The diagnosis and treatment of cancer triggers not only a negative psychological response for the patient, but also a positive psychological outcome. Positive dyadic coping, as a form of coping for ...mental health outcomes, can maintain or reestablish internal stability between the patient and his or her spouse, resulting in positive physical and psychological changes. However, there is a paucity of research on body image, dyadic coping, and post-traumatic growth in breast cancer patients. The purpose of this study was to explore the relationship and pathways between body image, dyadic coping, and post-traumatic growth in breast cancer patients.
A cross-sectional study was conducted from November 2022 to November 2023 at a tertiary care hospital in Wuxi, Jiangsu, China. This study was conducted among 154 breast cancer patients treated at the Affiliated Hospital of Jiangnan University, all of whom completed demographic and clinical information questionnaires, Body image self-rating questionnaire for breast cancer (BISQ-BC), Dyadic Coping Inventory (DCI) and Post Traumatic Growth Inventory (PTGI). A Pearson correlation analysis was used to explore the relationship between body image, dyadic coping, and post-traumatic growth. Structural equation modeling was used to analyze the path relationships among the three and to explore the mediating role of dyadic coping.
The level of body image was negatively correlated with post-traumatic growth (
= -0.462,
< 0.01); and the level of body image was negatively correlated with dyadic coping (
= -0.308,
< 0.01). And dyadic coping was positively associated with post-traumatic growth (
= 0.464,
< 0.01). The structural equation modeling results supported the mediation model with the following model fit indices, chi-square to degrees of freedom ratio (χ
/df = 2.05), goodness of fit index (GFI = 0.93), comparative fit index (CFI = 0.99), canonical fit index (NFI = 0.93), incremental fit index (IFI = 0.99), non-canonical fit index (TLI = 0.99) and the root mean square of the difference in approximation error (RMSEA = 0.03). Body image and dyadic coping directly affected post-traumatic growth (
= -0.33,
< 0.05;
= 0.43,
< 0.05). And body image indirectly influenced post-traumatic growth through dyadic coping (
= -0.17,
< 0.05).
Interconnections between body image, dyadic coping, and post-traumatic growth in breast cancer patients. A preliminary validation of the mediating role of dyadic coping between body image and post-traumatic growth, body image can have an impact on dyadic coping, which in turn can have an impact on post-traumatic growth. Whereby higher levels of dyadic coping in patients may also be associated with higher levels of post-traumatic growth, whereas body image disturbance may impede levels of post-traumatic growth.
Preoperative inflammatory factors and nutritional status are strongly associated with the prognosis of a variety of cancers. We explored the relationship between preoperative lymphocytes, neutrophils ...and albumin (LANR) and progression-free survival in breast cancer patients.
The clinical and follow-up data of 200 breast cancer patients were retrospectively analyzed in this study, and the value of LANR was determined as follows: LANR, lymphocytes × albumin/neutrophils. ROC curves, COX proportional risk regression analysis and subgroup analysis were used to assess the prognostic value of LANR in progression-free survival of breast cancer patients.
The median age of the patients was 55.5 years (range 50-62 years). The median follow-up time was 46 months (range 33-55 months). In progression-free survival, the area under the LANR curve was 0.748 and the HR (95% CI) was 0.035 (0.679-0.817). LANR was associated with age (
= 0.02), positive axillary lymph nodes (
< 0.001), TNM stage (
< 0.001) and human epidermal growth factor receptor 2(
= 0.004). The results indicated that preoperative LANR may be a reliable predictor of progression-free survival in patients with operable breast cancer.
LANR may be an essential predictor for breast cancer patients and provides a therapeutic basis for clinicians and patients.
Abstract
Background
The eating behaviors of older adults are associated with multiple factors. To promote older adults’ healthy diets, it is imperative to comprehensively study the factors associated ...with the eating behaviors of the aging population group. This study aimed to probe the associated factors of older adults’ eating behaviors from a socioecological model (SEM) perspective.
Methods
In 2021, a cross-sectional survey was performed to recruit participants in China. The survey data were analyzed using a multivariate generalized linear model to identify the factors associated with eating behaviors in older adults. Standardized regression coefficients (β) and 95% confidence intervals (CIs) were estimated using a multivariate generalized linear model.
Results
The survey contained 1147 valid older adult participants. Multivariate generalized linear model results showed that older adults with older age aged 71–80 (β = -0.61), ≥ 81 (β = -1.12), conscientiousness personality trait (β = -0.27), and higher family health levels (β = -0.23) were inclined to have better eating behaviors. The older adults with higher education levels junior high school and high school (β = 1.03), junior college and above (β = 1.71), higher general self-efficacy (β = 0.09), more severe depression symptoms (β = 0.24), and employment (β = 0.82) tended to have poorer eating behaviors.
Conclusions
This study identified factors that are specifically associated with older adults’ eating behaviors from an SEM perspective. The comprehensive multiple-angle perspective consideration may be a valuable idea for studying healthy eating behaviors in older adults.
With the advent of a new era for health and medical treatment, characterized by the integration of mobile technology, a significant digital divide has surfaced, particularly in the engagement of ...older individuals with mobile health (mHealth). The health of a family is intricately connected to the well-being of its members, and the use of media plays a crucial role in facilitating mHealth care. Therefore, it is important to examine the mediating role of media use behavior in the connection between the family health of older individuals and their inclination to use mHealth devices.
This study aims to investigate the impact of family health and media use behavior on the intention of older individuals to use mHealth devices in China. The study aims to delve into the intricate dynamics to determine whether media use behavior serves as a mediator in the relationship between family health and the intention to use mHealth devices among older adults. The ultimate goal is to offer well-founded and practical recommendations to assist older individuals in overcoming the digital divide.
The study used data from 3712 individuals aged 60 and above, sourced from the 2022 Psychology and Behavior Investigation of Chinese Residents study. Linear regression models were used to assess the relationships between family health, media use behavior, and the intention to use mHealth devices. To investigate the mediating role of media use behavior, we used the Sobel-Goodman Mediation Test. This analysis focused on the connection between 4 dimensions of family health and the intention to use mHealth devices.
A positive correlation was observed among family health, media use behavior, and the intention to use mHealth devices (r=0.077-0.178, P<.001). Notably, media use behavior was identified as a partial mediator in the relationship between the overall score of family health and the intention to use mHealth devices, as indicated by the Sobel test (z=5.451, P<.001). Subgroup analysis further indicated that a complete mediating effect was observed specifically between family health resources and the intention to use mHealth devices in older individuals with varying education levels.
The study revealed the significance of family health and media use behavior in motivating older adults to adopt mHealth devices. Media use behavior was identified as a mediator in the connection between family health and the intention to use mHealth devices, with more intricate dynamics observed among older adults with lower education levels. Going forward, the critical role of home health resources must be maximized, such as initiatives to develop digital education tailored for older adults and the creation of media products specifically designed for them. These measures aim to alleviate technological challenges associated with using media devices among older adults, ultimately bolstering their inclination to adopt mHealth devices.
Patients with type 2 diabetes (T2DM) have an increasing need for personalized and Precise management as medical technology advances. Artificial intelligence (AI) technologies on mobile devices are ...being developed gradually in a variety of healthcare fields. As an AI field, knowledge graph (KG) is being developed to extract and store structured knowledge from massive data sets. It has great prospects for T2DM medical information retrieval, clinical decision-making, and individual intelligent question and answering (QA), but has yet to be thoroughly researched in T2DM intervention. Therefore, we designed an artificial intelligence-based health education accurately linking system (AI-HEALS) to evaluate if the AI-HEALS-based intervention could help patients with T2DM improve their self-management abilities and blood glucose control in primary healthcare.
This is a nested mixed-method study that includes a community-based cluster-randomized control trial and personal in-depth interviews. Individuals with T2DM between the ages of 18 and 75 will be recruited from 40-45 community health centers in Beijing, China. Participants will either receive standard diabetes primary care (SDPC) (control, 3 months) or SDPC plus AI-HEALS online health education program (intervention, 3 months). The AI-HEALS runs in the WeChat service platform, which includes a KBQA, a system of physiological indicators and lifestyle recording and monitoring, medication and blood glucose monitoring reminders, and automated, personalized message sending. Data on sociodemography, medical examination, blood glucose, and self-management behavior will be collected at baseline, as well as 1,3,6,12, and 18 months later. The primary outcome is to reduce HbA1c levels. Secondary outcomes include changes in self-management behavior, social cognition, psychology, T2DM skills, and health literacy. Furthermore, the cost-effectiveness of the AI-HEALS-based intervention will be evaluated.
KBQA system is an innovative and cost-effective technology for health education and promotion for T2DM patients, but it is not yet widely used in the T2DM interventions. This trial will provide evidence on the efficacy of AI and mHealth-based personalized interventions in primary care for improving T2DM outcomes and self-management behaviors.
Biomedical Ethics Committee of Peking University: IRB00001052-22,058, 2022/06/06; Clinical Trials: ChiCTR2300068952, 02/03/2023.
This study was conducted to describe secondhand smoke (SHS) exposure among non-smoking employees in the workplace, and identify factors related to SHS exposure in Qingdao.
The study participants ...covered key non-smoking places stipulated in the "Qingdao City Smoking Control Regulations," which included three categories: restaurants, bars, and office buildings. Airborne nicotine concentration in the workplace and saliva cotinine concentration of employees were measured. The questionnaire included employees' demographic factors, smoke-free measures in the workplace, employers' tobacco hazard knowledge, and attitudes towards smoke-free policy.
A total of 222 non-smoking employees and 46 non-smoking employers were included in the study. The median concentrations of airborne nicotine and salivary cotinine were 0.389 μg/m3 and 0.575 ng/mL, respectively. Educational status, average number of workplace smokers per day, exposure time to SHS in the workplace, and whether smoking and non-smoking areas were divided significantly related to airborne nicotine concentration. Age, educational status, exposure time to SHS in the workplace, tobacco control training and publicity, and whether the employers support the "Qingdao Tobacco Control Regulation" were significantly related to salivary cotinine concentration.
Despite the implementation of the "Qingdao Smoking Control Regulations" in 2013, the workplace remains an important location for SHS exposure. Interventions such as raising workers' awareness of the risks associated with SHS exposure through health education and developing smoking prevention and cessation programs to reduce SHS exposure in the workplace are urgently needed.
Abstract
Background
COVID-19 pandemic emerged worldwide at the end of 2019, causing a severe global public health threat, and smoking is closely related to COVID-19. Previous studies have reported ...changes in smoking behavior and influencing factors during the COVID-19 period, but none of them explored the main influencing factor and high-risk populations for smoking behavior during this period.
Methods
We conducted a nationwide survey and obtained 21,916 valid data. Logistic regression was used to examine the relationships between each potential influencing factor (sociodemographic characteristics, perceived social support, depression, anxiety, and self-efficacy) and smoking outcomes. Then, variables related to smoking behavior were included based on the results of the multiple logistic regression, and the classification and regression tree (CART) method was used to determine the high-risk population for increased smoking behavior during COVID-19 and the most profound influencing factors on smoking increase. Finally, we used accuracy to evaluated the performance of the tree.
Results
The strongest predictor of smoking behavior during the COVID-19 period is acceptance degree of passive smoking. The subgroup with a high acceptation degree of passive smoking, have no smokers smoked around, and a length of smoking of ≥ 30 years is identified as the highest smoking risk (34%). The accuracy of classification and regression tree is 87%.
Conclusion
The main influencing factor is acceptance degree of passive smoking. More knowledge about the harm of secondhand smoke should be promoted. For high-risk population who smoke, the “mask protection” effect during the COVID-19 pandemic should be fully utilized to encourage smoking cessation.
Unhealthy dietary behaviors and body dissatisfaction are becoming increasingly common among college students. Understanding the association between body image flexibility and intermittent fasting is ...particularly meaningful, especially for medical college students. This study aimed to investigate the association between body image flexibility and intermittent fasting among medical students. We conducted a cross-sectional study with 5138 medical college students at Jitang College of North China University of Science and Technology. Univariate and multivariate logistic regression were used to evaluate the association between body image flexibility and intermittent fasting. Subgroup analysis and interaction tests were further used to examine the possible interaction between body image flexibility and intermittent fasting. In this study, 1329 (25.87%) students had intermittent fasting behavior. After adjustment for confounding factors, there was a negative association between body image flexibility and intermittent fasting (OR = 0.94, 95%CI = 0.93 to 0.95, p < 0.001). A significant interaction between body image flexibility and intermittent fasting was found in gender, academic year, major, and monthly living expenses (p for interaction < 0.05). E-value analysis suggested there was unlikely to be an unmeasured confounding. This association could contribute to the establishment of personalized health intervention strategies and provide recommendations for promoting the physical and mental health of medical students.
Photo crowdsourcing with smartphone has attracted considerable attention recently due to the prevalence of smartphones and the rich information provided by photos. In scenarios such as disaster ...recovery or battlefield, where the cellular network is partly damaged or severely overloaded, Disruption Tolerant Networks (DTNs) become the best way to deliver the crowdsourced photos. Since the bandwidth and storage resources in DTN are very limited and not enough to deliver all the crowdsourced photos, it is important to prioritize more valuable photos to use the limited resources. In this paper, we design a resource-aware photo crowdsourcing framework in DTN, which uses photo metadata including the smartphone's location, orientation, and other built-in camera's parameters, to estimate the value of photos. We propose a photo selection algorithm to maximize the value of photos delivered to the command center considering bandwidth and storage constraints. Both prototype implementation and trace-driven simulations demonstrate the effectiveness of our design.
The Duke Anticoagulation Satisfaction Scale (DASS) offers a method to measure the quality of life and satisfaction of patients taking oral anticoagulants. The study aimed to validate the Chinese ...version of the DASS in Chinese patients on anticoagulation therapy.
The DASS was translated, back-translated, and transculturally adapted into the Chinese version and then administered to participants taking oral anticoagulants in a physician-pharmacist collaborative anticoagulation clinic at a tertiary teaching hospital from October 2019 to December 2020. Reliability was analyzed through Cronbach's alpha (α) and split-half reliability. Confirmatory factor analysis was performed to test the structural validity of the scale. Exploratory factor analysis was performed for items in the scales using the varimax rotation method.
A total of 189 patients completed the Chinese version of the DASS. Four dimensions and 23 items were included, with Cronbach's α values of 0.89, 0.81, 0.89, and 0.74 for limitations on physical activities, diet restrictions, hassles and burdens, and positive psychological effect, respectively. Cronbach's α coefficient of whole scale was 0.91. The split-half reliability of this scale is 0.747 (>0.7).
The Chinese version of the DASS indicated excellent reliability and validity, compared to the original version. It could provide a practical instrument for healthcare practitioners to evaluate satisfaction and quality of life for anticoagulated patients in China. The difference in quality of life between patients taking warfarin and novel oral anticoagulants (NOACs) needs to be further explored in future studies.
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