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Non-participation of asymptomatic candidates in screening protocols reduces early diagnosis and worsens prognosis of colorectal cancer

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World Journal of Gastroenterology 2024年第26期30卷 3198-3200页

作者： Sergio Pérez-Holanda office of Regional Viceministry of health Regional Viceministry of HealthOviedo 33005AsturiasSpain

The Agatsuma et al’s study shows that despite the evidence of the benefits of an early colorectal cancer(CRC)diagnosis,through screening in asymptomatic subjects,up to 50%of candidates reject this option and many of those affected are diagnosed later,in advanced *** efficacy of screening programs has been well-established for several years,which reduces the risk of CRC morbidity and mortality,without taking into account the test used for screening,or other ***,a significant proportion of patients remain unscreened,so understanding the factors involved,as well as the barriers of the population to adherence is the first step to possibly modify the participation *** barriers could include a full range of social and political aspects,especially the type of financial provision of each health *** Japan,health services are universal,and this advantageous situation makes it easier for citizens to access to these services,contributing to the detection of various diseases,including ***,the symptomatic CRC group had a lower early-stage diagnosis rate than the patients detected during follow-up for other comorbidities,and symptomatic and cancer screening groups showed similar early-stage diagnosis.

关键词： Colorectal neoplasms Cancer registry Diagnostic route Cancer screening Stage at diagnosis

Social-ecological perspective on the suicidal behaviour factors of early adolescents in China:a network analysis

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General Psychiatry 2024年第1期37卷 143-150页

作者： Yuan Li Peiying Li Mengyuan Yuan Yonghan Li Xueying Zhang Juan Chen Gengfu Wang Puyu Su Department of Maternal Child and Adolescent HealthSchool of Public HealthKey Laboratory of Population Health Across Life Cycle(Anhui Medical University)Ministry of Education of the People's Republic of ChinaAnhui Medical UniversityKey Laboratory of Population Health Across Life Cycle(Anhui Medical University)HefeiAnhuiChina Tianjin Anding Hospital Mental Health Center of Tianjin Medical UniversityTianjin Medical UniversityTianjinChina Department of Environmental Medicine and Public health Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA Afiliated Psychological Hospital of Anhui Medical University Anhui Mental Health CenterFourth People's Hospital of HefeiHefeiAnhuiChina

Background In early adolescence,youth are highly prone to suicidal *** modifiable risk factors during this critical phase is a priority to inform effective suicide prevention *** To explore the risk and protective factors of suicidal behaviours(ie,suicidal ideation,plans and attempts)in early adolescence in China using a social-ecological *** Using data from the cross-sectional project‘healthy and Risky Behaviours Among Middle School Students in Anhui Province,China',stratified random cluster sampling was used to select 5724 middle school students who had completed self-report questionnaires in November *** analysis was employed to examine the correlates of suicidal ideation,plans and attempts at four levels,namely individual(sex,academic performance,serious physical llness/disability,history of self-harm,depression,impulsivity,sleep problems,resilience),family(family economic status,relationship with mother,relationship with father,family violence,childhood abuse,parental mental illness),school(relationship with teachers,relationship with classmates,school-bullying victimisation and perpetration)and social(social support,satisfaction with society).Results In total,37.9%,19.0%and 5.5%of the students reported suicidal ideation,plans and attempts in the past 6 months,*** estimated network revealed that suicidal ideation,plans and attempts were collectively associated with a history of self-harm,sleep problems,childhood abuse,school bullying and *** analysis indicated that the most influential nodes in the network were history of self-harm and childhood ***,the network also showed unique correlates of suicidal ideation(sex,weight=0.60;impulsivity,weight=0.24;family violence,weight=0.17;relationship with teachers,weight=-0.03;school-bullying perpetration,weight=0.22),suicidal plans(social support,weight=-0.15)and suicidal attempts(relationship with mother,weight=-0.10;par

关键词： network analysis prevention

Sexual and Reproductive Service Interventions for Menstrual Regulation, Safe Abortion, and Post-abortion Care and Their Effectiveness During Disaster Response: A Global Systematic Review

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International Journal of Disaster Risk Science 2024年第3期15卷 359-373页

作者： Nibedita S.Ray-Bennett Winifred Ekezie Isha Biswas Nimra Iqbal Choudhary David Cowie Lasith Dissanayake Lauren Macleod Azukaeogo Nnaji Madhulika Sahoo School of Business University of Leicester Avoidable Deaths Network University of Leicester Diabetes Research Centre Leicester General Hospital University of Leicester School of Social Sciences and Humanities Aston University Lifespan and population health School of Medicine University of Nottingham School of Public health and Interdisciplinary Studies Auckland University of Technology Faculty of Life Sciences and Education University of South Wales West African Regional ECHO (WARE) APIN Public Health Initiatives Department of Anthropology Kalahandi University

Sexual and reproductive health(SRH) services are crucial for women especially during disasters, to reduce maternal mortality and morbidity from miscarriages, unsafe abortions, and post-abortion complications. This study explored the SRH interventions provided during disaster response. A systematic review was conducted to identify what menstrual regulation(MR), safe abortion(SA), and post-abortion care(PAC) approaches/interventions exist to promote resilience in the health system in disaster settings; what intervention components were most eff ective; and challenges and opportunities to meeting SRH rights. Five electronic databases were searched, resulting in 4194 records. Following the screening process, seven publications were included. The intervention-related information in each publication was assessed based on availability,accessibility, acceptability, and quality. Two SRH approaches/interventions were found. The eff ectiveness of intervention components could not be conducted due to the limited number of relevant studies. Challenges were found at facility and community levels, and opportunities included overcoming them, making MR, SA, and PAC integral to the mitigation phase,and policy change to overcome barriers related to unaff ordability and inaccessibility. Recommendations are provided to encourage research and policy towards improving neglected SRH in disaster settings to realize Sustainable Development Goal 3 and the Global Strategy and Sendai Framework's priority to promote disaster-resilient health systems.

关键词： Abortion Disasters Sendai framework Sexual and reproductive health Sustainable development goal

Variations, effectiveness and its associated factors of a nationwide web-based hypertension management training project in China: insights from a government-led campaign for 1.2 million lay health workers

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Journal of Geriatric Cardiology 2024年第7期21卷 733-750页

作者： Wei WANG Hai-Bo ZHANG Jia-Min LIU Yan LI Na TIAN Lei YAN Jin-Xiao SONG Mei-Li LI Yue PENG Jing LI National Primary health Care Hypertension Management office National Clinical Research Center for Cardiovascular DiseasesNHC Key Laboratory of Clinical Research for Cardiovascular MedicationsFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina

OBJECTIVES To evaluate the effectiveness of a large-scale,web-based,in-service hypertension management training project among lay health workers(LHWs) at primary care health(PHC) settings in China,and to examine the factors contributing to the variations of *** We used data from a web-based national hypertension management training project implemented in 2018,it was designed to facilitate LHWs to learn,understand,and apply the relevant knowledge and skills in hypertension management through providing training courses by use of the web-based platform with unified *** LHWs were required to participate in the exams before and after training to acquire scores for the use of evaluating their performance of hypertension management *** first used descriptive analysis to present the variations of effectiveness in hypertension management knowledge among LHWs by important ***,we used multilevel logistic regression to examine the individual and regional factors contributing to the variations and quantify the magnitude of how these factors affected training *** There were 1,208,610 LHWs who completed training and were ***,the scores of LHWs increased significantly from 62.87 ± 21.14 out of 100 in the pre-test to 88.30 ± 11.31 in the post-test by 25.43(95% confidence interval[CI]:25.40-25.47).Training contents involved in antihypertensive medication showed the lowest score(54.36) in the pre-test and soared the most after training,up to 84.22 by 54.94%.Individual factors associated with disparities in the knowledge of hypertension management decreased substantially after training,which included sex,age,education,practice type,professional level,and hierarchy of working *** variations were shown at the provincial level,with the majority of them being explained by factors at the regional *** Accessible web-based training modality,government efforts,accompa

关键词： hypertension workers nationwide

Melatonin improves synapse development by PI3K/Akt signaling in a mouse model of autism spectrum disorder

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Neural Regeneration Research 2024年第7期19卷 1618-1624页

作者： Luyi Wang Man Xu Yan Wang Feifei Wang Jing Deng Xiaoya Wang Yu Zhao Ailing Liao Feng Yang Shali Wang Yingbo Li Institute of Neuroscience Department of PhysiologySchool of Basic Medical ScienceChongqing Medical UniversityChongqingChina Department of Pediatric Chongqing University Fuling HospitalChongqingChina Department of Neurosurgery Xinqiao HospitalArmy Medical UniversityChongqingChina Department of Pathology Affiliated Hospital of North Sichuan Medical CollegeNanchongSichuan ProvinceChina NHC Key Laboratory of Birth Defects and Reproductive health Chongqing Population and Family Planning Science and Technology Research InstituteChongqingChina China National Clinical Research Center for Neurological Diseases Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Advanced Innovation Center for Human Brain Protection Capital Medical UniversityBeijingChina

Autism spectrum disorders are a group of neurodevelopmental disorders involving more than 1100 genes,including Ctnnd2 as a candidate ***2knockout mice,serving as an animal model of autis m,have been demonstrated to exhibit decreased density of dendritic *** role of melatonin,as a neuro hormone capable of effectively alleviating social interaction deficits and regulating the development of dendritic spines,in Ctnnd2 deletion-induced nerve injury remains unclea *** the present study,we discove red that the deletion of exon 2 of the Ctnnd2 gene was linked to social interaction deficits,spine loss,impaired inhibitory neurons,and suppressed phosphatidylinositol-3-kinase(PI3K)/protein kinase B(Akt) signal pathway in the prefrontal *** findings demonstrated that the long-term oral administration of melatonin for 28 days effectively alleviated the aforementioned abnormalities in Ctnnd2 gene-knockout ***,the administration of melatonin in the prefro ntal cortex was found to improve synaptic function and activate the PI3K/Akt signal pathway in this *** pharmacological blockade of the PI3K/Akt signal pathway with a PI3K/Akt inhibitor,wo rtmannin,and melatonin receptor antagonists,luzindole and 4-phenyl-2-propionamidotetralin,prevented the melatonin-induced enhancement of GABAergic synaptic *** findings suggest that melatonin treatment can ameliorate GABAe rgic synaptic function by activating the PI3K/Akt signal pathway,which may contribute to the improvement of dendritic spine abnormalities in autism spectrum disorders.

关键词： autism Ctnnd2 deletion GABAergic neurons melatonin PI3K/Akt signal pathway prefrontal cortex social behavior spine density synaptic-associated proteins

Maternal serum branched-chain amino acids in early pregnancy and offspring growth patterns from 1 year to 8 years of age

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中华医学杂志(英文版) 2024年第15期137卷 1876-1878页

作者： Li Ninghua Leng Junhong Zhang Rui Wang Hui Li Weiqin Zhang Shuang Qiao Yijuan Li Jing Yu Zhijie Hu Gang Fang Zhongze Yang Xilin Department of Epidemiology and Biostatistics School of Public Health Tianjin Medical University Tianjin China Project office Tianjin Women and Children’s Health Center Tianjin China Tianjin Key Laboratory of Environment Nutrition and Public Health Tianjin China Tianjin Center for International Collaborative Research on Environment Nutrition and Public Health Tianjin China population Cancer Research Program and Department of Pediatrics Dalhousie University Halifax Canada Chronic Disease Epidemiology Laboratory Pennington Biomedical Research Center Baton Rouge LA USA Department of Toxicology and Sanitary Chemistry School of Public Health Tianjin Medical University Tianjin China

Portable spirometer-based pulmonary function test willingness in China: A nationwide cross-sectional study from the "Happy Breathing Program"

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中华医学杂志(英文版) 2024年第14期137卷 1695-1704页

作者： Qi Weiran Huang Ke Chen Qiushi Jiao Lirui Yu Fengyun Yu Yiwen Niu Hongtao Li Wei Fang Fang Lei Jieping Chu Xu Li Zilin Geldsetzer Pascal B?rnighausen Till Chen Simiao Yang Ting Wang Chen Department of health Economics and health Policy School of Population Medicine and Public Health Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China Department of Pulmonary and Critical Care Medicine National Center for Respiratory Medicine State Key Laboratory of Respiratory Health and Multimorbidity National Clinical Research Center for Respiratory Diseases Institute of Respiratory Medicine Chinese Academy of Medical Sciences Center of Respiratory Medicine China-Japan Friendship Hospital Beijing China The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering The Pennsylvania State University University Park PA USA Department of health Policy and Management Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill NC USA Heidelberg Institute of Global health (HIGH) Faculty of Medicine and University Hospital Heidelberg University Heidelberg Germany Administration office of Medical Reform and Development China-Japan Friendship Hospital Beijing China Data and Project Management Unit Institute of Clinical Medical Sciences China-Japan Friendship Hospital Beijing China Department of Statistics School of Mathematics and Statistics Northeast Normal University Changchun Jilin China Chan Zuckerberg Biohub Stanford University School of Medicine San Francisco CA USA Division of Primary Care and population health Department of Medicine Stanford University School of Medicine Stanford CA USA Harvard Center for population and Development Studies Harvard T.H. Chan School of Public Health Harvard University Cambridge MA USA

Background: Understanding willingness to undergo pulmonary function tests (PFTs) and the factors associated with poor uptake of PFTs is crucial for improving early detection and treatment of chronic obstructive pulmonary disease (COPD). This study aimed to understand willingness to undergo PFTs among high-risk populations and identify any barriers that may contribute to low uptake of ***: We collected data from participants in the "Happy Breathing Program" in China. Participants who did not follow physicians’ recommendations to undergo PFTs were invited to complete a survey regarding their willingness to undergo PFTs and their reasons for not undergoing PFTs. We estimated the proportion of participants who were willing to undergo PFTs and examined the various reasons for participants to not undergo PFTs. We conducted univariable and multivariable logistic regressions to analyze the impact of individual-level factors on willingness to undergo ***: A total of 8475 participants who had completed the survey on willingness to undergo PFTs were included in this study. Out of these participants, 7660 (90.4%) were willing to undergo PFTs. Among those who were willing to undergo PFTs but actually did not, the main reasons for not doing so were geographical inaccessibility (n = 3304, 43.1%) and a lack of trust in primary healthcare institutions (n = 2809, 36.7%). Among the 815 participants who were unwilling to undergo PFTs, over half (n = 447, 54.8%) believed that they did not have health problems and would only consider PFTs when they felt unwell. In the multivariable regression, individuals who were ≤54 years old, residing in rural townships, with a secondary educational level, with medical reimbursement, still working, with occupational exposure to dust, and aware of the abbreviation "COPD" were more willing to undergo ***: Willingness to undergo PFTs was high among high-risk populations. Policymakers may consider implementing strategies suc

关键词： Chronic obstructive pulmonary disease Pulmonary function tests Willingness to undergo pulmonary function tests population medicine

Predictors of Abnormal Vaginal Discharge among Women of Reproductive Age in Southeast Nigeria

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International Journal of Clinical Medicine 2024年第7期15卷 240-256页

作者： Jideuma Egwim Victor Dike Hope Igbonagwam Nkechinyere Oke Uzoma Amajo Akuchi Okafor Angela Izegbune Ijedimma Okafor Department of family Medicine Federal University Teaching Hospital Owerri Nigeria Department of Public health Central Michigan University Mount Pleasant Michigan USA Department of Ophthalmology Enugu State University Teaching Hospital Enugu Nigeria Department of family Medicine Lagos University Teaching Hospital Lagos Nigeria Department of Internal Medicine Alex Ekwueme Federal University Teaching Hospital Ebonyi State Nigeria Field office World Health Organisation Imo State Nigeria Department of Internal Medicine Ebonyi State University College of Health Sciences Ebonyi State Nigeria

Background: An abnormal vaginal discharge is a common complaint among women of reproductive age, and it can indicate serious conditions like pelvic inflammatory disease and cervical cancer. This study aimed to assess the predictors of abnormal vaginal discharge in women of reproductive age group in Imo State, Southeast Nigeria. Methods: A cross-sectional study was conducted among 368 women of reproductive age group attending the clinic at Federal University Teaching Hospital Owerri, in Imo State, Nigeria. Respondents were recruited using a systematic sampling technique. Data were collected using a pre-tested interviewer-administered questionnaire. Multivariable analysis was performed to determine predictors of abnormal vaginal discharge. Statistical significance was set at p Results: The mean age of the respondents was 30 ± 4.5 years. Predictors of abnormal vaginal discharge were: age 36 - 45 years (OR: 4.5;95% C.I: 1.023 - 8.967, p = 0.041), being a student (OR: 2.4: 95% C.I: 1.496 - 7.336, p = 0.003), use of oral contraceptives (OR: 3.4;95% C.I: 1.068 - 6.932, p = 0.010), use of water cistern (OR: 4.7;C.I: 1.654 - 5.210, p = 0.028) anal hygiene practices (OR: 2.7;95% C.I: 1.142 - 4.809, p Conclusion: These findings suggest that targeted sexual and reproductive health interventions should be provided to reduce the risk of abnormal vaginal discharge in women of reproductive age group.

关键词： Predictors Abnormal Vaginal Discharge

Prioritizing Strategies for Building the Resilience of Public health Systems to Disasters Across Multiple Communities and Countries

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International Journal of Disaster Risk Science 2024年第1期15卷 1-17页

作者： Benjamin J.Ryan Mayumi Kako Shelby Garner Rok Fink Ismail Tayfur Jonathan Abrahams Sanjaya Bhatia Adriana Campelo Matthew Fendt Alicia Fontenot Nahuel Arenas Garcia Tim Hatch Ryoma Kayano LaShonda Malrey‑Horne Makiko MacDermot Md Moshiur Rahman Chaverle Noel Shuhei Nomura Jeremy P.Novak Maria Opazo Kendell Oliver Luciana Peters Sohel Rahman PerihanŞimşek Andrew Stricklin Raymond Swienton Bryan W.Brooks Frist College of Medicine Belmont UniversityNashvilleTN 37212USA Department of Environmental Science Environmental Health Science ProgramCollege of Arts and SciencesBaylor UniversityWacoTX 76798USA Division of Nursing Science School of Biomedical and Health SciencesHiroshima UniversityHiroshima 734-8553Japan Gordon E.Inman College of health Sciences and Nursing Belmont UniversityNashvilleTN 37212USA Faculty of health Sciences University of Ljubljana1000 LjubljanaSlovenia Department of Emergency Medicine University of Health Sciences34668 IstanbulTurkey Monash University Accident Research Center MelbourneVIC 3800Australia Global Education and Training Institute United Nations Ofce for Disaster Risk ReductionIncheon 22004Republic of Korea Regional Ofce for the Americas and Caribbean United Nations Ofce for Disaster Risk ReductionPanama City 0843-03441Panama Engineering and Computer Science Baylor UniversityWacoTX 76798USA Department of Public health Robbins College of Health and Human SciencesBaylor UniversityWacoTX 76798USA Alabama Department of Public health MontgomeryAL 36092USA World health Organization Centre for health Development(WHO Kobe Centre) Kobe 651-0073Japan Waco-McLennan County Public health District WacoTX 76707USA Department of health Policy and Management School of MedicineKeio UniversityTokyo 160-8582Japan Department of Global health Policy Graduate School of MedicineThe University of TokyoTokyo 113-0033Japan Tokyo Foundation for Policy Research Tokyo 106-6234Japan Global Development College BrisbaneQLD 4000Australia Municipality of Pudahuel 13124 PudahuelChile City Hall of Porto Alegre Porto Alegre 90010-170Brazil Ministry of health and family Welfare Government of the People’s Republic of BangladeshDhaka 1000Bangladesh Department of Emergency Aid and Disaster Management Trabzon University61335 TrabzonTurkey Department of Emergency Medicine UT SouthwesternDallasTX 75390USA

The COVID-19 pandemic highlighted the urgent need to strengthen public health *** response,the United Nations Disaster Risk Reduction(UNDRR) Public health System Resilience Scorecard(Scorecard) was applied in workshops across multiple *** aim of our research was to explore the workshop findings to develop priority strategies for strengthening public health system *** conducted a workshop from 14 to 16 March 2023,at the UNDRR Global Education and Training Institute in Incheon,Republic of Korea.A sequential modified Delphi method was utilized to develop a set of prioritized resilience *** were drawn from 70 strategies identified from 13 distinct workshops in eight *** two surveys,23 strategies were *** received ratings of "High" or Very High" from89% of *** related to the inclusion of public health risks in emergency plans,integrating multidisciplinary teams into public health,enabling local transport mechanisms,and improving the ability to manage an influx of *** Scorecard provides an adaptable framework to identify and prioritize strategies for strengthening public health system *** leveraging this methodology,our study demonstrated how resilience strategies could inform disaster risk reduction funding,policies,and actions.

关键词： health system resilience Public policy Resilience scorecard Workshops