Early Guidance Research Articles

What's left of the leftward bias in scene viewing? Lateral asymmetries in information processing during early search guidance

Understanding how early scene viewing is guided can reveal fundamental brain mechanisms for quickly making sense of our surroundings. Viewing is often initiated from the left side. Across two experiments, we focused on search initiation for lateralised targets within real-world scenes, investigating the role of the cerebral hemispheres in guiding the first saccade. We aimed to disentangle hemispheric contribution from the effects of reading habits and distinguish between an overall dominance of the right hemisphere for visuospatial processing and finer hemispheric specialisation for the type of target template representation (from pictorial versus verbal cues), spatial scale (global versus local), and timescale (short versus longer). We replicated the tendency to initiate search leftward in both experiments. However, we found no evidence supporting a significant impact of left-to-right reading habits, either as a purely motor or attentional bias to the left. A general visuospatial dominance of the right hemisphere could not account for the results either. In Experiment 1, we found a greater probability of directing the first saccade toward targets in the left visual field but only after a verbal target cue, with no lateral differences after a pictorial cue. This suggested a contribution of the right hemisphere specialisation in perceptually simulating words' referents. Lengthening the Inter-Stimulus Interval between the cue and the scene (from 100 to 900 ms) resulted in reduced first saccade gain in the left visual field, suggesting a decreased ability of the the right hemisphere to use the target template to guide gaze close to the target object, which primarily depends on local information processing. Experiment 2, using visual versus auditory verbal cues, replicated and extended the findings for both first saccade direction and gain. Overall, our study shows that the multidetermined functional specialisation of the cerebral hemispheres is a key driver of early scene search and must be incorporated into theories and models to advance understanding of the mechanisms that guide viewing behaviour.

Navigating life with single-ventricle CHD: psychosocial needs across adulthood

Abstract Objective: The population of adults with single-ventricle congenital heart disease (CHD) is growing. This study explores their lived experiences through an adult developmental psychology framework. Methods: Individuals aged 18 and older with single-ventricle CHD participated in Experience Group sessions and 1:1 interviews. Sessions were transcribed and analysed thematically. Themes were categorized by developmental domains and age group. Results: Of the 29 participants, 18 (62%) were female, 10 (35%) were emerging (18–29 years), 13 (45%) were established (30–45 years), and 6 (21%) were midlife adults (46–60 years). Emerging adults expressed reluctance to initiate romantic relationships and fear of burdening partners, while established adults reported strong relationships with partners deeply involved in caregiving. Emerging adults struggled with finding fulfilling work that meets their health needs, whereas established and midlife adults faced unemployment or early retirement due to health limits. Family dynamics shifted, with established and midlife adults educating their children to become caregivers. Physical limitations and low self-rated health were consistent across life stages, and midlife adults did not worry about traditional chronic conditions. Mental health concerns, including anxiety and depression, persisted across all life stages, but resiliency and positive affect were also evident. Conclusion: Adults with single-ventricle CHD experience developmental milestones differently, indicating the need for early anticipatory guidance in these domains to achieve optimal outcomes in adulthood.

Assessing the Role of Blood Gas Analysis in COVID-19 Patients for Early Warning and Clinical Guidance.

To assess the role of blood gas analysis as an auxiliary tool for detecting and predicting the progression of COVID-19 in patients. A consecutive cohort study was conducted of 106 patients diagnosed with the novel coronavirus. Patients were divided into two groups based on age and the course of the disease (mild to moderate and severe). Blood gas analysis parameters were measured for all participants and results were compared between groups. This study was conducted in the Department of Laboratory Medicine, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China. Arterial/alveolar oxygen partial pressure ratio, reduced hemoglobin fraction, sodium ion, lactic acid, oxygen saturation, oxygen partial pressure, and oxyhemoglobin fraction. Findings indicated statistically significant differences between the two groups in the measured parameters. Blood gas analysis has the potential to more accurately assess the progression of COVID-19 in elderly patients, specifically related to respiratory and acid-base balance issues. This study underscores the importance for bedside nurses to pay close attention to acid-base balance, lung ventilation/ventilation function, and hypoxia status in elderly critically ill patients with COVID-19, in order to more effectively diagnose and predict the progression of the disease.

Abstract 4135434: Effect of early nutritional guidance for patients with acute myocardial infarction: A single center retrospective cohort study

Introduction/Background: Acute myocardial infarction (AMI) stands as a major global cause of mortality. Various intervention strategies, such as pre-hospital care, reperfusion therapies, pharmacological interventions, dietary modifications, and exercise therapies, have been researched to improve patient prognosis. Research Question: There remains a lack of evidence regarding the impact of early nutritionist-led dietary guidance on the prognosis of AMI patients. Aim: This study aimed to elucidate whether nutritional guidance by nutritionists who have national qualifications would improve the mortality and the primary composite endpoint (including acute decompensated heart failure, stroke, and acute coronary syndrome) of patients following an acute myocardial infarction. Methods/Approach: A retrospective cohort study enrolling 409 AMI patients who underwent emergency percutaneous coronary interventions between September 1, 2015, and October 31, 2023. Nutritionists guided 223 patients (54.5%) during hospitalization in this study. The nutritional guidance used in our study was also based on the definition of adequate caloric intake of 25–30 kcal per ideal body weight (kg). Under an appropriate total energy intake, a fat energy ratio of 20–25% and a carbohydrate energy ratio of 50–60% are recommended, with protein and lipid restrictions depending on the disease state. Results/Data: During a median follow-up of 39 months, 24 cases of all-cause mortality (5.9%) and 6 cases of cardiovascular mortality (1.5%) were recorded. Kaplan–Meier curves demonstrated significantly higher incidence rates of death and primary composite endpoints among patients without nutritional guidance during hospitalization. The multivariate Cox regression model revealed early nutritional guidance as a significant predictor for long-term mortality but not for primary composite endpoints. Furthermore, undernourished patients, defined as those with a geriatric nutritional risk index of 98 or less, showed a similar prognosis to those with good nutritional status after receiving nutritional guidance, indicating that nutritional guidance improves prognosis. Conclusion: Nutritionist-led dietary guidance for patients with AMI can potentially improve total mortality and is expected to be more effective in undernourished patients. Further research is warranted to explore the physiological impacts of improved diets resulting from such guidance and their effects on enhancing prognosis.

Enhanced walking function and quality of life in unicondylar knee replacement patients through continuous nursing intervention: A clinical study.

The knee joint anatomical structure is susceptible to external forces, which can lead to functional break down, profoundly affecting the quality of life and daily functioning of individuals. To investigate the effects of continuous nursing intervention on walking function, quality of life, and treatment satisfaction in patients undergoing unicondylar knee replacement. This prospective study included 90patients who underwent unicondylar knee arthroplasty due to unicondylar osteoarthritis. Participants were divided into two groups based on their nursing methods: the control group (n= 45) and the observation group (n= 45). Three months post-intervention, the observation group demonstrated significant improvements in knee joint range of motion, Hospital for Special Surgery Knee Score score, and Lysholm knee joint score compared to the control group (P< 0.05). The observation group also had a shorter completion time for the Timed Up and Go test and significantly higher SF-36 scores (P< 0.05 for both). Additionally, Knee Injury and Osteoarthritis Outcome Score scores in the observation group were significantly higher after three months of intervention (P< 0.05). And the observation group reported higher satisfaction rates and lower dissatisfaction rates compared to the control group (P< 0.05). Early postoperative rehabilitation guidance, regular reviews, and rehabilitation exercise guidance result in better rehabilitation outcomes, enhanced knee joint function, improved walking ability, and overall quality of life for patients undergoing unicondylar knee replacement.

FRET-Based Dual-Color Carbon Dot Ratiometric Fluorescent Sensor Enables the Smartphone-Integrated Device for Noninvasive and Portable Diagnosis of Chronic Kidney Disease.

Cystatin C (Cys C), a crucial renal disease marker for chronic kidney disease (CKD), plays a vital role in early diagnosis and treatment guidance. However, most current methods for detecting Cys C rely on a single signal and find it difficult to perform noninvasive and portable diagnosis. Here, we developed a ratiometric fluorescent carbon dot (CD) detection system for point-of-care testing (POCT) of Cys C through fluorescence resonance energy transfer (FRET). The detection is based on the hydrolysis effect of papain on a bovine serum albumin (BSA) scaffold and the specific inhibitory effect of Cys C on papain, endowing high-resolution color variance. Moreover, a low-cost, portable, yet reliable smartphone-assisted miniaturized device for real-time quantitative POCT of Cys C has been developed with a limit of detection (LOD) as low as 0.4 μg/mL. This sensing platform can effectively differentiate patients from healthy volunteers, which facilitates self-screening for healthy individuals and home monitoring for CKD patients.

The associations of insulin resistance, obesity, and lifestyle with the risk of developing hyperuricaemia in adolescents

BackgroundHyperuricaemia is common among obese children and adolescents, and is closely related to insulin resistance. The aim of this study was to explore the relationships between youth insulin resistance and hyperuricaemia, as well as their relationships with lifestyle factors in youths, to provide early guidance on the risk factors for hyperuricaemia in adolescents.MethodsThis study included 233 adolescents aged 10 to 20 years. Insulin resistance was evaluated via the homeostasis model assessment-insulin resistance (HOMA-IR) method. Binary logistic regression analysis was used to assess the associations of HOMA-IR with hyperuricaemia status and serum uric acid (UA) levels. The participants were subsequently divided into two groups, the noninsulin resistant group (HOMA-IR ≤ 3.2) and the insulin resistant group (HOMA-IR > 3.2), to further explore the factors that may affect the serum UA level. Finally, the predictive ability of different indicators of hyperuricaemia was evaluated via the ROC curve.ResultsBinary logistic regression analysis revealed a significant increase in the risk of developing hyperuricaemia for individuals with elevated HOMA-IR (p < 0.001) and insulin resistance (p < 0.01). Spearman’s correlation analysis revealed a significant positive linear correlation between HOMA-IR and serum UA levels (r = 0.4652, p < 0.001). Among insulin-resistant adolescents, UA levels were positively correlated with weight ratings, frequency of staying up late, and sugary beverages intake. Notably, individuals who engaged in 1–3 h of weekly exercise had the lowest UA levels. The area under the ROC curve for HOMA-IR was 0.847 (cut-off value = 2.165, p < 0.001), and the optimal prediction model included HOMA-IR, BMI z-score, and other lifestyle factors (AUC: 0.870, p < 0.001)).ConclusionHOMA-IR was identified as an independent risk factor for the development of hyperuricaemia and could be used as a sensitive indicator for the prediction its development in adolescents. In insulin-resistant adolescents with hyperuricaemia, maintaining normal weight, engaging in physical exercise for 1–3 h per week, avoiding staying up late and limiting sugary beverages intake are recommended to reduce the prevalence of hyperuricaemia among adolescents.

Bibliometric analysis of research trends on factors affecting older adults with mild cognitive impairment.

In recent years, the problem of cognitive impairment in the elderly has become increasingly prominent. Understanding the research trend of influencing factors of mild cognitive impairment, and provide reference for medical staff to early screening of the elderly with mild cognitive impairment. Through the visual analysis of the influence factors of the elderly with mild cognitive impairment, the current research status was discussed. The relevant literature in the field of influencing factors of mild cognitive impairment in the elderly included in the Web of Science core collection database from 2013 to 2022 was searched. Using software such as Cite Space and VOS viewer to visually analyze literature citations, country, keywords, and development trends. A total of 547 relevant literatures were included, and the number of publications showed an increasing trend in the past ten years. The United States ranked first in both the number of published papers (157) and centrality (0.34), and the United States and China had a greater influence on the influencing factors of mild cognitive impairment. Alzheimer's disease, cognitive decline, the elderly, risk factors, are the research hotspot in this field. Cognitive decline will affect the autonomy of the elderly. Cognitive frailty, MRI is the forefront of MCI research, to understand the research hotspots and frontiers in this field, to conduct early screening and intervention guidance for people with mild cognitive impairment, so as to delay the occurrence of Alzheimer's disease, and reduce the pressure on family caregivers and society.

Sleep and home parenteral nutrition in adults: A narrative review.

Infusions of home parenteral nutrition (HPN) are often cycled at night coinciding with sleep episodes. Adult consumers of HPN are known to experience poor sleep attributed to frequent awakenings and long durations of wakefulness after falling asleep. Consequently, most consumers do not meet recommendations for sleep duration and quality or daytime napping. The primary underlying pathophysiology resulting in sleep problems is nocturia; however, other factors also exist, including disruptions caused by medical equipment (ie, pump alarms), comorbid conditions, dysglycemia, and medication use. Early guidance on sleep is imperative because of the central role of sleep in physical health and wellbeing, including mitigating complications, such as infection risk, gastrointestinal problems, pain sensitivity, and fatigue. Clinicians should routinely inquire about the sleep of their patients and address factors known to perturb sleep. Nonpharmacologic opportunities to mitigate sleep problems include education on healthy sleep practices (ie, sleep hygiene); changes in infusion schedules, volumes, rates, and equipment; and, possibly, behavioral interventions, which have yet to be examined in this population. Addressing comorbid conditions, such as mood disorders, and nutrition deficiencies may also help. Pharmacologic interventions and technological advancement in HPN delivery are also needed. Research on sleep in this population is considered a priority, yet it remains limited at this time.

PSYCHOLOGICAL AND PEDAGOGICAL ASPECTS OF EARLY CAREER GUIDANCE FOR PRESCHOOLERS

This article discusses the psychological and pedagogical aspects of early career guidance in preschool age. The psychology of children in the adult group is always eager to be united, curious, andquickly adapts to a developing environment. It is a condition for a child to work from an early age, taking into account the peculiarities of his age before conducting career guidance work. In particular, it is necessary to take individual steps, taking into account the psychological state of the child. In kindergarten, children are familiar with the development and development of a professional. This simple education helps children expand their understanding of their work, fathers and grandfathers, as well as better understand the workplace of their fathers and grandchildren as they work in their work. Currently, career guidance is an important direction in the work of educational institutions. The established system of professional work helps to form a long-term approach to Labor results, as well as in creating a diverse presentation of World Labor and professionals, which includes the importance of professional work for the life and development of society.. Developed technologies are the basis of all preschool education. Child knows about professionals, in no case do not need to play! The game is a special, memorable form of overcoming it in real (or highly effective) activities for the purpose of improvement, creation, activity, inconsistency, self-realization.

Wood-based policies as a driver for the climate transition

Abstract In the context of global accelerating urbanization, the total floor area of buildings is expected to double by 2060, with a significant impact on the environment. While cities made consistent progress towards increasing energy efficiency, accounting for, and reducing embodied emissions for new and renovated constructions represents one critical priority for mitigating this impact and reaching genuine carbon neutrality. Wood is a renewable and carbon-positive material, which can have a meaningful contribution to changing paradigms on net-zero carbon ambitions of cities, but still faces the challenge of an immature integration into urban development policy framework. Through the Horizon 2020 “Build-in-Wood” project we addressed the challenge of translating novel wood building systems, pilots, wood value chains for the construction of multi-storey wood buildings, and promising practices into policy. As a result, we formulate transferable lessons learned, recommendations, and criteria that can serve as guidance for municipalities and policymakers who aim to channel their efforts toward creating a more sustainable built environment by prioritizing wood, either implicitly or explicitly. We achieved this by working on understanding the real needs of cities and territories, the drivers, and the key entry points and preconditions for new policies supporting multi-storey wood buildings and genuine carbon neutrality. Specifically, the findings are based on the close collaboration with seven affiliated cities (Early Adopter Cities in Europe), outlining and integrating the results of (i)Multi-criterial urban planning, strategic and regulatory context analysis, (ii)Participatory and co-design approaches implemented with their local stakeholder ecosystem from the wood construction value chains and (iii)Research of different best practice policies at national, regional and local level from different parts of the globe, that incentives through informative, financial, research or regulatory instruments building with wood. The entire process is presented in the form of a Build-in-Wood Policy Catalogue [1], offering insights on working with Early Adopter Cities and guidance for improving policy, governance, and the decision-making process for subnational governments. The research was not intended to be exhaustive in documenting all existing policies because of the field’s dynamics, but rather to provide an overview and understanding of different policy instruments’ applicability and potential impact.

Diagnostic value of serum vascular endothelial growth factor and interleukin-17 in primary hepatocellular carcinoma.

Despite significant advancements in the medical treatment of primary hepatocellular carcinoma (PHC) in recent years, enhancing therapeutic effects and improving prognosis remain substantial challenges worldwide. To investigate the expression levels of serum vascular endothelial growth factor (VEGF) and interleukin (IL)-17 in patients with PHC and evaluate their diagnostic value while exploring their relationship with patients' clinical characteristics. The study included 50 patients with confirmed PHC who visited Wuhan Hanyang Hospital from January 2021 to January 2022, and 50 healthy individuals from the same period served as the control group. Serum VEGF and IL-17 levels in both groups were measured by Enzyme-Linked Immunosorbent Assay, and their diagnostic value was assessed using receiver operating characteristic (ROC) curves. Pearson correlation analysis was performed to examine the relationship between serum VEGF and IL-17 levels. Pathological data of the PHC patients were analyzed to determine the relationship between serum VEGF and IL-17 levels and pathological characteristics. Serum VEGF and IL-17 levels were significantly higher in the study group compared to the control group (P < 0.05). No significant association was observed between serum VEGF and IL-17 levels and gender, age, combined cirrhosis, tumor diameter, or degree of differentiation (P > 0.05). However, there was a significant relationship between clinical TNM stage, tumor metastasis, and serum VEGF and IL-17 levels (P < 0.05). Correlation analysis revealed a positive correlation between serum VEGF and IL-17 (P < 0.05). ROC analysis demonstrated that both serum VEGF and IL-17 had good diagnostic efficacy for PHC. Serum VEGF and IL-17 levels were significantly higher in PHC patients compared to healthy individuals. Their levels were closely related to pathological features such as tumor metastasis and clinical TNM stage, and there was a significant positive correlation between VEGF and IL-17. These biomarkers may serve as valuable reference indicators for the early diagnosis and treatment guidance of PHC.

예비유아교사의 잠재적 역량 발전을 위한 마이크로티칭 경험에 대한 이야기

Objectives In this study, micro-teaching was conducted to develop potential teaching competencies of pre-service early childhood teachers, and these experiences were analyzed. Methods For this purpose, micro-teaching was conducted to 10 students among the subjects of early childhood curriculum research and guidance law operated by the Department of Early Childhood Education at a university located in Gyeongsangbuk-do, and their experiences were analyzed. Results As a result of this study, the pre-service early childhood teachers recognized the micro-teaching experience as an activity of personal reflection opportunity, understood their own class activity form, and tried to improve their class activity attitude and teaching skill from the perspective of others. Second, pre-service early childhood teachers were thinking more practically about the meaning of becoming a teacher by breaking away from their subjective perception through microteaching. Third, the improvement process through trial and error showed the possibility that the pre-service early childhood teachers themselves could improve by experiencing several trial and error processes. Finally, the pre-service early childhood teachers were expecting improvement of teaching efficacy through microteaching experience. This shows that it is an opportunity to improve class competencies by having opportunities for peer supervision as well as self supervision. As a result, it was found that pre-service early childhood teachers recognized the micro-teaching experience as an opportunity for personal reflection, an activity based on escape, an improvement process through trial and error, and an expectation for improvement of teaching efficacy. Conclusions This study presents the findings of preservice early childhood teachers taking a semester-long course in early childhood materials research and teaching methods at a university's early childhood education department, which may have implications for future preservice early childhood teacher education.

Predicting Mortality in Sepsis: The Role of Dynamic Biomarker Changes and Clinical Scores-A Retrospective Cohort Study.

The prognostic value of baseline inflammatory markers in sepsis remains controversial, with conflicting evidence regarding their association with mortality. The dynamic changes in these markers over time might offer additional insights into disease progression and patient outcomes. This retrospective observational study included 138 patients with severe infections. The inflammatory biomarkers procalcitonin (PCT), C-reactive protein (CRP), and lactate (LAC) were measured at three time points: upon hospital admission (baseline), approximately 24-48 h after admission (second measurement; M2), and 48-72 h after admission (third measurement; M3). The primary outcome was 30-day mortality. A Mann-Whitney U test was used to compare the biomarker levels between the survivors and non-survivors. A Spearman's correlation was used to assess the relationships between the baseline parameters. A logistic regression and a receiver operating characteristic (ROC) curve analysis were employed to evaluate the prognostic value of the baseline markers and their dynamic changes. The baseline LAC and SOFA score were significantly associated with 30-day mortality. The percentage decrease in PCT, CRP, and LAC from the baseline to M3 emerged as strong predictors of survival, with the ROC curve analysis demonstrating superior discriminatory ability compared to the baseline values. CRP_Delta exhibited the highest AUC (0.903), followed by PCT_Delta (0.843) and LAC_Delta (0.703). The dynamic changes in these inflammatory biomarkers, particularly PCT, CRP, and LAC, offer valuable prognostic information beyond their baseline levels in predicting 30-day mortality in severe infections. These findings highlight the importance of monitoring biomarker trends for early risk stratification and potential treatment guidance.

Audio-Vestibular Evaluation of Pediatric Pseudo-Conductive Hearing Loss: Third Window Syndromes.

Conductive hearing loss caused by external or middle ear problems prevents the transmission of sound waves from the external auditory canal to the cochlea, and it is a common condition, especially in pediatric patients aged 1-5 years. The most common etiological factors are otitis media and cerumen during childhood. In some patients, external and middle ear functions and structures may be normal bilaterally despite the air-bone gap on the audiogram. This condition, which is often a missed diagnosis in children, is defined as a pseudo-conductive hearing loss (PCHL) caused by third window syndromes (TWSs) such as semicircular canal dehiscence, inner ear malformations with third window effect, and perilymphatic fistula. In this review of the literature, the authors emphasize the pitfalls of pediatric audio-vestibular evaluation on TWSs as well as the key aspects of this evaluation for the differential diagnosis of PCHL brought on by TWSs. This literature review will provide audiologists and otologists with early diagnostic guidance for TWSs in pediatric patients.

Early maternal guidance of mother-child emotion dialogues predicts adolescents’ attachment representations: a longitudinal study

ABSTRACT This study examined the contribution of early vs. concurrent maternal guidance of emotion dialogues with their children to the security and coherence of the children’s attachment representations as adolescents. Maternal Sensitive Guidance was assessed from mother-child emotion dialogues when participants were preschoolers (approximate age 4 years) and young adolescents (approximate age 12.5 years), along with an assessment of adolescents’ attachment representations using the Friends and Family Interview (FFI). Mothers’ Sensitive Guidance in preschool predicted adolescents’ coherence in the FFI, secure maternal (but not paternal) representations, and a positive representation of sibling relationships. In contrast, mothers’ concurrent Sensitive Guidance was related only to adolescents’ sibling relationships. These results highlight the significance of mothers’ sensitive guidance of emotion dialogues during the early years for their children’s later attachment representations, and point to the need for further examination of mothers’ role when they guide emotion dialogues with their adolescents.

Serum biomarkers for predicting microvascular complications of diabetes mellitus.

Diabetic microvascular complications such as retinopathy, nephropathy, and neuropathy are primary causes of blindness, terminal renal failure, and neuropathic disorders in type 2 diabetes mellitus patients. Identifying reliable biomarkers promptly is pivotal for early detection and intervention in these severe complications. This review offers a thorough examination of the latest research concerning serum biomarkers for the prediction and assessment of diabetic microvascular complications. It encompasses biomarkers associated with glycation, oxidative stress, inflammation, endothelial dysfunction, basement membrane thickening, angiogenesis, and thrombosis. The review also highlights the potential of emerging biomarkers, such as microRNAs and long non-coding RNAs. Serum biomarkers are emerging as valuable tools for the early assessment and therapeutic guidance of diabetic microvascular complications. The biomarkers identified not only reflect the underlying pathophysiology but also align with the extent of the disease. However, further validation across diverse populations and improvement of the practicality of these biomarkers in routine clinical practice are necessary. Pursuing these objectives is essential to advance early diagnosis, risk assessment, and individualized treatment regimens for those affected by diabetes.

Использование искусственного интеллекта для профориентации школьников

This article examines the use of artificial intelligence for early career guidance of schoolchildren. Various areas of career guidance and ways of using artificial intelligence algorithms are analyzed, the problems that schools and parents may face when using artificial intelligence and ways to overcome them are highlighted. The article also provides examples of various resources that can help students at the initial stage of choosing a future profession.

Prevalence of personal, work-related and patient-related burnout during the COVID-19 pandemic and its associated factors among healthcare workers in health clinics in the district of Manjung, Perak: A cross-sectional study.

Burnout is a syndrome characterised by physical, emotional and mental exhaustion that results from a long period of involvement in an overwhelming work condition. It is prevalent among frontline workers. This study aimed to identify the prevalence of burnout among primary healthcare workers in the district of Manjung, Perak and determine the factors associated with burnout. This cross-sectional study was conducted among healthcare workers in seven health clinics located in the district from August to September 2022. The self-administered validated Malay version of the Copenhagen Burnout Inventory and the Malay version of the Multidimensional Scale of Perceived Social Support were used. These instruments consisted of 31 questions rated on a 5-point Likert scale. The scores were then summed up to determine the burnout level. Data were analysed using SPSS version 20. Simple logistic regression analysis was performed. Thereafter, multiple logistic regression analysis was conducted to determine the factors associated with burnout. A total of 224 participants were included. Among them, 61.6% were nurses; 21.4%, doctors; and 17.0%, assistant medical officers. The prevalence of personal burnout was 31.3%; work-related burnout, 16.5%; and patient-related burnout, 5.4%. The factors associated with burnout were the highest educational level, financial difficulties and low perceived social support from friends and significant others. Healthcare workers in Manjung health clinics have a higher prevalence of personal burnout than work- and patient-related burnout. The findings of this study provide early insights and guidance for possible interventions.

Early identification of high attention content for online mental health community users based on multi-level fusion model

PurposeThe overload of user-generated content in online mental health community makes the focus and resonance tendencies of the participating groups less clear. Thus, the purpose of this paper is to build an early identification mechanism for users' high attention content to promote early intervention and effective dissemination of professional medical guidance.Design/methodology/approachWe decouple the identification mechanism from two processes: early feature combing and algorithmic model construction. Firstly, based on the differentiated needs and concerns of the participant groups, the multiple features of “information content + source users” are refined. Secondly, a multi-level fusion model is constructed for features processing. Specifically, Bidirectional Encoder Representation from Transformers (BERT)-Bi-directional Long-Short Term Memory (BiLSTM)-Linear are used to refine the semantic features, while Graph Attention Networks (GAT) is used to capture the entity attributes and relation features. Finally, the Convolutional Neural Network (CNN) is used to optimize the multi-level fusion features.FindingsThe results show that the ACC of the multi-level fusion model is 84.42%, F1 is 79.43% and R is 76.71%. Compared with other baseline models and single feature elements, the ACC and F1 values are improved to different degrees.Originality/valueThe originality of this paper lies in analyzing multiple features based on early stages and constructing a new multi-level fusion model for processing. Further, the study is valuable for the orientation of psychological patients' needs and early guidance of professional medical care.