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Expression level of myocardial enzymes in patients with schizophrenia: Predictive value in the occurrence of violence

BACKGROUND Schizophrenic patients are prone to violence, frequent recurrence, and difficult to predict. Emotional and behavioral abnormalities during the onset of the disease, resulting in active myocardial enzyme spectrum. AIM To explored the expression level of myocardial enzymes in patients with schizophrenia and its predictive value in the occurrence of violence. METHODS A total of 288 patients with schizophrenia in our hospital from February 2023 to January 2024 were selected as the research object, and 100 healthy people were selected as the control group. Participants’ information, clinical data, and laboratory examination data were collected. According to Modified Overt Aggression Scale score, patients were further divided into the violent (123 cases) and non-violent group (165 cases). RESULTS The comparative analysis revealed significant differences in serum myocardial enzyme levels between patients with schizophrenia and healthy individuals. In the schizophrenia group, the violent and non-violent groups also exhibited different levels of serum myocardial enzymes. The levels of myocardial enzymes in the non-violent group were lower than those in the violent group, and the patients in the latter also displayed aggressive behavior in the past. CONCLUSION Previous aggressive behavior and the level of myocardial enzymes are of great significance for the diagnosis and prognosis analysis of violent behavior in patients with schizophrenia. By detecting changes in these indicators, we can gain a more comprehensive understanding of a patient’s condition and treatment.

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Effect of quantitative consciousness index on seizure parameters during electroconvulsive therapy in patients with major depressive disorder

BACKGROUND Electroconvulsive therapy (ECT) is both an effective treatment for patients with major depressive disorder (MDD) and a noxious stimulus. Although some studies have explored the effect of sedation depth on seizure parameters in ECT, there is little research on the noxious stimulation response to ECT. In this study, we used two electroencephalography (EEG)-derived indices, the quantitative consciousness (qCON) index and quantitative nociceptive (qNOX) index, to monitor sedation, hypnosis, and noxious stimulation response in patients with MDD undergoing acute ECT. AIM To evaluate the effect of anesthesia depth based on the qCON and qNOX indices on seizure parameters. METHODS Patients with MDD (n = 24) underwent acute bilateral temporal ECT under propofol anesthesia. Before ECT, the patients were randomly divided into three groups according to qCON scores (qCON60-70, qCON50-60, and qCON40-50). Continuous qCON monitoring was performed 3 minutes before and during ECT, and the qCON, qNOX, vital signs, EEG seizure parameters, and complications during the recovery period were recorded. The 24-item Hamilton Rating Scale for Depression, Zung’s Self-rating Depression Scale, and Montreal Cognitive Assessment scores were evaluated before the first ECT session, after the fourth ECT session, and after the full course of ECT. RESULTS A total of 193 ECT sessions were performed on 24 participants. The qCON index significantly affected the EEG seizure duration, peak mid-ictal amplitude, and maximum heart rate during ECT (P < 0.05). The qNOX index significantly affected the post-ictal suppression index (P < 0.05). Age, number of ECT sessions, and anesthetic-ECT time intervals also had a significant effect on EEG seizure parameters (P < 0.05). However, there were no significant differences in complications, 24-item Hamilton Rating Scale for Depression scores, Zung’s Self-rating Depression Scale scores, or Montreal Cognitive Assessment scores among the three groups (P > 0.05). CONCLUSION Electrical stimulation at a qCON index of 60-70 resulted in better EEG seizure parameters without increasing complications in patients with MDD undergoing bilateral temporal ECT under propofol anesthesia.

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Study on psychological resilience and associated influencing factors in lung cancer patients with bone metastases

BACKGROUND Evaluating the psychological resilience of lung cancer (LC) patients helps understand their mental state and guides future treatment. However, there is limited research on the psychological resilience of LC patients with bone metastases. AIM To explore the psychological resilience of LC patients with bone metastases and identify factors that may influence psychological resilience. METHODS LC patients with bone metastases who met the inclusion criteria were screened from those admitted to the Third Affiliated Hospital of Wenzhou Medical University. The psychological scores of the enrolled patients were collected. They were then grouped based on the mean psychological score: Those with scores lower than the mean value were placed in the low-score group and those with scores equal to or greater than the mean value was placed in the high-score group. The baseline data (age, gender, education level, marital status, residence, monthly income, and religious beliefs), along with self-efficacy and medical coping mode scores, were compared. RESULTS This study included 142 LC patients with bone metastases admitted to our hospital from June 2022 to December 2023, with an average psychological resilience score of 63.24 ± 9.96 points. After grouping, the low-score group consisted of 69 patients, including 42 males and 27 females, with an average age of 67.38 ± 9.55 years. The high-score group consisted of 73 patients, including 49 males and 24 females, with a mean age of 61.97 ± 5.00 years. χ 2 analysis revealed significant differences between the two groups in education level (χ 2 = 6.604, P = 0.037), residence (χ 2 = 12.950, P = 0.002), monthly income (χ 2 = 9.375, P = 0.009), and medical coping modes (χ 2 = 19.150, P = 0.000). Independent sample t -test showed that the high-score group had significantly higher self-efficacy scores (t = 3.383, P = 0.001) and lower age than the low-score group (t = 4.256, P < 0.001). Furthermore, multivariate logistic regression hazard analysis confirmed that self-efficacy is an independent protective factor for psychological resilience [odds ratio (OR) = 0.926, P = 0.035, 95% confidence interval (CI): 0.862-0.995], while age (OR = 1.099, P = 0.003, 95%CI: 1.034-1.169) and medical coping modes (avoidance vs confrontation: OR = 3.767, P = 0.012, 95%CI: 1.342-10.570; resignation vs confrontation: OR = 5.687, P = 0.001, 95%CI: 1.974-16.385) were identified as independent risk factors. A predictive model based on self-efficacy, age, and medical coping modes was developed. The receiver operating characteristic analysis showed an area under the curve value of 0.778 (95%CI: 0.701-0.856, P < 0.001), indicating that the model has good predictive performance. CONCLUSION LC patients with bone metastases are less psychologically resilient than the general population. Factors such as self-efficacy, age, and medical coping modes influence their psychological resilience. Patients with low self-efficacy, old age, and avoidance/resignation coping modes should be closely observed.

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Circular economy design strategies in mass timber construction: a systematic literature review

PurposeThis study evaluates the implementation of circular economy (CE) design strategies in mass timber construction to identify knowledge gaps and define crucial future research areas for promoting CE design adoption in this field.Design/methodology/approachA two-stage systematic literature review (SLR) was conducted to, first, identify CE design strategies applicable to the construction industry and then investigate the current state of CE design research in mass timber construction. Scopus and Web of Science databases were searched for relevant literature. In total, 52 peer-reviewed journal articles published between 2016 and 2023 were shortlisted. Descriptive and thematic analyses were then employed to analyse and synthesise the relevant literature.FindingsSeven CE design strategies were identified in the first stage of the SLR. The second stage of the SLR revealed limited research on CE design strategies in mass timber construction. Several research problems were identified, including a lack of suitable connectors for the deconstruction phase, durability concerns, insufficient knowledge of CE design methods, lack of knowledge and education about mass timber construction, missing actors within the value chain, higher cost, an underdeveloped market and inadequate regulatory requirements. These findings highlighted the future research directions to foster CE design adoption in mass timber construction.Originality/valueThe study systematically identifies existing knowledge on the application of CE design strategies in mass timber construction. Moreover, it presents a conceptual framework that links current research problems to future research directions across technical, social, economic and regulatory categories, thereby advancing CE practice in mass timber construction.

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Implementing a mental health app intervention in a university setting: multi-methods evaluation study

Purpose The number of university students seeking mental health support is rapidly increasing. To provide additional psychological support to students accessing well-being services, this study aimed to pilot a mental health Web application (app) called Orpheus®. Design/methodology/approach Guided by student consultations, a multi-methods approach was adopted, including an examination of in-app data, chart reviews of routinely collected student information and interviews with mental health practitioners. Usage data were analysed descriptively. Changes in mental health outcomes were examined using means, standard deviations and reliable change indices for anxiety and depression scores. Inductive and deductive thematic analysis was conducted on qualitative data from staff interviews and student feedback. Findings A total of 26 students registered an account with 39 completed app visits. On 37 of the 39 (94.9%) occasions, students reported reductions in the intensity of unwanted negative emotions. Statistically significant reductions in the average pooled anxiety and depression scores were observed. Of the 15 students who completed pre- and post-routine outcome measures, between 20% and 60% showed reliable and meaningful symptom improvements. Students reported that the app was helpful and easy to set up and use, with no adverse events. Practitioners highlighted barriers and facilitators related to the technology features, situational contexts and individual differences. Originality/value Integrating Orpheus in real-world settings resulted in promising implementation processes, potential for future uptake and positive outcomes. However, ongoing research, staff training and app testing are needed to further improve the implementation processes for digital mental health interventions.

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Am I willing to take a mental health day off? Integrating perspectives from self-determination theory and the theory of planned behavior

Purpose The mental health issues faced by young people can significantly hinder a nation’s development. The purpose of this study is to integrate the Self-Determination Theory and the Theory of Planned Behavior to examine the factors influencing the utilization of mental health days among young individuals. Design/methodology/approach An online survey was conducted to collect data from young people. Findings The results indicated that more positive attitudes, favorable subjective norms and a stronger sense of perceived behavioral control regarding mental health days are all associated with a higher intention to use them. Young individuals who have used counseling resources are more likely to endorse the use of mental health days. Satisfaction of the three basic psychological needs of autonomy, competence and relatedness has a diminishing effect on both motivation and intention to request mental health days. However, there is a positive relationship between motivation and intention to apply for mental health days. When competence needs are less well satisfied, the motivation and, in turn, the intention to request mental health days are enhanced. Research limitations/implications Shifting the leave framework from a disease-centered approach to a psychological leave model focused on mood adjustment can maximize the positive impact of mental health leave. Originality/value This study contributes to the theoretical understanding of the relationships between needs and motivation within the framework of self-determination theory. Furthermore, it integrates components from the theory of planned behavior to examine the influence of social pressures and self-efficacy on the intention to use mental health days. Mental health days can be seen as a cry for help from young adults. The utilization of mental health days serves as an effective means of managing one's mental state.

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