BACKGROUND Depression and anxiety were both ranked among the top 25 leading causes of global burden of diseases in 2019 prior to the coronavirus disease 2019(COVID-19)pandemic.The pandemic affected,and in many cases t...BACKGROUND Depression and anxiety were both ranked among the top 25 leading causes of global burden of diseases in 2019 prior to the coronavirus disease 2019(COVID-19)pandemic.The pandemic affected,and in many cases threatened,the health and lives of millions of people across the globe and within the first year,global prevalence of anxiety and depression increased by 25%with the greatest influx in places highly affected by COVID-19.AIM To explore the psychological impact of the pandemic and resultant restrictions in different countries using an opportunistic sample and online questionnaire in different phases of the pandemic.METHODS A repeated,cross-sectional online international survey of adults,16 years and above,was carried out in 10 countries(United Kingdom,India,Canada,Bangladesh,Ukraine,Hong Kong,Pakistan,Egypt,Bahrain,Saudi Arabia).The online questionnaire was based on published approaches to understand the psychological impact of COVID-19 and the resultant restrictions.Five standardised measures were included to explore levels of depression[patient health questionnaire(PHQ-9)],anxiety[generalized anxiety disorder(GAD)assessment],impact of trauma[the impact of events scale-revised(IES-R)],loneliness(a brief loneliness scale),and social support(The Multidimensional Scale of Perceived Social support).RESULTS There were two rounds of the online survey in 10 countries with 42866 participants in Round 1 and 92260 in Round 2.The largest number of participants recruited from the United Kingdom(112985 overall).The majority of participants reported receiving no support from mental health services throughout the pandemic.This study found that the daily cumulative COVID-19 cases had a statistically significant effect on PHQ-9,GAD-7,and IES-R scores.These scores significantly increased in the second round of surveys with the ordinary least squares regression results with regression discontinuity design specification(to control lockdown effects)confirming these results.The study findings imply that participants’mental health worsened with high cumulative COVID-19 cases.CONCLUSION Whist we are still living through the impact of COVID-19,this paper focuses on its impact on mental health,discusses the possible consequences and future implications.This study revealed that daily cumulative COVID-19 cases have a significant impact on depression,anxiety,and trauma.Increasing cumulative cases influenced and impacted education,employment,socialization and finances,to name but a few.Building a database of global evidence will allow for future planning of pandemics,particularly the impact on mental health of populations considering the cultural differences.展开更多
Sexual and reproductive health (SRH) is among the fundamental packages of health care, which all clients seeking health care should receive. However, it is unclear how healthcare providers, in particular, nurses perce...Sexual and reproductive health (SRH) is among the fundamental packages of health care, which all clients seeking health care should receive. However, it is unclear how healthcare providers, in particular, nurses perceive the issue of people with mental problems having sexual health needs. The aim of this study was to explore perceptions of nurses at Ndola Teaching Hospital towards sexual health needs of people with mental health problems. A general descriptive qualitative study design was utilized and data were collected using three focus group discussions (FGDs) that were recorded and later transcribed verbatim. Purposive sampling was used to select 21 nurses who participated in the study. Nine were male, while 12 were female. Each FGD comprised seven participants. Thematic analysis was used to analyze the data, and six major themes: 1) physiological interplay among different body systems, 2) disease process and effects of psychotropic, 3) participant differences in age, gender, educational level, and cultural backgrounds, 4) staff shortages in mental health units, 5) deficient record keeping, and 6) Social stereotypes and labelling theories emerged. Despite acknowledging the existence of sexual activity among people with mental health problems;participants had both positive and negative perceptions. It is, therefore, recommended that interventions aimed at strengthening implementation of SRH guidelines among nurses caring for people with mental health problems should be put in place.展开更多
Introduction: Frontline health workers who work in COVID-19 isolation treatment centers are susceptible to developing mental health issues due to the overwhelming workload and stress associated with their job. Thus un...Introduction: Frontline health workers who work in COVID-19 isolation treatment centers are susceptible to developing mental health issues due to the overwhelming workload and stress associated with their job. Thus understanding their lived experiences provides insights that helps alleviate health worker burnout and improving their quality of life thereby leading to an efficient delivery of health care services during a pandemic. Aim: To understand the lived experiences of front line health workers during the COVID-19 pandemics at Levy Mwanawasa Teaching University Hospital. Design and Methods: A qualitative interpretative phenomenological study design was used. Purposive sampling method was adopted to select the 14 participants who took part in the study. The data were collected through face-to-face, audio-taped interviews using an in-depth interview guide, after which the responses were transcribed verbatim before using NVIVO to generate codes. The data were analyzed using thematic method. Results: The lived experiences of the participants were found to be mainly negative with few positive experiences. Their lived experiences were mainly negative emotional and psychological experiences including fear, anger, depression, frustration, anxiety and sadness. The thoughts that were identified included thoughts of surviving through the pandemic, thoughts of getting infected, and dying. The frontline health workers also experienced some personal and professional changes as they offered health services in the COVID-19 wards. The personal changes reported included;social limitations and collapse of extra income business while the professional changes included a change in the way health services were delivered, a gain in knowledge and skills and shaping of a career path. The main challenges experienced were limited resources (man power, resuscitation equipment, drugs, personal protective equipment), limited literature on the disease and limited social interactions. Conclusion and Recommendations: Relevant stakeholders should come on board in order to offer support during a pandemic or a similar situation so as to better the experience of frontline health workers with particular attention directed towards the provision of adequate resources to enable them deliver their services effectively. Frontline health workers perspectives and opinions should be taken into account by the institution’s administrators and policymakers when planning for and managing a pandemic.展开更多
BACKGROUND Symptoms of depression and comorbid anxiety are known risk factors for cognitive impairment in major depressive disorder(MDD).Understanding their relationships is crucial for developing targeted interventio...BACKGROUND Symptoms of depression and comorbid anxiety are known risk factors for cognitive impairment in major depressive disorder(MDD).Understanding their relationships is crucial for developing targeted interventions to mitigate cognitive impairments in MDD patients.We expect that the severity of sleep disturbances and other depressive symptoms will be positively correlated with the degree of cognitive impairments.We also hypothesize that anxiety symptoms,especially psychic anxiety,is a key factor in predicting cognitive performance in MDD patients and may indirectly contribute to cognitive impairment by affecting sleep disturbances and other potential factors.AIM To determine which dimension of the depressive and anxiety symptoms predicts cognitive impairment during a depressive episode.METHODS A comprehensive neurocognitive test battery assessed executive function,attention,processing speed,and memory in 162 medication-free MDD patients and 142 matched healthy controls.The 24-item Hamilton Depression Rating Scale was used to assess depressive symptoms,and the 14-item Hamilton Anxiety Scale was used to assess anxiety symptoms.Linear regression analyses and mediation analyses were conducted to evaluate the impact of depressive and anxiety symptoms,as well as their interactions,on cognitive impairments.RESULTS Among the depressive symptoms,sleep disturbances were associated with poorer executive function(P=0.004),lower processing speed(P=0.047),and memory impairments(P<0.001),and psychomotor retardation(PR)was associated with lower processing speed in patients with MDD(P=0.019).Notably,PR was found to mediate the impact of sleep disturbances on the processing speed.Regarding anxiety symptoms,psychic anxiety,rather than somatic anxiety,was associated with cognitive impairments in all aspects.Sleep disturbances mediated the effect of psychic anxiety on executive function[β=-0.013,BC CI(-0.027,-0.001)]and memory[β=-0.149,BC CI(-0.237,-0.063)],while PR mediated its effect on processing speed(β=-0.023,BC CI(-0.045,-0.004)].CONCLUSION Sleep disturbances may be a key predictor of poorer executive function,lower processing speed,and memory loss,while PR is crucial for lower processing speed during a depressive episode.Psychic anxiety contributes to all aspects of cognitive impairments,mediated by sleep disturbances and PR.展开更多
Background: While mental health among collegiate athletes is receiving increased attention, research on factors surrounding collegiate athletes' decision to seek mental health services is limited. The goal of the ...Background: While mental health among collegiate athletes is receiving increased attention, research on factors surrounding collegiate athletes' decision to seek mental health services is limited. The goal of the present review was to analyze and synthesize the current literature concerning collegiate athletes' utilization of mental health services, including the facilitators of and barriers to use of these services.Methods: The analysis was guided and organized using a socio-ecological framework, which considered the unique context in which collegiate athletes study and perform. A total of 21 articles, published between 2005 and 2016, which concern U.S. collegiate athletes' mental health services utilization(MHSU) were selected and included for the final analysis. Conceptualizations and operationalizations of MHSU were compared and contrasted. Facilitators of and barriers to athletes MHSU were examined and summarized while appropriately considering the proximity of each factor(facilitator or barrier) to the athletes.Results: Results showed variations in conceptualizations and operationalizations of MHSU in the articles analyzed, which made interpretation and cross comparison difficult. Collegiate athletes are willing to utilize mental health services, but gender, perceived stigma, peer norms—for athletes and coaches—plus service availability impact their MHSU.Conclusion: Key stakeholders, administrators, and public health officials should partner to eliminate MHSU barriers, support facilitators, and generally empower collegiate athletes to actively manage their mental health.展开更多
Background: Globally, it is estimated that more than 800,000 individuals die by suicide each year, making suicide one of the biggest causes of death worldwide. Additionally, suicide kills far more males than women, mo...Background: Globally, it is estimated that more than 800,000 individuals die by suicide each year, making suicide one of the biggest causes of death worldwide. Additionally, suicide kills far more males than women, more so in developing regions that are characterized by economic distress due to low income. Although the number of suicide cases has been seen to increase from 2013 to date, limited studies provide information on the factors influencing the trend. Therefore, this study aimed at investigating the prevalence of suicidal ideation and factors associated with suicide in males in selected compounds of Lusaka. Methods: The study used an analytical quantitative cross- sectional study design that involved 367 men in Mtendere and Kaunda Square townships in Lusaka district, Zambia. A structured questionnaire was used to collect data from participants, which was analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. The Chi-square, Fisher’s exact test and Wilcoxon rank sum tests were used to test relationships among variables at a five percent level of significance. Ethical approval and clearance was obtained from the National Health Research Authority. Results: Participants had a median age of 29 years (IQR, 27 - 32 years), 216 (58.9%) were single and 278 (75.8%) attained tertiary education. Under a quarter, 75 (20.4%) reported suicide ideations, and 97 (26.4%) reported low social support. For most participants, 347 (94.7%) experienced at least one stressful life event, and 359 (97.8%) experienced severe levels of stress. Under half, 170 (46.3%) were alcohol dependent, while 54 (14.7%) used alcohol harmfully. Suicide ideation was significantly associated with marital status (p Conclusion: Suicide ideation is relatively high among men in Mtendere and Kaunda Square townships, mainly influenced by marital status, education level, social support, stressful events alcohol abuse. Efforts must be channeled towards suicide awareness campaigns, and establishment of supportive environments in health facilities which can make it easy for men to open up about their struggles.展开更多
BACKGROUND Blonanserin(BNS)is a well-tolerated and effective drug for treating schizophrenia.AIM To investigate which types of patients would obtain the most benefit from BNS treatment.METHODS A total of 3306 particip...BACKGROUND Blonanserin(BNS)is a well-tolerated and effective drug for treating schizophrenia.AIM To investigate which types of patients would obtain the most benefit from BNS treatment.METHODS A total of 3306 participants were evaluated in a 12-week,prospective,multicenter,open-label post-marketing surveillance study of BNS.Brief psychiatric rating scale(BPRS)scores were calculated to evaluate the effectiveness of BNS,and its safety was assessed with the incidence of adverse drug reactions.Linear regression was used to screen the influencing factors for the reduction of BPRS total score,and logistic regression was used to identify patients with a better response to BNS.RESULTS The baseline BPRS total score(48.8±15.03)decreased to 27.7±10.08 at 12 weeks(P<0.001).Extrapyramidal symptoms(14.6%)were found to be the most frequent adverse drug reactions.The acute phase,baseline BPRS total score,current episode duration,number of previous episodes,dose of concomitant antipsychotics,and number of types of sedative-hypnotic agents were found to be independent factors affecting the reduction of BPRS total score after treatment initiation.Specifically,patients in the acute phase with baseline BPRS total score≥45,current episode duration<3 months,and≤3 previous episodes derived greater benefit from 12-week treatment with BNS.CONCLUSION Patients in the acute phase with more severe symptoms,shorter current episode duration,fewer previous episodes,and a lower psychotropic drug load derived the greatest benefit from treatment with BNS.展开更多
Background Intimate partner violence(IPV) and sexual violence(SV) occur commonly and are a violation of basic human rights. There are limited studies to date that examine the impact of IPV, SV and mental health outcom...Background Intimate partner violence(IPV) and sexual violence(SV) occur commonly and are a violation of basic human rights. There are limited studies to date that examine the impact of IPV, SV and mental health outcomes in Thailand.Aims The objective of the present study was to estimate the prevalence of intimate partner physical violence and IPV in Thai women and the association between these forms of violence and psychiatric disorders.Methods The present study used data from a national cross-sectional, population-based, household design survey. This study analysed data from 3009 female respondents above the age of 18 who were interviewed in person using the World Mental Health-Composite International Diagnostic Interview V.3.0(WMH-CIDI 3.0). We estimated the lifetime and the 12-month period prevalence of IPV and SV, the lifetime and the past 12-month period correlation of IPV/SV with psychiatric disorders and the OR for psychiatric disorders associated with these types of violence.Results There was only 5.2 % of the weighted sample that reported experiencing some form of violence, including reported rates of intimate partner physical violence of 3.5% and IPV of 2.0%. Women who had experienced IPV have a lifetime prevalence for common psychiatric disorders of 28.9%, for suicidal behaviours of 12.2% and for substance use disorders of 8.8%. Women who had experienced SV have a lifetime diagnoses for common psychiatric disorders of 21.4%, for suicidal behaviours of 16.5% and for substance use disorders of 19.4%. There was a statistically significant association between IPV/SV and being diagnosed with a psychiatric disorder during the past year and also during one's lifetime.Conclusion The association between IPV/SV and psychiatric disorders is significant; therefore, performing a formal assessment for a history of violence in psychiatric patients is often beneficial in refining the diagnosis and treatment.展开更多
The COVID-19 pandemic has posed a serious threat to global mental health.Multiple lines of evidence suggest that there is a varying yet considerable increase in mental health issues among the general population and vu...The COVID-19 pandemic has posed a serious threat to global mental health.Multiple lines of evidence suggest that there is a varying yet considerable increase in mental health issues among the general population and vulnerable groups.12 The aftermath is obscure and speculative from a social,economic,individual and public mental health perspective.Recently published studies support the existence of an emotional epidemic curve,describing a high probability of an increase in the burden of mental health issues in the post-pandemic era.34 Furthermore,previous major public health emergencies showed that more than half of the population devel-oped mental health problems and required mental health intervention.45 There is,therefore,an urgent need to reorganise existing mental health services to address the current unmet needs for mental health and to prepare for future challenges in the postpandemic era in terms of prevention and management.展开更多
Cervical cancer is a serious health concern in Uganda. Early screening and detection certainly improves chances of survival and treatment outcome. Sound knowledge and positive attitudes highly influence acceptability ...Cervical cancer is a serious health concern in Uganda. Early screening and detection certainly improves chances of survival and treatment outcome. Sound knowledge and positive attitudes highly influence acceptability and uptake of screening methods. This descriptive cross-sectional study determines knowledge and attitudes towards Cervical Cancer screening amongst female out-patients aged 15 - 49 years, attending Health Centre IIIs in Oyam District, Northern Uganda. A systematically obtained sample of 445 respondents was interviewed using semi-structured questionnaires and focused group discussions. Quantitative data was analyzed using SPSS 16.0. Directed content analysis of themes of transcribed qualitative data was conducted manually. Of the 445 respondents, only 62.7% (n = 279) had heard of cervical cancer amongst which only 35.1% (n = 85) had been screened;13.7% (n = 34) did not know what screening was;3.7% (n = 9) were not sure and 5.8% (n = 14) knew it as removal of the cervix. Only 39.1% (n = 174) believed that cervical cancer can be prevented. There is still limited knowledge and lots of misconceptions about cervical cancer screening in the communities, which requires massive sensitization of the population at risk to change negative attitudes and maximize acceptability to screening methods.展开更多
Introduction: Marital satisfaction has remained a topic of great interest worldwide. Association has been postulated between marital satisfaction, job satisfaction and mental health. There is, however, a paucity of re...Introduction: Marital satisfaction has remained a topic of great interest worldwide. Association has been postulated between marital satisfaction, job satisfaction and mental health. There is, however, a paucity of research on marital satisfaction in Nigeria, particularly in relation to job satisfaction and psychological health. Objective: The objective of this study is thus to assess the level of marital satisfaction and to explore the relationship if any between marital satisfaction, job satisfaction and mental health of secondary school teachers in Benin City, Edo State, Nigeria. Methods: A cross sectional study was conducted on teachers in secondary schools in Benin City, Nigeria. A total population of 300 teachers who had been married and teaching for at least one year were included in the study. The information required for the study were collected using a self-administered questionnaire and two standard instruments, the Index of Marital Satisfaction (IMS) and the General Health Questionnaire 28 (GHQ 28). The GHQ was used to assess the workers psychological health, while the IMS was used to assess the degree of marital satisfaction. Results: Two hundred and fifteen (82.7%) teachers had marital satisfaction, 54 (20.8%) had psychological disorder while 56 (21.5%) were dissatisfied with their job. A strong association was found between marital dissatisfaction and psychological disorder (X2 = 56.826;df = 1, P = 0.0004). No association was found between marital dissatisfaction and job dissatisfaction. No association was also found between job dissatisfaction and psychological disorder. Conclusion: A high level of marital satisfaction was found in the study population. However, the strong association also found between marital dissatisfaction and psychological disorder provides empirical evidence on the need to educate married couples as well as the general public on the mental health implication of marital dissatisfaction.展开更多
Background: The integration of relevant high-quality research evidence into the health decision and policy formulation process is a key strategy for improving health systems especially in developing countries such as ...Background: The integration of relevant high-quality research evidence into the health decision and policy formulation process is a key strategy for improving health systems especially in developing countries such as Zambia. However, the lack of capacity to understand and value research evidence by policy and decision makers makes it difficult for them to find and use research evidence in a timely manner even when motivated to do so. This study aimed to establish the views, attitudes and practices of policy makers on the use of research evidence in policy and decision-making process in Zambia. Methodology: This descriptive cross-sectional study was conducted in Lusaka, Zambia among selected public health decision and policy making institutions. A purposive sample of 21 consenting policy makers who were working in different positions in the Ministry of Health Headquarters, Provincial and District Health Offices, Health Professions Regulatory Bodies, United Nations Agencies, International Non-Governmental Organizations and University Deans from the University of Zambia participated in the study. A self-administered questionnaire was used to collect data. The IBM? SPSS? Statistics for Windows Version 20.0 was used for data analysis. Results: The concept of Evidence Informed Health Policy was not well understood such that only less than half (47.5%) of the participants reported having heard specifically about Evidence Informed Health Policy meanwhile almost two thirds (61.9%) reported that they used research evidence in decision making and policy formulation. Similar discrepancy was expressed in the understanding of and use of rapid response mechanisms such that although (47.6%) of the participants reported having heard about it, (57%) had never used rapid response mechanisms for deci-sion-making. With regard to the sources of information, about half (52.3) of the participants reported scholarly articles as their main source of evidence. Con-clusion and Recommendations: There is need for more sensitization and ca-pacity building among the decision and policy makers on the importance of using research evidence in decision and policy making process as incorporation of relevant high-quality research evidence into the health policy making pro-cess is a key strategy for improving health systems.展开更多
Since the first identification in December of 2019 and the fast spread of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection,it has represented a dramatic global public health concern.Though affectin...Since the first identification in December of 2019 and the fast spread of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection,it has represented a dramatic global public health concern.Though affecting mainly the respiratory system,SARS-CoV-2 disease,defined as coronavirus disease 2019(COVID-19),may have a systemic involvement leading to multiple organ dysfunction.Experimental evidence about the SARS-CoV-2 tropism for the liver and the increasing of hepatic cytolysis enzymes during infection support the presence of a pathophysiological relationship between liver and SARS-CoV-2.On the other side,patients with chronic liver disease have been demonstrated to have a poor prognosis with COVID-19.In particular,patients with liver cirrhosis appear extremely vulnerable to infection.Moreover,the etiology of liver disease and the vaccination status could affect the COVID-19 outcomes.This review analyzes the impact of the disease stage and the related causes on morbidity and mortality,clinical outcomes during SARS-CoV-2 infection,as well as the efficacy of vaccination in patients with chronic liver disease.展开更多
Background Many people who are gender variant have undiagnosed gender dysphoria,resulting in delayed receipt of gender-affirming support and prolonged distress in living with their gender-non-conforming sex.The Utrech...Background Many people who are gender variant have undiagnosed gender dysphoria,resulting in delayed receipt of gender-affirming support and prolonged distress in living with their gender-non-conforming sex.The Utrecht Gender Dysphoria Scale-Gender Spectrum(UGDS-GS)is a newly developed tool that measures dissatisfaction with gender identity and expression.However,there is no translated version of this tool in Thai.Moreover,the sensitivity,specificity and cut-off point of the UGDS-GS to detect gender dysphoria in people who are transgender remain unknown.Aims This study translated the UGDS-GS into Thai and then examined the validity and reliability of the Thai UGDS-GS.Methods 185 participants with and without gender dysphoria were selected from the Gender Variation Clinic in Ramathibodi Hospital and from social media platforms.The UGDS-GS was translated into Thai according to the World Health Organization(WHO)guidelines on translation.The medical records of patients with gender dysphoria and semi-structured interviews were used to confirm the diagnosis of gender dysphoria.Subsequently,the validity and reliability of the instrument were analysed.Results The mean age of participants was 30.43(7.98)years among the 51 assigned males(27.6%)and 134 assigned females(72.4%)at birth.The Thai UGDS-GS average score was 77.82(9.71)for those with gender dysphoria(n=95)and 46.03(10.71)for those without gender dysphoria(n=90).Cronbach’s alpha coefficient was 0.962,showing excellent internal consistency.In addition,exploratory factor analysis showed compatibility with the original version’s metrics.The value of the area under the curve was 0.976(95%confidence interval:0.954 to 0.998),indicating outstanding concordance.At the cut-off point of‘60’,sensitivity and specificity were good(96.84%and 91.11%,respectively).Conclusions The Thai UGDS-GS is an excellent,psychometrically reliable and valid tool for screening gender dysphoria in clinical and community settings in Thailand.The cut-off point of‘60’scores suggests a positive indicator or a high chance of gender dysphoria.展开更多
Introduction: Diabetes mellitus (DM) is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. It is “a group of metabo...Introduction: Diabetes mellitus (DM) is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. It is “a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both” manifested by carbohydrates, fat and protein metabolism abnormality. If untreated high blood sugar can damage the nerves, eyes, kidneys, and other organs. The purpose of this study was to assess the information needs and self-care practice of Diabetic Patients in Mbala, Northern Province Zambia. Methods: This was an analytical cross-sectional study where 105 respondents aged 18 years and above participated in the study. Participants were randomly selected. A structured interview schedule and a check list were used to collect data. Statistics Package for Social Sciences computer software package version 23.0 was used to analyze data. Chi square and fisher’s exact tests were used to test the significance of the association between Knowledge of Diabetes Mellitus, attitude towards self-care practices, self-care practices among Diabetic patients and the need for information among Diabetic patients. A 95% confidence interval and P value of 0.05 were used to ascertain the degree of significance. Multi-variate binary logistic regression model to determine predictors of self-care practices and need for information was also used. Result: On analyzing the dependent variables, more than half (61.9%), had high need for information and three quarters (85.7%) of respondents had poor self-care practices. Slightly more than half (58.1%) had high knowledge levels majority (78.1%), had a negative attitude. Significant associations were found P Conclusion: Negative attitudes and lack of information among Diabetic patients were the main reasons associated with poor self-care practices. Particular attention should therefore be given to ensuring that Diabetic patients are given adequate information on Diabetes self-care in order to improve the quality of life.展开更多
Introduction: The addiction to games of chance and money is frequently encountered among some players. The general objective of this study was to describe the level of the gambling addiction among the players of the T...Introduction: The addiction to games of chance and money is frequently encountered among some players. The general objective of this study was to describe the level of the gambling addiction among the players of the Togolese National Lottery (LONATO) in the city of Lomé. Method: This was a descriptive cross-sectional study through non-random sampling by convenience surveys, conducted on October 09, 2019 in 20 LONATO plying sites which affected 611 players. The screening was done using the South Oaks Gambling Screen (SOGS) questionnaire. Results: Of the 611 players surveyed, 55% were aged 18 to 35 years with an average age of 36 years and the extremes ranging from 14 to 78 years. The male gender was in the majority (84.26%). The prevalence of pathological gambling was 62.52%. Among the pathological gamblers, 16.89% had a family history of pathological gambling, 19.00% had a mood disorder, 28.50% had excessive alcoholism, and 17.15% consumed another psychoactive substance. Cannabis was the most consumed substance (6.87%) followed by tobacco (6.07%) and soporific (6.07%). More than half of players (62.03%) thought that pathological gambling is not a disease. Conclusion: The pathological gambling is a global phenomenon and a reality in Togo. Raising everyone’s awareness will reduce its negative impact on the players.展开更多
Depression,a common mental illness,seriously affects the health of individuals and has deleterious effects on society.The prevention and treatment of depression has drawn the attention of many researchers and has beco...Depression,a common mental illness,seriously affects the health of individuals and has deleterious effects on society.The prevention and treatment of depression has drawn the attention of many researchers and has become an important social issue.The treatment strategies for depression include drugs,psychotherapy,and physiotherapy.Drug therapy is ineffective in some patients and psychotherapy has treatment limitations.As a reliable adjuvant therapy,physiotherapy compensates for the shortcomings of drug and psychotherapy and effectively reduces the disease recurrence rate.Physiotherapy is more scientific and rigorous,its methods are diverse,and to a certain extent,provides more choices for the treatment of depression.Physiotherapy can relieve symptoms in many ways,such as by improving the levels of neurobiochemical molecules,inhibiting the inflammatory response,regulating the neuroendocrine system,and increasing neuroplasticity.Physiotherapy has biological effects similar to those of antidepressants and may produce a superimposed impact when combined with other treatments.This article summarizes the findings on the use of physiotherapy to treat patients with depression over the past five years.It also discusses several methods of physiotherapy for treating depression from the aspects of clinical effect,mechanism of action,and disadvantages,thereby serving as a reference for the in-depth development of physiotherapy research.展开更多
The complex morphological,anatomical,physiological,and chemical mechanisms within the aging brain have been the hot topic of research for centuries.The aging process alters the brain structure that affects functions a...The complex morphological,anatomical,physiological,and chemical mechanisms within the aging brain have been the hot topic of research for centuries.The aging process alters the brain structure that affects functions and cognitions,but the worsening of such processes contributes to the pathogenesis of neurodegenerative disorders,such as Alzheimer's disease.Beyond these observable,mild morphological shifts,significant functional modifications in neurotransmission and neuronal activity critically influence the aging brain.Understanding these changes is important for maintaining cognitive health,especially given the increasing prevalence of age-related conditions that affect cognition.This review aims to explore the age-induced changes in brain plasticity and molecular processes,differentiating normal aging from the pathogenesis of Alzheimer's disease,thereby providing insights into predicting the risk of dementia,particularly Alzheimer's disease.展开更多
Background: Smokeless tobacco is defined as a product that contains tobacco, is not smoked or burned at the time of use, and commonly consumed orally or nasally. These products can be placed in the mouth, cheek or the...Background: Smokeless tobacco is defined as a product that contains tobacco, is not smoked or burned at the time of use, and commonly consumed orally or nasally. These products can be placed in the mouth, cheek or the lip and are sucked or chewed. The Zambian government, in the 2019 country report, gave an estimated figure of 4.5% of females aged 15 years and above in 2017 used smokeless tobacco and by 31st December, 2018, there was an increase of smokeless tobacco users to 6.8% women of the same age group. This study aimed to explore the extent of smokeless tobacco use among women in Kasama district-Zambia. Methodology: An analytical cross-sectional quantitative study design was used to collect data using the modified structured interview schedule, adopted from Medicine for Global Health. Simple random sampling method using rotary technique was used to select 430 respondents after meeting the inclusion criteria. Informed consent to participate in the study was obtained. Data was analysed using version 26.0 of the Statistical Package for Social Sciences. Appropriate parametric or non-parametric statistical tests (Chi-squared or Fisher’s exact test) were adopted in testing for associations between variables. Univariable and multivariable binary logistic regression analysis were employed in identifying smokeless tobacco use among women using an investigator-led stepwise approach, guided by various fit statistics and the likelihood ratio test. All statistical analyses adopted a 5% significance level at 95% confidence interval. Results: The results showed that most of the respondents were aged between 18 and 25 years (45.6%), (53.7%) lived in urban settlements and the majority (80%) were unemployed. The majority of respondents (83.5%) had a friend/relative who used smokeless tobacco and over half (53.5%) thought smokeless tobacco was beneficial to them. The commonly mentioned benefits of smokeless tobacco included body warmth (13.6%) and vaginal tightening (7.9%). The results revealed that most of the respondents attained a secondary level of education (38.4%). According to the study, smokeless tobacco use among women of Kasama-Zambia was significantly associated with the following;age (p Conclusion: Based on these findings, the study recommends that efforts should be channeled towards the dissemination of information on the impacts of smokeless tobacco use in order to overcome cultural beliefs attached to smokeless tobacco use.展开更多
A large number of studies have demonstrated that depression patients have cognitive dysfunction. With recently developed brain functional imaging, studies have focused on changes in brain function to investigate cogni...A large number of studies have demonstrated that depression patients have cognitive dysfunction. With recently developed brain functional imaging, studies have focused on changes in brain function to investigate cognitive changes. However, there is still controversy regarding abnormalities in brain functions or correlation between cognitive impairment and brain function changes. Thus, it is important to design an emotion-related task for research into brain function changes. We selected positive, neutral, and negative pictures from the International Affective Picture System. Patients with major depressive disorder were asked to judge emotion pictures. In addition, functional MRI was performed to synchronously record behavior data and imaging data. Results showed that the total correct rate for recognizing pictures was lower in patients compared with normal controls. Moreover, the consistency for recognizing pictures for depressed patients was worse than normal controls, and they frequently recognized positive pictures as negative pictures. The consistency for recognizing pictures was negatively correlated with the Hamilton Depression Rating Scale. Functional MRI suggested that the activation of some areas in the frontal lobe, temporal lobe, parietal lobe, limbic lobe, and cerebellum was enhanced, but that the activation of some areas in the frontal lobe, parietal lobe and occipital lobe was weakened while the patients were watching positive and neutral pictures compared with normal controls. The activation of some areas in the frontal lobe temporal lobe, parietal lobe, and limbic lobe was enhanced, but the activation of some areas in the occipital lobe were weakened while the patients were watching the negative pictures compared with normal controls. These findings indicate that patients with major depressive disorder have negative cognitive disorder and extensive brain dysfunction. Thus, reduced activation of the occipital lobe may be an initiating factor for cognitive disorder in depressed patients.展开更多
基金Supported by MRC Global Health Research Program,No.MR.N006267/1.
文摘BACKGROUND Depression and anxiety were both ranked among the top 25 leading causes of global burden of diseases in 2019 prior to the coronavirus disease 2019(COVID-19)pandemic.The pandemic affected,and in many cases threatened,the health and lives of millions of people across the globe and within the first year,global prevalence of anxiety and depression increased by 25%with the greatest influx in places highly affected by COVID-19.AIM To explore the psychological impact of the pandemic and resultant restrictions in different countries using an opportunistic sample and online questionnaire in different phases of the pandemic.METHODS A repeated,cross-sectional online international survey of adults,16 years and above,was carried out in 10 countries(United Kingdom,India,Canada,Bangladesh,Ukraine,Hong Kong,Pakistan,Egypt,Bahrain,Saudi Arabia).The online questionnaire was based on published approaches to understand the psychological impact of COVID-19 and the resultant restrictions.Five standardised measures were included to explore levels of depression[patient health questionnaire(PHQ-9)],anxiety[generalized anxiety disorder(GAD)assessment],impact of trauma[the impact of events scale-revised(IES-R)],loneliness(a brief loneliness scale),and social support(The Multidimensional Scale of Perceived Social support).RESULTS There were two rounds of the online survey in 10 countries with 42866 participants in Round 1 and 92260 in Round 2.The largest number of participants recruited from the United Kingdom(112985 overall).The majority of participants reported receiving no support from mental health services throughout the pandemic.This study found that the daily cumulative COVID-19 cases had a statistically significant effect on PHQ-9,GAD-7,and IES-R scores.These scores significantly increased in the second round of surveys with the ordinary least squares regression results with regression discontinuity design specification(to control lockdown effects)confirming these results.The study findings imply that participants’mental health worsened with high cumulative COVID-19 cases.CONCLUSION Whist we are still living through the impact of COVID-19,this paper focuses on its impact on mental health,discusses the possible consequences and future implications.This study revealed that daily cumulative COVID-19 cases have a significant impact on depression,anxiety,and trauma.Increasing cumulative cases influenced and impacted education,employment,socialization and finances,to name but a few.Building a database of global evidence will allow for future planning of pandemics,particularly the impact on mental health of populations considering the cultural differences.
文摘Sexual and reproductive health (SRH) is among the fundamental packages of health care, which all clients seeking health care should receive. However, it is unclear how healthcare providers, in particular, nurses perceive the issue of people with mental problems having sexual health needs. The aim of this study was to explore perceptions of nurses at Ndola Teaching Hospital towards sexual health needs of people with mental health problems. A general descriptive qualitative study design was utilized and data were collected using three focus group discussions (FGDs) that were recorded and later transcribed verbatim. Purposive sampling was used to select 21 nurses who participated in the study. Nine were male, while 12 were female. Each FGD comprised seven participants. Thematic analysis was used to analyze the data, and six major themes: 1) physiological interplay among different body systems, 2) disease process and effects of psychotropic, 3) participant differences in age, gender, educational level, and cultural backgrounds, 4) staff shortages in mental health units, 5) deficient record keeping, and 6) Social stereotypes and labelling theories emerged. Despite acknowledging the existence of sexual activity among people with mental health problems;participants had both positive and negative perceptions. It is, therefore, recommended that interventions aimed at strengthening implementation of SRH guidelines among nurses caring for people with mental health problems should be put in place.
文摘Introduction: Frontline health workers who work in COVID-19 isolation treatment centers are susceptible to developing mental health issues due to the overwhelming workload and stress associated with their job. Thus understanding their lived experiences provides insights that helps alleviate health worker burnout and improving their quality of life thereby leading to an efficient delivery of health care services during a pandemic. Aim: To understand the lived experiences of front line health workers during the COVID-19 pandemics at Levy Mwanawasa Teaching University Hospital. Design and Methods: A qualitative interpretative phenomenological study design was used. Purposive sampling method was adopted to select the 14 participants who took part in the study. The data were collected through face-to-face, audio-taped interviews using an in-depth interview guide, after which the responses were transcribed verbatim before using NVIVO to generate codes. The data were analyzed using thematic method. Results: The lived experiences of the participants were found to be mainly negative with few positive experiences. Their lived experiences were mainly negative emotional and psychological experiences including fear, anger, depression, frustration, anxiety and sadness. The thoughts that were identified included thoughts of surviving through the pandemic, thoughts of getting infected, and dying. The frontline health workers also experienced some personal and professional changes as they offered health services in the COVID-19 wards. The personal changes reported included;social limitations and collapse of extra income business while the professional changes included a change in the way health services were delivered, a gain in knowledge and skills and shaping of a career path. The main challenges experienced were limited resources (man power, resuscitation equipment, drugs, personal protective equipment), limited literature on the disease and limited social interactions. Conclusion and Recommendations: Relevant stakeholders should come on board in order to offer support during a pandemic or a similar situation so as to better the experience of frontline health workers with particular attention directed towards the provision of adequate resources to enable them deliver their services effectively. Frontline health workers perspectives and opinions should be taken into account by the institution’s administrators and policymakers when planning for and managing a pandemic.
基金Supported by National Key Research and Development Program of China,No.2019YFA0706200National Natural Science Foundation of China,No.82301738Natural Science Foundation of Hunan Province,No.2022JJ40701 and No.2022JJ40697.
文摘BACKGROUND Symptoms of depression and comorbid anxiety are known risk factors for cognitive impairment in major depressive disorder(MDD).Understanding their relationships is crucial for developing targeted interventions to mitigate cognitive impairments in MDD patients.We expect that the severity of sleep disturbances and other depressive symptoms will be positively correlated with the degree of cognitive impairments.We also hypothesize that anxiety symptoms,especially psychic anxiety,is a key factor in predicting cognitive performance in MDD patients and may indirectly contribute to cognitive impairment by affecting sleep disturbances and other potential factors.AIM To determine which dimension of the depressive and anxiety symptoms predicts cognitive impairment during a depressive episode.METHODS A comprehensive neurocognitive test battery assessed executive function,attention,processing speed,and memory in 162 medication-free MDD patients and 142 matched healthy controls.The 24-item Hamilton Depression Rating Scale was used to assess depressive symptoms,and the 14-item Hamilton Anxiety Scale was used to assess anxiety symptoms.Linear regression analyses and mediation analyses were conducted to evaluate the impact of depressive and anxiety symptoms,as well as their interactions,on cognitive impairments.RESULTS Among the depressive symptoms,sleep disturbances were associated with poorer executive function(P=0.004),lower processing speed(P=0.047),and memory impairments(P<0.001),and psychomotor retardation(PR)was associated with lower processing speed in patients with MDD(P=0.019).Notably,PR was found to mediate the impact of sleep disturbances on the processing speed.Regarding anxiety symptoms,psychic anxiety,rather than somatic anxiety,was associated with cognitive impairments in all aspects.Sleep disturbances mediated the effect of psychic anxiety on executive function[β=-0.013,BC CI(-0.027,-0.001)]and memory[β=-0.149,BC CI(-0.237,-0.063)],while PR mediated its effect on processing speed(β=-0.023,BC CI(-0.045,-0.004)].CONCLUSION Sleep disturbances may be a key predictor of poorer executive function,lower processing speed,and memory loss,while PR is crucial for lower processing speed during a depressive episode.Psychic anxiety contributes to all aspects of cognitive impairments,mediated by sleep disturbances and PR.
文摘Background: While mental health among collegiate athletes is receiving increased attention, research on factors surrounding collegiate athletes' decision to seek mental health services is limited. The goal of the present review was to analyze and synthesize the current literature concerning collegiate athletes' utilization of mental health services, including the facilitators of and barriers to use of these services.Methods: The analysis was guided and organized using a socio-ecological framework, which considered the unique context in which collegiate athletes study and perform. A total of 21 articles, published between 2005 and 2016, which concern U.S. collegiate athletes' mental health services utilization(MHSU) were selected and included for the final analysis. Conceptualizations and operationalizations of MHSU were compared and contrasted. Facilitators of and barriers to athletes MHSU were examined and summarized while appropriately considering the proximity of each factor(facilitator or barrier) to the athletes.Results: Results showed variations in conceptualizations and operationalizations of MHSU in the articles analyzed, which made interpretation and cross comparison difficult. Collegiate athletes are willing to utilize mental health services, but gender, perceived stigma, peer norms—for athletes and coaches—plus service availability impact their MHSU.Conclusion: Key stakeholders, administrators, and public health officials should partner to eliminate MHSU barriers, support facilitators, and generally empower collegiate athletes to actively manage their mental health.
文摘Background: Globally, it is estimated that more than 800,000 individuals die by suicide each year, making suicide one of the biggest causes of death worldwide. Additionally, suicide kills far more males than women, more so in developing regions that are characterized by economic distress due to low income. Although the number of suicide cases has been seen to increase from 2013 to date, limited studies provide information on the factors influencing the trend. Therefore, this study aimed at investigating the prevalence of suicidal ideation and factors associated with suicide in males in selected compounds of Lusaka. Methods: The study used an analytical quantitative cross- sectional study design that involved 367 men in Mtendere and Kaunda Square townships in Lusaka district, Zambia. A structured questionnaire was used to collect data from participants, which was analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. The Chi-square, Fisher’s exact test and Wilcoxon rank sum tests were used to test relationships among variables at a five percent level of significance. Ethical approval and clearance was obtained from the National Health Research Authority. Results: Participants had a median age of 29 years (IQR, 27 - 32 years), 216 (58.9%) were single and 278 (75.8%) attained tertiary education. Under a quarter, 75 (20.4%) reported suicide ideations, and 97 (26.4%) reported low social support. For most participants, 347 (94.7%) experienced at least one stressful life event, and 359 (97.8%) experienced severe levels of stress. Under half, 170 (46.3%) were alcohol dependent, while 54 (14.7%) used alcohol harmfully. Suicide ideation was significantly associated with marital status (p Conclusion: Suicide ideation is relatively high among men in Mtendere and Kaunda Square townships, mainly influenced by marital status, education level, social support, stressful events alcohol abuse. Efforts must be channeled towards suicide awareness campaigns, and establishment of supportive environments in health facilities which can make it easy for men to open up about their struggles.
文摘BACKGROUND Blonanserin(BNS)is a well-tolerated and effective drug for treating schizophrenia.AIM To investigate which types of patients would obtain the most benefit from BNS treatment.METHODS A total of 3306 participants were evaluated in a 12-week,prospective,multicenter,open-label post-marketing surveillance study of BNS.Brief psychiatric rating scale(BPRS)scores were calculated to evaluate the effectiveness of BNS,and its safety was assessed with the incidence of adverse drug reactions.Linear regression was used to screen the influencing factors for the reduction of BPRS total score,and logistic regression was used to identify patients with a better response to BNS.RESULTS The baseline BPRS total score(48.8±15.03)decreased to 27.7±10.08 at 12 weeks(P<0.001).Extrapyramidal symptoms(14.6%)were found to be the most frequent adverse drug reactions.The acute phase,baseline BPRS total score,current episode duration,number of previous episodes,dose of concomitant antipsychotics,and number of types of sedative-hypnotic agents were found to be independent factors affecting the reduction of BPRS total score after treatment initiation.Specifically,patients in the acute phase with baseline BPRS total score≥45,current episode duration<3 months,and≤3 previous episodes derived greater benefit from 12-week treatment with BNS.CONCLUSION Patients in the acute phase with more severe symptoms,shorter current episode duration,fewer previous episodes,and a lower psychotropic drug load derived the greatest benefit from treatment with BNS.
基金funded by the Department of Mental Health,Ministry of Public Health
文摘Background Intimate partner violence(IPV) and sexual violence(SV) occur commonly and are a violation of basic human rights. There are limited studies to date that examine the impact of IPV, SV and mental health outcomes in Thailand.Aims The objective of the present study was to estimate the prevalence of intimate partner physical violence and IPV in Thai women and the association between these forms of violence and psychiatric disorders.Methods The present study used data from a national cross-sectional, population-based, household design survey. This study analysed data from 3009 female respondents above the age of 18 who were interviewed in person using the World Mental Health-Composite International Diagnostic Interview V.3.0(WMH-CIDI 3.0). We estimated the lifetime and the 12-month period prevalence of IPV and SV, the lifetime and the past 12-month period correlation of IPV/SV with psychiatric disorders and the OR for psychiatric disorders associated with these types of violence.Results There was only 5.2 % of the weighted sample that reported experiencing some form of violence, including reported rates of intimate partner physical violence of 3.5% and IPV of 2.0%. Women who had experienced IPV have a lifetime prevalence for common psychiatric disorders of 28.9%, for suicidal behaviours of 12.2% and for substance use disorders of 8.8%. Women who had experienced SV have a lifetime diagnoses for common psychiatric disorders of 21.4%, for suicidal behaviours of 16.5% and for substance use disorders of 19.4%. There was a statistically significant association between IPV/SV and being diagnosed with a psychiatric disorder during the past year and also during one's lifetime.Conclusion The association between IPV/SV and psychiatric disorders is significant; therefore, performing a formal assessment for a history of violence in psychiatric patients is often beneficial in refining the diagnosis and treatment.
文摘The COVID-19 pandemic has posed a serious threat to global mental health.Multiple lines of evidence suggest that there is a varying yet considerable increase in mental health issues among the general population and vulnerable groups.12 The aftermath is obscure and speculative from a social,economic,individual and public mental health perspective.Recently published studies support the existence of an emotional epidemic curve,describing a high probability of an increase in the burden of mental health issues in the post-pandemic era.34 Furthermore,previous major public health emergencies showed that more than half of the population devel-oped mental health problems and required mental health intervention.45 There is,therefore,an urgent need to reorganise existing mental health services to address the current unmet needs for mental health and to prepare for future challenges in the postpandemic era in terms of prevention and management.
文摘Cervical cancer is a serious health concern in Uganda. Early screening and detection certainly improves chances of survival and treatment outcome. Sound knowledge and positive attitudes highly influence acceptability and uptake of screening methods. This descriptive cross-sectional study determines knowledge and attitudes towards Cervical Cancer screening amongst female out-patients aged 15 - 49 years, attending Health Centre IIIs in Oyam District, Northern Uganda. A systematically obtained sample of 445 respondents was interviewed using semi-structured questionnaires and focused group discussions. Quantitative data was analyzed using SPSS 16.0. Directed content analysis of themes of transcribed qualitative data was conducted manually. Of the 445 respondents, only 62.7% (n = 279) had heard of cervical cancer amongst which only 35.1% (n = 85) had been screened;13.7% (n = 34) did not know what screening was;3.7% (n = 9) were not sure and 5.8% (n = 14) knew it as removal of the cervix. Only 39.1% (n = 174) believed that cervical cancer can be prevented. There is still limited knowledge and lots of misconceptions about cervical cancer screening in the communities, which requires massive sensitization of the population at risk to change negative attitudes and maximize acceptability to screening methods.
文摘Introduction: Marital satisfaction has remained a topic of great interest worldwide. Association has been postulated between marital satisfaction, job satisfaction and mental health. There is, however, a paucity of research on marital satisfaction in Nigeria, particularly in relation to job satisfaction and psychological health. Objective: The objective of this study is thus to assess the level of marital satisfaction and to explore the relationship if any between marital satisfaction, job satisfaction and mental health of secondary school teachers in Benin City, Edo State, Nigeria. Methods: A cross sectional study was conducted on teachers in secondary schools in Benin City, Nigeria. A total population of 300 teachers who had been married and teaching for at least one year were included in the study. The information required for the study were collected using a self-administered questionnaire and two standard instruments, the Index of Marital Satisfaction (IMS) and the General Health Questionnaire 28 (GHQ 28). The GHQ was used to assess the workers psychological health, while the IMS was used to assess the degree of marital satisfaction. Results: Two hundred and fifteen (82.7%) teachers had marital satisfaction, 54 (20.8%) had psychological disorder while 56 (21.5%) were dissatisfied with their job. A strong association was found between marital dissatisfaction and psychological disorder (X2 = 56.826;df = 1, P = 0.0004). No association was found between marital dissatisfaction and job dissatisfaction. No association was also found between job dissatisfaction and psychological disorder. Conclusion: A high level of marital satisfaction was found in the study population. However, the strong association also found between marital dissatisfaction and psychological disorder provides empirical evidence on the need to educate married couples as well as the general public on the mental health implication of marital dissatisfaction.
文摘Background: The integration of relevant high-quality research evidence into the health decision and policy formulation process is a key strategy for improving health systems especially in developing countries such as Zambia. However, the lack of capacity to understand and value research evidence by policy and decision makers makes it difficult for them to find and use research evidence in a timely manner even when motivated to do so. This study aimed to establish the views, attitudes and practices of policy makers on the use of research evidence in policy and decision-making process in Zambia. Methodology: This descriptive cross-sectional study was conducted in Lusaka, Zambia among selected public health decision and policy making institutions. A purposive sample of 21 consenting policy makers who were working in different positions in the Ministry of Health Headquarters, Provincial and District Health Offices, Health Professions Regulatory Bodies, United Nations Agencies, International Non-Governmental Organizations and University Deans from the University of Zambia participated in the study. A self-administered questionnaire was used to collect data. The IBM? SPSS? Statistics for Windows Version 20.0 was used for data analysis. Results: The concept of Evidence Informed Health Policy was not well understood such that only less than half (47.5%) of the participants reported having heard specifically about Evidence Informed Health Policy meanwhile almost two thirds (61.9%) reported that they used research evidence in decision making and policy formulation. Similar discrepancy was expressed in the understanding of and use of rapid response mechanisms such that although (47.6%) of the participants reported having heard about it, (57%) had never used rapid response mechanisms for deci-sion-making. With regard to the sources of information, about half (52.3) of the participants reported scholarly articles as their main source of evidence. Con-clusion and Recommendations: There is need for more sensitization and ca-pacity building among the decision and policy makers on the importance of using research evidence in decision and policy making process as incorporation of relevant high-quality research evidence into the health policy making pro-cess is a key strategy for improving health systems.
文摘Since the first identification in December of 2019 and the fast spread of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection,it has represented a dramatic global public health concern.Though affecting mainly the respiratory system,SARS-CoV-2 disease,defined as coronavirus disease 2019(COVID-19),may have a systemic involvement leading to multiple organ dysfunction.Experimental evidence about the SARS-CoV-2 tropism for the liver and the increasing of hepatic cytolysis enzymes during infection support the presence of a pathophysiological relationship between liver and SARS-CoV-2.On the other side,patients with chronic liver disease have been demonstrated to have a poor prognosis with COVID-19.In particular,patients with liver cirrhosis appear extremely vulnerable to infection.Moreover,the etiology of liver disease and the vaccination status could affect the COVID-19 outcomes.This review analyzes the impact of the disease stage and the related causes on morbidity and mortality,clinical outcomes during SARS-CoV-2 infection,as well as the efficacy of vaccination in patients with chronic liver disease.
文摘Background Many people who are gender variant have undiagnosed gender dysphoria,resulting in delayed receipt of gender-affirming support and prolonged distress in living with their gender-non-conforming sex.The Utrecht Gender Dysphoria Scale-Gender Spectrum(UGDS-GS)is a newly developed tool that measures dissatisfaction with gender identity and expression.However,there is no translated version of this tool in Thai.Moreover,the sensitivity,specificity and cut-off point of the UGDS-GS to detect gender dysphoria in people who are transgender remain unknown.Aims This study translated the UGDS-GS into Thai and then examined the validity and reliability of the Thai UGDS-GS.Methods 185 participants with and without gender dysphoria were selected from the Gender Variation Clinic in Ramathibodi Hospital and from social media platforms.The UGDS-GS was translated into Thai according to the World Health Organization(WHO)guidelines on translation.The medical records of patients with gender dysphoria and semi-structured interviews were used to confirm the diagnosis of gender dysphoria.Subsequently,the validity and reliability of the instrument were analysed.Results The mean age of participants was 30.43(7.98)years among the 51 assigned males(27.6%)and 134 assigned females(72.4%)at birth.The Thai UGDS-GS average score was 77.82(9.71)for those with gender dysphoria(n=95)and 46.03(10.71)for those without gender dysphoria(n=90).Cronbach’s alpha coefficient was 0.962,showing excellent internal consistency.In addition,exploratory factor analysis showed compatibility with the original version’s metrics.The value of the area under the curve was 0.976(95%confidence interval:0.954 to 0.998),indicating outstanding concordance.At the cut-off point of‘60’,sensitivity and specificity were good(96.84%and 91.11%,respectively).Conclusions The Thai UGDS-GS is an excellent,psychometrically reliable and valid tool for screening gender dysphoria in clinical and community settings in Thailand.The cut-off point of‘60’scores suggests a positive indicator or a high chance of gender dysphoria.
文摘Introduction: Diabetes mellitus (DM) is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. It is “a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both” manifested by carbohydrates, fat and protein metabolism abnormality. If untreated high blood sugar can damage the nerves, eyes, kidneys, and other organs. The purpose of this study was to assess the information needs and self-care practice of Diabetic Patients in Mbala, Northern Province Zambia. Methods: This was an analytical cross-sectional study where 105 respondents aged 18 years and above participated in the study. Participants were randomly selected. A structured interview schedule and a check list were used to collect data. Statistics Package for Social Sciences computer software package version 23.0 was used to analyze data. Chi square and fisher’s exact tests were used to test the significance of the association between Knowledge of Diabetes Mellitus, attitude towards self-care practices, self-care practices among Diabetic patients and the need for information among Diabetic patients. A 95% confidence interval and P value of 0.05 were used to ascertain the degree of significance. Multi-variate binary logistic regression model to determine predictors of self-care practices and need for information was also used. Result: On analyzing the dependent variables, more than half (61.9%), had high need for information and three quarters (85.7%) of respondents had poor self-care practices. Slightly more than half (58.1%) had high knowledge levels majority (78.1%), had a negative attitude. Significant associations were found P Conclusion: Negative attitudes and lack of information among Diabetic patients were the main reasons associated with poor self-care practices. Particular attention should therefore be given to ensuring that Diabetic patients are given adequate information on Diabetes self-care in order to improve the quality of life.
文摘Introduction: The addiction to games of chance and money is frequently encountered among some players. The general objective of this study was to describe the level of the gambling addiction among the players of the Togolese National Lottery (LONATO) in the city of Lomé. Method: This was a descriptive cross-sectional study through non-random sampling by convenience surveys, conducted on October 09, 2019 in 20 LONATO plying sites which affected 611 players. The screening was done using the South Oaks Gambling Screen (SOGS) questionnaire. Results: Of the 611 players surveyed, 55% were aged 18 to 35 years with an average age of 36 years and the extremes ranging from 14 to 78 years. The male gender was in the majority (84.26%). The prevalence of pathological gambling was 62.52%. Among the pathological gamblers, 16.89% had a family history of pathological gambling, 19.00% had a mood disorder, 28.50% had excessive alcoholism, and 17.15% consumed another psychoactive substance. Cannabis was the most consumed substance (6.87%) followed by tobacco (6.07%) and soporific (6.07%). More than half of players (62.03%) thought that pathological gambling is not a disease. Conclusion: The pathological gambling is a global phenomenon and a reality in Togo. Raising everyone’s awareness will reduce its negative impact on the players.
文摘Depression,a common mental illness,seriously affects the health of individuals and has deleterious effects on society.The prevention and treatment of depression has drawn the attention of many researchers and has become an important social issue.The treatment strategies for depression include drugs,psychotherapy,and physiotherapy.Drug therapy is ineffective in some patients and psychotherapy has treatment limitations.As a reliable adjuvant therapy,physiotherapy compensates for the shortcomings of drug and psychotherapy and effectively reduces the disease recurrence rate.Physiotherapy is more scientific and rigorous,its methods are diverse,and to a certain extent,provides more choices for the treatment of depression.Physiotherapy can relieve symptoms in many ways,such as by improving the levels of neurobiochemical molecules,inhibiting the inflammatory response,regulating the neuroendocrine system,and increasing neuroplasticity.Physiotherapy has biological effects similar to those of antidepressants and may produce a superimposed impact when combined with other treatments.This article summarizes the findings on the use of physiotherapy to treat patients with depression over the past five years.It also discusses several methods of physiotherapy for treating depression from the aspects of clinical effect,mechanism of action,and disadvantages,thereby serving as a reference for the in-depth development of physiotherapy research.
文摘The complex morphological,anatomical,physiological,and chemical mechanisms within the aging brain have been the hot topic of research for centuries.The aging process alters the brain structure that affects functions and cognitions,but the worsening of such processes contributes to the pathogenesis of neurodegenerative disorders,such as Alzheimer's disease.Beyond these observable,mild morphological shifts,significant functional modifications in neurotransmission and neuronal activity critically influence the aging brain.Understanding these changes is important for maintaining cognitive health,especially given the increasing prevalence of age-related conditions that affect cognition.This review aims to explore the age-induced changes in brain plasticity and molecular processes,differentiating normal aging from the pathogenesis of Alzheimer's disease,thereby providing insights into predicting the risk of dementia,particularly Alzheimer's disease.
文摘Background: Smokeless tobacco is defined as a product that contains tobacco, is not smoked or burned at the time of use, and commonly consumed orally or nasally. These products can be placed in the mouth, cheek or the lip and are sucked or chewed. The Zambian government, in the 2019 country report, gave an estimated figure of 4.5% of females aged 15 years and above in 2017 used smokeless tobacco and by 31st December, 2018, there was an increase of smokeless tobacco users to 6.8% women of the same age group. This study aimed to explore the extent of smokeless tobacco use among women in Kasama district-Zambia. Methodology: An analytical cross-sectional quantitative study design was used to collect data using the modified structured interview schedule, adopted from Medicine for Global Health. Simple random sampling method using rotary technique was used to select 430 respondents after meeting the inclusion criteria. Informed consent to participate in the study was obtained. Data was analysed using version 26.0 of the Statistical Package for Social Sciences. Appropriate parametric or non-parametric statistical tests (Chi-squared or Fisher’s exact test) were adopted in testing for associations between variables. Univariable and multivariable binary logistic regression analysis were employed in identifying smokeless tobacco use among women using an investigator-led stepwise approach, guided by various fit statistics and the likelihood ratio test. All statistical analyses adopted a 5% significance level at 95% confidence interval. Results: The results showed that most of the respondents were aged between 18 and 25 years (45.6%), (53.7%) lived in urban settlements and the majority (80%) were unemployed. The majority of respondents (83.5%) had a friend/relative who used smokeless tobacco and over half (53.5%) thought smokeless tobacco was beneficial to them. The commonly mentioned benefits of smokeless tobacco included body warmth (13.6%) and vaginal tightening (7.9%). The results revealed that most of the respondents attained a secondary level of education (38.4%). According to the study, smokeless tobacco use among women of Kasama-Zambia was significantly associated with the following;age (p Conclusion: Based on these findings, the study recommends that efforts should be channeled towards the dissemination of information on the impacts of smokeless tobacco use in order to overcome cultural beliefs attached to smokeless tobacco use.
基金supported by the National Natural Science Foundation of China,No.30971054,30770770,81171290
文摘A large number of studies have demonstrated that depression patients have cognitive dysfunction. With recently developed brain functional imaging, studies have focused on changes in brain function to investigate cognitive changes. However, there is still controversy regarding abnormalities in brain functions or correlation between cognitive impairment and brain function changes. Thus, it is important to design an emotion-related task for research into brain function changes. We selected positive, neutral, and negative pictures from the International Affective Picture System. Patients with major depressive disorder were asked to judge emotion pictures. In addition, functional MRI was performed to synchronously record behavior data and imaging data. Results showed that the total correct rate for recognizing pictures was lower in patients compared with normal controls. Moreover, the consistency for recognizing pictures for depressed patients was worse than normal controls, and they frequently recognized positive pictures as negative pictures. The consistency for recognizing pictures was negatively correlated with the Hamilton Depression Rating Scale. Functional MRI suggested that the activation of some areas in the frontal lobe, temporal lobe, parietal lobe, limbic lobe, and cerebellum was enhanced, but that the activation of some areas in the frontal lobe, parietal lobe and occipital lobe was weakened while the patients were watching positive and neutral pictures compared with normal controls. The activation of some areas in the frontal lobe temporal lobe, parietal lobe, and limbic lobe was enhanced, but the activation of some areas in the occipital lobe were weakened while the patients were watching the negative pictures compared with normal controls. These findings indicate that patients with major depressive disorder have negative cognitive disorder and extensive brain dysfunction. Thus, reduced activation of the occipital lobe may be an initiating factor for cognitive disorder in depressed patients.
