Moreover, the enhancement in the exercise tolerance in the CR + IMT group was accompanied by a negligible change in the HRpeak. The results confirm that the addition of IMT to the standard rehabilitation process of patients with heart failure can increase the therapeutic effect while influencing some of the parameters measured by exercise electrocardiography and respiratory function.This article describes a user-centred approach taken by a group of five procurers to set specifications for the procurement of value-based research and development services for IT-supported integrated hypertension management. The approach considered the unmet needs of patients and health systems of the involved regions. The procurers established a framework for requirements and a solution design consisting of nine building blocks, divided into three domains service delivery, devices and integration, and health care organisation. The approach included the development of questionnaires, capturing patients’ and professionals’ views on possible system functionalities, and a template collecting information about the organisation of healthcare, professionals involved and existing IT systems at the procurers’ premises. A total of 28 patients diagnosed with hypertension and 26 professionals were interviewed. The interviewees identified 98 functional requirements, grouped in the nine building blocks. A total of nine use cases and their corresponding process models were defined by the procurers’ working group. As result, a digitally enabled integrated approach to hypertension has been designed to allow citizens to learn how to prevent the development of hypertension and lead a healthy lifestyle, and to receive comprehensive, individualised treatment in close collaboration with healthcare professionals.Longer durations for near-work activities, such as studying, worsen eyesight. In contrast, outdoor exercise is effective in reducing the risk of developing myopia. Despite these findings, however, the interaction between studying and exercise in eyesight has not been quantitatively evaluated. Moreover, since there is a culture of attending lessons in Japan, it is important to investigate the relationship between elementary school activities, such as cram schools or sports clubs, and vision. Therefore, in this study, we examined whether attending cram schools and/or sports clubs is associated with the use of glasses among elementary school students. We conducted a survey among 7419 elementary school students in Tokyo, Japan using a food education questionnaire. A logistic regression analysis was used to evaluate the relationship between wearing glasses, an objective variable, and attending sports clubs and cram schools. Sex and school year were considered confounding factors. The results of this study showed that students who attended only sports clubs were more likely to be categorized into the „not wearing glasses” group (p = 0.03, OR = 1.45), whereas those who attended only cram schools were more likely to be categorized into the „wearing glasses” group (p = 0.008, OR = 0.67). In addition, students who attended both cram schools and sports clubs were more likely to be categorized into the „not wearing glasses” group than those who only attended cram schools (p = 0.28, OR = 0.85). Our findings indicate that attending not only cram schools but also sports clubs may prevent deterioration of eyesight. Parents and health care providers need to take these findings into account in order to prevent visual impairment in children.The purpose of this paper is to investigate environmental performance of a supply chain which consists of an upstream supplier and a downstream firm. A mathematical model considering both downstream firm’s monitoring and governmental intervention is developed. Afterwards, a numerical example is presented to show the equilibriums of these models and the optimal choices of firms and government. The results show that when customers’ environmental awareness increases, both total environmental impact and social welfare decrease. The downstream firm’s monitoring will certainly reduce the total environmental impact. In most cases, it does not matter whether the downstream firm chooses to monitor the supplier or not, the total environmental impact and social welfare would not be affected when the government chooses subsidy. If a subsidy is present, firms and environment will be better than those without subsidy. Hence, the government is more likely to choose to provide subsidy and the downstream firm will not monitor the supplier’s greenhouse gas (GHG) emissions reduction effort. In a few cases when environmental impact is too large, taxation may be the optimal choice for the government and the downstream firm will choose to monitor the supplier’s GHG emissions reduction investment.An investigation of inappropriate medication use in treatment of depressivity in institutionalized older adults, based on a nurse-led evaluation of functional status and depressive symptoms in nursing home residents. Methods A cross-sectional multicenter study was performed using records from 1087 residents cared for in fifteen nursing homes (NHs) in the Czech Republic. Inclusion criteria were being a permanent resident of one of the facilities, being 60 years of age or older, having a Geriatric Depression Scale score of 6 or more, and having a Mini Mental State examination score 10 or more. The final sample for analysis included 317 depressed NH residents. Results 52 percent of NH residents with depressivity had no antidepressant treatment. Benzodiazepines were the only medication in 16 percent of depressed residents, and were added to antidepressant treatment in 18 percent of residents. Benzodiazepine users had significantly higher GDS scores compared to non-users (p = 0.007). Conclusion More than half of depressed NH residents remained without antidepressant treatment. Residents inappropriately treated with benzodiazepines were more depressed than residents treated with antidepressants only, or even not treated at all. Cooperation of the interprofessional team in the screening of depressive symptoms has the potential to improve the quality of care.Earth’s life-supporting ecosystems are integral to human and planetary health. Ecosystem services connect ecosystem functions to human wellbeing. The complex, multifaceted socio-ecological challenges of ecosystem decline necessitate a transdisciplinary approach, including the active and meaningful engagement and participation of local communities. Communities uniquely possess expert local knowledge, which, when integrated into policy development and community planning, has the potential to enhance and sustain ecosystem benefits for health and wellbeing. Community-informed mapping tools provide an opportunity for integrating science, policy, and public participation in data collection. However, there is a dearth of community-informed mapping tools demonstrating the interconnection of the ecological and social determinants of health at a place-based level. This paper presents a study that employs a community-based participatory research approach to mapping local knowledge systems on EcoHealth. The study seeks to develop a community mapping tool for shared dialogue and decision-making on EcoHealth between local communities and policymakers. The participatory research methods used to explore community awareness and knowledge regarding ecosystem services, health, and sustainability in the local area are described. The process of co-producing a Community EcoHealth Toolkit, based on the integration of different knowledge systems into local policy and planning, is discussed.

To explore the relationship between different amounts of physical exercise and drug craving in individuals with substance-use disorders (SUD), and to reveal the mediating role of internal inhibition between physical activity and drug craving.

This study adopted the Physical Activity Rating Scale, Internal Inhibition Scale, and Drug Craving Scale to assess 438 cases of SUD in a compulsory isolation detoxification center in southwest China.

(1) The amount of physical exercise individuals with SUD engaged in was positively correlated with internal inhibition and negatively correlated with drug craving, while the amount of physical exercise was negatively correlated with drug craving. (2) The amount of physical exercise was able to negatively predict drug craving in addicts, the amount of physical exercise and internal inhibition were able to jointly predict drug craving, and internal inhibition played a mediating role between the amount of physical exercise and drug craving (the mediating effect was 0.22). (3) There was a dose-effect relationship regarding different amounts of physical exercises and drug craving. Internal inhibition did not mediate between a low amount of physical exercise and drug craving, it played a partial mediating role between a moderate amount of physical exercise and drug craving (the mediating effect was -0.19), and it played a partial mediating role between a high amount of physical exercise and drug craving (the mediating effect was -0.15).

Physical activity has a positive effect on reducing drug craving in individuals with SUD. Moreover, in the process of sports rehabilitation for SUD, medium or high amounts of physical activity were required in order to effectively reduce and alleviate drug cravings.

Physical activity has a positive effect on reducing drug craving in individuals with SUD. Moreover, in the process of sports rehabilitation for SUD, medium or high amounts of physical activity were required in order to effectively reduce and alleviate drug cravings.Frailty is a common syndrome in older people that carries an increased risk of mortality. Two main models describe frailty, either as a loss of physical functions or as an accumulation of multiple deficits. The aim of our study was to compare the physical frailty index developed in the Cardiovascular Health Study (CHS) with a multidimensional frailty tool, the Multidimensional Prognostic Index (MPI), in predicting death in community-dwelling older subjects. Four hundred and seven community-dwelling older subjects were enrolled. Each subject underwent a comprehensive geriatric assessment (CGA) with calculation of the MPI and CHS index. Mortality was recorded over the following 5 years. In the overall sample (mean age of 77.9 ± 4.5 years; 51.6% female), 53 subjects (13%) died during the 5-year follow-up period. Both the MPI and CHS index were able to predict mortality; however, the MPI was significantly more accurate than the CHS index in predicting mortality (C-index = 0.69 and 0.59, respectively; p less then 0.001), with a statistically significant difference of 10%. In conclusion, multidimensional frailty, assessed by the MPI, predicts five-year mortality in community-dwelling older people better than physical frailty, as assessed by the CHS index. These findings suggest the usefulness of assessing frailty by means of CGA-based tools to predict relevant health-negative outcomes in older people.Radiation emergency medicine (REM) systems are operated around the world to provide specialized care for injured individuals who require immediate medical attention in accidents. This manuscript describes the current status of REM safety regulation in Korea and summarizes an assessment of the effects of this regulation. Responding to the requests of people for stronger safety regulations related to radiation exposure, a unique REM safety regulation for nuclear licensees, which is enforceable by laws, has been established and implemented. It is not found in other countries. It can provide a good example in practice for sustainable REM management including document reviews on medical response procedures and inspections of equipment and facilities. REM preparedness of nuclear or radiologic facilities has been improved with systematic implementation of processes contained in the regulation. In particular, the medical care system of licensees has become firmly coordinated in the REM network at the national level, which has enhanced their abilities by providing adequate medical personnel and facilities.