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Associations of living in residential care facilities with participation in physical activities among older adults in the United States 美国老年人居住在养老院与参加体育活动之间的联系
Pub Date : 2023-02-01 DOI: 10.1097/NR9.0000000000000018
Weijiao Zhou, J. Larson
Abstract Background: Physical activity (PA) is important for the healthy aging period, and existing research indicates that older adults in residential care facilities (RCFs) are less physically active compared with community-dwelling, but sociodemographic and health-related characteristics were not controlled. Lower PA levels might be due to older age and worse health conditions of the RCFs residents. Objective: This study examined the association between residential status (RCF vs. community-dwelling) and participation in PA, in a sample of 4009 older adults (65 and above) in the National Health and Aging Trends Study (NHATS), adjusting for sociodemographic and health-related characteristics. Methods: The current study used Rounds 8 and 9 of the NHATS which was collected in 2018 and 2019. We conducted design-based logistic regression analyses to determine whether residential care status was significantly associated with participation in walking exercises and vigorous activities, and controlled for sociodemographic and health-related characteristics. Results: Using multivariable logistic regression models, older adults in RCFs (n=214) were more likely to participate in walking exercises (adjusted odds ratios=1.94, P<0.01) and equally likely to participate in vigorous activities (adjusted odds ratios=1.04, P=0.84) than community-dwelling (n=3795). Conclusions: Our finding adds new evidence to the conventional thinking about the potential effect of RCFs on PA. Further research is needed to address the underlying mechanisms.
摘要背景:体力活动(Physical activity, PA)对于健康的老年期至关重要,现有研究表明,与社区居住相比,居住在养老院(residential care facilities, rcf)的老年人体力活动较少,但社会人口学和健康相关特征未得到控制。较低的PA水平可能是由于rcf居民年龄较大和健康状况较差。目的:本研究在国家健康与老龄化趋势研究(NHATS)的4009名老年人(65岁及以上)的样本中,检查了居住状态(RCF vs.社区居住)与参与PA之间的关系,调整了社会人口统计学和健康相关特征。方法:本研究使用了2018年和2019年收集的NHATS的第8轮和第9轮。我们进行了基于设计的逻辑回归分析,以确定住院护理状态是否与步行锻炼和剧烈活动的参与显著相关,并控制了社会人口统计学和健康相关特征。结果:采用多变量logistic回归模型,rcf中的老年人(n=214)比社区居民(n=3795)更有可能参加步行锻炼(调整优势比=1.94,P<0.01),同样有可能参加剧烈运动(调整优势比=1.04,P=0.84)。结论:我们的发现为RCFs对PA的潜在影响的传统思维提供了新的证据。需要进一步的研究来解决潜在的机制。
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引用次数: 0
The association between sense of coherence and health outcomes among community-dwelling older adults: a systematic review 在社区居住的老年人中,连贯性感与健康结果之间的关系:一项系统综述
Pub Date : 2023-02-01 DOI: 10.1097/NR9.0000000000000016
Jinghong Lv, Min Qian, Mengying Deng, Mingming Yu
Abstract Objective: The objective of this study was to systematically review evidence of the association between the sense of coherence (SOC) and health outcomes in community-dwelling older adults. Methods: Six databases, including PubMed, Web of Sciences, Scopus, CINAHL Plus with full text (EBSCO), OVID, and the Cochrane Library, were thoroughly searched. The checklist developed by the Agency for Healthcare Research and Quality and the Newcastle-Ottawa Scale were used to assess the quality of the relevant studies. Results: Twenty-nine studies were included in this review. Generally, higher SOC levels are associated with better physical health (less symptom reporting, better functional status, less disability, better daily activity ability, less pain, better sleep quality, and better oral health) and better psychological health (less perceived stress, more positive self-perception of aging, less depression, and less posttraumatic stress reaction) in older adults. Higher SOC levels are also correlated with greater preventive/self-management behaviors ability, subjective well-being, adjustment to aging later in life, cumulative survival, quality of life, life satisfaction, and self-perceived health. Higher SOC levels are a vital mediators or moderators of health in older adults. Conclusions: The SOC is a protective factor for the health of community-dwelling older adults. Interventions targeting improvement in SOC levels should be developed and implemented to facilitate active aging in older adults.
摘要目的:本研究的目的是系统地回顾社区居住老年人的连贯感(SOC)与健康结果之间的关联证据。方法:对PubMed、Web of Sciences、Scopus、CINAHL Plus全文(EBSCO)、OVID、Cochrane Library等6个数据库进行全面检索。使用由卫生保健研究和质量机构制定的检查表和纽卡斯尔-渥太华量表来评估相关研究的质量。结果:本综述纳入了29项研究。一般来说,较高的SOC水平与老年人更好的身体健康(较少的症状报告,更好的功能状态,更少的残疾,更好的日常活动能力,更少的疼痛,更好的睡眠质量和更好的口腔健康)和更好的心理健康(更少的感知压力,更积极的衰老自我感知,更少的抑郁和更少的创伤后应激反应)相关。较高的SOC水平还与较高的预防/自我管理行为能力、主观幸福感、晚年对衰老的适应、累积生存、生活质量、生活满意度和自我感知健康相关。较高的SOC水平是老年人健康的重要中介或调节因子。结论:SOC是社区居住老年人健康的保护因素。针对改善SOC水平的干预措施应该开发和实施,以促进老年人的积极老龄化。
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引用次数: 0
Nutritional prehabilitation strategies for patients undergoing head and neck cancer: a scoping review 头颈癌患者的营养康复策略:范围综述
Pub Date : 2023-02-01 DOI: 10.1097/NR9.0000000000000019
Fang-Zhen Xue, Mengli Zhang, Huan Duan, Jing Zhang
Abstract Background: Given the high incidence of malnutrition before anti-cancer treatment in patients with head and neck cancer (HNC), it is necessary to pay attention to nutritional interventions for them before surgery, radiotherapy, and chemotherapy. Nutritional prehabilitation strategies vary considerably in their implementations. Objective: This scoping review aimed to summarize the nutritional prehabilitation strategies for HNC patients. Methods: We conducted a scoping review based on the framework outlined by the Joanna Briggs Institute (JBI) methodology (Joanna Briggs Institute, 2020). Twelve articles focused on the effects of preoperative nutritional intervention on the nutritional status of patients with HNC who underwent surgery, radiotherapy, or chemotherapy. We synthesized the screening or evaluation tool for the nutrition prerehabilitation intervention strategy, type of nutrition supplement, intervention goal, frequency, duration, re-evaluation, and supervision. Results: Findings suggest that preoperative nutritional intervention can improve recovery from anti-cancer treatment and patient physical reserves for coping with surgical stress. Therefore, patients with HNC who are at risk of malnutrition are recommended for early nutritional interventions.
摘要背景:头颈癌(HNC)患者在抗癌治疗前营养不良的发生率较高,有必要重视其术前、放疗、化疗前的营养干预。营养康复战略在实施上差别很大。目的:本综述旨在总结HNC患者的营养康复策略。方法:我们根据乔安娜布里格斯研究所(Joanna Briggs Institute, 2020)方法论概述的框架进行了范围审查。12篇文章聚焦于术前营养干预对接受手术、放疗或化疗的HNC患者营养状况的影响。我们综合了营养康复前干预策略、营养补充类型、干预目标、频率、持续时间、重新评估和监督的筛选或评估工具。结果:术前营养干预可提高患者抗癌治疗后的恢复,提高患者应对手术应激的体力储备。因此,建议有营养不良风险的HNC患者进行早期营养干预。
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引用次数: 0
The application of health recommender systems based on knowledge graph: a scoping review 基于知识图谱的健康推荐系统的应用综述
Pub Date : 2023-02-01 DOI: 10.1097/NR9.0000000000000014
Xu Zhang, Mo Yi, Y. Sun, Shuyu Han, Wenmin Zhang, Zhiwen Wang
Abstract Background: Tailored knowledge graph-based recommender systems (KGRSs) have been demonstrated to be able to provide accurate and effective health recommendations to users, and thus significantly reduce health care costs. They are now strongly recommended to be applied in the health care field. Objective: This scoping review aims to identify the current application of KGRSs, their target users and performance metrics, and the potential limitations of implementing health recommender systems in clinical practice. Methods: A review of the studies published from inception to November 1, 2022 was conducted, using key search terms in 6 scientific databases to identify health recommender systems based on knowledge graph technology. Key information from the included studies was extracted and charted. The scoping review was reported following the PRISMA Extension for Scoping Reviews. Result: We included 16 studies and 5 grants totally about the health recommender systems based on knowledge graph technology. They were used in different health areas: traditional Chinese medicine, health management, disease-related decision support, diet, and nutrition recommendations. Among them, 6 studies were for the general public and 6 were for physicians. A total of 13 (81.25%) studies evaluated the KGRS using performance metrics, such as accuracy, recall, F1 score, and area under the curve. All studies pointed out the limitations of the recommender systems and provided directions for their subsequent optimization and improvement. Conclusion: This review describes the state-of-the-art and potential limitations of KGRS used in the health care field. This novel approach has been proven to be effective in overcoming the drawbacks of traditional algorithms, helping users filter massive amounts of data to find out the personalized information they need. Its great potential in digital health needs to be further explored.
背景:基于知识图谱的定制推荐系统(KGRSs)已被证明能够为用户提供准确有效的健康建议,从而显著降低医疗成本。现在强烈建议将它们应用于保健领域。目的:本综述旨在确定KGRSs的当前应用,其目标用户和性能指标,以及在临床实践中实施健康推荐系统的潜在局限性。方法:利用6个科学数据库中的关键搜索词,对自成立以来至2022年11月1日发表的研究进行综述,识别基于知识图谱技术的健康推荐系统。从纳入的研究中提取关键信息并绘制图表。范围审查是在PRISMA范围审查扩展之后报告的。结果:基于知识图谱技术的健康推荐系统共纳入16项研究和5项拨款。它们被用于不同的健康领域:传统中医、健康管理、疾病相关决策支持、饮食和营养建议。其中6项研究是针对公众的,6项研究是针对医生的。共有13项(81.25%)研究使用准确性、召回率、F1分数和曲线下面积等性能指标来评估KGRS。所有的研究都指出了推荐系统的局限性,并为推荐系统的后续优化和改进提供了方向。结论:本文综述了KGRS在医疗保健领域应用的现状和潜在局限性。这种新颖的方法已被证明有效地克服了传统算法的缺点,帮助用户过滤大量的数据,找到他们需要的个性化信息。它在数字卫生方面的巨大潜力有待进一步发掘。
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引用次数: 0
Invisible voices: experiences and perceptions of mothers and grandmothers caring for newborns with neonatal abstinence syndrome 看不见的声音:母亲和祖母照顾患有新生儿戒断综合征的新生儿的经验和看法
Pub Date : 2023-01-19 DOI: 10.1097/NR9.0000000000000011
Amberly Lao, Tessa Li, Sarah Battaglia, J. Berry, Valarie Artigas, X. Cong
Abstract Objective: This study was designed to give mothers with opioid use disorder (OUD) and their families a “voice” in sharing their experiences surrounding the relationship with health care staff in the care of their newborn with neonatal abstinence syndrome (NAS) and aimed to identify their perceptions of the care received during their newborn’s hospitalization. Methods: A cross-sectional study was administered through Qualtrics online survey software. The survey questions with quantitative and qualitative components were developed and validated by the researchers to explore perceptions and experiences regarding the care the mother and the infant received, and their feelings about whether they were adequately educated and prepared to care for themselves and infant with NAS. A convenience sampling method was used to recruit mothers (18 years old and above) who gave birth to infants with NAS as well as their family members from the Department of Behavioral and Community Health in the Northeastern United States. Descriptive analysis methods were used to describe the quantitative survey data and thematic content analysis approach was used to explore the qualitative narrative data. Results: Twenty mothers were eligible for the study and a total of 10 mothers and 3 grandmothers participated in the final study. Primary outcomes for quantitative results from mothers were frustration based on how they were treated, the belief that the newborn required the neonatal intensive care unit, and the conclusion that they were treated inferiorly compared with mothers without OUD. Four major themes identified by the mothers were: judgment by the health care providers, trying to be a good mother, education needs of mothers to receive more information about NAS, and not understood by the health care providers and the need for training specified to caring for OUD during pregnancy and NAS. Results of the grandmothers’ study demonstrated a deficiency in personal knowledge about caring for an infant with NAS, and a belief that the mother was treated poorly due to her history. Conclusions: Women with OUD are blamed and stigmatized for their decisions and experience a lack of knowledge in caring for their infants. While further research is warranted in exploring these topics, the disparities between this population and health care providers may increase health risks for both the mother and newborn.
摘要目的:本研究旨在为阿片类药物使用障碍(OUD)母亲及其家人提供一个“声音”,分享他们在新生儿戒断综合征(NAS)新生儿护理中与医护人员关系的经验,并旨在确定他们对新生儿住院期间所接受的护理的看法。方法:采用qualics在线调查软件进行横断面研究。研究人员开发并验证了带有定量和定性成分的调查问题,以探讨母亲和婴儿接受护理的看法和经验,以及他们是否接受了充分的教育并准备好照顾自己和患有NAS的婴儿的感受。采用便利抽样方法,从美国东北部行为和社区卫生部门招募了生育NAS婴儿的母亲(18岁及以上)及其家庭成员。定量调查数据采用描述性分析方法进行描述,定性叙事数据采用专题内容分析方法进行挖掘。结果:20位母亲符合研究条件,共有10位母亲和3位祖母参加了最终的研究。来自母亲的定量结果的主要结果是基于她们的治疗方式的挫败感,认为新生儿需要新生儿重症监护病房,以及与没有OUD的母亲相比,她们的待遇较差的结论。母亲们确定的四个主要主题是:卫生保健提供者的判断,努力成为一个好母亲,母亲需要接受教育,以获得更多关于NAS的信息,而卫生保健提供者不了解这些信息,以及需要接受专门培训,以在怀孕期间照顾OUD和NAS。这些祖母的研究结果表明,她们对照顾患有NAS的婴儿缺乏个人知识,并且认为母亲因其病史而受到不良对待。结论:患有OUD的妇女因其决定而受到指责和污名化,并且在照顾婴儿方面缺乏知识。虽然需要进一步的研究来探索这些主题,但这一人群和卫生保健提供者之间的差异可能会增加母亲和新生儿的健康风险。
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引用次数: 0
Trends of multimorbidity status among the older Chinese population: findings from the Chinese Longitudinal Healthy Longevity Survey 2000 to 2018 中国老年人多重发病状况的趋势:2000年至2018年中国纵向健康寿命调查结果
Pub Date : 2022-11-01 DOI: 10.1097/NR9.0000000000000002
H. Su, Yu-Ming Chen, Huiwen Xu, Kaipeng Wang, Yan Luo, Beibei Xu
Abstract Objectives: This paper aimed to assess temporal trends and risk factors of multimorbidity among older Chinese adults from 2000 to 2018. Methods: A total of 51,326 participants aged 65–105 from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2000–2018 were included. Multimorbidity was defined as the co-occurrence of 2 or more (up to 14) chronic conditions in a single person. The adjusted proportion of the number of chronic conditions by follow-up year was examined and described. The generalized estimating equation model including the natural cubic spline was used to predict the prevalence of multimorbidity. Associated factors were identified using generalized estimating equation models from 2000 to 2018. All analyses were conducted separately in 2 age groups: the young-old group (aged 65–79) and the older-old group (aged 80–105). Results: The adjusted multimorbidity prevalence for the young-old group increased from 23.9% in 2002 to 72.5% in 2014 and remained high at 46.3% in 2018; the adjusted prevalence for the older-old group increased from 63.4% in 2000 to 87.2% in 2011 and remained at 73.0% in 2018. Being female, having fewer educational years, a professional or technical occupation, and a history of smoking or drinking were associated with an increased risk for multimorbidity in young-old group; while in older-old group, being female, current smoker or drinker, and less engagement in social and leisure activity were associated with an increased risk for multimorbidity. Conclusion: The prevalence of multimorbidity first increases and then decreases for both age groups. Management of multimorbidity requires more attention from health policymakers, service providers, and educators of health professionals in China. Health systems should prioritize improving the management of older patients, especially women who have lower education levels.
目的:研究2000 - 2018年中国老年人多发病的时间趋势和危险因素。方法:纳入2000-2018年中国纵向健康寿命调查(CLHLS)中65-105岁的51326名参与者。多重发病定义为一个人同时出现2种或以上(最多14种)慢性疾病。对随访年份的慢性疾病数量的调整比例进行了检查和描述。采用包含自然三次样条的广义估计方程模型对多病患病率进行预测。2000 - 2018年采用广义估计方程模型确定相关因素。所有分析分别在2个年龄组进行:年轻-老年组(65-79岁)和老年组(80-105岁)。结果:中老年组调整后多病患病率由2002年的23.9%上升至2014年的72.5%,2018年保持在46.3%的高位;老年人群体的调整患病率从2000年的63.4%上升到2011年的87.2%,并在2018年保持在73.0%。女性、受教育年限较低、从事专业或技术职业、有吸烟或饮酒史与青壮年组多病风险增加有关;而在老年人群中,女性、目前吸烟或饮酒、社交和休闲活动较少与多重疾病的风险增加有关。结论:两年龄组多病患病率均呈先上升后下降趋势。在中国,多病的管理需要卫生政策制定者、服务提供者和卫生专业人员的教育工作者给予更多的关注。卫生系统应优先改善老年患者的管理,特别是教育水平较低的妇女。
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引用次数: 0
Effectiveness of a novel augmented reality cardiopulmonary resuscitation self-training environment for laypeople in China: a randomized controlled trial 一种新型增强现实心肺复苏自我训练环境在中国的有效性:一项随机对照试验
Pub Date : 2022-11-01 DOI: 10.1097/NR9.0000000000000010
Luoya Hou, Xu Dong, Ke Li, Congying Yang, Yang Yu, Xiaoyan Jin, Shaomei Shang
Abstract Objectives: The training rate of cardiopulmonary resuscitation (CPR) among the general population in China is relatively low. Augmented reality (AR) may be an effective method of CPR training, especially where in-person interactions may not be possible. The purpose of this study was to analyze the effectiveness of AR CPR self-training for people who are not professional health care workers. Methods: A 2-arm and prospective randomized controlled trial was conducted. Participants were recruited via advertisements from August to October 2021 in Beijing and were randomly assigned to either an AR self-training CPR group (n=82) or an instructor-led training group (n=81). Participants in the AR group spent 25 minutes in a simulated environment using HoloLens to engage them in immersive multisensory CPR self-training. Participants in the instructor-led group received 25 minutes of CPR instruction with the guidance of a certified instructor. The outcomes, including the mean chest compression depth (centimeter) and rate (/min), the proportion of correct positioning of hands, correct rescue breaths, compression accuracy, and the proportion of participants that adhered to the American Heart Association’s CPR guidelines, were compared between the 2 groups. Results: The median age of the participants was 23 years old (interquartile range: 22–25) and the median weight was 55 kg (interquartile range: 51–63). The mean difference (95% CI) in the compression rate between the 2 groups [mean (SD): AR 109.03 (2.68)/min vs. instructor-led 110.88 (3.03)/min] was −1.85 (−2.74 to −0.96)/min. The mean difference (95% CI) in the depth of compressions between the groups [mean (SD): AR 5.59 (0.59) cm vs. instructor-led 5.55 (0.47) cm] was 0.04 (−0.13 to 0.20) cm. The AR self-training was noninferior to the instructor-led CPR training, as measured by the rate and depth of compressions (P<0.001). The proportion of participants that adhered to the AHA guideline for compression depth (AR: 65.85% vs. instructor: 72.84%, χ2=0.935, P=0.334) was similar in the 2 groups. The proportion of correct rescue breaths [AR: 64 (78.05%) vs. instructor: 74 (91.36%), P<0.001] were significantly higher in the instructor-led group. Heterogeneity of the effect of AR self-training on the chest-compression rate were found in subgroups of sex (P=0.03 for the interaction) and weight (P=0.03 for the interaction). Discussion: The AR self-training and instructor-led training are comparable in terms of both groups’ compression rate and depth. This study may have important implications to improve the CPR training rates in China.
摘要目的:中国普通人群心肺复苏(CPR)培训率较低。增强现实(AR)可能是一种有效的CPR培训方法,特别是在无法进行面对面互动的情况下。本研究的目的是分析非专业医护人员进行心肺复苏术自我训练的有效性。方法:采用两组前瞻性随机对照试验。参与者于2021年8月至10月在北京通过广告招募,并随机分配到AR自我训练CPR组(n=82)或教练指导的训练组(n=81)。AR组的参与者在模拟环境中花了25分钟,使用HoloLens进行沉浸式多感官心肺复苏自我训练。教练指导组的参与者在持证教练的指导下接受了25分钟的心肺复苏术指导。比较两组的结果,包括平均胸按压深度(厘米)和频率(/分钟)、手部正确定位的比例、正确的人工呼吸、按压准确性以及遵守美国心脏协会CPR指南的参与者比例。结果:受试者年龄中位数为23岁(四分位数范围为22-25),体重中位数为55 kg(四分位数范围为51-63)。两组间压缩率的平均差异(95% CI) [mean (SD): AR 109.03 (2.68)/min vs.教师引导的110.88 (3.03)/min]为- 1.85(- 2.74至- 0.96)/min。两组间按压深度的平均差异(95% CI) [mean (SD): AR 5.59 (0.59) cm vs.教师引导的5.55 (0.47)cm]为0.04(- 0.13至0.20)cm。通过按压频率和按压深度来衡量,AR自我训练不逊于指导员指导的CPR训练(P<0.001)。两组中遵守AHA压缩深度指南的参与者比例(AR: 65.85% vs.指导员:72.84%,χ2=0.935, P=0.334)相似。指导员组正确抢救呼吸比例[AR: 64(78.05%)比指导员组74 (91.36%),P<0.001]显著高于指导员组。在性别(相互作用P=0.03)和体重(相互作用P=0.03)亚组中,AR自我训练对胸压率的影响存在异质性。讨论:在两组的压缩率和深度方面,AR自主训练和讲师指导训练具有可比性。本研究对提高中国心肺复苏术培训率具有重要意义。
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引用次数: 0
Trends of fecal calprotectin levels and associations with early life experience in preterm infants. 早产儿粪便钙保护蛋白水平的变化趋势及其与早期生活经历的关系。
Pub Date : 2022-11-01 DOI: 10.1097/NR9.0000000000000006
Wanli Xu, Yiming Zhang, Wenxiao Zhao, Jie Chen, Kendra Maas, Naveed Hussain, Wendy A Henderson, Xiaomei Cong

Background: Preterm infants are at risk for severe infections due to their immature immune systems. Factors such as early life pain/stress experiences and feeding may influence immune activation and maturation of immune systems. However, the underlying mechanism remains unclear. Fecal calprotectin (FCP) is a noninvasive surrogate biomarker of mucosal inflammation in the gastrointestinal tract and has been used in detecting intestinal inflammation in specific pediatric gastrointestinal disorders.

Objective: To describe the longitudinal trajectory of FCP levels in preterm infants and investigate the contributing factors that are associated with FCP levels.

Design: A longitudinal study design was used.

Settings: Preterm infants were recruited from 2 neonatal intensive care units (NICU) of a children's medical center in the North-eastern US.

Methods: Preterm infants were followed during their first 4 weeks of NICU hospitalization. Stool samples were collected twice per week to quantify the FCP levels. Cumulative pain/stress experiences and feeding types were measured daily. A linear mixed-effect model was used to examine the associations between FCP levels and demographic and clinical characteristics, cumulative pain/stress, and feeding over time.

Results: Forty-nine preterm infants were included in the study. Infants' FCP levels varied largely with a mean of 268.7±261.3 µg/g and increased over time. Preterm infants experienced an average of 7.5±5.0 acute painful procedures and 15.3±20.8 hours of chronic painful procedures per day during their NICU stay. The mean percentage of mother's own milk increased from the first week (57.1±36.5%) to the fourth week (60.7±38.9%) after birth. Elevated FCP concentration was associated with acute and cumulative (chronic) pain/stress levels, mother's own milk, non-White race, and higher severity of illness score.

Conclusions: FCP levels were elevated in preterm infants with wide interindividual and intraindividual variations. Cumulative pain/stress during the NICU hospitalization, feeding, race, and health status may influence FCP concentrations in early life that may be associated with inflammatory gut processes.

背景:由于早产儿免疫系统不成熟,他们有严重感染的风险。早期生活中的疼痛/压力经历和喂养等因素可能影响免疫系统的激活和成熟。然而,其潜在机制尚不清楚。粪钙保护蛋白(FCP)是胃肠道粘膜炎症的一种无创替代生物标志物,已被用于检测特定儿科胃肠道疾病的肠道炎症。目的:描述早产儿FCP水平的纵向轨迹,并探讨与FCP水平相关的影响因素。设计:采用纵向研究设计。环境:从美国东北部儿童医疗中心的2个新生儿重症监护病房(NICU)招募早产儿。方法:对新生儿重症监护病房前4周早产儿进行随访。每周收集两次粪便样本以量化FCP水平。每天测量累积疼痛/应激体验和喂养类型。使用线性混合效应模型来检查FCP水平与人口统计学和临床特征、累积疼痛/压力和喂养之间的关系。结果:49例早产儿纳入研究。婴儿的FCP水平变化很大,平均为268.7±261.3µg/g,并随着时间的推移而增加。在新生儿重症监护病房期间,早产儿平均每天经历7.5±5.0个急性疼痛过程和15.3±20.8个慢性疼痛过程。自出生后第1周(57.1±36.5%)至第4周(60.7±38.9%),母乳平均百分比有所增加。FCP浓度升高与急性和累积(慢性)疼痛/压力水平、母乳、非白种人和较高的疾病严重程度评分有关。结论:早产儿FCP水平升高具有广泛的个体间和个体内差异。NICU住院期间的累积疼痛/应激、喂养、种族和健康状况可能影响生命早期FCP浓度,这可能与炎症性肠道过程有关。
{"title":"Trends of fecal calprotectin levels and associations with early life experience in preterm infants.","authors":"Wanli Xu,&nbsp;Yiming Zhang,&nbsp;Wenxiao Zhao,&nbsp;Jie Chen,&nbsp;Kendra Maas,&nbsp;Naveed Hussain,&nbsp;Wendy A Henderson,&nbsp;Xiaomei Cong","doi":"10.1097/NR9.0000000000000006","DOIUrl":"https://doi.org/10.1097/NR9.0000000000000006","url":null,"abstract":"<p><strong>Background: </strong>Preterm infants are at risk for severe infections due to their immature immune systems. Factors such as early life pain/stress experiences and feeding may influence immune activation and maturation of immune systems. However, the underlying mechanism remains unclear. Fecal calprotectin (FCP) is a noninvasive surrogate biomarker of mucosal inflammation in the gastrointestinal tract and has been used in detecting intestinal inflammation in specific pediatric gastrointestinal disorders.</p><p><strong>Objective: </strong>To describe the longitudinal trajectory of FCP levels in preterm infants and investigate the contributing factors that are associated with FCP levels.</p><p><strong>Design: </strong>A longitudinal study design was used.</p><p><strong>Settings: </strong>Preterm infants were recruited from 2 neonatal intensive care units (NICU) of a children's medical center in the North-eastern US.</p><p><strong>Methods: </strong>Preterm infants were followed during their first 4 weeks of NICU hospitalization. Stool samples were collected twice per week to quantify the FCP levels. Cumulative pain/stress experiences and feeding types were measured daily. A linear mixed-effect model was used to examine the associations between FCP levels and demographic and clinical characteristics, cumulative pain/stress, and feeding over time.</p><p><strong>Results: </strong>Forty-nine preterm infants were included in the study. Infants' FCP levels varied largely with a mean of 268.7±261.3 µg/g and increased over time. Preterm infants experienced an average of 7.5±5.0 acute painful procedures and 15.3±20.8 hours of chronic painful procedures per day during their NICU stay. The mean percentage of mother's own milk increased from the first week (57.1±36.5%) to the fourth week (60.7±38.9%) after birth. Elevated FCP concentration was associated with acute and cumulative (chronic) pain/stress levels, mother's own milk, non-White race, and higher severity of illness score.</p><p><strong>Conclusions: </strong>FCP levels were elevated in preterm infants with wide interindividual and intraindividual variations. Cumulative pain/stress during the NICU hospitalization, feeding, race, and health status may influence FCP concentrations in early life that may be associated with inflammatory gut processes.</p>","PeriodicalId":73407,"journal":{"name":"Interdisciplinary nursing research","volume":"1 1","pages":"36-42"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/0f/nr9-1-36.PMC9766919.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10459362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Emerging information technologies for the next generation of elderly care 新兴的资讯科技为下一代长者提供照顾
Pub Date : 2022-11-01 DOI: 10.1097/NR9.0000000000000003
Ting Zhang, Xiao Li
As life expectancy increases and fertility rates decrease, many middle-income and high-income countries are becoming “ aging countries ” 1 . This has introduced many challenges to current health care systems.
随着预期寿命的增加和生育率的下降,许多中等收入和高收入国家正在成为“老龄化国家”。这给当前的卫生保健系统带来了许多挑战。
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引用次数: 0
An RGB camera-based fall detection algorithm in complex home environments 基于RGB相机的复杂家庭环境跌倒检测算法
Pub Date : 2022-11-01 DOI: 10.1097/NR9.0000000000000007
Zhiyu Tian, L. Zhang, Guoan Wang, Xuefeng Wang
Abstract Objectives: Accidental falls are a threat to the well-being of older people. This study aimed to develop a real-time human fall detection system to detect fall behaviors and provide timely medical treatment for older adults. Methods: An RGB camera-based fall detection system is designed and it can send alarm messages when a fall occurs. This fall detection system consists of two design aspects: a hardware and a software algorithm. The fall detection algorithm includes (1) algorithm initialization phase to obtain environmental parameters; (2) 2-dimensional pose detection to identify human targets and human joint locations; and (3) limb-length and multiframe fall judgment to confirm the occurrence of falls based on its practical features. Results: By combining fall detection algorithms with a hardware system, the test results in complex home environments showed that the system sensitivity was 94.2%, the specificity was 96%, and the accuracy was 94.5%. Conclusion: The proposed method is more robust compared with the algorithm based exclusively on action recognition. Using only a monocular camera is cost-friendly and can realize real-time fall detections, and help older people to get timely and effective care after a fall.
摘要目的:意外跌倒是对老年人健康的威胁。本研究旨在开发一种实时人体跌倒检测系统,以检测老年人的跌倒行为,并提供及时的医疗治疗。方法:设计一种基于RGB摄像机的跌倒检测系统,并在发生跌倒时发送报警信息。该跌落检测系统由硬件和软件算法两部分组成。跌落检测算法包括(1)算法初始化阶段获取环境参数;(2)二维姿态检测,识别人体目标和人体关节位置;(3)根据其实际特点进行肢体长度和多帧跌落判断,确认跌落的发生。结果:将跌倒检测算法与硬件系统相结合,在复杂家庭环境下的测试结果表明,系统灵敏度为94.2%,特异性为96%,准确率为94.5%。结论:与单纯基于动作识别的算法相比,该方法具有更强的鲁棒性。仅使用单目摄像头成本低廉,可以实现实时跌倒检测,帮助老年人在跌倒后得到及时有效的护理。
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引用次数: 2
期刊
Interdisciplinary nursing research
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