A comparative study on transradial vs transfemoral artery access for primary percutaneous coronary intervention in patients with acute myocardial infarction

Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI).Methods Two hundred and eight patients with AMI episoded within 12 hours, male 159, female 49, age 58.9 ±11.9 (34～88)years, were randomly divided into transradial artery access for primary PCI (TRA pPCI) group of 106 cases and transfemoral artery access for PCI (TFA pPCI) group of 102 cases during Sept, 2000 to Aug, 2002. The protocols of the manipulation duration and the effect for TRA pPCI and TFA pPCI procedures were respectively compared, including the time of transradial artery puncture and the rate of puncture success at first time ; the time of guiding catheter engaging into target coronary ostium; the rate of patence in infarct related artery (IRA); total duration of manipulation and the successful rate.The incidence of complications such as bleeding, vessel injury,thrombi and embolism as well as the average stay of hospitalization between two groups was compared. The status and the incidance of vessel spasm were observed and the effect of medicine administration to prevent from and relieve the vascular spasm was evaluated. The time of Allen’s test before and after TRA pPCI , the inner diameter and the peak of blood velocity of the right and left radial artery were investigated with color Doppler vessel echography as well as the complications of radial artery were followed up 1 month after TRA pPCI procedure. Results Two cases in every TRA pPCI and TFA pPCI groups were crossed over each other because procedure of the transradial or transfemoral access was failure. One handred and six vessels (48 vessels in LAD,22 vessels in LCX and 36 vessels in RCA) associated with 28 vessels of total occlusion in TRA pPCI group and 102 vessels (51 vessels in LAD,18 veesles in LCX and 33 vessels in RCA) with 24 vessels in total occlusion in TFA pPCI group were angioplasticized . The successful rates of the first time puncture in access artery, the re patence IRA and pPCI were similar in TRA pPCI and TFA pPCI groups ( 93.4% vs 96.1% ;100% vs 100%; 96.2% vs 97.1% , P >0.05 ). There were no significant diffierence in the average time of puncture time of access artery ,engaging in target vessels of guiding catheters and the total procedure of PCI between the two groups ( 1.3 ±0.3s vs 1.2 ±0.3s ; 6.0 ±1.6min vs 5.8 ±0.9min ; 49.2 ±24.1min vs 46.5 ± 26.4min , P >0.05 ). The access artery complications such as bleeding ,hematoma and embolism as well the veneous thrombosis in TFA pPCI group were much more than those in TRA pPCI group(p< 0.01 ). Although slight artery spasm of 4.7% cases in TRA pPCI group was happened during the procedure of PCI , the procedure had being continued after administration of medicine to release the spasm. The time of Allen’s test ,diameter and the systolic velocity of blood in daul radial arteries were no significant change before and after pPCI.Conclusions The duration and effect by TRA pPCI for AMI with stable hemodynamics was similar to TFA pPCI. The complications such as of bleeding,vessel injury, thrombi and embolism by TRA pPCI were few, and it was unnecessary to discontinue the anticoagulation medicine. TRA pPCI might be selected as a access vessel for pPCI in AMI patients with stable hemodynamics.

Relevance of early intervention in Fahr's disease: understanding through a case study

SUMMARY Intracranial calcification may result from disturbances in calcium metabolism. It often remains asymptomatic, but may present with symptoms like seizure and neurological deficits. Correction of the underlying metabolic disturbance before damage of neuronal tissues due to intracranial calcification may be useful in preventing irreversible neurological deficits. This window period may be the crucial period that needs a thorough clinical evaluation and urgent intervention. We highlight the case of an adult woman with Fahr's disease presented with generalised tonic-clonic seizure. The management priorities were also discussed along with review of literature.

Changes in postoperative depression and anxiety and their relationship with recovery from femoral head necrosis:A longitudinal study

BACKGROUND Femoral head necrosis(FHN)can significantly affect patients'psychological well-being and functional outcomes.However,the long-term relationship between postoperative depression,anxiety,and functional recovery in patients with FHN remains unclear.AIM To investigate the dynamic changes in postoperative depression and anxiety and their relationship with functional recovery in patients with FHN for 3 years.METHODS Ninety-three patients with FHN who underwent surgical treatment in March 2020 to 2023 were enrolled in this longitudinal study.Depression and anxiety status were assessed using the hospital anxiety and depression scale(HADS)at baseline,6 months,1,2,and 3 years postoperatively.Functional recovery was evaluated using the Harris hip score(HHS).The dynamic changes in HADS and HHS were analyzed using repeated measures ANOVA;the relationship between depre-ssion/anxiety status and functional recovery was examined using Pearson’s correlation analysis.RESULTS The mean HADS-depression(HADS-D)and HADS-anxiety(HADS-A)scores significantly improved over time(P<0.001).The prevalence of depression and anxiety decreased from 36.6%and 41.9%at baseline to 10.8%and 12.9%,respectively,at 3 years postoperatively.The mean HHS increased sig-nificantly from 52.3±10.5 at baseline to 88.1±7.2 at 3 years postoperatively(P<0.001).Significant negative correl-ations were found between HADS-D/HADS-A scores and HHS at all time points(P<0.05).CONCLUSION The severity of depression and anxiety negatively correlated with functional recovery,highlighting the importance of psychological interventions in the management of patients with FHN.

Does a population-based multi-factorial lifestyle intervention increase social inequality in smoking? The Inter99 study

Introduction: The social inequality in smoking in the Western countries has been increasing. It has been suggested that the most important strategy to reduce health inequalities related to socio economic status (SEP) is to promote smoking cessation in persons with low SEP. One could fear that a smoking cessation intervention might benefit smokers with high SEP more, and thereby increase the social inequality in smoking. We wanted to investigate whether the effect differed across SEP. Methods: The study was an individual multi-factorial lifestyle intervention study with a control group, Inter99 (1999-2006), Copenhagen, Denmark. We included 1991 daily-smokers with self-reported information on education in the intervention group, and 1135 in the control group. Smokers in the intervention group were repeatedly offered individual life-style-counselling and group-based smoking cessation. We used generalised linear mixed models under the assumption of missing at random, including interaction term between intervention effect and SEP. Results: The gap in self-reported abstinence rates increased over time between persons with high and low education. Probability of abstinence was significantly higher in the intervention group than in the control group, at all follow-up-visits but the effect of the intervention changed over time. The differences in quit-rates across educational groups were not significantly different in the intervention than in the control group at any time. Conclusion: In this randomised population-based intervention study we found that smokers across all educational levels benefited from the anti-smoking intervention, and that the intervention did not increase the social inequality in smoking, as one could have feared.

A quality evaluation of nursing intervention studies in China's Mainland: From 1979 to 2012

Background:The number of papers published in the field of nursing practice has greatly increased in recent years in China's Mainland,yet the quality of these papers is highly variable.There has been no attempt to comprehensively estimate the overall quantity and quality of these papers.Objectives:To systematically retrieve nursing intervention studies published in simplified Chinese from 1979 to 2012,critically appraise their quality,and provide suggestions for future development.Methods:All of the papers were retrieved from China Biology Medicine disc database.The preliminary screening of retrieved publications was performed prior to conducting a rigorous quality evaluation of the remaining publications.10 characteristics would be included in consideration in quality evaluations.Results:69,150 papers were retrieved according to searching strategy.7391 of them were included after preliminary screening and appraised critically.Among the 10 characteristics considered in quality evaluations,the lowest ratings were observed for the factors of“utilisation of blind method”(13 articles),“description of loss of follow-up”(499 articles),“appropriate calculation of sample size”(511 articles)and“randomised assignment of patients to treatments”(652 articles).Conclusions:Chinese papers published in the field of nursing practice have increased over time,but improvements remain needed to ensure that thorough studies with high-quality research methodologies are being performed.Future nursing researchers should not only improve the design of their intervention studies but also clearly describe the methodology they used,especially in group randomisation,blinded research designs,and estimations of required sample sizes.

Accuracy of combined PET/CT in image-guided interventions of liver lesions: An ex-vivo study

AIM： Positioning of interventional devices in liver lesions is a challenging task if only CT is available. We investigated the potential benefit of combined PET/CT images for localization of interventional devices in interventional liver studies. METHODS： Thirty lesions each of hyperdense, isodense and hypodense attenuation compared to normal liver parenchyma were injected into 15 ex-vivo pig livers. All lesions were composed of the same amounts of gelatine containing 0.5 MBq of ^18F-FDG. Following lesion insertion, an interventional needle was placed in each lesion under CT-guidance solely. After that, a PET/CT study was performed. The localization of the needle within the lesion was assessed for CT alone and PET/CT and the root mean square （RMS） was calculated. Results were compared with macroscopic measurements after lesion dissection serving as the standard of reference. RESULTS： In hypo- and isodense lesions PET/CT proved more accurate in defining the position of the interventional device when compared with CT alone. The mean RMS for CT and PET/CT differed significantly in isodense and hypodense lesions. No significant difference was found for hyperdense lesions. CONCLUSION： Combined FDG-PET/CT imaging provides more accurate information than CT alone concerning the needle position in FDG-PET positive liver lesions. Therefore combined PET/CT might be potentially beneficial not only for localization of an interventional device, but may also be beneficial for guidance in interventional liver procedures.

Effects of a Nurse-Led Educational Intervention for Chinese Adult Patients with Psoriatic Arthritis: A Case-Control Study

The aim of this study was to evaluate the effect of an individual nurse-led educational intervention for patients with psoriatic arthritis (PsA). This was a case-control study. The case group consisted of six individual educational sessions delivered by a nurse. A total of 40 patients with PsA joined in this study: the case group (n = 20) and the control group (n = 18). After a 6-week intervention, the case group had significantly better management for the severity of arthritis symptoms (p < 0.05), better psychological well-being and significant lower levels of anxiety (p < 0.05), and depression score (p < 0.01), and reported better improvement of physical and psychological domain of quality of life (QOL) (both p values < 0.05) than the control group. In conclusion, this nurse-led individual education intervention has statistically significant benefits for the management of clinical symptoms of arthritis and for psychological well-being and QOL in patients with PsA.

A Case Study of Intercultural Interventions for Chinese University Students During Study Abroad Program in the University of Minnesota

In 21st Century, Chinese and American universities are experiencing great development in the number of students studying abroad. This research adopts the method of natural investigation, selecting Chinese student samples during study abroad program in the University of Minnesota to complete the designed questionnaires to examine the intercultural interventions taken before, during and after this type of study abroad in Chinese universities. Also, after students complete the questionnaires, email communication is made to analyze the reasons for their answers to the questionnaires. The questionnaire results and email communication show that there is a great gap in the practice of intercultural interventions in study abroad programs between Chinese universities and students expectations. It is time for Chinese universities to design appropriate intercultural interventions in order to maximize Chinese university students＇ intercultural development during study abroad. These intercultural interventions should be run consistently to cover the phrases of pre-departure, during and after the study abroad program. Also, more dynamic and interactive intercultural interventions rather than knowledge-based intercultural instructions or guidance should be the focus for intercultural interventions.

Effect of Xingnao-Jianshen granules in treating AIS patients:study protocol for a non-randomized controlled intervention trial

Objective:Acute ischemic stroke(AIS)is characterized by high morbidity and high mortality.In recent years,complementary and alternative medicine has gradually been widely accepted and applied.At present,traditional Chinese medicine therapy and standard treatments are used for the treatment of AIS.Xingnao-Jianshen prescriptions(XNJS)is an effective prescription for the clinical treatment of AIS,but there is a lack of large-scale clinical evidence to confirm its clinical efficacy.Therefore,our team designed this protocol to evaluate the initial therapeutic effect of XNJS.Methods:The protocol for a non-randomized controlled trial is designed in which 72 eligible patients will be allocated to one of two groups.The control group(n=36)will receive standard treatment for AIS,the test group(n=36)will receive XNJS and standard treatment.Patients will be recruited after stroke onset and will receive the intervention continuously over 10±1 days,with a follow-up period of 90 days.The primary outcome will be the change in the NIHSS,BI,mRS scores.All outcome measures will be assessed at inception,after the intervention(10±1 days),and at the follow-up(90 days).The results will be disseminated to the public through peerreviewed journals and academic conferences.Discussion:The study will provide evidence of the preliminary effects.

Effectiveness of an intervention for reducing social stigma towards mental illness in adolescents

AIM: To evaluate the effectiveness of an intervention for reducing social stigma towards mental illness in adolescents. The effect of gender and knowledge of someone with mental illness was measured. METHODS: Two hundred and eighty secondary school students were evaluated using the Community Attitudes towards Mental Illness(CAMI) questionnaire. The schools were randomized and some received the intervention and others acted as the control group. The programme consisted of providing information via a documentary film and of contact with healthcare staff in order to reduce the social stigma within the school environment. RESULTS: The intervention was effective in reducing the CAMI authoritarianism and social restrictiveness subscales. The intervention showed significant changes in girls in terms of authoritarianism and social restrictiveness, while boys only showed significant changes in authoritarianism. Following the intervention, a significant reduction was found in authoritarianism and social restrictiveness in those who knew someone with mental illness, and only in authoritarianism in those who did not know anyone with mental illness. CONCLUSION: The intervention was effective to reduce social stigma towards people with mental illness, especially in the area of authoritarianism. Some differences were found depending on gender and whether or not the subjects knew someone with mental illness.

Effects of a theory of planned behavior-based intervention on breastfeeding behaviors after cesarean section:A randomized controlled trial

Objectives:To examine the efficacy of an intervention based on the theory of planned behavior(TPB)in improving breastfeeding behavior among women with cesarean sections(C-sections).Methods:This research was a randomized controlled trial.Women with planned elective C-sections were recruited to participate in a randomized controlled trial between June and September 2020.One hundred thirty-two women were divided randomly into the intervention(n=66)and control group(n=66)by systematic random sampling.In the intervention group,an intervention project was implemented after Keywords:Breastfeeding Cesarean section Intervention studies Theory of planned behavior the C-section to establish positive breastfeeding attitudes,cultivate supportive subjective norms,enhance perceived behavioral control,and strengthen breastfeeding intention to change behaviors.Those in the control group received routine pre-and post-delivery care.Exclusive breastfeeding rate and breast problem were collected at 5 days,2 weeks,and 1 month after C-section.The modified Breastfeeding Attrition Prediction Tool(BAPT)on the first day in the hospital,two weeks,and one month after C-section and Numerical Rating Scale(NRS)24 h postoperatively were used to compare the intervention effect between the two groups.Results:After the intervention,the intervention group had significantly higher exclusive breastfeeding rates than the control group at five days(86.4%vs.60.6%),two weeks(77.3%vs.57.6%),and one month(74.2%vs.50.0%)after the C-section.Besides,the intervention group was less likely to have sore nipples at five days(6.1%vs.18.2%in the control group,P<0.05)and two weeks(9.1%vs.12.1%in the control group,P<0.05).After two weeks of intervention,attitude scores(90.64±8.31 vs.87.20±8.15,P<0.05),subjective norm scores(88.07±24.65 vs.79.42±19.47,P<0.05)and behavior control scores in the intervention group were significantly higher than those in the control group.After one month of intervention,attitude scores(90.34±10.35 vs.84.22±10.51,P<0.05)and behavior control scores(43.13±5.02 vs.39.15±4.69,P<0.05)in the intervention group were significantly higher than those in the control group,which resulted in the higher breastfeeding intention in the intervention group.Conclusion:This study indicated that the TPB-based interventions effectively improved women's breastfeeding behaviors after C-sections.

Pharmacist intervention in home care program for diabetes patients

Majority of research reports identified moderate reduction in glycated haemoglobin with education interventions regardless of age group. Our study objective was to evaluate the pharmacist interventions in providing patient home care. A 24-week longitudinal quasi-experimental—pre-test/post-test study design was used to assess the effectiveness of a diabetes education program to enhance self-care practices. A double-blinded randomized study design was considered but was not feasible as the investigator was responsible for implementing the intervention and collecting data on outcomes. Since this was a longitudinal study a 25% attrition rate was included in the calculation of sample size. Hence the sample size for the proposed study was 106 subjects with 53 subjects in each group. All analyses were done using SPSS version 18?. The level of significance was set at 0.05. The Research Ethics Committee of hospital and the Malaysian Medical Research and Ethics Committee approved the study. Of the 109 subject who met the study-entry criteria, 3 subjects declined to participate due to lack of time and interest. There was no significant relationship between the demographic and clinical characteristic of participants who completed the study. No significant relationship between the intervention and control groups who completed the study in demographic, clinical and psychosocial contexts. Of the 47 subjects from the intervention group who reported adherent to their daily medication intake after the education intervention, 51 subjects (31.9%) reported taking their medication at the wrong time. The recommended times for oral anti-hyperglycemic medication (OAM) are: sulphonylureas 30 minutes before food, acarbose with food, metformin with or within 30 minutes after food. This research has shown a brief structured education program that incorporated behavior science specifically self-efficacy was effective in enhancing self-care practices (SMBG and medication adherence) and improving glycaemic control in the intervention group.

Motor-Cognitive Intervention in Mexican Older Adults

Two motor-cognitive interventions were implemented to evaluate their efficacy in cognitive improvement in Mexican older adults 65 years and more. The intervention group received a dance video games plus a cognitive task (dual-task);the comparison group received only the dance video game, in sessions of 45 minutes, 3 times a week, for 12 weeks. The Barthel Index and Lawton and Brody Index, the Center for Epidemiologic Studies Depression Scale-Revised were applied the Digit Span Test, the Stroop Test, and Color Trail Making. Gait parameters were assessed by GAITRite? electronic walkway (CIR Systems). The design was quasi-experimental. Sites were randomly assigned to intervention groups. The intervention group started with 32 participants and finished with 15;the comparison group started with 20 participants and finished with 18. Participants in the intervention group had to mimic the dance movement of a video game and, after the second week to name progressively three objects without stopping dancing. A multivariate repeated measures model (MANO-VA) was fit with four variables. A time-by-group interaction was observed in the Stroop test, and Digits Span Backwards was in favor of the dual task group. The Stroop test, Digit Span Backwards, gait speed, and step length showed effect time. Both groups improved in gait speed and step length by the end of the intervention. Results show it is feasible for Mexican older adults with little schooling to perform dual tasks and improve cognitive tasks and gait speed. Limitations were high attrition due to unforeseen situations and small sample size.

Clinical Outcomes and Risk Factor in Patients with STEMI Treated with Percutaneous Coronary Intervention

This study was carried out to analyze risk factors and short-term clinical outcomes in different age groups of Indian patients with ST-elevation myocardial infarction who underwent percutaneous coronary intervention. This prospective, non-randomized, and observational study was carried out at a tertiary care hospital. The patients who were treated with primary percutaneous coronary intervention for ST-elevation myocardial infarction at study center from December 2011 to September 2012 were included in the study. Study population is divided into three groups: Group-I consisted of patients with age ≤ 40 years, Group-II consisted of patients with age between 41 - 60 years and Group-III consisted of patients with age > 60 years. The primary end-point of the study was occurrence of major adverse clinical outcomes which were a composite of death, reinfarct, repeat percutaneous coronary intervention, major bleeding and emergency coronary artery bypass grafting at 30-day follow-up. A total of 200 patients with ST-elevation myocardial infarction who underwent percutaneous coronary intervention were included in the study. Among study population, 10 (5%) patients constituted Group-I, 96 (48%) patients constituted Group-II and 94 (47%) patients constituted Group-III. Diabetes (0% vs. 35.4% vs. 43.6%) and hypertension (10% vs. 35.4% vs. 44.7%) were more prevalent in Group-III as compared to Group-II and Group-I. The prevalence of single vessel disease was significantly higher in the Group-I compared to Group-II and Group-III (80% vs. 41.66% vs. 17%). At 30-day clinical follow-up, the rate of occurrence of major adverse clinical outcomes in Group-I, Group-II and Group-III is 0%, 2% and 5.4%, respectively. The young ST-elevation myocardial infarction patients had lower incidences of diabetes and hypertension compared with elderly patients. The young age group had more favorable in-hospital and 30-day clinical outcomes.

Effects of bilirubin on perioperative myocardial infarction and its long-term prognosis in patients undergoing percutaneous coronary intervention

BACKGROUND Although bilirubin is known to be an antioxidant,any relationship with coronary heart disease remains controversial.To the best of our knowledge,no previous study has investigated the association between bilirubin and perioperative myocardial infarction(PMI),including its long-term prognosis.AIM To investigate the impact of bilirubin levels on PMI in patients undergoing percutaneous coronary intervention(PCI),and long-term prognosis in post-PMI patients.METHODS Between January 2014 and September 2018,10236 patients undergoing elective PCI were enrolled in the present study.Total bilirubin(TB)and cardiac troponin I(cTnI)levels were measured prior to PCI and cTnI at further time-points,8,16 and 24 h after PCI.Participants were stratified by pre-PCI TB levels and divided into three groups:<10.2;10.2-14.4 and>14.4μmol/L.PMI was defined as producing a post-procedural cTnI level of>5×upper limit of normal(ULN)with normal baseline cTnI.Major adverse cardiovascular events(MACEs)included cardiac death,MI,stroke and revascularization during a maximum 5-year follow-up.RESULTS PMI was detected in 526(15.3%),431(12.7%)and 424(12.5%)of patients with pre-PCI TB levels of<10.2,10.2-14.4 and>14.4μmol/L(P=0.001),respectively.Multivariate logistical analysis indicated that patients with TB 10.2-14.4 and>14.4μmol/L had a lower incidence of PMI[TB 10.2-14.4μmol/L:Odds ratio(OR):0.854;95%confidence interval(CI):0.739-0.987;P=0.032;TB>14.4μmol/L:OR:0.846;95%CI:0.735-0.975;P=0.021]compared with patients with TB<10.2μmol/L.Construction of a Kaplan-Meier curve demonstrated a higher MACE-free survival time for patients with higher TB than for those with lower TB(log-rank P=0.022).After adjustment for cardiovascular risk factors and angiographic characteristics,multivariate Cox analysis showed that a TB level>14.4μmol/L was associated with a reduced risk of MACEs compared with a TB level<10.2μmol/L(hazard ratio 0.667;95%CI:0.485-0.918;P=0.013).CONCLUSION Bilirubin was a protective factor in PMI prediction.For post-PMI patients,elevated bilirubin levels were independently associated with a reduced risk of MACEs during long-term follow-up.

Effect of distinct psychological interventions on changes in selfreported distress,depression and loneliness among older adults during COVID-19

BACKGROUND Older adults have been considered a primary at-risk population during the coronavirus disease 2019(COVID-19)pandemic,and many efforts have been and still are directed toward supporting them and enhancing their capacity to cope with the pandemic.Evidence shows that by enhancing proactive coping abilities through psychological interventions,in which cognitive-behavioral and mindfulness techniques are taught and practiced effectively,these interventions have supported older adults throughout the pandemic.However,the underlying mechanisms by which specific intervention components affect various mental states such as distress,depression and loneliness among older adults remain unclear and warrant investigation.AIM To determine the effect of an intervention using cognitive-behavioral and mindfulness techniques on changes in distress,depression and loneliness.METHODS We performed a secondary analysis on data from a previous study in which community-dwelling older adults attended a short-term,internet-based intervention during the first COVID-19 wave in Israel.The intervention included seven sessions during which various cognitive-behavioral and mindfulness techniques were learned and practiced.In-session changes in psychological distress were measured using the Subjective Units of Distress Scale(SUDS),which participants rated at the beginning and end of each session.Participants also filled out questionnaires that evaluated levels of depression[Patient Health Questionnaire(PHQ-9)]and loneliness(UCLA loneliness Scale)prior to and after the entire intervention process.The effect of in-session changes in the SUDS on changes in post-intervention depression and loneliness levels were assessed,as a proxy for distinct technique effectiveness.RESULTS The findings indicated in-session differences in terms of a decrease in psychological distress(SUDS).Sessions that included relaxation exercises and guided imagery,as well as sessions that included cognitive restructuring and mindfulness meditation,demonstrated the largest decreases in in-session psychological distress(≥35%).Two multivariate regression models,one for levels of post-intervention depression(PHQ-9 score)and the other for levels of post-intervention loneliness(UCLA loneliness score),were fitted.The results revealed two statistically significant explanatory variables for depression:The SUDS difference for sessions in which cognitive restructuring and mindfulness meditation were practiced,beta=-0.25,95%CI:-1.23 to-0.1,and the pre-intervention level of depression,beta=0.62,95%CI:0.37-0.75.The second model for loneliness revealed only one significant explanatory variable:The SUDS difference for sessions in which relaxation and guided imagery were practiced,beta=0.41,95%CI:0.14-0.65.CONCLUSION Different psychological techniques seem to have different effects on distress,loneliness and depression.Understanding the pathways by which distinct techniques affect negative mental symptoms has implications for future intervention design.

Tobacco Control Intervention:A Comparative Multimodal Discourse Analysis of Video Advertisements in China and Australia

Significant differences in tobacco-control initiatives and achievements between Australia and China have been witnessed in the world,despite the fact that thecountries share the Asia-pacific region and have intimate relationships.The smoking rate in Australia has been on a downward trend since the 1980s and therefore Australia has been portrayed as a“dark market”by global tobacco industry companies.However in China,cigarette smoking is the chief killer that causes deadly health risks to both direct users of tobacco and people exposed to second-hand smoke.Non-communicable diseases due to this have caused great burden to the national medical resources.As a vital intervention tool of mass media campaign,public health advertisements on tobacco-control have played an important role in influencing the cognition and behavior of recipients.This study aims to compare the strategies adopted by the advertisements in Australia and China through corpus-driven multimodal discourse analysis to conduct quantitative analysis and qualitative case study.The results of comparative analysis indicate different pathways of tobacco-control advertisements constructions in the two countries that Australian tobacco-control advertisements achieved better in terms of health communication intervention to encourage cessation among smokers and reduce smoking initiation among potential smokers at the population level.To be compared,Chinese tobacco-control advertisements placed a heavier emphasis on the health hazards caused by second-hand smoking to protect people from the attributable morbidity and mortality.From the perspective of content theme,this study argues that Chinese tobacco-control advertisements should shift the focus to the health damage of smoking to smokers which is more targeted and fundamental.From the perspective of multimodal presentations of the video advertisements,a more prominent demonstration of the health damage is recommended.Moreover,this study argues that cultural-oriented strategies should be developed in the tobacco-control advertisements if considering the cigarette sharing and gifting social phenomenon in the Chinese society.

Verbal Dyspraxia: A Case Study

Introduction: While approaching the aspect of learning disorders, particular attention is paid to verbal dyspraxia, a phenomenon that runs its course regularly over the last years. Verbal dyspraxia is inherent in the person without mental disorders and accompanies them throughout the whole spectrum of life. Comorbidity is an added issue. Although dyspraxia is met in homogeneous groups, some common elements such as intelligence, difficulty regarding linguistic skills, low learning performance and low self-esteem are present. Purpose: The object is to research how dyspraxia is manifested and how it affects a 6-year-old boy as well as the possibility of promptly interfering and simplifying his everyday life. Method: In the current case study, Achenbach’s questionnaire was used, combined with the use of expressive vocabulary. Results: The results of the research were unveiled through experts’ references in coordinance with the conferences conducted. Conclusion: Winding up, dyspraxia is a learning disorder that exists within the person through their lifespan. Immediate diagnosis, combined with experts’ personalized intervention programs (and perhaps, a differentiated curriculum, where applicable) can guide the person to live up to the educational needs. Family’s role is to be supportive, intending to eliminate possible emotional strains.

Knowledge and Perceptions of Hospital Care Staff towards Medical Internet of Things and the Role of Awareness Videos: A Quasi Experimental Study

Introduction: The healthcare industry continues to adopt and integrate smart technology into its operations. However, the adoption of the eHealth solutions has not been smooth in the Kingdom of Saudi Arabia (KSA) due to negative beliefs about the technology, lack of awareness and motivation and resistance to change. Thus, this study was developed to investigate the knowledge and perceptions of hospital care staff towards the Medical Internet of Things and to explore the role of awareness videos in changing negative perceptions. Methods: One group pre-test post-test quasi-experimental study design was incorporated, and 116 participants from Ministry of Health hospitals in Riyadh, KSA, were included. A series of four videos were developed to observe their influence on the knowledge and perceptions of mIoT. Results: The findings showed that participants had more knowledge about the individual components of mIoT (particularly wearable devices) compared to the processes or functions of mIoT. Similarly, just over half (56.0%) of the individuals think that the current systems in the hospital are enough to deliver mIoT. However, 90% think mIoT is the future of digital health. Similarly, PE, SI, BI, EE and CESE were considered facilitators and PTA and CC were considered grave barriers to mIoT adoption. The awareness videos positively influenced knowledge and perceptions of PE, EE, CESE and SI. Conclusion: The study concludes that hospital staff in Riyadh (excluding doctors) possess basic mIoT knowledge, consider various adoption factors as enablers, and awareness video can play a critical role in effectively introducing the technology to the hospital care staff.

多学科分级协作管理在慢性阻塞性肺疾病患者吞咽筛查及干预中的效果评价

目的:探讨多学科分级协作管理对慢性阻塞性肺疾病患者吞咽筛查及干预的效果。方法:成立慢性阻塞性肺疾病患者吞咽项目多学科管理小组,制订慢性阻塞性肺疾病患者吞咽功能筛查、干预流程,以及制定多学科分级协作管理流程、进食管理常规、培训方案和质量控制方案,开展培训并完成考核。于2022年5—10月在中山大学附属第三医院呼吸与危重症医学科实施吞咽筛查及干预并持续质量控制。结果:共筛查慢性阻塞性肺疾病患者186例,其中,并发吞咽障碍43例,发生率为23.12%(43/186)。实施多学科分级协作管理后,患者吞咽筛查率为100.00%(186/186),吞咽障碍患者根据容积-黏度吞咽测试结果进行干预率为100.00%(43/43),营养吞咽专科护士会诊率为24.19%(45/186),营养医生会诊率为19.89%(37/186),吞咽康复治疗师会诊率为5.91%(11/186)。43例吞咽障碍患者干预后体质量[(61.21±10.99)kg]、血红蛋白[(132.44±11.27)g/L]、血清白蛋白[(37.63±3.51)g/L]、血清前白蛋白水平[(199.77±40.15)mg/L]均高于干预前[分别为(59.99±10.96)kg、(124.67±10.86)g/L、(35.01±2.82)g/L、(177.12±40.09)mg/L](t=-9.871、-8.634、-7.708、-11.703,P值均<0.001);干预后营养风险NRS 2002评分[(2.47±0.74)分]、显性误吸发生率[16.28%(7/43)]、吸入性肺炎发生率[2.33%(1/43)]均低于干预前[分别为(3.53±0.91)分、89.74%(35/39)、35.90%(14/39)](t=10.488,χ^(2)=44.177、0.245,P值均<0.001);干预后专科护理团队临床营养及吞咽理论得分[(86.43±3.80)分]、技能得分[(87.29±2.51)分]均高于干预前[分别为(76.00±6.04)分、(76.76±4.95)分](t=-10.890、-8.584,P值均<0.001)。结论:对慢性阻塞性肺疾病患者常规进行吞咽功能筛查,及早识别并发吞咽障碍患者,进行多学科分级协作管理,可降低患者的营养风险,提升患者进食的安全性,促进专科护理的精细化发展。