We previously showed that hydrogen sulfide(H2S)has a neuroprotective effect in the context of hypoxic ischemic brain injury in neonatal mice.However,the precise mechanism underlying the role of H2S in this situation r...We previously showed that hydrogen sulfide(H2S)has a neuroprotective effect in the context of hypoxic ischemic brain injury in neonatal mice.However,the precise mechanism underlying the role of H2S in this situation remains unclear.In this study,we used a neonatal mouse model of hypoxic ischemic brain injury and a lipopolysaccharide-stimulated BV2 cell model and found that treatment with L-cysteine,a H2S precursor,attenuated the cerebral infarction and cerebral atrophy induced by hypoxia and ischemia and increased the expression of miR-9-5p and cystathionineβsynthase(a major H2S synthetase in the brain)in the prefrontal cortex.We also found that an miR-9-5p inhibitor blocked the expression of cystathionineβsynthase in the prefrontal cortex in mice with brain injury caused by hypoxia and ischemia.Furthermore,miR-9-5p overexpression increased cystathionine-β-synthase and H2S expression in the injured prefrontal cortex of mice with hypoxic ischemic brain injury.L-cysteine decreased the expression of CXCL11,an miR-9-5p target gene,in the prefrontal cortex of the mouse model and in lipopolysaccharide-stimulated BV-2 cells and increased the levels of proinflammatory cytokines BNIP3,FSTL1,SOCS2 and SOCS5,while treatment with an miR-9-5p inhibitor reversed these changes.These findings suggest that H2S can reduce neuroinflammation in a neonatal mouse model of hypoxic ischemic brain injury through regulating the miR-9-5p/CXCL11 axis and restoringβ-synthase expression,thereby playing a role in reducing neuroinflammation in hypoxic ischemic brain injury.展开更多
Wuhan University,the development of death education in China has a history of more than 30 years.But it has lacked the clout it deserves in China.However,in recent years,death education has begun to attract more and m...Wuhan University,the development of death education in China has a history of more than 30 years.But it has lacked the clout it deserves in China.However,in recent years,death education has begun to attract more and more attention from the medical community.Various lectures and pieces of training related to death education held by the government and medical institutions,as well as related academic salons,seminars,workshops and“Death Cafes”held by the people have appeared and become popular.Death education has been developed in China for more than 30 years,why has it suddenly become popular and even popular in recent years?This has an important relationship with China’s aging population and the medicalization of death.展开更多
BACKGROUND Test anxiety is prevalent among medical students and leads to impaired academic performance.Test-related attentional bias has been identified as an important maintaining factor in test-anxious individuals.A...BACKGROUND Test anxiety is prevalent among medical students and leads to impaired academic performance.Test-related attentional bias has been identified as an important maintaining factor in test-anxious individuals.AIM To evaluate whether hypnosis and progressive muscle relaxation(PMR)could modify medical college students’test anxiety and attentional bias.METHODS A total of 598 medical students were screened.The participants were divided into higher and lower test anxiety groups according to their scores on the test anxiety scale(TAS).Ninety medical college students with high TAS score were randomly assigned to a hypnosis or PMR group.Another 45 students with low TAS score were included,forming a baseline control group.The intervention was conducted weekly for 6 wk,and each session lasted approximately 30 min.The total intervention time and the number of intervention sessions for the hypnosis and PMR groups were equal.Data were collected at the pretest,posttest,and 2-mo follow-up.RESULTS Hypnosis group participants had a significantly lower TAS score at posttest(t=-21.827,P<0.001)and at follow-up(t=-14.824,P<0.001),compared to that at pretest.PMR group participants also had a significantly lower TAS score at posttest(t=-10.777,P<0.001)and at follow-up(t=-7.444,P<0.001),compared to that at pretest.At the posttest level,the hypnosis group had a significantly lower TAS score than the PMR group(t=-3.664,P<0.001).At the follow-up level,the hypnosis group also had a significantly lower TAS score than the PMR group(t=-2.943,P=0.004).Clinically significant improvement was found in both the hypnosis and PMR groups(hypnosis=64.0%;PMR=62.22%).Hypnosis was more effective than PMR in reducing test anxiety among medical college students.Hypnosis could modify attentional bias toward threatening stimuli,but PMR could not.CONCLUSION These results suggest that attentional bias plays an important role in test anxiety treatment.展开更多
Objective:To screen risk factors for epilepsy after acute ischaemic stroke based on meta-analysis and cohort study and to establish a predictive model.Methods:Computer searches of MEDLINE,Embase,Cochrane library,Web o...Objective:To screen risk factors for epilepsy after acute ischaemic stroke based on meta-analysis and cohort study and to establish a predictive model.Methods:Computer searches of MEDLINE,Embase,Cochrane library,Web of Scinence,PubMed,CNKI,and WanFang Data data were conducted to collect literature on epilepsy after in acute ischemic stroke,from database creation to September 1,2022.The RRs and their 95%confidence intervals(CI)for risk factors for post stroke epilepsy were extracted for each study,and pooled estimates of the RRs and 95%CIs for each study were generated using either a random-effects model or a fixed-effects model.Beta coefficients for each risk factor were calculated based on the combined RR and their corresponding 95%CIs.The beta coefficients were multiplied by 10 and rounded.Results:Ten articles were identified for final inclusion in this meta-analysis,with a total of 141948 cases and 3702 cases of post stroke epilepsy.The risk factors included in the final risk prediction model were infarct size(RR 4.67,95%CI 1.41~15.47;P=0.01),stroke recuRRence(RR 2.48,95%CI 2.01~3.05;P<0.00001),stroke etiology(RR 1.70,95%CI 1.34~2.15;P<0.00001),stroke severity(RR 1.70,95%CI 1.34~2.15;P<0.00001),and stroke risk.stroke severity(RR 1.53,95%CI 1.39~1.70;P<0.00001),NIHSS score(RR 2.91,95%CI 1.64~5.61;P=0.0003),early-onset epilepsy(RR 5.62,95%CI 5.08~6.22;P<0.00001),cortical lesions(RR 3.83.95%CI 2.23~6.58;P<0.00001),total anterior circulation infarction(RR 18.94,95%CI 10.38~34.57;P<0.00001),partial anterior circulation infarction(RR 4.39,95%CI 2.29~8.40;P<0.00001),cardiovascular events(RR 1.78,95%CI 1.59~1.99;P<0.00001).Conclusion:Based on a systematic review and meta-analysis,we developed a simple risk prediction model for late epilepsy in baseline ischemic stroke that integrates clinical risk factors,including infarct size,stroke recurrence,stroke etiology,stroke severity,NIHSS score,early onset epilepsy,cortical lesions,stroke subtype,and cardiovascular events.展开更多
Ganoderma lucidum is a traditional Chinese medicine,which has been shown to have both anti-oxidative and anti-inflammatory effects,and noticeably decreases both the infarct area and neuronal apoptosis of the ischemic ...Ganoderma lucidum is a traditional Chinese medicine,which has been shown to have both anti-oxidative and anti-inflammatory effects,and noticeably decreases both the infarct area and neuronal apoptosis of the ischemic cortex.This study aimed to investigate the protective effects and mechanisms of pretreatment with ganoderma lucidum(by intragastric administration)in cerebral ischemia/reperfusion injury in rats.Our results showed that pretreatment with ganoder-ma lucidum for 3 and 7 days reduced neuronal loss in the hippocampus,diminished the content of malondialdehyde in the hippocampus and serum,decreased the levels of tumor necrosis fac-tor-αand interleukin-8 in the hippocampus,and increased the activity of superoxide dismutase in the hippocampus and serum.These results suggest that pretreatment with ganoderma lucidum was protective against cerebral ischemia/reperfusion injury through its anti-oxidative and an-ti-inflammatory actions.展开更多
Extracellular vesicles(EVs)from mesenchymal stromal cells(MSCs)have previously been shown to protect against brain injury caused by hypoxia-ischemia(HI).The neuroprotective effects have been found to relate to the ant...Extracellular vesicles(EVs)from mesenchymal stromal cells(MSCs)have previously been shown to protect against brain injury caused by hypoxia-ischemia(HI).The neuroprotective effects have been found to relate to the anti-inflammatory effects of EVs.However,the underlying mechanisms have not previously been determined.In this study,we induced oxygen-glucose deprivation in BV-2 cells(a microglia cell line),which mimics HI in vitro,and found that treatment with MSCs-EVs increased the cell viability.The treatment was also found to reduce the expression of pro-inflammatory cytokines,induce the polarization of microglia towards the M2 phenotype,and suppress the phosphorylation of selective signal transducer and activator of transcription 3(STAT3)in the microglia.These results were also obtained in vivo using neonatal mice with induced HI.We investigated the potential role of miR-21a-5p in mediating these effects,as it is the most highly expressed miRNA in MSCs-EVs and interacts with the STAT3 pathway.We found that treatment with MSCs-EVs increased the levels of miR-21a-5p in BV-2 cells,which had been lowered following oxygen-glucose deprivation.When the level of miR-21a-5p in the MSCs-EVs was reduced,the effects on microglial polarization and STAT3 phosphorylation were reduced,for both the in vitro and in vivo HI models.These results indicate that MSCs-EVs attenuate HI brain injury in neonatal mice by shuttling miR-21a-5p,which induces microglial M2 polarization by targeting STAT3.展开更多
Objectives:to verify the feasibility and reliability of the electronic version of Chinese SF-36 based on the Quality-of-Life-Recorder. Design: A crossover randomized controlled trial, comparing a paper-based and an el...Objectives:to verify the feasibility and reliability of the electronic version of Chinese SF-36 based on the Quality-of-Life-Recorder. Design: A crossover randomized controlled trial, comparing a paper-based and an electronic version of the Chinese SF-36, was conducted. According to generated random numbers, interviewees were asked to fill out either the electronic version or the paper version first. The second version was filled in after a pause of at least 10 min. Settings and participants: One group of 100 medical students at the School of Medicine of Zhejiang University and the other group of 50 outpatients at a clinic for general practice in Hangzhou City (China) were eventually recruited in this study. Results: The acceptance of the electronic version was good (60% of medical students and 84% of outpatients preferred the electronic version). At the level of eight-scale scores, the mean-difference for each scale (except for general health) between the two versions was less than 5%. At the level of 36 questions, the percentage of "exact agreement" ranged within 64%～99%; the percentage of "global agreement" ranged within 72%～99%; 77% of the kappa coefficients demonstrated "good/excellent agreement" and 23% of the kappa coefficients demonstrated "medium agreement". Conclusion: This study, for the first time, can provide empirical basis for the confirmation of the feasibility and reliability of the electronic version of the Chinese SF-36 and may provide an impulse towards widespread deployment of the Quality-of-Life-Recorder in Chinese populations.展开更多
A severe impairment of cognitive function characterizes dementia.Mild cognitive impairment represents a transition between normal cognition and dementia.The frequency of cognitive changes is higher in women than in me...A severe impairment of cognitive function characterizes dementia.Mild cognitive impairment represents a transition between normal cognition and dementia.The frequency of cognitive changes is higher in women than in men.Based on this fact,hormonal factors likely contribute to cognitive decline.In this sense,cognitive complaints are more common near menopause,a phase marked by a decrease in hormone levels,especially estrogen.Additionally,a tendency toward worsened cognitive performance has been reported in women during menopause.Vasomotor symptoms(hot flashes,sweating,and dizziness),vaginal dryness,irritability and forgetfulness are common and associated with a progressive decrease in ovarian function and a subsequent reduction in the serum estrogen concentration.Hormone therapy(HT),based on estrogen with or without progestogen,is the treatment of choice to relieve menopausal symptoms.The studies conducted to date have reported conflicting results regarding the effects of HT on cognition.This article reviews the main aspects of menopause and cognition,including the neuroprotective role of estrogen and the relationship between menopausal symptoms and cognitive function.We present and discuss the findings of the central observational and interventional studies on HT and cognition.展开更多
Hydrogen sulfide,which can be generated in the central nervous system from the sulfhydryl-containing amino acid,L-cysteine,by cystathionine-β-synthase,may exert protective effects in experimental subarachnoid hemorrh...Hydrogen sulfide,which can be generated in the central nervous system from the sulfhydryl-containing amino acid,L-cysteine,by cystathionine-β-synthase,may exert protective effects in experimental subarachnoid hemorrhage;however,the mechanism underlying this effect is unknown.This study explored the mechanism using a subarachnoid hemorrhage rat model induced by an endovascular perforation technique.Rats were treated with an intraperitoneal injection of 100 mM L-cysteine(30μL)30 minutes after subarachnoid hemorrhage.At 48 hours after subarachnoid hemorrhage,hematoxylin-eosin staining was used to detect changes in prefrontal cortex cells.L-cysteine significantly reduced cell edema.Neurological function was assessed using a modified Garcia score.Brain water content was measured by the wet-dry method.L-cysteine significantly reduced neurological deficits and cerebral edema after subarachnoid hemorrhage.Immunofluorescence was used to detect the number of activated microglia.Reverse transcription-polymerase chain reaction(RT-PCR)was used to detect the levels of interleukin 1β and CD86 mRNA in the prefrontal cortex.L-cysteine inhibited microglial activation in the prefrontal cortex and reduced the mRNA levels of interleukin 1βand CD86.RT-PCR and western blot analysis of the complement system showed that L-cysteine reduced expression of the complement factors,C1q,C3αand its receptor C3aR1,and the deposition of C1q in the prefrontal cortex.Dihydroethidium staining was applied to detect changes in reactive oxygen species,and immunohistochemistry was used to detect the number of NRF2-and HO-1-positive cells.L-cysteine reduced the level of reactive oxygen species in the prefrontal cortex and the number of NRF2-and HO-1-positive cells.Western blot assays and immunohistochemistry were used to detect the protein levels of CHOP and GRP78 in the prefrontal cortex and the number of CHOP-and GRP78-positive cells.L-cysteine reduced CHOP and GRP78 levels and the number of CHOP-and GRP78-positive cells.The cystathionine-β-synthase inhibitor,aminooxyacetic acid,significantly reversed the above neuroprotective effects of L-cysteine.Taken together,L-cysteine can play a neuroprotective role by regulating neuroinflammation,complement deposition,oxidative stress and endoplasmic reticulum stress.The study was approved by the Animals Ethics Committee of Shandong University,China on February 22,2016(approval No.LL-201602022).展开更多
Background The importance of psychosocial functioning in the assessment,diagnosis and treatment of major depressive disorder(MDD)is widely recognised.However,there is a lack of effective scales to assess psychosocial ...Background The importance of psychosocial functioning in the assessment,diagnosis and treatment of major depressive disorder(MDD)is widely recognised.However,there is a lack of effective scales to assess psychosocial functioning in patients with MDD.Aims To develop a professional questionnaire to evaluate the psychosocial functioning of patients with MDD.Methods Using a literature review,an open-ended questionnaire survey,and patient interviews,a theoretical model of psychosocial functioning was constructed,and an initial questionnaire was formed which included four dimensions.After two rounds of testing,using items analysis and exploratory factor analysis,a finalized questionnaire was created.There were 460 patients with MDD selected from six psychiatric hospitals for formal testing using a convenience sampling method.Forty patients were randomly selected and retested one week later to evaluate the test-retest reliability of the scale.The Patient Health Questionnaire-9(PHQ-9),Short Form of Quality of Life Enjoyment and Satisfaction Questionnaire(Q-LES Q SF),Sheehan Disability Scale(SDS),and Dysfunctional Attitudes Scale(DAS)provided major standards to check the criterion validity of this questionnaire.Correlation analysis,confirmatory factor analysis,and internal consistency reliability testing were used to examine other psychometric characteristics of the finalized questionnaire.Results The Psychosocial Functioning Questionnaire(PFQ)for patients with MDD included three dimensions:psychological cognitive functioning,subjective well-being,and social functioning,with a total of 18 items.The overall internal consistency reliability of the questionnaire was 0.957,and the test-retest reliability was 0.840.Confirmatory factor analysis showed that the model fitted well:Goodness of Fit Index(GFI)=0.888;Root Mean SquareError of Approximation(RMSEA)=0.085.The total score of PFQ was significantly correlated with the total score of PHQ-9,DAS,SDS and Q-LES Q SF(|r|=0.599-0.870,p<0.001).Conclusions The Psychosocial Functioning Questionnaire has good reliability and validity.It can be used to measure the psychosocial functioning of patients with MDD.展开更多
BACKGROUND Illness perception has long been hypothesized to be linked to psychological well-b eing in patients with rheumatic diseases,although substantial evidence is lacking,and the contribution of ruminative coping...BACKGROUND Illness perception has long been hypothesized to be linked to psychological well-b eing in patients with rheumatic diseases,although substantial evidence is lacking,and the contribution of ruminative coping style to this relationship is unclear.AIM To investigate the roles of illness perception and rumination in predicting fatigue and negative emotions in patients with chronic rheumatic diseases.METHODS Illness perception,rumination,fatigue and negative emotions(i.e.depression,anxiety and stress)were assessed by the Illness Perception Questionnaire-Revised,Stress Reactive Rumination Scale,Multidimensional Assessment of Fatigue,and the Depression,Anxiety and Stress Scale respectively.Multivariate regression analysis,the Sobel test,and the bootstrap were used to identify the mediating effect of rumination.RESULTS All five subscales of illness perception,including perceived illness identity,chronicity,cyclical nature,consequences and coherence of illness,were significantly associated with fatigue and negative emotions.In mediational analysis,rumination was found to mediate three components of illness perception(the identity,cyclical nature and consequences of illness)and negative emotions/fatigue.CONCLUSION Perceived identity,cyclical nature,and consequences of illness are significantly associated with fatigue and negative emotions in patients with chronic rheumatic diseases and these associations are mediated by rumination.Our findings suggest that psychological intervention should target rumination to improve physical and emotional well-being of patients with chronic rheumatic diseases.展开更多
BACKGROUND Recently,there has been a range of studies about smartphone-based interventions and monitoring for reducing symptoms of bipolar disorder(BD).However,their efficacy for BD remains unclear.AIM To compare the ...BACKGROUND Recently,there has been a range of studies about smartphone-based interventions and monitoring for reducing symptoms of bipolar disorder(BD).However,their efficacy for BD remains unclear.AIM To compare the effect of smartphone-based interventions and monitoring with control methods in treating patients with BD.METHODS A systematic literature search was performed on PubMed,Embase,Clinical trials,psycINFO,Web of Science,and Cochrane Library.Randomized clinical trials(RCTs)or single-group trials in which smartphone-based interventions and monitoring were compared with control methods or baseline in patients with symptoms of BD were included.Data were synthesized using a random-effects or a fixed-effects model to analyze the effects of psychological interventions and monitoring delivered via smartphone on psychiatric symptoms in patients with BD.The primary outcome measures were set for mania and depression symptoms.Subgroups were created to explore which aspects of smartphone interventions are relevant to the greater or lesser efficacy of treating symptoms.RESULTS We identified ten articles,including seven RCTs(985 participants)and three single-group trials(169 participants).Analysis of the between-group study showed that smartphone-based interventions were effective in reducing manic[g=-0.19,95%confidence interval(CI):-0.33 to-0.04,P=0.01]and depressive(g=-0.28,95%CI:-0.55 to-0.01,P<0.05)symptoms.In within-group analysis,smartphone-based interventions significantly reduced manic(g=0.17,95%CI:0.04 to 0.30,P<0.01)and depressive(g=0.48,95%CI:0.18 to 0.78)symptoms compared to the baseline.Nevertheless,smartphone-based monitoring systems significantly reduced manic(g=0.27,95%CI:0.02 to 0.51,P<0.05)but not depressive symptoms.Subgroup analysis indicated that the interventions with psychoeducation had positive effects on depressive(g=-0.62,95%CI:-0.81 to-0.43,P<0.01)and manic(g=-0.24,95%CI:-0.43 to-0.06,P=0.01)symptoms compared to the controlled conditions,while the interventions without psychoeducation did not(P>0.05).The contacts between therapists and patients that contributed to the implementation of psychological therapy reduced depression symptoms(g=-0.47,95%CI:-0.75 to-0.18,P=0.01).CONCLUSION Smartphone-based interventions and monitoring have a significant positive impact on depressive and manic symptoms of BD patients in between-group and within-group analysis.展开更多
Background The COVID-19 pandemic has placed tremendous pressure on healthcare workers who are at the frontline in the battle against it,causing various forms of psychological distress.Aims To outline the prevalence an...Background The COVID-19 pandemic has placed tremendous pressure on healthcare workers who are at the frontline in the battle against it,causing various forms of psychological distress.Aims To outline the prevalence and dynamic changing features of medical workers’psychological issues and to review the related national policies during the COVID-19 pandemic in China.Methods We systematically searched for studies on the psychological states of Chinese medical staff from 1 January 2020 to 8 May 2020.The aggregate prevalence of each psychological issue was calculated and plotted to observe the changes over time.Policies on psychological support for medical staff during the pandemic were reviewed to explore their link to the prevalence of psychological problems.Results In total,26 studies were included in this study.A total of 22062 medical workers were surveyed from 31 January to 27 February 2020.Medical staff exhibited a substantial prevalence of anxiety symptoms,depression symptoms,stress-related symptoms and sleep problems during the survey period,with aggregate prevalence rates of 27.0%,26.2%,42.1%and 34.5%,respectively.Cumulative meta-analyses revealed that the prevalence of psychological distress peaked at the beginning of the pandemic and subsequently exhibited a slow downward trend.Conclusion Chinese medical staff displayed significant psychological disturbance during the outbreak of the COVID-19 pandemic,which was especially severe at the early stage.Implementing supportive policies may help alleviate ongoing psychological problems in healthcare workers.展开更多
This article is the result of a research carried out in a private hospital of Belo Horizonte, Brazil. The patient care model of the Mastology Department includes an interdisciplinary staff that aims for the comprehens...This article is the result of a research carried out in a private hospital of Belo Horizonte, Brazil. The patient care model of the Mastology Department includes an interdisciplinary staff that aims for the comprehensive treatment of these surgical patients. The research is based on clinical approach, under the framework of Analytical Psychology. Feminine archetypal images are symbolically represented by the Main Goddesses of the Olympus. It is natural for one of these expressions to prevail throughout a woman’s life, or even in specific moments of her life, but it is important to recognize that all of them are part of the feminine soul. We can, therefore, define and understand the Goddesses from Greek Mythology symbolically as being representative of the various feminine psychogenic forces that are projected. In reality, they are internal images that can be used to help know and understand personal issues and changes that are necessary in a woman’s life, enabling personal growth and the possibility to identify herself with the more authentic elements of her being. In this work experience, the feminine force showed itself to be a force of creation, of expression and of overcoming.展开更多
Questionnaire data from two projects on the development of quality assurance instruments for an inpatient rehabilitation/prevention program for parents were used for a secondary analysis. In this analysis, the associa...Questionnaire data from two projects on the development of quality assurance instruments for an inpatient rehabilitation/prevention program for parents were used for a secondary analysis. In this analysis, the associations of gains in a psychosocial resource (parenting self-efficacy) and two types of stressors experienced by mothers at the start of treatment (parenting hassles, depressive symptoms) with general life satisfaction and satisfaction with health at the end of treatment were explored. Structural equation modeling was applied to data from N = 1724 female patients. Potential resource-stressor interactions were tested using the Latent Moderated Structural Equations approach. Results showed that parenting hassles were negatively associated with general life satisfaction and satisfaction with health while self-efficacy gains were weakly positively correlated with both variables. No interaction of parenting hassles and self-efficacy gains was found. Depressive symptoms were negatively associated with both satisfaction measures. In these models, self-efficacy gains were not substantially correlated with life satisfaction, but showed a small association with satisfaction with health. There was no significant interaction of depressive symptoms and self-efficacy gains. The findings imply that interventions for distressed mothers—as exemplarily illustrated by this inpatient setting—should focus on identifying and reducing initial stressors as these may continue to impair mothers’ subjective health despite gains in parenting-related resources.展开更多
The article presents a critical review regarding the premature termination of eating disorder’s treatment among inpatients and outpatients, with the aim of identifying—emotional, psychodynamic and family-related asp...The article presents a critical review regarding the premature termination of eating disorder’s treatment among inpatients and outpatients, with the aim of identifying—emotional, psychodynamic and family-related aspects involved. The search strategy used the following MeSH terms combined by Boolean operators: “eating disorders” AND “treatment” OR “patient dropouts” OR “drop-out/dropouts” OR “attrition” OR “premature termination” AND “empirical study” OR “qualitative research”, for on Medline/PUBMED, PsycINFO and EMBASE databases. This article follows the PRISMA Guidelines. A total of 26 studies composed this review, of which 24 were original research articles, 1 was a review and 1 a theoretical article. Only two articles applied qualitative methods analyzing categories of content obtained by in-depth interviews, three combine quantitative and qualitative methods and other three present qualitative analyses while discussing quantitative studies. Further qualitative studies should be carried out to clarify meanings of dropout, premature termination of treatment, and attrition. Different expectations held by patients and by therapeutic teams, and the interpersonal difficulties of these types of patients, stand out as difficulties in constructing “therapeutic alliances”, with impacts on dropout, premature termination and attrition rates.展开更多
Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent...Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent of psychosocial burdens in migrant populations the prevalence among the study population remains unclear. The aim of this study was to collect prevalence data for the largest migrant population in Germany-individuals with Turkish migration backgrounds—using a culturally and linguistically sensitive approach. Methods: The study employs a cross-sectional design. The multi-centre study (Hamburg, Berlin) is based on a sample of individuals with Turkish migration backgrounds living in the two cities stratified by age, gender, and education. The study programme consists of three phases: 1) a qualitative focus group to collect information on how to increase the participation rate of the target population as a minority group in Germany;2) a translation phase to create culture and linguistic sensitive versions of the assessment tools (e.g., the Composite International Diagnostic Interview (CIDI) for Turkish speaking individuals;and 3) a baseline community study to assess the lifetime, 12-month and four-week prevalence and comorbidity rates of mental disorder, health care utilization and help-seeking behaviour in individuals of Turkish migration backgrounds living in Germany. Discussion: The study provides important data on the lifetime prevalence of mental disorders and health care utilization of individuals with Turkish migration backgrounds. Furthermore, the study is an important step towards gaining a better understanding of potential barriers to participation, creating resources for difficult-to- reach minorities, and understanding the need for assessing mental disorders in migrant populations. These results can offer a starting point for the initiation of the necessary structural changes for mental health care services and policies for groups with migration backgrounds.展开更多
Background: To understand what life is like for US children with a diagnosis of Growth Hormone Deficiency or Idiopathic Short Stature, the impact of short stature on Health related Quality of Life (HrQoL) was qualitat...Background: To understand what life is like for US children with a diagnosis of Growth Hormone Deficiency or Idiopathic Short Stature, the impact of short stature on Health related Quality of Life (HrQoL) was qualitatively examined and needs for care from the young patients and their parents perspective were identified. Methods: Focus group discussions with 26 American-English speaking and nine American-Spanish speaking children and their parents were conducted, transcribed verbatim and subsequently qualitatively analyzed by two independent raters, using an existing coding guideline, based on the multidimensional HrQoL concept and a special software (VERBI-Software MAXQDA 10). Results: A total of 1313 statements for the English-speaking and 447 statements for the Spanish-speaking families were categorized. In the US, the strongest frequency of mention was found for the HrQoL dimension “Social” across respondents, followed by “Treatment” and “Emotion”. Conclusion: Conducting and analyzing data generated from focus groups ensure that young patients’ experiences of disease are represented in the measure of outcomes for use in clinical trials and patient care.展开更多
Patient-centeredness is one of the most important quality and outcome criteria in health care. Health care organizations are continually searching for approaches that will enable them to establish sustainable patient-...Patient-centeredness is one of the most important quality and outcome criteria in health care. Health care organizations are continually searching for approaches that will enable them to establish sustainable patient-centeredness in their daily practice. Existing approaches frequently focus on interaction between patient and health care professional (external participation). However, this is often not sufficient;other elements, such as good teamwork among the health care professionals (internal participation), are also essential. The model of integrated patient-centeredness differentiates between these two participations forms, both of which are explored from a patient and health care professional perspective in our study. The aim of the study was to confirm the model from the viewpoint of staff and patients. To this end we conducted a multi-center cross-sectional study consisting of a patient and staff survey to assess internal and external participation and patient-centeredness. A total of 15 rehabilitation clinics were involved, with 272 staff members and 536 patients included in the final analysis. Although evaluation was positive (mainly slightly above the middle of the scale), there was potential for improvement for both types of participation. Internal and external rating differed between patients and health care staff, with the first group assessing internal significantly better and external lower than the second group. The low to middle correlation of both types, as well as the correlation and regression with patient-centeredness, confirmed the model of integrated patient-centeredness. The model underlines the importance of both participation forms for patient-centeredness, as well as their interdependence. Further studies are needed in order to verify the impact of internal and external participation, as well as that of further possible dimensions of patient-centeredness, on clinical and functional outcome criteria.展开更多
基金supported by the National Natural Science Foundation of China,Nos.82271327(to ZW),82072535(to ZW),81873768(to ZW),and 82001253(to TL).
文摘We previously showed that hydrogen sulfide(H2S)has a neuroprotective effect in the context of hypoxic ischemic brain injury in neonatal mice.However,the precise mechanism underlying the role of H2S in this situation remains unclear.In this study,we used a neonatal mouse model of hypoxic ischemic brain injury and a lipopolysaccharide-stimulated BV2 cell model and found that treatment with L-cysteine,a H2S precursor,attenuated the cerebral infarction and cerebral atrophy induced by hypoxia and ischemia and increased the expression of miR-9-5p and cystathionineβsynthase(a major H2S synthetase in the brain)in the prefrontal cortex.We also found that an miR-9-5p inhibitor blocked the expression of cystathionineβsynthase in the prefrontal cortex in mice with brain injury caused by hypoxia and ischemia.Furthermore,miR-9-5p overexpression increased cystathionine-β-synthase and H2S expression in the injured prefrontal cortex of mice with hypoxic ischemic brain injury.L-cysteine decreased the expression of CXCL11,an miR-9-5p target gene,in the prefrontal cortex of the mouse model and in lipopolysaccharide-stimulated BV-2 cells and increased the levels of proinflammatory cytokines BNIP3,FSTL1,SOCS2 and SOCS5,while treatment with an miR-9-5p inhibitor reversed these changes.These findings suggest that H2S can reduce neuroinflammation in a neonatal mouse model of hypoxic ischemic brain injury through regulating the miR-9-5p/CXCL11 axis and restoringβ-synthase expression,thereby playing a role in reducing neuroinflammation in hypoxic ischemic brain injury.
文摘Wuhan University,the development of death education in China has a history of more than 30 years.But it has lacked the clout it deserves in China.However,in recent years,death education has begun to attract more and more attention from the medical community.Various lectures and pieces of training related to death education held by the government and medical institutions,as well as related academic salons,seminars,workshops and“Death Cafes”held by the people have appeared and become popular.Death education has been developed in China for more than 30 years,why has it suddenly become popular and even popular in recent years?This has an important relationship with China’s aging population and the medicalization of death.
基金Supported by the Anhui Natural Science Foundation,No.1808085MH291the Project of human Social Science of Anhui Province,No.SK2016A047Grants for Scientific Research of BSKY from Anhui Medical University,No.XJ201826.
文摘BACKGROUND Test anxiety is prevalent among medical students and leads to impaired academic performance.Test-related attentional bias has been identified as an important maintaining factor in test-anxious individuals.AIM To evaluate whether hypnosis and progressive muscle relaxation(PMR)could modify medical college students’test anxiety and attentional bias.METHODS A total of 598 medical students were screened.The participants were divided into higher and lower test anxiety groups according to their scores on the test anxiety scale(TAS).Ninety medical college students with high TAS score were randomly assigned to a hypnosis or PMR group.Another 45 students with low TAS score were included,forming a baseline control group.The intervention was conducted weekly for 6 wk,and each session lasted approximately 30 min.The total intervention time and the number of intervention sessions for the hypnosis and PMR groups were equal.Data were collected at the pretest,posttest,and 2-mo follow-up.RESULTS Hypnosis group participants had a significantly lower TAS score at posttest(t=-21.827,P<0.001)and at follow-up(t=-14.824,P<0.001),compared to that at pretest.PMR group participants also had a significantly lower TAS score at posttest(t=-10.777,P<0.001)and at follow-up(t=-7.444,P<0.001),compared to that at pretest.At the posttest level,the hypnosis group had a significantly lower TAS score than the PMR group(t=-3.664,P<0.001).At the follow-up level,the hypnosis group also had a significantly lower TAS score than the PMR group(t=-2.943,P=0.004).Clinically significant improvement was found in both the hypnosis and PMR groups(hypnosis=64.0%;PMR=62.22%).Hypnosis was more effective than PMR in reducing test anxiety among medical college students.Hypnosis could modify attentional bias toward threatening stimuli,but PMR could not.CONCLUSION These results suggest that attentional bias plays an important role in test anxiety treatment.
基金This study was supported by Hainan Provincial Key Research and Development Plan(ZDYF2021SHFZ092,ZDYF2022SHFZ109),Hainan Provincial Natural Science Foundation(822RC832)Hainan Provincial Clinical Medical Center(2021)Epilepsy Research Innovation Team of Hainan Medical College(2022)。
文摘Objective:To screen risk factors for epilepsy after acute ischaemic stroke based on meta-analysis and cohort study and to establish a predictive model.Methods:Computer searches of MEDLINE,Embase,Cochrane library,Web of Scinence,PubMed,CNKI,and WanFang Data data were conducted to collect literature on epilepsy after in acute ischemic stroke,from database creation to September 1,2022.The RRs and their 95%confidence intervals(CI)for risk factors for post stroke epilepsy were extracted for each study,and pooled estimates of the RRs and 95%CIs for each study were generated using either a random-effects model or a fixed-effects model.Beta coefficients for each risk factor were calculated based on the combined RR and their corresponding 95%CIs.The beta coefficients were multiplied by 10 and rounded.Results:Ten articles were identified for final inclusion in this meta-analysis,with a total of 141948 cases and 3702 cases of post stroke epilepsy.The risk factors included in the final risk prediction model were infarct size(RR 4.67,95%CI 1.41~15.47;P=0.01),stroke recuRRence(RR 2.48,95%CI 2.01~3.05;P<0.00001),stroke etiology(RR 1.70,95%CI 1.34~2.15;P<0.00001),stroke severity(RR 1.70,95%CI 1.34~2.15;P<0.00001),and stroke risk.stroke severity(RR 1.53,95%CI 1.39~1.70;P<0.00001),NIHSS score(RR 2.91,95%CI 1.64~5.61;P=0.0003),early-onset epilepsy(RR 5.62,95%CI 5.08~6.22;P<0.00001),cortical lesions(RR 3.83.95%CI 2.23~6.58;P<0.00001),total anterior circulation infarction(RR 18.94,95%CI 10.38~34.57;P<0.00001),partial anterior circulation infarction(RR 4.39,95%CI 2.29~8.40;P<0.00001),cardiovascular events(RR 1.78,95%CI 1.59~1.99;P<0.00001).Conclusion:Based on a systematic review and meta-analysis,we developed a simple risk prediction model for late epilepsy in baseline ischemic stroke that integrates clinical risk factors,including infarct size,stroke recurrence,stroke etiology,stroke severity,NIHSS score,early onset epilepsy,cortical lesions,stroke subtype,and cardiovascular events.
基金supported by the Natural Science Foundation of Taishan Medical University in China,No.2007.ZR-087
文摘Ganoderma lucidum is a traditional Chinese medicine,which has been shown to have both anti-oxidative and anti-inflammatory effects,and noticeably decreases both the infarct area and neuronal apoptosis of the ischemic cortex.This study aimed to investigate the protective effects and mechanisms of pretreatment with ganoderma lucidum(by intragastric administration)in cerebral ischemia/reperfusion injury in rats.Our results showed that pretreatment with ganoder-ma lucidum for 3 and 7 days reduced neuronal loss in the hippocampus,diminished the content of malondialdehyde in the hippocampus and serum,decreased the levels of tumor necrosis fac-tor-αand interleukin-8 in the hippocampus,and increased the activity of superoxide dismutase in the hippocampus and serum.These results suggest that pretreatment with ganoderma lucidum was protective against cerebral ischemia/reperfusion injury through its anti-oxidative and an-ti-inflammatory actions.
基金National Science and Technology Support Plan[Key Technique of Major Mental Illness Prevention Study](2012BAI01B04)Shanghai "Science and Technology Innovation Action Plan"Science and Technology Support Project in Medicine and Agriculture in 2015(Code:15411950201)Shanghai Construction Plan of Key Medical Specialty(ZK2015A06)
基金supported by the National Natural Science Foundation of China,Nos.81873768,82072535,81671213(to ZW),81770436(to WQC)the National Key Project of Chronic Non-Communicable Disease of China,No.2016YFC1300403(to WQC).
文摘Extracellular vesicles(EVs)from mesenchymal stromal cells(MSCs)have previously been shown to protect against brain injury caused by hypoxia-ischemia(HI).The neuroprotective effects have been found to relate to the anti-inflammatory effects of EVs.However,the underlying mechanisms have not previously been determined.In this study,we induced oxygen-glucose deprivation in BV-2 cells(a microglia cell line),which mimics HI in vitro,and found that treatment with MSCs-EVs increased the cell viability.The treatment was also found to reduce the expression of pro-inflammatory cytokines,induce the polarization of microglia towards the M2 phenotype,and suppress the phosphorylation of selective signal transducer and activator of transcription 3(STAT3)in the microglia.These results were also obtained in vivo using neonatal mice with induced HI.We investigated the potential role of miR-21a-5p in mediating these effects,as it is the most highly expressed miRNA in MSCs-EVs and interacts with the STAT3 pathway.We found that treatment with MSCs-EVs increased the levels of miR-21a-5p in BV-2 cells,which had been lowered following oxygen-glucose deprivation.When the level of miR-21a-5p in the MSCs-EVs was reduced,the effects on microglial polarization and STAT3 phosphorylation were reduced,for both the in vitro and in vivo HI models.These results indicate that MSCs-EVs attenuate HI brain injury in neonatal mice by shuttling miR-21a-5p,which induces microglial M2 polarization by targeting STAT3.
基金Project (No. WKJ2006-2-016) supported by the project of "Effect of Chronic Disease and Health-Related Quality of Life on Health Service Utilization" from the Ministry of Health, China
文摘Objectives:to verify the feasibility and reliability of the electronic version of Chinese SF-36 based on the Quality-of-Life-Recorder. Design: A crossover randomized controlled trial, comparing a paper-based and an electronic version of the Chinese SF-36, was conducted. According to generated random numbers, interviewees were asked to fill out either the electronic version or the paper version first. The second version was filled in after a pause of at least 10 min. Settings and participants: One group of 100 medical students at the School of Medicine of Zhejiang University and the other group of 50 outpatients at a clinic for general practice in Hangzhou City (China) were eventually recruited in this study. Results: The acceptance of the electronic version was good (60% of medical students and 84% of outpatients preferred the electronic version). At the level of eight-scale scores, the mean-difference for each scale (except for general health) between the two versions was less than 5%. At the level of 36 questions, the percentage of "exact agreement" ranged within 64%～99%; the percentage of "global agreement" ranged within 72%～99%; 77% of the kappa coefficients demonstrated "good/excellent agreement" and 23% of the kappa coefficients demonstrated "medium agreement". Conclusion: This study, for the first time, can provide empirical basis for the confirmation of the feasibility and reliability of the electronic version of the Chinese SF-36 and may provide an impulse towards widespread deployment of the Quality-of-Life-Recorder in Chinese populations.
基金Supported by National Council for Scientific and Technological Development of Brazil(CNPq),No.312400/2018-7.
文摘A severe impairment of cognitive function characterizes dementia.Mild cognitive impairment represents a transition between normal cognition and dementia.The frequency of cognitive changes is higher in women than in men.Based on this fact,hormonal factors likely contribute to cognitive decline.In this sense,cognitive complaints are more common near menopause,a phase marked by a decrease in hormone levels,especially estrogen.Additionally,a tendency toward worsened cognitive performance has been reported in women during menopause.Vasomotor symptoms(hot flashes,sweating,and dizziness),vaginal dryness,irritability and forgetfulness are common and associated with a progressive decrease in ovarian function and a subsequent reduction in the serum estrogen concentration.Hormone therapy(HT),based on estrogen with or without progestogen,is the treatment of choice to relieve menopausal symptoms.The studies conducted to date have reported conflicting results regarding the effects of HT on cognition.This article reviews the main aspects of menopause and cognition,including the neuroprotective role of estrogen and the relationship between menopausal symptoms and cognitive function.We present and discuss the findings of the central observational and interventional studies on HT and cognition.
基金supported by the National Natural Science Foundation of China,Nos.81873768 and 81671213(to ZW),81571284 and 81874083(to GL)the Key Research and Development Foundation of Shandong Province of China,No.2017GSF218091(to ZW)+2 种基金the Natural Science Foundation of Shandong Province of China,No.ZR2016HM33(to DXL)the Shandong Medical and Health Science and Technology Development Plan Project of China,No.2017WS068(to QH)the Taishan Scholars of Shandong Province of China,No.ts201511093(to GL)
文摘Hydrogen sulfide,which can be generated in the central nervous system from the sulfhydryl-containing amino acid,L-cysteine,by cystathionine-β-synthase,may exert protective effects in experimental subarachnoid hemorrhage;however,the mechanism underlying this effect is unknown.This study explored the mechanism using a subarachnoid hemorrhage rat model induced by an endovascular perforation technique.Rats were treated with an intraperitoneal injection of 100 mM L-cysteine(30μL)30 minutes after subarachnoid hemorrhage.At 48 hours after subarachnoid hemorrhage,hematoxylin-eosin staining was used to detect changes in prefrontal cortex cells.L-cysteine significantly reduced cell edema.Neurological function was assessed using a modified Garcia score.Brain water content was measured by the wet-dry method.L-cysteine significantly reduced neurological deficits and cerebral edema after subarachnoid hemorrhage.Immunofluorescence was used to detect the number of activated microglia.Reverse transcription-polymerase chain reaction(RT-PCR)was used to detect the levels of interleukin 1β and CD86 mRNA in the prefrontal cortex.L-cysteine inhibited microglial activation in the prefrontal cortex and reduced the mRNA levels of interleukin 1βand CD86.RT-PCR and western blot analysis of the complement system showed that L-cysteine reduced expression of the complement factors,C1q,C3αand its receptor C3aR1,and the deposition of C1q in the prefrontal cortex.Dihydroethidium staining was applied to detect changes in reactive oxygen species,and immunohistochemistry was used to detect the number of NRF2-and HO-1-positive cells.L-cysteine reduced the level of reactive oxygen species in the prefrontal cortex and the number of NRF2-and HO-1-positive cells.Western blot assays and immunohistochemistry were used to detect the protein levels of CHOP and GRP78 in the prefrontal cortex and the number of CHOP-and GRP78-positive cells.L-cysteine reduced CHOP and GRP78 levels and the number of CHOP-and GRP78-positive cells.The cystathionine-β-synthase inhibitor,aminooxyacetic acid,significantly reversed the above neuroprotective effects of L-cysteine.Taken together,L-cysteine can play a neuroprotective role by regulating neuroinflammation,complement deposition,oxidative stress and endoplasmic reticulum stress.The study was approved by the Animals Ethics Committee of Shandong University,China on February 22,2016(approval No.LL-201602022).
基金This work was supported by the research project fund of the Health Care for Cadres in Jiangsu Province(BJ19005)Key R&D Plan of Jiangsu Province(Social Development,BE2015609).
文摘Background The importance of psychosocial functioning in the assessment,diagnosis and treatment of major depressive disorder(MDD)is widely recognised.However,there is a lack of effective scales to assess psychosocial functioning in patients with MDD.Aims To develop a professional questionnaire to evaluate the psychosocial functioning of patients with MDD.Methods Using a literature review,an open-ended questionnaire survey,and patient interviews,a theoretical model of psychosocial functioning was constructed,and an initial questionnaire was formed which included four dimensions.After two rounds of testing,using items analysis and exploratory factor analysis,a finalized questionnaire was created.There were 460 patients with MDD selected from six psychiatric hospitals for formal testing using a convenience sampling method.Forty patients were randomly selected and retested one week later to evaluate the test-retest reliability of the scale.The Patient Health Questionnaire-9(PHQ-9),Short Form of Quality of Life Enjoyment and Satisfaction Questionnaire(Q-LES Q SF),Sheehan Disability Scale(SDS),and Dysfunctional Attitudes Scale(DAS)provided major standards to check the criterion validity of this questionnaire.Correlation analysis,confirmatory factor analysis,and internal consistency reliability testing were used to examine other psychometric characteristics of the finalized questionnaire.Results The Psychosocial Functioning Questionnaire(PFQ)for patients with MDD included three dimensions:psychological cognitive functioning,subjective well-being,and social functioning,with a total of 18 items.The overall internal consistency reliability of the questionnaire was 0.957,and the test-retest reliability was 0.840.Confirmatory factor analysis showed that the model fitted well:Goodness of Fit Index(GFI)=0.888;Root Mean SquareError of Approximation(RMSEA)=0.085.The total score of PFQ was significantly correlated with the total score of PHQ-9,DAS,SDS and Q-LES Q SF(|r|=0.599-0.870,p<0.001).Conclusions The Psychosocial Functioning Questionnaire has good reliability and validity.It can be used to measure the psychosocial functioning of patients with MDD.
文摘BACKGROUND Illness perception has long been hypothesized to be linked to psychological well-b eing in patients with rheumatic diseases,although substantial evidence is lacking,and the contribution of ruminative coping style to this relationship is unclear.AIM To investigate the roles of illness perception and rumination in predicting fatigue and negative emotions in patients with chronic rheumatic diseases.METHODS Illness perception,rumination,fatigue and negative emotions(i.e.depression,anxiety and stress)were assessed by the Illness Perception Questionnaire-Revised,Stress Reactive Rumination Scale,Multidimensional Assessment of Fatigue,and the Depression,Anxiety and Stress Scale respectively.Multivariate regression analysis,the Sobel test,and the bootstrap were used to identify the mediating effect of rumination.RESULTS All five subscales of illness perception,including perceived illness identity,chronicity,cyclical nature,consequences and coherence of illness,were significantly associated with fatigue and negative emotions.In mediational analysis,rumination was found to mediate three components of illness perception(the identity,cyclical nature and consequences of illness)and negative emotions/fatigue.CONCLUSION Perceived identity,cyclical nature,and consequences of illness are significantly associated with fatigue and negative emotions in patients with chronic rheumatic diseases and these associations are mediated by rumination.Our findings suggest that psychological intervention should target rumination to improve physical and emotional well-being of patients with chronic rheumatic diseases.
基金Supported by The Anhui Natural Science Foundation,No.1808085MH291The Project of Human Social Science of Anhui Province,No.SK2016A047Grants for Scientific Research of BSKY from Anhui Medical University,No.XJ201826.
文摘BACKGROUND Recently,there has been a range of studies about smartphone-based interventions and monitoring for reducing symptoms of bipolar disorder(BD).However,their efficacy for BD remains unclear.AIM To compare the effect of smartphone-based interventions and monitoring with control methods in treating patients with BD.METHODS A systematic literature search was performed on PubMed,Embase,Clinical trials,psycINFO,Web of Science,and Cochrane Library.Randomized clinical trials(RCTs)or single-group trials in which smartphone-based interventions and monitoring were compared with control methods or baseline in patients with symptoms of BD were included.Data were synthesized using a random-effects or a fixed-effects model to analyze the effects of psychological interventions and monitoring delivered via smartphone on psychiatric symptoms in patients with BD.The primary outcome measures were set for mania and depression symptoms.Subgroups were created to explore which aspects of smartphone interventions are relevant to the greater or lesser efficacy of treating symptoms.RESULTS We identified ten articles,including seven RCTs(985 participants)and three single-group trials(169 participants).Analysis of the between-group study showed that smartphone-based interventions were effective in reducing manic[g=-0.19,95%confidence interval(CI):-0.33 to-0.04,P=0.01]and depressive(g=-0.28,95%CI:-0.55 to-0.01,P<0.05)symptoms.In within-group analysis,smartphone-based interventions significantly reduced manic(g=0.17,95%CI:0.04 to 0.30,P<0.01)and depressive(g=0.48,95%CI:0.18 to 0.78)symptoms compared to the baseline.Nevertheless,smartphone-based monitoring systems significantly reduced manic(g=0.27,95%CI:0.02 to 0.51,P<0.05)but not depressive symptoms.Subgroup analysis indicated that the interventions with psychoeducation had positive effects on depressive(g=-0.62,95%CI:-0.81 to-0.43,P<0.01)and manic(g=-0.24,95%CI:-0.43 to-0.06,P=0.01)symptoms compared to the controlled conditions,while the interventions without psychoeducation did not(P>0.05).The contacts between therapists and patients that contributed to the implementation of psychological therapy reduced depression symptoms(g=-0.47,95%CI:-0.75 to-0.18,P=0.01).CONCLUSION Smartphone-based interventions and monitoring have a significant positive impact on depressive and manic symptoms of BD patients in between-group and within-group analysis.
基金Shanghai Clinical Research Center for Mental Health(19MC1911100)Shanghai Jiao Tong University Special Grant for the Prevention and Control of Novel Coronavirus(2020RK61).
文摘Background The COVID-19 pandemic has placed tremendous pressure on healthcare workers who are at the frontline in the battle against it,causing various forms of psychological distress.Aims To outline the prevalence and dynamic changing features of medical workers’psychological issues and to review the related national policies during the COVID-19 pandemic in China.Methods We systematically searched for studies on the psychological states of Chinese medical staff from 1 January 2020 to 8 May 2020.The aggregate prevalence of each psychological issue was calculated and plotted to observe the changes over time.Policies on psychological support for medical staff during the pandemic were reviewed to explore their link to the prevalence of psychological problems.Results In total,26 studies were included in this study.A total of 22062 medical workers were surveyed from 31 January to 27 February 2020.Medical staff exhibited a substantial prevalence of anxiety symptoms,depression symptoms,stress-related symptoms and sleep problems during the survey period,with aggregate prevalence rates of 27.0%,26.2%,42.1%and 34.5%,respectively.Cumulative meta-analyses revealed that the prevalence of psychological distress peaked at the beginning of the pandemic and subsequently exhibited a slow downward trend.Conclusion Chinese medical staff displayed significant psychological disturbance during the outbreak of the COVID-19 pandemic,which was especially severe at the early stage.Implementing supportive policies may help alleviate ongoing psychological problems in healthcare workers.
文摘This article is the result of a research carried out in a private hospital of Belo Horizonte, Brazil. The patient care model of the Mastology Department includes an interdisciplinary staff that aims for the comprehensive treatment of these surgical patients. The research is based on clinical approach, under the framework of Analytical Psychology. Feminine archetypal images are symbolically represented by the Main Goddesses of the Olympus. It is natural for one of these expressions to prevail throughout a woman’s life, or even in specific moments of her life, but it is important to recognize that all of them are part of the feminine soul. We can, therefore, define and understand the Goddesses from Greek Mythology symbolically as being representative of the various feminine psychogenic forces that are projected. In reality, they are internal images that can be used to help know and understand personal issues and changes that are necessary in a woman’s life, enabling personal growth and the possibility to identify herself with the more authentic elements of her being. In this work experience, the feminine force showed itself to be a force of creation, of expression and of overcoming.
文摘Questionnaire data from two projects on the development of quality assurance instruments for an inpatient rehabilitation/prevention program for parents were used for a secondary analysis. In this analysis, the associations of gains in a psychosocial resource (parenting self-efficacy) and two types of stressors experienced by mothers at the start of treatment (parenting hassles, depressive symptoms) with general life satisfaction and satisfaction with health at the end of treatment were explored. Structural equation modeling was applied to data from N = 1724 female patients. Potential resource-stressor interactions were tested using the Latent Moderated Structural Equations approach. Results showed that parenting hassles were negatively associated with general life satisfaction and satisfaction with health while self-efficacy gains were weakly positively correlated with both variables. No interaction of parenting hassles and self-efficacy gains was found. Depressive symptoms were negatively associated with both satisfaction measures. In these models, self-efficacy gains were not substantially correlated with life satisfaction, but showed a small association with satisfaction with health. There was no significant interaction of depressive symptoms and self-efficacy gains. The findings imply that interventions for distressed mothers—as exemplarily illustrated by this inpatient setting—should focus on identifying and reducing initial stressors as these may continue to impair mothers’ subjective health despite gains in parenting-related resources.
文摘The article presents a critical review regarding the premature termination of eating disorder’s treatment among inpatients and outpatients, with the aim of identifying—emotional, psychodynamic and family-related aspects involved. The search strategy used the following MeSH terms combined by Boolean operators: “eating disorders” AND “treatment” OR “patient dropouts” OR “drop-out/dropouts” OR “attrition” OR “premature termination” AND “empirical study” OR “qualitative research”, for on Medline/PUBMED, PsycINFO and EMBASE databases. This article follows the PRISMA Guidelines. A total of 26 studies composed this review, of which 24 were original research articles, 1 was a review and 1 a theoretical article. Only two articles applied qualitative methods analyzing categories of content obtained by in-depth interviews, three combine quantitative and qualitative methods and other three present qualitative analyses while discussing quantitative studies. Further qualitative studies should be carried out to clarify meanings of dropout, premature termination of treatment, and attrition. Different expectations held by patients and by therapeutic teams, and the interpersonal difficulties of these types of patients, stand out as difficulties in constructing “therapeutic alliances”, with impacts on dropout, premature termination and attrition rates.
文摘Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent of psychosocial burdens in migrant populations the prevalence among the study population remains unclear. The aim of this study was to collect prevalence data for the largest migrant population in Germany-individuals with Turkish migration backgrounds—using a culturally and linguistically sensitive approach. Methods: The study employs a cross-sectional design. The multi-centre study (Hamburg, Berlin) is based on a sample of individuals with Turkish migration backgrounds living in the two cities stratified by age, gender, and education. The study programme consists of three phases: 1) a qualitative focus group to collect information on how to increase the participation rate of the target population as a minority group in Germany;2) a translation phase to create culture and linguistic sensitive versions of the assessment tools (e.g., the Composite International Diagnostic Interview (CIDI) for Turkish speaking individuals;and 3) a baseline community study to assess the lifetime, 12-month and four-week prevalence and comorbidity rates of mental disorder, health care utilization and help-seeking behaviour in individuals of Turkish migration backgrounds living in Germany. Discussion: The study provides important data on the lifetime prevalence of mental disorders and health care utilization of individuals with Turkish migration backgrounds. Furthermore, the study is an important step towards gaining a better understanding of potential barriers to participation, creating resources for difficult-to- reach minorities, and understanding the need for assessing mental disorders in migrant populations. These results can offer a starting point for the initiation of the necessary structural changes for mental health care services and policies for groups with migration backgrounds.
文摘Background: To understand what life is like for US children with a diagnosis of Growth Hormone Deficiency or Idiopathic Short Stature, the impact of short stature on Health related Quality of Life (HrQoL) was qualitatively examined and needs for care from the young patients and their parents perspective were identified. Methods: Focus group discussions with 26 American-English speaking and nine American-Spanish speaking children and their parents were conducted, transcribed verbatim and subsequently qualitatively analyzed by two independent raters, using an existing coding guideline, based on the multidimensional HrQoL concept and a special software (VERBI-Software MAXQDA 10). Results: A total of 1313 statements for the English-speaking and 447 statements for the Spanish-speaking families were categorized. In the US, the strongest frequency of mention was found for the HrQoL dimension “Social” across respondents, followed by “Treatment” and “Emotion”. Conclusion: Conducting and analyzing data generated from focus groups ensure that young patients’ experiences of disease are represented in the measure of outcomes for use in clinical trials and patient care.
基金German Ministry of Education and Research The German statutory pension insurance scheme (project number: 01GX720)
文摘Patient-centeredness is one of the most important quality and outcome criteria in health care. Health care organizations are continually searching for approaches that will enable them to establish sustainable patient-centeredness in their daily practice. Existing approaches frequently focus on interaction between patient and health care professional (external participation). However, this is often not sufficient;other elements, such as good teamwork among the health care professionals (internal participation), are also essential. The model of integrated patient-centeredness differentiates between these two participations forms, both of which are explored from a patient and health care professional perspective in our study. The aim of the study was to confirm the model from the viewpoint of staff and patients. To this end we conducted a multi-center cross-sectional study consisting of a patient and staff survey to assess internal and external participation and patient-centeredness. A total of 15 rehabilitation clinics were involved, with 272 staff members and 536 patients included in the final analysis. Although evaluation was positive (mainly slightly above the middle of the scale), there was potential for improvement for both types of participation. Internal and external rating differed between patients and health care staff, with the first group assessing internal significantly better and external lower than the second group. The low to middle correlation of both types, as well as the correlation and regression with patient-centeredness, confirmed the model of integrated patient-centeredness. The model underlines the importance of both participation forms for patient-centeredness, as well as their interdependence. Further studies are needed in order to verify the impact of internal and external participation, as well as that of further possible dimensions of patient-centeredness, on clinical and functional outcome criteria.
