Frontiers in Public Health最新文献

Background: Machine learning is pivotal for predicting Peripherally Inserted Central Catheter-related venous thrombosis (PICC-RVT) risk, facilitating early diagnosis and proactive treatment. Existing models often assess PICC-RVT risk as static and discrete outcomes, which may limit their practical application.

Objectives: This study aims to evaluate the effectiveness of seven diverse machine learning algorithms, including three deep learning and four traditional machine learning models, that incorporate time-series data to assess PICC-RVT risk. It also seeks to identify key predictive factors for PICC-RVT using these models.

Methods: We conducted a retrospective multi-center cohort study involving 5,272 patients who underwent PICC placement. After preprocessing patient data, the models were trained. Demographic, clinical pathology, and treatment data were analyzed to identify predictive factors. A variable analysis was then conducted to determine the most significant predictors of PICC-RVT. Model performance was evaluated using the Concordance Index (c-index) and the composite Brier score, and the Intraclass Correlation Coefficient (ICC) from cross-validation folds assessed model stability.

Results: Deep learning models generally outperformed traditional machine learning models in terms of predictive accuracy (mean c-index: 0.949 vs. 0.732; mean integrated Brier score: 0.046 vs. 0.093). Specifically, the DeepSurv model demonstrated exceptional precision in risk assessment (c-index: 0.95). Stability varied with the number of predictive factors, with Cox-Time showing the highest ICC (0.974) with 16 predictive factors, and DeepSurv the most stable with 26 predictive factors (ICC: 0.983). Key predictors across models included albumin levels, prefill sealant type, and activated partial thromboplastin time.

Conclusion: Machine learning models that incorporate time-to-event data can effectively predict PICC-RVT risk. The DeepSurv model, in particular, shows excellent discriminative and calibration capabilities. Albumin levels, type of prefill sealant, and activated partial thromboplastin time are critical indicators for identifying and managing high-risk PICC-RVT patients.

Introduction: This study aimed to systematically review the effects of different physical activity programs on the fundamental movement skills of 3 - 7-year-old children.

Methods: For this review, the databases of CNKI, Web of Science, and PubMed were searched to collect relevant literature on the effects of different physical activity program interventions on fundamental movement skills, and a total of 10 articles with 1,121 subjects were included. The Cochrane Risk of Bias Assessment Tool was used to assess the quality of the literature, and meta-analysis was performed using Review Manager 5.4 software.

Results: Physical activity significantly influenced children's running ability, horizontal jump, dribbling the ball, kicking ability, catching ability, overhand throwing, striking a stationary ball, and dynamic balance. However, the intervention effect was insignificant for the hop and underhand throwing abilities. The intervention effects for running ability, horizontal jump, kicking ability, and catching ability were better at less than 12 weeks than at 12 weeks and above. In addition, an intervention duration of 90 min or more was better than less than 90 min for running ability and horizontal jump.

Conclusion: Future research is recommended to focus on the common factors of the intervention effects of physical activity programs to develop more precise and effective intervention practices to further improve children's fundamental movement skill levels.

Objective: This study aimed to update baseline data on monkeypox (mpox)-related knowledge and vaccination willingness among human immunodeficiency virus (HIV) diagnosed and suspected males.

Methods: The cross-sectional survey was conducted in Changsha, a provincial capital in China, during 5 JULY to 5 SEPTEMBER 2023. Among the three study groups, the participants in the "previously diagnosed" group were recruited from a cohort of HIV-infected patients. The "newly diagnosed" and the "suspected" groups were recruited from the outpatients and grouped according to their confirmatory test results. The the exploratory factor analysis was firstly applied to capture the latent structure of participants' response to the questionnaire about monkeypox. The component and factor scores were compared between groups using the Kruskal-Wallis H tests. The chi-square test was then used to assess the difference of mpox vaccination willingness between MSM and non-MSM in each group. Finally, multivariate logistic regression analysis was performed to identify the determinants of vaccination willingness.

Results: A total of 481 males were included in the final analysis. The results revealed that there was a gap in knowledge about monkeypox between the three participant groups. The vaccination willingness rate of HIV-infected participants was above 90%, while the rate in the HIV-suspected group was 72.60%. Multivariate logistic regression analysis revealed that the previously diagnosed group (adjusted odds ratio [aOR] = 0.314, 95% confidence interval [CI]: 0.105-0.940) and the suspected group (aOR = 0.111, 95% CI: 0.034-0.363) had a lower level of vaccination willingness and they were referred to the newly diagnosed group. Participants in the age groups ranging 25-34 (aOR = 0.287, 95% CI: 0.086-0.959) and 35-44 (aOR = 0.136, 95% CI: 0.039-0.478) years showed a lower level of vaccination willingness, referred to the 15-24 year age group. A better knowledge about monkeypox was associated with a higher level of vaccination willingness (aOR = 1.701, 95% CI: 1.165-2.483). Additionally, a considerable percentage of heterosexual individuals in each group indicated their acceptance of monkeypox vaccines.

Conclusion: An overall high level of vaccination willingness was observed among HIV-infected and-suspected male individuals with disparities noted among those with different HIV infection status, knowledge levels of monkeypox, and age. Addressing the existing knowledge gap and engaging people with persistent risks-regardless of their sexual orientation-for a timely HIV diagnosis may facilitate vaccine-based mitigation measures against monkeypox.

Background: Globally, nearly one-third of workplace violence (WPV) occurs in the health sector. Exposure to WPV among Jordanian nurses has been widely speculated to be underreported. Understanding of the factors contributing to WPV among nurses and their consequences is limited.

Objectives: This study aimed to examine the consequences and contributing factors of WPV and explore suggestions for reducing WPV among nurses working in peripheral hospitals.

Methods: This descriptive, cross-sectional study included 431 Jordanian nurses. Data were collected using a self-report instrument between December 2022 and June 2023. A modified version of the ILO/ICN/WHO/PSI Workplace Violence in the Health Sector Country Case Study Questionnaire developed and validated in 2003 was used.

Results: The ages of the participants ranged from 20 to 49 years. A total of 349 nurses (81%) had experienced verbal violence, while 110 (25.5%) had experienced physical violence. Of the 110 nurses who were physically attacked, 44 (40 %) reported that an investigation was conducted to determine the cause of the incident. Approximately 38.2% of incidents involving physical violence in the last 12 months involved the use of weapons. The current study revealed that 59.6% of the nurses reported that verbal incidents were common in their workplace. The highest level of agreement among all participants was leniency in applying penalties to perpetrators of violence inside hospitals. The majority of participants (95.8%) agreed that improving staff-patient communication skills would effectively reduce violence.

Conclusion: Creating awareness among healthcare professionals, patients, and the general public regarding the impact of WPV and the importance of respect and professionalism is crucial.

Objective: Workplace violence (WPV) poses a serious occupational risk. This study aims to explore the association between WPV from patients and the occurrence of insomnia, depression, and anxiety among healthcare workers.

Methods: Information about the WPV from patients was collected by a self-designed questionnaire. Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Insomnia Severity Index (ISI) were used for the assessment of mental health. Logistic regression was used to explore the association between WPV from patients and insomnia, depression, and anxiety. Mediation analysis was used to evaluate the mediation effect of depression and anxiety on the relationships between WPV from patients and insomnia.

Results: Of 10,413 included healthcare workers, 40.05% experienced verbal violence, 6.44% experienced physical violence from patients in the past year. There is a significant association between verbal violence and insomnia (OR = 1.780, 95% CI: 1.591-1.990), depression (OR = 1.823, 95% CI: 1.640-2.026), and anxiety (OR = 1.831, 95% CI: 1.606-2.087), as well as physical violence (insomnia: OR = 1.220, 95% CI: 1.002-1.481; depression: OR = 1.274, 95% CI: 1.052-1.540; anxiety: OR = 1.316, 95% CI: 1.058-1.630). Moreover, depression and anxiety mediated the relationship between WPV and insomnia, the mediated proportion was 62.21% in the association between verbal violence and insomnia, and 60.22% in the association between physical violence and insomnia.

Conclusions: The association between WPV from patients and heightened risks of mental health issues emphasizes the necessity of supportive work environments. Recognizing the mediating role of depression and anxiety stresses the significance of tailored mental health training for healthcare staff.

Background: Population aging and smoking are both major challenges worldwide, particularly in developing countries. We preliminarily explored the relationship of smoking cessation duration and cognitive function among middle-aged and older Chinese.

Methods: The data comes from China Health and Retirement Longitudinal Study (CHARLS) wave 4. Smoking information was collected by standardized questionnaire. Global and memory-specific cognitive functions were assessed. We used restricted cubic spline to explore curvilinear relationship. After discretizing the duration of ex-smokers (quitting ≤2 years, 3-8 years, 9-19 years, and ≥20 years), multiple linear regression models were established with current smokers as reference.

Results: A total of 5,561 respondents (67.7 ± 6.2 years; 54.1% men) were included. Respondents who quit smoking for longer showed better global cognitive function. This trend leveled off among respondents who had quit smoking for ≥20 years. There were significant differences in global cognitive function among those who quit smoking for ≥9 years (9-19 years, β = 0.75, 95%CI 0.32-1.18; ≥20 years, β = 0.94, 95%CI 0.42-1.46). The differences mainly came from men. In immediate memory, all ex-smokers performed better. In delayed memory, only those quit for ≥9 years had significant differences.

Conclusion: Compared with current smokers, both never smokers and ex-smokers showed better cognitive function. Respondents who quit smoking for longer had better cognitive performance, especially those who had quit for at least 9 years.

Background: Musculoskeletal pain represents an increase in medical expenses due to disability and decreased quality of life among workers. Various biopsychosocial factors contribute to the development of persistent and disabling musculoskeletal pain. The Prevent for Work questionnaire (P4Wq) intended to analyze these factors. In this study, the original Italian version of the P4Wq was translated and culturally adapted to Spanish. Moreover, the psychometric properties were evaluated among Spanish workers with and without recent history of disabling spinal pain.

Methods: The first phase consisted of a forward-and-backward translation process and evaluating the face-validity of the questionnaire among 30 Spanish workers. The second phase involved 153 Spanish workers who completed the P4Wq, Oswestry Disability Index (ODI), and EQ-5D-5L questionnaires. Finally, 50 Spanish workers completed the P4Wq 2 weeks later to evaluate test-retest reliability and measurement error.

Results: Minor changes were made after the forward-and-backward translation process, which ensured that the Spanish versions was face-valid. The P4Wq demonstrated acceptable internal consistency for Spanish version (Cronbach's alpha: 0.91), a moderate negative association with the indicator of quality of life (ρ < -0.39; p = 0.001) and moderate positive association with the disability index (ρ > 0.46; p = 0.001). Furthermore, the P4Wq showed good to excellent item response stability (weighted kappa = 0.75-0.96) and good for the total score (ICC = 0.98).

Conclusion: The Spanish version of the P4Wq was face-valid and exhibited a similar structure as the original version. Additionally, good internal consistency and construct validity were found. This translated version of the questionnaire can therefore be considered acceptable for use by workers with and without history of disabling musculoskeletal pain.

Background: The "Double Reduction" policy requires schools to reduce Chinese students' extracurricular activities and homework to lessen academic stress and improve mental well-being. However, there is limited research on primary school teachers' psychological well-being within the context of the "Double Reduction" policy. This study examined self-reported burnout levels of primary school teachers and investigated the relationship between burnout and depressive symptoms in the context of the "Double Reduction" policy in China.

Methods: A cross-sectional survey recruited 3,199 primary school teachers from 15 cities across China. The teachers' burnout levels were assessed with the Maslach Burnout Inventory, and depressive symptoms were evaluated with the Patient Health Questionnaire depression scale.

Results: Under the "Double Reduction" policy in China, 66.6% of the primary school teachers experience burnout. Individual and work-related characteristics were independently correlated with burnout. These factors included holding a bachelor's degree (OR = 2.244, 95% CI: 1.559-3.230, p < 0.001), being married (OR = 0.598, 95% CI: 0.443-0.807, p < 0.001), being dissatisfied with one's income (OR = 2.602, 95% CI: 2.191-3.090, p < 0.001), and having an intermediate professional title (OR = 1.351, 95% CI: 1.086-1.681, p = 0.007). The correlation coefficients between burnout subscale scores and depressive symptoms were 0.588 for emotional exhaustion, 0.585 for cynicism, and - 0.180 for professional efficacy (all p < 0.001).

Conclusion: Our findings indicate that the prevalence of burnout among primary school teachers in China is exceptionally high, particularly under the "Double Reduction" policy. This situation is correlated with various psychological disorders, including depression. It is crucial to urgently implement psychological interventions for primary school teachers. Specifically, psychological assistance should be targeted at educators who are bachelor degree holders, married, dissatisfied with their income, and holders of an intermediate professional title.

Objective: To develop a patient version of guidelines (PVG) for rehabilitation nursing (RN) in stroke patients with limb dysfunction, aiming to enhance patients' awareness, self-management skills, and adherence to rehabilitation programs.

Methods: This guideline was developed based on the cultural and healthcare context of China, and was guided on the Minimum standards for the Development Process, Content and Governance of Patient-Directed Knowledge Tools and the PVG tool book of the Guidelines International Network. The guideline was constructed through a normative process involving clarifying priority questions, assessing and integrating evidence, detailing and contextualizing recommendations, and evaluating the prototype of PVG.

Results: Fifteen priority RN issues were identified, and eight articles (four guidelines and four evidence summaries) were included, all demonstrating robust methodological quality. The final guideline encompassed five themes: disease knowledge, functional assessment, symptom prevention and nursing, rehabilitation training, and traditional Chinese medicine nursing - a specialized approach integrating traditional Chinese medicine principles with modern nursing practices, including 26 recommendations.

Conclusion: This patient-centered guideline, grounded in a robust scientific framework and tailored to patient needs, serves as a valuable reference for the RN of stroke patients with limb dysfunction. The development of context-specific patient guidelines that integrate best available evidence remains an area requiring continued effort and refinement. Further research is warranted to evaluate the implementation and effectiveness of this guideline within diverse Chinese healthcare context.