Journal of Medicine, Surgery, and Public Health最新文献

Introduction

Hope plays a crucial role in the well-being of youth, impacting various aspects of their lives. However, less is known about the role of hope in pre-adolescents. This study aims to explore the psychosocial and behavioral correlates of hope in 9–10-year-old pre-youth transitioning into adolescence.

Methods

Using data from the Adolescent Brain Cognitive Development (ABCD) study, 4631 youth entered our study. The investigation follows these individuals for up to 36 months, specifically observing the initiation of marijuana and tobacco use. The methods employed include bivariate correlations.

Results

Baseline high hope offered protection against marijuana and tobacco use over the following 36 months. Elevated levels of hope could be seen in pre-youth with higher family income and those experienced lower levels of stressful life events and financial difficulties. High hope was also linked to lower behavioral problems, improved emotional function, lower impulsivity, lower sensation seeking, and higher cognitive function. Notably, hope was not correlated with parental education, neighborhood income, family conflict, blood pressure, body mass index, grade point average, prosocial behaviors, or puberty.

Conclusion

In conclusion, the findings suggest a close interplay between hope and various dimensions of resilience including lower tobacco and marijuana use. Higher levels of hope, influenced by factors such as family income and life events, may be a mechanism that connects hope to enhanced emotional and cognitive functioning and acts as a protective factor against early initiation of substance use. These findings underscore the potential utility of fostering hope as a strategy to promote positive development and reduce tobacco and marijuana use.

Introduction

Residential stability is increasingly recognized as a significant factor influencing youth positive development. While the existing body of research provides valuable insights, gaps remain regarding the determinants of residential stability and how its outcomes may vary by gender and race. This study aims to investigate the relationship between residential stability, substance use, and behavioral issues among children aged 9–10 years, with a focus on the mediating role of trauma exposure.

Methods

This research utilizes data from the Adolescent Brain Cognitive Development (ABCD) study, a longitudinal project initiated in 2016 with a sample of 11,849 participants. It explores the links between residential stability, socioeconomic factors, stress, and emotional and behavioral outcomes using the Child Behavior Checklist (CBCL). Structural equation modeling was employed to analyze the data.

Results findings

indicate that higher household income, living in a household with married parents, and residing in areas with greater household incomes correlate with residential stability. In turn, residential stability is linked to lower levels of life stress and reduced substance use in the future. Furthermore, the impact of residential stability on substance uses and CBCL scores was entirely mediated by trauma exposure.

Conclusions

The findings advocate for the implementation of economic, social, and public policies aimed at fostering stable living environments for children and families to mitigate the emotional and behavioral challenges future generations may face. Enhancing socioeconomic status and supporting structures that promote married family living arrangements emerge as effective strategies to improve residential stability and the well-being of young people in the United States.

Introduction

Surgery represents a distinct medical specialization that necessitates direct interaction with patients and the ability to manage complications. Burn-out is defined as a syndrome arising from persistent workplace stress that has not been effectively addressed. The objective of this work was to assess the prevalence and factors associated with burn-out among practitioners managing abdominal surgical emergencies in Senegal. A descriptive and analytical cross-sectional study was conducted; the study included healthcare professionals (general practitioners, general surgeons, anesthesiologists, nurses) involved in the management of surgical emergencies across all hospitals in Senegal. A standardized assessment of perceived stress was conducted using the Maslach Burnout Inventory (MBI) in three domains: emotional exhaustion, depersonalization, and personal accomplishment. A multiple linear regression model was used to estimate the determinants of burn-out on the three subscales. A total of 186 observations were included in the study, for a response rate of 90.7%. The majority of participants were from the capital region of Dakar (44. 6%). There were 46 women (24. 7%) and 140 men (75. 3%). The mean age was 34 years 9 ±6.7 years, with a range of 24–59 years. The majority of participants were married (71%), followed by single individuals (26. 3%), divorced (2. 2%), and widowed (0. 5%). The majority of participants were physicians (80. 6%), followed by nurses (19. 4%). The most common medical specializations were general surgery (58.7%), anesthesia and resuscitation (22. 7%), and general medicine (18. 7%). Additionally, 46% of participants were in training (residency program). The predominant motivations included passion for the profession (75.3%), patient satisfaction (69. 9%), stimulating challenges (21%), and salary considerations (11. 8%). The overall prevalence of high burn-out (at least in one dimension) was 46.2%. A multiple linear regression model showed that the risk factors contributing to high burn-out were divorce status, being in training, and being motivated by stimulating challenges, salary considerations or passion for the profession. The protective factors were a positive perception of one's salary, a favorable physical work environment, and high-quality training. This study revealed an alarming prevalence of burn-out among surgical teams dealing with abdominal emergencies in Senegal. These findings call for immediate action to ensure the well-being of surgical teams and, by extension, the quality of healthcare delivery.

This case report highlights a rare condition known as PANDAS (Pediatrics Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections), which is characterized by sudden-onset neuropsychiatric symptoms following a streptococcal infection. The report also describes the unusual occurrence of cerebellitis, an uncommon neurological manifestation involving inflammation of the cerebellum, along with symptoms of vomiting and cerebellitis in a 9-year-old patient. The patient exhibited sudden onset of obsessive-compulsive symptoms, tics, stomach pain, and signs of intestinal blockage, which led to cerebellar dysfunction upon neurological examination. Laboratory tests confirmed a recent streptococcal infection, suggesting a diagnosis of PANDAS, while imaging studies revealed inflammation in the cerebellum and intestinal obstruction. This case presents a challenge to our understanding of the pathophysiological processes underlying PANDAS and its relationship with gastrointestinal and cerebellar symptoms. The treatment plan included immunomodulatory therapy, antibiotics, and surgical intervention for the intestinal obstruction, which led to a gradual improvement in symptoms. The report underscores the importance of considering atypical manifestations of PANDAS and adopting a multidisciplinary approach for precise diagnosis and effective management in complex situations.

Background

Poor self-rated health (SRH) has been shown to predict adverse health outcomes among older people, however these associations have traditionally only been considered at one point in the lifecourse, usually midlife or later. Here we examined lifecourse correlates of SRH in early, mid and later life, relating these to subsequent risk of mortality in a community-dwelling cohort.

Methods

2989 men and women from the Hertfordshire Cohort Study (HCS) were included in this study. The HCS was initially retrospective and linked contemporary health outcome data to early life data available from health ledgers but investigations from baseline (1998–2004, aged 59–73) onwards have been prospective. At baseline, participants completed an initial clinic visit, which included questionnaire assessment of SRH, reported as 'excellent', 'very good', 'good', 'fair', or 'poor'. Socioeconomic, lifestyle, mental health and demographic information was also collected. Deaths were recorded from baseline to 31/12/2018. Baseline characteristics in relation to SRH were examined using sex-stratified ordinal logistic regression; these factors were examined in relation to mortality using sex-stratified Cox regression. Statistically significant exposures were then included in sex-stratified mutually-adjusted models.

Results

In mutually-adjusted analysis, numerous contemporaneous correlates of poorer SRH in the seventh decade were identified and included obesity, lower physical activity, greater comorbidity and higher levels of depression among men and women. For example, odds ratios for being in a lower category of SRH were as follows: obese (BMI≥30) vs underweight/healthy (BMI<25) (men 1.60 (1.21, 2.11), women 1.65 (1.25, 2.17)) and per additional system medicated (men 1.62 (1.47, 1.77), women 1.53 (1.41, 1.66)). By contrast, factors earlier in the lifecourse (early growth, age left full-time education) were not associated with SRH in late adulthood. 36% of men and 26% of women died during follow-up. Hazard ratios (95% CI) for mortality per lower category of SRH were 1.22 (1.10,1.36) among men and 1.17 (1.01,1.35) among women after adjustment for age, BMI, smoking, physical activity, diet quality, education, home ownership status, comorbidity level and depression levels, suggesting residual confounding by other unrecorded factors that are related to SRH.

Conclusions

Poorer SRH in the seventh decade was a risk factor for mortality. Importantly modifiable adverse health behaviours in the seventh decade, such as low physical activity, were associated with poorer SRH and later mortality after adjustment for socioeconomic factors and comorbidity level. By contrast early growth and education were not related to later SRH. These data suggest that attention to lifestyle in late midlife may be associated with better SRH and subsequent health outcomes, highlighting the value of interven