[Game Products: Innovative Pathways for Nursing Education and Clinical Training].

To excel in their work, nurses must have specialized tools to support their tasks and professional development. Games, as a crucial pathway to achieving nursing education and clinical training goals, demonstrate significant potential and application value, making them an innovative product. Nursing education games come in various forms, including virtual reality, augmented reality, tabletop, and digital, and may be designed as needed for individual, two-player, or team play (Avsar et al., 2023; Bermejo et al., 2023; Tsai et al., 2024). These games, beyond their entertainment value, have clear educational objectives embedded in their design. Through levels, challenging tasks, and reward mechanisms, they stimulate learning enjoyment and promote nursing development. In this column, experts and scholars in the field of nursing engaged in game development share their experiences and achievements. Integrating games into nursing delivers a wealth of tools and resources for nursing education and clinical practice, offering immersive learning experiences, instant feedback, and individualized learning paths. For nursing students, gamified products offer safe and risk-free learning environments in which they can practice critical tasks and make decisions in simulated medical scenarios, increasing their clinical experience and confidence and enhancing their clinical judgment and decision-making skills (Wu et al., 2023). For patients, many therapeutic games have already been designed that use gameplay to improve health by facilitating user engagement in rehabilitation exercises, promoting healthy eating, and fostering social interactivity (Tsai et al., 2024). For nurses, various games are being used to promote continuous professional growth in an interactive and enjoyable learning environment, improving overall quality of care and job satisfaction (Hsieh et al., 2023). In summary, the application of game products in nursing education and clinical training has introduced new learning and training models that provide multifaceted benefits for nurses, nursing students, and patients. We hope that readers will gain a deeper understanding of related game products after reading this column and use games effectively to enhance nursing quality.

[The Efficacy of Joyful Learning on Exercise in Older Adults: The GAME Strategy].

Exercise can effectively slow aging and prevent the onset and reduce the complications of chronic diseases in the elderly. However, roughly one-third of older adults are inactive. Joyful learning is an effective method for promoting physical activity, while using games is a feasible strategy for achieving joyful learning that enables individuals to fully immerse themselves in and enjoy an activity. Therefore, exploring gaming strategies to enhance physical activity among the elderly is worthwhile. In this paper, a set of gaming strategies based on the literature and practical experience is proposed. The name of this strategy, GAME, is an acronym of the following: goal setting and educational content development (G), activity design and game content creation (A), mechanics and dynamics implementation (M), and evaluation of qualitative and quantitative health outcomes (E). This systematic descriptive approach helps clearly demonstrate how gamification strategies can promote physical activity and health in older adults. The aim of this paper is to provide a reference and guide for education, research, and clinical practice in health promotion programs targeting older adults.

Effects of traditional Chinese medicines on weight management among adults with overweight or obesity: A systematic review and network meta-analysis.

Increasing evidence has reported the anti-obesity effects of traditional Chinese medicines (TCMs) and their potential advantages in weight loss, such as fewer side effects and lower costs compared to the current recommended treatments like Western medicines. Previous review studies have examined the effects of a few commonly used TCM therapies such as acupuncture and herbal medicines on weight loss. This network meta-analysis (NMA) study aims to review and rank the effects of currently available TCMs on weight loss and to compare the effects of TCMs with different intervention durations. Eligible Randomized controlled trials (RCTs) conducted among Chinese adults with overweight or obesity were searched on electronic databases (PubMed, Embase, CNKI, WanFang, VIP, and SinoMed) up to 1 March 2023. Pairwise meta-analysis was performed to examine the pooled effects of TCMs on weight loss, and NMA was conducted to rank different types of TCMs. Subgroup analysis stratified by intervention duration was performed. Forty-six RCTs were eligible for inclusion in the review. The results showed that TCMs, especially when the treatment duration was ≤6 months, were more effective in both body weight and Body Mass Index (BMI) reduction than non-pharmacological interventions and placebo/no treatment. Acupotomy was ranked as the most effective TCM treatment in reducing both body weight and BMI. Traditional Chinese medicines have promising potential for weight loss and could be included in future clinical guidance as a standalone or supplementary treatment for obesity. Future studies need to further investigate under-researched TCMs, examine the long-term effects and safety of TCMs in obesity treatment, and validate the findings from this study among other ethnic populations.

Structural equation modeling of dispositional mindfulness, internal environmental factors, external environmental factors, and self-care behaviors in people with type 2 diabetes.

BACKGROUND: To achieve suitable diabetes care, understanding the factors that affect self-care behaviors is necessary. OBJECTIVE: To construct a model of dispositional mindfulness, internal environmental factors, external environmental factors, and self-care behaviors in people with diabetes. DESIGN AND METHODS: This cross-sectional study analyzed a convenience sample of 311 people with type 2 diabetes in Taiwan. Data were collected through questionnaires, including the Diabetes Symptoms Checklist, Emotional Distress Scale, Empowerment Process Scale, Interpersonal Communication Scale and Self-Care Behavior scale. RESULTS: Structural equation modeling indicated that a model of dispositional mindfulness, internal environmental factors, external environmental factors, and self-care behaviors in the patients with diabetes best fit the data. Dispositional mindfulness (ß = 0.39), internal environmental factors (ß = 0.52), and external environmental factors (ß = 0.71) directly influenced self-care behaviors in the patients with diabetes. Dispositional mindfulness significantly indirectly affected self-care behaviors via internal and external environmental factors. CONCLUSIONS: To improve self-care behaviors, interventions should consider mindfulness training, and also include internal environmental factors and external environmental factors in the mindfulness training.

Identification of NOx emissions and source characteristics by TROPOMI observations - A case study in north-central Henan, China.

With the development of industries, air pollution in north-central Henan is becoming increasingly severe. The TROPOspheric Monitoring Instrument (TROPOMI) provides nitrogen dioxide (NO2) column densities with high spatial resolution. Based on TROPOMI, in this study, the nitrogen oxides (NOx) emissions in north-central Henan are derived and the emission hotspots are identified with the flux divergence method (FDM) from May to September 2021. The results indicate that Zhengzhou has the highest NOx emissions in north-central Henan. The most prominent hotspots are in Guancheng Huizu District (Zhengzhou) and Yindu District (Anyang), with emissions of 448.4 g/s and 300.3 g/s, respectively. The Gaussian Mixture Model (GMM) is applied to quantify the characteristics of emission hotspots, including the diameter, eccentricity, and tilt angle, among which the tilt angle provides a novel metric for identifying the spatial distribution of pollution sources. Furthermore, the results are compared with the CAMS global anthropogenic emissions (CAMS-GLOB-ANT) and Multi-resolution Emission Inventory model for Climate and air pollution research (MEIC), and they are generally in good agreement. However, some point sources, such as power plants, may be missed by both inventories. It is also found that for emission hotspots near transportation hubs, CAMS-GLOB-ANT may not have fully considered the actual traffic flow, leading to an underestimation of transportation emissions. These findings provide key information for the accurate implementation of pollution prevention and control measures, as well as references for future optimization of emission inventories. Consequently, deriving NOx emissions from space, quantifying the characteristics of emission hotspots, and combining them with bottom-up inventories can provide valuable insights for targeted emission control.

The effect of a bone-preserving board game program on the knowledge, attitudes and preventive behaviors of osteoporosis in older adults.

Osteoporosis predisposes to fractures, which affect the quality of life and can be life-threatening. However, the knowledge, attitudes and preventive behaviors of osteoporosis in older adults are insufficient. The aim of this paper was to develop and test the effect of a bone-preserving board game program among older adults. A convenience sample of 85 older adults recruited from two community activity centers in southern Taiwan were assigned to either an experimental group or a control group. The experimental group played a bone-preserving board game for 4 weeks, and the control group participated in routine community center activities. The generalized estimating equation showed significantly larger improvements in knowledge, attitudes, and preventive behaviors in the experimental group than in the control group. Board games designed for older adults can support public health education and help prevent osteoporosis. Our results provide a reference for educators, clinical practitioners and researchers.

Mid-term outcomes of total neointima implantation in surgical repair of acute type A aortic dissection.

Total neointima implantation (patch neointima technique + triple-branched stent graft placement) has been performed in proximal aortic repair for acute type A aortic dissection (ATAAD) for more than 10 years at a center. However, there is no report on the mid-term outcomes with a control group of the surgical procedure. Consequently, the authors aimed to evaluate the safety and efficacy of this technique in this study. Patients who underwent the total neointima implantation were classified as Group A, and those who underwent the conventional aortic root reconstruction with the "sandwich" technique and the total aortic arch replacement were classified as Group B. Furthermore, the authors described the preoperative characteristics, operative data, and patient outcomes. Group A patients experienced a shorter surgery duration, lower volumes of perioperative bleeding, and fewer red blood cell transfusions. The incidence of neurological complications was significantly reduced in Group A. All patients maintained a normal range of proximal aortic sizes after surgery. Kaplan-Meier analysis revealed no significant differences between the patients in the two groups regarding cumulative mortality and the incidence of moderate-to-severe aortic insufficiency. In well-selected patients, total neointima implantation is an alternative procedure for the surgical repair of ATAAD.