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1.
J Affect Disord ; 282: 1203-1209, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33601697

RESUMO

BACKGROUND: The prevalence of depression increase with the outbreaks of epidemic disease. The prevalence of depression during the outbreak of Corona Virus Disease 2019 (COVID-19) in prenatal and postnatal women was examined in China. METHODS: 2201 prenatal and postnatal women in mainland China were recruited in this cross-sectional study from February 28th to April 26th, 2020. The Patient Health Questionnaire (PHQ-9) was used to assess depression in prenatal and postnatal women. RESULTS: The prevalence rate of depression was 35.4%. The risk factors for depression included drinking (p = 0.04; adjusted OR = 2.81, 95%CI: 1.26~6.24), nausea and vomiting during pregnancy (p < 0.001; adjusted OR = 3.54, 95%CI: 1.10~11.44), pregnancy's influence on mobility (p = 0.02; adjusted OR = 1.42, 95%CI: 1.11~1.83), anxiety (p < 0.001; adjusted OR = 1.66, 95%CI: 1.57~1.75), insomnia (p < 0.001; adjusted OR = 1.17, 95%CI: 1.14~1.21) and daily attention to fetal movement (p < 0.001; adjusted OR = 0.41, 95%CI: 0.31~0.56). LIMITATIONS: This study used a cross-sectional design, and cannot compare changes in the incidence of depression before and after the COVID-19 outbreak. CONCLUSIONS: During the COVID-19 outbreak, the prevalence rate of depression among Chinese prenatal and postnatal women was 35.4%. Moreover, anxiety, insomnia, drinking, nausea and vomiting during pregnancy, as well as the impaired movement and less daily monitoring of fetal movement were risk factors for depression.


Assuntos
Depressão , Ansiedade , China/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Surtos de Doenças , Feminino , Humanos , Saúde Mental , Gravidez , Prevalência , Fatores de Risco , Inquéritos e Questionários
2.
Artigo em Inglês | MEDLINE | ID: mdl-33375149

RESUMO

Grandchild caregiving is suggested to improve the elderly's cognitive function, but the specific relationship remains under-investigated. Considering gender disparity, this study aimed to understand the relationship between grandchild caregiving and cognition. In total, 7236 Chinese residents (≥45 years old) were selected from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The China Health and Retirement Longitudinal Study Harmonized Cognitive Assessment Protocol (CHARLS-HCAP) was used to measure cognition. Grandparenting was measured from three dimensions: caregiving frequency, intensity, and the number of grandchildren cared for. The relationship was examined by multivariate linear regression, with age as a moderator. The results showed that the majority of respondents provided care to their grandchildren, especially grandmothers. Grandchild caregiving was positively associated with cognition (ß = 0.686, 95% CI = 0.334-1.038), especially in the older-aged group. Moderate, not regular grandparenting, or caring for one grandchild was more positively associated with cognitive function. However, intensive and regular grandchild care was significantly associated with cognition only in men. No moderating effects of age were found in women. The study confirmed that moderate intensity and frequency of caregiving was related to better cognitive function in middle-aged and older Chinese population, whereas cultural context and gender differences could be considered when designing targeted policies.


Assuntos
Cognição , Avós , Relação entre Gerações , Idoso , Idoso de 80 Anos ou mais , Criança , China , Família , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
3.
BMC Geriatr ; 20(1): 475, 2020 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-33198656

RESUMO

BACKGROUND: Despite the incremental implementation of the essential public health services (EPHS) during the last decade, the goal of EPHS's equalization is impossible to cannot be achieved without appropriate policies targeting older migrants. Therefore, this study aims to examine whether the supply side meets the needs of older migrants and to explore the relationships among health status, the use of health services, and diverse factors. METHODS: The data were derived from a national cross-sectional dataset (N = 11,161) of the 2015 Chinese Migrant Dynamic Monitoring Survey. Mediating effects analysis and moderating effects analysis were conducted to explore the interactions between physical status and the use of EPHS in older migrants such as physical examination, health record, and follow-up services. RESULTS: The use of physical examination, health record, and follow-up services were correlated with each other. Household income, migrating for employment, and migrating for offspring were negatively associated with the use of EPHS. A positive association was observed between the use of EPHS and willingness for long-stay. The mediating effects of household income, migrating for employment, migrating for offspring, and willingness for long-stay were observed on the relationship between physical status and the use of EPHS. The moderating effects of household income and migrating for employment were discovered. CONCLUSION: Public health policies that may be worthy of consideration include further enhancing the delivery capacity of primary health institutions, integrating professional clinical resources into the primary health system, and launching the target policies to improve the accessibility of EPHS in older migrants.

4.
Front Oncol ; 10: 574889, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33134173

RESUMO

Background and purpose: To evaluate the feasibility of dose-guided adaptive radiotherapy (ART) based on deformable image registration (DIR) using fractional megavoltage cone-beam CT (MVCBCT) images from Halcyon system that uses identical beams for treatment and imaging and to retrospectively investigate the influence of anatomic changes on target coverage and organ-at-risk (OAR) sparing across various tumor sites. Materials and Methods: Four hundred twenty-two MVCBCT images from 16 patients (three head and neck, seven thoracic, three abdominal, and three pelvic cases) treated in a phase II clinical trial for Halcyon were selected. DIR between the planning CT and daily MVCBCT image was implemented by Velocity software to create pseudo CT. To investigate the accuracy of dose calculation on pseudo CT, three evaluation patients with rescanned CT and adaptive plans were selected. Dose distribution of adaptive plans calculated on pseudo CT was compared with that calculated on the rescanned planning CT on the three evaluation patients. To investigate the impact of inter-fractional anatomic changes on target dose coverage and dose to OARs of the 16 patients, fractional dose was calculated and accumulated incrementally based on deformable registration between planning CT and daily MVCBCT images. Results: Passing rates using 3 mm/3%/10% threshold local gamma analysis were 93.04, 96.00, and 91.68%, respectively, for the three evaluation patients between the reconstructed dose on pseudo CT (MVCBCT) and rescanned CT, where accumulated dose deviations of over 97% voxels were smaller than 0.5 Gy. Planning target volume (PTV) D95% and D90% (the minimum dose received by at least 95/90% of the volume) of the accumulated dose could be as low as 93.8 and 94.5% of the planned dose, respectively. OAR overdose of various degrees were observed in the 16 patients relative to the planned dose. In most cases, OARs' dose volume histogram (DVH) lines of accumulated and planned dose were very close to each other if not overlapping. Among cases with visible deviations, the differences were bilateral without apparent patterns specific to tumor sites or organs. Conclusion: As a confidence building measure, this simulation study suggested the possibility of ART for Halcyon based on DIR between planning CT and MVCBCT. Preliminary clinical data suggested the benefit of patient-specific dose reconstruction and ART to avoid unacceptable target underdosage and OAR overdosage.

5.
Med Phys ; 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33128263

RESUMO

PURPOSE: The implementation of radiomics and machine learning (ML) techniques on analyzing two-dimensional gamma maps has been demonstrated superior to the conventional gamma analysis for error identification in intensity modulated radiotherapy (IMRT) quality assurance (QA). Recently, the Structural SIMilarity (SSIM) sub-index maps were shown to be able to reveal the error types of the dose distributions. In this study, we aimed to apply radiomics analysis on SSIM sub-index maps and develop ML models to classify delivery errors in patient-specific dynamic IMRT QA. METHODS: Twenty-one sliding-window IMRT plans of 180 beams for three treatment sites were involved in this study. Four types of machine-related errors of various magnitudes were simulated for each beam at each control point, including the monitor unit (MU) variations, same-directional and opposite-directional shifts of the multileaf collimators (MLCs) and random mispositioning of the MLCs. In the QA process, a total of 1620 portal dose (PD) images were acquired for the beams with and without errors. The predicted PD images of the original beams were set as references. To quantify the agreement between a measured PD image and the corresponding predicted PD image, four difference maps including three SSIM sub-index maps, and one dose difference-derived map were calculated. Then, radiomic features were extracted from the four difference maps of each measured PD image. We tested four typical classifiers including linear discriminant classifier (LDC), two supporting vector machine (SVM) classifiers, and random forest (RF) for this multiclass classification task. A nested cross-validation scheme was used for model evaluations, where the SVM recursive feature elimination method was applied for feature selection. Finally, the performance of the ML model on identifying the error-free and the erroneous cases was compared to that of the conventional gamma analysis. RESULTS: The statistics of the selected features showed that all of the difference maps and the feature categories made balanced contributions to solve this classification task. Best performance was achieved by the Linear-SVM model with average overall classification accuracy of 0.86. Specifically, the average classification accuracies of the shift, opening, and the random errors were around 0.9. Moreover, ~80% of error-free and MU errors were correctly classified. Using gamma analysis, the 3 mm/3% criterion was found insensitive to errors (sensitivity was only 0.33). Although the sensitivity to errors with the 2 mm/2% criterion increased to 0.79, still 8% worse than that of the ML model. CONCLUSIONS: We proposed an ML-based method for machine-related error identification in patient-specific dynamic IMRT QA, where radiomic analysis on SSIM sub-index maps were used for feature extraction. With extensive validation to select the best features and classifiers, high accuracies in error classification were achieved. Compared with the conventional gamma threshold method, this approach has great potential in error identification for the patient-specific IMRT QA process.

6.
BMC Psychiatry ; 20(1): 514, 2020 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-33092555

RESUMO

BACKGROUND: Bereavement is the experience of an individual following the death of a person of significance to the individual, most often referring to the spouse. Increased morbidity, health care utilization, and mortality are known to be associated with bereavement. Given China's growing population of older adults, there is a critical need to assess the health consequences of bereavement. METHOD: We use data from the China Health and Retirement Longitudinal Study to examine the impact of bereavement on mental health and quality of life among a sample of mid- and older-aged adults. We use propensity score matching to construct a matching sample and difference-in-differences method to estimate the impact of bereavement on mental health and self-assessed health. RESULTS: We find bereavement is associated with increased depression symptoms among women (1.542 point or 0.229 standard deviations of Center for Epidemiologic Studies Depression (CES-D) 10 score) but not consistently for men over time. No statistically significant effect of bereavement on self-assessed health is found. CONCLUSIONS: Our results show a harmful impact of bereavement on mental health among older women in China and point to the need for a comprehensive policy on survivor benefits in China, particularly for rural older women.

7.
J Glob Health ; 10(2): 020801, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33110597

RESUMO

Background: Social Participation (SP) is known to benefit cognitive function. However, whether the positive relationship holds across different types of SP and dimensions of cognitive function, and whether the statement stays true in middle- and old-aged Chinese have not been investigated. The present study aimed to understand the current patterns of SP and cognitive function in China's context, and therefore, explore the associations between cognitive function and SP at different levels from various aspects. Methods: A total of 7973 community residents aged 45 years and older were selected from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015). A fixed-effects analysis was used to explore the association between changes in SP (diversity, frequency, and type) and that in cognitive function (memory and mental status) over a four-year period. Results: Changing from no SP to more variety (ß = 0.377, 95% confidence interval (CI) = 0.192-0.562 for 1 type, ß = 0.703, 95% CI = 0.470-0.937 for ≥2 types) or higher frequency (ß = 0.235, 95% CI = 0.007-0.462 for not regularly, ß = 0.604, 95% CI = 0.411-0.798) of SP was associated with improvements in cognitive function. Playing mah-jong and using Internet were associated with improved memory but not with mental status. Sports and volunteering were associated with improved mental status but not with memory. The same pattern was observed in men and in women. Conclusions: The study confirmed that more diversity and higher frequency of SP was associated with improved cognitive function, whereas reminded policymakers to consider cultural context when developing target strategies to improve cognitive function.

8.
J Affect Disord ; 277: 893-900, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33065831

RESUMO

BACKGROUND: The mental health status caused by major epidemics is serious and lasting. At present, there are few studies about the lasting mental health effects of COVID-19 outbreak. The purpose of this study was to investigate the mental health of the Chinese public during the long-term COVID-19 outbreak. METHODS: A total of 1172 online questionnaires were collected, covering demographical information and 8 common psychological states: depression, anxiety, somatization, stress, psychological resilience, suicidal ideation and behavior, insomnia, and stress disorder. In addition, the geographical and temporal distributions of different mental states were plotted. RESULTS: Overall, 30.1% of smokers increased smoking, while 11.3% of drinkers increased alcohol consumption. The prevalence rates of depression, anxiety, mental health problems, high risk of suicidal and behavior, clinical insomnia, clinical post-traumatic stress disorder symptoms, moderate-to-high levels of perceived stress were 18.8%, 13.3%, 7.6%, 2.8%, 7.2%, 7.0%, and 67.9%, respectively. Further, the geographical distribution showed that the mental status in some provinces/autonomous regions/municipalities was relatively more serious. The temporal distribution showed that the psychological state of the participants was relatively poorer on February 20, 24 to 26 and March 25, especially on March 25. LIMITATIONS: This cross-sectional design cannot make causal inferences. The snowball sampling was not representative enough. CONCLUSION: Our findings suggest that the prevalence rate of mental disorders in the Chinese public is relatively low in the second month of the COVID-19 pandemic. In addition, people's mental state is affected by the geographical and temporal distributions.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus , Depressão/epidemiologia , Pandemias , Pneumonia Viral , Transtornos Somatoformes/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Ideação Suicida , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Ansiedade/psicologia , Betacoronavirus , China/epidemiologia , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Prevalência , Resiliência Psicológica , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Fumar/epidemiologia , Fumar/psicologia , Transtornos Somatoformes/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adulto Jovem
9.
J Med Internet Res ; 22(11): e21099, 2020 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-33027037

RESUMO

BACKGROUND: Great efforts have been made to prevent the spread of COVID-19, including national initiatives to promote the change of personal behaviors. The lessons learned from the 2003 SARS outbreak indicate that knowledge and attitudes about infectious diseases are related to panic among the population, which may further complicate efforts to prevent the spread of infectious diseases. Misunderstandings may result in behaviors such as underestimation, panic, and taking ineffective measures to avoid infection; these behaviors are likely to cause the epidemic to spread further. OBJECTIVE: The purpose of this study is to assess public health perceptions and misunderstandings about COVID-19 in China, and to propose targeted response measures based on the findings to control the development of the epidemic. METHODS: The study was conducted in April 2020 through an online survey, with participants in 8 provinces in Eastern, Central, and Western China. We designed a questionnaire with a health knowledge section consisting of 5 questions (4 conventional questions and 1 misleading question) on clinical features of and preventive measures against COVID-19. Descriptive statistics, chi-square analysis, binary logistic regression, and Mantel-Haenszel hierarchical analysis were used for statistical analysis. RESULTS: In total, 4788 participants completed the survey and the mean knowledge score was 4.63 (SD 0.67), gained mainly through experts (76.1%), television (60.0%), newspapers (57.9%), and opinions (46.6%) and videos (42.9%) from social media. Compared to those who obtained information from only 1 or 2 channels, people who obtained information from >3 channels had increased health perception and a better ability to identify misleading information. Suggestions from experts were the most positive information source (χ2=41.61), while information on social media was the most misleading. Those aged >60 years (OR 1.52, 95% CI 1.10-2.11), those with a lower or middle income (OR 1.36, 95% CI 1.00-1.83), those not working and not able to work (OR 1.83, 95% CI 1.04-3.21), those with a household income <100,000 RMB (2 suspected symptoms (OR 2.95, 95% CI 1.50-5.80) were more likely to be misled by videos on social media, but the error correction effect of expert advice was limited in these groups. CONCLUSIONS: Multiple information channels can improve public health perception and the identification of misleading information during the COVID-19 pandemic. Videos on social media increased the risk of rumor propagation among vulnerable groups. We suggest the government should strengthen social media regulation and increase experts' influence on the targeted vulnerable populations to reduce the risk of rumors spreading.


Assuntos
Comunicação , Infecções por Coronavirus/psicologia , Educação em Saúde/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Internet , Pneumonia Viral/psicologia , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Criança , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Surtos de Doenças , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Saúde Pública , Mídias Sociais , Adulto Jovem
10.
Stem Cells Int ; 2020: 8836258, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32963550

RESUMO

Mesenchymal stem cells (MSCs) are a reliable source for cell-based regenerative medicine owing to their multipotency and biological functions. However, aging-induced systemic homeostasis disorders in vivo and cell culture passaging in vitro induce a functional decline of MSCs, switching MSCs to a senescent status with impaired self-renewal capacity and biased differentiation tendency. MSC functional decline accounts for the pathogenesis of many diseases and, more importantly, limits the large-scale applications of MSCs in regenerative medicine. Growing evidence implies that epigenetic mechanisms are a critical regulator of the differentiation programs for cell fate and are subject to changes during aging. Thus, we here review epigenetic dysregulations that contribute to MSC aging and osteoporosis. Comprehending detailed epigenetic mechanisms could provide us with a novel horizon for dissecting MSC-related pathogenesis and further optimizing MSC-mediated regenerative therapies.

11.
Nature ; 586(7827): 145-150, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32968273

RESUMO

Natural products serve as chemical blueprints for most antibiotics in clinical use. The evolutionary process by which these molecules arise is inherently accompanied by the co-evolution of resistance mechanisms that shorten the clinical lifetime of any given class of antibiotics1. Virginiamycin acetyltransferase (Vat) enzymes are resistance proteins that provide protection against streptogramins2, potent antibiotics against Gram-positive bacteria that inhibit the bacterial ribosome3. Owing to the challenge of selectively modifying the chemically complex, 23-membered macrocyclic scaffold of group A streptogramins, analogues that overcome the resistance conferred by Vat enzymes have not been previously developed2. Here we report the design, synthesis, and antibacterial evaluation of group A streptogramin antibiotics with extensive structural variability. Using cryo-electron microscopy and forcefield-based refinement, we characterize the binding of eight analogues to the bacterial ribosome at high resolution, revealing binding interactions that extend into the peptidyl tRNA-binding site and towards synergistic binders that occupy the nascent peptide exit tunnel. One of these analogues has excellent activity against several streptogramin-resistant strains of Staphylococcus aureus, exhibits decreased rates of acetylation in vitro, and is effective at lowering bacterial load in a mouse model of infection. Our results demonstrate that the combination of rational design and modular chemical synthesis can revitalize classes of antibiotics that are limited by naturally arising resistance mechanisms.

12.
Artigo em Inglês | MEDLINE | ID: mdl-32977538

RESUMO

COVID-19 presents unprecedented challenges to the global public health response. Preventive behaviors and keeping social distance are regarded as compelling ways to prevent COVID-19. This study focused on the sociological and psychological factors associated with proper and excessive preventive behaviors of the COVID-19 outbreak in China. For the sample, we collected the data of 4788 participants who were surveyed between 4 April and 15 April 2020 from eight provinces in China. This study designed a self-filled questionnaire that included demographic information, six components of the Health Belief Model, and target preventive behaviors. Descriptive analysis, Chi-square test, logistic regression analysis, Mantel-Haenszel hierarchical analysis, and propensity score matching were employed in this study. The results showed that 54.7% of the participants had adequate basic prevention, 63.6% of the participants had adequate advanced prevention, and 5.8% of the participants practiced excessive prevention. The elder participants were less likely to engage in proper preventive behaviors. Perceived susceptibility, perceived benefits, perceived barriers, cues to action, and knowledge levels were associated with preventive behaviors. Excessive preventive behaviors in high-risk groups with suspected symptoms were associated with their extreme psychological condition, while the support from the community and family plays an important role in avoiding these behaviors.


Assuntos
Infecções por Coronavirus/prevenção & controle , Comportamentos Relacionados com a Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Idoso , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Inquéritos e Questionários
13.
Transl Psychiatry ; 10(1): 319, 2020 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-32950999

RESUMO

Coronavirus disease 2019 (COVID-19) is rapidly spreading worldwide, with a staggering number of cases and deaths. However, available data on the psychological impacts of COVID-19 on pregnant women are limited. The purposes of this study were to assess the prevalence of psychiatric symptoms among pregnant women, and to compare them with non-pregnant women. From February 28 to March 12, 2020, a cross-sectional study of pregnant and non-pregnant women was performed in China. The online questionnaire was used to collect information of participants. The mental health status was assessed by patient health questionnaire, generalized anxiety disorder scale, insomnia severity index, somatization subscale of the symptom checklist 90, and post-traumatic stress disorder (PTSD) checklist-5. Totally, 859 respondents were enrolled, including 544 pregnant women and 315 non-pregnant women. In this study, 5.3%, 6.8%, 2.4%, 2.6%, and 0.9% of pregnant women were identified to have symptoms of depression, anxiety, physical discomfort, insomnia, and PTSD, respectively. However, the corresponding prevalence rates among non-pregnant women were 17.5%, 17.5%, 2.5%, 5.4%, 5.7%, respectively. After adjusting for other covariates, we observed that pregnancy was associated a reduced risk of symptoms of depression (OR = 0.23; 95% CI: 0.12-0.45), anxiety (OR = 0.26; 95% CI: 0.16-0.42), insomnia (OR = 0.19; 95% CI: 0.06-0.58), and PTSD (OR = 0.15; 95% CI: 0.04-0.53) during the COVID-19 epidemic. Our results indicate that during the COVID-19 epidemic in China, pregnant women have an advantage of facing mental problems caused by COVID-19, showing fewer depression, anxiety, insomnia, and PTSD symptoms than non-pregnant women.


Assuntos
Ansiedade , Infecções por Coronavirus , Depressão , Pandemias , Pneumonia Viral , Gestantes/psicologia , Distúrbios do Início e da Manutenção do Sono , Transtornos Somatoformes , Transtornos de Estresse Pós-Traumáticos , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Saúde Mental/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Gravidez , Pesquisa Qualitativa , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Transtornos Somatoformes/diagnóstico , Transtornos Somatoformes/epidemiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia
14.
J Affect Disord ; 277: 510-514, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32882508

RESUMO

BACKGROUND: To our best knowledge, this was the first time to investigate the prevalence and risk factors of psychological disturbances, including depression, anxiety, somatization symptoms, insomnia and suicide, among frontline medical staff, who were working with the COVID-10 infected patients directly. METHODS: Patient Health Questionnaire Depression (PHQ-9), Generalized Anxiety Disorder Questionnaire scale (GAD-7), Symptom Check List-90 (SCL-90) somatization, Insomnia Severity Index (ISI), and the suicidal module of the Mini International Neuropsychiatric Interview were used for online survey. RESULTS: A total of 606 frontline hospital staff and1099 general population were recruited. The prevalence of depression, anxiety, somatization symptoms, insomnia, and suicide risk in frontline medical staffs were 57.6%, 45.4%, 12.0%, 32.0% and 13.0%, respectively. Except for suicide risk, the prevalence of other psychological disorders in frontline medical staff were higher than those in general population (all p<0.01). Among the frontline medical staff, the daily working hours were associated with all psychological disturbance (all p<0.01), women with anxiety (p = 0.02), body mass index (BMI) with anxiety and insomnia (p = 0.02, p = 0.03). Age was negatively associated with depression, anxiety, and insomnia (all p<0.01). Finally, years of working and family income were negatively associated with suicide risk (p = 0.03, p<0.001). CONCLUSION: Our study demonstrates that during the outbreak of COVID-19, the frontline medical staff are more likely to suffer from psychological disturbances than general population. It is noticeable that daily working hours are a risk factor for all measured psychological disturbances, and some other variables may be involved in certain psychological disturbances of frontline medical staff.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus , Depressão/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Pandemias , Admissão e Escalonamento de Pessoal , Pneumonia Viral , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Transtornos Somatoformes/epidemiologia , Carga de Trabalho , Adulto , Fatores Etários , Ansiedade/psicologia , Betacoronavirus , Índice de Massa Corporal , Estudos Transversais , Depressão/psicologia , Feminino , Pessoal de Saúde/psicologia , Humanos , Renda , Masculino , Saúde Mental , Questionário de Saúde do Paciente , Prevalência , Medição de Risco , Fatores de Risco , Fatores Sexuais , Transtornos Somatoformes/psicologia , Suicídio , Adulto Jovem
15.
Artigo em Inglês | MEDLINE | ID: mdl-32881201

RESUMO

WHAT IS KNOWN ON THE SUBJECT: Low utilization of the family-oriented community rehabilitation services is a threatening challenge facing low- and middle- income countries. Family caregiver's trust in community healthcare providers is the precondition of service utilization and is shaped by their perceived quality of primary healthcare services from previous experience. Most of the studies concerning the relationship between perceived quality and institutional trust were conducted in western countries, resulting in limited attention paid to conditions in non-western countries. Which aspect of quality predicts institutional trust in China has not been studied yet. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: In China's context, institutional trust was generally associated with communication, worry relief and risk of privacy leak, but not with technical competence. Significant rural-urban disparity was observed: among rural respondents, institutional trust was associated with technical competence, communication and risk of privacy leak, but not with worry relief; institutional trust was only associated with worry relief in urban respondents. WHAT ARE THE IMPLICATIONS FOR PRACTICE: Mental health nurses training or working with community healthcare workers may improve their technical and communicative competence. Priorities may differ between rural and urban areas. Mental health nurses or community healthcare workers may provide more family-oriented psycho-education to rural families, and more emotional support to urban families. Wider public anti-stigma initiatives are needed to reduce the affiliated stigma of families of persons diagnosed with a severe mental illness. ABSTRACT: Introduction Prior studies suggested that caregiver's trust in community healthcare providers is the precondition of the utilization of community-based rehabilitation services and is shaped by their perceived quality of primary healthcare services. Nevertheless, the research conducted in non-western countries is scarce, and which aspect of quality is associated with institutional trust in China has not been studied. Aim To explore the association between perceived quality of primary healthcare services and institutional trust in China's context. Methods This cross-sectional study was conducted with 796 family caregivers from Eastern, Central and Western China between August 2018 and October 2019. Perceived quality of primary healthcare services was measured by technical competence, communication, worry relief and risk of privacy leak. Results Institutional trust was generally associated with communication, worry relief and risk of privacy leak, but not with technical competence. Among rural respondents, institutional trust was associated with technical competence, communication and risk of privacy leak, but not with worry relief. Contrary finding was observed in urban respondents. Discussion and implications for practice With rural-urban disparity considered, strategies such as improving the technical and communicative competence of community healthcare workers, providing family-oriented psycho-education and emotional support, and promoting public anti-stigma initiatives may be worth consideration.

16.
Sci Adv ; 6(29): eabb2307, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32832639

RESUMO

Many natural surfaces are capable of rapidly shedding water droplets-a phenomenon that has been attributed to the presence of low solid fraction textures (Φs ~ 0.01). However, recent observations revealed the presence of unusually high solid fraction nanoscale textures (Φs ~ 0.25 to 0.64) on water-repellent insect surfaces, which cannot be explained by existing wetting theories. Here, we show that the contact time of bouncing droplets on high solid fraction surfaces can be reduced by reducing the texture size to ~100 nm. We demonstrated that the texture size-dependent contact time reduction could be attributed to the dominance of line tension on nanotextures and that compact arrangement of nanotextures is essential to withstand the impact pressure of raindrops. Our findings illustrate a potential survival strategy of insects to rapidly shed impacting raindrops, and suggest a previously unidentified design principle to engineering robust water-repellent materials for applications including miniaturized drones.

17.
AIDS Behav ; 2020 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-32809074

RESUMO

People living with human immunodeficiency virus (PLWH) has been reported to have a high prevalence of depressive symptoms. Low-income populations account for a large proportion of PLWH, hence indicating a high level of depressive symptoms in low-income PLWH. Telephone-based therapy has been shown to be effective for treating PLWH's depressive symptoms, but its effects among low-income PLWH remain unclear. The purpose of this meta-analysis was to evaluate the effects of telephone-based therapy targeting depressive symptoms among low-income PLWH. Six databases (PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, VIP Database and Wanfang Data) were searched until May 2020 using search terms related to telephone-based therapy, depressive symptoms, and PLWH. Eight studies were included in the meta-analysis. Both postintervention effects (primary outcome) and long-term effects (secondary outcome) were evaluated using a random effects model. The meta-analysis revealed a small to moderate effect size (g = - 0.29, 95% CI - 0.51, - 0.06) on reducing depressive symptom scores (Z = 2.51, p = 0.01) in telephone-based intervention group compared with the control group at postintervention. However, there was no statistically significant long-term effects (Z = 0.77, p = 0.44) at follow-up. For postintervention effects, calculation of the I2 index indicated moderate heterogeneity (I2 = 50%); sensitivity analysis and subgroup analysis were performed to explore the source of heterogeneity. Ethnic group was classified into minority and majority which refers to most of the population were ethnic minority and majority respectively. Between-group differences were found across ethnic groups. The results suggested that there was a slightly stronger effect of telephone-based therapy in low-income PLWH than among PLWH in general, but its long-term effect requires future investigation. The effects of the intervention were better among the ethnic majority subgroups of low-income PLWH. Treatment format and intervention duration might also influence the intervention effects. However, the overall quality of evidence was low and directly impacted on the interpretation of our results, suggesting that more high-quality random controlled trial (RCT)/longitudinal studies with less selection and detection bias, less inconsistency and less indirectness are needed when applying telephone-based therapy to low-income PLWH with depressive symptoms in further studies.

18.
Cell Mol Life Sci ; 2020 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-32789690

RESUMO

Poly(ADP-ribosyl)ation (PARylation) is an important post-translational modification mainly catalyzed by poly-ADP-ribose polymerase 1 (PARP1). In addition to having important roles in DNA damage detection and repair, it functions in gene expression regulation, especially at the posttranscriptional level. Embryonic lethal abnormal vision-like 1/human antigen R (ELAVL/HuR), a canonical 3' untranslated region AU-rich element-binding protein, is a crucial mRNA-stabilizing protein that protects target mRNAs from RNA-destabilizing protein- or microRNA-induced silencing complex (miRISC)-mediated degradation. Additionally, in some cases, HuR itself either promotes or suppresses translation. Here, we demonstrated that in response to inflammatory stimuli, the PARylation of HuR, mostly at the conserved D226 site, by PARP1 increased the formation of the HuR oligomer/multimer, and HuR oligomerization promoted the disassociation of miRISC and stabilized the pro-inflammatory gene mRNAs. The prevention of PARP1 activation or HuR oligomerization attenuated lipopolysaccharide-induced inflammatory gene expression and the airway recruitment of neutrophils in mouse lungs. The present study verified a novel mechanism of PARP1 and HuR PARylation in the RNA stability regulation, increasing our understanding of how PARP1 regulates gene expression.

19.
Artigo em Inglês | MEDLINE | ID: mdl-32652746

RESUMO

The dealkenylative alkenylation of alkene C(sp3 )-C(sp2 ) bonds has been an unexplored area for C-C bond formation. Herein 64 examples of ß-alkylated styrene derivatives, synthesized through the reactions of readily accessible feedstock olefins with ß-nitrostyrenes by ozone/FeII -mediated radical substitutions, are reported. These reactions proceed with good efficiencies and high stereoselectivities under mild reaction conditions and tolerate an array of functional groups. Also demonstrated is the applicability of the strategy through several synthetic transformations of the products, as well as the syntheses of the natural product iso-moracin and the drug (E)-metanicotine.

20.
Artigo em Inglês | MEDLINE | ID: mdl-32667104

RESUMO

Men who have sex with men (MSM) are at risk of contracting the hepatitis C virus (HCV). Previous studies have documented low uptake of sexually transmitted disease (STD) prevention and health services among Chinese MSM. We carried out qualitative research among MSM in Southwest China. By taking the Health Brief Model (HBM) as a framework, we aimed to determine the underlying factors related to use of HCV health intervention services among MSM. From May to July 2018, we conducted in-depth interviews in Southwest China with 20 participants. Our research revealed that a lack of knowledge about HCV prevention was the main reason why MSM failed to perceive their susceptibility to HCV and had low motivation to seek preventive services. Poor service accessibility and unpleasant experiences seeing doctors also exerted negative influences on health care-seeking behaviour in MSM. More trust and understanding needs to be built between health providers and MSM. Protection of privacy for MSM should be guaranteed in the delivery of health interventions. In addition, the interviewees showed refusal to engage with health interventions being specifically targeted at MSM, which would create a sense of being 'labelled'. Tailored health interventions may overemphasise their sexuality, segregate them from heterosexuals, and make them feel alienated. Therefore, we speculate that differential treatment may be an obstacle for MSM to become involved in health interventions.

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