Medical Health Services Research Articles

Assessing how paramedical faculty’s professors and students at Kurdistan- Iraq Universities of Medical Sciences and Health Services perceive the quality of clinical learning environments through the application of the DREEM model

BackgroundThe education process in paramedical faculties is influenced by various factors affecting students’ learning.The present study aimed to assess the quality of clinical learning environments in the paramedical faculty of Kurdistan-Iraq Universities of Medical Science.MethodsThis study used a cross-sectional survey based on convenience sampling, involving 552 paramedical students and 125 professors from relevant departments within Kurdistan-Iraq’s medical sciences universities. Data analysis involved descriptive and inferential statistics, including frequency, mean, standard deviation,, t-test and ANOVA, conducted using SPSS version 22.ResultsThe mean scores of the overall DREEM scores for students and professors were 115.07 ± 31.65 and 95.16 ± 12.67, respectively. Significant differences were observed in students’ fields of study and in all areas of the attitudes questionnaire. Additionally, a significant difference was found between professors’ degrees in the scientific ability subscale of attitude towards the fields, and characteristics of clinical learning environments (p < .05).ConclusionThe findings suggest relative satisfaction among professors and students with the clinical education environment within the paramedical faculty.

The prehospital paediatric emergency care burden managed by a public ambulance service in the Western Cape, South Africa

BackgroundPaediatric mortality rates in low- and middle-income countries account for over 80% of the global burden. In South Africa, one in every 33 children will not reach the age of five. Despite the high mortality rate, there is a paucity of data describing the prehospital paediatric under-five emergency care burden in South Africa. Such data are essential to inform the development of local prehospital emergency care guidelines and targeted prevention strategies.AimThis study describes the prehospital paediatric under-five emergency care burden managed by the Western Cape Government Health and Wellness (WCGHW) Emergency Medical Services (EMS) in South Africa.MethodsA retrospective review of the prehospital records was conducted, extracting epidemiological and clinical data from the WCGHW EMS patient record database. The review included all paediatric cases under-five, managed between 1 January 2022 and 31 December 2023, in the Western Cape of South Africa.ResultsIn the 87 457 cases, there was a similar distribution between the primary cases (50.7%) and interfacility transfers (49.3%). Most activations emanated from rural areas (47 980, 54.9%), with respiratory emergencies (30 934, 35.4%), non-cardiac pain (11 381, 13.0%) and trauma (10 831,12.4%) being the most common presenting complaints. Most cases were prioritised as priority 2 (46 034, 52.6%), with most of these being older children between one and five years old (29 008, 63.0). Low acuity cases accounted for 67.2% (58 818) of the sample, with the highest mortality occurring between 29 days and 12 months (190, 52.9.%). Most patients spent less than one hour in the prehospital setting (64 431, 73.7%), with advanced airway management (748, 43.1%) being the most common airway intervention.ConclusionThis first description of the prehospital paediatric under-five emergency care burden managed by the WCGHW EMS reveals a unique burden, particularly regarding the high interfacility transfer rates. As illustrated in graphical abstract, these findings underscore critical considerations for healthcare planners and the prehospital training environment. Future research among this population should focus on characterising the reasons for the high interfacility transfer rates through assessments of healthcare access, EMS care quality and post-EMS follow-up.Graphical

Evaluating the effectiveness of self-attention mechanism in tuberculosis time series forecasting

BackgroundWith the increasing impact of tuberculosis on public health, accurately predicting future tuberculosis cases is crucial for optimizing of health resources and medical service allocation. This study applies a self-attention mechanism to predict the number of tuberculosis cases, aiming to evaluate its effectiveness in forecasting.MethodsMonthly tuberculosis case data from Changde City between 2010 and 2021 were used to construct a self-attention model, a long short-term memory (LSTM) model, and an autoregressive integrated moving average (ARIMA) model. The performance of these models was evaluated using three metrics: root mean square error (RMSE), mean absolute error (MAE), and mean absolute percentage error (MAPE).ResultsThe self-attention model outperformed the other models in terms of prediction accuracy. On the test set, the RMSE of the self-attention model was approximately 7.41% lower than that of the LSTM model, MAE was reduced by about 10.99%, and MAPE was reduced by approximately 9.87%. Compared to the ARIMA model, RMSE was reduced by about 28.86%, MAE by about 32.22%, and MAPE by approximately 29.89%.ConclusionThe self-attention model can effectively improve the prediction accuracy of tuberculosis cases, providing guidance for health departments optimizing of health resources and medical service allocation.

Transcultural Studies: Naturalistic and Personalistic on Health and Illness in Jember Society

The community that adheres to the naturalistic concept assumes that a person suffers from illness due to the influence of the environment, food, lifestyle, and imbalance in the body. Meanwhile, the community that adheres to the personalistic concept assumes that the emergence of illness is caused by the intervention of an active agent that can be a non-human creature (ghost, spirit, ancestor, or evil spirit). This research aims to identify the perception of health and illness of the Jember community based on the theory of transcultural nursing in the scope of personalistic and naturalistic. This research is a descriptive study with a case study and a qualitative type of research. Data were obtained by conducting interviews with in-depth interview guide instruments. There were four main participants in this study and two additional participants. The steps in conducting research are preliminary studies, data collection, and conclusions. This research uses the Colaizzi method analysis technique. The study results show that the community believes that illness is caused by a person's biological condition, which is influenced by environmental conditions, adequate nutrition, lifestyle, body imbalance, and congenital diseases (naturalistic). The treatment method based on the naturalistic concept allows the community to get a cure for their illness by seeking treatment from modern medical health services, such as going to a doctor or buying medicine at a shop. People who understand and comprehend the meaning of illness and the causes of illness will determine their choice of treatment, whether naturalistic or personalistic.

Study on the co-occurrence of multiple health service needs throughout the lifecourse of rural residents in China based on association rules.

To understand the multiple health service needs of rural residents in China and explore the co-occurrence patterns of these needs throughout the entire life course, providing a basis for the formulation and optimization of health service packaging policies. This study utilized a stratified random sampling method, resulting in a final sample size of 15,125 individuals. The R statistical software was employed to apply the Apriori algorithm to mine the co-occurrence relationships among multiple health service needs across the life course and to explore the packaging model of these services. The health service needs rate among rural residents in China is 86.76%, with a multiple health service needs rate of 78.72%. The most needed services are health exercise guidance (17.10%), Traditional Chinese Medicine health care (15.53%), and internet health information services (14.40%). The highest combined health service need is for "exercise guidance need + internet health information need + Traditional Chinese Medicine health care need," followed by "exercise guidance need + internet information need." There are significant differences in the content and strength of associations in the co-occurrence structure of multiple health service needs across different age groups. During the life preparation stage, the need for multiple health services is high, with modern medical care and child management having the highest support. In the life protection stage, the focus shifts to preventive health needs, with strong associations among co-occurring needs (the highest support rule being Traditional Chinese Medicine health care + exercise guidance, support = 21.12%). The co-occurrence of medical and preventive health service needs among the older adult is diverse, with the strongest association being between chronic disease management services and rehabilitation services (support = 31.24%). The multiple health service needs rate among rural residents in China is high, with the greatest needs being for exercise guidance, Traditional Chinese Medicine health care, and internet health information services. There are significant differences in health service needs across different life stages. It is essential to enhance the integration and packaging of health service resources to promote diversity in health services and meet the multiple health service needs of residents throughout their life courses.

Experiences of caregivers of patients with traumatic brain injury during hospitalization in western China: A qualitative study

ABSTRACT Family members frequently provide both physical and emotional support to patients. Previous studies have focused primarily on the experiences of patients with traumatic brain injury (TBI) and their caregivers during home care and the transition from hospital care to the community, with less emphasis on their experiences during acute hospital care immediately after TBI. This study aimed to explore the experiences of caregivers of patients with TBI during acute hospitalizations. A qualitative descriptive study using individual semistructured interviews was conducted at the trauma center of a tertiary hospital in western China. A purposive sample of 21 caregivers of patients with TBI were recruited. The interviews were conducted face to face in the inpatient ward from July to September 2023. Conventional content analysis was used to conduct the framework analysis. The experiences of caregivers were identified within three key themes: TBI consequences in patients (physical impairments, psychological distress, and cognitive dysfunctions), challenges of caregivers (physiological/emotional/economic burdens, conflicts, and concerns regarding recovery), and needs of caregivers (health information, medical services, and recovery expectations). This study highlights the experiences of caregivers of patients with TBI during hospital stays in western China. The challenges faced by caregivers and the needs of caregivers are multidimensional. Appropriate support should be provided to alleviate the burden of caregiving.

Health-related quality of life and associated factors among children with Transfusion-dependent β-thalassaemia: a cross-sectional study in Guangxi Province

BackgroundTransfusion-dependent β-thalassemia (TDT) is a severe inherited disorder. Without regular treatment, patients with TDT experience complications that can significantly shorten life expectancy and severely impact both their quality of life and that of their families. The condition has attracted significant attention in global health discussions. Due to the challenges of blood supply shortages, the high costs of iron chelation therapy, and hematopoietic stem cell transplantation (HSCT), TDT presents a serious health risk to patients and imposes a substantial burden on families and society. However, research on the health-related quality of life (HRQoL) of thalassemia patients in China remains limited. This study evaluated the factors affecting the HRQoL of these patients, with the goal of developing strategies to improve their quality of life.MethodsIn this cross-sectional study, children with TDT were recruited from five treatment centers in Guangxi, a province with a high prevalence of thalassemia in China. Structured questionnaires were employed to gather relevant data on sociodemographic variables, disease characteristics, treatments, and associated costs. The HRQoL was assessed using the Transfusion-Dependent Quality of Life (TranQoL) questionnaire, with a proxy version for patients aged 0–11 years and a child version for those aged 12–18 years.ResultsThe study included 418 participants, yielding an overall TranQoL score of 60.6 ± 16.3 among thalassemia patients. Multiple linear regression analysis revealed a negative correlation (P < 0.05) between overall TranQoL scores and several factors: increasing patient age, the presence of multiple thalassemia patients within a family, and undergoing HSCT. Conversely, adherence to regular treatment was positively correlated with higher TranQoL scores (P < 0.05).ConclusionThe study demonstrates that HRQoL among Chinese patients with TDT is at a low level. Age, treatment adherence, family support, and socioeconomic status were identified as key determinants influencing HRQoL. It is essential to further enhance and optimize health insurance policies and medical services to support comprehensive treatment strategies for these patients.

Physical activity habits among members of the Athens Medical Society in Greece

Abstract Introduction Benefits of regular physical activity and exercise are well documented. Healthcare workers play a crucial role in counseling and appropriately referring their patients to adopt physical activity. However, doctors’ exercise habits range between different medical specialties and health service infrastructure. Purpose In this study, we assess physicians’ exercise performance according to the recommendations of 2020 ESC Guidelines. Methods The population of this cross-sectional study comprised 742 physicians of the Athens Medical Society (AMS), Greece. The study instrument was a self-administered questionnaire mailed in October 2023 to investigate physicians’ exercise habits, baseline characteristics of population, specialty, and health service infrastructure [Greek National Healthcare System (GNHS) or Private Practice (PP)]. European Society of Cardiology (ESC) Guidelines recommend at least 150 min/week of moderate-intensity exercise in all healthy adults. Subjects were divided in two groups according to their compliance to ESC Guidelines: 1. Moderate-intensity endurance exercise training per week ≥ 150 min (Group A); 2. Moderate-intensity endurance exercise training per week &amp;lt;150 min (Group B). Results The recommended exercise training per week goal is achieved by the majority of AMS members (53.4%) with an estimated mean exercise endurance training time of 240 ± 285 minutes. Between Group A and Group B there was no difference in age (50±12years vs. 50±13years, p=0.73), whereas there was significant difference in male sex prevalence (58% vs. 43%, p &amp;lt;0.001), in Body Mass Index (24.7 ± 3.8 kg/m2 vs. 26.2 ± 4.7 kg/m2, p &amp;lt;0.001), in Smoking habits (17.4% vs. 23.5%, p=0.04), in diabetes mellitus incidence (6.6% vs. 11.8%, p= 0.01) and in the use of activity monitoring wearables (45.2% vs. 29.8%, p&amp;lt;0.001). Interestingly, there was significant difference between GNHS and PP doctors representation in Group A and B with more doctors in the PP categorized in the Group A (p=0.008) (Figure 1). Importantly, logistic regression analysis revealed that even after adjustment for the aforementioned confounders there was significant under-representation of the GNHS in the Group A or otherwise doctors in the GNHS have 33% decrease odds of achieving the recommended exercise training per week (Odds Ratio: 0.676, 95%CI 0.484, 0.943, p=0.02) (Table 1). Conclusion A significant proportion of the AMS members follows the recommended ESC guidelines for minimum exercise training per week. Several factors affect their adherence to exercise time recommendation. Interestingly, AMS doctors working on the GNHS independently of other factors are less adherent to exercise recommendations. These findings emphasize the need to strengthen prevention strategies to AMS.

Developing a Policy Model to Support Family Caregivers of Dependent Older Adults in Bangkok

This article aims to present the situation of family caregivers of dependent older individuals in the Bangkok area and proposes a model policy to support them. This study used mixed methods with a multi-phase design. Based on 357 participants, the results indicate that family caregivers in Bangkok faced problems, with moderate levels (x ̅ = 2.51) in caring for older dependents and their roles as direct caregivers. Yet, they hold high expectations for support (x ̅ = 3.86). The proposed model comprises four components derived from exploratory factor analysis of quantitative data, supplemented by qualitative data from a case study involving five individuals, tested and assessed by Bangkok executives or representatives (totaling six individuals), along with seven practitioners supporting older adult caregivers. These components include establishing systems, mechanisms, rights, and welfare; supporting work and relaxation; creating all-inclusive care service units for dependent older individuals; and providing medical and public health services. Implementing local-level policies is crucial for supporting family caregivers, with the Department of Older Persons collaborating with civil society for integration and engagement. Through this collaboration, concrete forms of support for family caregivers of independent older individuals are expected to be established.

Health of the Pandemic Dementia Paid Staff and Unpaid Caregiver Workforce in Congregate Care and Community Settings

The objective of this study was to assess the impact of the pandemic on the health, well-being, and access to services of paid staff and unpaid caregivers of persons living with dementia. Questionnaires were developed to capture the experiences of paid staff and unpaid caregivers throughout the pandemic, leveraging a pre-existing clinical trial collaborative. Community and long-term care locations in Miami, Florida, Boston, Massachusetts, and the greater Baltimore, Maryland, and D.C. areas. Paid staff from Miami Jewish and Benchmark who worked with patients with dementia during the first two years of the pandemic. Unpaid caregivers who lived within the catchment area of the study sites and provided care for community-based persons with dementia. Measures included the Coronavirus Impact Scale, the Herth Hope Index, NPI-Q, the Modified Caregiver Strain Index, PHQ-8, items about workplace changes, caregiving relationship, and changes to caregiver support. Paid staff were statistically more likely to have been exposed to, tested for, hospitalized, or seriously ill with COVID-19 and indicated moderate to severe impacts to medical and mental health services compared to unpaid caregivers. Unpaid caregivers exhibited significantly higher rates of depressive symptom severity and overall lower scores on the Herth Hope Scale compared to paid staff. Our findings suggest that the pandemic had significant impacts on the mental health and general well-being of unpaid caregivers. While notable that paid staff suffered from increased exposure and decreased access to services, policies supporting both workforces should respond to the unique outcomes that each faced, post-pandemic.

Zagrożenia związane ze stosowaniem chemicznych środków dezynfekcyjnych i maseczek chroniących przed zakażeniem podczas epidemii

Risks related to the use of chemical disinfectants and masks using to protect against infection during an epidemic Actions to prevent the spread of pathogenic microorganisms are inextricably linked to medical activities and health services, they are indispensable in the activities of beauty and hairdressing salons, in agriculture, food production and animal breeding, the food industry, and during an epidemic or pandemic, they also apply to the general public. In addition to the benefits that such activities bring to health, one should be aware that the use of measures to protect against infection may also be associated with adverse effects for people who use them. The article discusses the risks associated with the use of chemical disinfectants and face masks protecting the respiratory system against the penetration of viruses. Keywords: chemical disinfectants, face masks, infections, hazards, epidemic

The Current Role of Analytical Psychology in Maintaining Fictitious Boundaries that are Promoted through the Race Lie: A call to dismantle the virtual wall that exists through attitudes of white supremacy.

In 1928, the American Anthropological Association declared that "Anthropology provided no scientific basis for discrimination against any people on the ground of racial inferiority, religious affiliation, or linguistic heritage" (Guthrie, 1976/1998/2004, p. 30). In 1945, Jung denounced race theory as a pseudo-science. In 1950, UNESCO released its statement denouncing race. Long discredited as scientifically invalid, the race concept still holds uncanny value and significance for Americans and Europeans. In effect, the concept seems to be mysteriously linked to the limited accessibility and the limited economic support that is allotted to people of colour, internationally. This paper will explore the global implications of Jung's expressed attitude towards people of colour prior to 1945, which I identify as an attitude of white supremacy, an attitude that stands in direct contrast to the analytical ethos, as expressed by the International Association for Analytical Psychology (IAAP). This attitude may promote the continuance of racialized beliefs and behaviours within the planning and provision of care to individuals in need of medical and mental health services. It is requested that a written acknowledgment of harm be added to the works of C. G. Jung.

Research Trends and Hot Spots in Telemedicine for the Elderly: A Scientometric Analysis.

As the elderly population rapidly grows, age-related health issues are increasing. Telemedicine helps older adults adapt by providing efficient and accessible health management and medical services. This study employs bibliometric analysis to examine research focus areas, emerging trends, and collaboration networks in telemedicine for older adults over the past three decades. The Web of Science Core Collection served as the primary data source for the publications on telemedicine and the elderly since the database's inception through June 2024. Using CiteSpace.6.2.R4 software, keyword and collaboration network visualizations were generated, including clusters, co-authors, and co-citations. This study analyzed 586 papers from 252 countries or regions, which were published across 246 journals and written by 2750 authors. The analysis revealed three primary research directions encompassing 42 clusters: (1) health literacy and technology adaptation; (2) telemedicine technology and health management; and (3) social interaction and economic impact. Research hotspots include elderly fitness, mobile health, technology acceptance, telemedicine, elderly care, and health literacy. Despite the potential benefit of telemedicine, challenges persist in areas such as technology acceptance, usability, effectiveness, service quality, and privacy concerns. This review provides a comprehensive overview of current research on telemedicine for the elderly and highlights emerging trends in the field.

The impact of COVID-19 on the male reproductive system.

The relevance of the study is determined by the deepening understanding of the global consequences of the coronavirus pandemic, which affect not only lung health but also a wide range of other body systems. In light of new data on the long-term effects of coronavirus infection, this study is highly significant. The purpose of this study is to investigate the impact of coronavirus infection on the male reproductive system and assess its potential influence on male fertility to refine the mechanisms of damage and provide recommendations for medical care. The study utilised a combination of methods, including a meta-analysis of medical organisation databases, analysis of clinical cases, representative sample method, and quantitative survey method. These approaches allowed for a comprehensive and multifaceted view of the problem. The samples of sperm showed a noticeable decrease in progressive motility, sperm concentration, and volume, especially in patients with moderate and severe symptoms of COVID-19, whereas patients with mild symptoms only experienced a decrease in progressive motility and overall sperm motility. The survey identified symptoms of male reproductive system dysfunction after recovering from COVID-19. Predominant symptoms included decreased libido (15%), impotence (13%), and infections of the genital organs (12%). Most surveyed men lacked sufficient awareness of other aspects of male reproductive health, including infections, genetic defects, chronic diseases, and available medical services. As a result of the study, it was concluded that coronavirus infection can have a negative impact on the male reproductive system. The practical value of this study lies in improving approaches to medical care for men who have recovered from COVID-19 and creating preventive programmes.

Understanding Lived Experience Organizations: A Systematic Scoping Review of Organizational Elements and Characteristics.

Mental health lived experience organizations (LEOs) and their lived experience workforce are increasingly recognized as invaluable. However, a deeper understanding of the elements that enhance or inhibit LEOs' efficacy is required to learn how to sustain LEOs and support their workforce. Rapid international expansion has resulted in significant LEO growth and change, challenging many LEOs to adapt. With this rapid expansion, the field is evolving faster than many LEOs can keep pace with. This review, codesigned and coproduced in partnership with a LEO to draw on both lived experience and academic perspectives, aims for a deeper understanding of which elements within a LEO enhance or inhibit its efficacy, growth, and support for its lived experience workforce. A systematic search of peer-reviewed and non-peer-reviewed literature, following the PRISMA-ScR guidelines and JBI methodology, identified 60 records published in English between 2000 and 2022. The results indicate general agreement regarding which LEO elements are important (e.g., culture, leadership, board composition, organizational structure, financial arrangements, and professionalization). However, considerable disagreements exist regarding the relative influence of several of these elements, especially funding arrangements, in which funder and LEO values often diverge; training for increased lived experience professionalization; and partnerships with medical model-focused mental health services. Organizational disagreements relate to managing future LEO growth and advancing the lived experience workforce while preserving LEOs' unique characteristics that make them valued mental health services. Further research should examine community differences among LEOs, including hybrid LEOs within services and non-LEO mental health organizations.

Legal Consequences of Negligence Committed by Traditional Health Workers

As stated in the 1945 Constitution of the Republic of Indonesia, health is a human right and is a component of welfare that must be realized following with Pancasila and the ideals of the Indonesian nation. To be healthy, people not only trust medical health services, but also traditional medicine such as shamans, acupuncturists, healers, and others. This research is a type of normative legal research. This research collects data through relevant literature research. The Indonesian Central Statistics Agency (BPS) describes the percentage of use of traditional medicine from year to year, namely, traditional medicine used in 2011 was 23.63 percent, in 2014 was 20.99 percent and in 2023 it was 27.57 percent. This shows that public interest in traditional medicine is relatively high. The results of the discussion showed that the legal consequences obtained due to negligence committed by Traditional Health Workers in accordance with the Government Regulation of the Republic of Indonesia Number 103 of 2014 received administrative sanctions and were also based on the Criminal Code, so the negligence caused could be held accountable by the district in accordance with the provisions Article 205 of the Criminal Code and Article 343 of Law 1/2023 Article 359 of the Criminal Code and Article 474 paragraph (3).

Professional competencies in geriatric nursing for geriatric nurses: a latent profile analysis

BackgroundAs the global population continues to age, social realities such as advanced age, disability and living alone are coming to the fore, and the demand for medical care and health services for the elderly is increasing dramatically, especially in geriatrics. Given the important role geriatric nurses play in the diagnosis and treatment of diseases and rehabilitation of elderly patients, and due to the uniqueness and complexity of geriatric work, this requires geriatric nurses not only to have the competencies that are available in general nursing, but also to ensure that they have sufficient geriatric core competencies in order to effectively meet the needs of the patients and accelerate their recovery. Although previous studies have investigated the core competencies of nursing staff, there has been little research on geriatric nurses’ core geriatric nursing competencies and their predictors. The aim of this study was to investigate the current status of the geriatric nursing competency inventory (GNCI) among geriatric nurses using latent profiling, to identify potential subgroups and their population characteristics, and to explore the factors that influence the potential subgroups.MethodsFrom January to March 2024, 1,313 geriatric nurses in Hefei City were selected by stratified cluster sampling method and surveyed with general information questionnaire, geriatric nursing competency inventory, and occupational coping self-efficacy scale for nurses(OCSE-N). Potential subgroups of GNCI differences among geriatric nurses were identified by latent profile analysis (LPA). Multiple logistic regression analyses were used to explore the factors influencing the GNCI of geriatric nurses with different latent profiles.ResultsGeriatric nurses’ OCSE-N was positively correlated with GNCI, and the GNCI score was 123.06(41.60), which indicated that geriatric nurses’ GNCI was at an intermediate level. The OCSE-N score was 35.44(7.34), which was at a relatively high level. There was heterogeneity in the GNCI of geriatric nurses, which was classified into three subgroups i.e., Low-competency group, Medium-competency group, High-competency group. The results of multiple logistic regression analyses showed that OCSE-N, title, whether or not they attended geriatric nurse specialist training, and specialist nurse status were predictors of GNCI among geriatric nurses (P < 0.05).ConclusionThe GNCI categorical characteristics of geriatric nurses are obvious, and nursing managers should adopt targeted interventions according to the characteristics of nurses in different profiles to improve the overall quality of care.

Physical Activity Habits Among Physicians: Data From the Athens Medical Association.

Physicians' exercise habits vary across different medical specialties and health service infrastructure. We assessed physicians' exercise performance according to the recommendations of the 2020 European Society of Cardiology Guidelines. This cross-sectional study comprised 742 physicians of the Athens Medical Association (AMA), Greece. Utilizing a self-administered questionnaire, physicians' exercise habits, demographics, specialty, and infrastructure [Hellenic National Health care System (HNHS) or Private System (PS)] were assessed. Subjects were categorized: Moderate-intensity weekly exercise ≥150min. (Group A); Moderate-intensity weekly exercise <150 min. (Group B). 53.4% of AMA members met the recommended exercise criteria, averaging 240 ± 285 min./week. Significant differences were noted between Group A and B in male sex (58.3% vs 43.1%, P < 0.001), Body Mass Index (24.7 ± 3.8kg/m2 vs 26.2 ± 4.7kg/m2, P < 0.001), Smoking (17.4% vs 23.5%, P = 0.04), Diabetes Mellitus (6.6% vs 11.8%, P = 0.01), and activity monitoring wearables usage (45.2% vs 29.8%, P < 0.001). Significantly more doctors in the PS categorized in Group A (P = 0.008). After adjustment for confounders, HNHS reported 33% decreased odds of achieving the exercise recommendations compared to PS (Odds Ratio: 0.676; 95% CI: 0.484-0.943, P = 0.03). Several factors affect adherence of AMA members to exercise goals. HNHS AMA doctors are less adherent to exercise recommendations, emphasizing the need to strengthen prevention strategies.

Core-Shell Gel Nanofiber Scaffolds Constructed by Microfluidic Spinning toward Wound Repair and Tissue Regeneration.

Growing demand for wound care resulting from the increasing chronic diseases and trauma brings intense pressure to global medical health service system. Artificial skin provides mechanical and microenvironmental support for wound, which is crucial in wound healing and tissue regeneration. However, challenges still remain in the clinical application of artificial skin since the lack of the synergy effect of necessary performance. In this study, a multi-functional artificial skin is fabricated through microfluidic spinning technology by using core-shell gel nanofiber scaffolds (NFSs). This strategy can precisely manipulate the microstructure of artificial skin under microscale. The as-prepared artificial skin demonstrates superior characteristics including surface wettability, breathability, high mechanical strength, strain sensitivity, biocompatibility and biodegradability. Notably, this artificial skin has the capability to deliver medications in a controlled and sustained manner, thereby accelerating the wound healing process. This innovative approach paves the way for the development of a new generation of artificial skin and introduces a novel concept for the structural design of the unique core-shell gel NFSs.

Temporal trends in medication and service use patterns for mental health issues among men with prostate cancer.

Prostate cancer can significantly impact mental wellbeing, creating uncertainty and morbidity. This study described patterns of psychotropic medication and mental health service use, as a proxy measure for mental health problems, 5years before and 5years after prostate cancer diagnosis. Population-based registry data were linked with Pharmaceutical Benefits Scheme and Medicare Benefits Schedule data for all prostate cancer patients diagnosed in South Australia between 2012 and 2020 (n=13,693). We estimated the proportion and rates of psychotropic medication and mental health service use before and after diagnosis. Multivariable adjusted interrupted time series analyses (ITSA) were conducted to uncover temporal patterns. Fifteen percent of men commenced psychotropic medications and 6.4% sought out mental health services for the first time after diagnosis. Psychotropic medication use rose from 34.5% 5years before to 40.3% 5years after diagnosis, including an increase in use of antidepressants (from 20.7% to 26.0%) and anxiolytics (from 11.3% to 12.8%). Mental health service use increased from 10.2% to 12.1%, with the increase mostly being general practice mental health visits (from 7.8% to 10.6%). Multivariable ITSA indicated a significant rise in medication and service utilisation immediately before and in the first 2years following prostate cancer diagnosis. There is a clear increase in psychotropic medication use and mental health service use around the time of prostate cancer diagnosis. Mental health outcomes of men with prostate cancer may be improved with early mental health screening, particularly during the diagnosis process, to enable early intervention.