Patient Health Research Articles

The effectiveness of reproductive midwifery care with the flour albus approach: A Case Study of handling vaginal discharge in women of childbearing age

Introduction: Women of childbearing age have a higher risk of vaginal discharge than adolescents because of the frequent occurrence of pelvic inflammatory disease (PID). One of the symptoms of reproductive organ infections in women is vaginal discharge. Objective: This study aims to apply midwifery care to cases of vaginal discharge (flour albus). Methods: A descriptive method with a case study approach is used. Data was collected through primary data, including assessment and observation of the patient's health status, interviews to obtain subjective data, and direct examination for objective data. Secondary data was obtained through patient records, registered books in the KIA room, and literature studies. Result: The results showed that the symptoms of vaginal discharge in patients included thick white mucus, unpleasant odor, and itching in the genital area. The care provided uses red betel leaf water decoction as a treatment effort. After obstetric care was carried out from July 16 to 20, 2024, the results were obtained that the patient's vaginal discharge improved without signs of genetic infection. Conclusion: The success of this care is also marked by an increase in patients' understanding of good personal hygiene, how to properly clean the feminine area from front to back, and the effective use of red betel leaf boiled water. Thus, the management of obstetric care applied to this case of vaginal discharge is quite successful and practical, with a decoction of red betel leaves providing a positive effect in reducing the incidence of pathological vaginal discharge.

Evaluating associations between social risks and health care utilization in patients with chronic low back pain.

Care and outcomes for patients with chronic low back pain (cLBP) are influenced by the social risk factors that they experience. Social risk factors such as food insecurity and housing instability have detrimental effects on patient health and wellness, healthcare outcomes, and health disparities. This retrospective cross-sectional study examined how social risk factors identified in unstructured and structured electronic health record (EHR) data for 1,295 patients with cLBP were associated with health care utilization. We also studied the impact of social risk factors, controlling for back pain-related disability on health care utilization. Included patients who received outpatient spine and/or physical therapy services at an urban academic medical center between 2018 and 2020. Five identified social risks were financial insecurity, housing instability, food insecurity, transportation barriers, and social isolation. Outcomes included 4 categories of health care utilization: emergency department (ED) visits/hospitalizations, imaging, outpatient specialty visits related to spine care, and physical therapy (PT) visits. Poisson regression models tested associations between the presence of identified social risks and each outcome measure. Identified social risks in 12.8% of the study population (N = 166/1,295). In multivariate models, social isolation was positively associated with imaging, specialty visits, and PT visits; housing instability was positively associated with ED visits/hospitalizations and imaging; food insecurity was positively associated with ED visits/hospitalizations and specialty visits but negatively associated with PT visits; and financial strain was positively associated with PT visits but negatively associated with ED visits/hospitalization. These associations were seen above and beyond other factors used as markers of socioeconomic marginalization, including neighborhood-level social determinants of health, race/ethnicity, and insurance type. Identifying and intervening on social risk factors that patients with cLBP experience may improve outcomes and be cost-saving.

Assessing Whole-Person Outcomes During Routine Clinical Care: A Rapid Scoping Review.

To identify and describe research conducted on the implementation, validity, and utility of whole-person outcome measures administered during routine inpatient or outpatient care. Incorporating information about patients' overall health, health-related quality of life, and global well-being into health care delivery has the potential to increase referral rates, enhance doctor-patient communication, and improve the detection of untreated symptoms. Assessment of these whole-person outcomes during routine clinical care is of broad interest to health care providers and health systems. We employed a scoping review design and searched Ovid MEDLINE, APA PsycINFO, and CINAHL for relevant English-language primary studies and systematic reviews published through November 13, 2023. Screening for inclusion and data abstraction were conducted by 1 investigator then checked by another. Study risks of bias and the strength of available evidence were not assessed. Of 1327 potentially relevant publications, 44 primary studies and 5 systematic reviews met eligibility criteria. Assessment of global well-being was comparatively less researched than overall health or health-related quality of life. Available research provided a range of perspectives on the performance, feasibility, acceptability, implementation, and clinical utility of whole-person outcome measures. No studies reported change in patient health or disease outcomes attributed to whole person outcome assessment (directly or through changes to care delivery). Currently available evidence provides insights about the performance and implementation of whole-person outcome measures during routine clinical care, but no studies are available that examine the impact of assessing whole-person outcomes on clinical or patient outcomes.

Associations between magnesium depletion score and depression among individuals aged 20 to 60 years

BackgroundMagnesium is closely associated with depression. The study aims to explore the relationship between magnesium depletion score (MDS), used to evaluate the body’s magnesium deficiency status, and depression. MethodsThis population-based cross-sectional study used data from the National Health and Nutrition Examination Survey in 2005-2018 and included adults aged 20 to 60 years. Depression was determined using the Patient Health Questionnaire-9 (PHQ-9). MDS was a practical assessment instrument used to assess the status of magnesium deficiency. Multivariable logistic and restricted cubic spline models were used to assess the associations between MDS and depression. ResultsAmong the 18247 adults, 1753 participants were diagnosed with depression. Multivariable logistic regression analysis indicated that when MDS was treated as a continuous variable, each one-unit increase in MDS was associated with an odds ratio (OR) for depression of 1.15 (1.04, 1.26). When MDS was considered a categorical variable, compared to participants with MDS of 0, the ORs for depression for those with MDS of 1, 2, and ≥3 were 1.03 (0.87, 1.21), 1.41 (1.12, 1.78), and 1.58 (1.06, 2.35), respectively. Restricted cubic spline analysis showed that there was no non-linear relationship between MDS and the prevalence of depression. Subgroup analyses indicated the positive associations between MDS and depression were generally similar in different populations. ConclusionsMDS may be positively associated with the prevalence of depression. In the future, additional longitudinal studies are needed to validate our findings and investigate potential mechanisms.

Effect of Intensive Nursing Management on Quality of Life and Mental Health in Elderly Gastric Cancer Patients Undergoing Chemotherapy: A Retrospective Study

Aims/Background Implementing effective nursing management is particularly critical in the case of elderly gastric cancer (GC) patients receiving chemotherapy, who are more vulnerable to risk events. Therefore, this study explored the effect of intensive nursing management on quality of life (QoL) and mental health in elderly GC patients receiving chemotherapy. Methods A total of 155 elderly patients with GC undergoing chemotherapy in Central Hospital Affiliated to Shandong First Medical University from July 2021 to July 2023 were selected as the study subjects. The sample was divided into two groups according to different nursing methods: 74 patients who received intensive nursing management were classified in the observation group, while 81 patients treated with routine nursing management were classified under the reference group. The QoL, mental health and adverse reactions to chemotherapy were compared between the two groups. Results Before nursing management was implemented, there was no significant difference in the scores of the quality of life questionnaire-core 30 (QLQ-C30), patient health questionnaire-9 items (PHQ-9), and the Chinese version of the M.D. Anderson Symptom Inventory (MDASI-C) (p > 0.05). After management, in comparison with the reference group, the observation group showed significantly higher scores in each dimension of QLQ-C30, as well as significantly lower scores in PHQ-9 and MDASI-C (p < 0.001). The incidences of gastrointestinal reaction, myelosuppression, neurotoxicity, and hepatorenal damage were lower in the observation group than in the reference group (45.95% vs 70.37%, 40.54% vs 65.43%, 35.14% vs 53.09%, and 33.78% vs 51.25%, respectively; p < 0.05). Conclusion The application of intensive nursing management in treating elderly GC patients during chemotherapy effectively improves their physical and mental states, ameliorates clinical symptoms and enhances the QoL, showing certain clinical application value.

Application of Intelligent Management Model Based on Electronic Patient-Reported Outcome During Immunotherapy in Patients with Gastric Cancer: A Single-Center Retrospective Study

Aims/Background Gastric cancer is the third leading cause of cancer-related death worldwide, which seriously affects the health of patients. Immunotherapy is a commonly used clinical treatment for gastric cancer, but the adverse events caused by it seriously affect the prognosis of patients. Therefore, it is necessary to control and manage the disease risk of patients during immunotherapy. To explore the effect of applying an intelligent management model based on electronic patient-reported outcome (ePRO) in patients with gastric cancer during immunotherapy. Methods The clinical data of 184 gastric cancer patients receiving immunotherapy in The Fourth Hospital of Hebei Medical University from September 2021 to September 2023 were retrospectively analyzed. Ninety patients receiving ePRO-based intelligent management were selected, and 85 patients were included in the observation group after excluding 5 patients. For the reference group, 94 patients receiving common case management were selected, with 90 patients being included after excluding 4 patients. After 6 months of follow-up, the nutritional status score, quality of life, treatment compliance and adverse events were compared between the two groups. Results No significant difference was detected in nutritional status and World Health Organization Quality of Life-BREF (WHOQOL-BREF) scores of the patients before discharge (p > 0.05). After 2 months of follow-up, compared with the reference group, the observation group had a higher proportion of patients in grade A and grade B, which was not statistically significant (p > 0.05), and significantly higher physiological and psychological scores (p < 0.001), but showed no meaningful differences in other fields (p > 0.05). After 4 months of follow-up, the nutritional status in the observation group was significantly improved (p < 0.05), and the subjects displayed higher WHOQOL-BREF scores (p < 0.05) than those in the reference group. No significant difference in the incidence of adverse events was detected (p > 0.05). After 6 months of follow-up, the treatment compliance of the observation group was 83.53%, which was significantly higher than that of the reference group (70.00%; p < 0.05). Conclusion The intelligent management model based on ePRO is conducive to improving the nutritional status of patients with gastric cancer during immunotherapy, as well as enhancing their quality of life and treatment compliance, making it worthy of clinical application.

CTN-0138: adaptation, implementation, and cluster randomized trial of a Community Pharmacy-Based Prescription Drug Monitoring Program Opioid Risk Assessment Tool—a protocol paper

Abstract Background As the opioid epidemic continues to have a major negative impact across the US, community pharmacies have come under scrutiny from legal systems attempting to hold them accountable for their role in over dispensing and lack of patient intervention. While the most available tool for monitoring patients’ opioid use is Prescription Drug Monitoring Programs (PDMP), these do not provide pharmacists with actionable information and decision support. Our study addresses this gap through three objectives: [1] incorporate validated opioid risk metric thresholds into a PDMP platform to create the Opioid Risk Reduction Clinical Decision Support (ORRCDS) tool; [2] assess ORRCDS’ ability to reduce patient opioid risk; [3] assess ORRCDS’ sustainability and viability for broader dissemination in community pharmacy. Methods For objective 1, our team is partnering with leadership from the largest US PDMP organization and a top-five pharmacy chain to implement ORRCDS into the pharmacy chain’s workflow following the Guideline Implementation with Decision Support (GUIDES) framework. For objective 2, our team will conduct a type-1 implementation mixed methods study using a 2-arm parallel group clustered randomized design. We anticipate enrolling ~ 6,600 patients with moderate and high opioid use risk during the 6-month enrollment phase across 80 pharmacies. This sample size will provide 96.3% power to detect a 5% or greater difference in responder rate between the intervention and control arm. Responders are patients with moderate-risk at baseline who reduce to low-risk or those with high-risk at baseline who reduce to moderate or low-risk at 180 days post last intervention. To accomplish objective 3, we will use the Consolidated Framework for Implementation Research (CFIR) to develop and execute cross-sectional qualitative interviews with pharmacists (n = 15), pharmacy leaders (n = 15), and PDMP leaders (n = 15) regarding long term adoption and sustainability of the ORRCDS tool. Conclusions A PDMP tool that addresses moderate- and high-risk opioid use is not available in community pharmacy. This study will implement ORRCDS in a large retail pharmacy chain that will include additional screening and guidance to pharmacy staff to address risky opioid medication use. Our results will make critical advancements for protecting patient health and addressing the opioid epidemic.

Predictors and Outcomes of Mental Health Conditions Among Patients with Colorectal Cancer.

Mental health (MH) conditions are common in patients with colorectal cancer (CRC) due to the unique challenges these patients encounter. The primary aim was to investigate predictors of new onset MH conditions after a diagnosis of CRC and determine the association of new MH conditions on survival. A single institution, retrospective study was conducted. A multivariable Fine-Gray competing risks model was used to describe the primary study outcome of new MH diagnosis in patients at least 18years of age with CRC. Survival was modeled using Cox proportional hazards regression with a time-varying covariate for new MH diagnosis. 456 patients were identified for inclusion, with 16% developing a new MH condition and 29% dying during follow-up. A new MH condition was more likely among non-Hispanic white patients compared to non-Hispanic black and were less likely among those who are male or had a pre-cancer MH condition. The onset of a new MH condition was associated with a threefold decrease in survival. In addition, having a pre-cancer MH condition decreased survival nearly twofold. Our findings emphasize the importance of new-onset MH in patients after CRC diagnosis. Standardized screenings may alleviate some of the MH burden that patients with CRC experience in addition to potentially improving the overall health of patients. MH conditions may impact not only CRC outcomes but may direct future studies analyzing the risks of new onset MH conditions in other types of cancers, further expanding the importance of psychiatric support in patients with cancer.

. Changes in Serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and matrix metallopeptidase-2/9 (MMP-2/9), serum CD3+, CD4+, and CD8+ in patients undergoing thoracoscopic surgery for non-small-cell lung cancer

Abstract Objective: Non-small-cell lung cancer (NSCLC) remains one of the most common malignancies worldwide, posing a great potential threat to the health and life safety of patients. Methods: One hundred and fifty NSCLC patients admitted to our hospital from September 2022 to September 2023 were selected, inflammatory response, changes in T-lymphocyte subpopulations before and after surgery were detected, and patients' psychological status was investigated. Finally, patients were followed up for 6 months to record the prognostic survival rate. Results: Postoperative inflammatory factors and CD8+ were lower in the research group than in the control group, while CD3, CD4+ and CD4/CD8+ were higher than in the control group (P<0.05). Meanwhile, the psychological status of the research group was better. But there was no difference in prognostic survival between the two groups (P>0.05). Conclusion: Perioperative refinement of care can optimize the surgical process in patients with NSCLC, and the cellular immune function was enhanced.

Food Insecurity and Depressive Symptoms Among Persons With Diabetes in the United States: Findings From the 2022 National Health Interview Survey (NHIS).

The purpose of this study is to examine whether food insecurity increases risk for depressive symptoms among adults with diabetes. Food insecurity is associated with depression in the general population. However, minimal research has examined this relationship among persons with diabetes. Adults with diabetes were identified from the 2022 National Health Interview Survey. Depressive symptoms were assessed by the 8-item Patient Health Questionnaire. Food insecurity status was measured with the USDA 10-item food insecurity scale. Participants were categorized as food secure, low food security, and very low food security. The association between food insecurity and depressive symptoms was examined using weighted logistic regression, adjusting for potentially influential covariates (age, sex, ethnicity, poverty to income ratio, education, diabetes type, body mass index, region, and general health). Among 2595 persons with diabetes, nearly one third (29.8%) reported symptoms of depression. Over one tenth (11.7%) had low or very low food security. Persons who had low or very low food security were more than twice as likely to report depressive symptoms (adjusted odds ratio [AOR] = 2.15, 95% CI, 1.39-3.32; AOR = 3.84, 95% CI, 2.28-6.45, respectively). Persons who were older, had higher income, and better general health were less likely to report depressive symptoms. Among adults with diabetes, low or very low food security was associated with increased risk for depressive symptoms. Further research is needed to evaluate the relationship between food insecurity and depressive symptoms among persons with diabetes.

The Impact of Telemedicine on Chronic Disease Management: A Post-Pandemic Analysis of Patient Outcomes and Accessibility

This study explores the impact of telemedicine on chronic disease management, focusing on patient outcomes and healthcare accessibility in the post-pandemic context. Using a qualitative research approach, the study examines how telemedicine has transformed the management of chronic conditions, especially for patients facing geographical or mobility barriers. Data were collected through in-depth interviews with patients, healthcare providers, and policy experts to gain insights into the experiences and challenges associated with telemedicine for chronic care. The findings reveal that telemedicine has improved patient accessibility to healthcare services, enabling consistent monitoring and timely interventions, which positively impact patient health outcomes. However, the study also identifies challenges, including technological barriers and limitations in patient-provider communication, that may affect care quality and patient satisfaction. Despite these issues, telemedicine is seen as a valuable supplement to traditional healthcare, enhancing healthcare access, especially for underserved populations. This research provides key insights for healthcare policymakers and practitioners in improving telemedicine practices, ensuring that they address accessibility gaps without compromising quality. The study concludes that, with strategic improvements, telemedicine holds significant potential to transform chronic disease management and make healthcare more equitable.

Evaluating effects of community-based social healing model on Ubuntu, mental health and psychosocial functioning in post-genocide Rwanda: protocol for cluster randomized control trial.

The community-based social healing (CBSH) model, developed by Ubuntu Centre for Peace, aims to support individuals with traumatic experiences and mental health challenges in achieving better mental health. CBSH combines BREATH-BODY-MIND™ (BBM) practices with collective narrative and rituals, facilitated by Community Healing Assistants in therapeutic groups. A previous pilot study involving 1889 Rwandan CBSH participants showed significant mental health improvements, including reductions in depression, anxiety, and PTSD, along with enhanced work productivity, and decreased intimate partner violence. The trial investigates the CBSH model's impact on Ubuntu and mental health. Ubuntu, a concept that encompasses humanness, compassion, and interconnectedness, is deeply rooted in the African philosophy. This cluster randomized controlled trial will involve 54 villages randomly selected in the Kirehe district, with 1080 participants randomly allocated equally to the CBSH intervention or a wait-list control group. While the trial will be conducted at the village (cluster) level, both primary and secondary outcomes will be measured individually for participants within each cluster. The Primary outcome "Ubuntu" will be measured using a context-adapted Ubuntu measurement scale. Secondary outcomes include psychosocial indicators which will be assessed through standardized tools such as the Patient Health Questionnaire for depression (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), Warwick-Edinburgh Mental Wellbeing scale (WEMWS), Connor-Davidson Resilience scale (CD-RISK-10), Somatic Symptom Severity Scale (PHQ-15), Revised Conflict Tactics scale (CTS2S), and Adapted Social Capital Assessment Tool (SASCAT). This trial aims to evaluate the CBSH model's impacts on Ubuntu, mental health, and social functioning among trauma-affected Rwandans, including those impacted by the 1994 Genocide against the Tutsi, mass killings, sexual abuse, and domestic violence. The findings could be of value to the Ubuntu Centre for Peace, policymakers, healthcare practitioners, and other stakeholders, by highlighting the significance of promoting Ubuntu as a foundation for addressing mental health challenges and the consequences of psychosocial trauma. ISRCTN ISRCTN17659369. Registered on February 09, 2024.

Associations of Physical Activity and Sedentary Behavior With Mental Distress According to Caregiver Status: Analysis of the Health Information National Trends Survey, 2022.

To (1) examine how physical activity and sedentary behavior are related to mental distress and (2) identify and compare how various levels of sedentary behaviors may differentially predict mental distress after accounting for physical activity, among caregivers vs non-caregivers. Cross-sectional secondary data. National Cancer Institute's Health Information National Trends Survey Cycle 6 fielded online from March-November 2022. U.S. adults aged 18 and older. The Patient Health Questionnaire-4 was administered along with caregiving status, moderate weekly physical activity, sedentary behavior, and sociodemographic characteristics. After applying population weights, we conducted multiple adjusted logistic regression models and estimated predictive margins to understand whether a specific dose of sedentary behavior (hours/day) is associated with risk of mental distress, at different levels of physical activity. Caregivers (15.41% of sample) reporting 10-hour of daily sedentary behavior were significantly more likely to experience mental distress, than those reporting lower amounts of sedentary behavior (OR = 3.372, 95%CI = 1.968, 5.776, P < 0.001). Regardless of physical activity amount, 10 hours of sedentary behavior may be a risk factor for mental distress among non-caregivers. Just 6 hours of sedentary behavior may be related to mental distress among caregivers. Physical activity interventions tailored to caregivers' needs, responsibilities, and circumstances are required. Innovative methodologies are needed to understand caregivers' daily behaviors and the intensity of their caregiving activities.

Impact of Physicians’ Perception of Social Determinants of Health (SDoH) on the Practice of Lifestyle Medicine. Findings From a Family Physicians Survey

Lifestyle Medicine emphasizes evidence-based lifestyle changes to address chronic conditions Yet, concerns have emerged regarding its ability to address broader social determinants of health (SDoH). This study examines how family physicians’ perceptions of SDoH relate to their use of lifestyle medicine competencies. This cross-sectional survey was administered to 5770 family physicians. Participants rated the importance of LM core competencies and the impact of community conditions on patient health. Data analysis involved descriptive statistics, factor analysis, regression models, and t-tests. This study encompassed 447 responses. The findings revealed that while respondents recognized the effect of certain SDoH, such as access to unhealthy food (89%), alcohol (86%), and tobacco (83%), they showed less awareness of factors like racism and discrimination (53%), and access to parks (56%) or education (60%). Gender and the level of social deprivation in their area were significant factors influencing respondents’ perception of SDoH impact. Additionally, those who valued and used lifestyle medicine core competencies were more likely to acknowledge the influence of SDoH on patient health. Our findings suggest that comprehensive education on SDoH, especially with a focus on community aspects, is crucial across all levels of medical training to address this gap and ensure equitable care.

Delineating the psychiatric morbidity spectrum in congenital adrenal hyperplasia: a population-based registry study.

Clinical studies of psychiatric morbidity in patients with congenital adrenal hyperplasia (CAH) imply impaired mental health. To delineate psychiatric morbidity in a national CAH cohort by using complete data on psychiatric diagnoses from all Danish hospitals between 1977-2018 and on all psychiatric medication prescribed between 1995-2018. A registry-based cohort study. A public uniform healthcare system. Four-hundred-forty-eight patients (females: n=215) with CAH, hereof 410 with 21-hydroxylase deficiency (21-OHD) (females: n=255) and 44,527 age- and sex-matched general population controls. Diagnoses were analyzed by negative binomial regression yielding incidence rate ratios (IRR). Medication were analyzed by Cox regression yielding hazard ratios (HR). 21-OHD was associated with an increased risk of any psychiatric diagnosis; females: IRR=2.32 (confidence interval (CI) (1.48-3.64), males: IRR=2.74 (CI 1.31-5.71) as well as of medication related to psychiatric disorders; females: HR=1.74 (CI 1.42-2.13), males: HR=1.74 (CI1.30-2.33). Both females and males with 21-OHD had a significantly increased risk of alcohol use, stress- and adjustment disorders, and of suicidal behavior. For patients with more rare forms of CAH (n=24), the risk of any psychiatric diagnosis was significantly increased for males, IRR=12.85 (CI 1.78-92.87), but not for females, IRR=0.54 (CI 0.10-3.00). The risk of being prescribed psychiatric medication was not increased for neither females, HR=1.05 (CI 0.39-2.84), or males, HR=0.72 (CI 0.10-5.13), with rare forms of CAH. 21-OHD is associated with a significantly increased psychiatric morbidity. This study underlines a need for awareness of mental health in patients with 21-OHD.

Impact of Image Content on Medical Crowdfunding Success: A Machine Learning Approach.

As crowdfunding sites proliferate, visual content often serves as the initial bridge connecting a project to its potential backers, underscoring the importance of image selection in effectively engaging an audience. This paper aims to explore the relationship between images and crowdfunding success in cancer-related crowdfunding projects. We used the Alibaba Cloud platform to detect individual features in images. In addition, we used the Recognize Anything Model to label images and obtain content tags. Furthermore, the discourse atomic topic model was used to generate image topics. After obtaining the image features and image content topics, we built regression models to investigate the factors that influence the results of crowdfunding success. Images with a higher proportion of young people (β=0.0753; P<.001), a larger number of people (β=0.00822; P<.001), and a larger proportion of smiling faces (β=0.0446; P<.001) had a higher success rate. Image content related to good things and patient health also contributed to crowdfunding success (β=0.082, P<.001; and β=0.036, P<.001, respectively). In addition, the interaction between image topics and image characteristics had a significant effect on the final fundraising outcome. For example, when smiling faces are considered in conjunction with the image topics, using more smiling faces in the rest and play theme increased the amount of money raised (β=0.0152; P<.001). We also examined causality through a counterfactual analysis, which confirmed the influence of the variables on crowdfunding success, consistent with the results of our regression models. In the realm of web-based medical crowdfunding, the importance of uploaded images cannot be overstated. Image characteristics, including the number of people depicted and the presence of youth, significantly improve fundraising results. In addition, the thematic choice of images in cancer crowdfunding efforts has a profound impact. Images that evoke beauty and resonate with health issues are more likely to result in increased donations. However, it is critical to recognize that reinforcing character traits in images of different themes has different effects on the success of crowdfunding campaigns.

Effects of internet-based health education on patients with acute intermittent porphyria.

Acute intermittent porphyria (AIP) is a rare genetic metabolic disorder characterized by acute attacks of neurovisceral symptoms. This disease not only poses a threat to patients' physical and mental well-being, but its frequent acute attacks also have a profound impact on patients' mental state and overall quality of life (QoL). This study aimed to explore the impact of internet-based health education on the acute attacks, mental health, and QoL of patients with AIP. This study employed a pre-post comparison design, recruiting 52 patients diagnosed with AIP and treated at the Second Hospital of Hebei Medical University between September 2021 and May 2023 as the subjects of investigation. All participants underwent a 12-month internet-based health education intervention. Quantitative assessments of the intervention's efficacy in reducing acute attacks, enhancing mental health status, and improving QoL among AIP patients were conducted using various instruments, including measures of acute episode frequency and severity, the Depression Anxiety Stress Scales-21 (DASS-21), the Positive and Negative Affect Schedule (PANAS), and the MOS 36-Item Short Form Health Survey (SF-36). Data were collected at two distinct time points: pre- and post-health education interventions, which were then subjected to comparative analysis. Compared to pre-health education, the frequency of acute attacks among patients with AIP significantly decreased post-health education intervention (p < 0.05). Furthermore, notable improvements were observed in the severity of acute attacks, PANAS scores, DASS-21 scores, and SF-36 scores (p < 0.05). This study validated that health education effectively reduced the frequency and severity of acute attacks in AIP patients while enhancing their mental health status and quality of life. Internet-based health education emerges as a practical and productive strategy for AIP patients.

Anxiety and depression among a community-recruited cohort of people who use methamphetamine: A longitudinal analysis.

This study (1) estimated changes in anxiety and depression throughout 3 years in a community-recruited cohort who use methamphetamine and (2) modelled whether these changes were associated with patterns of methamphetamine use or other time-varying or fixed covariates. We used a longitudinal analysis using data derived from surveys conducted between August 2016 and March 2020, set in metropolitan and rural locations in Victoria, Australia. Participants comprised a total of 849 adults with regular methamphetamine use history at baseline, recruited for the prospective VMAX study via snowball and respondent-driven sampling. Anxiety and depression symptoms were measured using the Generalized Anxiety Disorder (GAD)-7 and the Patient Health Questionnaire (PHQ)-9 instruments. Frequency of methamphetamine use was measured by self-reported number of days per week participants used any form of methamphetamine in the past month. Changes in anxiety and depression symptom scores were associated with change in route of administration from non-injecting to injecting [adjusted coefficient (adj. coeff.) = 1.44, 95% confidence intervals (CI) = 0.39, 2.48, adj. coeff. = 1.49, 95% CI = 0.39, 2.58], change in severity of dependence for methamphetamine (adj. coeff. = 0.29, 95% CI = 0.21, 0.37, adj. coeff. = 0.34, 95% CI = 0.26, 0.42), starting treatment for drugs other than methamphetamine (adj. coeff. = -2.21, 95% CI = -3.70, -0.73, adj. coeff. = -2.09, 95% CI = -3.60, -0.58) and other covariates. Among regular methamphetamine users in Australia, changes in anxiety or depression scores are associated with changes in route of administration, dependence severity and starting treatment for other drugs, but do not appear to be associated with frequency of methamphetamine use.

The Relationship Between Work Engagement, Depression, Anxiety, and COVID-19 Anxiety in Physician Assistant Students.

Introduction: Physician assistants (PAs) are subject to high levels of burnout, depressive symptoms, and anxiety, which can negatively impact quality of care and patient outcomes. Learning how to handle stress in the classroom may increase success and engagement in PA programs. The goal of this study was to characterize burnout, depressive symptoms, and anxiety in current PA students and examine the relationship between these factors and work engagement.Methods: This cross-sectional study surveyed PA students (n = 42) via convenience sampling from eighteen different PA programs across North and South Carolina in October, 2021. Questionnaires included the Utrecht Work Engagement Scale (UWES-17), the Patient Health Questionnaire (PHQ-2), the General Anxiety Disorder scale (GAD-7), and the COVID-19 Anxiety Scale (CIAS). Adjusted linear regression was used to assess associations between the GAD-7, PHQ-2, and CIAS and the three subscales of the UWES-17 (vigor, dedication, and absorption).Results: Students were primarily female (79%), white (79%), second-year students (62%), and had an average body mass index of 21.0 ± 3.9kg/m2. A one-unit increase in the GAD-7 was associated with a decrease in the vigor (β = -0.94, SE = 0.19, p < .01) and dedication (β = -0.42, SE = 0.15, p = .01) subscales. A one-unit increase in the PHQ-2 was associated with a decrease in the vigor subscale (β = -2.94, SE = 0.60, p < .01).Conclusions: Recognizing warning signs of declining mental health early among PA school students may be key to increasing resilience, enthusiasm, and concentration, which may enhance school/work engagement. More work is needed to elucidate potential intervention targets to increase school/work engagement in PA students.

Hybrid Machine Learning Approach for Early Stroke Prediction in Elderly People

Stroke represents a significant global health challenge, often leading to severe disability and mortality. The timely prediction and intervention of stroke are paramount in enhancing patient outcomes and reducing healthcare burdens. This project proposes a machine learning-based approach to predict stroke risk using multi-modal biosignals, specifically electrocardiogram (ECG) data. By leveraging advanced algorithms, including Convolutional Neural Networks (CNNs) and Long Short-Term Memory (LSTM) networks, the system aims to classify patient health data into critical risk categories such as Normal, Abnormal, Ischemic, and Hemorrhagic. The study utilizes a comprehensive dataset consisting of ECG signals and incorporates techniques for data preprocessing, class balancing, and feature extraction. The predictive model is trained and validated using robust evaluation metrics, including accuracy, precision, recall, and F1-score. The findings underscore the efficacy of the proposed system in providing real-time stroke risk assessments, offering a cost-effective alternative to traditional diagnostic methods. Furthermore, this research explores the integration of wearable technology with machine learning, highlighting its potential for continuous patient monitoring and early detection of stroke symptoms. By creating a user-friendly interface for healthcare professionals and patients, the system aims to facilitate prompt decision-making and intervention, ultimately improving the overall quality of care for individuals at risk of stroke