Conectar
by Sicheng Huang, Xuebao Zhang, Long Chen, Xihe Ni, Ying Fan, Chaomin Zhao, Junfeng Xiao, Feng Ruan
BackgroundA public health emergency information system serves as a critical tool for collecting and analyzing data from sudden public health events, thereby providing a scientific basis for governmental decision-making. However, research on the systematic construction of such information system frameworks within China’s public health infrastructure is lacking.
ObjectiveTaking Zhuhai city as a case study, this study aims to construct a comprehensive public health emergency information system framework applicable to public health departments at the municipal, county, and street/township levels.
MethodsFirst, through a literature review and expert group discussion, the preliminary framework of system indicators is determined. Second, through two rounds of the Delphi method, 41 experts are invited to qualitatively select the system framework indicators, with the aim of obtaining consensus among experts. Finally, the system is improved through application, feedback, and redesign.
ResultsAfter two rounds of consultation, the final system at the city and county levels consists of 5 first-level indicator modules and 21 second-level indicator modules, whereas the system at the city, county, and street/township levels consists of 4 first-level indicator modules and 17 second-level indicator modules. Most of the indicators in the “emergency preparedness” and “emergency response” modules are considered important and should be retained as they can play a role in collecting and analysing information on infectious disease outbreaks through practical applications.
ConclusionThe public health emergency information system constructed in this study can be applied to public health departments such as disease prevention and control centres. Promotion can improve the efficiency of handling infectious disease outbreaks and provide a scientific basis for decision-making analysis.
Surrogates make decisions for critically ill patients in intensive care units (ICUs). Because such decisions are critical, many surrogates experience decisional conflict, which can lead to long-term regret and psychological distress. Understanding surrogates' needs during decision-making, particularly when invasive procedures are involved, is essential to improving patient outcomes.
To identify and analyse the needs of surrogates and the decisional conflict they experience during the decision-making process for invasive procedures in ICUs.
This convergent, parallel, mixed-methods study was conducted at a tertiary medical centre in southern Taiwan. Eligible participants were surrogates aged 20 years or older. The patients represented by these surrogates had a Glasgow Coma Scale (GCS) score of < 12 and were expected to undergo at least one invasive procedure. Quantitative data were collected from 100 surrogates using a structured questionnaire assessing decisional conflict and needs, and qualitative data were obtained through in-depth interviews with 13 surrogates.
The following factors were significantly associated with decisional conflict: lower education level (β = −6.24, p = 0.042), lower family income (β = −9.91, p = 0.027), and resuscitative types of invasive procedure (β = −6.40, p = 0.045). Information needs were the most critical because information is often overwhelming without a medical background. Meeting surrogates' support needs, including the need for support from family members, can help reduce isolation in decision-making. The findings also indicate that internal resources played a key role in alleviating decisional conflict in surrogates.
The informational, support, and resource needs of surrogates play a critical role in decision-making for invasive procedures. Their informational needs primarily indicate difficulties in comprehending and integrating complex medical information within a limited timeframe. Clear, structured communication and emotional support may reduce decisional conflict and long-term regret.
This study aimed to evaluate and rank the effectiveness of various acupoint stimulation therapies in alleviating cancer-related fatigue (CRF), a pervasive and distressing symptom among cancer patients.
CRF severely compromises patients' quality of life across treatment and survivorship stages. Despite growing interest in nonpharmacological interventions, comparative evidence on the efficacy of acupoint stimulation therapies remains limited.
A systematic review and network meta-analysis of 28 randomized controlled trials (RCTs) involving 2370 participants was conducted. Databases searched included MEDLINE, CINAHL, Embase, Cochrane, Web of Science, and Airiti Library. Interventions included acupuncture, acupressure, oil acupressure, moxibustion, and transcutaneous electrical acupoint stimulation (TEAS). Standardized mean differences (SMDs) were calculated using a random-effects model. Surface Under the Cumulative Ranking Curve (SUCRA) was used to rank therapies.
Oil acupressure (SUCRA: 73.6%), relaxing acupressure (73.4%), and acupuncture (72.7%) were the most effective interventions. Both professionally administered and self-administered therapies significantly reduced CRF, with no major differences in efficacy. Subgroup analyses revealed consistent effectiveness across cancer types, particularly breast and lung cancer, and treatment stages.
Acupoint stimulation therapies, especially acupressure and acupuncture, effectively reduce CRF and are suitable for integration into routine cancer care. Self-administered acupressure offers a practical, low-cost alternative, especially in resource-limited settings. Standardization of protocols and long-term studies are warranted to guide clinical implementation.
The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42024556455)
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