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Self-perceived health is an important indicator of illness and mortality. This study aims at identifying a wide range of factors that can influence self-perceived health status among a representative sample in Portugal.
We used the 2014 National Health Survey (
= 17,057), whereby participants were required to assess their health status from "Very good," "Good," "Fair," "Poor" to "Very poor." We grouped the answers "Very good" and "Good," and "Poor" and "Very poor," respectively. Multinomial logistic regression was used to compare participants' characteristics across groups by computing odds ratio and corresponding 95% confidence intervals. Models included Socioeconomic/demographic characteristics, objective health status, healthcare use, functional disability, barriers to healthcare services utilization, lifestyle variables, mental health status, social support, and satisfaction with life as potential factors that can affect self-perceived health. Models were adjusted for sex, age, educational level, dee of socioeconomic factors, chronic illness, barriers to access healthcare services, social isolation, and mental health status in influencing self-perceived health and highlights the urgent need for social-informed policies, strategies, and interventions to reduce health inequalities in Portugal.
Subjects living in Portugal tend to report less good/very good health status and more poor/very poor health when compared to the rest of Europe. This study stresses the importance of socioeconomic factors, chronic illness, barriers to access healthcare services, social isolation, and mental health status in influencing self-perceived health and highlights the urgent need for social-informed policies, strategies, and interventions to reduce health inequalities in Portugal.Malaria is a serious and lethal disease that has been reported by the World Health Organization (WHO), with an estimated 219 million new cases and 435,000 deaths globally. The most frequent malaria detection method relies mainly on the specialists who examine the samples under a microscope. Therefore, a computerized malaria diagnosis system is required. In this article, malaria cell segmentation and classification methods are proposed. Muvalaplin concentration The malaria cells are segmented using a color-based k-mean clustering approach on the selected number of clusters. After segmentation, deep features are extracted using pre-trained models such as efficient-net-b0 and shuffle-net, and the best features are selected using the Manta-Ray Foraging Optimization (MRFO) method. Two experiments are performed for classification using 10-fold cross-validation, the first experiment is based on the best features selected from the pre-trained models individually, while the second experiment is performed based on the selection of best features from the fusion of extracted features using both pre-trained models. The proposed method provided an accuracy of 99.2% for classification using the linear kernel of the SVM classifier. An empirical study demonstrates that the fused features vector results are better as compared to the individual best-selected features vector and the existing latest methods published so far.Enterocytozoon bieneusi is a zoonotic pathogen commonly found in humans and animals all over the world. Here, we investigated the occurrence and genotype constitute of E. bieneusi among the individuals from Haikou city of Hainan, China. A total of 1,264 fecal samples of humans were collected, including 628 samples from patients with diarrhea (325 adults and 303 children) and 636 samples from the asymptomatic population (383 college students and 253 kindergarten children). E. bieneusi was detected using nested polymerase chain reaction (PCR) amplification of the internal transcribed spacer (ITS) region. A phylogenetic tree was constructed using a neighbor-joining tree construction method. The overall prevalence of E. bieneusi was 3.7% (47/1,264), while it was 5.6% in the patients with diarrhea (5.8% in adults and 5.3% in children) and 1.9% in the asymptomatic population (2.9% in college students and 0.4% in kindergarten children). The prevalence of E. bieneusi in humans with diarrhea was significantly higher than that in the asymptomatic population (χ2 = 36.9; P less then 0.05). A total of 28 genotypes were identified, including ten known genotypes CHG2 (n = 3), CHG3 (n = 5), CHG5 (n = 10), CM21 (n = 1), EbpA (n = 1), EbpC (n = 1), PigEBITS4 (n = 1), PigEBITS7 (n = 1), SHR1 (n = 4), Type IV (n = 2), and 18 novel genotypes (HNH-1 to HNH-18; one each). All these genotypes were categorized into three groups, including group 1 (n = 6), group 2 (n = 14), and group 13 (n = 8). This was the first study on the identification of E. bieneusi among humans in Hainan, China. The correlation between E. bieneusi infection and diarrhea was observed. The high diversity and distinctive distribution of E. bieneusi genotypes found in this study reflected the unique epidemic genetic characteristics of E. bieneusi in humans living in Hainan.
Adolescence and emerging adulthood are critical periods for an individual's sexual identity development. The internet has become a primary avenue for gay identity exploration. The purpose of this study was to examine the role of the internet in Chinese young gay male's sexual identity development.
Qualitative interviews were conducted with 37 gay males aged 16 to 29. Data were analyzed using grounded theory methods.
Three categories of identity development in relation to use of the internet were identified (1)
, which includes verifying same-sex attraction and connecting the attraction feeling to gay identity through consumption of pornography, Tanbi (boy's love) materials, and searching for information online. (2)
, includes interacting with the gay community to gain understandings of gay subcultures and make close gay friends, engaging in same-sex sexual and romantic relationship development through online group and interpersonal interactions. The internet practice impact on an individual's cognitcate that an individual's internet practice facilitates gay identity confirmation, enriches identity practice, and promotes the transition from self-identification to identity disclosure and integration. Internet practice also threatens to young gay males' sexual risk behavior, emotional hurts from failed romantic relationships. Interventions including sexual identity education and healthy internet use strategies need to be developed tailored to the developmental characteristics.
This study examined whether pandemic related family economic hardships influenced adolescents' mental health during the COVID-19 pandemic in Korea.
Data were collected from 54,948 adolescents who participated in the 2020 Korea Youth Risk Behavior Web-Based Survey. We performed a multiple logistic regression analysis to examine the association between family economic hardship and mental health (anxiety, depressive symptoms, and suicidal ideation).
Among the adolescents, 39.7, 24.7, and 5.9% reported slight, moderate, and severe economic hardship, respectively. COVID-19 related family economic hardship was significantly associated with higher odds of adolescents reporting anxiety, depressive symptoms, and suicidal ideation. This association was stronger among adolescents with low to middle family economic status.
This study suggests that adolescents from more economically vulnerable families are likely to be at a higher risk for long-term mental health effects due to the financial consequences of the COVID-19 pandemic.
This study suggests that adolescents from more economically vulnerable families are likely to be at a higher risk for long-term mental health effects due to the financial consequences of the COVID-19 pandemic.Most tourism researchers agree on the effects of the COVID-19 on ecotourism. The present study aims to assess the effects of the COVID-19 pandemic on the ecotourism status in Lorestan province in Iran. To this aim, 29 effects were identified using Delphi technique. According to results, the effects were divided into six categories including the decreased number of incoming tourists, the reduced activity of hotels and resorts, the declined income of goods and service suppliers for tourists, the decreased activity of travel agencies and tourist tours, as well as positive and negative environmental effects. Generally, the results provide new knowledge in the field of ecotourism crisis management. In addition, the identified effects provide the basis for further research on the method of reducing the negative effects.
Physical restraint (PR) reduction interventions are currently exploring in developed regions with well-established welfare systems, whereas developing countries with fast population aging have not attracted enough attention. This China's pilot study evaluated the effects of a minimized PR program on restraint reduction and nursing assistants' knowledge, attitudes, intention, and practice toward PR and explored nursing assistants' experience of the program.
This was a one-group, pretest, and posttest pilot trial with a nested qualitative descriptive study. A minimized PR program was obtained by summarizing the best evidence and was implemented in one Chinese nursing home with 102 older adults from December 18, 2020, to March 21, 2021. An educational program including three theoretical lectures and one operation training was first conducted for nursing assistants one-month period. The primary outcome was PR rate at 3 months. The secondary outcomes contained duration of restraints, types of restraints, the rte and other secondary outcomes at follow-up. Qualitatively, nursing assistants demonstrated overtly supportive perspectives and that assistance from the program enhanced their knowledge and practice. They noted several challenges that impeded implementation.
The intervention has acknowledged some benefits and was valued by nursing assistants. Implementation barriers should be addressed before delivering in larger trials.
The intervention has acknowledged some benefits and was valued by nursing assistants. Implementation barriers should be addressed before delivering in larger trials.
The coronavirus disease 2019 (COVID-19) public health emergency has amplified the potential value of deploying telehealth solutions. Less is known about how trends in access to care through telehealth changed over time.
To investigate trends in forgone care and telehealth coverage among Medicare beneficiaries during the COVID-19 pandemic.
A cross-sectional study design was used to analyze the outcomes of 31,907 Medicare beneficiaries using data from three waves of survey data from the Medicare Current Beneficiary Survey COVID-19 Supplement (Summer 2020, Fall 2020, and Winter 2021). We identified informative variables through a multivariate classification analysis utilizing Random Forest machine learning techniques.
The rate of reported forgone medical care because of COVID-19 decreased largely (22.89-3.31%) with a small increase in telehealth coverage (56.24-61.84%) from the week of June 7, 2020, to the week of April 4 to 25, 2021. Overall, there were 21.97% of respondents did not know whether their primary care providers offered telehealth services; the rates of forgone care and telehealth coverage were 11.