Care Activities Research Articles

A case study on development of a spiral oral health curriculum for medical students

AbstractInadequate oral healthcare remains a critical public health issue in children and adults in the US affecting adverse social, psychological, economic, and health outcomes. Medical clinicians have a clear role in addressing oral health issues and improving outcomes. Oral health guidelines for health profession schools were developed by the Association of American Medical Colleges (AAMC) oral health core competencies, and the newer Center for Integration of Primary Care and Oral Health's (CIPCOH) Entrustable Professional Activities (EPAs). However, the majority of health professional school deans and residency directors in the US report they are not satisfied with the oral health knowledge and skills of their learners at graduation. To address this issue, faculty at the University of Massachusetts Chan Medical School (UMCMS) have worked for the past decade to develop and implement a true spiral curriculum building on lessons of knowledge, skills, and attitudes throughout the 4‐year student experience. The current UMCMS curriculum involves most courses at the medical school, has community‐based and interprofessional components, and is taught using multimedia. Most of the curriculum is mandatory with selective opportunities for those in specialty tracks or who are seeking more hands‐on training. Our study evaluated the UMCMS curriculum using the AAMC and CIPCOH EPA guidelines. Findings show that all students receive training in 42 of 48 AAMC oral health competencies and seven of seven CIPCOH oral health EPAs with the opportunity to explore oral health further through elective courses. Assessments of students show they perform well and evaluation of the oral health curricula by students are positive. Although our oral health curriculum is robust, the next steps include expanding the evaluation of students to ensure they universally meet competencies. We expect that this case study can serve as a map for creating a generalizable, spiral curriculum for other medical schools.

HOME CARE POST FEMUR FRACTURE SURGERY ON MR. A IN THE WATUBELAH AREA, CIREBON REGENCY IN 2024

Home Care is a health service carried out at home and aims to improve, maintain, and increase the independence of patients and families. The home care activities at Mr. A aim to be a form of community service with the hope that the family can be independent in caring for Mr. A. The implementation of community service in the form of home care services uses a family nursing care approach, starting from conducting assessments, determining diagnoses, and providing interventions, documentation, and evaluations. The implementation of home care services is carried out for three days by providing education and wound care. After the wound was treated, Mr. A's wound no longer had fluid coming out of the wound, and when given education, Mr. A and his family understood what was conveyed.

Sociodemographic and health disparities in self-care difficulties among older individuals: Evidence from South Africa

BackgroundAs South Africa’s population rapidly ages, the burden of non-communicable diseases and the challenges of performing daily care activities among older individuals are increasing. This study investigates trends in self-reported difficulties with daily care activities among older adults in South Africa and examines the association between these difficulties, sociodemographic factors, and chronic conditions.MethodsThe study used cross-sectional data from ten rounds of South Africa General Household Survey (2012–2021). Sample population included 26,362 men and 42,400 women aged 60 years and above. The outcome measure was assessed by self-reported difficulty in performing basic care activities such as washing or dressing.ResultsBetween 2012 and 2021, the percentage of participants reporting “A lot of difficulty” increased by 79.75%, “Some difficulty” increased by 112.11%, while “Unable to do” decreased by 8.97%. The risk of self-care difficulties was higher for men (RR = 1.11, 95% CI = 1.02, 1.20) and increased with age: RR = 1.24 (95% CI = 1.08, 1.42) for ages 65–69; RR = 2.27 (95% CI = 2.00, 2.58) for ages 70–74; and RR = 5.65 (95% CI = 5.08, 6.28) for ages 75+. Not being currently married (RR = 1.65, 95% CI = 1.51, 1.79), being of African/Black (RR = 1.21, 95% CI = 1.06, 1.38) or Coloured race (RR = 1.41, 95% CI = 1.21, 1.65), and having diabetes (RR = 1.44, 95% CI = 1.34, 1.55), hypertension (RR = 1.35, 95% CI = 1.26, 1.45), or asthma (RR = 1.30, 95% CI = 1.14, 1.48) were also associated with a higher risk of self-care difficulties.ConclusionThere was a notable increase in the proportion of participants reporting significant difficulty and some difficulty in performing self-care tasks, while a decrease was observed in the category of participants unable to do such tasks. Health policies should prioritize the specific needs of vulnerable sociodemographic and health groups, considering their increased risk of self-care difficulties.

Exploring the suitability of a ward-based clinical pharmacy activity collection tool for ambulatory care practice: a mixed-methods study.

At a London-based hospital, a validated ward-based clinical pharmacy activity collection tool has been used to monitor activities of clinical pharmacy teams across all settings, including ambulatory care services. No data confirm its representativeness for the full range of ambulatory clinical pharmacy services, and pharmacists share this concern. This study aimed to identify the range of clinical pharmacy activities in ambulatory care, assess the suitability of the existing ward-based tool for capturing these activities, and recommend modifications. Non-participant direct observations were conducted to record pharmacists' clinical activities in ambulatory clinics and multidisciplinary meetings. These observations were compared to the existing ward-based tool to identify discrepancies. Semi-structured interviews with eight ambulatory pharmacists were transcribed verbatim and thematically analysed inductively to explore the tool's representativeness of their routine clinical activities. Twenty-nine clinical pharmacy activities were observed in ambulatory services. Only fifteen were captured by the existing tool, with therapy monitoring and recommending therapeutic changes not accurately captured. Pharmacists agreed that the tool was not fully representative and included irrelevant activities. Four common uncaptured activities were multidisciplinary meeting-specific activities, arranging laboratory tests, monitoring patient outcomes, and liaising with community healthcare professionals. This study identified 33 candidate ambulatory clinical pharmacy activities. The existing ward-based tool does not fully capture the full range of ambulatory care clinical pharmacy activities, highlighting the need for an improved tool. Pharmacists recommended including the uncaptured activities. The candidate activities provide a foundation for standardised measurement of relevant ambulatory care activities to enable effective workforce deployment and improve patient outcomes.

Achieving and sustaining reduction in hospital-acquired complications in an Australian local health service

BackgroundReducing the prevalence of hospital-acquired complications (HACs) is paramount for both patient safety and hospital financial performance because of its impact on patient’s recovery and health service delivery by diverting...

Interventional Strategies to Mitigate Maternal Stress and Enhance Coping Skills During Neonatal Admission Into Intensive Care Units in Low- and Middle-Income Countries: A Scoping Review.

Mothers of high-risk neonates experience tremendous stress during neonatal intensive care unit (NICU) admission. This stress has a negative impact on mothers' participation in neonatal care activities, psychological health and coping skills in the NICU. To determine the impact of interventional strategies to reduce maternal stress and enhance coping skills during neonatal admission to the NICU. A scoping review was carried out following the methodological framework outlined by Arksey and O'Malley. This scoping review was conducted as per the Joanna Briggs Institute guidelines, including a quality appraisal checklist for randomised and nonrandomised controlled trials. Patterns, advances, gaps, evidence for practice and research recommendations from the review (PAGER framework) were used to report the results. The following international databases were used to search for primary articles: Medline via PubMed, EBSCOhost via CINAHL, Scopus, Web of Science and the ProQuest Medical Library. Original studies published in English between January 2011 and January 2023 from low- and middle-income countries (LMICs) that assessed maternal stress and coping skills during neonatal NICU admission were included in the review. The review included 15 articles from LMICs, of which 60% were from middle-income, 25% were from lower-middle-income and 15% were from low-income countries. Interventional strategies were described under five categories. Maternal stress decreased significantly across all three subscales of the PSPS: 'sight and sound', 'baby looks and behavior' and 'parental relationship with baby and role alteration' during neonatal NICU admission. Interventional strategies involving family-centred care and emotional and psychological supportive care have been reported to have a consistently positive impact on alleviating maternal stress and enhancing coping skills in the NICU. Healthcare professionals, especially nurses, are pivotal in promptly recognising maternal stress and NICU stressors. The participation of mothers in neonatal care, such as through family-centred care and emotional support interventions, significantly reduces maternal stress and enhances coping skills.

Toward Zero New HIV Infections in Amsterdam in 2026: Building Bridges Between Community Organizations, Undocumented Migrants, and Sexual Health Care Providers.

In the 4 largest cities in the Netherlands, an estimated 400 people live with undiagnosed HIV, including 170 in Amsterdam. Amsterdam targets having zero new HIV infections in 2026. Undocumented migrants are disproportionately affected by HIV and often contract HIV after migration. Moreover, they often experience difficulties accessing health care. The aim of this study was to analyze the outcomes of an HIV/sexually transmitted infection testing program for undocumented migrants through community based testing. Between May 2021 and January 2022, data for this cross-sectional study were collected during outreach testing activities of the Amsterdam Center for Sexual Health of the Public Health Service, and the NGO Doctors of the World. Activities were organized in collaboration with migrant partner organizations. Participants were tested free-of-charge for HIV, syphilis, gonorrhea, chlamydia, and, if indicated, hepatitis B and C. Before testing, a health care provider-administered questionnaire was filled out. A total of 126 people from 22 countries were tested for HIV during 28 outreach activities. Mean age was 37 (IQR 32-43). Forty-nine people (39%) were additionally tested, (through self-sampling) for chlamydia, gonorrhea and syphilis, 42 (33%) for Hepatitis B and 14 (11%) for Hepatitis C. We found zero new HIV infections and 5 positive chlamydia cases.Reaching 52 HIV first time testers and 19 first time testers since migration shows the importance of these activities. The number of participants tested were lower than initially expected due to lower attendance per testing day for various reasons. To increase the likelihood of reaching undocumented migrants for HIV/sexually transmitted infection testing and linkage to care, focus should be on on-site provider-initiated testing, e.g. during outreach health care activities, and on easy access to centers for sexual health. Collaboration between health care providers and community stakeholders is essential.

Including adults and peers through translanguaging in literacy activities

ABSTRACT Translanguaging in reading activities in Early Childhood Education and Care (ECEC) can result in child engagement, language learning and the development of multilingual identities. Few studies have explored the engagement of very young children and languaging when they participate in activities with both educators and parents. The present study therefore investigates the ways in which educators in two daycare centres and parents jointly supported children when the parents read in the home language as well as the children’s engagement and interactions. The observational and interview data were collected in Luxembourg where a multilingual education policy is in place in ECEC. The findings show that the parents used the home language on its own or together with the instructional language which, in turn, resulted in different emotional and instructional support and impacted children’s engagement and interactions differently. While the opportunities to hear and speak a home language other than the institutional one resulted in most children performing their multilingual identities, children only engaged with content, interacted with the parent, educator and peers, and included them when the adults translanguaged. The findings suggest that children and parents can benefit from collaborative reading events when the adults draw on children’s multilingual repertoires.

Modeli organizacije paliativne oskrbe odraslih

Palliative care is a young medical profession in Slovenia. It ensures the best possible quality of life for patients with chronic incurable diseases, regardless of their age, and offers support to their loved ones during the patient’s illness and after death during the mourning period. In the early period, palliative care is integrated with specific treatment. However, later, it continues with the period of late palliative care and throughout the last days of life. Its central purpose is to preserve the dignity of life and the values of the individual. Contemporary guidelines envision the implementation of palliative care tailored to individual needs throughout the entire course of life with an incurable disease. It should be holistic, continuous, and integrated into core medical disciplines. The appropriate coordination of palliative care activities, which directs the patient to the most suitable provider based on their current needs is of key importance. In this paper, based on a review of international recommendations, local characteristics and experiences, we will present the most common palliative care activities, their interrelationship and interdependence in the provision of palliative care, and thus define a model of palliative care that can, in our environment, provide appropriate support to as many patients as possible.

Frailty and related factors among community-dwelling older adults in Türkiye

Abstract Background Frailty in elderly can lead to complex challenges in the follow-up and management of health services. Ensuring comprehensive primary care services and social support can avert, reverse, or mitigate frailty in old age. We aimed to evaluate frailty and its associated factors in individuals aged ≥65 years. Methods We conducted a cross-sectional study in patients applying to primary care centres in 2024, in a city where 10% of the population is elderly. The centres were divided into clusters based on the socioeconomic status of the regions they serve, and nine were randomly selected by weight. A total of 1154 elderly who consecutively presented were included. A questionnaire including sociodemographic characteristics, Edmonton Frailty Scale, Loneliness Scale for the Elderly (LSE), Charlson Comorbidity Index (CCI), International Falls Effectiveness Scale (FES-I) was applied to the elderly. Results The mean age was 71.3±5.3 years, and 50.8% were male. In the study, 20.1% were frail, and 19.6% were apparently vulnerable. It was found that those aged 70-79 and ≥80 years, women, deceased/separated from their spouses, those with low education, those whose occupation was housewife, those earning below minimum wage, those who lived alone, non-exercisers, those taking >8 medications/day, and those who had ≥2 falls/last year were more frail. In multivariate logistic regression analysis, illiteracy (Odds ratio-OR:15.2, 95%CI:1.7-135.5), taking >8 medications/day (OR:4.1, 1.7-9.9), falling ≥2 times/last year (OR:3.4, 1.8-6.4) and ≥4 points on the CCI (OR:1.9, 1.0-3.4) were found to be predictors of frailty. Each score on the FES-I and LSE increased the risk of frailty by 1.08 (1.05-1.11) and 1.13 (1.08-1.17) times, respectively. Conclusions One in five people was found to be frail. Low education level, >8 medications/day, ≥2 falls in the last year, severity of comorbidity, fear of falling, and high levels of loneliness were found to be predictive factors for frailty. Key messages • Encouraging a healthy lifestyle to prevent comorbid diseases and early interventions to avoid falls can reduce frailty. • Providing social activities in primary care and promoting the elderly to participate in these activities can help prevent loneliness, which is a risk factor of frailty.

Practicing what you preach. Do cardiology trainees in the United Kingdom follow the lifestyle advice that they would give to patients?

Abstract Background The role of lifestyle factors in determining the risk of cardiovascular disease is well established. As a result, lifestyle modification is recommended as part of numerous European Society of Cardiology guidelines. However, it remains uncertain how closely cardiologists adhere to guidelines in their personal life. Poor lifestyle among clinicians can contribute to poor health and may increase absenteeism and potentially reduce the quality of patient care. Purpose To establish whether cardiology trainees in the UK follow appropriate guideline-directed lifestyle advice in their personal life. Methods All cardiology trainees within the UK were eligible to participate in the 2023 British Junior Cardiologists' Association (BJCA) training survey and the survey was advertised through national and local campaigns. The survey contained questions on smoking status, alcohol intake, healthy diet, partaking in regular exercise, frequency of adequate quality of sleep, and demographic questions. Responders were eligible for inclusion if they consented to participate in health and wellbeing survey questions, and if they had completed four demographic questions. Results Of the 398 responders to the 2023 BJCA survey, 212 consented to answer health and wellbeing questions (66% male, age 34±4 years, 42% had dependents) and were included. Responders included trainees representing all four UK nations. Very few cardiology trainees were current smokers either of cigarettes/cigars (n=2, 1%), or e-cigarettes (n=2, 1%), with 12 (6%) being ex-smokers. Few trainees (n=13, 6%) consumed alcohol above the UK recommended maximum of 14 units per week (Fig 1A). However, only 14% (n=29) regularly achieved 30 minutes of moderate or 15 minutes of intense exercise on at least 5 days each week (Fig 1B). Most trainees (n=167, 80%) only obtained adequate sleep on four or fewer nights each week (Fig 1C). Only 37% (n=78) of trainees agreed or strongly agreed that they were able to maintain a healthy diet most days (Fig 1D). Conclusions Most UK cardiology trainees followed guidance related to smoking and alcohol intake. However, far fewer trainees followed healthy lifestyle guidance relating to exercise, sleep, and diet. Whether these findings are similar across other ESC nations should be investigated. Further work is required to establish the impact of healthy living on clinician working activity and subsequent quality of patient care. Training bodies should consider how occupational factors may contribute to a trainee’s adverse healthy living.

Economic burden of suicide in Sweden in 2022

Abstract Background Suicide and suicidal behaviors bring massive human, social and economic impacts. Estimates of the cost of suicide can give some guidance as to where research on developing new interventions might be focused to give the greatest potential gain. The aim of the study is to quantify the economic cost of suicide in Sweden in 2022. Methods Incidence of suicide attempts and mortality due to suicide, intentional and undetermined (ICD10 X60-X84 and Y10-Y34) were sourced from the Swedish National Board of Health and Welfare databases for 2022. Cost were estimated from a societal perspective, including costs for inpatient and outpatient care, medication, police and justice activities as well as productivity losses due to early mortality. Results In 2022, a total of 1,569 suicide death were registered in Sweden (1,102 men and 467 women). The incidence rate remains stable during the last ten years, 17 death per 100 000. In total, 18,854 patients (10, 359 women and 8,459 men) were treated in inpatient and outpatient hospital care with suicide-related diagnoses, generated 32,843 days in inpatient care and 11,471 outpatient care visits. Direct costs for suicide death including forensic examination, emergency services, police investigation and property damage were estimated as €6,02 million, while indirect costs for productivity losses totaled €690 million. Direct healthcare costs for suicide related treatment were estimated at €54.3 million. Overall, suicide and suicide attempts cost around €750 million per year to society. Conclusions Estimates of the economic burden of suicide are needed for the Swedish setting, and these amounted to €60.3 million in direct costs and €690 million in indirect costs in 2022. The cost might be underestimated because the societal cost of suicide bereaved persons was not considered. These cost estimates can provide useful inputs to a cost-effectiveness analysis of a specific preventive intervention, and to its subsequent evaluation. Key messages • Economic burden of suicide is substantial for society. • Public health policies aimed at the prevention of suicide should be increased.

Risk perception survey for healthcare-associated infections in a large teaching hospital in Rome

Abstract Background Healthcare-associated infections (HAIs) are the main complications of hospitalization. The goal of the study was to enhance awareness, improve risk perception, and facilitate measures to reduce the outcomes of HAIs. A bottom-up approach, in which the healthcare workers involved play a key role, can be adopted to decrease the spread of HAIs. Therefore, a survey was conducted in a large teaching hospital in Rome from 2019 to 2023, excluding 2020 due to COVID-19. Methods A longitudinal study was conducted in all integrated care departments with beds. The data was collected using a standardized, anonymous, self-administered questionnaire for healthcare workers. The questionnaire consisted of 61 items assessing socio-professional features, knowledge of HAIs, attitudes and barriers to hygiene compliance, self-analysis of professional behavior and advice for new interventions. The study lasted 21 days between November and December, which is considered a period of normal care activity. A multivariable logistic regression model was built. Statistical analyses were performed with STATA 18.0. Results There were 384 health workers respondents: female (67.7%) and nurses (56.5%). The most represented areas were internal medicine (37.9%) and surgery (27.3%). The correct frequency of perception of HAIs increased from 33.3% in 2019 to 36.3% in 2023. From 2022 to 2023, the multivariable model showed that physicians (OR 0.48, CI 95% 0.24-0.93, p-value 0.03) and elder staff (OR 1.02, CI 95%, 1.0-1.1, p-value 0.04) seemed to be more aware of the prevalence of HAIs in their ward. Conclusions Targeted training days were organized after the study to discuss the data collected. Staff awareness of the prevalence of HAIs in their ward is improving, even if it is complicated to quantify it by attending HAIs training events. The survey has been included as a corporate goal for 2024 as a useful tool to improve awareness of HAIs and to evaluate the effectiveness of ongoing training. Key messages • A bottom-up approach, in which healthcare workers assume a pivotal role, can be employed to reduce the spread of HAIs as it serves as a valuable tool to evaluate the efficacy of targeted training. • The results indicate that the education of healthcare workers is a crucial factor in enhancing awareness of HAIs. Therefore, there is a need to improve the education of younger and non-medical staff.

Web-Based Nursing Care Documentation for Students to Support Online Learning

Nursing care is the most critical element in nursing services, which aims to improve the patient’s health status. Ineffective and inefficient care documentation can impact the quality of nursing services. However, the increasingly advanced development of technology provides freedom for the health world to improve the quality of patient-centered services. Educational institutions have also used information technology in learning process activities. As prospective health professionals, students must be equipped with competencies to support their performance. In this study, a web-based nursing care information system was developed to assist students in documenting care activities. The website application was designed to increase student competency in nursing documentation activities to provide high-quality nursing services even though learning is online. The waterfall model approach was used in application design. The design stage started with analyzing application requirements, followed by system design and coding. Next, using a Likert-scale questionnaire, a usability test was performed on 15 beta users to assess the functionality of the application. The results showed that the nursing care website application was easy to use and that students felt satisfied. It is hoped that the website application can be made more attractive by including a decisional support system to make it easier for students to enforce nursing diagnoses on patients.

Young carers in Ghana: caring activities, ways into care and the impacts of caregiving

ABSTRACT In Ghana, children often provide care and support to family members with disabilities, mental illnesses and other health conditions. Understanding the nature of their caring activities is essential for identifying stressors and promoting better health and wellbeing outcomes for this group of children, described in the wider literature as young carers. This qualitative study investigated the nature and impact of caring activities on young carers aged 11–17 years. The findings revealed that young carers provide domestic, financial, medical and personal care. Caring activities while beneficial, result in a double burden, as young carers often support both the care recipients and their dependents. Despite the challenges associated with caring activities, the study also reveals the myriad reasons young carers enter care work, suggesting that the work of young carers is not simply an obligation or a choice but a process and an integral part of Ghanian family structures. The study highlights the urgent need for formal mechanisms to identify and support young carers and their care recipients in Ghana.

Evaluation and redesign of an internal medicine pharmacy practice model at a tertiary care hospital.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Clinical pharmacists are embedded into the care for patients admitted to internal medicine floors at Cleveland Clinic. The existing practice model utilized by the internal medicine pharmacy team had an uneven distribution of clinical activities among the various pharmacist roles. A study was completed to evaluate a potential adjustment to the pharmacy practice model. The objective of this study was to assess the type and quantity of clinical activities performed by each pharmacist role. These data were then utilized to evaluate the need for redistribution of care activities among the pharmacist roles and to determine the need for additional pharmacist full-time equivalents. From January to February 2023, data pertaining to the amount and type of clinical activities completed by the 9 internal medicine pharmacist roles was either manually collected or extracted from the electronic medical record. The data were then utilized to calculate a responsibility score for each role. Descriptive statistics were also calculated to assess the results. Each pharmacist role cared for an average of 34.4 patients (minimum, 24.4; maximum, 57.7) during the study period. The average responsibility score for each pharmacist role was 309.8 (minimum, 237.5; maximum, 447.8). On the basis of the data collected during the 4-week study period, a new pharmacy practice model was developed that incorporated 2 additional full-time equivalents. This model balanced patient care responsibilities among the pharmacist roles and moved the practice model from a location-based to a team-based coverage model.

The relationship of diabetes knowledge and self-care practices among patients with type 2 diabetes mellitus

Background: Diabetes Mellitus (DM) is a disease characterized by increased blood glucose levels and cannot be cured so it requires self-care. DM self-care is a program that must be carried out throughout the life of DM sufferers. DM self-care aims to optimize metabolic control, optimize quality of life, and prevent acute and chronic complications. Good knowledge and self-care consisting of good diet, physical exercise, medication, and education can control blood sugar levels and prevent complications of type 2 DM. Purpose: To determine the relationship between knowledge and self-care in patients with type 2 diabetes mellitus. Method: Descriptive correlational research design with a cross-sectional approach. The study population was patients with type 2 diabetes mellitus in the work area of ​​the Pasar Rebo District Health Center, East Jakarta, totaling 690 patients, carried out in November-December 2023. The sampling technique used the Accidental Sampling technique with the Slovin formula and a sample of 87 respondents was obtained. The research instrument used the Diabetes Knowledge Questionnaire (DKQ-24) for the knowledge questionnaire and the Summary of Diabetes Self Care Activity (SDSCA) for the self-care questionnaire. Data analysis used the univariate and bivariate Chi Square alternative tests. Results: Respondents with poor knowledge resulted in poor self-care of 30 respondents (53.6%), while respondents with good knowledge resulted in good self-care of 16 respondents (51.6%). The results of the Chi-Square test showed a significant p value of 0.001 (<0.05). Conclusion: There is a significant relationship between knowledge and self-care in type 2 DM patients with a p value of 0.001.

Study on Active Components and Mechanism of Lettuce Latex Against Spodoptera Litura.

Plant latex is a sticky emulsion exuded from laticifers once the plant is damaged. Latex is an essential component of plant defense against herbivores. Lettuce (Lactuca sativa L.) in the Compositae family has relatively fewer insect herbivores compared with other leaf vegetables. The larvae of a generalist lepidopteran pest Spodoptera litura (Fabricius) avoided feeding on living lettuce plants. However, the larvae rapidly damaged the excised leaves that were unable to produce latex. Six compounds were isolated from lettuce latex. They were identified as 2,5-dihydroxybenzaldehyde (1), 3β-hydroxy-4,15-dehydrograndolide (2), annuolide D (3), lactucin (4), lactucopicrin (5), and hanphyllin (6). Bioassays showed that the inhibition rate of compound 1 (2,5-dihydroxybenzaldehyde) and 6 (hanphyllin, a sesquiterpene lactone) on the weight gain of S. litura were 52.4 % and 10 %, respectively, at the concentration of 100 μg/g. RNA-seq analyses showed that larval exposure to compound 1 down-regulated the genes associated with heterobiotic metabolism including drug metabolism-cytochrome P450, metabolism of xenobiotics by cytochrome P450, retinol metabolism, glutathione metabolism, and drug metabolism-other enzymes (mainly uridine diphosphate glucuronyltransferase, UGTs). RT-qPCR further confirmed that 33 genes in the family of carboxylesterase (CarE), P450s and UGTs were down-regulated by compound 1. The activities of CarE, P450s and UGTs in the larvae fed on diets containing compound 1 were significantly lower than those fed on control diets, with the inhibition for the three detoxification enzymes being 55.4 %, 53.9 %, and 52.9 %. These findings suggest that secondary metabolites including 2,5-dihydroxybenzaldehyde in the latex play a key role in protecting lettuce from insect herbivory.

A Comparative Study of the Chemical Composition and Skincare Activities of Red and Yellow Ginseng Berries.

This study was conducted to investigate the differences in chemical composition between red (RGBs) and yellow ginseng berries (YGBs) and their whitening and anti-aging skincare effects. The differences in the chemical composition between RGB and YGB were analyzed by ultra-high-performance liquid chromatography tandem quadrupole electrostatic field orbit trap mass spectrometry (UHPLC-Q-Exactive-MS/MS) combined with multivariate statistics. An aging model was established using UVB radiation induction, and the whitening and anti-aging effects of the two ginseng berries were verified in vitro and in vivo using cell biology (HaCaT and B16-F10 cells) and zebrafish model organisms. A total of 31 differential compounds, including saponins, flavonoids, phenolic acids, and other chemical constituents, were identified between the two groups. Superoxide dismutase (SOD) activity was more significantly increased (p < 0.05) and malondialdehyde (MDA) content was more significantly decreased (p < 0.01) in RGB more than YGB induced by UVB ultraviolet radiation. In terms of whitening effects, YGB was more effective in inhibiting the melanin content of B16-F10 cells (p < 0.01). The results of zebrafish experiments were consistent with those of in vitro experiments and cell biology experiments. The DCFH fluorescence staining results revealed that both ginseng berries were able to significantly reduce the level of reactive oxygen species (ROS) in zebrafish (p < 0.01). Comparison of chemical composition and skin care activities based on RGB and YGB can provide a theoretical basis for the deep development and utilization of ginseng berry resources.

Time Unmasked: Illuminating the Hidden Dimensions of Economic Stratification during COVID-19 in the United States

This paper delves into the nuanced impact of the COVID-19 pandemic on time use activities in the United States, particularly examining gender and parental status differences. Drawing on data from the 2018–2022 American Time Use Survey, the study analyzes trends in six distinct time use categories: unpaid care work, leisure, employed activities, personal care, childcare, and household activities. The research sheds light on the evolving dynamics within households during the pandemic, emphasizing the potential implications for economic stratification and societal well-being. The COVID-19 pandemic completely disrupted established time use patterns, forcing a reconsideration of ‘traditional’ gender roles and caregiving responsibilities in certain countries. While early studies hinted at a temporary shift toward more equitable distribution of household activities, particularly childcare, this paper scrutinizes these trends over a more extended period. Despite the short-lived increases in fathers’ involvement in childcare during the pandemic, the study finds that the caregiving burden remained disproportionately on mothers and women. Notably, the analysis reveals persistent gender disparities in unpaid care work, with women and mothers spending a disproportionate amount of time on household activities, housework, and caring for children. This unequal distribution of caregiving responsibilities limits a women’s ability to engage in paid work activities, contributing to economic stratification and constraining their financial resources. While some activities demonstrated slight reductions in gender gaps, the overall picture suggests that the pandemic may not bring about lasting changes in how time is allocated within households.