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Purpose: To investigate the effects of nonpharmacological interventions (NPIs) on poststroke depression (PSD) in stroke patients. Methods: Computer searches were conducted on the PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and Wanfang databases from their establishment to December 2023. The selection was made using the inclusion and exclusion criteria, and 40 articles were included to compare the effects of the 17 NPIs on patients with PSD. Results: Forty studies involving seventeen interventions were included. The network findings indicated that compared with conventional therapy (COT), superior PSD improvement was observed for cognitive behavioral therapy (CBT) + acupoint acupuncture (CBTA) (mean difference [MD], -4.25; 95% CI, -5.85 to -2.65), team positive psychotherapy (MD, -4.05; 95% CI, -5.53 to -2.58), music therapy (MT) + positive psychological intervention (MD, -2.25; 95% CI, -3.65 to -0.85), CBT (MD, -1.52; 95% CI, -2.05 to -0.99), mindfulness-based stress reduction (MD, -1.14; 95% CI, -2.14 to -0.14), MT (MD, -0.95; 95% CI, -1.39 to -0.52), acupoint acupuncture + MT (AAMT) (MD, -0.69; 95% CI, -1.25 to -0.14). Furthermore, CBT (MD, -3.87; 95% CI, -4.57 to -3.17), AAMT (MD, -1.02; 95% CI, -1.41 to -0.62), acupressure + MT (MD, -0.91; 95% CI, -1.27 to -0.54), and narrative care + acupressure (MD, -0.74; 95% CI, -1.19 to -0.29) demonstrated superior Pittsburgh Sleep Quality Index (PSQI) improvement compared with COT. Conclusion: Evidence from systematic reviews and meta-analyses suggests that CBTA improves depression in patients with PSD. Moreover, CBT improves sleep in these patients. Additional randomized controlled trials are required to further investigate the efficacy and mechanisms of these interventions.
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BACKGROUND: Data on multiple consecutive healthcare-associated infections (HAIs) in patients undergoing extracorporeal membrane oxygenation (ECMO) are limited. We aim to identify the characteristics and outcomes of multiple, consecutive HAIs. METHODS: This retrospective cohort study included adult patients who underwent ECMO in a single cardiac intensive care unit in China from May 2015 to December 2022. The incidence, clinical characteristics, risk factors, and impact on in-hospital mortality were analyzed among patients with non-HAI, single HAI, and multiple HAIs. The pathogens and sites of each new episode of infection were evaluated and compared. RESULTS: Of 192 patients, 92 (47.92%) developed 141 separate infections, with 41 (21.35%) experiencing multiple infections during a single ECMO period. Respiratory tract infections (RTIs) constituted the majority (75.89%), and Gram-negative bacteria were the predominant pathogens (71.63%). The proportion of RTIs decreased from 86.9% in the first infection episode to 14.3% in the third (p < 0.001), while bloodstream infections increased from 10.9% to 57.1% (p < 0.001). Furthermore, from the first to the third HAI, the proportion of Gram-positive bacteria increased from 9.8% to 42.9% (p = 0.032). Prolonged ECMO duration was the only independent risk factor for multiple consecutive HAI (OR = 1.220; p < 0.001). CONCLUSIONS: The frequency of consecutive multiple HAIs during ECMO support was high, with distinct microbiological changes between initial and subsequent HAIs.
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Introduction: In the context of the digital economy, the emergence and application of emerging technologies have accelerated the integration of traditional social structures with new technologies, leading to the inception of the "Future Community" as an innovative urban unit. With an aging population's rapid and sustained rise, integrating health care for older adults with modern information technology is gradually moving towards holistic governance. This approach utilizes the Future Community as a medium and aims for quality enhancement and increased efficiency, which instrumentally addresses the diversified health care needs of China's aging era. Methods: In this study, we employed a questionnaire survey method that covered 11 communities in Tianjin City to understand better the current status and characteristics of their health care services. Results: The survey results show that the means of community health care for older adults are gradually being upgraded, and the demands are shifting. Then, we arrive at three conclusions: firstly, technological innovation and smart approaches have the potential to positively influence the quality of health care in these communities. Secondly, allocating health care resources within communities can have a salutary effect on the psychological well-being of seniors. Thirdly, actively involving seniors in community life and governance can elevate their self-worth. Discussion: At last, in conjunction with current challenges, we think that deepening multi-party collaboration, educating specialized talents, and bridging the "digital gap" would be effective ways to establish a future community for seniors.