Importancia cultural de la flora empleada por la comunidad nativa Asheninka Sheremashe, Ucayali, Perú / Cultural importance of the flora used by the Asheninka Sheremashe native community, Ucayali, Peru

The cultural significance of the flora used by the native Asheninka Sheremashe community in Ucayali, Peru was determined. To do this, a fieldwork of over 4 months was conducted, involving semi-structured interviews with 106 residents through non-probabilistic convenience sampling. The community utilizes 139 plant species in their daily lives, belonging to 120 genera and 52 families, with the most abundant being Fabaceae, Arecaceae, Malvaceae, Solanaceae, Poaceae, and Rutaceae. Furthermore, 25.9% of the species are of significant importance to theinhabitants according to the Cultural Index (CI), such as Manihot esculenta, Theobroma cacao, Bixa orellana, Musa paradisiaca, Ficus insipida, among others. It can be concluded that the flora plays a prominent role in the life of the community, with the categories reporting the highest number of species being: food (29.35%), medicine (28.36%), culture (9.95%), construction (9.45%), lumber (6.97%), commerce (3.48%), craftsmanship (2.49%), toxic (2.49%), and other uses (7.46%)

Se determinó la importancia cultural de la flora empleada por la comunidad nativa Asheninka Sheremashe, en Ucayali, Perú. Para ello, se realizó un trabajo de campo de más de 4 meses, donde se aplicaron entrevistas semiestructuradas a 106 habitantes mediante un muestreo no probabilístico por conveniencia. La comunidad emplea 139 especies vegetales en su día a día, pertenecientes a 120 géneros y 52 familias; siendo las más abundantes las Fabaceae, Arecaceae, Malvaceae, Solanaceae, Poaceae y Rutaceae. Además, el 25.9% de las especies tiene gran importancia para los pobladores según el Índice Cultural (IC): Manihot esculenta, Theobroma cacao, Bixa orellana, Musa paradisiaca, Ficus insipida, entre otras. Se concluye que la flora tiene un rol preponderante en la vida de la comunidad, siendo las categorías que presentaron mayor reporte de especies: alimentación (29.35%), medicina (28.36%), cultura (9.95%), construcción (9.45%), aserrío (6.97%), comercio (3.48%), artesanía (2.49%), tóxico (2.49%) y otros usos (7.46%)

Outcomes of a Community of Practice on Quebec Speech Language Pathologists' Voice Assessment Practices and Professional Identity

In a context where different protocols for recommended practices in clinical voice assessment exist, while there are gaps in the literature regarding the evidence base supporting assessment procedures and measures, clinicians from regions where a strong community holding expertise in clinical and scientific voice practices lack can struggle to confidently develop their voice assessment practices. In an effort to improve voice assessment practices and strengthen professional identity among speech-language pathologists in Quebec, Canada, a community of practice (CoP) was established, with the aim of promoting knowledge sharing, implementing change in clinical practice, and improving professional identity. Thirty-nine participants took part in the CoP activities conducted over a four-month period, including virtual meetings and in-person workshops. Participants had a high rate of attendance (> 74% participation rate in virtual meetings), and were highly satisfied with their participation and intended to remain involved after the project's end. Statistically significant changes in voice assessment practices were observed post-CoP, regarding probability of performing assessments (p < .001), and perceived importance of assessment for evaluative purposes (p <.001), as well as improvements in assessment specific confidence, specifically for procedure of auditory-perceptual assessment (p < .001) and purpose of aerodynamic assessment (p = .05). Moreover, there was an increase in professional identity post-CoP (p < .001) and participants felt they made significant learnings. The present study highlighted the need to involve SLPs in future research to identify assessments that are relevant to the specific evaluative objectives of SLPs working with voice, and suggests CoPs are an efficient tool for that purpose.

En un contexto en el que existen diferentes protocolos para las prácticas recomendadas en la evaluación vocal clínica, y en el que se presentan vacíos en la literatura respecto a la base de evidencia que respalda los procedimientos y medidas de evaluación, los profesionales de regiones donde no hay una comunidad sólida con experiencia en prácticas vocales clínicas y científicas pueden enfrentar dificultades para desarrollar con confianza sus prácticas de evaluación vocal. Con el propósito de mejorar las prácticas de evaluación vocal y fortalecer la identidad profesional entre los logopedas de Quebec, Canadá, se estableció una comunidad de práctica (CdP). Esta tenía como objetivo fomentar el intercambio de conocimientos, implementar cambios en la práctica clínica y mejorar la identidad profesional. Un total de treinta y nueve participantes se involucraron en las actividades de la CdP, llevadas a cabo durante un período de cuatro meses, que incluyeron reuniones virtuales y talleres presenciales. Los participantes tuvieron una alta tasa de asistencia (> 74% de participación en las reuniones virtuales) y expresaron un alto grado de satisfacción con su participación, manifestando su intención de continuar involucrados después de la finalización del proyecto. Se observaron cambios estadísticamente significativos en las prácticas de evaluación vocal posterior a la CdP, en lo que respecta a la probabilidad de llevar a cabo evaluaciones (p < .001) y la percepción de la importancia de la evaluación con fines evaluativos (p < .001), así como mejoras en la confianza específica en la evaluación, particularmente en el procedimiento de evaluación auditivo-perceptual (p < .001) y el propósito de la evaluación aerodinámica (p = .05). Además, se registró un aumento en la identidad profesional posterior a la CdP (p < .001) y los participantes sintieron que obtuvieron aprendizajes significativos. El presente estudio destacó la necesidad de involucrar a los logopedas en investigaciones futuras, para identificar evaluaciones pertinentes a los objetivos evaluativos específicos de los logopedas que trabajan con la voz, y sugiere que las CdP son una herramienta eficiente con ese propósito.

Enfoque Rápido en Contexto Comunitario (ERCC): evaluando las medidas preventivas para Hantavirus en la Comarca Andina Patagónica desde la perspectiva de la participación comunitaria / Rapid Approach in Community Context (ERCC): evaluating preventive measures for Hantavirus in the Andean Patagonian Region from the perspective of community participation

Introducción: la creciente preocupación por eventos epidémicos de origen zoonótico generó la necesidad de estrategias integrales que corrigiesen la baja adaptabilidad y tensiones que se generan al implementar acciones de orden jerárquico superior en el contexto comunitario. Con el objeto de explicar un Enfoque Rápido en Contexto Comunitario (ERCC), este trabajo se propone evaluar dentro del contexto de un programa de salud pública la participación comunitaria en la prevención del Hantavirus en la Comarca Andina del Paralelo 42. Metodología: El presente ERCC utilizó visitas y observaciones al sitio, entrevistas cara a cara y grupales, precedidas por una revisión documental de la literatura. La información se recopiló en un corto período de tiempo y el análisis se utilizó para desarrollar recomendaciones informadas para los tomadores de decisiones de salud pública. Resultados: Se observo que cada comunidad enfrenta desafíos más allá del hantavirus y es esencial que epidemiólogos, prestadores de servicios asistenciales y municipalidades trabajen más estrechamente con la población local para prevenir y manejar mejor cualquier brote de enfermedad. Se pudieron identificar 6 recomendaciones que le permitirían a las comunidades un mejor manejo de futuros brotes con un enfoque participativo. Conclusiones: El ERCC es una intervención rápida y discreta que puede ser llevada a cabo por un pequeño equipo con una interferencia mínima en la comunidad. El ERCC también podría ser adaptado por las autoridades de salud pública a muchos contextos diferentes, incluso con grupos vulnerables, para ayudar a que la promoción y la prevención sean más relevantes y efectivas a nivel local (AU)

Introduction: the growing concern for epidemic events of zoonotic origin generated the need for comprehensive strategies that correct the low adaptability and tensions generated when implementing actions of higher hierarchical order in the community context. In order to explain a Rapid Approach in Community Context (ERCC), this paper aims to evaluate within the context of a public health program community participation in the prevention of Hantavirus in the Andean Region of the 42nd Parallel. Methodology: The present ERCC used site visits and observations, face-to-face and group interviews, preceded by a documentary review of the literature. The information was collected over a short period of time and the analysis was used to develop informed recommendations for public health decision makers. Results: It was observed that each community faces challenges beyond hantavirus and it is essential that epidemiologists, care providers and municipalities work more closely with the local population to better prevent and manage any disease outbreak. We were able to identify 6 recommendations that would allow communities to better manage future outbreaks with a participatory approach. Conclusions: The ERCC is a rapid and discreet intervention that can be carried out by a small team with minimal interference in the community. The ERCC could also be adapted by public health authorities to many different contexts, including with vulnerable groups, to help make promotion and prevention more relevant and effective at the local level (AU)

Analysis of the current status and related factors of first aid knowledge among middle-aged and elderly residents in a community in Shanghai / 上海预防医学

ObjectiveTo investigate the current status of first aid knowledge among middle-aged and elderly residents aged 50 and above in a community in Shanghai， in order to provide reference for improving the self-rescue and mutual aid capabilities of middle-aged and elderly residents. MethodsA multi-stage stratified random sampling method was used to conduct a survey on 335 residents aged 50 and above in a community in Shanghai using a self-made survey questionnaire. The current situation and related factors of emergency knowledge level of residents aged 50 and above in the community were comprehensively analyzed. ResultsFirst aid knowledge level of 335 residents aged 50 and above was low， and the rate of high cognitive level was only 24.18%. Univariate analysis showed that male residents had a higher awareness rate than female residents （P=0.044）， while residents aged 70 and above and 60‒ had lower awareness rates than residents aged 50‒ （P<0.05）. Residents with chronic diseases had a higher awareness rate than those who did not （P=0.031）. Residents with family members suffering from chronic diseases had a higher awareness rate than those without （P<0.001）. Experience of first aid training affected residents’ awareness of first aid （P=0.003）. ConclusionThe level of first aid knowledge among middle-aged and elderly residents aged 50 and above in the community is low. Age， the presence of chronic diseases in family members， and emergency training are independent and relevant factors that affect the awareness of first aid knowledge among middle-aged and elderly residents. The government and relevant institutions should explore the establishment of a standardized emergency response training system， implement classification and grading for middle-aged and elderly groups with different characteristics， and provide targeted emergency training to strengthen their self-rescue and mutual aid capabilities and improve the success rate of pre-hospital emergency care.

Helicobacter pylori infection factors and immunological typing in community health examination population / 公共卫生与预防医学

Objective To investigate and analyze the risk factors of Helicobacter pylori (Hp) infection and the immunological classification of Hp-infected people in community health examination population. Methods Among of the 2 475 residents in a community who underwent health examination in Guangyuan First People's Hospital were selected between July 2022 and April 2023. Western blotting was used to detect and type the Hp antibodies. The risk factors of Hp infection in the community residents were analyzed by binary logistic regression analysis, and the results of immunological typing were compared among patients with different upper digestive tract diseases and chronic diseases. Results The Hp infection rate among of the 2 475 residents who underwent physical examination was 35.64% (882/2475), and the positive rates of type I Hp antibody and type II Hp antibody were 23.72% (587/2 475) and 11.92% (295/2 475) , respectively. There were significant differences in Hp infection rates in gender, age, smoking history, and whether or not people had diabetes (P<0.05). Multivariate logistic regression analysis showed that male, age ≥60 years old, drinking history and diabetes were risk factors of Hp infection in the community health examination population (P<0.05). The positive rate of type I Hp antibody in men and patients with coronary heart disease was higher than that in women and patients without coronary heart disease (P<0.05). Conclusion The infection rate of Hp among health examination population in this community is low, mainly type I. Hp infection is affected by gender, age, drinking history and diabetes. There are more males in the population with type I Hp antibody positivity, and the risk may be higher in patients with coronary heart disease. Clinically, it is necessary to take susceptible population as the focus of prevention and treatment, and take targeted monitoring and diagnosis and treatment measures.

Research on community-based rehabilitation exercise and physical activity and its benefits for people with mild and moderate disability in Shenzhen, Guangdong, China / 中国康复理论与实践

ObjectiveTo investigate the effect of community-based rehabilitation exercise and physical activity on the physical activity levels, functional states, and quality of life for people with mild and moderate disabilities in community settings, to ascertain the health benefits of their engagement in such fitness sports activities, anchoring in the WHO "Global Action Plan on Physical Activity 2018-2030: More Active People for a Healthier World" and the guidelines tailored for people with disabilities, using the theoretical framework and methodology of the International Classification of Functioning, Disability and Health (ICF). MethodsAligning with the WHO guidelines for people with disabilities and the ICF, a community-based rehabilitation exercise and physical activity program was designed for individuals with mild to moderate disabilities, featuring activities like fitness training (aerobic and resistance exercises), skill exercises (such as balance and coordination), as well as sports and recreational games (ball and games, etc.). A total of 230 people with mild and moderate disabilities were recruited from 20 communities in Shenzhen, with types of disabilities including physical, speech, intellectual, and mental. Professional rehabilitation fitness instructors implemented and supervised the program. The activities were of low to moderate intensity, 30 to 50 minutes per session, five times a month for six months. The community-based rehabilitation exercise and physical activity progress of these individuals was surveyed using the International Physical Activity Questionnaire (IPAQ), and their overall functioning was evaluated with WHODAS 2.0. The health-related quality of life was measured with WHOQOL-BREF. The health benefits from participation in community-based rehabilitation exercise and physical activity were assessed in terms of functioning, activity involvement, and quality of life. ResultsAfter the fitness activities, participation levels significantly increased in IPAQ domains of work-related, transport-related, domestic and gardening activity, and leisure time (|t| > 3.391, P < 0.001). The scores significantly decreased in the domains of cognition, activity, self-care, getting along, life activities and participation; and overall scores also decreased in WHODAS 2.0 (t > 6.639, P < 0.001). The scores significantly increased in the four dimensions of WHOQOL-BREF (|t| > 7.486, P < 0.001). ConclusionAfter participating in a six-month community-based rehabilitation exercise and physical activity program of mild to moderate intensity, individuals with mild to moderate disabilities have improved in physical activity and engagement levels, and the overall functioning and quality of life.

Study on the Teaching Path of Medical Ethics in Medical Colleges and Universities in Ethnic Areas by Integrating the Consciousness of the Chinese National Community / 中国医学伦理学

From an ethical point of view, the ethical characteristics of the consciousness of the Chinese national community contain an ethical starting point based on "love"; ethical path with "people first" as the core; ethical vision for the purpose of "prosperity". The consciousness of the Chinese national community greatly conforms to the teaching objectives and teaching content of medical ethics. Therefore, medical ethics teaching from the perspective of the Chinese national community should implement the fundamental task of helping students develop good morals and enhance the moral quality of "love"; take the "community of doctor-patient destiny" as the starting point of education and build the concept of "people first"; strengthen the country’s sense of responsibility of "prosperity and strength" and establish the mission of "rooting and maintaining health at the grassroots level", build a strong consciousness of the Chinese national community.

Research on Patients’ Trust Risk Points and Promotion Path from the Perspective of Online Health Community / 中国医学伦理学

Online health community is a new medical treatment mode combining the Internet and medical treatment. Patients can get medical services through the network. However, it cannot be ignored that patients’ trust will be affected by the uncertainty of online medical information, the unsafe factors of patients’ private information, the insufficient standardization of the diagnosis and treatment process, and other issue in the process of using this new medical treatment mode. By taking measures such as improving the information quality in online health community, enhancing patients’ cognitive ability of health information, perfecting privacy protection measures in online health community, advancing patients’ participation in online health community and ensuring the standardization of diagnosis and treatment process, patients’ trust can be improved.

Ethical Considerations and Countermeasure Analysis of Public Mental Disorders Stigma in China / 中国医学伦理学

Discrimination against patients with mental disorders and the resulting stigma will not only affect patients’ medical treatment, but also bring about community isolation and lack of resources. Mental health problems have become a major public health problem and a prominent social problem. From the perspective of bioethics, the existence of public mental disorders stigma violates the principles of justice and respect. This paper quantitatively described the status quo of public mental disorders stigma in China, and explored its influencing factors through factor analysis and binary logistic regression analysis. The public stigma of mental disorders score was (54.64±11.048). Factor analysis extracted 4 common factors, namely isolation, pain, contact, and empathy, with a cumulative explained variance of 68.948%. The results showed that age and contact history were the main factors affecting the public stigma of mental disorders. It is recommended to reduce discrimination by enhancing understanding and improving empathy. Specifically, it is to implement the personal liability for discrimination through ethical regulation and legal construction, and strengthen the concept of a community of shared future for mankind by creating a tolerant social atmosphere, so as to achieve an appropriate balance between public safety and individual rights and interests.

Ethical Dilemma in Global Vaccine Cooperation and Its Countermeasures: Taking the Global Eradication of Smallpox as an Example / 中国医学伦理学

Vaccine cooperation is an important means to deal with global infectious diseases. However, the cooperation cannot be achieved overnight. Ethical dilemma is one of the obstacles that hinders vaccine cooperation. Reviewing the history, the most successful vaccine collaboration to date has been the global smallpox eradication program. In the process of eradicating smallpox, there were also many ethical dilemmas, including the international pattern of the US-Soviet hegemony, which impacted the mutual help between countries, the ethical disputes of the vaccine itself hindering solidarity and cooperation among actors, and the vaccine coercion adopted to overcome vaccine hesitancy undermining the principle of proportionality among the freedom, equality and efficacy. The ethical dilemmas of vaccine cooperation were resolved by shaping professional and scientific consensus among medical professional groups, reaching consensus on cooperation between leading countries and developing countries, and integrating local culture to improve vaccination methods. Finally, in 1980, the world successfully eradicated smallpox. The case of smallpox eradication provides us lessons for vaccine cooperation against COVID-19 and the construction of a community of common health for mankind today.

Reflection on Global Public Health Ethics from the Perspective of Community / 中国医学伦理学

The global spread of COVID -19 indicates that cultivating public health awareness and constructing the concept of human health community has become an urgent need and a long-term plan in the current social situation. In the post-epidemic period, only by adhering to the concept of human health community, strengthening the cooperation among individuals, families, communities, institutions, urban and rural areas, countries and so on, weaving closely and consolidating the "net bottom" of grass-roots prevention and control from point to area, and establishing the mechanism of group prevention, group control and joint prevention and control, can we thoroughly curb the spread of the epidemic in the world. Under the development concept and value orientation of human health community, the individual is not only a booster of public health, but also a component of public health, and also a beneficiary of public health. The realization of public health is inseparable from the practice of each individual. Under the guidance of the concept of human health community and the awareness of individual health first responsibility, all citizens need to shape health promotion behaviors that fit the individual’s own situation, promote the health maintenance atmosphere consciously followed by the whole society, create a healthy ecological environment accessible to everyone, and let all citizens share the good results of public health management, so as to achieve the good vision of human health community.

Practice and Reflection on Building Community of Doctor-patient in Foreign Aid Medical Work: Taking the Eighth Batch of China (Shaanxi) Medical Team Assisting Malawi as an Example / 中国医学伦理学

China’s foreign aid medical work is an important part of development of friendly relations with foreign countries and an important way to build a human health community. African countries generally have backward economic and social development, poor medical and health conditions and different languages and cultures, which makes the development of foreign aid medical work special and challenging. Foreign aid doctors and local patients share common feelings, mutual respect, equality, mutual trust and sincere cooperation, and building a community of destiny with the common goal of defeating diseases is an essential content to promote the health of the people of the recipient countries and realize the community of human health. Taking the work practice of the eighth batch of China (Shaanxi) medical team assisting Malawi as an example, this paper expounded the specific practice of building a community of doctor-patient in foreign aid medical work and discussed its significance, to provide theoretical and practical basis for the smooth development of foreign aid medical work in the future.

Research on the Significance and Path of Standardizing Patients’ Obligations from the Perspective of Building the Community of Doctor-patient / 中国医学伦理学

One of the crux of the problem of doctor-patient relationship is the uneven division of rights and obligations between doctors and patients. Among them, it is significantly essential to emphasize the patient’s obligation as a weak point. The reasons cover many aspects. On the one hand, it is of great significance to standardize patient obligations: the definition of patients’ obligations is better health protection for patients; the emphasis on patients’ obligations is the moral support for doctors’ responsibilities; the fulfillment of patients’ obligations promotes the win-win interests of doctors and patients. On the other hand, the current situation of standardizing patients’ obligations is not optimistic: the provisions of patients’ obligations in existing laws and regulations are not ideal; the current ethical discussion on patient obligations also needs to be deepened. Therefore, in order to standardize patients’ obligations, build harmonious doctor-patient relationship and build a community of doctor-patient, this paper put forward specific suggestions from three aspects: improving laws and regulations, standardizing the management of medical institutions and enhancing patients’ literacy.

Research on the Ethical Supervision of Human Gene Editing Technology: Based on the Perspective of Game Theory / 中国医学伦理学

In view of the current norms and demands of human gene editing technology at home and abroad, the paper explained that the regulatory difficulties faced by human gene editing technology were due to the conflict between economic interests and moral bottom line by constructing a game model in a hypothetical way. On this basis, the ideas of the supervision mode of human gene editing technology were put forward: establish unified international standards based on the country as the main body, enact more stringent and effective laws, to jointly deal with the behavior of genetic manipulation of human gametes, zygotes and embryos for the purpose of reproductive, and ensure the normalization and legalization of gene editing technology to avoid technology abuse.

Risk analysis of hypertension among community-dwellers at risk for high blood pressure in Minhang District of Shanghai / 上海预防医学

ObjectiveTo investigate the incidence of hypertension and its influencing factors in community-dwellers at risk for high blood pressure in Minhang District of Shanghai， and to provide scientific evidence for the community management. MethodsA retrospective cohort study was conducted using the electronic health records of community-dwellers at risk for high blood pressure in Minhang District， Shanghai from January 1， 2011 to December 31， 2017. The study end-point was the occurrence of hypertension，and the followup was finished in December 2021. A total of 17 265 community-dwellers at risk for high blood pressure were enrolled in our study. Log-rank test and Cox regression analysis were used to determine the influencing factors. ResultsAfter 6.04 years of follow-up， the hypertension incidence among community-dwellers at risk for high blood pressure in Minhang District of Shanghai was 25.5%. Family history of hypertension （HR=1.250， 95%CI： 1.168‒1.338）， family history of stroke （HR=1.295， 95%CI： 1.080‒1.553）， history of diabetes （HR=1.203， 95%CI： 1.076‒1.345）， daily smoking （HR=1.187， 95%CI： 1.087‒1.296）， overweight （HR=1.393， 95%CI：1.308‒1.484）， obesity（HR=1.903， 95%CI： 1.719‒2.106）， high values of normal blood pressure （HR=1.275， 95%CI： 1.195‒1.359） and advanced age （HR=1.033， 95%CI： 1.030‒1.036） were all risk factors. Emaciation （HR=0.649， 95%CI： 0.500‒0.840） was a protective factors. ConclusionBlood pressure monitoring should be strengthened for people elderly， with family history of hypertension， family history of stroke， diabetes or high values of normal blood pressure， so as to diagnose hypertension early. Timely intervention measures should be taken for community-dwellers with unhealthy lifestyles such as smoking， overweight and obesity.

Association between skeletal muscle mass and metabolic syndrome in middle-aged and elderly community residents / 上海预防医学

ObjectiveTo explore the correlation between skeletal muscle mass and metabolic syndrome （MS） disease risk among middle-aged and elderly community residents in Urumqi， and to provide a theoretical basis for understanding the relationship between skeletal muscle mass and MS among middle-aged and elderly community residents in China. MethodsA total of 1 438 community residents ≥ 50 years old were selected as the research subjects from July 2018 to January 2019 in Urumqi. They were selected from a multi-ethnic natural population cohort in Xinjiang. Data were collected through questionnaires， physical examination， bioelectrical impedance analysis （BIA）， laboratory tests， etc. Skeletal muscle mass was evaluated using the limb skeletal muscle mass index （SMI） corrected for body weight； MS was defined as it at least includes three of the following： abdominal obesity， hypertension， hyperglycemia， high triglycerides and low high-density lipoprotein cholesterol. SMI was divided into four quantile arrays of Q1‒Q4. Trend χ2 test was applied to explore whether there was a correlation between SMI changes and MS. A multivariate logistic regression model was used to analyze whether there is a difference in the risk of MS between the higher SMI group （Q2， Q3， Q4） and the reference group Q1. ResultA total of 560 MS patients were detected in this study， with a prevalence rate of 38.94%. Among them， the prevalence rate of MS was 39.16% in males and 38.80% in females. The increase in male SMI grading level is not correlated with the prevalence of MS （trend P>0.05）； After adjusting for confounding factors （model 4）， the increase in SMI was still not related to the prevalence of MS （Ptrend=0.995）. There was no statistical difference in the risk of MS between the lowest quartile group Q1 and the highest quartile group Q4 （OR=1.01， 95%CI： 0.69‒1.78）. The prevalence of MS in women gradually decreased with the increase of SMI grading level （Ptrend<0.001）； After adjusting for confounding factors （model 4）， there was still a correlation between the increase of SMI and the prevalence of MS （Ptrend=0.005）. With the lowest quartile of SMI Q1 as the reference group， the risk of MS in Q2 （OR=0.63， 95%CI： 0.40‒1.00）， Q3 （OR=0.56， 95%CI： 0.34‒0.94）， Q4 （OR=0.42， 95%CI： 0.23‒0.76） decreased. ConclusionAn increase in skeletal muscle mass may be beneficial for preventing MS， especially among middle-aged and elderly female residents. Considering the intensification of aging in China and the close relationship between MS and related comorbidities， managing skeletal muscle mass may contribute to potential MS prevention.

Establishment and application of a prospective follow-up research method for acute infectious diseases in Shanghai community residents / 上海预防医学

ObjectiveTo present the exploration and application of a prospective follow-up research method for acute infectious disease surveillance based on natural community populations， using COVID-19 infection as an example， and to provide a reference for improving the infectious disease surveillance and early warning system. MethodsA multi-stage probability proportional sampling method was employed to sample residents from all communities of 16 administrative districts in Shanghai， with households as the units. A cohort for acute infectious diseases based on natural community populations was established. The baseline survey was conducted for all cohort subjects， and COVID-19 antigen test kits were distributed. From December 21， 2022 to September 30， 2023， prospective follow-up monitoring of COVID-19 antigen and nucleic acid was carried out on the study subjects on a weekly basis. The baseline characteristics and follow-up information of the cohort subjects were described. ResultsThe cohort for acute infectious diseases included a total of 12 881 subjects， comprising 6 098 males （47.3%） and 6 783 females （52.7%）. The baseline survey revealed that 35.2% （4 540/12 881） of the subjects had a history of COVID-19 infection. During the follow-up period from December 21， 2022 to September 30， 2023， the average incidence density in the cohort was 0.61/person-year， with a higher incidence density in females （0.63/person-year） compared to males （0.59/person-year）. Individuals aged 60 and above （0.64/person-year） and those with underlying health conditions （0.67/person-year） had a higher incidence density. Healthcare workers showed a notably higher incidence density （0.84/person-year） than that in other occupational groups. As of September 30， 2023， a total of 340 subjects in the cohort experienced secondary infections， with a median interval of 170 days between the first and second infections. ConclusionThis study applies cohort study method to acute infectious disease surveillance， providing crucial data support for estimating infection rates and forecasting alerts for acute infectious diseases in the community. This method can be promoted and applied as a new approach for acute infectious disease surveillance.

Risk prediction models of dangerous behaviors among patients with severe mental disorder in community / 四川精神卫生

BackgroundThe occurrence rate of dangerous behaviors in patients with severe mental disorders is higher than that of the general population. In China， there is limited research on the prediction of dangerous behaviors in community-dwelling patients with severe mental disorders， particularly in terms of predicting models using data mining techniques other than traditional methods. ObjectiveTo explore the influencing factors of dangerous behaviors in community-dwelling patients with severe mental disorders and testing whether the classification decision tree model is superior to the Logistic regression model. MethodsA total of 11 484 community-dwelling patients with severe mental disorders who had complete follow-up records from 2013 to 2022 were selected on December 2023. The data were divided into a training set （n=9 186） and a testing set （n=2 298） in an 8∶2 ratio. Logistic regression and classification decision trees were separately used to establish predictive models in the training set. Model discrimination and calibration were evaluated in the testing set. ResultsDuring the follow-up period， 1 115 cases （9.71%） exhibited dangerous behaviors. Logistic regression results showed that urban residence， poverty， guardianship， intellectual disability， history of dangerous behaviors， impaired insight and positive symptoms were risk factors for dangerous behaviors （OR=1.778， 1.459， 2.719， 1.483， 3.890， 1.423， 2.528， 2.124， P<0.01）. Being aged ≥60 years， educated， not requiring prescribed medication and having normal social functioning were protective factors for dangerous behaviors （OR=0.594， 0.824， 0.422， 0.719， P<0.05 or 0.01）. The predictive effect in the testing set showed an area under curve （AUC） of 0.729 （95% CI： 0.692~0.766）， accuracy of 70.97%， sensitivity of 59.71%， and specificity of 72.05%. The classification decision tree results showed that past dangerous situations， positive symptoms， overall social functioning score， economic status， insight， household registration， disability status and age were the influencing factors for dangerous behaviors. The predictive effect in the testing set showed an AUC of 0.721 （95% CI： 0.705~0.737）， accuracy of 68.28%， sensitivity of 64.46%， and specificity of 68.60%. ConclusionThe classification decision tree does not have a greater advantage over the logistic regression model in predicting the risk of dangerous behaviors in patients with severe mental disorders in the community. ［Funded by Chengdu Medical Research Project （number， 2020052）］

Survival analysis of patients with severe acute malnutrition admitted at the in-patient therapeutic care of the Bicol Regional Training and Teaching Hospital

Background@#Severe acute malnutrition (SAM) in children under five years remains a major global health concern. It carries a burden to the overall health of a child, contributes to mortality, and adds financial strain to the family and the hospital. The Philippine Integrated Management of Acute Malnutrition was established to address acute malnutrition in Filipino children. @*Objective@#This study aimed to determine the factors affecting survival of patients admitted at Bicol Regional Training and Teaching Hospital (BRTTH) In-patient Therapeutic Care (ITC).@*Methods@#This is a retrospective cohort study design utilizing survival analysis. Accrual period was from January 1, 2018 to December 31, 2018. Follow-up ended on March 31, 2019. There were 154 admissions and excluded 17 missing charts. Survival analysis was done utilizing STATA 14.@*Results@#The prevalence of SAM requiring ITC admission was 3.0 percent. Majority belonged to 6-59 months of age (63%), with equal predilection for both sexes (1:1) and 71% came from the home province, Albay. Most of patients’ caretakers had middle educational attainment. Sixty-eight percent (68%) were new patients, 16% readmitted, 15% transferred from the Out-patient Therapeutic Care (OTC) and <1% relapsed. The top three most common complications and co-morbidities include: pneumonia, low electrolytes, and fever. Sixty-three percent (63%) of patients at the ITC had a desirable treatment outcome, of which, 8% were cured and 55% transferred to OTC. Undesirable outcomes accounted for 37% of the cases which included non-cured, defaulter, and died at 12%, 8%, and 17%, respectively. The risk of dying was higher in SAM patients with parents having middle and low educational attainment as compared to those with high educational attainment (2-5 folds to 100-200 folds). SAM patients presenting with hypovolemic shock were likely to die by 1.5-19 times (1.5-19x) as compared to those without. SAM patients with malignancy were more likely to die 4-44 folds as compared to patients without malignancy.@*Conclusion and Recommendations@#Educational attainment of parents, malignancy, and hypovolemic shock were significant predictors of mortality. We recommend prompt intervention by educating families, strengthen policies targeting socio-economic determinants, capacitate medical staff, refine current clinical practice guidelines and treatment pathways to reduce the number of children who die from severe acute malnutrition.

The Benefit of Garlic from Islamic Perspective and Malay Practise / Jurnal Sains Kesihatan Malaysia

@#Garlic is one of the herbs used as a flavor in food. But it is also known as traditional medicine among the Malay community. However, the scientific observation about the benefits of garlic, especially from the Islamic perspective has not been fully documented. Thus, in this research, we aim to unravel the remedies of garlic and its uniqueness from the Islamic perspective and explain the efficacy and uses of garlic in treating diseases practiced by the Malay community. The findings show that garlic as a traditional medicine has been used since time immemorial and has been proven to bring many good effects in curing diseases such as helping to lower body pressure, reduce the risk of cancer, eliminate bad breath and many more. The findings also show different beliefs, races, and cultures are among the factors in different ways of using garlic as a medicine. However, this study will focus more on Malay practitioners. In this research, descriptive analysis is used and involves many types of text such as Al-Qur’an, Hadith Nabawi, and selected Malay manuscripts on Malay traditional medicine to study the remedies of garlic and its practice among Malay practitioners. This study is important to increase the understanding and knowledge about the benefit of garlic in medicine as a cure rather than just using it as a flavor in food.