systems to the community,the evolution of nursing practices,and the attention from policies and practices,community nurses play a crucial role in the management of critical and emergency conditions.However,there is still a lack of comprehensive understanding regarding the factors that promote or hinder their capabilities in this area.AIM To understand the facilitators and barriers of community nurses in managing critical and emergency conditions,exploring the fundamental reasons and driving forces influencing their treatment capabilities.METHODS This study utilized the destination sampling method between May 2023 and July 2023.It employed a descriptive phenomenological approach within qualitative research methodologies.Through objective sampling,17 community nurses from 7 communities in Changning District,Shanghai,were selected as the study subjects.Semi-structured interviews were conducted to gather data,which were subsequently organized and analyzed using Colaizzi's seven-step analysis method,leading to the extraction of final themes.RESULTS The barrier factors identified from the interviews encompassed three topics:resource allocation,professional factors,and personal literacy.The facilitators comprised three themes:professionalism,management attention,and training and continuing education.We identified that the root causes of the barriers included the lack of practical treatment experience among community nurses,insufficient awareness of self-directed learning,and limited knowledge and technical proficiency.The professional quality of community nurses and management attention serve as motivation for them to enhance their treatment abilities.CONCLUSION To enhance the capability of community nurses in treating acute and critical patients,it is recommended to bolster training specifically tailored to acute and critical care,raise awareness of first aid practices,and elevate knowledge and skill levels.

Carbamazepine in osteoarthritis treatment:A novel approach targeting Nav1.7 channels

Osteoarthritis(OA)presents a growing health concern,with substantial societal and healthcare burdens.Current management focuses on symptom relief,lacking disease-modifying options.Emerging research suggests the sodium channel Nav1.7 as a pivotal target in OA treatment.Preclinical studies demonstrate carbamazepine's efficacy in Nav1.7 blockade,offering significant joint protection in animal models.However,human trials are needed to validate these findings.Carbamazepine's repurposing holds promise for OA management,potentially revolutionizing treatment paradigms.Further research is essential to bridge the gap between preclinical evidence and clinical application,offering hope for improved OA management and enhanced patient quality of life.