We investigated factors contributing to mobile phone dependence. To 139 medical students, we administered a self-reporting questionnaire designed to evaluate mobile phone dependence, health-related lifestyle, patterns...We investigated factors contributing to mobile phone dependence. To 139 medical students, we administered a self-reporting questionnaire designed to evaluate mobile phone dependence, health-related lifestyle, patterns of behavior, and depressive state. Multivariate logistic regression analysis revealed that scores for poor health-related lifestyle, Type A behavior pattern, and presence of depression are independently associated with degree of mobile phone dependency. These findings suggest that persons with an unhealthy lifestyle, Type A behavior traits, or depression might benefit from mobile phone use guidance.展开更多
The argument of this study is that social capital is a key factor of health literacy. Data came from an island-wide sample. Position generator was adopted to measure social capital. A regression model is constructed t...The argument of this study is that social capital is a key factor of health literacy. Data came from an island-wide sample. Position generator was adopted to measure social capital. A regression model is constructed to test the social capital which is known as a robust predictor of health literacy after controlling gender, age, education, income, and health communication ability. The results reveal that female, higher education, and better health communication ability are also correlated with health literacy. Implications for public health are discussed.展开更多
Objective:Although evidence has already demonstrated that the performance of Health Deliv- ery System(HDS) varies widely across nations,relatively little is known about the factors that give rise to these variations a...Objective:Although evidence has already demonstrated that the performance of Health Deliv- ery System(HDS) varies widely across nations,relatively little is known about the factors that give rise to these variations and the key point to improve the performance besides adjusting system structure.By setup of HDS performance measurement system on the base of association of financial,social,and environmental characteristics,we construct system dynamic model of HDS to simulate the invention policies.Methods: Performance measures were collected from HDS in 31 regions of China and combined with secondary data sources.Multivariate,linear,nonlinear regression and factor analysis models were used to estimate associ- ations between system characteristics and the performance.Results:Performance varied significantly with the size,financial resources and organizational structure of HDS.Performance measurement system of health delivery system was developed to give the rank of all Chinese regions.Conclusion:Performance measurement system of HDS is the basic of HDS modeling by system dynamic.展开更多
Objectives:This study was to longitudinally investigate the association between occupational change trajectories and mental health in the Korean population aged 45 years and older from the Korean Longitudinal Study of...Objectives:This study was to longitudinally investigate the association between occupational change trajectories and mental health in the Korean population aged 45 years and older from the Korean Longitudinal Study of Aging(KLo-SA).Methods:After excluding missing values,the data of 6,224 participants from thefirst to eighth waves of the KLo-SA were analyzed using t-test,Analysis of variance(ANOVA),Group-based Trajectory Model(GBTM)from 1–5th KLoSA and Time-Lagged Generalized estimating equation(GEE)model from 5–8th KLoSA to analyze the association between occupational change trajectories and mental health in the Korean population aged 45 years and older.Results:An analysis of the association between occupational change trajectories and mental health demonstrated that,among all age group,the“sustained in unemployment”group had a worse MMSE and CESD score compared to“sustained WC”group.unlike the under-54 age group,those aged≥55 years demonstrated reductions in the MMSE and CESD scores in the sustained unemployment and the changed working condition from Standard BC to Unemployment groups,whereas those who underwent a change from the Standard WC to unemployment group only demonstrated a reduction in MMSE scores.Conclusions:There was a close relationship between occupational change trajectories and mental health.Therefore,this study can serve as the foundation for policies and institutional measures to manage the deteriorate mental health in the late middle-aged and older population.展开更多
The objective of this study was to examine the inpatient bed (IB) allocation equity and utilization in Chinese city commtmity health service centers (CHSCs). The data were derived from the Baseline Survey of Natio...The objective of this study was to examine the inpatient bed (IB) allocation equity and utilization in Chinese city commtmity health service centers (CHSCs). The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms oflB alloca- tion quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.展开更多
Background: Dual Practice (DP) allows full-time public sector doctors to concurrently offer the same clinical services in the private sector. The debate against this practice seems to be largely influenced by its pote...Background: Dual Practice (DP) allows full-time public sector doctors to concurrently offer the same clinical services in the private sector. The debate against this practice seems to be largely influenced by its potential to reduce the contracted hours in the public sector and shift attention to private work. Purpose: The purpose of this secondary research is to estimate the monetary value of hours lost to the Nigerian public healthcare system when full-time government employee doctors are engaged in private practice. It attempts to quantify the amount of resource outflow from the public system due to absences and lateness arising from competition for time between the public system’s contracted hours and private practice. Methods: Sensitivity analysis in Excel 2010 was used to calculate doctors’ hourly pay in the public sector using the 2015 Consolidated Medical Salary Structure for medical and dental officers in Nigeria’s federal public service. The parameters used for the calculation were the official 40-hour working week and the average monthly gross pay of doctors on different grade levels. Hypothetical scenarios of hours lost due to absences associated with DP were created. The value of different hypothetical hour losses by the percentage of doctors assumed to engage in dual practice across all doctor grade levels was then computed. Results: The estimated annual value of hours lost from dual practice to a single public tertiary care hospital was N4,851,754 or 15,855 USD (best case scenario) and N19,407,017 or 63,422 USD (worst case scenario) for the normal routine work and N1,800,133 or 5883 USD (best case scenario) and N3,600,266 or 11,766 USD (worst case scenario) for the on-call duty. Conclusion: The government may have been paying salaries for large volumes of work not rendered in the public sector. The overall financial impact of dual practice in the Nigerian public system might be negative.展开更多
In the current socio-economic scenario characterized by a growing shortage of resources and progressive budget constraints, the need to better coordinate processes in health institutions appears as a relevant aspect t...In the current socio-economic scenario characterized by a growing shortage of resources and progressive budget constraints, the need to better coordinate processes in health institutions appears as a relevant aspect to ensure the future sustainability of system. In this sense, Relational Coordination(RC) provides a valuable opportunity for the reconfiguration of clinical guidelines concerning isolated single-level considerations. In this research the RC model has been applied to explain best results in the process of diagnosing and offering clinical treatments for lung cancer. Lung cancer presents the higher rates of tumor's mortality worldwide. Through unstructured and informal interviews with clinicians at both levels(Primary/Specialist Care), a diagnosis of the situation in relation to joint management of lung cancer is provided. Solutions of continuity in terms of coordination are explained due to the observation of lack of effective knowledge transfer between the two levels. It is this disconnection which justifies the introduction of a modified model of RC for the study and implementation of transfer relations between the knowledge holders, in order to structure consolidated and cooperative evidence-based models that lead to a substantial shortening in the response times with a marked outcomes improvement. To our knowledge, the application of this model to a Public Health problem bringing together both levels of care, hasn't been made till now.展开更多
Background: The United Arab Emirates aims to provide “world-class healthcare” to its citizens. This study aims to determine the association between overall satisfaction and various aspects of healthcare services in ...Background: The United Arab Emirates aims to provide “world-class healthcare” to its citizens. This study aims to determine the association between overall satisfaction and various aspects of healthcare services in the United Arab Emirates on a country level. Methods: The data was collected from 5855 respondents on the affordability, quality, accessibility, and responsiveness dimensions of health care. Besides frequency tables and descriptive statistics, statistical methods, such as Principal Component Analysis and Multiple Regression, were used to reduce and model the association between dependent (overall satisfaction) and independent (affordability, quality, accessibility, and responsiveness) variables. Results: The preliminary analysis using frequency tables and descriptive clearly highlighted the uncertainty associated with affordability and responsiveness dimensions of healthcare provision in the country. Analysis of variance and t-test results indicated statistically significant differences between perceptions of the respondents based on the socio-demographic factors and other factors such as the kind of insurance held by respondents, having a designated family physician, recent medical visits in the UAE, and intention to go back to home countries for medical treatment. The findings indicated higher satisfaction levels with quality and accessibility and lower satisfaction levels with affordability and responsiveness. Recommendations are provided to address the latter two factors. Conclusion: The study identifies healthcare service provision issues in the United Arab Emirates and recommends enhancing affordability and responsiveness.展开更多
Since the declaration of the Covid-19 pandemic by the World Health Organization on March 11, 2020, the coronavirus has upended communities and dramatically changed people’s daily endeavors across the globe [<a hre...Since the declaration of the Covid-19 pandemic by the World Health Organization on March 11, 2020, the coronavirus has upended communities and dramatically changed people’s daily endeavors across the globe [<a href="#ref1">1</a>]. The current Covid-19 circumstances are occasioned by social realities such as the proliferation of misinformation, social inequalities, and nations’ inability to prepare for unprecedented crises such as the coronavirus. While Covid-19 has managed to elicit anxiety, cause illnesses and deaths, different sectors, individuals, and health dockets utilize technology to combat the pandemic. As we advance, there will be a need for a critical social understanding of how technology can be used to apprehend global crises such as coronavirus. To comprehend how technology is being used to address the coronavirus crises, the current paper assesses, evaluates, and rates the Covid-19 website developed by the Ministry of Health of Saudi Arabia [<a href="#ref2">2</a>].展开更多
Objective: Out of pocket expenditure is the primary means of financing healthcare in middle and low-income countries. The 2021 government health expenditure in Nigeria at 4.52% falls short of the 15% recommendation of...Objective: Out of pocket expenditure is the primary means of financing healthcare in middle and low-income countries. The 2021 government health expenditure in Nigeria at 4.52% falls short of the 15% recommendation of the 2001 Abuja Declaration. This paper examines healthcare purchasing in Nigeria, in order to explore how resources were allocated and create better insight into healthcare purchasing for universal health coverage. Data Source/Study Setting: The study was conducted in the Federal Capital Territory and three states—Lagos, Enugu and Sokoto. Study Design: A cross sectional method was used to examine health purchasing functions in Nigeria. Key informant interviews and review of grey and published literature on health financing in the selected study areas. Data Collection Methods: Primary data were collected from relevant stakeholders across the selected study areas, using a structured interview guide. A search of grey and published literature gave a total of 57 references. Principal Findings: The NHIS has a clearly articulated benefit package, for its formal sector and pro-poor BHCPF program. NHIS covers only about 5% of the Nigerian population. BHCPF (SOML) program targets the bottom 40% of Nigerians on paper, but there is no specific design for reaching them. The NHIS uses both public and private sector providers. It is not clear which providers are used for the BHCPF (SOML) program. The NHIS uses actuarially calculated capitations for primary care services and market-based fee-for-service rates for reimbursing secondary and tertiary care. BHCPF (SOML) uses a macroscale pay-for-performance mechanism to reward states achieving specific health outcomes. Conclusion: Health purchasing functions have serious implication for UHC. However, health care provision in Nigeria is not pro-poor and government efforts do not promote efficiency. Available option is prioritization of health initiatives that ensure value for money through performance-based financing and partnering with the private sector.展开更多
Introduction: Khat chewing is believed to be rapidly increasing worldwide. Worldwide, it is estimated that 10 million people consume khat daily. Khat chewing practice renders certain influence on physical and psycholo...Introduction: Khat chewing is believed to be rapidly increasing worldwide. Worldwide, it is estimated that 10 million people consume khat daily. Khat chewing practice renders certain influence on physical and psychological well being of the community and it can cause more serious adverse psychiatric, cardiovascular, dental and gastrointestinal effects. The recent sharp increase in khat consumption may not only affect the health of individuals but could also have serious socio-economic consequences. This study was conducted to assess prevalence of khat chewing practice, its associated factors and perceived health effects among communities in Dera woreda, Amhara region, Ethiopia 2013. Methods: Community-based cross-sectional study was conducted by using both quantitative and qualitative method of data. The sample size for quantitative was determined by using single population proportion formula and the households were selected by systematic sampling method and in the selected household, one respondent was selected by lottery among members of household aged 15 years and above. Data were collected by means of a pretested questionnaire;analysis was carried out using SPSS version 16. For the qualitative part ten in-depth interviews were conducted on purposely selected individuals and sample size for this method was determined through continuing to interview participants until no new information was obtained. Results: The response rate was 98.3%. Current prevalence of khat chewing practice was 17%. Males were more likely to chew khat (AOR, 18.53;95%CI, 7.20-47.66) compared to females. Muslims were more likely to chew khat (AOR, 4.34;95%CI, 2.07-9.11) compared to Orthodox Christians. Respondents who had family member chewing khat were more likely to chew khat (AOR, 2.67;95%CI, 1.15-6.21) compared to family member without a chewer. Among all the respondents, 92.8% perceived the health effects of khat chewing practice. Respondents who did not perceive health effect of khat were 5 times more likely to chew khat (AOR = 5.10, 95%CI;1.64-15.5) compared to those who perceived health effect of khat. Conclusions: The prevalence of khat chewing practice was 17% with high proportion of the khat chewers found in the urban setting. Sex, religion, residence, family chewing habit and perceived health effect were significantly associated factors with khat chewing practice. In this study 92.8% of the respondents perceived that khat chewing practice had harmful effects on health and the perceived health effects reported were sleeping disorder, hallucination, tooth staining, anxiety, and loss of appetite, depression, constipation, gastritis, hypertension and psychosis.展开更多
Gender-specific differences in the prevalence,incidence,comorbidities,prognosis,severity,risk factors,drug-related aspects and outcomes of various medical conditions are well documented.We present a literature review ...Gender-specific differences in the prevalence,incidence,comorbidities,prognosis,severity,risk factors,drug-related aspects and outcomes of various medical conditions are well documented.We present a literature review on the extent to which research in this field has developed over the years,and reveal gaps in gender-sensitive awareness between the clinical portrayal and the translation into gender-specific treatment regimens,guidelines and into gender-oriented preventive strategies and health policies.Subsequently,through the lens of gender,we describe these domains in detail for four selected medical conditions:Asthma,obesity and overweight,chronic kidney disease and coronavirus disease 2019.As some of the key gender differences become more apparent during adolescence,we focus on this developmental stage.Finally,we propose a model which is based on three influential issues:(1)Investigating gender-specific medical profiles of related health conditions,rather than a single disease;(2)The dynamics of gender disparities across developmental stages;and(3)An integrative approach which takes into account additional risk factors(ethnicity,socio-demographic variables,minorities,lifestyle habits etc.).Increasing the awareness of gender-specific medicine in daily practice and in tailored guidelines,already among adolescents,may reduce inequities,facilitate the prediction of future trends and properly address the characteristics and needs of certain subpopulations within each gender.展开更多
Background: Any healthcare facility must be prepared to handle a dramatic increase in deaths that can be produced by a catastrophic disaster. A mass fatality incident (MFI) will significantly increase the usual number...Background: Any healthcare facility must be prepared to handle a dramatic increase in deaths that can be produced by a catastrophic disaster. A mass fatality incident (MFI) will significantly increase the usual number of deaths that hospitals or forensic science services can manage on a daily basis. A survey was conducted to assess the hospital emergency department level of preparedness to deal with an MFI. Objective: To examine healthcare facilities level of preparedness for an MFI and morgue capacity. Methods: A total of 39 out of a sample of 44 hospitals participated in the study. Seven questionnaires were administered to explore: hospital general characteristics;emergency plans;equipment and infrastructure;collaborative agreements;personnel trainings;emergency communications;laboratory facilities;treatment protocols;security;and, epidemiologic surveillance. Results: Three-fourths (79.5%) of the healthcare facilities reported having a morgue, their average storage capacity was of three bodies. More than two-thirds (66.7%) of the institutions stated that they could not increase their morgue’s capacity. Most installations without a morgue do not possess an agreement with any other institution for the management of bodies. Hospitals have a very limited number of body bags utilized for the handling and transport of bodies. Conclusion: Most of healthcare facilities have morgues, but there are limitations with the current capacity and the lack of resources to increase their capacity in case of a disaster. Management of an MFI must be part of every hospital’s emergency plan, and must include collaborative agreements with forensic authorities, emergency management and public health agencies, and the community.展开更多
BACKGROUND Previous studies that compared the postoperative health-related quality of life(HRQoL)outcomes after receiving laparoscopic resection(LR)or open resection(OR)in patients with colorectal cancer(CRC)have diff...BACKGROUND Previous studies that compared the postoperative health-related quality of life(HRQoL)outcomes after receiving laparoscopic resection(LR)or open resection(OR)in patients with colorectal cancer(CRC)have different conclusions.AIM To explore the medium-term effect of postoperative HRQoL in such patients.METHODS This study randomized 567 patients undergoing non-metastatic CRC surgery managed by one surgeon to the LR or OR groups.HRQoL was assessed during the preoperative period and 3,6,and 12 mo postoperative using a modified version of the 36-Item Short Form(SF-36)Health Survey questionnaire,emphasizing eight specific items.RESULTS This cohort randomly assigned 541 patients to receive LR(n=296)or OR(n=245)surgical procedures.More episodes of postoperative urinary tract infection(P<0.001),wound infection(P<0.001),and pneumonia(P=0.048)were encountered in the OR group.The results demonstrated that the LR group subjectively gained mildly better general health(P=0.045),moderately better physical activity(P=0.006),and significantly better social function recovery(P=0.0001)3 mo postoperatively.Only the aspect of social function recovery was claimed at 6 mo,with a significant advantage in the LR group(P=0.001).No clinical difference was found in HRQoL during the 12 mo.CONCLUSION Our results demonstrated that LR resulted in better outcomes,including intra-operative blood loss,surgery-related complications,course of recovery,and especially some health domains of HRQoL at least within 6 mo postoperatively.Patients should undergo LR if there is no contraindication.展开更多
Artificial intelligence(AI)technology has become integral in the realm of medicine and healthcare,particularly in human activity recognition(HAR)applications such as fitness and rehabilitation tracking.This study intr...Artificial intelligence(AI)technology has become integral in the realm of medicine and healthcare,particularly in human activity recognition(HAR)applications such as fitness and rehabilitation tracking.This study introduces a robust coupling analysis framework that integrates four AI-enabled models,combining both machine learning(ML)and deep learning(DL)approaches to evaluate their effectiveness in HAR.The analytical dataset comprises 561 features sourced from the UCI-HAR database,forming the foundation for training the models.Additionally,the MHEALTH database is employed to replicate the modeling process for comparative purposes,while inclusion of the WISDM database,renowned for its challenging features,supports the framework’s resilience and adaptability.The ML-based models employ the methodologies including adaptive neuro-fuzzy inference system(ANFIS),support vector machine(SVM),and random forest(RF),for data training.In contrast,a DL-based model utilizes one-dimensional convolution neural network(1dCNN)to automate feature extraction.Furthermore,the recursive feature elimination(RFE)algorithm,which drives an ML-based estimator to eliminate low-participation features,helps identify the optimal features for enhancing model performance.The best accuracies of the ANFIS,SVM,RF,and 1dCNN models with meticulous featuring process achieve around 90%,96%,91%,and 93%,respectively.Comparative analysis using the MHEALTH dataset showcases the 1dCNN model’s remarkable perfect accuracy(100%),while the RF,SVM,and ANFIS models equipped with selected features achieve accuracies of 99.8%,99.7%,and 96.5%,respectively.Finally,when applied to the WISDM dataset,the DL-based and ML-based models attain accuracies of 91.4%and 87.3%,respectively,aligning with prior research findings.In conclusion,the proposed framework yields HAR models with commendable performance metrics,exhibiting its suitability for integration into the healthcare services system through AI-driven applications.展开更多
Background:This study conducted a longitudinal analysis of the association between job satisfaction and stress or depressive symptoms of employed persons with disabilities(PWDs)based on the data from the 1st to 8th Pa...Background:This study conducted a longitudinal analysis of the association between job satisfaction and stress or depressive symptoms of employed persons with disabilities(PWDs)based on the data from the 1st to 8th Pannel Survey of Employment for the Disabled(PSED).Methods:After excluding missing values,data on 1614 participants at baseline(1st wave)were analyzed using the chi-square test and generalized estimating equation(GEE)model for data from 1st to 8thPSED.Results:It was found that for each one-unit increase in the job satisfaction score,the stress scale decreased by 0.004(B:−0.004,95%CI:−0.006–−0.002,p-value:<0.0001).Compared to the very high job satisfaction group,the low job satisfaction group was more likely to experience perceived stress(odds ratio[OR]:2.127,p-value:0.001)and experience depressive symptoms(OR:3.557,p-value<0.0001).Furthermore,in terms of the overall satisfaction with their current job among the PWDs,compared to the‘satisfied’group,the‘unsatisfied’group had higher perceived stress(OR:1.593,p-value<0.0001)and depressive symptoms(OR:2.688,p-value<0.0001).Conclusions:There was a close association between job satisfaction and stress or depressive symptoms among employed PWDS.This study’s findings may serve as foundational research to support improving mental health in this population.In addition,it is anticipated that these findings can be used as evidence to improve the work environment for PWDs within the context of Korean corporate culture.展开更多
Objective This study aimed to identify differentially methylated genes(DMGs) associated with natural killer cells in patients with autoimmune thyroiditis(AIT), focusing on the influence of varying water iodine exposur...Objective This study aimed to identify differentially methylated genes(DMGs) associated with natural killer cells in patients with autoimmune thyroiditis(AIT), focusing on the influence of varying water iodine exposure levels.Methods Participants were divided into categories based on median water iodine(MWI)concentrations: iodine-fortified areas(IFA, MWI < 10 μg/L), iodine-adequate areas(IAA, 40 ≤ MWI ≤ 100μg/L), and iodine-excessive areas(IEA, MWI > 300 μg/L). A total of 176 matched AIT cases and controls were recruited and divided into 89, 40, and 47 pairs for IFA, IAA, and IEA, respectively. DMGs were identified using 850K Bead Chip analysis for 10/10 paired samples. Validation of DNA methylation and m RNA expression levels of the DMGs was conducted using Methyl Target^(TM) and QRT-PCR for 176/176paired samples.Results KLRC1, KLRC3, and SH2D1B were identified as significant DMGs. Validation revealed that KLRC1 was hypomethylated and highly expressed, whereas KLRC3 was hypermethylated and highly expressed in individuals with AIT. Furthermore, KLRC1 was hypomethylated and highly expressed in both IFA and IEA.Conclusion The DNA methylation status of KLRC1 and KLRC3 may play crucial roles in AIT pathogenesis. Additionally, DNA methylation of KLRC1 seems to be influenced by different iodine concentrations in water.展开更多
Macronutrients serve as a source of energy for both gut microbiota and its host. An increase or decrease in macronutrients can either increase or decrease the composition of gut microbiota, leading to gut dysbiosis wh...Macronutrients serve as a source of energy for both gut microbiota and its host. An increase or decrease in macronutrients can either increase or decrease the composition of gut microbiota, leading to gut dysbiosis which has been implicated in many diseases state including non-communicable diseases. To achieve this, seven diets were formulated by restricting 60% of each macronutrient. These diets were fed on 42 albino rats (Wistar), divided into 7 groups of 6 rats each. Group 1 was fed on a normal laboratory chow diet (ND), group 2 received a fat-restricted diet (FRD), group 3 received a protein-restricted diet, (PFD), group 4 received a carbohydrate-restricted diet (CRD), group 5 received a protein and fat-restricted diet (PFRD), group 6 re-ceived a carbohydrate and fat-restricted diet (CFRD) and group 7 received a carbohydrate and protein-restricted diet (CPRD). Feed and water intake were given ad libitum and daily weight and food intake were recorded. The experiment went on for 4 weeks after which animals were sacrificed and intestinal content and blood were collected for analysis (gut microbial composition, glucose, insulin levels, serum lipid, and enzyme). Compared to the control group results showed a decrease in Bacteroides (40.50 - 14.00 CFU), HDL (68.20 - 40.40 mg/dl), and AST (66.62 - 64.74 U/L) in FRD. An increase in AST (66.6 - 69.43 U/L), Bifidobacterial (59.50 - 92.00 CFU) and decreased Bacteroides (40.5 - 19.5 CFU) for PRD was also recorded. CRD reduced Lactobacillus (73 - 33.5 CFU), total bacterial count (129 - 48 CFU), HDL (68.2 - 30.8 mg/dl), and cholesterol (121.44 - 88.65 mg/dl) whereas intestinal composition of E. coli (30.5 - 51.5 CFU) increased. PFRD increased Lactobacillus (73.00 - 102.5 CFU), Bifidobacterial (59.5 - 100 CFU), HDL (68.2 - 74.7 mg/dl), and Triglyceride (111.67 - 146.67 mg/dl) concentration. Meanwhile, a reduction in Bifidobacterial (59.5 - 41.5 CFU), and an increasing of AST (66.62 - 70.30 U/l) were recorded for CFRD. However, Bacteroides (40.5 69.5 CFU), LDL (30.95 - 41.98 mg/dl) increased and Bifidobacterial (59.5 - 38.00 CFU) and HDL (68.2 - 53.5 mg/dl) decreased for CPRD. This work, therefore, concludes that macronutrient restriction causes significant changes in serum marker and enzyme profile, and gut microbial composition which can cause gut dysbiosis and later on could expose the host to inflammatory diseases in the long run.展开更多
文摘We investigated factors contributing to mobile phone dependence. To 139 medical students, we administered a self-reporting questionnaire designed to evaluate mobile phone dependence, health-related lifestyle, patterns of behavior, and depressive state. Multivariate logistic regression analysis revealed that scores for poor health-related lifestyle, Type A behavior pattern, and presence of depression are independently associated with degree of mobile phone dependency. These findings suggest that persons with an unhealthy lifestyle, Type A behavior traits, or depression might benefit from mobile phone use guidance.
文摘The argument of this study is that social capital is a key factor of health literacy. Data came from an island-wide sample. Position generator was adopted to measure social capital. A regression model is constructed to test the social capital which is known as a robust predictor of health literacy after controlling gender, age, education, income, and health communication ability. The results reveal that female, higher education, and better health communication ability are also correlated with health literacy. Implications for public health are discussed.
文摘Objective:Although evidence has already demonstrated that the performance of Health Deliv- ery System(HDS) varies widely across nations,relatively little is known about the factors that give rise to these variations and the key point to improve the performance besides adjusting system structure.By setup of HDS performance measurement system on the base of association of financial,social,and environmental characteristics,we construct system dynamic model of HDS to simulate the invention policies.Methods: Performance measures were collected from HDS in 31 regions of China and combined with secondary data sources.Multivariate,linear,nonlinear regression and factor analysis models were used to estimate associ- ations between system characteristics and the performance.Results:Performance varied significantly with the size,financial resources and organizational structure of HDS.Performance measurement system of health delivery system was developed to give the rank of all Chinese regions.Conclusion:Performance measurement system of HDS is the basic of HDS modeling by system dynamic.
文摘Objectives:This study was to longitudinally investigate the association between occupational change trajectories and mental health in the Korean population aged 45 years and older from the Korean Longitudinal Study of Aging(KLo-SA).Methods:After excluding missing values,the data of 6,224 participants from thefirst to eighth waves of the KLo-SA were analyzed using t-test,Analysis of variance(ANOVA),Group-based Trajectory Model(GBTM)from 1–5th KLoSA and Time-Lagged Generalized estimating equation(GEE)model from 5–8th KLoSA to analyze the association between occupational change trajectories and mental health in the Korean population aged 45 years and older.Results:An analysis of the association between occupational change trajectories and mental health demonstrated that,among all age group,the“sustained in unemployment”group had a worse MMSE and CESD score compared to“sustained WC”group.unlike the under-54 age group,those aged≥55 years demonstrated reductions in the MMSE and CESD scores in the sustained unemployment and the changed working condition from Standard BC to Unemployment groups,whereas those who underwent a change from the Standard WC to unemployment group only demonstrated a reduction in MMSE scores.Conclusions:There was a close relationship between occupational change trajectories and mental health.Therefore,this study can serve as the foundation for policies and institutional measures to manage the deteriorate mental health in the late middle-aged and older population.
基金The Baseline Survey of "The National Urban Community Health Service System Building Project" was funded by Ministry Of Health of China
文摘The objective of this study was to examine the inpatient bed (IB) allocation equity and utilization in Chinese city commtmity health service centers (CHSCs). The data were derived from the Baseline Survey of National City Community Health Service System Building Project, which was conducted in 1917 CHSCs in 28 cities in 2007. The IB allocation was analyzed in terms oflB alloca- tion quantity and distribution equity, and the IB utilization was analyzed by the IB utilization rate and average length of stay of the CHSC inpatients. The results showed that 49.3% of the CHSCs were equipped with IB; averagely, there were 45 IBs per CHSC, 0.94 IBs per 1000 people, and 0.38 nurses and 0.57 doctors per IB; the IB Gini coefficient was 0.32; the IB utilization rate was 40.06%; and the average length of stay of inpatients was 12.24 days. The conclusions were that IB allocation among the population was equitable, but the number of nurse per IB was not up to the national standard; and the CHSC IB utilization was low as a whole, thus inpatient service was not the main health service for Chinese CHSCs.
文摘Background: Dual Practice (DP) allows full-time public sector doctors to concurrently offer the same clinical services in the private sector. The debate against this practice seems to be largely influenced by its potential to reduce the contracted hours in the public sector and shift attention to private work. Purpose: The purpose of this secondary research is to estimate the monetary value of hours lost to the Nigerian public healthcare system when full-time government employee doctors are engaged in private practice. It attempts to quantify the amount of resource outflow from the public system due to absences and lateness arising from competition for time between the public system’s contracted hours and private practice. Methods: Sensitivity analysis in Excel 2010 was used to calculate doctors’ hourly pay in the public sector using the 2015 Consolidated Medical Salary Structure for medical and dental officers in Nigeria’s federal public service. The parameters used for the calculation were the official 40-hour working week and the average monthly gross pay of doctors on different grade levels. Hypothetical scenarios of hours lost due to absences associated with DP were created. The value of different hypothetical hour losses by the percentage of doctors assumed to engage in dual practice across all doctor grade levels was then computed. Results: The estimated annual value of hours lost from dual practice to a single public tertiary care hospital was N4,851,754 or 15,855 USD (best case scenario) and N19,407,017 or 63,422 USD (worst case scenario) for the normal routine work and N1,800,133 or 5883 USD (best case scenario) and N3,600,266 or 11,766 USD (worst case scenario) for the on-call duty. Conclusion: The government may have been paying salaries for large volumes of work not rendered in the public sector. The overall financial impact of dual practice in the Nigerian public system might be negative.
文摘In the current socio-economic scenario characterized by a growing shortage of resources and progressive budget constraints, the need to better coordinate processes in health institutions appears as a relevant aspect to ensure the future sustainability of system. In this sense, Relational Coordination(RC) provides a valuable opportunity for the reconfiguration of clinical guidelines concerning isolated single-level considerations. In this research the RC model has been applied to explain best results in the process of diagnosing and offering clinical treatments for lung cancer. Lung cancer presents the higher rates of tumor's mortality worldwide. Through unstructured and informal interviews with clinicians at both levels(Primary/Specialist Care), a diagnosis of the situation in relation to joint management of lung cancer is provided. Solutions of continuity in terms of coordination are explained due to the observation of lack of effective knowledge transfer between the two levels. It is this disconnection which justifies the introduction of a modified model of RC for the study and implementation of transfer relations between the knowledge holders, in order to structure consolidated and cooperative evidence-based models that lead to a substantial shortening in the response times with a marked outcomes improvement. To our knowledge, the application of this model to a Public Health problem bringing together both levels of care, hasn't been made till now.
文摘Background: The United Arab Emirates aims to provide “world-class healthcare” to its citizens. This study aims to determine the association between overall satisfaction and various aspects of healthcare services in the United Arab Emirates on a country level. Methods: The data was collected from 5855 respondents on the affordability, quality, accessibility, and responsiveness dimensions of health care. Besides frequency tables and descriptive statistics, statistical methods, such as Principal Component Analysis and Multiple Regression, were used to reduce and model the association between dependent (overall satisfaction) and independent (affordability, quality, accessibility, and responsiveness) variables. Results: The preliminary analysis using frequency tables and descriptive clearly highlighted the uncertainty associated with affordability and responsiveness dimensions of healthcare provision in the country. Analysis of variance and t-test results indicated statistically significant differences between perceptions of the respondents based on the socio-demographic factors and other factors such as the kind of insurance held by respondents, having a designated family physician, recent medical visits in the UAE, and intention to go back to home countries for medical treatment. The findings indicated higher satisfaction levels with quality and accessibility and lower satisfaction levels with affordability and responsiveness. Recommendations are provided to address the latter two factors. Conclusion: The study identifies healthcare service provision issues in the United Arab Emirates and recommends enhancing affordability and responsiveness.
文摘Since the declaration of the Covid-19 pandemic by the World Health Organization on March 11, 2020, the coronavirus has upended communities and dramatically changed people’s daily endeavors across the globe [<a href="#ref1">1</a>]. The current Covid-19 circumstances are occasioned by social realities such as the proliferation of misinformation, social inequalities, and nations’ inability to prepare for unprecedented crises such as the coronavirus. While Covid-19 has managed to elicit anxiety, cause illnesses and deaths, different sectors, individuals, and health dockets utilize technology to combat the pandemic. As we advance, there will be a need for a critical social understanding of how technology can be used to apprehend global crises such as coronavirus. To comprehend how technology is being used to address the coronavirus crises, the current paper assesses, evaluates, and rates the Covid-19 website developed by the Ministry of Health of Saudi Arabia [<a href="#ref2">2</a>].
文摘Objective: Out of pocket expenditure is the primary means of financing healthcare in middle and low-income countries. The 2021 government health expenditure in Nigeria at 4.52% falls short of the 15% recommendation of the 2001 Abuja Declaration. This paper examines healthcare purchasing in Nigeria, in order to explore how resources were allocated and create better insight into healthcare purchasing for universal health coverage. Data Source/Study Setting: The study was conducted in the Federal Capital Territory and three states—Lagos, Enugu and Sokoto. Study Design: A cross sectional method was used to examine health purchasing functions in Nigeria. Key informant interviews and review of grey and published literature on health financing in the selected study areas. Data Collection Methods: Primary data were collected from relevant stakeholders across the selected study areas, using a structured interview guide. A search of grey and published literature gave a total of 57 references. Principal Findings: The NHIS has a clearly articulated benefit package, for its formal sector and pro-poor BHCPF program. NHIS covers only about 5% of the Nigerian population. BHCPF (SOML) program targets the bottom 40% of Nigerians on paper, but there is no specific design for reaching them. The NHIS uses both public and private sector providers. It is not clear which providers are used for the BHCPF (SOML) program. The NHIS uses actuarially calculated capitations for primary care services and market-based fee-for-service rates for reimbursing secondary and tertiary care. BHCPF (SOML) uses a macroscale pay-for-performance mechanism to reward states achieving specific health outcomes. Conclusion: Health purchasing functions have serious implication for UHC. However, health care provision in Nigeria is not pro-poor and government efforts do not promote efficiency. Available option is prioritization of health initiatives that ensure value for money through performance-based financing and partnering with the private sector.
文摘Introduction: Khat chewing is believed to be rapidly increasing worldwide. Worldwide, it is estimated that 10 million people consume khat daily. Khat chewing practice renders certain influence on physical and psychological well being of the community and it can cause more serious adverse psychiatric, cardiovascular, dental and gastrointestinal effects. The recent sharp increase in khat consumption may not only affect the health of individuals but could also have serious socio-economic consequences. This study was conducted to assess prevalence of khat chewing practice, its associated factors and perceived health effects among communities in Dera woreda, Amhara region, Ethiopia 2013. Methods: Community-based cross-sectional study was conducted by using both quantitative and qualitative method of data. The sample size for quantitative was determined by using single population proportion formula and the households were selected by systematic sampling method and in the selected household, one respondent was selected by lottery among members of household aged 15 years and above. Data were collected by means of a pretested questionnaire;analysis was carried out using SPSS version 16. For the qualitative part ten in-depth interviews were conducted on purposely selected individuals and sample size for this method was determined through continuing to interview participants until no new information was obtained. Results: The response rate was 98.3%. Current prevalence of khat chewing practice was 17%. Males were more likely to chew khat (AOR, 18.53;95%CI, 7.20-47.66) compared to females. Muslims were more likely to chew khat (AOR, 4.34;95%CI, 2.07-9.11) compared to Orthodox Christians. Respondents who had family member chewing khat were more likely to chew khat (AOR, 2.67;95%CI, 1.15-6.21) compared to family member without a chewer. Among all the respondents, 92.8% perceived the health effects of khat chewing practice. Respondents who did not perceive health effect of khat were 5 times more likely to chew khat (AOR = 5.10, 95%CI;1.64-15.5) compared to those who perceived health effect of khat. Conclusions: The prevalence of khat chewing practice was 17% with high proportion of the khat chewers found in the urban setting. Sex, religion, residence, family chewing habit and perceived health effect were significantly associated factors with khat chewing practice. In this study 92.8% of the respondents perceived that khat chewing practice had harmful effects on health and the perceived health effects reported were sleeping disorder, hallucination, tooth staining, anxiety, and loss of appetite, depression, constipation, gastritis, hypertension and psychosis.
文摘Gender-specific differences in the prevalence,incidence,comorbidities,prognosis,severity,risk factors,drug-related aspects and outcomes of various medical conditions are well documented.We present a literature review on the extent to which research in this field has developed over the years,and reveal gaps in gender-sensitive awareness between the clinical portrayal and the translation into gender-specific treatment regimens,guidelines and into gender-oriented preventive strategies and health policies.Subsequently,through the lens of gender,we describe these domains in detail for four selected medical conditions:Asthma,obesity and overweight,chronic kidney disease and coronavirus disease 2019.As some of the key gender differences become more apparent during adolescence,we focus on this developmental stage.Finally,we propose a model which is based on three influential issues:(1)Investigating gender-specific medical profiles of related health conditions,rather than a single disease;(2)The dynamics of gender disparities across developmental stages;and(3)An integrative approach which takes into account additional risk factors(ethnicity,socio-demographic variables,minorities,lifestyle habits etc.).Increasing the awareness of gender-specific medicine in daily practice and in tailored guidelines,already among adolescents,may reduce inequities,facilitate the prediction of future trends and properly address the characteristics and needs of certain subpopulations within each gender.
文摘Background: Any healthcare facility must be prepared to handle a dramatic increase in deaths that can be produced by a catastrophic disaster. A mass fatality incident (MFI) will significantly increase the usual number of deaths that hospitals or forensic science services can manage on a daily basis. A survey was conducted to assess the hospital emergency department level of preparedness to deal with an MFI. Objective: To examine healthcare facilities level of preparedness for an MFI and morgue capacity. Methods: A total of 39 out of a sample of 44 hospitals participated in the study. Seven questionnaires were administered to explore: hospital general characteristics;emergency plans;equipment and infrastructure;collaborative agreements;personnel trainings;emergency communications;laboratory facilities;treatment protocols;security;and, epidemiologic surveillance. Results: Three-fourths (79.5%) of the healthcare facilities reported having a morgue, their average storage capacity was of three bodies. More than two-thirds (66.7%) of the institutions stated that they could not increase their morgue’s capacity. Most installations without a morgue do not possess an agreement with any other institution for the management of bodies. Hospitals have a very limited number of body bags utilized for the handling and transport of bodies. Conclusion: Most of healthcare facilities have morgues, but there are limitations with the current capacity and the lack of resources to increase their capacity in case of a disaster. Management of an MFI must be part of every hospital’s emergency plan, and must include collaborative agreements with forensic authorities, emergency management and public health agencies, and the community.
基金Supported by The Research Foundation of E-Da Cancer Hospital and E-Da Hospital,Kaohsiung,Taiwan,No.EDCHI111002 and NCKUEDA11110.
文摘BACKGROUND Previous studies that compared the postoperative health-related quality of life(HRQoL)outcomes after receiving laparoscopic resection(LR)or open resection(OR)in patients with colorectal cancer(CRC)have different conclusions.AIM To explore the medium-term effect of postoperative HRQoL in such patients.METHODS This study randomized 567 patients undergoing non-metastatic CRC surgery managed by one surgeon to the LR or OR groups.HRQoL was assessed during the preoperative period and 3,6,and 12 mo postoperative using a modified version of the 36-Item Short Form(SF-36)Health Survey questionnaire,emphasizing eight specific items.RESULTS This cohort randomly assigned 541 patients to receive LR(n=296)or OR(n=245)surgical procedures.More episodes of postoperative urinary tract infection(P<0.001),wound infection(P<0.001),and pneumonia(P=0.048)were encountered in the OR group.The results demonstrated that the LR group subjectively gained mildly better general health(P=0.045),moderately better physical activity(P=0.006),and significantly better social function recovery(P=0.0001)3 mo postoperatively.Only the aspect of social function recovery was claimed at 6 mo,with a significant advantage in the LR group(P=0.001).No clinical difference was found in HRQoL during the 12 mo.CONCLUSION Our results demonstrated that LR resulted in better outcomes,including intra-operative blood loss,surgery-related complications,course of recovery,and especially some health domains of HRQoL at least within 6 mo postoperatively.Patients should undergo LR if there is no contraindication.
基金funded by the National Science and Technology Council,Taiwan(Grant No.NSTC 112-2121-M-039-001)by China Medical University(Grant No.CMU112-MF-79).
文摘Artificial intelligence(AI)technology has become integral in the realm of medicine and healthcare,particularly in human activity recognition(HAR)applications such as fitness and rehabilitation tracking.This study introduces a robust coupling analysis framework that integrates four AI-enabled models,combining both machine learning(ML)and deep learning(DL)approaches to evaluate their effectiveness in HAR.The analytical dataset comprises 561 features sourced from the UCI-HAR database,forming the foundation for training the models.Additionally,the MHEALTH database is employed to replicate the modeling process for comparative purposes,while inclusion of the WISDM database,renowned for its challenging features,supports the framework’s resilience and adaptability.The ML-based models employ the methodologies including adaptive neuro-fuzzy inference system(ANFIS),support vector machine(SVM),and random forest(RF),for data training.In contrast,a DL-based model utilizes one-dimensional convolution neural network(1dCNN)to automate feature extraction.Furthermore,the recursive feature elimination(RFE)algorithm,which drives an ML-based estimator to eliminate low-participation features,helps identify the optimal features for enhancing model performance.The best accuracies of the ANFIS,SVM,RF,and 1dCNN models with meticulous featuring process achieve around 90%,96%,91%,and 93%,respectively.Comparative analysis using the MHEALTH dataset showcases the 1dCNN model’s remarkable perfect accuracy(100%),while the RF,SVM,and ANFIS models equipped with selected features achieve accuracies of 99.8%,99.7%,and 96.5%,respectively.Finally,when applied to the WISDM dataset,the DL-based and ML-based models attain accuracies of 91.4%and 87.3%,respectively,aligning with prior research findings.In conclusion,the proposed framework yields HAR models with commendable performance metrics,exhibiting its suitability for integration into the healthcare services system through AI-driven applications.
文摘Background:This study conducted a longitudinal analysis of the association between job satisfaction and stress or depressive symptoms of employed persons with disabilities(PWDs)based on the data from the 1st to 8th Pannel Survey of Employment for the Disabled(PSED).Methods:After excluding missing values,data on 1614 participants at baseline(1st wave)were analyzed using the chi-square test and generalized estimating equation(GEE)model for data from 1st to 8thPSED.Results:It was found that for each one-unit increase in the job satisfaction score,the stress scale decreased by 0.004(B:−0.004,95%CI:−0.006–−0.002,p-value:<0.0001).Compared to the very high job satisfaction group,the low job satisfaction group was more likely to experience perceived stress(odds ratio[OR]:2.127,p-value:0.001)and experience depressive symptoms(OR:3.557,p-value<0.0001).Furthermore,in terms of the overall satisfaction with their current job among the PWDs,compared to the‘satisfied’group,the‘unsatisfied’group had higher perceived stress(OR:1.593,p-value<0.0001)and depressive symptoms(OR:2.688,p-value<0.0001).Conclusions:There was a close association between job satisfaction and stress or depressive symptoms among employed PWDS.This study’s findings may serve as foundational research to support improving mental health in this population.In addition,it is anticipated that these findings can be used as evidence to improve the work environment for PWDs within the context of Korean corporate culture.
基金supported by National Natural Science Foundation of China,82073490.
文摘Objective This study aimed to identify differentially methylated genes(DMGs) associated with natural killer cells in patients with autoimmune thyroiditis(AIT), focusing on the influence of varying water iodine exposure levels.Methods Participants were divided into categories based on median water iodine(MWI)concentrations: iodine-fortified areas(IFA, MWI < 10 μg/L), iodine-adequate areas(IAA, 40 ≤ MWI ≤ 100μg/L), and iodine-excessive areas(IEA, MWI > 300 μg/L). A total of 176 matched AIT cases and controls were recruited and divided into 89, 40, and 47 pairs for IFA, IAA, and IEA, respectively. DMGs were identified using 850K Bead Chip analysis for 10/10 paired samples. Validation of DNA methylation and m RNA expression levels of the DMGs was conducted using Methyl Target^(TM) and QRT-PCR for 176/176paired samples.Results KLRC1, KLRC3, and SH2D1B were identified as significant DMGs. Validation revealed that KLRC1 was hypomethylated and highly expressed, whereas KLRC3 was hypermethylated and highly expressed in individuals with AIT. Furthermore, KLRC1 was hypomethylated and highly expressed in both IFA and IEA.Conclusion The DNA methylation status of KLRC1 and KLRC3 may play crucial roles in AIT pathogenesis. Additionally, DNA methylation of KLRC1 seems to be influenced by different iodine concentrations in water.
文摘Macronutrients serve as a source of energy for both gut microbiota and its host. An increase or decrease in macronutrients can either increase or decrease the composition of gut microbiota, leading to gut dysbiosis which has been implicated in many diseases state including non-communicable diseases. To achieve this, seven diets were formulated by restricting 60% of each macronutrient. These diets were fed on 42 albino rats (Wistar), divided into 7 groups of 6 rats each. Group 1 was fed on a normal laboratory chow diet (ND), group 2 received a fat-restricted diet (FRD), group 3 received a protein-restricted diet, (PFD), group 4 received a carbohydrate-restricted diet (CRD), group 5 received a protein and fat-restricted diet (PFRD), group 6 re-ceived a carbohydrate and fat-restricted diet (CFRD) and group 7 received a carbohydrate and protein-restricted diet (CPRD). Feed and water intake were given ad libitum and daily weight and food intake were recorded. The experiment went on for 4 weeks after which animals were sacrificed and intestinal content and blood were collected for analysis (gut microbial composition, glucose, insulin levels, serum lipid, and enzyme). Compared to the control group results showed a decrease in Bacteroides (40.50 - 14.00 CFU), HDL (68.20 - 40.40 mg/dl), and AST (66.62 - 64.74 U/L) in FRD. An increase in AST (66.6 - 69.43 U/L), Bifidobacterial (59.50 - 92.00 CFU) and decreased Bacteroides (40.5 - 19.5 CFU) for PRD was also recorded. CRD reduced Lactobacillus (73 - 33.5 CFU), total bacterial count (129 - 48 CFU), HDL (68.2 - 30.8 mg/dl), and cholesterol (121.44 - 88.65 mg/dl) whereas intestinal composition of E. coli (30.5 - 51.5 CFU) increased. PFRD increased Lactobacillus (73.00 - 102.5 CFU), Bifidobacterial (59.5 - 100 CFU), HDL (68.2 - 74.7 mg/dl), and Triglyceride (111.67 - 146.67 mg/dl) concentration. Meanwhile, a reduction in Bifidobacterial (59.5 - 41.5 CFU), and an increasing of AST (66.62 - 70.30 U/l) were recorded for CFRD. However, Bacteroides (40.5 69.5 CFU), LDL (30.95 - 41.98 mg/dl) increased and Bifidobacterial (59.5 - 38.00 CFU) and HDL (68.2 - 53.5 mg/dl) decreased for CPRD. This work, therefore, concludes that macronutrient restriction causes significant changes in serum marker and enzyme profile, and gut microbial composition which can cause gut dysbiosis and later on could expose the host to inflammatory diseases in the long run.