Interactive Journal of Medical Research最新文献

Background: Dementia is a global health challenge, particularly in Nigeria, where limited health care infrastructure, cultural stigmas, and poor awareness hinder its care. Telemedicine can improve patient outcomes, increase health care access, and support caregivers. However, challenges such as poor internet connectivity, digital literacy, and a lack of integrated strategies hinder its adoption, particularly in rural areas.

Objective: This scoping review aims to evaluate the adoption of telemedicine for dementia care in Nigeria by highlighting existing interventions, their effectiveness, implementation challenges, and contextual barriers. It also draws on global evidence to propose culturally relevant, sustainable strategies.

Methods: A scoping review was conducted using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) framework. Peer-reviewed articles were included if they focused on telemedicine or digital health interventions for dementia care in Nigeria or sub-Saharan Africa and published between January 2010 and February 2024. Databases searched included PubMed, Scopus, CINAHL, PsycINFO, Cochrane Library, and Google Scholar. A total of 23 articles met the inclusion criteria.

Results: Among the 23 studies, 10 (43.5%) focused on mobile health apps, 8 (34.8%) on video consultations, and 5 (21.7%) on remote monitoring tools. These interventions improved caregiver support, medication adherence, and access to specialist care. Key barriers included limited digital literacy, poor internet access, and a lack of cohesive national telemedicine policy.

Conclusions: There is an urgent need for an inclusive national telemedicine policy in Nigeria. Interventions such as mobile health, video consultations, and remote monitoring tools show potential to enhance dementia care, reduce caregiver burden, and improve health outcomes.

Background: Bowel preparation compliance is an important intervenable factor that affects bowel preparation quality, and improving compliance is an important way to optimize bowel preparation outcomes. Despite its importance, the compliance rate and its influencing factors have not been thoroughly evaluated.

Objective: This study aimed to investigate the overall compliance with bowel preparation instructions in patients undergoing colonoscopy.

Methods: From September 2024 to March 2025, a cross-sectional questionnaire-based study was conducted at West China Hospital of Sichuan University, recruiting 740 participants via convenience sampling. We used an 8-item self-report scale to evaluate compliance with bowel preparation instructions. Items were rated on a 4-point Likert scale (0=completely noncompliant to 3=completely compliant), yielding a total score of 0-24. Higher scores reflected greater compliance, with ≥95% of the maximum score considered adequate compliance. Univariate analysis and multivariate logistic regression analysis were used to assess factors (age, educational level, knowledge of bowel preparation, satisfaction with the taste of the laxative, physical discomfort during bowel preparation) influencing bowel preparation compliance.

Results: In this study, 42.0% (311/740) of patients demonstrated adequate compliance with bowel preparation instructions. In the univariate analysis, hypertension history, knowledge of bowel preparation, laxative type, satisfaction with the taste of the laxative, anxiety during bowel preparation, and physical discomfort during bowel preparation all had statistically significant influences. Multivariate analysis showed that older age (odds ratio [OR] 2.27, 95% CI 1.16-4.49), higher educational level (OR 3.29, 95% CI 1.41-8.33), adequate knowledge of bowel preparation (OR 1.59, 95% CI 1.14-2.24), satisfaction with the taste of the laxative (OR 2.11, 95% CI 1.48-3.02), and no physical discomfort during bowel preparation (OR 0.45, 95% CI 0.31-0.64) were key factors for adequate bowel preparation compliance.

Conclusions: Personalizing bowel preparation instructions according to patients' age and education level, and selecting a laxative that suits the patients' taste preferences when available, are feasible ways to improve compliance with bowel preparation.

Background: Poststroke depression (PSD) is a common complication following stroke. In recent years, several systematic reviews have evaluated the effects of moxibustion and acupuncture on PSD; however, their findings have been inconsistent.

Objective: This overview of systematic reviews aimed to assess the methodological quality, reporting quality, and strength of evidence of existing systematic reviews on acupuncture and moxibustion for PSD. In addition, this study also analyzed the limitations of previous studies and suggested directions for future research.

Methods: Systematic reviews concerning acupuncture and moxibustion for PSD published before August 10, 2024, were identified from 8 databases, including PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang, VIP Database, and Chinese Biomedical Literature Database. Eligible studies included systematic reviews and meta-analyses of randomized controlled trials comparing moxibustion and acupuncture for the treatment of PSD. The methodological quality, reporting quality, and evidence quality were evaluated using AMSTAR 2 (Assessment of Multiple Systematic Reviews-2), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020, and GRADE (Grading of Recommendations Assessment, Development and Evaluation), respectively. The corrected covered area was calculated to assess overlap among the included primary studies.

Results: A total of 24 studies were included. According to the Assessment of Multiple Systematic Reviews-2 assessment, all studies were rated as having "low" or "critically low" methodological quality. Based on PRISMA, 1 study demonstrated seriously inadequate reporting quality, while 21 studies had partially inadequate reporting quality. The quality of evidence in the included reviews ranged from very low to moderate. Most of the primary outcomes exhibited mild to moderate overlap among studies.

Conclusions: Most of the included systematic reviews indicated that acupuncture may be beneficial for PSD. Nevertheless, the methodology, reporting, and evidence quality of these reviews require improvement. Stronger evidence will depend on the conduct of larger, multicenter, rigorously designed randomized controlled trials, as well as high-quality systematic reviews.

Background: Little is known regarding patient attitudes toward automatic sharing of race, ethnicity, and language (REL) data in health care settings despite the universal practice of data sharing across health care institutions and providers.

Objective: This study aims to assess public comfort with disclosing and automatically sharing REL data in health care settings and understand the social factors associated with these attitudes.

Methods: Using the 2022 DataHaven Community Wellbeing Survey from 1196 adult Connecticut residents, we examined factors associated with public comfort with disclosing and automatically sharing REL data across health care settings. We generated unadjusted and adjusted logistic models to examine associations between factors and responses to the data-sharing questions.

Results: Most residents surveyed were White (n=873, 73%), followed by African American or Black (n=167, 14%), Asian or Native Hawaiian or other Pacific Islander (n=31, 2.6%), multiracial (n=31, 2.6%), and American Indian or Alaska Native (n=12, 1%). The majority of respondents were not Hispanic or Latino (n=1051, 87.9%). More than half of respondents reported excellent or very good self-rated health (SRH; n=635, 53.1%), and most participants reported almost always trusting their health care provider (n=939, 78.5%). Most participants reported being willing to share race and ethnicity data at a hospital or clinic (n=1008, 84.3%) and REL data automatically (n=947, 79.2%) in health care settings. Hispanic or Latino (adjusted odds ratio [AOR] 0.049, 95% CI 0.25-0.94) and multiracial (AOR 0.32, 95% CI 0.14-0.76) respondents were less likely to be willing to disclose race and ethnicity data compared to those who were not Hispanic or Latino and who were White, respectively. Individuals who sometimes trust health care providers (AOR 0.57, 95% CI 0.35-0.94) or rarely/never (AOR 0.35, 95% CI 0.15-0.85) were less likely to be willing to disclose race and ethnicity data than those who almost always trust health care providers. African American or Black (AOR 0.46, 95% CI 0.29-0.72) and American Indian or Alaska Native (AOR 0.18, 95% CI 0.04-0.75) individuals were less likely to be willing to share REL data automatically than White individuals. Those who sometimes trust health care providers (AOR 0.48, 95% CI 0.31-0.74) or rarely/never trust health care providers (AOR 0.25, 95% CI 0.11-0.56) were less likely to be willing to share REL data automatically than those who almost always trust health care providers. Those with poor/fair SRH versus very good/excellent SRH were less likely to be willing to share REL data automatically (AOR 0.54, 95% CI 0.34-0.85).

Conclusions: Racial and ethnic identity, SRH, and trust in health care providers affect willingness to share REL information with providers and other health systems.

Background: Dengue fever remains the most significant vector-borne disease in Southeast Asia, imposing a substantial burden on public health systems. Global warming and increased international mobility may exacerbate the disease's prevalence. Furthermore, the unprecedented COVID-19 pandemic may have influenced the epidemiological patterns of dengue.

Objective: This study aimed to evaluate epidemiological changes in dengue incidence in Southeast Asia.

Methods: We conducted a retrospective, multicountry ecological study analyzing trends in dengue incidence in 7 Southeast Asian countries from January 2000 to December 2023. Data were extracted from official World Health Organization reports and national health department databases. Countries with data that were incomplete, inconsistent, or not publicly available were excluded from the final analysis. Annual incidence rates were analyzed, and linear trends were calculated to assess long-term patterns.

Results: Epidemiological data from 7 Southeast Asian countries, comprising Thailand, Singapore, Vietnam, Malaysia, the Philippines, Cambodia, and Taiwan, were analyzed across the 24-year study period. A notable nadir in dengue cases was observed coinciding with the COVID-19 pandemic. Significant increasing trends in dengue incidence were identified in Singapore, Vietnam, Malaysia, and the Philippines (slopes: 8.243, 6.513, 8.737, and 8.172; R2 values: 0.14, 0.34, 0.345, and 0.46, respectively, all P<.05).

Conclusions: Dengue fever continues to pose a significant public health challenge in Southeast Asia. Our analysis demonstrates a substantial increase in dengue cases in several countries over the study period. While a temporary decline was observed during the COVID-19 pandemic, a subsequent resurgence of cases highlights the persistent threat of dengue in the region. These findings underscore the critical need for sustained surveillance and innovative control strategies to mitigate the impact of dengue in Southeast Asia.