Application of models of behavior change communication in various stages of healthcare

A resource-limited country like India calls for a deeper focus on preventive health than it is now. So far, behaviour change communication (BCC) has been more or less limited to campaigns and awareness activities. Treating physicians applying BCC interventions in their clinics is particularly rare. This article aims to describe the role of BCC at the primary healthcare level in preventing diseases. The article also attempts to highlight the importance of BCC in helping cure and rehabilitate patients. Evidence-based interventions can be derived from BCC models that help physicians handle their patients better. Health education an already defined domain of health promotion will be the key to achieving the said goal. It promises to be one of the cheap and effective tools in achieving the vision of universal healthcare. It provides room for flexibility and customised care for each patient. After a thorough understanding of various models and theories of BCC, a physician should be able to apply them on a regular basis in their day-to-day interaction with patients in the most scientific manner possible.

Evaluating the performance of ChatGPT in preventive and social medicine in medical university examination

Artificial Intelligence (AI) for community health holds transformative potential, offering data-driven insights, virtual health advisories, and efficient resource allocation for improved healthcare outcomes and population well-being. This study evaluates the potential of ChatGPT 3.5, an AI language model, in preventive and social medicine. Using medical exam questions, ChatGPT demonstrated commendable understanding, scoring 62% and 65% in Paper 1 and Paper 2, respectively. While promising for medical education and public health, caution is advised due to occasional inaccuracies, ethical considerations, and the model's inability to replace human expertise. Refinement efforts are crucial for harnessing ChatGPT's full potential in enhancing medical education and positively impacting public health outcomes. Further research should focus on real-world applications and addressing limitations for responsible integration.

Controversies in the diagnosis and treatment of acute lateral ankle sprains / 国际外科学杂志

Acute lateral ankle sprains are the most common musculoskeletal injury of the lower limbs. Without timely intervention, the condition may progress to chronic ankle instability, leading to a series of adverse consequences. Therefore, accurate diagnosis, classification, and active intervention are essential. Currently, there are numerous diagnostic methods, classification criteria, and treatment methods for acute lateral ankle sprains in clinical practice, with some aspects still subject to debate. This article will provide an overview of the progress and controversial issue in diagnosis, classification, and treatment methods for acute lateral ankle sprains.

Asociación del riesgo a desarrollar diabetes mellitus tipo 2 según la calculadora de la asociación americana de diabetes (ADA) y los hábitos tóxicos no ilícitos en pacientes que residen en una comunidad rural de Peravia, República Dominicana / Association of the risk of developing type 2 diabetes mellitus according to the American Diabetes Association (ADA) calculator and non-illicit toxic habits in patients residing in a rural community in Peravia, Dominican Republic

Introducción: la diabetes mellitus tipo 2 (DM2) se define como un trastorno metabólico caracterizado por niveles de glucosa en sangre crónicamente elevados. La DM2 representa el paradigma de las enfermedades crónicas en las que existe una estrecha asociación entre factores familiares y ambientales. Por este motivo, este estudio tiene como finalidad determinar la asociación del riesgo a desarrollar DM2 y los hábitos tóxicos no ilícitos en pacientes que residen en una comunidad rural de Peravia, República Dominicana. Tales incluyen: alcohol, café y té. Metodología: Estudio observacional, transversal, analítico y prospectivo. Se aplicó cuestionario, recolectaron datos antropométricos y se determinó glucosa capilar a la muestra (n=304). Resultados: la prevalencia a presentar un alto riesgo a desarrollar DM2 en la población es de 35.5%, mientras que la prevalencia a presentar riesgo bajo es de 64.5%. En cuanto a hábitos tóxicos, no existió correlación positiva entre consumo de té y desarrollo de DM2. Sin embargo, sí entre el consumo de café y alcohol. Conclusiones: los habitantes de salinas presentan un bajo riesgo a desarrollar DM2, pero utilizan factores de riesgos modificables que aumentan la prevalencia a DM2.

Introduction: Type 2 diabetes mellitus (DM2) is defined as a metabolic disorder characterized by chronically elevated blood glucose levels. DM2 represents the paradigm of chronic diseases in which there is a close association between family and environmental factors. Therefore, the purpose of this study is to determine the association of the risk of developing DM2 and non-illicit toxic habits in patients residing in a rural community in Peravia, Dominican Republic. Such habits include alcohol, coffee and tea. Methodology: Observational, cross-sectional, analytical and prospective study. A questionnaire was applied, anthropometric data was collected, and capillary glucose was determined in the study sample (n=304). Results: the prevalence of presenting a high risk of developing DM2 in the population is 35.5%, while the prevalence of presenting low risk is 64.5%. Regarding toxic habits, there was no positive correlation between tea consumption and the development of DM2. However, this result differed between consumption of coffee and alcohol. Conclusions: the inhabitants of Salinas have a low risk of developing DM2 but are subject to modifiable risk factors that increase said prevalence.

Impacto da suplementação nutricional na disfunção entérica ambiental (DEA) em crianças que vivem em áreas rurais: uma revisão sistemática / Impact of nutritional supplementation on environmental enteric dysfunction (eed) in children living in rural areas: a systematic review

ABSTRACT Background: A staggering 99% of infant undernutrition mortality comes from Sub-Saharan Africa and South Asia. Despite multiple interventions focusing on nutrition adequacy, 2.7 million children worldwide remain associated with undernutrition-related mortality. The lack of impact from multiple interventions toward undernutrition reflects a strong reason to believe that EED is the missing link that sustains undernutrition in low-to-middle-income countries (LMICs). EED is a sub-clinical condition caused by repeated oral enteropathogenic and non-pathogenic fecal microbes exposure that causes intestinal villous malformation, multi-omics changes, chronic intestinal and systemic inflammation, and gut dysbiosis. EED impacts the absorptive capacity and the integrity of the gut, causing a cycle of undernutrition in children. There is currently no protocol for the diagnosis and treatment of EED, hence EED is widely believed to be highly prevalent and underdiagnosed in LMICs. Objective: To our knowledge, this is the first systematic review to study the impact of nutritional interventions on EED. Previous studies yielded inconsistent results, hence the synthesis of this information is essential in attaining a deeper understanding of EED to formulate new targets of intervention against child undernutrition. Methods: This systematic review is registered to PROSPERO (CRD42022363157) in accordance to PRISMA, using keywords referring to nutrient supplementation, EED, and child growth failure. Results: Eleven articles were eligible for review, comprising randomized controlled trials performed mainly in the African continent, with a total of 5689 healthy children eligible for analysis. Conclusion: The systematic review illustrates that nutritional interventions have a minimal impact on EED biomarkers and linear growth and reflects the importance of understanding better the mechanisms causing EED and its consequences. It appears that the anabolic contribution of nutrition intervention to child growth is negated by EED.

RESUMO Contexto: Um número impressionante de 99% da mortalidade por desnutrição infantil provém da África Subsaariana e do Sul da Ásia. Apesar de múltiplas intervenções focadas na adequação nutricional, 2,7 milhões de crianças em todo o mundo permanecem associadas à mortalidade relacionada à desnutrição. A falta de impacto de múltiplas intervenções em direção à desnutrição reflete uma forte razão para acreditar que a disfunção entérica ambiental (DEA) é o elo perdido que sustenta a desnutrição em países de baixa e média renda. A DEA é uma condição subclínica causada pela exposição repetida a micróbios fecais enteropatogênicos e não patogênicos por via oral, que causa malformação vilosa intestinal, alterações multiômicas, inflamação intestinal e sistêmica crônica, e disbiose intestinal. A DEA impacta a capacidade absortiva e a integridade do intestino, causando um ciclo de desnutrição em crianças. Atualmente, não existe protocolo para o diagnóstico e tratamento da DEA, portanto, acredita-se amplamente que a DEA seja altamente prevalente e subdiagnosticada em países de baixa e média renda. Objetivo: Até onde sabemos, esta é a primeira revisão sistemática para estudar o impacto das intervenções nutricionais na DEA. Estudos anteriores apresentaram resultados inconsistentes, portanto, a síntese dessas informações é essencial para obter uma compreensão mais profunda da DEA e formular novos alvos de intervenção contra a desnutrição infantil. Métodos: Esta revisão sistemática está registrada no PROSPERO (CRD42022363157) de acordo com o PRISMA, utilizando palavras-chave referentes à suplementação de nutrientes, DEA e falha no crescimento infantil. Resultados: Onze artigos foram elegíveis para revisão, compreendendo ensaios clínicos randomizados realizados principalmente no continente africano, com um total de 5689 crianças saudáveis elegíveis para análise. Conclusão: A revisão sistemática ilustra que as intervenções nutricionais têm um impacto mínimo nos biomarcadores da DEA e no crescimento linear, e reflete a importância de entender melhor os mecanismos que causam a DEA e suas consequências. Parece que a contribuição anabólica da intervenção nutricional para o crescimento infantil é negada pela DEA.

La medicina social y las ciencias sociales en América Latina: tensiones conceptuales para la transformación de la salud pública en el siglo XX / Social medicine and the social sciences in Latin America: conceptual tensions for the transformation of public health in the 20th century / Medicina social e ciências sociais na América Latina: tensões conceituais para a transformação da saúde pública no século XX

RESUMEN El desarrollo de la salud pública en América Latina durante el siglo XX combinó, desde el principio, el marco de la medicina social sobre los orígenes sociales, políticos y ambientales de la enfermedad con los aportes del trabajo de campo de la antropología médica. A pesar de la hegemonía del modelo médico, el surgimiento del marco de la medicina preventiva legitimó aún más la participación de los científicos sociales en el estudio de la multicausalidad de la enfermedad. Sin embargo, las limitaciones que trajo consigo la falta de contextualización histórica y política del modelo de la medicina preventiva dieron paso al movimiento latinoamericano de medicina social, basado en el materialismo histórico, y al desarrollo tanto de la epidemiología crítica como de la antropología médica crítica.

ABSTRACT The development of public health in Latin America during the 20th century combined, early on, the social medicine framework on the social, political, and environmental origins of disease with the contributions of medical anthropological fieldwork. Despite the hegemony of the medical model, the surge of the preventive medicine framework further legitimized the involvement of social scientists in the study of the multicausality of disease. However, the limitations brought by the preventive medicine model's lack of historical and political contextualization gave way to the Latin American social medicine movement, which was grounded in historical materialism, and the development of both critical epidemiology and critical medical anthropology.

RESUMO Desde o início, a evolução da saúde pública na América Latina ao longo do século XX combinou o marco teórico da medicina social sobre as origens sociais, políticas e ambientais das doenças com as contribuições derivadas do trabalho de campo da antropologia médica. Apesar da hegemonia do modelo médico, o surgimento do modelo de medicina preventiva legitimou ainda mais a participação dos cientistas sociais no estudo da multicausalidade das doenças. Entretanto, as limitações causadas pela falta de contextualização histórica e política do modelo de medicina preventiva abriram espaço para o movimento latino-americano de medicina social, fundamentado no materialismo histórico, e para o desenvolvimento da epidemiologia crítica e da antropologia médica crítica.

Countering COVID-19, dengue and their mutants, using evolved homeopathy

Experts anticipate that the world will be fighting COVID-19 virus for many years next. This implies that Teens, allergic and non-vaccinated people (those who are not getting adequate supply of Primary Vaccines/ Boosters) need to learn to “Live with COVID”, utilizing either of the two preventive methodologies presented here: one, principally based on vaccinations developed by Allopathy (conventional-medicine) and the other on Evolved-homeopathy. The preventive methodology of Evolved-homeopathy for Flu (which was developed about two decades before COVID-19 virus was born), and Allopathic vaccinations for COVID utilize the first fundamental-principle of cure (“Prevention is better than cure”). The second fundamental-principle of cure (“Nipping in the bud”) takes care, so that no organ-degeneration takes place. Those who take 100% effective Evolved-homeopathy preventive medicines for COVID, Dengue and their mutants, have been found to rarely require Evolved-homeopathy treatment medicines (except after missing the preventive medicine for several days), which is useful to prevent organ-degeneration and leads to health-promotion to near-zero disease-level as revealed from organ wise diagnostic-chart of GDV (Gas-Discharge-Visualization). It seems evident that COVID is dictating three conditions for “Living with COVID”, i.e., to employ (i) both first and second fundamental-principles of cure mentioned above; (ii) medicines that work like the best of Evolved-homeopathy treatment medicines, with a focus on health-promotion, for preventing organ-degeneration; (iii) the global vaccination-drive by making it foolproof utilizing the 100% effective Evolved-homeopathy medicines for preventing COVID from getting any breeding-ground among non-vaccinated people, to avoid developing formidable mutants that may defeat some vaccines/Boosters.

Impacto de la caracterización genómica en pacientes con atrofia muscular espinal no 5q / Impact of Genomic Characterization in Patients with Non-5q Spinal Muscular Atrophy / Impacto da caracterização genômica em pacientes com atrofia muscular espinhal não 5q

Resumen: La atrofia muscular espinal (AME) se define como un conjunto de trastornos neurodegenerativos hereditarios causantes de una variabilidad fenotípica y genotípica que genera un impacto sobre la calidad de vida, desarrollo psicosocial, emocional y funcional de quien la padece. En Colombia se considera una enfermedad huérfana con relación a su baja prevalencia, cronicidad y alta complejidad. El objetivo de este reporte de caso es describir, caracterizar y correlacionar fenotípica y genotípicamente un paciente con sospecha clínica de enfermedad neurodegenerativa. Se trata de una paciente femenina de 32 años de edad, con cuadro clínico consistente en equinismo, varismo, supinación del retropié, aducción del antepié derecho y limitación en muñecas con posterior debilidad y atrofia muscular predominantemente en miembros inferiores, arreflexia generalizada y signo de Gowers positivo. Ante sospecha de enfermedad neuromuscular progresiva degenerativa se solicitan estudios endocrinos, neuromusculares, cardiovasculares, biopsia de nervio sural y estudio genético. Los resultados arrojan biopsia de nervio sural con pérdida de axones con poca desmielinización, y estudio genómico secuenciación de exoma clínico trío realizado utilizando la tecnología Illumina con identificación de variantes con significado clínico patogénico en el gen NOD2 con cigosidad heterocigota y DYNC2H1 homocigota. Finalmente se realiza red de interacción génica mediante programa GeneMania determinando asociaciones génicas. Conclusión: el diagnóstico de AME representa un desafío debido a su amplia variabilidad fenotípica-genotípica, aunque en la mayoría de los pacientes se deben a variantes en el gen SMN1 existen otros genes no 5q asociados a esta patología, un diagnóstico específico impacta en el tratamiento, pronóstico y morbimortalidad atribuida, estableciendo riesgo de heredabilidad y consejería genética en aras de medicina preventiva, predictiva, personalizada y participativa.

Abstract: Spinal Muscular Atrophy (SMA) is defined as a set of hereditary neurodegenerative disorders that cause phenotypic and genotypic variability, impacting the quality of life, psychosocial, emotional, and functional development of those affected. In Colombia, it is considered a rare disease due to its low prevalence, chronicity, and high complexity. The objective of this case report is to describe, characterize, and correlate phenotypically and genotypically a patient with clinical suspicion of neurodegenerative disease. The patient is a 32-year-old female with a clinical picture of equinus, varus, supination of the hindfoot, adduction of the right forefoot, and limitation in wrists with subsequent weakness and predominantly lower limb muscle atrophy, generalized areflexia, and positive Gowers sign. Given the suspicion of progressive degenerative neuromuscular disease, endocrine, neuromuscular, cardiovascular studies, sural nerve biopsy, and genetic testing are requested. The results show sural nerve biopsy with axonal loss with little demyelination, and genomic study using trio clinical exome sequencing performed using Illumina technology with identification of pathogenic clinically significant variants in the Nod2 gene with heterozygous and DYNC2H1 gene with homozygous status. Finally, a gene interaction network is created using the GeneMania program, determining gene associations. The conclusion of this study was the diagnosis of Sma represents a challenge due to its wide phenotypic-genotypic variability. Although most patients are due to variants in the SmN1 gene, there are other non-5q genes associated with this pathology. A specific diagnosis impacts treatment, prognosis, and attributed morbidity and mortality, establishing heritability risk and genetic counseling for the sake of preventive, predictive, personalized, and participatory medicine.

Resumo: A atrofia muscular espinhal (AME) é definida como um conjunto de transtornos neurodegenerativos hereditários causadores de uma variabilidade fenotípica e genotípica que tem um impacto na qualidade de vida, desenvolvimento psicossocial, emocional e funcional daqueles que a têm. Na Colômbia, ela é considerada uma doença rara devido à sua baixa prevalência, cronicidade e alta complexidade. O objetivo deste relatório de caso é descrever, caracterizar e correlacionar fenotípica e genotipicamente um paciente com suspeita clínica de doença neurodegenerativa. Trata-se de uma paciente do sexo feminino, com 32 anos de idade, com quadro clínico consistente em equinismo, varismo, supinação do retropé, adução do antepé direito e limitação nos pulsos, com subsequente fraqueza e atrofia muscular predominantemente nos membros inferiores, arreflexia generalizada e sinal de Gowers positivo. Diante da suspeita de doença neuromuscular progressiva degenerativa, foram solicitados estudos endócrinos, neuromusculares, cardiovasculares, biópsia do nervo sural e estudo genético. Os resultados mostraram biópsia do nervo sural com perda de axônios com pouca desmielinização e estudo genômico de sequenciamento do exoma clínico trio realizado com tecnologia Illumina, identificando variantes com significado clínico patogênico no gene Nod2 com zigosidade heterozigota e DYNC2H1 homozigota. Finalmente, realizou-se uma rede de interação gênica mediante o programa GeneMania, determinando associações genéticas. Conclusão: O diagnóstico de AME representa um desafio devido à sua ampla variabilidade fenotípica-genotípica. Embora a maioria dos pacientes devem-se a variantes no gene SmN1, existem outros genes não 5q associados a essa patologia. Um diagnóstico específico impacta no tratamento, prognóstico e morbimortalidade atribuída, estabelecendo risco de hereditariedade e aconselhamento genético em prol da medicina preventiva, preditiva, personalizada e participativa.

Prevenção do câncer de colo uterino em homens transgênero: desafios e novas perspectivas de rastreio / Prevention of cervical cancer in transgender men: challenges and new screening perspectives

O homem transgênero apresenta alta susceptibilidade às neoplasias de colo uterino devido à escassez de exames preventivos. O estudo objetiva levantar informações acerca dos desafios e estratégias para a promoção do rastreio e prevenção do câncer cervical em homens transgênero. Trata-se de uma revisão integrativa, desenvolvida em seis etapas a partir da pergunta norteadora: "Quais os desafios e estratégias atuais para a promoção do rastreio efetivo e prevenção de câncer de colo uterino em homens transgênero?". Utilizaram-se descritores combinados com operador booleano "cervical cancer" AND "transgender persons", e foram incluídos artigos completos de 2018 a 2022. Verificou-se que os desafios enfrentados incluem preconceito, despreparo profissional e susceptibilidade à disforia de gênero. Estudos mostraram benefícios relacionados ao uso de swabs vaginais autocolhidos para reduzir o impacto psicológico do exame Papanicolaou, com vistas a reduzir os desafios enfrentados por essa população, e a necessidade de implementar estratégias que aumentem a adesão aos serviços de saúde.

Transgender men are highly susceptible to cervical cancer due to the lack of preventive screening exams. This study aims to gather information about the challenges and strategies for promoting cervical cancer screening and prevention in transgender men. This is an integrative review, developed in six stages, based on the guiding question: "What are the current challenges and strategies for promoting effective screening and prevention of cervical cancer in transgender men?". Descriptors combined with Boolean operator "cervical cancer" AND "transgender persons" were used and full articles from 2018 to 2022 were included. It was found that the challenges faced include prejudice, professional unpreparedness and susceptibility to gender dysphoria. Studies have shown benefits related to the use of self-collected vaginal swabs to reduce the psychological impact of the Pap smear exam, aiming to reduce the challenges faced by this population and to implement strategies to increase adherence to health services.

Asociación entre SARS-COV-2 y enfermedades crónicas en personal de salud. Un programa de medicina preventiva / Association between SARS-COV-2 and chronic diseases in health personnel. A preventive medicine program

RESUMEN Objetivo La infección por SARS-CoV-2 ha sido relacionada con hipertensión, obesidad y diabetes para riesgo de hospitalización y muerte. Con respecto a las enfermedades pulmonares obstructivas, la literatura es diversa; hay variación en la frecuencia de estas y por ende en su relación con la COVID-19. La evidencia disponible únicamente detalla a los pacientes hospitalizados, y es escasa la referida a trabajadores de la salud, por lo que el analizar las principales comorbilidades en este grupo resulta de ayuda para la implementación de programas preventivos. El objetivo de este estudio fue describir la prevalencia y la asociación de diversas comorbilidades con la infección por SARS-CoV-2 en trabajadores de la salud. Métodos Estudio transversal analítico, en trabajadores del principal centro de referencia nacional para enfermedades respiratorias de México, que acudieron a atención para descarte de infección por SARS-CoV-2 mediante un programa preventivo; para el tamaño de muestra se usó fórmula para cálculo de proporciones. Se analizaron medidas de resumen y asociación. Resultados La prevalencia de COVID-19 fue de 22,9 %. Las comorbilidades más frecuentes en cuanto a prevalencia fueron: sobrepeso (29,0 %), obesidad (13,2 %), tabaquismo (8,6 %), hipertensión (5,5 %), rinitis alérgica (3,9 %) y asma (2,8 %). El sobrepeso, la obesidad y la vacunación contra SARS-CoV-2 tuvieron razones de momios para prevalencia de 1,78, 1,72 y 0,43, respectivamente. Las personas vacunadas y con comorbilidades tienen menor duración de la enfermedad (p=0,001). Conclusiones La obesidad y el sobrepeso muestran asociación con SARS-CoV-2, la vacunación es un factor protector, sobre todo en aquellos pacientes con comorbilidades.

ABSTRACT Objective The SARS-CoV-2 infection has been linked to hypertension, obesity and diabetes as risks of hospitalization and death. Regarding obstructive pulmonary diseases, the scientific literature is diverse; finding variation in the frequency of these and therefore their relationship with COVID-19. The available evidence only details hospitalized patients, with insufficient information referring to health workers, so analyzing the main comorbidities in this group is helpful for the implementation and improvement of preventive programs. The objective of this study was to describe the prevalence and association of comorbidities with SARS-CoV-2 infection in health care workers. Methods Analytical cross-sectional study, in workers of the main national reference center for respiratory diseases in Mexico, who came to care to rule out SARS-CoV-2 infection through a preventive program; calculation of proportions was performed for the sample size. Summary and association measures were calculated. Results The prevalence of COVID-19 was 22.9 %. The most frequent comorbidities were: overweight obesity, smoking, hypertension, allergic rhinitis and asthma, with prevalences of 29.0 %, 13.2 %, 8.6 %, 5.5 %, 3.9%, 2.8 % respectively. Overweight, obesity and vaccination against SARS-CoV-2 had Prevalence Ratios of 1.78, 1.72 and 0.43 respectively. Conclusions Obesity and overweight show association with SARS-CoV-2; vaccination is a protective factor, especially in people with comorbidities.

Ambient Fine Particulate Matter Exposure and Blood Pressure: Evidence from a Large Chinese Multiple Follow-Up Study / 生物医学与环境科学（英文）

OBJECTIVE@#This study aimed to investigate the association of ambient PM2.5 exposure with blood pressure (BP) at the population level in China.@*METHODS@#A total of 14,080 participants who had at least two valid blood pressure records were selected from the China Health and Retirement Longitudinal Survey during 2011-2015. Their long-term PM2.5 exposure was assessed at the geographical level, on the basis of a regular 0.1° × 0.1° grid over China. A mixed-effects regression model was used to assess associations.@*RESULTS@#Each decrease of 10 μg/m3 in the 1 year-mean PM2.5 concentration (FPM1Y) was associated with a decrease of 1.24 [95% confidence interval (CI): 0.84-1.64] mmHg systolic BP (SBP) and 0.50 (95% CI: 0.25-0.75) mmHg diastolic BP (DBP), respectively. A robust association was observed between the long-term decrease in PM2.5 and decreased BP in the middle-aged and older population. Using a generalized additive mixed model, we further found that SBP increased nonlinearly overall with FPM1Y but in an approximately linear range when the FPM1Y concentration was < 70 µg/m3; In contrast, DBP increased approximately linearly without a clear threshold.@*CONCLUSION@#Efficient control of PM2.5 air pollution may promote vascular health in China. Our study provides robust scientific support for making the related air pollution control policies.

The Apparent Increase in Diabetes Mellitus in Habitual Spa-Bathers Is due to the Cancer Survival Effect of Spa-Bathing: A Cross-Sectional Study in Beppu / 日本温泉気候物理医学会雑誌

  In 2018, we reported an epidemiological study on disease-preventive effects of habitual hot spa-bathing in the elderly in Beppu city, which has the highest number of hot spring sources in the world. In this analysis, women with diabetes mellitus were observed more often as hot spa-bathers than non-spa-bathers [odds ratio (OR): 1.238, confidence interval (CI): 1.011-1.517]. To see whether there is an apparent harmful effect of spa-bathing, complicated background diseases of women with diabetes mellitus were investigated in this study. We compared background diseases of women complicated with diabetes mellitus in spa-bathers and non-spa-bathers. Compared with non-spa-bathers, female spa-bathers with diabetes mellitus revealed a higher occurrence of cancer history (OR: 2.626, CI 1.517-4.545). The occurrence of diabetes mellitus in women with no cancer history was not significantly different between habitual spa-bathers and non-spa-bathers (OR:1.041, CI 0.837-1.293). The observed odds ratios suggest that spa-bathing associated cancer surviving promotion leads to an increasing number of diabetic women with a past history of cancer and contributes to more women with diabetes mellitus in spa-bathers rather than habitual spa-bathing promoting the pathogenesis of diabetes mellitus.

Thinking of the cultivation mode of preventive medicine undergraduates based on student research training projects / 中华医学教育探索杂志

There are still some shortcomings in the training of preventive medicine undergraduates in China, such as outdated education mode, disjointed theory/practice, and lack of multi-dimensional integration. This paper proposes an attempt to reform the cultivation mode of preventive medicine undergraduates by combining student research training programs. However, many problems have been exposed during the implementation of the reform, and it has not achieved satisfactory results, especially in emergency management and solving practical problems. In order to cultivate practical preventive medicine talents in line with the needs of the times, the training mode based on student research training projects still needs considerable efforts in many aspects, including project approval, project guidance, project evaluation and so on.

Evaluation of teaching effect of opening experiments on occupational health and occupational medicine / 中华医学教育探索杂志

Objective:To carry out opening experiments on occupational health and occupational medicine for students majoring in preventive medicine, reform the experimental teaching mode, and explore the teaching methods to improve students' professional quality and scientific research ability.Methods:Opening experiments were carried out in the experimental course of occupational health and occupational medicine for students of preventive medicine major. A total of 147 students majoring in preventive medicine of Batch 2016 were classified as the control group, and the routine confirmatory experiment was carried out in the group; 176 students majoring in preventive medicine of Batch 2017 were classified as the experimental group, and this group carried out opening experiment. The evaluation was made from three aspects: comprehensive evaluation results, teacher self-evaluation and student satisfaction survey. SPSS 22.0 software was used for analysis and comparison by independent-samples t-test and Chi-square test. Results:The theoretical scores of the experimental group and the control group students were (84.37±10.45) vs. (81.44±9.22) ( t=2.68, P=0.008), and the experimental skills scores were (93.66±3.89) vs. (88.41±5.67) ( t=9.51, P<0.001). Questionnaire investigation showed that the students in the opening experimental group were more satisfied with the courses arrangement ( χ2=8.31, P=0.004), group cooperation ( χ2=21.10, P<0.001), assessment form ( χ2 =7.92, P=0.005), improvement of the writing ability of scientific research papers ( χ2 =17.56, P<0.001), improvement of practical skills ( χ2=11.70, P=0.001), logical thinking, language organization and expression ability ( χ2=10.33, P=0.001). They considered the opening experiment was helpful to cultivate innovative thinking and ability, but it had limited effect on the cultivation of employment advantages. And the students considered the opening experiments of setting up professional courses was sufficient and necessary. Conclusion:Carrying out opening experiments for students majoring in preventive medicine is helpful to improve students' professional quality and cultivate their practical ability and scientific research ability.

Analysis of enrollment of postgraduate students of public health and preventive medicine in China, 2022 / 中华医学教育探索杂志

Based on the information of China Postgraduate Admissions Information Network and the official website of the enrollment unit, this study statistically analyzed the enrollment of master's and doctoral students in the first-level discipline of public health and preventive medicine in China in 2022. The results showed a regional imbalance in the enrollment of postgraduate students of public health and preventive medicine, research fields to be further expanded, a lack of international top colleges or institutions for public health and preventive medicine postgraduate cultivation, a weakening phenomenon in the cultivation of postgraduates related to infectious disease prevention and control, and the interdiscipline to be further strengthened. It is suggested to pay attention to the regional balance in the enrollment of public health and preventive medicine postgraduate students; the research field of postgraduate enrollment in public health and preventive medicine should be further expanded; the high-level public health colleges constructed needs to attach importance to postgraduate enrollment and cultivation, and to balance infectious and non-infectious disease research; public health and preventive medicine should be combined with life science, biosafety/biosecurity, and social sciences.

Analysis on the source of students and the way to understand the policy of public and non-public undergraduates majoring in preventive medicine in Shandong Province / 中华医学教育探索杂志

Objective:To explore the source of students and the way to understand the policy of public and non-public undergraduate students majoring in preventive medicine.Methods:Using cluster random sampling, a total of 205 students from the first batch of public funded undergraduates and the same batch of non-public funded undergraduates of preventive medicine from Batch 2020 of two medical colleges in Shandong Province were selected as research objects. Questionnaires were issued on the platform of Sojump to investigate the source of students and the way to understand the policy. SPSS 22.0 statistical software was used to analyze the data, and the relative number and composition ratio were used to describe the counting data. Chi-square test was used to compare the characteristics of students and the understanding degree of the policy between government-funded undergraduates and non-government-funded undergraduates. Multiple responses were used to analyze students' understanding of the policy.Results:There were significant differences in the gender ( χ2=10.29, P<0.001), place of household registration ( χ2=5.61, P=0.018), father's educational level ( χ2=9.78, P=0.044) and the way to understand the policy ( χ2=17.19, P<0.001) of the public and non-public funded undergraduates majoring in preventive medicine. And 88.4% of the students knew about the policy of public medical students through their teachers, classmates and family members. Conclusion:There are more female government-funded undergraduates in preventive medicine than male students, and more rural students than urban students, with the spreading way of from mouth to mouth as the main approach to know this policy.

Development and future application of the Mibyou Score / 全日本鍼灸学会雑誌

Most acupuncture and moxibustion treatments are for indefinite complaints, or so-called "Mibyou". Therefore, it is natural that "Pattern," the Oriental medical diagnosis, differs from person to person. Unfortunately, the general public, accustomed to Western medicine, may think that "any place to stimulate is the same" because different acupuncture points are used for the same symptoms, and acupuncturists themselves are largely responsible for not having explained and studied the evaluation criteria for "Pattern". In the development of the Mibyou Score (Five Viscera Score), the aim was to eliminate as much as possible the influence of "Pattern" that varies from acupuncturist to acupuncturist, and to objectify and standardize the system by combining "multiple" indefinite complaints, even if "one" indefinite complaint could not be evaluated. Now, the government is emphasizing the use of the concept of "Mibyou" in Oriental medicine for the health of the people. It will be effective only when each citizen knows his or her own "Mibyou" and connects it to Youjou (Regimen). The study of acupuncture and moxibustion must not only " effect" the disease, but also "evaluate" the Mibyou. This will expand the field of activities of acupuncture and moxibustion practitioners.

The Apparent Increase in Diabetes Mellitus in Habitual Spa-Bathers Is due to the Cancer Survival Effect of Spa-Bathing: A Cross-Sectional Study in Beppu / 日本温泉気候物理医学会雑誌

  In 2018, we reported an epidemiological study on disease-preventive effects of habitual hot spa-bathing in the elderly in Beppu city, which has the highest number of hot spring sources in the world. In this analysis, women with diabetes mellitus were observed more often as hot spa-bathers than non-spa-bathers [odds ratio (OR): 1.238, confidence interval (CI): 1.011-1.517]. To see whether there is an apparent harmful effect of spa-bathing, complicated background diseases of women with diabetes mellitus were investigated in this study. We compared background diseases of women complicated with diabetes mellitus in spa-bathers and non-spa-bathers. Compared with non-spa-bathers, female spa-bathers with diabetes mellitus revealed a higher occurrence of cancer history (OR: 2.626, CI 1.517-4.545). The occurrence of diabetes mellitus in women with no cancer history was not significantly different between habitual spa-bathers and non-spa-bathers (OR:1.041, CI 0.837-1.293). The observed odds ratios suggest that spa-bathing associated cancer surviving promotion leads to an increasing number of diabetic women with a past history of cancer and contributes to more women with diabetes mellitus in spa-bathers rather than habitual spa-bathing promoting the pathogenesis of diabetes mellitus.

Research on Foods and Ingredients That Contribute to Maintenance and Improvement of Brain Function / 日本補完代替医療学会誌

From the perspective of complementary and alternative medicine, we searched for human clinical research reports on functional foods and nutrients that aimed at maintaining and improving brain function. Specifically, we comprehensively investigated the clinical reports that examined the efficacy of functional ingredients in terms of the maintenance and improvement of brain function, memory, and cognition in healthy individuals. Moreover, we examined the summary of intervention and test results of articles extracted from the Ichushi-Web and J Dream III databases.

Current situation and discussion on curriculum construction of "Fundamentals of Toxicology" in preventive medicine major of TCM universities in China / 中华医学教育探索杂志

Objective:To know the current situation of curriculum construction of "Fundamentals of Toxicology" of preventive medicine major in traditional Chinese medicine (TCM) universities.Methods:The undergraduates of preventive medicine major from TCM universities in whole China were selected as the research objects using the cluster sampling method, who took "Fundamentals of Toxicology" course in the 2019-2020 academic year. Questionnaires were compiled and analyzed using descriptive method and radar chart.Results:Six TCM universities were investigated in this study. According to the results, 83.09% (344/414) thought it was necessary to set up the "Fundamentals of Toxicology" course, and the main motivation was to deal with the examination. The agreement rate between the opening semester and the students' wishes was 59.90% (248/414), and the percentages of better satisfaction of theoretical course teaching content, selection of teaching materials and class time were 64.73% (268/414), 55.07% (228/414) and 59.90% (248/414) respectively. The satisfaction rate of experimental course setting, teaching effect and class time was 59.66% (247/414), 62.08% (257/414) and 58.21% (241/414) respectively. It was better to set five times [27.29% (113/414)] or four times [26.81% (111/414)], and four students in each group was the best [53.86% (223/414)]. The most interesting experiment project was bone marrow micronucleus test [29.21% (59/202)], and comprehensive design experiments and highly operable experimental projects should be added. The radar chart of the core knowledge was normal operation type, and there were some differences among students in different schools.Conclusion:There are some differences in the course setting and core knowledge mastery level of the "Fundamentals of Toxicology" course of preventive medicine major in TCM universities. It is necessary to optimize the curriculum construction from opening semester, textbook selection, teaching content, experimental project, etc.