Family medicine and community health have borderless health topics

Objective: To determine if meat or soy protein dietary supplementation will enhance the neurocognitive performance of HIV-affected children at-risk of malnutrition and food insecurity. Methods: A randomized, double-blind, controlled intervention trial evaluated the effect of nutritional supplementation on the neurocognitive outcomes of 49 HIV-affected school-age children in western Kenya. The intervention consisted in providing the mother, target child, and siblings with one of three isocaloric biscuit-type supplements – soy, wheat, or beef – on 5 days per week for 18 months. Neurocognitive outcomes of the target children were assessed by a battery of eight measures and followed up longitudinally for up to 24 months. Results: Mixed effects modeling demonstrated significant differences in the rates of increase over time among all three groups ( F test degrees of freedom of 2, P <0.05) for Raven’s progressive matrices performance, but not for verbal meaning, arithmetic, digit span backward, forward, and total, embedded figure test, and Beery visual–motor integration scores. Conclusion: HIV-affected school-age children provided with soy protein supplementation showed greater improvement in nonverbal cognitive (fluid intelligence) performance compared with peers who received isocaloric beef or wheat biscuits. Soy nutrients may have an enhancing effect on neurocognitive skills in HIV-affected school-age children.

Additive manufacturing (AM), also known as three-dimensional (3D) printing, is gaining increasing attention in medical fields, especially in dental and implant areas. Because AM technologies have many advantages in comparison with traditional technologies, such as the ability to manufacture patient-specific complex components, high material utilization, support of tissue growth, and a unique customized service for individual patients, AM is considered to have a large potential market in medical fields. This brief review presents the recent progress of 3D-printed ­biomedical materials for bone applications, mainly for metallic materials, including multifunctional alloys with high strength and low Young’s modulus, shape memory alloys, and their 3D fabrication by AM technologies. It describes the potential of 3D printing techniques in precision medicine and community health.

Objective: This study aimed to survey patient safety culture in a county hospital and to provide evidence for strategies to improve patient safety culture. Methods: Nine hundred and thirty-two medical staff in a county hospital were surveyed with use of the Hospital Survey on Patient Safety Culture. Information was analyzed by one-way ANOVA and multiple linear regression analysis. Results: Nine hundred and thirty-two questionnaires were distributed, of which 661 of those returned were valid. The subscale-level results showed that the positive response rate for “teamwork across units” was higher than 75.0%, indicating it was an area of strength. Five areas – “nonpunitive response to error,” “staffing,” “communication openness,” “overall perceptions of patient safety,” and “frequency of event reporting” – had potential for improvement, with a positive responsive rate lower than 50%. Twenty-nine percent of respondents gave their work area a patient safety grade of “excellent” or “very good.” Further, 60.1% of respondents had reported no event in the previous 12 months. Multiple linear regression analysis indicated that position and number of years working in this hospital were the factors influencing patient safety culture. Conclusion: Patient safety culture in the county hospital has potential for improvement, ­especially in the areas of “nonpunitive response to error,” “staffing,” “overall perceptions of patient safety,” “communication openness,” and “frequency of event reporting.” Statement of Significance: It has been recognized for almost 20 years that safety culture is important in ensuring high-quality and safe care. This article describes the results of a patient safety culture survey undertaken in one Chinese county hospital, which distributed the Hospital Survey on Patient Safety Culture to 932 health care staff. It reaffirms that there is still a long way to go until hospitals have successfully established positive safety cultures. In terms of relevance, we believe the findings will be most useful to the hospital where the study was undertaken. Many of the recommendations in the discussion should be useful for the hospital.