ABSTRACT
Opioid switching is a common practice of substituting one opioid for another to improve analgesia or adverse effects; however, it has limited evidence. This study aimed to examine the effectiveness of opioid switching in advanced cancer. This multi-center prospective cohort study recruited patients assessed to switch opioids (opioid switch group) or to continue ongoing opioid treatment (control group). Clinical data (demographics, opioids) and validated instruments (pain and adverse effects) were collected over two timepoints seven days apart. Descriptive analyses were utilized. Non-parametric tests were used to determine differences. Fifty-four participants were recruited (23 control group, 31 switch group). At the follow-up, opioid switching reduced pain (worst, average, and now) (p < 0.05), uncontrolled breakthrough pain (3-fold reduction, p = 0.008), and psychological distress (48% to 16%, p < 0.005). The switch group had a ≥25% reduction in the reported frequency of seven moderate-to-severe adverse effects (score ≥ 4), compared to a reduction in only one adverse effect in the control group. The control group experienced no significant pain differences at the follow-up. Opioid switching is effective at reducing pain, adverse effects, and psychological distress in a population with advanced cancer pain, to levels of satisfactory symptom control in most patients within 1 week.
ABSTRACT
Objectives: This paper aimed to describe acceptance of the COVID-19 vaccine and its determinants among Vietnamese teachers. Methods: This was a web-based cross-sectional survey with a sample of 17,176 teachers from kindergarten to high school who currently reside in Vietnam. A participant who exhibited "acceptance" towards the vaccine gave the following response: "have the readiness to get COVID-19 vaccine". Results: About 88% of all participants were accepting of the COVID-19 vaccine, while 70.4% were willing to pay (WTP) for it. The vaccine acceptance rate increased by age with odds ratios (OR) of 1.65 (1.41-1.93), 1.96 (1.67-2.29), and 2.4 (1.95-2.95) for the age groups 30-39, 40-49, and 50-59 respectively, when compared to the 18-29 age group. Male were found to be more likely to accept the vaccination than females (OR = 1.16; 95% CI: 1.02-1.31); teachers without a chronic disease were 4.13 times (95% CI: 2.67-6.37) more likely to accept the vaccine than those with an underlying condition. Willingness to pay and beliefs about the safety and efficacy of the vaccine were major factors in driving participants' responses. Conclusion: A high proportion of COVID-19 vaccine acceptance is a promising indicator of high coverage among this priority group for vaccination. Communication campaigns should consider addressing determinants uncovered by this study to achieve better vaccine acceptance.
ABSTRACT
OBJECTIVES: To examine i) the use of mobile apps and fitness trackers in adults during the COVID-19 pandemic to support health behaviors; ii) the use of COVID-19 apps; iii) associations between using mobile apps and fitness trackers, and health behaviors; iv) differences in usage amongst population subgroups. METHODS: An online cross-sectional survey was conducted during June-September 2020. The survey was developed and reviewed independently by co-authors to establish face validity. Associations between using mobile apps and fitness trackers and health behaviors were examined using multivariate logistic regression models. Subgroup analyses were conducted using Chi-square and Fisher's exact tests. Three open-ended questions were included to elicit participants' views; thematic analysis was conducted. RESULTS: Participants included 552 adults (76.7% women; mean age: 38±13.6 years); 59.9% used mobile apps for health, 38.2% used fitness trackers, and 46.3% used COVID-19 apps. Users of mobile apps or fitness trackers had almost two times the odds of meeting aerobic physical activity guidelines compared to non-users (odds ratio = 1.91, 95% confidence interval 1.07 to 3.46, P = .03). More women used health apps than men (64.0% vs 46.8%, P = .004). Compared to people aged 18-44 (46.1%), more people aged 60+ (74.5%) and more people aged 45-60 (57.6%) used a COVID-19 related app (P < .001). Qualitative data suggest people viewed technologies (especially social media) as a 'double-edged sword': helping with maintaining a sense of normalcy and staying active and socially connected, but also having a negative emotional effect stemming from seeing COVID-related news. People also found that mobile apps did not adapt quickly enough to the circumstances caused by COVID-19. CONCLUSIONS: Use of mobile apps and fitness trackers during the pandemic was associated with higher levels of physical activity, in a sample of educated and likely health-conscious individuals. Future research is needed to understand whether the association between using mobile devices and physical activity is maintained in the long-term.
ABSTRACT
In this work, we reported synthesis of a novel magnetically separable g-C3N4/Zn doped Fe3O4 composite (g-CN/ZnFe) by a simple polyol thermal method. The characteristics of the as-prepared composite was checked by XRD, SEM, TEM, XPS, PL technologies. The optimized weight ratio of g-C3N4 and Zn doped Fe3O4 was investigated. In addition, the photocatalytic activities of the composite products were checked by degradation of Cephalexin (CEX) under visible light. The results showed that g-CN/ZnFe composite with an added 20% g-C3N4 exhibited the highest photocatalytic activity for cephalexin under visible light irradiation. The improved photocatalytic activity of 20% g-CN/ZnFe can be ascribed to the low combination rate of photoinduced electron/hole pairs. Especially, g-CN/ZnFe can be recovered easily by using an external magnetic field and has the high stability after six runs. These properties of the g-CN/ZnFe as-prepared composite could be a promising photocatalyst for the degradation of pharmaceutical contaminants.
