Background Little is known about the association between stressors(especially positive stressors)during pregnancy and postpartum depression and anxiety.Aims We investigated the association between positive and negativ...Background Little is known about the association between stressors(especially positive stressors)during pregnancy and postpartum depression and anxiety.Aims We investigated the association between positive and negative stress events during different stages of pregnancy and postpartum mental health outcomes among low-income pregnant women with symptoms of anxiety in Pakistan and evaluated whether an intervention based on cognitive behavioural therapy(CBT)had a regulatory effect.Methods Participants were 621 pregnant Pakistani women with mild anxiety.Using the Pregnancy Experience Scale-Brief Version,six scores were created to assess positive and negative stressors.We performed a multivariate linear regression to examine whether these six scores,measured both at baseline and in the third trimester,were associated with postpartum anxiety and depressive symptoms.The effect of the intervention on this relationship was examined by adding an interaction term to the regression model.Results Hassles frequency measured in the third trimester was positively associated with depression(B=0.22,95%confidence interval(Cl):0.09 to 0.36)and anxiety(B=0.19,95%Cl:0.08to 0.30).At the same timepoint,uplifts intensity was negatively associated with symptoms of depression(B=-0.82,95%Cl:1.46 to-0.18)and anxiety(B=-0.70,95%Cl:-1.25 to-0.15),whereas hassles intensity was positively related to symptoms of depression(B=1.02,95%Cl:0.36 to 1.67)and anxiety(B=0.90,95%Cl:0.34 to 1.47).The intensity ratio of hassles to uplifts reported in the third trimester was positively related to both depression(B=1.40,95%Cl:0.59 to 2.20)and anxiety(B=1.26,95%Cl:0.57 to 1.96).The intervention strengthened the overall positive effects of uplfts and the negative effects of hassles.Pregnancy experiences at baseline during early pregnancy to mid-pregnancy were not associated with mental health outcomes.Conclusions Stressors in the third trimester but not earlier in pregnancy were associated with postpartum symptoms of anxiety and depression.The CBT intervention modified the association between pregnancy stressors and postpartum mental health outcomes.Programmes that promote positive experiences and reduce negative experiences,especially in late pregnancy,may mitigate postpartum mental health consequences.展开更多
Railway accidents,particularly serious derailments,can lead to catastrophic consequences.Therefore,it is essential to prevent derailment escalation to reduce the likelihood of severe derailments.Train post-derailment ...Railway accidents,particularly serious derailments,can lead to catastrophic consequences.Therefore,it is essential to prevent derailment escalation to reduce the likelihood of severe derailments.Train post-derailment behaviours and containment methods play a critical role in preventing derailment escalation and providing passive safety protection and accident prevention in the event of a derailment.However,despite the increasing attention on this field from academia and industry in recent years,there is a lack of systematic exploration and summarization of emerging applications and containment methods in train post-derailment research.For this reason,this paper presents a comprehensive review of existing studies on train post-derailment behaviours,encompassing various topics such as post-derailment contact-impact models,dynamic modelling and simulation techniques,and the primary factors influencing post-derailment behaviours.Significantly,this review introduces and elucidates substitute guidance mechanisms(SGMs),which serve as railway-specific passive safety protection and accident prevention measures.The various types of SGMs are depicted,and their ongoing developments and applications are explored in depth.The review additionally points out several unresolved challenges including the adverse effects of SGMs,and proposes future research directions to advance the theoretical understanding and practical application of train post-derailment behaviours and containment methods.This review seeks to be a valuable reference for railway industry professionals in preventing catastrophic derailment consequences through post-derailment containment methods.展开更多
Background The presence of mental health conditions is pervasive in patients who experienced acute myocardial infarction(AMI),significantly disrupting their recovery.Providing timely and easily accessible psychologica...Background The presence of mental health conditions is pervasive in patients who experienced acute myocardial infarction(AMI),significantly disrupting their recovery.Providing timely and easily accessible psychological interventions using virtual reality-based cognitive-behavioural therapy(VR-CBT)could potentially improve both acute and long-term symptoms affecting their mental health.Aims We aim to examine the effectiveness of VR-CBT on anxiety symptoms in patients with AMI who were admitted to the intensive care unit(ICU)during the acute stage of their illness.Methods In this single-blind randomised clinical trial,participants with anxiety symptoms who were admitted to the ICU due to AMI were continuously recruited from December 2022 to February 2023.Patients who were Han Chinese aged 18-75 years were randomly assigned(1:1)via block randomisation to either the VR-CBT group to receive VR-CBT in addition to standard mental health support,or the control group to receive standard mental health support only.VR-CBT consisted of four modules and was delivered at the bedside over a 1-week period.Assessments were done at baseline,immediately after treatment and at 3-month follow-up.The intention-to-treat analysis began in June 2023.The primary outcome measure was the changes in anxiety symptoms as assessed by the Hamilton Anxiety Rating Scale(HAM-A).Results Among 148 randomised participants,70 were assigned to the VR-CBT group and 78 to the control group.The 1-week VR-CBT intervention plus standard mental health support significantly reduced the anxiety symptoms compared with standard mental health support alone in terms of HAM-A scores at both post intervention(Cohen’s d=−1.27(95%confidence interval(CI):−1.64 to−0.90,p<0.001)and 3-month follow-up(Cohen’s d=−0.37(95%CI:−0.72 to−0.01,p=0.024).Of the 70 participants who received VR-CBT,62(88.6%)completed the entire intervention.Cybersickness was the main reported adverse event(n=5).Conclusions Our results indicate that VR-CBT can significantly reduce post-AMI anxiety at the acute stage of the illness;the improvement was maintained at the 3-month follow-up.Trial registration number The trial was registered at www.chictr.org.cn with the identifier:ChiCTR2200066435.展开更多
目的探究心理认知因素对肥胖儿童健康相关行为的影响,为未来临床针对肥胖儿童行为管理提供依据。方法选取2023年7月至12月于南京医科大学附属儿童医院儿童保健科就诊的274例7~16岁儿童作为研究对象,专人测量儿童身高、体质量和体脂肪含...目的探究心理认知因素对肥胖儿童健康相关行为的影响,为未来临床针对肥胖儿童行为管理提供依据。方法选取2023年7月至12月于南京医科大学附属儿童医院儿童保健科就诊的274例7~16岁儿童作为研究对象,专人测量儿童身高、体质量和体脂肪含量,并计算身体质量指数(body mass index,BMI)。参考中国6~18岁学龄儿童超重与肥胖BMI参考界值点将研究对象分为肥胖组及对照组,其中肥胖组168名,对照组106名。通过问卷及量表收集儿童的一般资料,评估儿童体质量感知、健康相关行为(包括饮食行为、身体活动及睡眠情况)及心理健康状况。统计学方法采用t检验、Mann-Whitney U检验、χ^(2)检验、偏相关分析及线性回归分析。结果对照组儿童平均年龄(10.61±1.67)岁,肥胖组儿童平均年龄(10.88±2.03)岁。健康相关行为方面,肥胖组儿童过饱响应、进食缓慢分量表评分以及儿童身体活动问卷(Physical Activity Questionnaire for Older Children,PAQ-C)量表评分均低于对照组(t值分别为3.703、4.562、2.798,P值均<0.05),食物响应、食物喜好、渴望饮料、情绪性过度饮食分量表评分均高于对照组(t值分别为-8.759、-9.073、-3.362、-3.277,P值均<0.05),周末平均每日睡眠时间不足9小时的占比明显高于对照组(χ^(2)=14.536,P<0.001)。心理健康状况方面,肥胖组儿童生理功能、社会功能的生活质量评分明显低于对照组(t值分别为3.136、2.792,P值均<0.05),社交回避及苦恼维度评分显著高于对照组(t=-2.363,P=0.019)。多元线性回归矫正混杂因素后,社会功能与情绪性过度饮食评分呈负相关(β=-0.195,P=0.014),情感功能与食物响应评分呈负相关(β=-0.172,P=0.028),BMI与食物喜好评分呈正相关(β=0.318,P=0.001)。中介效应分析显示,肥胖儿童社会功能在体脂肪含量与身体活动关系间存在完全中介作用,中介占比21.05%。结论肥胖儿童表现出异常饮食行为、身体活动少、睡眠不足等一系列危害健康行为以及社交回避,同时心理健康水平会影响肥胖儿童健康相关行为的发生,尤其是社会交往。肥胖儿童行为管理过程中,在关注肥胖儿童不良生活方式改变的同时,还需改善肥胖儿童的心理健康水平。展开更多
In this study, the boundary-value problem with eigenvalue parameter generated by the differential equation with discontinuous coefficients and boundary conditions which contains not only endpoints of the considered in...In this study, the boundary-value problem with eigenvalue parameter generated by the differential equation with discontinuous coefficients and boundary conditions which contains not only endpoints of the considered interval, but also point of discontinuity and linear functionals is investigated. So, the problem is not pure boundary-value. The authors single out a class of linear functionals and find simple algebraic conditions on coefficients, which garantee the existence of infinit number eigenvalues. Also the asymptotic formulas for eigenvalues are found.展开更多
This paper investigates the oscillatory and nonoscillatory behaviour of solu- tions of a class of third order nonlinear differential equations. Results extend and improve some known results in the literature.
基金the National Institute of Mental Health at the US National Institutes of Health(grant number:R01 MH111859).
文摘Background Little is known about the association between stressors(especially positive stressors)during pregnancy and postpartum depression and anxiety.Aims We investigated the association between positive and negative stress events during different stages of pregnancy and postpartum mental health outcomes among low-income pregnant women with symptoms of anxiety in Pakistan and evaluated whether an intervention based on cognitive behavioural therapy(CBT)had a regulatory effect.Methods Participants were 621 pregnant Pakistani women with mild anxiety.Using the Pregnancy Experience Scale-Brief Version,six scores were created to assess positive and negative stressors.We performed a multivariate linear regression to examine whether these six scores,measured both at baseline and in the third trimester,were associated with postpartum anxiety and depressive symptoms.The effect of the intervention on this relationship was examined by adding an interaction term to the regression model.Results Hassles frequency measured in the third trimester was positively associated with depression(B=0.22,95%confidence interval(Cl):0.09 to 0.36)and anxiety(B=0.19,95%Cl:0.08to 0.30).At the same timepoint,uplifts intensity was negatively associated with symptoms of depression(B=-0.82,95%Cl:1.46 to-0.18)and anxiety(B=-0.70,95%Cl:-1.25 to-0.15),whereas hassles intensity was positively related to symptoms of depression(B=1.02,95%Cl:0.36 to 1.67)and anxiety(B=0.90,95%Cl:0.34 to 1.47).The intensity ratio of hassles to uplifts reported in the third trimester was positively related to both depression(B=1.40,95%Cl:0.59 to 2.20)and anxiety(B=1.26,95%Cl:0.57 to 1.96).The intervention strengthened the overall positive effects of uplfts and the negative effects of hassles.Pregnancy experiences at baseline during early pregnancy to mid-pregnancy were not associated with mental health outcomes.Conclusions Stressors in the third trimester but not earlier in pregnancy were associated with postpartum symptoms of anxiety and depression.The CBT intervention modified the association between pregnancy stressors and postpartum mental health outcomes.Programmes that promote positive experiences and reduce negative experiences,especially in late pregnancy,may mitigate postpartum mental health consequences.
基金support from the National Natural Science Foundation of China (No.52172407 and No.U19A20110)the Natural Science Foundation of Sichuan Province (No.2022NSFSC0415).
文摘Railway accidents,particularly serious derailments,can lead to catastrophic consequences.Therefore,it is essential to prevent derailment escalation to reduce the likelihood of severe derailments.Train post-derailment behaviours and containment methods play a critical role in preventing derailment escalation and providing passive safety protection and accident prevention in the event of a derailment.However,despite the increasing attention on this field from academia and industry in recent years,there is a lack of systematic exploration and summarization of emerging applications and containment methods in train post-derailment research.For this reason,this paper presents a comprehensive review of existing studies on train post-derailment behaviours,encompassing various topics such as post-derailment contact-impact models,dynamic modelling and simulation techniques,and the primary factors influencing post-derailment behaviours.Significantly,this review introduces and elucidates substitute guidance mechanisms(SGMs),which serve as railway-specific passive safety protection and accident prevention measures.The various types of SGMs are depicted,and their ongoing developments and applications are explored in depth.The review additionally points out several unresolved challenges including the adverse effects of SGMs,and proposes future research directions to advance the theoretical understanding and practical application of train post-derailment behaviours and containment methods.This review seeks to be a valuable reference for railway industry professionals in preventing catastrophic derailment consequences through post-derailment containment methods.
基金The study was supported by the Transverse Project of Zhongshan Hospital and Hangzhou Xinjing Science and Technology(XH,H2022-009)National Key Research and Development Program of China(XH,2023YFC2506200)Shanghai Clinical Research Center for Interventional Medicine(JBG,19MC1910300).
文摘Background The presence of mental health conditions is pervasive in patients who experienced acute myocardial infarction(AMI),significantly disrupting their recovery.Providing timely and easily accessible psychological interventions using virtual reality-based cognitive-behavioural therapy(VR-CBT)could potentially improve both acute and long-term symptoms affecting their mental health.Aims We aim to examine the effectiveness of VR-CBT on anxiety symptoms in patients with AMI who were admitted to the intensive care unit(ICU)during the acute stage of their illness.Methods In this single-blind randomised clinical trial,participants with anxiety symptoms who were admitted to the ICU due to AMI were continuously recruited from December 2022 to February 2023.Patients who were Han Chinese aged 18-75 years were randomly assigned(1:1)via block randomisation to either the VR-CBT group to receive VR-CBT in addition to standard mental health support,or the control group to receive standard mental health support only.VR-CBT consisted of four modules and was delivered at the bedside over a 1-week period.Assessments were done at baseline,immediately after treatment and at 3-month follow-up.The intention-to-treat analysis began in June 2023.The primary outcome measure was the changes in anxiety symptoms as assessed by the Hamilton Anxiety Rating Scale(HAM-A).Results Among 148 randomised participants,70 were assigned to the VR-CBT group and 78 to the control group.The 1-week VR-CBT intervention plus standard mental health support significantly reduced the anxiety symptoms compared with standard mental health support alone in terms of HAM-A scores at both post intervention(Cohen’s d=−1.27(95%confidence interval(CI):−1.64 to−0.90,p<0.001)and 3-month follow-up(Cohen’s d=−0.37(95%CI:−0.72 to−0.01,p=0.024).Of the 70 participants who received VR-CBT,62(88.6%)completed the entire intervention.Cybersickness was the main reported adverse event(n=5).Conclusions Our results indicate that VR-CBT can significantly reduce post-AMI anxiety at the acute stage of the illness;the improvement was maintained at the 3-month follow-up.Trial registration number The trial was registered at www.chictr.org.cn with the identifier:ChiCTR2200066435.
文摘目的探究心理认知因素对肥胖儿童健康相关行为的影响,为未来临床针对肥胖儿童行为管理提供依据。方法选取2023年7月至12月于南京医科大学附属儿童医院儿童保健科就诊的274例7~16岁儿童作为研究对象,专人测量儿童身高、体质量和体脂肪含量,并计算身体质量指数(body mass index,BMI)。参考中国6~18岁学龄儿童超重与肥胖BMI参考界值点将研究对象分为肥胖组及对照组,其中肥胖组168名,对照组106名。通过问卷及量表收集儿童的一般资料,评估儿童体质量感知、健康相关行为(包括饮食行为、身体活动及睡眠情况)及心理健康状况。统计学方法采用t检验、Mann-Whitney U检验、χ^(2)检验、偏相关分析及线性回归分析。结果对照组儿童平均年龄(10.61±1.67)岁,肥胖组儿童平均年龄(10.88±2.03)岁。健康相关行为方面,肥胖组儿童过饱响应、进食缓慢分量表评分以及儿童身体活动问卷(Physical Activity Questionnaire for Older Children,PAQ-C)量表评分均低于对照组(t值分别为3.703、4.562、2.798,P值均<0.05),食物响应、食物喜好、渴望饮料、情绪性过度饮食分量表评分均高于对照组(t值分别为-8.759、-9.073、-3.362、-3.277,P值均<0.05),周末平均每日睡眠时间不足9小时的占比明显高于对照组(χ^(2)=14.536,P<0.001)。心理健康状况方面,肥胖组儿童生理功能、社会功能的生活质量评分明显低于对照组(t值分别为3.136、2.792,P值均<0.05),社交回避及苦恼维度评分显著高于对照组(t=-2.363,P=0.019)。多元线性回归矫正混杂因素后,社会功能与情绪性过度饮食评分呈负相关(β=-0.195,P=0.014),情感功能与食物响应评分呈负相关(β=-0.172,P=0.028),BMI与食物喜好评分呈正相关(β=0.318,P=0.001)。中介效应分析显示,肥胖儿童社会功能在体脂肪含量与身体活动关系间存在完全中介作用,中介占比21.05%。结论肥胖儿童表现出异常饮食行为、身体活动少、睡眠不足等一系列危害健康行为以及社交回避,同时心理健康水平会影响肥胖儿童健康相关行为的发生,尤其是社会交往。肥胖儿童行为管理过程中,在关注肥胖儿童不良生活方式改变的同时,还需改善肥胖儿童的心理健康水平。
文摘In this study, the boundary-value problem with eigenvalue parameter generated by the differential equation with discontinuous coefficients and boundary conditions which contains not only endpoints of the considered interval, but also point of discontinuity and linear functionals is investigated. So, the problem is not pure boundary-value. The authors single out a class of linear functionals and find simple algebraic conditions on coefficients, which garantee the existence of infinit number eigenvalues. Also the asymptotic formulas for eigenvalues are found.
文摘This paper investigates the oscillatory and nonoscillatory behaviour of solu- tions of a class of third order nonlinear differential equations. Results extend and improve some known results in the literature.
