The "weekend effect" does not impact on outcome of trauma laparotomy - Experience from a level 1 trauma centre in New Zealand / 中华创伤杂志(英文版)

PURPOSE@#Trauma centres have been proven to provide better outcomes in developed countries for overall trauma, but there is limited literature on the systematic factors that describe any discrepancies in outcomes for trauma laparotomies in these centres. This study was conducted to examine and interrogate the effect of systematic factors on patients undergoing a trauma laparotomy in a developed country, intending to identify potential discrepancies in the outcome.@*METHODS@#This was a retrospective study of all laparotomies performed for trauma at a level 1 trauma centre in New Zealand. All adult patients who had undergone an index laparotomy for trauma between February 2012 and November 2020 were identified and laparotomies for both blunt and penetrating trauma were included. Repeat laparotomies and trauma laparotomies in children were excluded. The primary clinical outcomes reviewed included morbidity, length of hospital stay, and mortality. All statistical analysis was performed using R v.4.0.3.@*RESULTS@#During the 9-year study period, 204 trauma laparotomies were performed at Waikato hospital. The majority (83.3%) were performed during office hours (170/204), and the remaining 16.7% were performed after hours (34/204). And 61.3% were performed on a weekday (125/204), whilst 38.7% were performed on the weekend/public holiday (79/204). Most of the parameters in office hours and after hours groups had no statistically significant difference, except lactate (p = 0.026). Most of the variables in weekday and weekend groups had no statistically significant difference, except pH, lactate, length of stay, and gastrointestinal complications (p = 0.012, p < 0.001, p = 0.003, p = 0.020, respectively).@*CONCLUSION@#The current trauma system at Waikato hospital is capable of delivering care for trauma laparotomy patients with the same outcome regardless of working hours or after hours, weekday or weekend. This confirms the importance of a robust trauma system capable of responding to the sudden demands placed on it.

Hemoglobin analysis after overload training in athletes / Análise de hemoglobina após treinamento de sobrecarga em atletas / Análisis de la hemoglobina tras el entrenamiento de sobrecarga en atletas

ABSTRACT Introduction: The cardiovascular system provides athletes with the proper conditions for blood circulation, ensuring the stability and normal metabolism of the body's internal environment during exercise. Objective: Investigate the effect of overload training on the hemoglobin of male taekwondo athletes. Methods: Twenty-one male taekwondo athletes (level 2 or higher) were selected and trained for four weeks, five days per week, with an initial load intensity of 60% of the maximum heart rate and a weekly intensity increase of 10%. Before training and on every weekend during training, hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), reticulocyte count (Ret) were checked, RBC volume distribution width (RDW), hemoglobin content distribution width (HDW), mean reticulocyte volume (MCVr), mean reticulocyte hemoglobin concentration (CHCMr), serum iron (Fe) and ferritin (Fer). Results: After four weeks of increasing load training, athletes showed a progressive and significant decrease in Hb (P<0.01), manifested as exercise-induced hypohemoglobin, and MCV, MCH, MCHC, CHCMr, HDW, and serum ferritin were significantly or extremely decreased(P<0.) 05, P<0.01); RDW increased significantly (P<0.05); Changes in Ret and serum iron showed no statistical significance (P>0.05). Correlation analysis found that hemoglobin concentration had the highest correlation with MCHC and CHCMr. Conclusion: Four-week incremental load training can induce exercise-induced hypohemoglobin in male taekwondo athletes, its changes being most correlated with MCHC and CHCMr, but without significant correlation with serum Fe, RDW, HDW, and MCV. Level of Evidence: Therapeutic Studies -Investigation of Outcomes.

RESUMO Introdução: O sistema cardiovascular fornece aos atletas as condições propícias para a circulação sanguínea, garantindo a estabilidade e o metabolismo normal do ambiente interno corporal durante o exercício. Objetivo: Investigar o efeito do treinamento em sobrecarga sobre a hemoglobina dos atletas masculinos de Taekwondo. Métodos: Vinte e um atletas masculinos de taekwondo (nível 2 ou superior) foram selecionados e treinados durante 4 semanas, 5 dias por semana, com uma intensidade de carga inicial de 60% da frequência cardíaca máxima e um aumento de intensidade semanal de 10%. Antes do treinamento e em todos os fins de semana durante o treinamento, foi verificada a hemoglobina (Hb), volume corpuscular médio (MCV), hemoglobina corpuscular média (MCH), concentração corpuscular média de hemoglobina (MCHC), contagem de reticulócitos (Ret), largura de distribuição do volume de hemácias (RDW), largura de distribuição do conteúdo de hemoglobina (HDW), volume médio de reticulócitos (MCVr), concentração média de hemoglobina reticulócitos (CHCMr), ferro sérico (Fe) e ferritina (Fer). Resultados: Após 4 semanas em treinamento de carga crescente, os atletas mostraram uma diminuição progressiva e significativa em Hb(P<0,01), manifestada como hipohemoglobina induzida por exercício, e MCV, MCH, MCHC, CHCMr, HDW, e ferritina sérica foram significativamente ou extremamente diminuídos(P<0). 05, P<0,01); RDW aumentou significativamente (P<0,05); Alterações de Ret e ferro sérico não apresentaram significância estatística (P>0,05). A análise de correlação constatou que a concentração de hemoglobina teve a maior correlação com MCHC e CHCMr. Conclusão: O treinamento de carga incremental de quatro semanas pode induzir hipohemoglobina induzida por exercício em atletas taekwondo masculinos, sendo suas alterações mais correlacionadas com MCHC e CHCMr, mas sem correlação significativa com Fe sérico, RDW, HDW e MCV. Nível de evidência: Estudos Terapêuticos -Investigação dos Resultados.

RESUMEN Introducción: El sistema cardiovascular proporciona a los deportistas las condiciones propicias para la circulación sanguínea, garantizando la estabilidad y el metabolismo normal del medio corporal interno durante el ejercicio. Objetivo: Investigar el efecto del entrenamiento de sobrecarga en la hemoglobina de los atletas masculinos de taekwondo. Métodos: Se seleccionaron 21 atletas masculinos de taekwondo (de nivel 2 o superior) y se entrenaron durante 4 semanas, 5 días a la semana, con una intensidad de carga inicial del 60% de la frecuencia cardíaca máxima y un aumento semanal de la intensidad del 10%. Antes del entrenamiento y cada fin de semana durante el mismo, se comprobó la hemoglobina (Hb), el volumen corpuscular medio (MCV), la hemoglobina corpuscular media (HCM), la concentración de hemoglobina corpuscular media (MCH) y el recuento de reticulocitos (Ret), Anchura de distribución del volumen de glóbulos rojos (RDW), anchura de distribución del contenido de hemoglobina (HDW), volumen reticulocitario medio (MCVr), concentración media de hemoglobina reticulocitaria (CHCMr), hierro sérico (Fe) y ferritina (Fer). Resultados: Después de 4 semanas de entrenamiento con carga creciente, los atletas mostraron una disminución progresiva y significativa de la Hb (P<0,01), que se manifestó como hipohemoglobina inducida por el ejercicio, y el MCV, el MCH, el MCHC, el CHCMr, el HDW y la ferritina sérica disminuyeron de forma significativa o extrema (P<0,01). 05, P<0,01); el ADE aumentó significativamente (P<0,05); los cambios en el Ret y el hierro sérico no mostraron significación estadística (P>0,05). El análisis de correlación encontró que la concentración de hemoglobina tenía la mayor correlación con MCHC y CHCMr. Conclusión: El entrenamiento de carga incremental de cuatro semanas puede inducir hipohemoglobina inducida por el ejercicio en atletas masculinos de taekwondo, siendo sus cambios los más correlacionados con MCHC y CHCMr, pero sin correlación significativa con el Fe sérico, RDW, HDW y MCV. Nivel de evidencia: Estudios terapéuticos - Investigación de resultados.

Effect of screen time on sleep in preschool children in Haikou City / 中国学校卫生

Objective@#To understand the impact of screen time on duration and quality of sleep, so as to provide scientific basis for the development of interventions.@*Methods@#A total of 3 584 preschool children in Haikou City were selected by stratified sampling method from March to June in 2022, and the Children s Sleep Habits Questionnaire (CSHQ) and self designed questionnaire were used.@*Results@#The average sleep duration of preschool children was (10.41±0.98)h/d, the rate of sleep deprivation was 28.71 %, and the report rate of sleep problems was 50.47%. The average sleep duration in general as well as on weekdays and weekends decreased by age ( F=21.00, 29.53, 3.26, P ＜0.05), and insufficient sleep duration rate significantly varied by age groups ( χ 2=29.85, P ＜ 0.01 ). The average screen time was (1.15±0.37)h/d, and the screen exposure rate was 55.39%. The total sleep problems ( 52.14 %), poor bedtime habits (43.02%), daytime sleepiness (67.10%), irregular sleep duration (53.05%), and abnormal sleep latency ( 24.99 %) were all higher than those in the non exposed group (48.41%, 39.59%, 63.29%, 48.91%, 19.57 %) ( χ 2= 4.94 , 4.31, 5.69 , 6.08, 14.85, P <0.05). Multiple linear regression analysis showed that age and weekend average screen time were negatively associated with sleep duration ( β =-0.01, -0.06), weekday and weekend average outdoor activity duration were positively correlated with sleep duration ( β =0.08, 0.08) ( P <0.05).@*Conclusion@#Screen exposure to preschool children s sleep time,sleep quality was closely related. Parents should cultivate good sleep habits of preschool children, and limit children s screen time to maximize outdoor activities, so as to ensure healthy development of children.

Effect of a blended learning mode of sleeping intervention for college freshmen / 中国学校卫生

Objective@#To explore the impact of sleep education programs on freshman sleep time, knowledge, attitudes, behavior and daytime sleepiness, so as to provide a reference for further improving the sleep status of college students.@*Methods@#By using the method of cluster sampling, freshmen were invited from a university in Beijing (288 at baseline, 187 at posttest and 108 at follow up for experimental group (EG); 207 at baseline and 105 at posttest for control group (CG). The sleep education content was embedded into other courses and implemented in a blending learning mode for EG, lasting 10 weeks, while the CG received no intervention. Both groups were assessed using questionnaires at both baseline and 2 weeks after the intervention, and reassessed at 9 months follow up after posttest for EG.@*Results@#After intervention, compared with CG, the weekday and weekend bedtime in EG was 21 min and 17 min earlier than that in CG respectively ( t=-2.78, -2.15, P <0.05). The sleep duration at night on weekday in EG was 19 min longer than that in CG ( t=3.51, P<0.01). In EG, the phenomenon of going to bed with electronic products before sleep, no delay in falling asleep, sleep knowledge, sleep attitude, sleep habit and daytime sleepiness were significantly better than those in CG ( χ 2/t =9.15, 2.82, 5.71, 3.98, 2.41, -4.90, P <0.05). After intervention, comparing with that at baseline, the weekday and weekend bedtime in EG were significantly earlier by 11 min and 17 min respectively ( t=3.50, 3.67, P <0.01), the sleep duration at nights on weekdays and weekend increased by 13 min and 18 min, respectively ( t=-3.01, -3.67, P <0.05), and the daytime sleepiness, going to bed with electronic products before sleep, no delay in falling asleep, sleep knowledge, sleep attitude and sleep habit were significantly improved ( χ 2/t =4.64, 15.19, -2.08, -9.31, -3.28, -2.14, P<0.05). At the 9 months follow up after the posttest, the bedtime on working day was significantly advanced by 8 min ( t =2.00), the sleep duration at night on working day was prolonged by 9 min ( t =-2.15), and the phenomenon of going to bed with electronic products before sleep and sleep knowledge were still significantly improved( χ 2/t =21.50, -6.26)( P <0.05).@*Conclusion@#Sleep education programs embedded in other courses and implemented in a blending learning mode can improve students sleep knowledge, sleep attitude and some habits, and reduce daytime sleepiness.

Differences in mechanical thrombectomy for acute ischemic stroke on weekdays versus nights/ weekends in a Japanese primary stroke core center

Objective@#The term “weekend effect” refers to an increase in the mortality rate for hospitalizations occurring on weekends versus weekdays. In this study, we investigated whether such an effect exists in patients undergoing mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (currently the standard treatment for this condition) at a single center in Japan. @*Methods@#We surveyed 151 patients who underwent mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (75 and 76 patients were treated during daytime and nighttime, respectively) from January 2019 to June 2021. The items evaluated in this analysis were the rate of modified Rankin Scale ≤2 or prestroke scale, mortality, and procedural treatment time. @*Results@#The rates of modified Rankin Scale ≤2 or prestroke scale and mortality at 90 days after treatment did not differ significantly between daytime and nighttime (41.3% vs. 29.0%, p=0.11; 14.7% vs. 11.8%, p=0.61, respectively). The door-to-groin time tended to be shorter during daytime versus nighttime (57 [IQR: 42.5–70] min vs. 70 [IQR: 55–82]) min, p=0.0507). @*Conclusions@#This study did not reveal differences in treatment outcome between daytime and nighttime in patients undergoing mechanical thrombectomy for acute ischemic stroke with large vessel occlusion. Therefore, the “weekend effect” was not observed in our institution.

Effects of horticultural therapy on social function for elderly inpatients with cognitive dysfunction / 中华行为医学与脑科学杂志

Objective:To investigate the effect of horticultural therapy on social function of elderly inpatients with cognitive dysfunction.Methods:Ninety inpatients with cognitive dysfunction who met the diagnostic criteria of ICD-10 were randomly divided into horticultural research group and control group, with 45 patients in each group.Finally, totally 82 completed the test with 41 in each group.Patients in the two groups were both given drug therapy according to clinical symptoms.At the same time, patients in the research group were given horticultural therapy 3 times a week, 90 minutes each section, for 12 weeks.Scale of social function in psychosis inpatients(SSPI) was used to assess the social function of the patients in the two groups were at baseline, 4, 8 and 12 weekends of the treatment.SPSS 25.0 software was used to conduct chi-square test and independent sample t-test for demographic data of the two groups, and repeated measures ANOVA was performed for SSPI score. Results:The results of repeated measure analysis of variance showed that the group main effect ( F=7.226, F=13.428, F=24.817, F=19.793) and interaction effect between time and group were all statistically significant ( F=29.644, F=42.937, F=53.246, F=67.215)(all P<0.01) in daily living ability (factor Ⅰ), mobility and interaction (factor Ⅱ), social activity skills score (factor Ⅲ) and total score.Simple effect analysis showed there were no statistically significant differences in each factor score and total score between the two groups at the baseline ( P>0.05), and there were statistically significant differences in each factor scores and total score at the end of the 8th weekend ((9.95±2.41), (10.39±3.38), (6.56±3.24), (26.90±7.88) vs (8.10±2.45), (6.88±3.48), (2.81±2.50), (17.78±6.96))and 12th weekend((10.27±2.16), (11.61±3.07), (7.88±3.08), (29.76±7.40) vs (7.56±2.41), (5.78±3.21), (2.34±2.02), (15.68±6.24)) (all P<0.01). The pair-to-pair comparison within the group showed that the differences in factor Ⅱ, factor Ⅲ and total score of the research group at the end of the 12th weekend ((11.61±3.07), (7.88±3.08), (29.76±7.40)) were higher than those at the baseline((8.59±3.93), (4.56±3.32), (22.02±8.35)), 4th weekend((9.07±4.14), (5.12±3.35), (23.59±8.51)), and 8th weekend((10.39±3.38), (6.56±3.24), (26.90±7.88))(all P<0.05). Factor Ⅰ (10.27±2.16) showed a statistically significant difference compared with the baseline (8.88±2.65) and 4th weekend (9.39±2.63)(both P<0.05). All the scores showed an upward trend. Conclusion:Horticultural therapy can improve the social function of elderly inpatients with cognitive impairment.

Proposal to establish a hospital dedicated for surgical essential medicines: a pilot project to strengthen the essential medical service in Korea

In December 2022, the Ministry of Health and Welfare of the Korean government announced the “action plan for essential medicine (EM),” featuring that the regional emergency centers in tertiary general hospitals would be responsible for emergency medical care. There have been several limitations in regional emergency centers because of lacking operating rooms, intensive care units, and wards during weekdays and surgery staff during the nighttime and holidays. Thus, this plan may be insufficient to achieve the goal.Current Concepts: This paper proposes special hospitals for EM, especially essential surgery in which there are no scheduled surgeries and outpatient clinics during weekdays. At least half of wards should be reserved for EM patients because of lacking wards, and these empty wards should be financially rewarded. During weekends, a team of five surgical specialists works 16 h per day to prevent the so-called weekend or Friday effect because of lacking surgeons. The special hospital would operate 365 days and 24 hours with an EM surgeon pool in the digital twin system—virtual and real hospitals (so-called smart essential surgery metaverse hospital).Discussion and Conclusion: This paper proposes a pilot project to establish a smart essential surgery metaverse hospital to compare the efficiency of EM with the regional emergency centers in tertiary general hospitals.

Effect of start time of surgery on short-term prognosis in patients undergoing elective cardiac surgery with cardiopulmonary bypass / 中华麻醉学杂志

Objective:To evaluate the effect of start time of surgery on short-term prognosis in the patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB).Methods:A total of 928 patients of both sexes, aged 18-81 yr, with body mass index of 14.5-37.7 kg/m 2, scheduled for elective cardiac surgery with CPB from November 14, 2019 to May 14, 2020, were selected.Based on the start time of skin incision, the patients were divided into morning group (08: 00-13: 59) and afternoon group (14: 00-20: 00) or into on-hour group (08: 00-15: 59 on weekday) and off-hour group (16: 00-20: 00 on weekday, 08: 00-20: 00 on weekend). Propensity score matching was used to calibrate confounding factors.The primary outcomes were 30-day mortality and serious cardiovascular and cerebrovascular events after surgery.Secondary outcomes included the development of acute kidney injury within 3 days after surgery and development of pulmonary complications within 30 days after surgery, occurrence of surgical site infection, postoperative length of hospital stay, length of intensive care unit stay and duration of mechanical ventilation, and total hospitalization costs. Results:There was no significant difference in 30-day mortality and serious cardiovascular and cerebrovascular events after surgery, development of acute kidney injury within 3 days after surgery, and incidence of pulmonary complications within 30 days after surgery and of surgical site infection, postoperative length of hospital stay, length of intensive care unit stay and duration of mechanical ventilation, and total hospitalization costs between morning group and afternoon group and between on-hour group and off-hour group ( P>0.05). Conclusions:The start time of surgery exerts no effect on short-term prognosis in the patients undergoing elective cardiac surgery with CPB.

The Association Between Weekend Catch-Up Sleep and Depression by Age Group in Korean Adults / 정신신체의학

Objectives@#：We aimed to explore weekend catch-up sleep (CUS) by age and to find out the association between CUS and depression by the age group and weekday sleep duration (SD). @*Methods@#：Using data from the 2016-2018 Korean National Health and Nutrition Examination Survey, the CUS by age of 16,174 subjects was investigated, and the depression data of 11,088 subjects were analyzed. CUS was calculated as the weekend sleep duration minus weekday sleep duration (SD). The mean of CUS and weekday SD in depression group and non-depression group was compared by early, middle, and late adulthood groups, and logistic regression analysis was performed to investigate the effect of CUS on the depression by age group when weekday SD was insufficient. @*Results@#：The CUS tended to decrease continuously with age, the mean of CUS in the late adult group was the shortest. However, the average SD, adjusted for weekend CUS, was the shortest in the middle adulthood group. Overall, the sleep durations were shorter in the depression group than in the non-depression group, but the CUS difference between the two groups was significantly only in the middle adulthood. The risk of depression was signifi-cantly higher when weekend CUS was less than 1hour with a short weekday SD of less than 6hours (OR 2.44, 95% CI: 1.78-3.35), and this finding was significant in all adult groups. @*Conclusions@#：The findings of this study suggest that short weekday SD and inadequate weekend CUS are as-sociated with depression and that CUS is an option to compensate for sleep deprivation and prevent depression.

El "efecto fin de semana" en pacientes que asisten a urgencias por hemorragia digestiva superior no varicosa. La experiencia en un hospital de alta complejidad / The "Weekend Effect" in patients admitted to the Emergency Unit with non-variceal upper gastrointestinal bleeding. A high-complexity hospital experience

Resumen Introducción y objetivos: el "efecto fin de semana" se define como un incremento en la mortalidad en pacientes que ingresan a centros asistenciales durante el fin de semana o días festivos. Este estudio se realizó para evaluar el posible "efecto fin de semana" en pacientes con hemorragia digestiva superior (HDS) con base en una experiencia de 3 años en un hospital de alta complejidad en Latinoamérica. Materiales y métodos: estudio observacional descriptivo realizado entre 2016 y 2018. Se describieron las características demográficas, factores de riesgo, síntomas de ingreso, hallazgos endoscópicos y diferentes intervenciones médicas. Además, se compararon los tiempos de realización de endoscopia, estancia hospitalaria y mortalidad entre los pacientes admitidos durante el fin de semana frente a días entre semana. Resultados: el análisis incluyó 274 pacientes en fines de semana y festivos (39,1 %) frente a pacientes en días entre semana (60,9 %). La mediana de edad fue de 68,5 años (rango intercuartílico [RIC]: 53-79), el 56,6 % fueron hombres. Las manifestaciones más comunes fueron melenas y hematemesis. La úlcera péptica fue el diagnóstico endoscópico más común (48,7 %). Los tiempos de estancia hospitalaria (7,38 ± 8,7 frente a 7,38 ± 7,1; p = 0,234) y mortalidad (1,9 % frente a 4,2 %; p = 0,274) fueron similares en ambos grupos. Se realizó una mayor cantidad de endoscopias después de las 24 horas en pacientes ingresados el fin de semana (19,6 % frente a 9,6 %; p = 0,041). Conclusiones: en esta cohorte no se presentó el "efecto fin de semana", no se observan diferencias en relación con la estancia hospitalaria, ni con la mortalidad en pacientes ingresados por HDS.

Abstract Introduction and Objectives: The "Weekend Effect" refers to an increase in mortality of patients admitted to health care centers on weekends or holidays. This study was performed to assess the impact of weekend admissions in patients with upper gastrointestinal bleeding (UGIB) based on a three year-experience in a high-complexity hospital in Latin America. Materials and Methods: A descriptive observational study was performed between 2016 and 2018. Data on demographic characteristics, risk factors, symptoms, endoscopic findings, and medical treatment was described. Moreover, the time to perform an endoscopy, the length of hospital stay, and the mortality level among patients admitted on weekends were compared with the same factors during the week. Results: The analysis included 274 patients admitted during the weekend and holidays (39.1%) versus patients admitted during the week (60.9%). The median age was 68.5 years old (interquartile range [IQR]: 53-79), and 56.6% were men. The most common conditions were tarry stools and hematemesis. Peptic ulcer was the most common endoscopic diagnosis (48.7%). Similar results were found in the length of hospital stay (7,38 ± 8,7 versus 7,38 ± 7,1; p = 0,234) and mortality groups (1,9 % versus 4,2 %; p = 0,274). A higher number of endoscopies 24 hours after the patient was admitted was performed (19,6 % versus 9,6 %; p = 0,041). Conclusions: The "Weekend Effect" was not present in the analyzed group, and there are no significant differences related to the length of hospital stay or the mortality of patients diagnosed with UGIB.

Efficacy of sertraline combined with low-dose olanzapine in patients with depression and anxiety comorbidity / 四川精神卫生

ObjectiveTo observe the efficacy and safety of sertraline combined with low-dose olanzapine in the treatment of depression and anxiety comorbidity and its effect on sleep quality， so as to provide references for the related clinical treatment. MethodsA total of 121 patients who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for depressive episode and generalized anxiety disorder in The Third People's Hospital of Tianshui and the Sanatorium for Mental Illness of Veterans in Tianshui from October 2019 to August 2020 were enrolled， and they were divided into two groups according to the random number table method. Study group （n=61） received sertraline combined with low-dose olanzapine， while control group （n=60） received sertraline only. Then the disease severity degree， sleep quality and adverse reactions were assessed using Hamilton Depression Scale - 17 item （HAMD-17）， Hamilton Anxiety Scale （HAMA）， Pittsburgh Sleep Quality Index （PSQI） and Treatment Emergent Symptom Scale （TESS） at the baseline， 1st， 2nd， 4th， 6th and 8th weekend， respectively. ResultsPost-treatment HAMD-17， HAMA and PSQI scores in both groups were lower than those before treatment （P<0.05）. At each time point after treatment， HAMD-17， HAMA and PSQI scores of study group were lower than those of control group， with statistical significance （P<0.05）. ConclusionSertraline alone and its combination with low-dose olanzapine are both effective in the treatment of depression and anxiety comorbidity， while the combination therapy achieves better efficacy and higher safety in alleviating anxiety and insomnia symptoms.

Compliance with Recommendations on Work Schedule for Shift Nurses in South Korea

Background@#A well-designed shift schedule has been reported to have a positive effect on improving health problems associated with shift work. This study aimed to identify compliance with the 17 recommendations on work schedule (WSRs) for shift nurses and related factors. @*Methods@#The descriptive study was conducted with 182 nurses who worked in three shifts for more than 1 year at superior general and general hospitals in three regions. Data were collected with self-administered questionnaire and 13-week work schedule tables, and analyzed with both person- and cycle-based compliance. @*Results@#Person-based compliance was 11.77 among 17 items in total. However, no one completely complied with WSRs of “no work on weekends” and which showed the lowest cycle-based compliance (22.3%). Compliance with some WSRs was related to hospital type, proportion of nurses in school and having standards on work schedule at institutional level. @*Conclusion@#Compliance with WSRs of shift nurses in Korea is still unsatisfactory, and one day off after night shift and work on weekend are quite common. Hospitals should keep the standards on work schedule, monitor compliance with standards, and try to introduce modified shift systems to improve the current problems.

Compliance with Recommendations on Work Schedule for Shift Nurses in South Korea

Background@#A well-designed shift schedule has been reported to have a positive effect on improving health problems associated with shift work. This study aimed to identify compliance with the 17 recommendations on work schedule (WSRs) for shift nurses and related factors. @*Methods@#The descriptive study was conducted with 182 nurses who worked in three shifts for more than 1 year at superior general and general hospitals in three regions. Data were collected with self-administered questionnaire and 13-week work schedule tables, and analyzed with both person- and cycle-based compliance. @*Results@#Person-based compliance was 11.77 among 17 items in total. However, no one completely complied with WSRs of “no work on weekends” and which showed the lowest cycle-based compliance (22.3%). Compliance with some WSRs was related to hospital type, proportion of nurses in school and having standards on work schedule at institutional level. @*Conclusion@#Compliance with WSRs of shift nurses in Korea is still unsatisfactory, and one day off after night shift and work on weekend are quite common. Hospitals should keep the standards on work schedule, monitor compliance with standards, and try to introduce modified shift systems to improve the current problems.

Continuous monitoring of fine particulate matter in school classrooms and assessment of students exposure level / 中国学校卫生

Objective@#To explore the status of PM 2.5 pollution in school classrooms and the student exposure level, and to provide basic data to safeguard the health of students.@*Methods@#This study continuously monitored the PM 2.5 levels of 16 naturally ventilated classrooms in eight primary and secondary schools in Jiamusi for one academic year using an online environmental monitoring instrument. At the same time, outdoor PM 2.5 data was captured for comparative research, and student exposure to PM 2.5 during school hours was evaluated.@*Results@#The average concentration of PM 2.5 in the classroom in the spring and autumn semesters was (26.93±24.7) and (31.85±30.37)μg/m 3, respectively, and the indoor/outdoor ratio ( I/O ) was 0.92 and 0.95, respectively, which indicated a strong correlation between them. The daily average concentration of all classrooms during both semesters was ( 28.93 ±26.85)μg/m 3, which was slightly higher than the average concentration of (27.53±26.53)μg/m 3 during the daytime when students were in school. In addition, the concentration on workdays was higher than that observed on weekends, and this was termed the "weekend effect". The indoor PM 2.5 concentration was lower on higher floors. The comprehensive exposure concentration of students during school was 28.48 μg/m 3 in spring semester and 31.87 μg/m 3 in autumn semester.@*Conclusion@#PM 2.5 levels in the classrooms varied according to time, the horizontal space, and the vertical space, and the level of indoor PM 2.5 pollution largely depended on outdoor pollution sources. Differences in PM 2.5 exposure were observed between.

Study on the effect of optimized dosing regimen of atropine on the treatment of myopia in guinea pigs / 药学实践杂志

Objective To study the effect of optimized atropine administration regimen on myopia in guinea pigs. Methods Forty six 21-day old guinea pigs were used for this study. Six were randomly selected as blank control, and the remaining 40 were randomly divided into 5 intervention groups: 1% atropine group, 0.01% atropine group, optimized group 1, optimized group 2, and saline group. One eye of the guinea pig in the intervention groups was randomly selected as the model eye and given form deprivation, and the contralateral eye was the self-control. The duration of intervention was 4 weeks. The diopter and axial length of guinea pig eyes were measured before the experiment and at each weekend. Choroid and sclera were measured after the experiment. Results The diopter of the model eyes in the 0.01% atropine group decreased rapidly. There was a significant difference before and after the experiment [(2.82±1.35)D vs (−0.64±0.20)D, P<0.01]. The diopter of model eyes decreased in 1% atropine group and optimized group 1, and the difference was statistically significant [(3. 50±1.14)D vs (1.38±1.15)D, P<0.05; (3.55±1.85)D vs (0.95±1.90)D, P<0.01]. In optimized group 2, the diopter of model eyes decreased, and there was no significant difference before and after the experiment [(1.36±1.61)D vs (2.93±1.42)D, P>0.05). After form deprivation, the axial length in 1% atropine group did not change significantly (P>0.05). The axial length in other intervention groups was extended to varying degrees. The thickness of choroid and sclera in 1% atropine group, optimized group 1 and optimized group 2 were greater than that in 0.01% atropine group. Conclusion The two optimized dosing regimens worked better than 0.01% atropine in inhibiting myopia in guinea pigs with form deprivation, and were similar to 1% atropine.

Tempo de prática de atividade física de intensidade moderada a vigorosa e marcadores de síndrome metabólica em adolescentes / Time of practice of moderate to vigorous physical activity and markers of metabolic syndrome in adolescents

Intervenções envolvendo aumento da atividade física em adolescentes mostram-se promissoras em relação à redução de fatores de risco para a síndrome metabólica (SM). Entretanto, ainda não está bem estabelecido o efeito decorrente do acúmulo da atividade física nos dias de semana, final de semana e total. O objetivo do presente estudo foi verificar a correlação da prática de atividade física de intensidade moderada à vigorosa (AFMV), nos dias de semana (AFMV-DS), final de semana (AFMV-FS) e total (AFMV-T), com a SM e seus fatores. Foram avaliados 109 adolescentes de 10 a 16 anos de idade (66% do sexo feminino). A SM foi definida pelos marcadores: circunferência da cintura (CC), pressão arterial (PA), triglicérides, HDL-C e glicemia em jejum. O tempo em AFMV foi mensurada por acelerômetros ActiGraph modelo GT3X (≥ 4 dias de uso, sendo ≥ 1 de final de semana, ≥ 10 horas/dia de uso). O coeficiente de correlação de Spearman foi utilizado para a verificação da associação entre o escore "z" da prática de atividade física (AFMV-DS, AFMV-FS e AFMV-T) com o escore de cada fator da SM e o escore de SM (média dos fatores da SM). Foi verificada correlação inversa entre AFMV-FS e CC (rho = -0,20), PA sistólica (rho = -019) e SM (rho = -0,20). A AFMV-T apresentou correlação inversa com triglicerídeos (rho = -0,19). As magnitudes das correlações revelam pouco ou nenhum efeito. Conclui-se que de forma geral a AFMV parece apresentar pouca correlação com a SM e seus fatores, mas pode ter alguma contribuição em estratégias multifatoriais de tratamento ou prevenção

Interventions involving increased physical activity in adolescents are promising in terms of reducing risk factors for metabolic syndrome (MS). However, is not well established the effect resulting from the accumula-tion of physical activity on weekdays, weekends and total. The objective of the present study was to verify the correlation between moderate-to-vigorous physical activity (MVPA), on weekdays (MVPA-WD), weekend days (MVPA-WE) and total (MVPA-T), with SM and its factors. 109 adolescents aged 10 to 16 years (66% female) were evaluated. MS was defined by the markers: waist circumference ( WC), blood pressure (BP), triglycerides, HDL-C and fasting blood glucose. MVPA time was measured by ActiGraph accelerators model GT3X (≥ 4 days of use, ≥ 1 at the weekend, ≥ 10 hours/day of use). Spearman's correlation coefficient was used to verify the association between the "z" score of physical activity (MVPA-WD, MVPA-WE and MVPA-T) with the "z" score of each of the SM factors and the SM score (mean of SM factors). An inverse correlation was found between MVPA-WE and WC (rho = -0.20), systolic BP (rho = -019) and SM (rho = -0.20). MVPA-T showed an inverse correlation with triglycerides (rho = -0.19). The magnitudes of the cor-relations reveal little or no effect. It is concluded that, in general, MVPA seems to have little correlation with MS and its factors, but it could have some contribution in multifactorial treatment strategies or prevention

Impact of physical activity during weekdays and weekends on fat mass among adults: 12-month cohort study

ABSTRACT BACKGROUND: Physical activity (PA) practices seem to differ between weekdays and weekends and these pattern changes can affect body fat differently. However, previous studies did not assess the mediation effect of weekday and weekend PA on maintenance of body fat using sophisticated statistical models. OBJECTIVE: To analyze the mediation effect of PA during weekdays and weekends on maintenance of fat mass over a 12-month follow-up. DESIGN AND SETTING: Longitudinal cohort study (12 months) conducted at a public university in Presidente Prudente, Brazil. METHODS: A sample of 225 adults (117 females) was used. Body fatness and fat mass were assessed using dual-energy X-ray absorptiometry. PA levels were assessed using a pedometer. The statistical analysis consisted of paired-sample t tests, independent-sample t tests, Pearson correlations and mediation models. RESULTS: After 12 months, weekend PA had decreased while body composition indicators remained stable (without changes). The correlation between fat mass at baseline and follow-up was high for both sexes (men: 0.966; women: 0.941; P-value = 0.001 for both). Moreover, PA indices were inversely but moderately related to fat mass at baseline and follow-up. Lastly, weekend PA mediated the association between fat mass at baseline and follow-up (P-value < 0.05) by around 2% and 4%. CONCLUSION: Weekend PA mediated the association between fat mass at baseline and fat mass after one year of follow-up among these adults. Further studies are required to investigate the association between physical activity, body fat and other variables such as dietary patterns and sleep time.

Efeito do dia e do número de dias de aplicação na reprodutibilidade de um questionário de avaliação do consumo alimentar de escolares / Effect of the day and the number of days of application on reproducibility of a questionnaire to assess the food intake in schoolchildren

RESUMO: Introdução: O questionário de Consumo Alimentar e Atividade Física de Escolares (Web-CAAFE) foi desenvolvido para o monitoramento da dieta e atividade física de escolares brasileiros. Este estudo buscou avaliar o efeito do dia da semana e do número de aplicações na reprodutibilidade do Web-CAAFE. Metodologia: Escolares do 2º ao 5º ano (n = 197) de Florianópolis preencheram o Web-CAAFE por duas vezes no mesmo dia, dos quais 113 o fizeram em três dias não consecutivos. Avaliou-se a reprodutibilidade por meio da correlação intraclasse (CCI) e da regressão logística, para avaliação dos fatores associados à pior reprodutibilidade. Resultados: Observaram-se piores resultados de reprodutibilidade para o preenchimento do consumo nos finais de semana em relação àqueles que responderam em dias da semana (odds ratio - OR = 2,93; p = 0,045) e melhores resultados em meninas em relação aos meninos (OR = 0,29; p < 0,001). O preenchimento do consumo realizado nos segundo e terceiro dias apresentou melhor reprodutibilidade que o realizado no primeiro. Esses resultados são relevantes para o planejamento de futuros estudos que utilizem instrumentos de consumo alimentar em crianças, em especial sobre avaliação de sua validade e reprodutibilidade. Conclusões: Os resultados sugerem que pelo menos dois dias de aplicação do Web-CAAFE fornecem resultados aceitáveis de reprodutibilidade, e que o preenchimento referente ao fim de semana pode reduzi-la.

ABSTRACT: Introduction: The Food Intake and Physical Activity of School Children (Web-CAAFE) is an online questionnaire developed to monitor the diet and physical activity of Brazilian schoolchildren. The study aimed to evaluate the effect of the day of the week and the number of applications on Web-CAAFE reproducibility. Methods: Schoolchildren in grades 2 to 5 of two municipal schools in Florianópolis (n = 197) filled out the Web-CAAFE twice in the same day, of which 113 filled out the instrument in three non-consecutive days. The analysis was performed using the intraclass correlation (ICC) and logistic regression was used to evaluate the factors associated with poor reproducibility. Results: The reproducibility of the questionnaire was significantly lower for children who filled out their consumption mostly on weekends in relation to weekdays (OR = 2.93; p = 0.045), and was significantly better in girls in relation to boys (OR = 0.29; p< 0.001). Higher CCI was observed on the second and third day of Web-CAAFE application in relation to the first day. These results are relevant for planning future studies that use dietary assessment instruments in children, especially on evaluation of their validity and reproducibility. Conclusions: The results suggest that at least two days provides acceptable reproducibility results of the Web-CAAFE and that the weekend recall may reduce the reproducibility.

Effects of relative bedrest condition Morita therapy on personality characteristics and efficacy of patients with recurrent depressive disorder / 中华行为医学与脑科学杂志

Objective:To investigate the effect of Relative Bedrest Condition Morita Therapy(RBCMT) on the improvement of depression and anxiety symptoms and personality in patients with recurrent depression disorder.Methods:Seventy patients with recurrent depressive disorder hospitalized in Kailuan Mental Health Center were randomly divided into study group and control group( n=35 in each group) from June to October, 2019.The study group was given RBCMT on the basis of conventional treatment and nursing.The Eysenck personality questionnaire (EPQ), Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to assess the clinical symptoms and personality characteristics of the patients and to analyze and compare them. Results:(1) EPQ score in each dimension: There were significant differences within group among different time in introverted and extroverted dimension (study group: baseline: 46.14±10.99, the fifth weekend: 50.43±8.86, the eighth weekend: 53.86±7.08, F=6.291, P=0.003.Control group: baseline: 45.29±8.99, the fifth weekend: 48.29±8.31, the eighth weekend: 50.29±7.57, F=3.211, P=0.044) and neuroticism dimension score (study group: baseline: 60.14±5.49, the fifth weekend: 53.29±4.53, the eighth weekend: 50.57±4.33, F=36.809, P<0.001.Control group: baseline: 60.29±6.18, the fifth weekend: 55.86±6.00, the eighth weekend: 53.14±5.30, F=13.353, P<0.001) among different time points in the group.Neuroticism scores between the two groups at the same time were statistically significant(the fifth weekend: F=4.095, P=0.047, the eighth weekend: F=4.940, P=0.030). After 8 weeks of inclusion, there was a statistically significant difference between the two groups in the score of introverted and extroverted dimension ( F=4.157, P=0.045). There was no significant difference in the score of spiritual quality dimension at different time within the group or at the same time point between the groups.(2)HAMD score: There were statistically significant differences within group among different time(study group: baseline: 32.00±4.04, the fifth weekend: 15.23±5.01, the eighth weekend: 9.31±3.15, F=282.376, P<0.001.Control group: baseline: 31.91±4.59, the fifth weekend: 17.86±5.11, the eighth weekend: 11.17±3.64, F=195.019, P<0.001), and the differences between the two groups at the same time were statistically significant (the fifth weekend: F=4.724, P=0.033, the eighth weekend: F=5.205, P=0.026). (3)HAMA score: There were statistically significant differences within group among different time(study group: baseline: 18.69±8.87, the fifth weekend: 10.34±5.34, the eighth weekend: 7.97±2.98, F=28.679, P<0.001.Control group: baseline: 18.60±8.02, the fifth weekend: 13.31±6.35, the eighth weekend: 10.37±4.86, F=14.241, P<0.001). The difference between the two groups at the same time point was statistically significant (the fifth weekend: F=4.161, P=0.045, the eighth weekend: F=8.315, P=005). (4)Multiple linear regression results indicated that RBCMT ( β=-0.312, t=-2.360, P=0.022) and introverted and extroverted dimension personality ( β=-0.334, t=-2.355, P=0.022) were the influencing factors of HAMA. Conclusion:Compared with the conventional treatment, the Relative Bedrest Condition Morita Therapy can reduce the anxiety symptoms and improve the depressive symptoms by enhancing the extraversion personality characteristics of the patients.

Why do some trauma patients die while others survive? A matched-pair analysis based on data from Trauma Register DGU® / 中华创伤杂志(英文版)

PURPOSE@#The mortality rate for severely injured patients with the injury severity score (ISS) ≥16 has decreased in Germany. There is robust evidence that mortality is influenced not only by the acute trauma itself but also by physical health, age and sex. The aim of this study was to identify other possible influences on the mortality of severely injured patients.@*METHODS@#In a matched-pair analysis of data from Trauma Register DGU®, non-surviving patients from Germany between 2009 and 2014 with an ISS≥16 were compared with surviving matching partners. Matching was performed on the basis of age, sex, physical health, injury pattern, trauma mechanism, conscious state at the scene of the accident based on the Glasgow coma scale, and the presence of shock on arrival at the emergency room.@*RESULTS@#We matched two homogeneous groups, each of which consisted of 657 patients (535 male, average age 37 years). There was no significant difference in the vital parameters at the scene of the accident, the length of the pre-hospital phase, the type of transport (ground or air), pre-hospital fluid management and amounts, ISS, initial care level, the length of the emergency room stay, the care received at night or from on-call personnel during the weekend, the use of abdominal sonographic imaging, the type of X-ray imaging used, and the percentage of patients who developed sepsis. We found a significant difference in the new injury severity score, the frequency of multi-organ failure, hemoglobine at admission, base excess and international normalized ratio in the emergency room, the type of accident (fall or road traffic accident), the pre-hospital intubation rate, reanimation, in-hospital fluid management, the frequency of transfusion, tomography (whole-body computed tomography), and the necessity of emergency intervention.@*CONCLUSION@#Previously postulated factors such as the level of care and the length of the emergency room stay did not appear to have a significant influence in this study. Further studies should be conducted to analyse the identified factors with a view to optimising the treatment of severely injured patients. Our study shows that there are significant factors that can predict or influence the mortality of severely injured patients.