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Mental Health, Health-related Quality of Life and Behaviors among Outpatients during the COVID-19 Pandemic: A Multiple Hospitals and Health Centers Study in Vietnam

為了解決Cystic fibrosis prev的問題，作者NGUYEN HOANG MINH 這樣論述：

BackgroundGlobally, the coronavirus disease (COVID-19) pandemic has been placing unprecedented challenges and burdens on various aspects of life, such as economics, culture, politics, education, and healthcare. The uncertainty of COVID-19 increases concerns and fear in the communities, especially i

n those with symptoms like COVID-19 (S-LikeCV19). Additionally, many countries have implemented preventive measures (e.g., lockdown, home confinement, social distancing), leading to considerable changes in peoples’ lives, such as working and learning from home, unemployment, lack of physical connect

ion, and food insecurity. Besides, it is reported that people with underlying health conditions (UHC) and infected with COVID-19 have a higher risk of serious symptoms and complications. Therefore, COVID-19-related factors (e.g., fear, lockdown, S-LikeCV19) and UHC may influence peoples’ psychologic

al health and health behaviors, further lowering their health-related quality of life (HRQoL). Furthermore, people who need health services encountered many challenges during the pandemic, such as difficulties in accessibility, examination and treatment delays, and concerns about COVID-19 infection.

From a public health perspective, it is crucial to understand the impacts of COVID-19-related factors and explore protective factors that can improve lifestyles, psychological health, and HRQoL in outpatients. In addition, due to unavailable specific treatments, non-pharmaceutical interventions (e.g

., adherence to preventive measures, health knowledge improvement, healthy lifestyles) are highly recommended to mitigate the consequences of the COVID-19 pandemic.Therefore, this study was conducted on outpatients during the initial stage of the COVID-19 pandemic for the following purposes:(1) To e

xplore the impacts of UHC, S-LikeCV19, and lockdown on anxiety and depressive symptoms; and examine the modification effects of health behaviors (e.g., eating behaviors, physical activity, smoking, drinking) and preventive behaviors.(2) To explore impacts of UHC, S-LikeCV19, lockdown, and fear of CO

VID-19 (F-CV19) on HRQoL; and examine the modification effects of health literacy, eHealth literacy (eHEALS), digital healthy diet literacy (DDL).(3) To explore impacts of UHC, S-LikeCV19, lockdown, and fear of COVID-19 (F-CV19) on changes in eating behaviors and physical activity; and examine the m

odification effects of eHEALS, DDL.MethodsA cross-sectional study was conducted from 14th February to 31st May 2020 in 18 hospitals and health centers in Vietnam. Data were obtained from 8291 outpatients, including socio-demographic characteristics, UHC, S-LikeCV19, F-CV19, health-related behaviors

(smoking, drinking, eating behaviors, and physical activity), preventive behaviors, eHEALS, DDL, depression (measured by 9-item Patient Health Questionnaire), anxiety (measured by 7-item Generalized Anxiety Disorders), and HRQoL (measured by 36-item Short Form Survey). In addition, multiple linear a

nd logistic regression; and interaction models were performed to explore potential associations.ResultsThe prevalence of anxiety and depression was 12.5% and 22.3%, respectively. Patients with UHC had 3.44 times higher anxiety likelihood and 2.71 times higher depression likelihood, while patients wi

th S-LikeCV19 had 3.31 times higher anxiety likelihood and 3.15 times higher depression likelihood than their counterparts. Similarly, patients under lockdown were 2.39 and 2.89 times more likely to have anxiety and depression than those without lockdown, respectively. Interaction models indicated h

igh compliance with preventive behaviors, unchanged/more physical activity, and unchanged/healthier eating behaviors significantly attenuated the associations of UHC, S-LikeCV19, and lockdown with anxiety and depressive symptoms. In addition, unchanged/more alcohol drinking significantly attenuated

the association between UHC and anxiety. Furthermore, the association between S-LikeCV19 and depression was attenuated by higher health literacy scores in outpatients during the pandemic.This study showed that only fear of COVID-19 was negatively associated with HRQoL (B, -0.79; 95% CI, -0.88 to -0.

70; p < 0.001). Interaction models suggested that the inverse association between F-CV19 and HRQoL was mitigated by higher eHEALS scores or higher DDL scores.Patients with UHC, or with S-LikeCV19, or under lockdown had 54%, 52%, and 62% lower likelihoods of unchanged/healthier eating behaviors, and

21%, 58%, and 22% lower likelihoods of unchanged/more physical activity. Interaction models indicated that the association between lockdown and eating behaviors was significantly attenuated by higher DDL scores. Meanwhile, the association between lockdown and physical activity was significantly miti

gated by higher eHEALS scores. There was no statistically significant interaction of UHC and S-LikeCV19 with DDL and eHEALS on changes in health behavior outcomes.Conclusions:During the pandemic, patients under lockdown period, or with UHC, or S-LikeCV19 were more likely to have anxiety and depressi

ve symptoms; and less likely to have unchanged/healthier eating behaviors and unchanged/more physical activity. In addition, patients with higher F-CV19 were more likely to have poorer HRQoL.High adherence to preventive behaviors, physical activity, and healthy eating behaviors could mitigate the ne

gative impacts of UHC, S-LikeCV19, and lockdown on anxiety and depression. In addition, higher health literacy could mitigate the impact of S-LikeCV19 on depression during the pandemic. Besides, alcohol drinking was found to lower the impact of UHC on anxiety.Moreover, better eHEALS and DDL could mi

tigate the adverse impacts of F-CV19 on HRQoL. Higher eHEALS could help to alleviate the impact of lockdown on physical activity, while higher DDL could mitigate the impact of lockdown on eating behaviors.Our findings provide timely and reliable evidence for appropriate strategies to enhance healthy

lifestyles, preventive behaviors, eHEALS, and DDL, thereby preventing outpatients from psychological disorders and improving their HRQoL during the pandemic.

探討空污中常見氣態及氣膠污染物對小鼠之肺損傷及開發新穎草本氣膠藥物應用於肺損傷之預防及治療

為了解決Cystic fibrosis prev的問題，作者林以馨 這樣論述：

空氣污染對公眾健康具有很多的負面影響甚至導致許多疾病發生，然而其病理機制，無論是氣相還是顆粒相污染物，在分子層級上仍然尚未完全釐清。本論文選擇以臭氧作為氣相污染物，苯酚水溶液氣膠作為顆粒相污染物之代表，測試了這些選定的污染物對肺部疾病的影響，並構建了一個新設計的吸入暴露系統並用於進行小鼠實驗。第一部份，本實驗設計了苯酚水溶液氣膠吸入模型來評估苯酚水溶液氣膠暴露對A549/Luc細胞移植小鼠癌症進展及相關病理影響。經21天暴露後，小鼠的肝臟和腎臟重量都呈現出逐漸下降的趨勢，這表明苯酚水溶液顆粒可能已進入血液循環系統損害肺以外的器官。在免疫分析中，小鼠血清中Eotaxin、IL-5、IL-13、

G-CSF和IP-10的濃度上升，表示苯酚水溶液氣膠的暴露引起了嗜酸性粒細胞與白血球T細胞的相關免疫調節。另外，在生物冷光影像分析中，我們發現苯酚水溶液氣膠的暴露會影響肺癌細胞的生長。第二部份，我們建立了一個臭氧暴露系統來誘導小鼠發生慢性阻塞性肺病(COPD)。經8週臭氧暴露後，小鼠的抗氧化系統受到影響，其支氣管肺泡灌洗液(BALF)中之抗氧化劑榖胱甘肽(GSH) 濃度顯著下降。另外，BALF中的MIG、IP-10 和 TNF-α的濃度則顯著增加，這是 T 淋巴細胞相關免疫反應的特徵，表明臭氧的暴露激活了免疫調節。然而，在小鼠血液的紫外-可見吸收光譜中，沒有觀察到明顯的缺氧現象，意味著 8 週

的臭氧暴露尚不足以影響全身血液循環中血紅蛋白之輸氧功能。有鑑於空氣污染物所引起的氧化性傷害，本實驗同時以草本植物提取物的新型氣膠藥物作為減輕空氣污染對呼吸系統的損害之策略。魚腥草(Houttuynia Cordata)具有抗氧化、抗炎和抗癌的藥用特性，因此選為治療肺部疾病和氧化損傷的輔助因子。本論文應用紫外-可見光譜和 LC-ESI-MS/MS對魚腥草水提取物的物理化學性質進行分析，並且探討了以魚腥草為基底之氣膠藥物的功效，在苯酚水溶液氣膠暴露後，以魚腥草為基底的氣膠藥物可以抑制炎症和降低A549細胞的生長。在臭氧暴露模型中，H. Cordata/GSH 混合氣溶膠藥物減少臭氧引起的肺氧化應激

並降低Th1 細胞分泌的趨化因子水平。這些結果為開發治療 COPD 和預防與空氣污染相關的肺癌惡化的新型氣膠藥物提供了新的醫療策略。