Global Insights Into Rural Health Workers' Job Satisfaction: A Scientometric Perspective

Muscle quality index is correlated with insulin resistance and type 2 diabetes mellitus: a cross-sectional population-based study

BACKGROUND

Muscle quality index (MQI), an emerging health index, is calculated by dividing handgrip strength by skeletal muscle mass. Current evidence on the correlation between MQI and type 2 diabetes mellitus (T2DM), insulin resistance (IR) is limited. This work aims to study that correlation.

METHODS

This study involves a cross-sectional analysis on data from the National Health and Nutrition Examination Survey (NHANES) during the period from 2011 to 2014. To explore the correlation between MQI, IR and T2DM, multivariate logistic regression, receiver operating characteristic (ROC) curve, subgroup analysis, and restricted cubic spline regression were employed.

RESULTS

A total of 2816 American adults were enrolled in this study, among whom 1264 (44.9%) had IR, and 300 (10.7%) had T2DM. Logistic regression and RCS regression analyses showed a significant negative linearly correlation between MQI and the prevalence of IR (OR = 0.708, 95%=0.514, 0.976) and T2DM (OR = 0.676, 95%CI = 0.472, 0.969). Subgroup analysis further revealed a stronger correlation between MQI and IR among individuals with obesity. ROC analysis showed that compared with skeletal muscle and grip strength, MQI (AUC = 0.679 for IR and 0.688 for T2DM) can serve as a more reliable identification factor for IR and T2DM.

CONCLUSION

This study provides evidence that decreased levels of MQI are correlated with an increased risk of IR and T2DM, indicating the potential utility as a marker for identifying IR and T2DM.

Factors influencing reselection of village doctors in rural-oriented tuition-waived medical education program in Shanghai, China: a cross-sectional study

Background

In order to actively cultivate a new generation of village doctors (NGVDs) who possess a high level of education, provide high-quality healthcare services, Shanghai Municipal Health Bureau, together with the Municipal Education Commission, Municipal Finance Bureau, and Municipal Agriculture Commission initiated Rural-oriented Tuition-waived Medical Education (RTME) in 2006. This study aims to identify the factors that influence the reselection intention and perceptions of NGVDs of RTME program in Shanghai.

Methods

In 2023, a questionnaire survey was conducted among a sample of NGVDs enrolled in the RTME program in 8 districts of Shanghai. The research focused on five aspects, including demographic characteristics, job characteristics, reasons for choosing RTME, career identity and job satisfaction. The participants were asked questions related to their experiences, opinions, and perceptions. Analysis of variance (ANOVA), chi-square tests and logistic regression analysis was conducted.

Results

A total of 419 questionnaires were collected. The majority (64.44%) indicated they would reselect this career, while 35.56% expressed either no preference or indifference. Factors influencing reselection included "Volunteering to serve the grassroots people" (odds ratio [OR], 2.29 [95% confidence interval {CI}, 1.22-4.30]), "Enjoying the medical profession" (OR, 2.64 [95%CI, 1.33-5.27]), not fulfilling family wishes (OR, 0.47 [95%CI, 0.24-0.88]), Satisfied with the current salary (OR, 2.39 [95%CI, 1.27-4.49]). NGVDs who think village doctors can leverage their professional ability with "okay" (OR, 32.87 [95%CI, 3.69-293.64]) and "yes" (OR, 120.03 [95%CI, 12.78- > 999.99]) and who think NGVDs were "important" (OR, 3.74 [95%CI, 1.21-11.55]) were more inclinatively to reselect to be NGVD.

Conclusion

Reasons for choosing RTME, understanding of the government's policy, career identity, and job satisfaction were all influence the reselection of RTME. This research can contribute to the improvement and development of similar programs in the future, benefiting both the students and the healthcare system as a whole.

Impact of exercise type, duration, and intensity on depressive symptoms in older adults: a systematic review and meta-analysis

Objective

This systematic review and meta-analysis assessed the effects of three types of physical exercise (resistance exercise, aerobic exercise, and group exercise), different exercise intervention times (3 months, 6 months), and different exercise intensities (low, moderate, and high) on the improvement of depressive symptoms in older adults aged ≥60 years, as well as to explore the impact of the sustainability of these physical exercise intervention programs on depressive symptoms in older adults.

Methods

The randomized controlled trials (RCTs) on the effect of physical exercise on depressive symptoms in older adults were retrieved from Cochrane Library, Web of Science, PubMed, and Embase Data. The retrieval time limit is from establishing the database to January 7, 2024. We conducted a meta-analysis using a 95% confidence interval (95% CI) and the standardized mean differences (SMD). The I2 statistic was used to assess the heterogeneity of the outcomes of the studies. When I 2 < 50%, we used the fixed-effects model, and when I 2 > 50%, we used the random-effects model. Subgroup and sensitivity analyses investigated heterogeneity origins.

Results

There are 15 articles reported 20 studies, with a total of 1,346 patients, including 689 in the control group and 657 in the experimental group. The findings demonstrated a notable improvement in depression symptoms among older persons as an immediate result of engaging in physical exercise [SMD = -0.82, 95% CI (-1.19, -0.45)]. The subgroup analysis showed that moderate-intensity physical exercise [SMD = -0.25, 95% CI (-0.47, -0.03)], high-intensity physical exercise [SMD = -0.94, 95% CI (-1.37, -0.51)], resistance exercise [SMD = -0.70, 95% CI (-1.20, -0.20)], and group exercise [SMD = -0.97, 95% CI (-1.89, -0.05)], and the exercise intervention time was 3 months [SMD = -0.81, 95% CI (-1.38, -0.23)] or 6 months [SMD = -0.93, 95% CI (-1.46, -0.41)] were more effective in improving depressive symptoms in older adults.

Conclusion

The sustainable resistance and group exercise have a better effect on improving depressive symptoms in older adults. Appropriate exercise intervention time can also ensure the sustainable improvement effect of exercise.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/record_email.php, identifier CRD42023405525.

Decoding the past and future of distant metastasis from papillary thyroid carcinoma: a bibliometric analysis from 2004 to 2023

Background

Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, and its distant metastasis (PTCDM), although uncommon, seriously affects the survival rate and quality of life of patients. With the rapid development of science and technology, research in the field of PTCDM has accumulated rapidly, presenting a complex knowledge structure and development trend.

Methods

In this study, bibliometric analysis was used to collect 479 PTCDM-related papers published between 2004 and 2023 through the Web of Science (WoS) Core Collection (WoSCC) database. Keyword clustering analysis was performed using VOSviewer and citespace, as well as dual-map overlay analysis, to explore knowledge flows and interconnections between different disciplines.

Results

The analysis indicated that China, the United States, and South Korea were the most active countries in conducting research activities. Italy's research was notable due to its higher average citation count. Keyword analysis revealed that "cancer," "papillary thyroid carcinoma," and "metastasis" were the most frequently used terms in these studies. The journal co-citation analysis underscored the dominant roles of molecular biology, immunology, and clinical medicine, as well as the growing importance of computer science in research.

Conclusion

This study identified the main trends and scientific structure of PTCDM research, highlighting the importance of interdisciplinary approaches and the crucial role of top academic journals in promoting high-quality research. The findings not only provide valuable information for basic and clinical research on thyroid cancer but also offer guidance for future research directions.

Construction and analysis of a lysosome-dependent cell death score-based prediction model for non-small cell lung cancer

BACKGROUND

Non-small cell lung cancer (NSCLC) is the most common type of tumor globally and the leading cause of cancer-related deaths. Although treatment strategies such as immune checkpoint inhibitors and chemotherapy have advanced, the heterogeneity among NSCLC patients results in significant variability in treatment outcomes. Studies have shown that certain patients respond poorly to immune checkpoint inhibitors, indicating that treatment response is closely related to multiple factors. Therefore, it is necessary to develop predictive models to stratify patients based on gene expression and clinical characteristics, aiming for precision therapy.

OBJECTIVE

This study aims to construct a stratified prognostic model for NSCLC patients based on lysosome-dependent cell death (LDCD) scoring by integrating single-cell RNA sequencing (scRNA-seq) and bulk RNA sequencing data. By analyzing the immune-related characteristics of high-risk and low-risk groups, we further explored the impact of cell death patterns on lung cancer and identified potential therapeutic targets.

METHODS

This study obtained single-cell RNA sequencing data and gene expression data of NSCLC patients and normal lung tissues from the GEO and TCGA databases. We used R packages such as Seurat and CellChat for data preprocessing and analysis, and performed dimensionality reduction and visualization through Principal Component Analysis (PCA) and UMAP algorithms. LASSO regression analysis was used to construct the predictive model, followed by cross-validation and ROC curve analysis. The model's effectiveness was validated through survival analysis and immune microenvironment analysis.

RESULTS

The study showed a significant increase in the proportion of monocytes in NSCLC tissues, suggesting their important role in cancer progression. Cell communication analysis indicated that macrophages, smooth muscle cells, and myeloid cells exhibit strong intercellular communication during cancer progression. Using the constructed prognostic model based on 12 LDCD-related genes, we found significant differences in overall survival and immune microenvironment between the high-risk and low-risk groups.

A bibliometric analysis on the health behaviors related to mild cognitive impairment

Background

Mild cognitive impairment (MCI) is commonly defined as a transitional subclinical state between normal aging and dementia. A growing body of research indicates that health behaviors may play a protective role against cognitive decline and could potentially slow down the progression from MCI to dementia. The aim of this study is to conduct a bibliometric analysis of literature focusing on health behaviors and MCI to summarize the factors and evidence regarding the influence of health behaviors on MCI.

Methods

The study performed a bibliometric analysis by retrieving publications from the Science Citation Index and Social Sciences Citation Index sub-databases within the Web of Science Core Collection. Utilizing VOSviewer and CiteSpace software, a total of 2,843 eligible articles underwent co-citation, co-keywords, and clustering analyses. This methodology aimed to investigate the current status, trends, major research questions, and potential future directions within the research domain.

Results

The bibliometric analysis indicates that research on healthy behaviors in individuals with MCI originated in 2002 and experienced rapid growth in 2014, reflecting the increasing global interest in this area. The United States emerged as the primary contributor, accounting for more than one-third of the total scientific output with 982 articles. Journals that published the most articles on MCI-related health behaviors included "Journal of Alzheimer's Disease," "Neurobiology of Aging," "Frontiers in Aging Neuroscience," and other geriatrics-related journals. High-impact papers identified by VOSviewer predominantly cover concepts related to MCI, such as diagnostic criteria, assessment, and multifactorial interventions. Co-occurrence keyword analysis highlights five research hotspots in health behavior associated with MCI: exercise, diet, risk factors and preventive measures for dementia, cognitive decline-related biomarkers, and clinical trials.

Conclusion

This study provides a comprehensive review of literature on health behavior in individuals with MCI, emphasizing influential documents and journals. It outlines research trends and key focal points, offering valuable insights for researchers to comprehend significant contributions and steer future studies.

Global trends in research on MOG antibody-associated disease: bibliometrics and visualization analysis

Objective

The purpose of this study was to investigate the current research status, focus areas, and developmental trends in the field of Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) through an analysis of scientific literature.

Methods

The relevant research articles on MOGAD published from 1947 to 2022 were retrieved from the Web of Science database. The quantitative output of MOGAD related research articles, their distribution by country/region, data on collaborative publishing, influential authors, high-yield institutions, keywords, hotspots, and development trends were analyzed. Additionally, visual knowledge maps were generated using VOSviewer and Citespace.

Results

There has been a steady increase in the number of MOGAD related publications indicating that the subject has garnered increasing interest among researchers globally. The United States has been the leading contributor with 496 papers (19.25%), followed by China (244, 9.63%), Japan (183, 7.10%), the United Kingdom (154, 5.98%), and Germany (149, 5.78%). Among these countries, the United Kingdom boasts the highest citation frequency at the rate of 46.49 times per paper. Furthermore, active collaboration in MOGAD related research is observed primarily between the United States and countries such as Canada, Germany, Australia, Italy, the United Kingdom and Japan. Mayo Clinic ranks first in total articles published (109) and frequency of citations per article (77.79). Takahashi Toshiyuki from Tohoku University is the most prolific author, while Multiple Sclerosis and Related Disorders is the most widely read journal in this field. "Disease Phenotype", "Treatment", "Novel Coronavirus Infection and Vaccination", "Immunopathological Mechanisms", "Clinical characteristics of children" and "Prognosis" are the primary keywords clusters in this field. "Novel Coronavirus Infection and Vaccination" and "Immunopathological Mechanisms" are research hotspots and have great development potential.

Conclusion

The past three decades have witnessed a significant expansion of research on MOGAD. The pathogenetic mechanism of MOGAD is poised to be the prominent research focus in this field in the foreseeable future.

Knowledge structure and future research trends of body-mind exercise for mild cognitive impairment: a bibliometric analysis

Background

Mild cognitive impairment (MCI) is a common neurodegenerative disorder that poses a risk of progression to dementia. There is growing research interest in body-mind exercise (BME) for patients with MCI. While we have observed a rapid growth in interest in BME for MCI over the past 10 years, no bibliometric analysis has investigated the knowledge structure and research trends in this field. Consequently, the objective of this research is to conduct a bibliometric analysis of global publications of BME for MCI from 2013 to 2022.

Methods

A total of 242 publications in the field of BME for MCI were retrieved from the Web of Science Core Collection. Bibliometric analysis, including performance analysis, science mapping, and visualization, was performed using CiteSpace, VOSviewer, and Microsoft Excel.

Results

Publications and citations in the field of BME for MCI have shown a rapidly increasing trend over the last decade. Geriatrics & Gerontology, and Neurosciences were the most frequently involved research categories. China (78 documents) and the USA (75 documents) contributed to the largest number of publications and had the strongest international collaborative networks. Fujian University of Traditional Chinese Medicine contributed to the largest number of publications (12 documents), and Chen, L of this institution was the most prolific author (12 documents). Frontiers in Aging Neuroscience (16 documents), and JOURNAL OF ALZHEIMER'S DISEASE (12 documents) were the most prolific journals. Tai Chi and Baduanjin, as specific types of BME, were the hotspots of research in this field, while evidence synthesis and guidelines might be future research trends.

Conclusion

In the last decade, there has been a rapid growth in scientific activities in the field of BME for MCI. The results of this study provide researchers and other stakeholders with knowledge structure, hotspots, and future research trends in this field.

Global scientific trends on thyroid disease in early 21st century: a bibliometric and visualized analysis

Background

Bibliometrics has been used to analyze the literature in the field of thyroid disease studies in the early 21st century, indicating the changes in current international study trends.

Methods

In this study, a bibliometric analysis of data retrieved from the Web of Science (WoS) database was conducted, and the publication trends and thematic evolution in the field of thyroid disease research from January 1, 2000, to November 16, 2022, were analyzed. A total of 69283 articles related to thyroid diseases were evaluated for their characteristics, including annual publication volume, countries, journals, institutions, authors, keywords, and references. VOSviewer was utilized to perform the analysis of co-authorship, co-citation, co-occurrence and descriptive.

Results

The annual publication volume of thyroid disease research literature showed a fluctuating upward trend from 2000 to 2021, exceeding 5,000 articles for the first time in 2021. The United States (16120 counts, 678255 cities) ranks first in terms of publication volume and citation. Thyroid (n=3201) and Journal of Clinical Endocrinology&Metabolism (n=140399) are the most prolific and cited journals, respectively. The organization with the highest publication volume and citation frequency is Harvard University (1011 counts, 59429 cities), Miyauchi Akira (n=422), Schlumberger, and Martin (n=24839) possess the highest publication volume and citation frequency, respectively. Co-occurrence analysis of 307 keywords with frequencies of more than 20 resulted in 6 clusters (1): Thyroid dysfunction and diseases (2); mechanism of occurrence and development of thyroid cancer (3); autoimmune thyroiditis (4); scope and postoperative management of thyroid surgery (5); fine needle aspiration of thyroid nodules (6); radioactive iodine therapy for thyroid cancer. Active monitoring, thermal ablation, Lenvatinib, and long noncoding RNA refer to the latest keywords. Discussing the six clusters helps scholars to determine the scope and direction of studies.

Conclusion

Over the past two decades, the literature related to thyroid diseases has increased year by year, with closer collaboration between countries, institutions, and authors. In this study, the global trends, research hotspots, emerging subjects, and basic knowledge of literature related to thyroid diseases were respectively elucidated, which will facilitate researchers in this field to seek better development.

Systematic and meta-based evaluation of the relationship between the built environment and physical activity behaviors among older adults

Objectives

Existing assertions about the relationship between various factors of the built environment and physical activity behaviors are inconsistent and warrant further exploration and analysis.

Methods

This study systematically searched PubMed, Embase, Web of Science, Scopus, the Cochrane Library and Google Scholar for the effect of the built environment on the physical activity behaviors of older adults. R software was used to calculate the meta-estimated odds ratio with a 95% confidence interval. Simultaneously, the quality of included studies was evaluated using an observational study quality evaluation standard recommended by American health care quality and research institutions.

Results

A total of 16 original researches were included in this meta-analysis and eight factors of the built environment were evaluated. These factors which ranked from high to low according to their impact were traffic safety (OR = 1.58, 95% CI [1.14-2.20]), destination accessibility (OR = 1.24, 95% CI [1.06-1.44]), aesthetics of sports venues (OR = 1.21, 95% CI [1.07-1.37]), virescence of sports venues (OR = 1.14, 95% CI [1.06-1.23]), building density (OR = 1.07, 95% CI [1.02-1.13]). Additionally, it seemed that there was no potential association between mixed land use (OR = 1.01, 95% CI [0.92-1.10]), the quality of pedestrian facilities (OR = 1.00, 95% CI [0.92-1.08]) or commercial facilities (OR = 0.94, 95% CI [0.88-1.00]) and physical activity behaviors of older adults.

Conclusions

The built environment has been found to exhibit a significant relationship with the physical activity behaviors of older adults. It is proposed that factors such as traffic safety, destination accessibility, aesthetics of sports venues, virescence of sports venues, and building density be given more consideration when aiming to promote physical activity levels among older adults.

Job Satisfaction of Health Practitioners Providing Outreach Health Services during COVID-19 in Rural New South Wales (NSW) and the Australian Capital Territory (ACT), Australia

Background: Outreach health practitioners play a key role in enhancing access to healthcare for remote, rural, regional, and Aboriginal and Torres Strait Islander communities in Australia. Outreach health practitioners are those providing ongoing and integrated health services in communities that would otherwise have limited access. In the context of the COVID-19 pandemic, it is important to understand the job satisfaction of health workers as it correlates with long-term retention of the workforce, as well as effectiveness in the role and clinical outcomes for patients. Method: The study analysed data from 258 outreach health practitioners who responded to two cross-sectional surveys conducted by the NSW Rural Doctors Network during the COVID-19 pandemic in 2020/21 and 2021/22 in NSW and the ACT, Australia. Both bivariate and multivariate analyses were employed to assess the associations between the outcome variable (outreach health practitioners' job satisfaction) and independent variables (sociodemographic factors, motivation, self-confidence, communication, capability). Results: Overall, the study showed that 92.2% of health practitioners were satisfied in their role providing outreach health services during the COVID-19 pandemic. In the multivariable model, factors significantly associated with higher satisfaction included good communication with other local health practitioners, using telehealth along with in-person care, and having high self-rated capability compared to those health practitioners who said they had lower job satisfaction. Conclusions: Outreach health practitioners' job satisfaction is important because poor satisfaction may lead to suboptimal healthcare delivery, poor clinical outcomes, and poor retention of staff in rural settings. These findings should be taken into consideration when developing future strategies to improve job satisfaction among rural outreach health practitioners and to enhance attraction, recruitment and retention and may be applicable to the broader health workforce.

Village doctors' dilemma in China: A systematic evaluation of job burnout and turnover intention

Background

Village doctors (VDs) in China undertook arduous primary healthcare missions. However, they received little attention in comparison to doctors in urban public secondary and tertiary hospitals. There is an urgent need to explore the overall situation of turnover intention and job burnout among VDs to evaluate and adjust current health manpower policy.

Methods

In this study, seven databases like PubMed, EMBASE, Web of Science (WOS), WanFang, China Science and Technology Journal Database (VIP), Chinese BioMedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) were systematically searched, relevant experts were consulted, and empirical research on job burnout and turnover intention among VDs in international publications was evaluated. Therefore, we evaluated the prevalence of job burnout among VDs in general, across all dimensions and different severity levels, as well as the scores of each category. For turnover intention, we assessed the prevalence of different groups and their overall situation and also identified significant contributors.

Results

In this study, we integrated 20 research evidences on job burnout and turnover intention among 23,284 VDs from almost all provinces in China, and the prevalence of turnover intention among VDs in China was as high as 44.1% [95% confidence interval (CI): 34.1-54.2], which was two to four times that of primary health workers in high-income countries, but not much different from some developing countries. Simultaneously, VDs with the highest risk of turnover intention were men [odds ratio (OR): 1.22 (1.05-1.43)], those with a monthly income below USD 163.4 [OR: 0.88 (0.78-0.98)], those with a high educational level [OR: 0.88 (0.78-0.98)], and those <40 years old [OR: 1.27 (1.16-1.40)]. Similarly, the detection rate of job burnout toward them was 59.8% (95% CI: 38.7-79.1) with the MBI-GS score being 44.44 (95% CI: 37.02-51.86) in a total of 90, while the detection rate of job burnout in moderate and above almost reached 20%. The most significant contributor that affects job burnout was low personal accomplishment (LPA), and the detection rate for moderate and higher severity was 65.2% (95% CI: 58.7-71.7).

Conclusion

Attention should be paid to the high turnover intention and severe job burnout of primary health workers in rural areas of developing countries, and targeted measures should be taken to improve the situation. Health policymakers should increase financial subsidies for VDs, set a reasonable workload, improve various health policies such as pension insurance for VDs, and encourage "targeted training" for medical students to enrich and expand their team.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021289139.

Association between pulmonary ventilatory function and mild cognitive impairment: A population-based study in rural China

Background

Mild cognitive impairment (MCI), a reversible intermediate state, plays an important role in the development and prevention of dementia. The relationship between pulmonary function and MCI risk has not yet been well-elucidated.

Methods

We included 2,947 rural Chinese residents aged ≥35 years who were free from a history of stroke, dementia, or other brain diseases and measured pulmonary ventilatory function using calibrated spirometry according to the recommended method. MCI was assessed with the Montreal Cognitive Assessment-Basic for Chinese scale. Logistic regression models and restricted cubic splines with covariate adjustment were performed to explore the association between pulmonary function and MCI risk.

Results

The prevalence of MCI increased with decreasing pulmonary function, from the lowest quartile to the highest quartile of pulmonary function: 63.9, 50.5, 43.8, and 43.6%, respectively. After adjustment for confounding factors, participants in the first quartile had a significantly increased risk of MCI (ORs, 1.691, 95% CI, 1.267-2.258), with the highest quartile as the reference. In the subgroup analysis, a significant association of pulmonary function and MCI was found in females and those with low physical activity. Meanwhile, we observed an L-shaped relationship between pulmonary function and MCI (P _non-linear = 0.032).

Conclusions

Poor pulmonary function was associated with an increased risk of MCI among rural Chinese adults, and presented a non-linear relationship. These findings remind us of the need for early cognitive assessment in local populations with lower pulmonary function.