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Objective:To explore the relationship among physical exercise, self-control, and mobile phone dependence in adolescents.Methods:The entire group of random sampling method was used to extract 882 students from five junior high schools in Nanchang city from September 2020 to March 2021.A longitudinal survey was conducted using the sports activity rating scale, self control scale, and adolescent mobile phone dependence scale on all participants for 2 times with an interval for 6 months.The questionnaire results in the first stage were marked as T1.The questionnaire results in the second stage were marked as T2.SPSS 26.0 statistical software was used to conduct reliability analysis, common method bias test and Pearson correlation analysis on each variable in sequence.AMOS 23.0 was used for cross-lag analysis to explore the relationship among physical exercise, self-control and mobile phone dependence.Results:The score of physical exercise of adolescents was (17.71±5.62), the score of self-control was (51.48±9.71), and the score of mobile phone dependencies was (56.67±12.93). Adolescent physical exercise, self-control, and mobile phone dependence were all related to stability across time.There were positive correlation between T1 physical exercise and T2 physical exercise ( r=0.489), T1 self-control and T2 self-control ( r=0.482), as well as T1 mobile phone dependencies and T2 mobile phone dependencies ( r=0.498)(all P<0.01). Cross-lag analysis showed that: adolescent physical exercise behavior could unidirectionally predict self-control( β=0.197, P<0.01)and mobile phone dependence( β=-0.224, P<0.01) after 6 months, and self-control could predict the mobile phone dependence( β=-0.560, P<0.01) of junior high school students after 6 months.The mediating effect results showed that self-control had a mediating effect between physical exercise and mobile phone dependence of junior high school students, there were gender differences.The mediating effect accounted for 22.22%(-0.018/-0.081). Conclusion:Physical exercise can indirectly reduce the mobile phone dependence of junior high school students by affecting self-control.
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OBJECTIVE To provide scientific basis for establishing the evaluation index system of professional and specialized drug inspectors in China. METHODS Through the method of literature research， group discussions and behavioral event interview， combined with the practice situation of drug inspection at home and abroad， in accordance with the requirements of Chinese laws and regulations and department rules， the evaluation indexes for drug inspectors were extracted and screened. In addition， the Delphi method was used to conduct correspondence with experts in relevant fields so as to determine the evaluation index system of drug inspectors. RESULTS & CONCLUSIONS Finally， 62 experts completed two rounds of anonymous online questionnaires， including 29 experts in the first round and 33 experts in the second round. The questionnaire recovery rates were 96.67% and 94.29% respectively， and the expert authority coefficients were 0.81 and 0.79， indicating a high level of authority among experts. After expert consultation， evaluation index system for professional and specialized drug inspectors had been constructed， including five first-level indexes （personal characteristics， professional knowledge， professional skills， professional behavior and professional ethics） and their corresponding 27 second-level indexes. The average score of the importance of second-level indexes was 4.224- 4.879， the full score ratio was 81.8%-100%， the coefficient of variation was 0.067-0.177， and Kendall’s W was 0.643 （P＜0.001）. It indicates that this evaluation index system is relatively reliable and is expected to become a management tool for promoting the construction of professional and specialized drug inspector team and ensuring the quality of drug inspection.
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Objective:To analyze the career development path and related problems of general practitioners (GPs)in the community.Methods:In October 2019, general practitioners with different positions working in Malu Town Community Health Service Center of Shanghai Jiading district were selected by typical sampling to participate in a focus group interview. Based on the saturation principle, 5 general practitioners were invited for in-depth interviews on their career development and related issues. The original data were analyzed with Colaizzi′s seven-step analysis method.Results:The career development of the general practitioners working in the community was divided into three stages: start stage, experience-accumulation stage and career-differentiation stage. In the start stage (the first 0-24 months), the GPs mainly got familiar with the community health service center through community rotation. In the experience-accumulation stage (1-5 years after entering the community health service center), GPs accumulated clinical experience from outpatient clinic, ward, and being family doctor, etc; at the same time, they accumulated management experience through part-time public health management, research and education management, secondment in district health committee. In the professional differentiation stage (5 years or more after entering the community health service center), GPs may take a position of full-time management, or department head. The three respondents had confusion in certain career development stages, including confusion in clinical skills upgrading and balance between clinical and management duties.Conclusions:The study suggests that general practitioners in the entry stage need to be given timely clinical rotation as well as research and teaching training; in the career differentiation stage, it is necessary to incorporate upgrading clinical service and management capability with policy development directions and institutional development needs to promote the successful career differentiation of general practitioners.
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This study is to evaluate the application of the comprehensive capacity assessment system based on post competence in competitive recruitment of family doctors. Thirty five general practitioners participating in the family doctor post competition in 2019—2020 were graded and ranked by both the post competition method and the comprehensive capacity assessment system of family doctors. The top 32 candidates in terms of total scores were selected as the successful candidates for the family doctor job competition. Kappa test was used to assess the consistency of competition results between the two methods. Among 32 candidates who were qualified according to the 2019—2020 family doctors post competition method, 31 (96.9%) were also qualified for the family doctor′s comprehensive capacity assessment system ( Kappa=0.635, P<0.01). The results indicate that the comprehensive capacity assessment system for family doctors based on post competency is rational and objective, and can be used for competitive recruitment of family doctors in community health service center.
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Objective:To develop a comprehensive ability evaluation system for general practice management post in community health service institutions.Methods:Based on the previous studies and literature search on competency of general practitioners in various clinical posts, the first draft of the comprehensive ability indicator system for general management posts was designed. From November 2019 to January 2020, the comprehensive ability indicator system, classification and scoring method and evaluation method for general management posts were determined through three rounds of Delphi consultation.Results:Seventeen experts with administrative management experiences were invited for consultation, including 3 directors in charge and 14 general practice managers. The response rate of valid questionnaires in the three rounds of consultation were all 17/17, the authority of experts were all>0.7, and the coordination coefficients of expert opinions were 0.142, 0.212, and 0.532 (all P<0.01). The 11 evaluation indexes of the comprehensive ability of community general management posts were: achievement orientation, initiative, interpersonal understanding, service consciousness, influence, organization, training others, teamwork, team leadership, professional skills and confidence. Methods suitable for evaluation the ability of psychological test indicators were achievement orientation, interpersonal understanding, service consciousness and self-confident;appropriate indicators for no-leader group discussion were initiation, influence, team work, team leadership;appropriate indicators for in-tray test ability were organized cognition, professional skills;and the appropriate indicator for the ability of the structured interview was training others. Conclusions:The comprehensive ability evaluation system for community general management posts established in this study is scientific and practical, which may provide objective standard basis for the ability evaluation of community health management talents.
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Objective To develop and allocate regional elderly care resources based on local service needs.Methods From February 2016 to May 2016,a face-to-face questionnaire survey was conducted to measure the elderly care service needs among residents over 60 years of age in Malu Township of Shanghai Jiading District.A telephone survey on the old-age care resources in Malu Township was carried out in November 2016.The demarcation of the aged care service needs was considered according to the resource classification from supplier side and the needs scores from the demander side.Kappa consistency test was used to compare the current care setting and the care setting matched to the real needs on the basis of the demarcation criteria.Results The results of the demarcation showed that 8 old-aged with score ≥ 44.5 in the survey (0.2％) should have the skilled nursing facility-based care;218 with the score of 24.1 to 44.4 (5.1％) should have the welfare institution-based care;60 with score of 23.2 to 24.0 (1.4％) should have elderly home-based care;72 with scores of 22.1 to 23.1 (1.7％) should have the community-based care;3 954 with score ≤ 22.0 (91.6％) should have home-based care.The consistency between the status of current care setting and the care setting matched to the real needs based on the demarcation criteria was poor (Kappa=0.092,P＜0.01).Conclusions This study sets a grading criterion for the service objects of the various aged care services in Malu Township,and provides a basis for the orderly,rational and fair distribution of the regional old-age care service resources.However,the current resource allocation in the region is not accurately matched to the real needs,the problem should be solved with the application of the demarcation criterion.
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Objective To survey on the elderly care needs in the community of Shanghai.Methods From February 2017 to May 2017,a survey on the elderly care needs was conducted using stratified sampling method among 4 312 residents aged ≥60 years in Malu township of Shanghai Jiading District.The survey involved physical health status (illness,self-care ability,vision,risk of falls),mental health status (expression ability in feelings of self-will/information,comprehension in others' willingness/information,depression,anxiety),social health status(family care ability),and willingness for elderly care method (self-desires for old-age support,family-desires for old-age support).The survey was implemented by family doctors.Results The total demand for elderly care services for the elderly in Malu Township was skewed,with a median score of 9.9 points (5.7,15.1).In terms of physical health status,72.7％(3 135) of the elderly suffered from one or more diseases,90.8％(3 915) of the elderly had good self-care ability,83.5％ (3 600) of the elderly had good eyesight,and 98.5％(4 247) of the elderly had only mild risk of falling;in terms of mental health status,81.8％(3 527) of the elderly had normal expression ability of self-willingness/information,and 98.3％(4 239) of the elderly had normal understanding ability of wishes/information expressed by others,87.5％(3 773) of elderly people did not have depression,97.0％(4 183) of the elderly had no anxiety;in terms of social health,58.7％(2 531) of elderly people had normal family care ability;58.7％(2 531) of elderly people were willing to get home-based care,and 53.0％(2 285) of their families also hoped that the elderly could get home-based care.Conclusion The needs of elderly care services is at a lower level among old-aged residents in Malu township,however,there is a relatively low social health status.This study provides an objective quantitative basis for the targeted development of medical care and support services for the elderlv in the communitv in the future.
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Objective To develop a measuring tool for the elderly care service needs in the community.Methods Based on the literature search and Delphi expert consultation,a measuring tool for elderly care service needs was developed.The reliability (internal consistency coefficient) and validity (surface validity,content validity,criterion-related validity) of the developed measurement tool were evaluated with on-site expert consultation and the cross-sectional survey.Results A 11-dimension measurement tool was developed,which covered physical health,mental health and desires for old-age support assessment.The reliability evaluation showed that there was significant correlation (P＜0.05) among the measurement dimensions of the physical health and the mental health of the elderly in community.The validity evaluation showed that the measurement methods for the measurement dimensions of the elderly care needs,including the evaluation items,evaluation methods,and rating methods,all got below 2 scores in applicability assessment,and the measurement methods of the self-care ability,vision,the self-willingness/information expression of the elderly,the ability of the elderly to understand the willingness/information expressed by others,and the ability to provide family care were all supported by more than 50％ experts,which indicated that the surface validity and content validity were good.There was a significant positive correlation between the living places of the elderly and the needsof elderly care services (r=0.214,P＜0.01),and there were significant correlations between all measurement dimensions with the living place except anxiety (P＜0.05),which indicated that the measurement tool had an acceptable criterion-related validity.The consistency of self-supporting willingness,the family willingness to care for the elderly with the current old-age care place were relatively poor (Kappa=0.063,P=0.007;Kappa=0.051,P=0.006).Conclusion The overall performance of the measurement tool for the elderly care service needs developed in this study is acceptable.It has been approved by both the elderly care service suppliers and the elderly care service needs evaluators.It also shows some internal consistency in measurement results of the demanders,and is consistent with the actual living place.
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In order to solve the problem of early classification of Alzheimer's disease (AD), the conventional linear feature extraction algorithm is difficult to extract the most discriminative information from the high-dimensional features to effectively classify unlabeled samples. Therefore, in order to reduce the redundant features and improve the recognition accuracy, this paper used the supervised locally linear embedding (SLLE) algorithm to transform multivariate data of regional brain volume and cortical thickness to a locally linear space with fewer dimensions. The 412 individuals were collected from the Alzheimer's Disease Neuroimaging Initiative (ADNI) including stable mild cognitive impairment (sMCI, = 93), amnestic mild cognitive impairment (aMCI, = 96), AD ( = 86) and cognitive normal controls (CN, = 137). The SLLE algorithm used in this paper is to calculate the nearest neighbors of each sample point by adding the distance correction term, and the locally linear reconstruction weight matrix was obtained from its nearest neighbors, then the low dimensional mapping of the high dimensional data can be calculated. In order to verify the validity of SLLE in the task of classification, the feature extraction algorithms such as principal component analysis (PCA), Neighborhood MinMax Projection (NMMP), locally linear mapping (LLE) and SLLE were respectively combined with support vector machines (SVM) classifier to obtain the accuracy of classification of CN and sMCI, CN and aMCI, CN and AD, sMCI and aMCI, sMCI and AD, and aMCI and AD, respectively. Experimental results showed that our method had improvements (accuracy/sensitivity/specificity: 65.16%/63.33%/67.62%) on the classification of sMCI and aMCI by comparing with the combination algorithm of LLE and SVM (accuracy/sensitivity/specificity: 64.08%/66.14%/62.77%) and SVM (accuracy/sensitivity/specificity: 57.25%/56.28%/58.08%). In detail the accuracy of the combination algorithm of SLLE and SVM is 1.08% higher than the combination algorithm of LLE and SVM, and 7.91% higher than SVM. Thus, the combination of SLLE and SVM is more effective in the early diagnosis of Alzheimer's disease.
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The technical development and health system reform require high professionalism and competency for medical workers.At present the cultivation of medical professionalism is mainly limited in campus education only for medical and nursing students,and little is involved in clinical practice for health personnel.This paper introduces that the personnel professionalism and competency had been enhanced through scientific research practice in Shanghai Malu Community Health Service Center,the experiences would provide reference for other community health service institutions.
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Lung cancer is the leading cause of cancer-related deaths. Traditional chemotherapy causes serious toxicity due to the wide bodily distribution of these drugs. Curcumin is a potential anticancer agent but its low water solubility, poor bioavailability and rapid metabolism significantly limits clinical applications. Here we developed a liposomal curcumin dry powder inhaler (LCD) for inhalation treatment of primary lung cancer. LCDs were obtained from curcumin liposomes after freeze-drying. The LCDs had a mass mean aerodynamic diameter of 5.81 μm and a fine particle fraction of 46.71%, suitable for pulmonary delivery. The uptake of curcumin liposomes by human lung cancer A549 cells was markedly greater and faster than that of free curcumin. The high cytotoxicity on A549 cells and the low cytotoxicity of curcumin liposomes on normal human bronchial BEAS-2B epithelial cells yielded a high selection index partly due to increased cell apoptosis. Curcumin powders, LCDs and gemcitabine were directly sprayed into the lungs of rats with lung cancer through the trachea. LCDs showed higher anticancer effects than the other two medications with regard to pathology and the expression of many cancer-related markers including VEGF, malondialdehyde, TNF-, caspase-3 and BCL-2. LCDs are a promising medication for inhalation treatment of lung cancer with high therapeutic efficiency.
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Objective To define the assessment dimensions of community-based elderly care service.Methods Firstly 11 assessment dimensions of elderly care service needs were teased out through literature review and group discussion, these were illness, self-care ability, vision, risk of falls, willingness/information self-expression ability, the comprehension in others' willingness/information, depression, anxiety, family care ability, self-desires for old-age support, family-desires for old-age support.Then 37 experts were invited to reconfirm and empower theose assessment dimensions with two rounds of Delphi method.Results Results showed that the enthusiasm and authority degree of experts were favorable in two rounds, and the results from the second round showed strong opinion coordination.Finally, 12 assessment dimensions were confirmed, in which financial situation of the aged added and used for reference.After weight calculation, illness was weighted the highest (0.11), while vision and the degree of anxiety were weighted lowest in 11 dimensions (0.07).Conclusion The reliability of the assessment dimensions of the aged service needs is high.This study had positive significance on the solution of the dilemma in elderly care at the present stage.
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Nutrition therapy is an important part of the treatment of Crohn’s disease(CD),which plays an important role in correcting malnutrition,inducing disease remission,and for the perioperative management. Nutrition therapy, especially enteral nutrition(EN),has been studied for its effect on CD. We have long been focusing on the use of nutrition therapy in the treatment of CD,especially the use of EN in the perioperative management of CD. Here,we reviewed the indications,effects,endpoints and the underlying mechanisms of preoperative nutrition therapy,through which we hope can shed light on improving the optimization of preoperative management as well as the standardization of preoperative nutrition therapy in CD.