Objective To evaluate levels of lead(Pb) and cadmium(Cd) in the breast milk in the second postpartum month,to investigate the relationship between Pb/Cd levels in breast milk and some sociodemographic parameters,and t...Objective To evaluate levels of lead(Pb) and cadmium(Cd) in the breast milk in the second postpartum month,to investigate the relationship between Pb/Cd levels in breast milk and some sociodemographic parameters,and to explore whether these levels affect the infants' physical status or the mothers' psychological status(postpartum depression).Methods A cross-sectional study was conducted between November 2009 and December 2010.Altogether 170 healthy mothers were enrolled from Nanjing Maternity and Child Health Care Hospital.The inclusion criteria were:voluntary to participate in this study,healthy,with no chronic disease,breastfeeding in the second postpartum month,living in a suburban but not non-industrial area of Nanjing,and not occupationally exposed to toxic metals.All the mothers completed a questionnaire and were evaluated based on the Edinburgh Postpartum Depression Scale(EPDS) to identify the risk of postpartum depression.Pb and Cd levels in breast milk were determined by inductively coupled plasma mass spectroscopy.The infants of these mothers were examined for their z scores of weight for age,length for age,head circumference for age,and body mass index for age.Results The median breast milk levels of Pb and Cd were 40.6 μg/L and 0.67 μg/L,respectively.In 164(96.5%) of the 170 samples,Pb levels were higher than the limit reported by the World Health Organization(> 5 μg/L).Breast milk Cd level was > 1 μg/L in 54(31.8%) mothers.The mothers with a history of anemia had a higher breast milk Pb level than those without a history of anemia(41.1 μg/L vs.37.9 μg/L,P = 0.050).The median breast milk Cd level in those who were active and passive smokers during pregnancy was significantly higher than that in non-smokers(0.88 μg/L vs.0.00 μg/L,P = 0.025).The breast milk Cd level in the mothers not taking iron and vitamin supplements for 2 months postpartum was higher than in those taking the supplements(iron supplement:0.74 μg/L vs.0.00 μg/L,P = 0.025;vitamin supplement:0.78 μg/L vs.0.00 μg/L,P = 0.005).Breast milk Cd level at the second postpartum month was negatively correlated with the z scores of head circumference(r = 0.248,P = 0.042) and weight for age at birth(r = 0.241,P = 0.024) in girls.No correlation was found between the breast milk Pb/Cd levels and the EPDS scores.Conclusion Considering the high levels of Pb and Cd in breast milk in this study,breast milk monitoring programs are necessary.展开更多
Background One potential modifiable factor to improve the mental health of healthcare professionals(HCPs)during the pandemic is lifestyle.Aims This study aimed to assess whether an improved lifestyle during the pandem...Background One potential modifiable factor to improve the mental health of healthcare professionals(HCPs)during the pandemic is lifestyle.Aims This study aimed to assess whether an improved lifestyle during the pandemic is associated with improved mental health symptoms and mental well-being in HCPs over time.Methods This was a cohort study involving an online survey distributed at two separate time points during the pandemic(baseline(July–September 2020)and follow-up(December 2020–March 2021))to HCPs working in primary or secondary care in the UK.Both surveys assessed for major depressive disorder(MDD)(Patient Health Questionnaire-9(PHQ-9)),generalised anxiety disorder(GAD)(Generalised Anxiety Disorder-7(GAD-7)),mental well-being(Short Warwick-Edinburgh Mental Well-being Score(SWEMWBS))and self-reported lifestyle change(compared with the start of the pandemic)on multiple domains.Cumulative scores were calculated to estimate overall lifestyle change compared with that before the pandemic(at both baseline and follow-up).At each time point,separate logistic regression models were constructed to relate the lifestyle change score with the presence of MDD,GAD and low mental well-being.Linear regression models were also developed relating the change in lifestyle scores from baseline to follow-up to changes in PHQ-9,GAD-7 and SWEMWBS scores.Results 613 HCPs completed both baseline assessment and follow-up assessment.Consistent significant cross-sectional associations between increased lifestyle change scores and a reduced risk of MDD,GAD and low mental well-being were observed at both baseline and follow-up.Over the study period,a whole unit increase in the change in novel scores(ie,improved overall lifestyle)over 4 months was inversely associated with changes in PHQ-9(adjusted coefficient:−0.51,95%confidence interval(CI):−0.73 to−0.30,p<0.001)and GAD-7 scores(adjusted coefficient:−0.32,95%CI:−0.53 to−0.10,p=0.004)and positively associated with the change in SWEMWBS scores(adjusted coefficient:0.37,95%CI:0.18 to 0.55,p<0.001).Conclusions Improved lifestyle over time is associated with improved mental health and mental well-being in HCPs during the pandemic.Improving lifestyle could be a recommended intervention for HCPs to help mitigate the mental health impact during the current and future pandemics.展开更多
Background Mental health problems are the leading cause of disability among adolescents worldwide,yet access to treatment is limited.Brief digital interventions have been shown to improve youth mental health,but littl...Background Mental health problems are the leading cause of disability among adolescents worldwide,yet access to treatment is limited.Brief digital interventions have been shown to improve youth mental health,but little is known about which digital interventions are most effective.Aims To evaluate the effectiveness of two digital single-session interventions(Shamiri-Digital and Digital-CBT(cognitive-behavioural therapy))among Kenyan adolescents.Methods We will perform a school-based comparative effectiveness randomised controlled trial.Approximately 926 Kenyan adolescents will be randomly assigned to one of three conditions:Shamiri-Digital(focused on gratitude,growth mindsets and values),Digital-CBT(focused on behavioural activation,cognitive restructuring and problem solving)or a study-skills control condition(focused on note-taking and essay writing skills).The primary outcomes include depressive symptoms(measured by the Patient Health Questionnaire-8),anxiety symptoms(Generalized Anxiety Disorder Screener-7)and subjective well-being(Short Warwick-Edinburgh Mental Well-being Scale).The secondary outcomes include acceptability,appropriateness,primary control and secondary control.Acceptability and appropriateness will be measured immediately post-intervention;other outcomes will be measured 2 weeks,4 weeks and 12 weeks post-intervention.Results We hypothesise that adolescents assigned to Shamiri-Digital and adolescents assigned to Digital-CBT will experience greater improvements(assessed via hierarchical linear models)than those assigned to the control group.We will also compare Shamiri-Digital with Digital-CBT,although we do not have a preplanned hypothesis.Conclusions Our findings will help us evaluate two digital single-session interventions with different theoretical foundations.If effective,such interventions could be disseminated to reduce the public health burden of common mental health problems.展开更多
基金supported by Nanjing Maternity and Child Health Care Hospital
文摘Objective To evaluate levels of lead(Pb) and cadmium(Cd) in the breast milk in the second postpartum month,to investigate the relationship between Pb/Cd levels in breast milk and some sociodemographic parameters,and to explore whether these levels affect the infants' physical status or the mothers' psychological status(postpartum depression).Methods A cross-sectional study was conducted between November 2009 and December 2010.Altogether 170 healthy mothers were enrolled from Nanjing Maternity and Child Health Care Hospital.The inclusion criteria were:voluntary to participate in this study,healthy,with no chronic disease,breastfeeding in the second postpartum month,living in a suburban but not non-industrial area of Nanjing,and not occupationally exposed to toxic metals.All the mothers completed a questionnaire and were evaluated based on the Edinburgh Postpartum Depression Scale(EPDS) to identify the risk of postpartum depression.Pb and Cd levels in breast milk were determined by inductively coupled plasma mass spectroscopy.The infants of these mothers were examined for their z scores of weight for age,length for age,head circumference for age,and body mass index for age.Results The median breast milk levels of Pb and Cd were 40.6 μg/L and 0.67 μg/L,respectively.In 164(96.5%) of the 170 samples,Pb levels were higher than the limit reported by the World Health Organization(> 5 μg/L).Breast milk Cd level was > 1 μg/L in 54(31.8%) mothers.The mothers with a history of anemia had a higher breast milk Pb level than those without a history of anemia(41.1 μg/L vs.37.9 μg/L,P = 0.050).The median breast milk Cd level in those who were active and passive smokers during pregnancy was significantly higher than that in non-smokers(0.88 μg/L vs.0.00 μg/L,P = 0.025).The breast milk Cd level in the mothers not taking iron and vitamin supplements for 2 months postpartum was higher than in those taking the supplements(iron supplement:0.74 μg/L vs.0.00 μg/L,P = 0.025;vitamin supplement:0.78 μg/L vs.0.00 μg/L,P = 0.005).Breast milk Cd level at the second postpartum month was negatively correlated with the z scores of head circumference(r = 0.248,P = 0.042) and weight for age at birth(r = 0.241,P = 0.024) in girls.No correlation was found between the breast milk Pb/Cd levels and the EPDS scores.Conclusion Considering the high levels of Pb and Cd in breast milk in this study,breast milk monitoring programs are necessary.
基金This work was supported by a Barts Charity project grant(MGU0586).
文摘Background One potential modifiable factor to improve the mental health of healthcare professionals(HCPs)during the pandemic is lifestyle.Aims This study aimed to assess whether an improved lifestyle during the pandemic is associated with improved mental health symptoms and mental well-being in HCPs over time.Methods This was a cohort study involving an online survey distributed at two separate time points during the pandemic(baseline(July–September 2020)and follow-up(December 2020–March 2021))to HCPs working in primary or secondary care in the UK.Both surveys assessed for major depressive disorder(MDD)(Patient Health Questionnaire-9(PHQ-9)),generalised anxiety disorder(GAD)(Generalised Anxiety Disorder-7(GAD-7)),mental well-being(Short Warwick-Edinburgh Mental Well-being Score(SWEMWBS))and self-reported lifestyle change(compared with the start of the pandemic)on multiple domains.Cumulative scores were calculated to estimate overall lifestyle change compared with that before the pandemic(at both baseline and follow-up).At each time point,separate logistic regression models were constructed to relate the lifestyle change score with the presence of MDD,GAD and low mental well-being.Linear regression models were also developed relating the change in lifestyle scores from baseline to follow-up to changes in PHQ-9,GAD-7 and SWEMWBS scores.Results 613 HCPs completed both baseline assessment and follow-up assessment.Consistent significant cross-sectional associations between increased lifestyle change scores and a reduced risk of MDD,GAD and low mental well-being were observed at both baseline and follow-up.Over the study period,a whole unit increase in the change in novel scores(ie,improved overall lifestyle)over 4 months was inversely associated with changes in PHQ-9(adjusted coefficient:−0.51,95%confidence interval(CI):−0.73 to−0.30,p<0.001)and GAD-7 scores(adjusted coefficient:−0.32,95%CI:−0.53 to−0.10,p=0.004)and positively associated with the change in SWEMWBS scores(adjusted coefficient:0.37,95%CI:0.18 to 0.55,p<0.001).Conclusions Improved lifestyle over time is associated with improved mental health and mental well-being in HCPs during the pandemic.Improving lifestyle could be a recommended intervention for HCPs to help mitigate the mental health impact during the current and future pandemics.
文摘Background Mental health problems are the leading cause of disability among adolescents worldwide,yet access to treatment is limited.Brief digital interventions have been shown to improve youth mental health,but little is known about which digital interventions are most effective.Aims To evaluate the effectiveness of two digital single-session interventions(Shamiri-Digital and Digital-CBT(cognitive-behavioural therapy))among Kenyan adolescents.Methods We will perform a school-based comparative effectiveness randomised controlled trial.Approximately 926 Kenyan adolescents will be randomly assigned to one of three conditions:Shamiri-Digital(focused on gratitude,growth mindsets and values),Digital-CBT(focused on behavioural activation,cognitive restructuring and problem solving)or a study-skills control condition(focused on note-taking and essay writing skills).The primary outcomes include depressive symptoms(measured by the Patient Health Questionnaire-8),anxiety symptoms(Generalized Anxiety Disorder Screener-7)and subjective well-being(Short Warwick-Edinburgh Mental Well-being Scale).The secondary outcomes include acceptability,appropriateness,primary control and secondary control.Acceptability and appropriateness will be measured immediately post-intervention;other outcomes will be measured 2 weeks,4 weeks and 12 weeks post-intervention.Results We hypothesise that adolescents assigned to Shamiri-Digital and adolescents assigned to Digital-CBT will experience greater improvements(assessed via hierarchical linear models)than those assigned to the control group.We will also compare Shamiri-Digital with Digital-CBT,although we do not have a preplanned hypothesis.Conclusions Our findings will help us evaluate two digital single-session interventions with different theoretical foundations.If effective,such interventions could be disseminated to reduce the public health burden of common mental health problems.
文摘一、从信封谈起1)并列式(Block Form)2)斜列式(Indented Form) 其实英美人除了经常采用这两种格式外,越来越多的人将寄信人的姓名地址写在信封背面正中间或稍靠上。笔者在英国学习期间,经常使用邮局印制的信封,背面印有“Sender’s name and address”。现在国际流行的信笺、信封为一体,邮票已付的Aerogramme,格式如下:
