Physical and mental health

身心健康
  • 文章类型: Journal Article
    背景:由于人口老龄化,医学合并症和肥胖症的发生率不断增加,妇产科(OBGYN)手术变得越来越复杂。因此并发症很常见,不仅影响患者,而且还可能给作为“第二受害者”的OBGYN外科医生带来痛苦。
    目的:我们研究的目的是描述和量化并发症对OBGYN外科医生的影响范围,并评估社会人口统计学,与这种影响相关的临床医生和实践因素。
    方法:根据对OBGYNs的访谈和文献综述进行了横断面调查。调查评估了OBGYN的人口统计,临床和实践特点,估计每年的并发症数量,苦恼,身心健康,睡眠,由并发症引起的关系影响,并探讨了OBGYNs用于应对并发症的策略。单变量逻辑回归分析用于确定OBGYNs特征之间的关联,和并发症的后果。
    结果:总体而言,在727名受访者中,431(61%)为女性,384人(55%)50岁或以上,近一半的人在OBGYN工作了15年或更长时间(329(45%)),和527(73%)通常每周完成少于10次外科手术。大多数(568(78%))报告每年少于3次手术并发症,大多数(472(66%))认为这与他们的同事相似或更少。并发症在导致患者预后不良时引起的压力最大(653(90%)),有严重的患者后果(630(87%))或外科医生错误的结果(627(86%))。并发症影响了大多数OBGYN的健康和睡眠。50岁以下的人中有更多的人报告说他们的心理健康(32(10%),p=0.002)和睡眠(130(42%),发生并发症时,p=0.03)受到影响。女性也更有可能报告自己的身体健康(14(3%),p=<0.001),心理健康(39(9%),p=0.01)和睡眠(183(43%),p=<0.001)受到影响。与≥15年经验的外科医生(12(4%))相比,当前的受训者(11(10%))和经验少于15年的外科医生(25(9%))更有可能经历心理健康后果(p=0.01)。女性报告并发症发生时与同事互动的意愿较低(323(75%),p=0.006),受过不到15年培训的外科医生不太可能报告说话舒适(221(74%),p=0.03)和与他人互动(212(74%),p=0.02)。
    结论:当其中一名患者出现并发症时,绝大多数OBGYN患者会对他们的健康和福祉产生重大影响。报告的影响程度和类型与其他外科专业所经历的相似。未来的研究需要测试干预措施以减轻重大影响,并纵向跟踪OBGYN,以了解并发症的影响持续多长时间。
    BACKGROUND: Obstetric and gynecological (OBGYN) surgery is becoming increasingly complex due to an aging population with increasing rates of medical comorbidities and obesity. Complications are therefore common, and impact not only the patient but can also cause distress to the OBGYN surgeon as a \"second victim\".
    OBJECTIVE: The objective of our study was to describe and quantify the range of impacts of complications on OBGYN surgeons and assess sociodemographic, clinician and practice factors associated with such impact.
    METHODS: A cross-sectional survey was developed based on interviews with OBGYNs and a review of the literature. The survey assessed OBGYN\'s demographic, clinical and practice characteristics, estimated number of complications per year, distress, physical and mental health, sleep, relationship impact caused by complications, and explored strategies OBGYNs used to cope with complications. Univariate logistic regression analyses were used to determine the association between OBGYNs characteristics, and complication consequences.
    RESULTS: Overall, of 727 survey respondents, 431 (61%) were female, 384 (55%) were 50 years or older, almost half had worked as OBGYN for 15 years or more (329 (45%)), and 527 (73%) usually complete fewer than 10 surgical procedures per week. Most (568 (78%)) reported fewer than three surgical complications per year, and most (472 (66%)) thought this was similar or less than their colleagues. Complications caused most stress when they resulted in poor patient outcomes (653 (90%)), had severe patient consequences (630 (87%)) or were a result of surgeon error (627 (86%)). Complications impacted the majority of OBGYN\'s wellbeing and sleep. A greater proportion of those younger than 50 years old reported that their mental wellbeing (32(10%), p=0.002) and sleep (130(42%), p=0.03) were affected when a complication occurred. Females were also more likely to report that their physical health (14(3%), p=<0.001), mental health (39(9%), p=0.01) and sleep (183(43%), p=<0.001) were affected. Current trainees (11(10%)) and surgeons with less than 15 years of experience (25(9%)) were more likely to experience mental wellbeing consequences when compared to surgeons of ≥15 years experience (12(4%))(p=0.01). Females reported less willingness to interact with colleagues when complications occurred (323(75%), p=0.006) and surgeons with less than 15 years of training were less likely to report comfort in talking (221(74%), p=0.03) and interacting with others (212(74%), p=0.02).
    CONCLUSIONS: The vast majority of OBGYN experience major impact on their health and wellbeing when one of their patients develops a complication. The degree and type of impact reported is similar to those experienced by other surgical specialties. Future studies are needed that test interventions to alleviate the significant impact and follow OBGYNs longitudinally to understand how long the impact of complications lasts.
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  • 文章类型: Journal Article
    惩教人员面临着广泛的工作场所暴力和由此产生的过度劳累,这可能会严重损害他们的身心健康。
    本研究旨在调查过度劳累在劳教人员中工作场所暴力与身心健康问题表现之间的关系中的中介作用。
    本研究招募了472名符合条件的参与者。横断面数据使用中文版工作场所暴力量表(WVS)获得,同时通过相关量表评估惩教人员的身心健康。分析涉及描述性统计,相关分析,和中介模型的测试。
    研究发现工作场所暴力之间存在显著相关性,过度劳累,和各种心理健康变量(抑郁症,焦虑,压力,自杀意念,和失眠),相关性在0.135到0.822之间(p<0.01)。中介分析显示,工作场所暴力直接影响惩教人员的身心健康(p<0.001),也通过过度劳累产生间接影响(p<0.023)。这些发现强调了工作场所暴力对惩教人员健康的重大影响,直接和间接。
    工作场所暴力和过度劳累极大地加剧了惩教人员面临的身心健康挑战。过度劳累在工作场所暴力与这些健康问题之间的关系中起着中介作用。该研究建议通过增加惩教人员的人数来解决工作场所暴力和心理健康问题,改善工作环境,并实施增强的福利政策。
    UNASSIGNED: Correctional officers face widespread workplace violence and the resulting overwork that can profoundly damage their physical and mental health.
    UNASSIGNED: This study aims to investigate the mediating role of overwork in the relationship between workplace violence and the manifestation of physical and mental health issues among correctional officers.
    UNASSIGNED: This study enlisted 472 eligible participants. Cross-sectional data were obtained using the Chinese version of the Workplace Violence Scale (WVS), while the physical and mental health of correctional officers was evaluated through relevant scales. Analysis involved descriptive statistics, correlation analyses, and tests for mediation models.
    UNASSIGNED: The study found significant correlations between workplace violence, overwork, and various mental health variables (depression, anxiety, stress, suicidal ideation, and insomnia), with correlations ranging from 0.135 to 0.822 (p < 0.01). Mediation analysis revealed that workplace violence directly impacts correctional officers\' physical and mental health (p < 0.001) and also has an indirect effect through overwork (p < 0.023). These findings underscore the substantial impact of workplace violence on the health of correctional officers, both directly and indirectly.
    UNASSIGNED: Workplace violence and overwork significantly contribute to the physical and mental health challenges faced by correctional officers. Overwork acts as a mediator in the relationship between workplace violence and these health issues. The study suggests addressing workplace violence and mental health issues among correctional officers by increasing their numbers, improving the work environment, and implementing enhanced welfare policies.
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  • 文章类型: Journal Article
    目的:本研究调查了正念自我同情计划的影响,基于沃森的人类关怀模型理论,护理专业学生的身心健康。护理的本质是关怀和同情。虽然有关于护理中的同情心的研究,护士的自我同情在文献中是一个被低估的概念。
    方法:这项研究采用了随机对照设计,并在2021年12月至2022年6月期间,来自土耳其一所大学的80秒级护理学生参加了研究。干预小组接受了一个在线计划,包括六个每周的课程,而对照组未接受任何干预。数据是使用促进和保护健康行为量表收集的,沃森明爱自我评价评分,简短的弹性量表,和自我同情量表之前,在结束时,5个月后的计划。
    结果:在后测和后续测试中,干预组表现出促进健康和保护行为的增加,自我护理感知,心理韧性,与对照组相比,自我同情。
    结论:因此,建议使用该计划来改善护理实践领域个人的身心健康。此外,将该计划纳入护理教育课程将是有益的。我们的发现提供了支持护理学生和护士使用该计划的证据。
    OBJECTIVE: This study investigated the impact of the Mindful Self-Compassion Program, based on Watson\'s Theory of Human Caring Model, on the physical and mental health of nursing students. The essence of nursing is care and compassion. While there are studies on compassion in nursing care, nurses\' self-compassion is an underrecognized concept in the literature.
    METHODS: The study employed a randomized controlled design and involved 80 seconds-grade nursing students from a university in Turkey between December 2021 and June 2022. The intervention group received an online program consisting of six weekly sessions, while the control group did not receive any intervention. The data were collected using the Promotive and Protective Health Behaviors Scale, Watson Caritas Self-Rating Score, Brief Resilience Scale, and Self-Compassion Scale before, at the end of, and 5 months after the program.
    RESULTS: In both the post-test and follow-up test, the intervention group exhibited an increase in health-promoting and protective behaviors, self-care perception, psychological resilience, and self-compassion compared to the control group.
    CONCLUSIONS: Therefore, it is recommended to use the program to improve the physical and mental health of individuals in nursing practice areas. Additionally, it would be beneficial to include the program in the nursing education curriculum. Our findings provide evidence supporting the use of the program for nursing students and nurses.
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  • 文章类型: Journal Article
    研究背景:在终末期肾病患者中,营养不良与较低的生活质量(QoL)和较低的生存率密切相关。然而,肾移植对营养因素和生活质量的影响尚不清楚。因此,本研究旨在评估肾移植受者(KTRs)的QoL变化,并探讨其与营养因素的关系.材料和方法一项纵向研究包括86名年龄在18-65岁之间的透析患者,他们接受了原发性肾移植(KTx)并随访了一年。体重,生化参数,收集移植前(T0)和移植后6个月(T6)和12个月(T12)的QoL数据。使用效应大小(ES)来测量从T0到T12的KTx对QoL和营养状况的影响。用β系数计算QoL的预测因子,线性回归p<0.05。结果移植对KTRsQoL的影响较大,在1.1为健康变化,0.9为身体健康,一年以上的心理健康(MH)和中度(0.7)。血红蛋白和营养不良受KTx影响,ES分别为2.4和0.6。线性回归分析显示,血红蛋白(β=0.12,p<0.01)可预测身体健康,磷(β=7.82,p<0.05),和霉酚酸酯(MMF)的剂量(β=-0.01,p<0.05)。肥胖可预测心理健康(β=-7.63,p<0.05),血红蛋白(β=0.11,p<0.05),磷(β=8.49,p<0.01)。营养风险指数(NRI)评分(β=0.47,p<0.05)显示健康变化,总胆固醇(β=3.39,p<0.01),和肾功能(β=0.15,p<0.05)。结论从终末期肾脏疾病到移植的转变对QoL和营养指标有积极影响。营养状况,肾功能,霉酚酸酯的剂量是KTR中QoL的重要决定因素。
    Background Malnutrition is strongly associated with lower quality of life (QoL) and lower survival rates in patients with end-stage kidney disease. However, the impact of renal transplantation on nutrition factors and QoL is unclear. Therefore, this study aims to assess changes in QoL and investigate the relationships with nutrition factors among kidney transplant recipients (KTRs). Materials and methods A longitudinal study included 86 dialysis patients aged 18-65 years who underwent primary kidney transplantation (KTx) and were followed up for one year. Body weight, biochemical parameters, and QoL data were collected before transplantation (T0) and at six months (T6) and 12 months (T12) post-transplantation. Effect size (ES) was used to measure the impact of KTx on QoL and nutritional status from T0 to T12. The predictors of QoL were calculated with β-coefficients and p<0.05 in linear regression. Results The ES of transplantation on the QoL of KTRs was large, at 1.1 for health change, 0.9 for physical health, and moderate (0.7) for mental health (MH) over one year. Hemoglobin and malnourished were affected by KTx, with ES being 2.4 and 0.6, respectively. Linear regression showed that physical health was predicted by hemoglobin (β=0.12, p<0.01), phosphorus (β=7.82, p<0.05), and dose of mycophenolate mofetil (MMF) (β=-0.01, p<0.05). Mental health was predicted by obesity (β=-7.63, p<0.05), hemoglobin (β=0.11, p<0.05), and phosphorus (β=8.49, p<0.01). Health change was indicated by nutritional risk index (NRI) score (β=0.47, p<0.05), total cholesterol (β=3.39, p<0.01), and kidney function (β=0.15, p<0.05). Conclusions The transition from end-stage kidney disease to transplantation has positive impacts on QoL and nutrition markers. Nutritional status, kidney function, and the dose of mycophenolate mofetil are significant determinants of QoL in KTRs.
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  • 文章类型: English Abstract
    BACKGROUND: COVID-19 affected both the physical and mental health of frontline nurses and the stability of the nursing workforce.
    OBJECTIVE: This study was designed to explore the influence of demographic variables, physical and mental health status, perceived work stress, and job satisfaction on intention to continue working as nurses among nursing staff who had been infected by COVID-19.
    METHODS: In this cross-sectional study, an internal online survey was used to collect data from 152 nurses at a hospital in southern Taiwan. The questionnaires in the survey included the Chinese Health Survey Scale, Stress Scale on COVID-19 Patient Care, McCloskey/ Mueller Satisfaction Scale, and Employee Retention Scale. Data analysis was conducted using SPSS/Windows 22.0.
    RESULTS: The most significant predictors identified included age, seniority, level of education, job satisfaction, physical and mental wellbeing, and work stress. These predictors collectively explained 32% of the total variance in retention willingness (F [18,128] = 4.78, p < .001). Almost half (46.7%; 71/152) of the participants expressed intent to continue working in nursing. Being a senior staff and having a master\'s degree or higher were positively associated with retention.
    CONCLUSIONS: The findings may be referenced by healthcare organizations and managers to help healthcare staff gain strength and resilience against future pandemics. Key recommendations include reducing staff work stress, increasing job satisfaction, and facilitating a more equitable life-work balance.
    BACKGROUND: 曾確診COVID-19護理師留任意願重要預測因子之探討.
    UNASSIGNED: 感染COVID-19影響第一線護理師的身心健康和護理人力的穩定性。.
    UNASSIGNED: 探討南台灣醫院確診過COVID-19護理師留任意願的重要預測因子。.
    UNASSIGNED: 採取橫斷式研究設計,經南部一家醫院倫理委員會審核後通過,再經相關單位主管同意由院內系統通知同仁進行網路問卷調查152位護理師。採用「華人健康調查量表」、「醫院員工照顧COVID-19病人壓力量表」、「穆勒-麥克勞斯基工作滿意度量表」及「留任意願量表」結構式問卷,以SPSS/ Windows 22.0版軟體程式進行統計分析。.
    UNASSIGNED: 在醫院防疫過程中,年齡、教育程度、身心健康、工作滿意度及工作壓力為曾確診COVID-19護理師留任意願之重要預測因子,可解釋留任意願總變異量32%,F(18,128) = 4.78, p < .001。曾確診COVID-19護理師46.7%(71/152)有留任意願,資深、大學以上之護理師留任意願較高。.
    UNASSIGNED: 本研究結果能提供醫療機構及主管訊息,在傳染病防疫期間護理師受到感染後,可安排放鬆訓練與休閒活動,使生活與工作能達到平衡,讓護理師在面對新興傳染病散播衝擊時更有韌性,願意繼續留在工作崗位。.
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  • 文章类型: Journal Article
    非正式护理的负担代表了非正式护理者(IC)的慢性压力源。该研究调查了在COVID-19之前和期间,ICs与非非正式护理人员的身心健康差异。
    我们使用2019/2020年行为危险因素监测系统(BRFSS)的数据调查了在COVID-19国家紧急声明(NED)之前和之后,与非非正式护理人员相比,ICs的身体和心理健康不良天数的差异。一个倾向评分模型模拟了一个伪实验设计,将IC(“治疗”)与非非正式护理人员(“控制”)进行比较。差异回归模型估计了身体和心理健康不良天数的发生率比率,该比率是IC状态和护理提供时间的函数。
    共有44,583名受访者被确定为对非正式护理状况和关键社会人口统计学特征的有效回答。其中,6.24%(n=3073)是集成电路,与15365名非非正式护理人员相匹配。在匹配的样本中(n=18,848),与非非正式护理人员相比,ICs中身体健康不良天数的发生率高17%(p=0.003).与NED前时期相比,NED后身体健康不良天数的发生率低23%(p<0.001)。与非非正式护理人员相比,ICs中心理健康不良天数的发生率高44%(p<0.001),在NED之后进行调查的受访者中,与NED之前的受访者相比,心理健康不良天数的发生率高22%。从NED之前到之后,两组之间的身体和心理健康不良天数的发生率没有统计学上的显着差异。
    这些研究结果表明,需要在公共卫生限制所带来的益处与某些群体可能造成的心理健康负担之间取得平衡。包括IC,经历更高的负面心理健康结果。
    UNASSIGNED: The burden of informal caregiving represents a chronic stressor for the informal caregivers (ICs). The study investigates differences in the physical and mental health of ICs and that of non-informal caregivers before and during COVID-19.
    UNASSIGNED: We used data from the 2019/2020 Behavioral Risk Factor Surveillance System (BRFSS) to investigate differences in the rates of days of poor physical and mental health among ICs compared to non-informal caregivers before and after the COVID-19 National Emergency Declaration (NED). A propensity score model simulated a pseudo experimental design, comparing ICs (\"treated\") with non-informal caregivers (\"control\"). A difference-in-difference regression model estimated the incidence rate ratios for days of poor physical and mental health as a function of IC status and time of care provision.
    UNASSIGNED: A total of 44,583 respondents were identified with valid responses on informal caregiving status and key sociodemographic characteristics. Of those, 6.24% (n = 3073) were ICs, matched against 15,365 non-informal caregivers. In the matched sample (n = 18,848), the incidence rate for days of poor physical health among ICs was 17% (p = 0.003) higher compared to non-informal caregivers. The incidence rate for days of poor physical health was 23% (p < 0.001) lower in the post-NED compared to the pre-NED periods. The incidence rate for days of poor mental health was 44% (p < 0.001) higher among ICs compared to non-informal caregivers and 22% higher among respondents who took the survey post-NED compared to those who answered during the pre-NED period. No statistically significant differences were found between the two groups in their incidence rates for days of poor physical and mental health from the pre-to the post-NED period.
    UNASSIGNED: These findings suggest a need to balance between the benefits conferred by public health restrictions versus the mental health burden that may result among certain groups, including ICs, who experience higher negative mental health outcomes.
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  • 文章类型: Journal Article
    员工的健康状况不仅是员工自身的问题,也是公司和社会保持低医疗成本和高生产率的问题。
    在此分析中,使用了来自一家大公司四个运营地点的2319名员工的15574项观察结果。数据集包含从年度强制性体检中获得的身体和精神健康状况,简短的工作压力问卷(BJSQ),和工作记录信息。分析了与长期旷工(一个季度超过三天)有关的健康和其他因素。数据是在2021年2月至2022年1月之间收集的,我们将其转换为季度观察。在分析中使用logit(逻辑回归)模型。
    年龄和性别被确定为重要的基本特征。对这些变量的估计是正的和负的,在1%的水平上是显著的。在从体检中获得的变量中,舒张压的估计值,HbA1c,回忆,心脏病史,吸烟,体重增加,饮酒频率在1%的水平上是积极和显著的,另外,服用抗高血压药物和有肾脏疾病史的患者在5%水平为阳性且显著.相比之下,收缩压和饮酒量的估计值为负,且在1%时显著.服用抗高血糖药物和健康指南的估计值在5%的水平上是阴性和显着的。在从BJSQ获得的变量中,对感觉到的工作量的估计,疲劳和家人和朋友的支持在1%是积极的,显著的,对刺激的估计在5%水平是阳性和显著的。对控制工作和身体投诉的估计在1%的水平上是负面和显著的,和那些使用员工的工作能力和工作的适宜性在5%的水平上是负面的和显著的。由于四个作业地点均位于日本东北部地区(冬季寒冷多雪),在1%的水平上,季节性影响显著。年份的影响也是显着的,并且在1%的水平上观察到站点之间的显着差异。
    一些身心健康状况与长期缺勤密切相关。通过改善这些条件,公司可以减少员工缺勤天数。由于替代员工及其维持运营的培训成本,旷工对公司来说代价高昂,雇主必须关注不断上升的医疗保健(直接和间接)成本,并实施投资以改善员工的健康状况。
    这项研究的结果仅基于一家公司,数据集是观察站。员工主要是在建筑物内工作的操作员,其中大多数人都很健康。因此,样本选择偏差可能存在,结果不能推广到其他类型的工作,工作条件,或公司。由于日本大多数公司都必须进行体检和BJSQ,本研究的框架可以应用于其他公司。虽然我们使用了BJSQ结果,更好的心理措施可能存在。对不同的公司进行类似的分析是必要的。
    Employees\' health conditions are issues for not only employees themselves but also companies and society to keep medical costs low and productivity high.
    In this analysis, 15,574 observations from 2,319 employees at four operational sites of a large corporation were used. The dataset contained physical and mental health conditions obtained from annual mandatory medical checkups, the Brief Job Stress Questionnaire (BJSQ), and work record information. Health and other factors related to long-term absenteeism (over three days in a quarter) were analyzed. Data were collected between February 2021 and January 2022, and we converted into quarterly observations. A logit (logistic regression) model was used in the analysis.
    Age and gender were identified as important basic characteristics. The estimates for these variables were positive and negative and significant at the 1% level. Among the variables obtained from the medical checkups, the estimates for diastolic blood pressure, HbA1c, anamnesis, heart disease history, smoking, increased weight, and frequency of alcohol consumption were positive and significant at the 1% level, further those for taking antihypertensive medications and kidney disease history were positive and significant at the 5% level. In contrast, the estimates for systolic blood pressure and amount of alcohol consumption were negative and significant at the 1% level. The estimate for taking antihyperglycemic medications and health guidelines were negative and significant at the 5% level. Among the variables obtained from the BJSQ, the estimates for amount of work felt, fatigue and support from family and friends were positive and significant at the 1%, and the estimate for irritation was positive and significant at the 5% level. The estimates for controlling job and physical complaints were negative and significant at the 1% level, and those for usage of employee\'s ability to work and suitability of the work were negative and significant at the 5% level. As all four operational sites were located in the northeastern region of Japan (cold and snowy in winter), the seasonal effects were significant at the 1% level. The effect of year was also significant and significant differences were observed among the sites at the 1% level.
    Some physical and mental health conditions were strongly associated with long-term absenteeism. By improving these conditions, corporations could reduce the number of employee absence days. As absenteeism was costly for corporations due to replacement employees and their training costs to maintain operations, employers must be concerned about rising healthcare (direct and indirect) costs and implement investments to improve employees\' health conditions.
    This study\'s results were based on only one corporation and the dataset was observatory. The employees were primarily operators working inside the building and most of them are healthy. Therefore, the sample selection biases might exist, and the results cannot be generalized to other types of jobs, working conditions, or companies. As medical checkups and the BJSQ are mandatory for most companies in Japan, the framework of this study can be applied to other companies. Although we used the BJSQ results, better mental measures might exist. Similar analyses for different corporations are necessary.
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  • 文章类型: Journal Article
    我们进行了范围审查,以确定当前胎儿酒精谱系障碍(FASD)诊断标准之外的因素,作为整体评估过程的一部分。这包括物理,社会,文化,心理健康和福祉因素,以提供有针对性的建议和支持,以改善FASD患者的预后。此次审查的证据将用于为《澳大利亚FASD诊断指南》的修订提供信息。搜索了六个电子数据库。如果研究包括涵盖形态学畸形的诊断标准之外的因素,生长限制,神经发育障碍。进行了数据图表和内容分析以综合结果。纳入了121项研究,涉及12个关键领域,包括身体健康,睡眠,不良的产后经历,物质使用/其他冒险行为,与刑事司法系统的联系,心理健康,第一民族的文化考虑,过渡到成人角色,参与家庭外护理系统,喂养和进食,优势/兴趣/外部资源和失禁。被视为整体评估和诊断过程的一部分的领域跨越个人,家庭,和系统级因素。结果为临床医生提供了可能影响长期健康的广泛因素的指导。发展,以及产前酒精暴露和FASD患者的健康。在实践中,本指南可用于为个性化评估过程提供信息,以促进量身定制的建议和支持,从而最好地满足与FASD生活在一起的个人及其家人的复杂需求。
    We undertook a scoping review to identify the factors outside of current fetal alcohol spectrum disorder (FASD) diagnostic criteria to be considered as part of a holistic assessment process. This included physical, social, cultural, mental health and wellbeing factors to inform targeted recommendations and supports to improve outcomes for individuals with FASD. Evidence from this review will be used to inform the revision of the Australian Guide to the Diagnosis of FASD. Six electronic databases were searched. Studies were eligible if they included factors outside of the diagnostic criteria that cover dysmorphology, growth restriction, neurodevelopmental impairments. Data charting and content analysis were performed to synthesize the results. One hundred twenty-one studies were included that spanned 12 key areas These included physical health, sleep, adverse postnatal experiences, substance use/other risk-taking behaviors, contact with the criminal justice system, mental health, First Nations cultural considerations, transition to adult roles, involvement with the out-of-home care system, feeding and eating, strengths/interests/external resources and incontinence. Areas to be considered as part of a holistic assessment and diagnostic process spanned individual, family, and system level factors. Results provide guidance for clinicians on the wide range of factors that could influence long-term health, development, and wellbeing for individuals with prenatal alcohol exposure and FASD. In practice, this guidance can be used to inform an individualized assessment process to facilitate tailored recommendations and supports to best meet the complex needs of individuals living with FASD and their families.
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  • 文章类型: Journal Article
    背景:他汀类药物是主要的降脂药物,通过控制其合成来降低血液胆固醇。副作用与他汀类药物的使用有关,特别是他汀类药物相关的肌肉症状(SAMS)。一些数据表明补充维生素D可以减少SAMS。
    目的:本研究的目的是在一项随机对照试验中评估补充维生素D的潜在益处。
    方法:男性(n=23)和女性(n=15)(50.5±7.7年[平均值±SD])在初级心血管预防中,自我报告或不SAMS,被招募。停用他汀类药物2个月后,患者被随机分配接受补充治疗(维生素D或安慰剂).补充1个月后,他汀类药物被重新引入。在重新引入药物之前和之后2个月,测量肌肉损伤(肌酸激酶和肌红蛋白)。力(F),腿部伸肌(ext)和屈肌(fle)的耐力(E)和力量(P)以及握力(FHG)也用等速和手持式测力计进行了测量,分别。采用简短表格36健康调查问卷(SF-36)和视觉模拟量表(VAS)评估参与者自我报告的健康相关生活质量和SAMS强度,分别。重复测量分析用于调查时间的影响,补充,和他们的互动,根据SAMS的存在。
    结果:尽管客观指标没有变化,重新引入他汀类药物后主观测量恶化,独立于补充(VAS,SF-36心理成分评分,所有p<0.05)。然而,对于任何变量,没有观察到时间和根据SAMS存在的补充之间的相互作用.
    结论:补充维生素D似乎不能缓解SAMS。
    BACKGROUND: Statins are the leading lipid-lowering drugs, reducing blood cholesterol by controlling its synthesis. Side effects are linked to the use of statins, in particular statin-associated muscle symptoms (SAMS). Some data suggest that vitamin D supplementation could reduce SAMS.
    OBJECTIVE: The purpose of this study was to evaluate the potential benefits of vitamin D supplementation in a randomized controlled trial.
    METHODS: Men (n = 23) and women (n = 15) (50.5 ± 7.7 years [mean ± SD]) in primary cardiovascular prevention, self-reporting or not SAMS, were recruited. Following 2 months of statin withdrawal, patients were randomized to supplementation (vitamin D or placebo). After 1 month of supplementation, statins were reintroduced. Before and 2 months after drug reintroduction, muscle damage (creatine kinase and myoglobin) was measured. Force (F), endurance (E) and power (P) of the leg extensors (ext) and flexors (fle) and handgrip strength (FHG) were also measured with isokinetic and handheld dynamometers, respectively. The Short Form 36 Health Survey (SF-36) questionnaire and a visual analog scale (VAS) were administrated to assess participants\' self-reported health-related quality of life and SAMS intensity, respectively. Repeated-measures analysis was used to investigate the effects of time, supplementation, and their interaction, according to the presence of SAMS.
    RESULTS: Despite no change for objective measures, subjective measures worsened after reintroduction of statins, independent of supplementation (VAS, SF-36 mental component score, all p < 0.05). However, no interaction between time and supplementation according to the presence of SAMS was observed for any variables.
    CONCLUSIONS: Vitamin D supplementation does not appear to mitigate SAMS.
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  • 文章类型: Journal Article
    这项研究的重点是异质性,互动,以及中国老年人身心健康轨迹发展的不平衡。
    本研究使用的数据来自2011年至2018年进行的中国健康与退休纵向研究(CHRLS)的四波浪潮。采用多维生长混合模型(MGMM)来分析同时发生的身心健康发展的模式和特征。此外,进行了多项逻辑回归分析,以系统地研究预测身心健康联合轨迹的因素。
    研究结果揭示了存在四种不同的潜在类型的身体和心理健康的联合轨迹。这些类别分为:“身体和心理健康恶化”,\'身体疾病增加和低心理脆弱性维持\',\'低身体和心理脆弱性维持\',和“高身体疾病增加和心理健康中度稳定”。此外,人口特征,社会经济地位,家庭-社会关系,健康行为,和制度因素被发现显着预测这些潜在的类别。
    该研究强调了中国老年人群身心共同发展健康问题的多样性和复杂性。这些发现对于考虑到老年人经历的独特健康变化的有针对性的干预策略的制定具有重要意义。此外,它们可以作为建立全面长期护理系统的证据。
    UNASSIGNED: This study focuses on the heterogeneity, interaction, and imbalance in the concurrent development of physical and mental health trajectories among Chinese elderly.
    UNASSIGNED: The data used in this study are from four waves of the China Health and Retirement Longitudinal Study (CHRLS) conducted between 2011 and 2018. A multidimensional growth mixture model (MGMM) was employed to analyze the patterns and characteristics of co-occurring physical and mental health development. Additionally, multinomial logistic regression analysis was conducted to systematically investigate the factors that predict the conjoint trajectories of physical and mental health.
    UNASSIGNED: The study findings reveal the presence of four distinct latent classes of conjoint trajectories for physical and mental health. These classes are categorized as follows: \'physical and mental health deteriorating\', \'physical disease increasing & low mental vulnerability maintaining\', \'low physical & mental vulnerability maintaining\', and \'high physical disease increased & mental health moderate-stable\'. Furthermore, demographic characteristics, socioeconomic status, family-society relations, health behaviors, and institutional factors were found to significantly predict these latent classes.
    UNASSIGNED: The study emphasizes the diversity and complexity of physical and mental co-occurring developmental health issues in the elderly population in China. These findings have significant implications for the development of targeted intervention strategies that take into account the unique health changes experienced by older adults. Additionally, they can serve as evidence for the establishment of a comprehensive long-term care system.
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