To investigate the prevalence of post-traumatic stress disorder (PTSD) symptoms in the hard-hit areas 10 years after the Wenchuan earthquake, and explore the risk factors of long-term PTSD among ...Wenchuan earthquake survivors.
A matched case-control study was conducted. The involving participants were from the hard-hit areas 10 years after the Wenchuan earthquake. The collected information includes demographic characteristics, socioeconomic status, behaviour habits, earthquake exposure, perceived social support, physical health and mental health. Mental health status was measured using the PTSD Checklist-Civilian Version (PCL-C). Respondents with PCL-C score ⩾38 were classified as cases, and then the cases and controls were matched based on age (±3 years) and community location according to a ratio of 1:3.
We obtained 86 cases and 258 controls. After controlling for confounding factors, it was found that lower income (OR 2.42; 95% CI 1.16-5.03), chronic diseases (OR 3.00; 95% CI 1.31-6.88) and death of immediate families in the earthquake (OR 7.30; 95% CI 2.36-22.57) were significantly associated with long-term PTSD symptoms.
Even 10 years after the Wenchuan earthquake, the survivors in the hard-hit areas still suffered from severe mental trauma. Low income, chronic diseases and death of immediate families in the earthquakes are significantly associated with long-term PTSD symptoms. Interventions by local governments and health institutions to address these risk factors should be undertaken to promote the health of survivors.
In this paper, an aluminum foam sandwich (AFS) was prepared by the rolling composite-powder metallurgy method, and its fatigue properties were studied. It was compared with an AFS made by the ...adhesive method to study its fatigue properties more directly. In this experiment, the fatigue performance was investigated by studying the microscopic interface, fatigue life, deflection curve, and failure mode. The results show that the fatigue life of an AFS with the rolling composite-powder metallurgy method is much longer than that with the adhesive method. The failure mode of an AFS made by the rolling composite-powder metallurgy method is shear failure, and that of an AFS made by the adhesive method is shear failure and interface debonding. An AFS with the rolling composite-powder metallurgy method has better fatigue properties. This paper also explored the fatigue damage model using the fatigue modulus method, and the polynomial fitting method has a higher fitting degree.
Abstract
Background
In China, fragmented and inefficient health care systems are common while quality resources are limited. To promote an organized, efficient system, the government launched a ...medical consortium policy to vertically integrate health care through the collaboration of different levels of medical care. Logically, medical staff’s knowledge, attitudes and practices (KAP) regarding the consortium are critical for its development. The objective of this study was to explore the KAP regarding the medical consortium among medical staff in a medical consortium in Sichuan Province, China.
Methods
A cross-sectional survey was conducted. In total, 690 medical staff members in 3 cities of Sichuan Province, China, were interviewed from November 2018 to December 2018. The questionnaire consisted of 18 items, including 4 items related to perceived knowledge, 4 items related to attitudes and 2 items related to practices, and was rated on a 5-point Likert scale (one = strongly disagree/do not know, five = strongly agree/know).
Results
The effective response sample was 640 copies of the questionnaire, and most medical staff members (92.50%) knew about the cooperation with other hospitals in the medical consortium. Medical staff scored differently on each item in the questionnaire, with the highest score being the item ‘agreeing with the ward rounds and clinical teaching and training organized by the leading hospital’ (4.54 ± 0.76), and the lowest score being the item ‘frequency in participating in ward rounds and clinical teaching organized by the leading hospital’ (2.83 ± 1.36). In addition, the effect of demographic characteristics on KAP was evaluated by stepwise multiple regression analysis, and a significant positive correlation was found between all the studied variables by Spearman’s correlation (p < 0.05).
Conclusions
This study showed that the attitudes toward and knowledge of the medical consortium significantly contribute to practices, satisfaction with the support work performed by the leading hospital and agreement of improvement after joining the medical consortium. Thus, to improve medical staff’s KAP and satisfaction, publicity and educational programs in medical consortia are necessary, and the leading hospital should attach importance to the informatization construction and demand of different medical staff members.
Clinical trial registration
There are no clinical trials in this study.
While previous research shows that bilinguals' ability to mix and switch between two separate languages is influenced by both cross-language similarity and language use contexts, little attention has ...been paid to bidialectal populations. Given the linguistic and sociolinguistic differences between bilingualism and bidialectalism, it is thus unclear to what extent mechanisms underlying bidialectal variety switching resemble those underlying bilinguals. To investigate the effects of cross-variety phonological distance and variety use contexts on variety switching, we tested two groups of Chinese speakers in a bidialectal auditory word recognition task. Both groups speak a regional dialect (Chengdu Mandarin or Cantonese) as their native language and are also highly proficient in Standard Mandarin. Participants' language background and linguistic experience are collected by a language background questionnaire. Mixing and switching between two varieties are costly for bidialectal speakers in comprehension. Mixing costs can be attributed to variety switches instead of the mere presence of a mixed-variety context. While variety switch and mixing costs are not influenced by cross-variety phonological distance, they are modulated by variety dominance and habitual variety use contexts. This study highlights the similarities between bidialectals and bilinguals in language processing, as well as the significance of recognizing between- and within-group differences in conducting psycholinguistics research with multilingual populations.
Many countries, including China, have identified the primary health care system as a reform priority. The purpose of this study is to compare the perceived service capacity of primary care from the ...perspectives of physicians and their patients in Sichuan province of China.
A cross-sectional survey was conducted through Quality and Costs of Primary Care (QUALICOPC) questionnaires. A representative sample of 319 primary care physicians and 641 patients in 48 primary healthcare settings were recruited to take part in the study.
Physicians perceived equity of care the best, while quality of care was rated the highest from the perspective of patients. They both regarded coordination as the weakest dimension of primary care service capacity.
Although primary health care reform may have been effective in helping patients acquire better primary care services, our results suggest that coordination is still perceived to be problematic for both physicians and patients. Improving the coordination of care has to be one of the main goals in the future primary care reforms in China.
Delayed-onset post-traumatic stress disorder after catastrophes is a major public health issue. However, good designs for identifying post-traumatic stress disorder (PTSD) among earthquake survivors ...are rare. This is the first nested case-control study to explore the possible factors associated with delayed-onset PTSD symptoms.
A nested case-control study was conducted. The baseline (2011) and follow-up (2018) surveys were utilized to collect data. A total of 361 survivors of the Wenchuan earthquake were investigated and 340 survivors underwent follow-up. The survivors, from the hardest-hit areas, who met the criteria for PTSD were included in the case group, and PTSD-free survivors from the same area, matched for age, were included in the control group, with a ratio of one to four. Conditional logistic regression was used to evaluate the variables' odds ratio (OR).
The overall prevalence of delayed-onset PTSD symptoms in survivors of the Wenchuan earthquake was 9.7% (33/340). The unemployed earthquake survivors had a higher risk of developing delayed-onset PTSD symptoms (OR = 4.731, 95% CI = 1.408-15.901), while higher perceived social support was a protective factor against delayed-onset PTSD symptoms (OR = 0.172, 95% CI = 0.052-0.568).
Delayed-onset PTSD symptoms, after a disaster, should not be ignored. Active social support and the provision of stable jobs can contribute to the earthquake survivors' mental health.
Neurexins are presynaptic membrane cell-adhesion molecules which bind to neuroligins, a family of proteins that are associated with autism. To explore the possibility that structural variants in the ...neurexin α genes predispose to autism, the coding regions and associated splice junctions of the neurexin 1α gene were sequenced in 116 Caucasian patients with autism and 192 Caucasian controls. Five ultra-rare structural variants including a predicted splicing mutation were found in patients with autism and absent in 10,000 control alleles. Only one ultra-rare structural variant was found in controls (5/116 vs. 1/192;
P
=
0.03, Fisher's exact test, one-sided). In the context of all available data, the ultra-rare structural variants of the neurexin 1α gene are consistent with mutations predisposing to autism.
We describe a novel congenital motor neuron disease with early demise due to respiratory insufficiency with clinical overlap with spinal muscular atrophy with respiratory distress (SMARD) type 1 but ...lacking a mutation in the IGHMBP2 gene.
Exome sequencing was used to identify a de novo mutation in the LAS1L gene in the proband. Pathogenicity of the mutation was validated using a zebrafish model by morpholino-mediated knockdown of las1l.
We identified a de novo mutation in the X-linked LAS1L gene in the proband (p.S477N). The mutation is in a highly conserved region of the LAS1L gene predicted to be deleterious by bioinformatic analysis. Morpholino-based knockdown of las1l, the orthologous gene in zebrafish, results in early lethality and disruption of muscle and peripheral nerve architecture. Coinjection of wild-type but not mutant human RNA results in partial rescue of the phenotype.
We report a patient with a SMARD phenotype due to a mutation in LAS1L, a gene important in coordinating processing of the 45S pre-rRNA and maturation of the large 60S ribosomal subunit. Similarly, the IGHMB2 gene associated with SMARD type 1 has been suggested to have an important role in ribosomal biogenesis from its role in processing the 45S pre-rRNA. We propose that disruption of ribosomal maturation may be a common pathogenic mechanism linking SMARD phenotypes caused by both IGHMBP2 and LAS1L.
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