An ecological resilience model for adolescents with type 1 diabetes: a cross-sectional study.

BACKGROUND: Highly resilient adolescents with type 1 diabetes have been proved to achieve within-target glycemic outcomes and experience high quality of life. The ecological resilience model for adolescents with type 1 diabetes was developed in this study. It aims to increase our understanding of how resilience is both positively and negatively affected by internal and environmental ecological factors. METHODS: This cross-sectional study surveyed 460 adolescents with type 1 diabetes from 36 cities in 11 provinces, China. Participants completed self-report questionnaires on resilience, family functioning, peer support, peer stress, coping style, and demographics. Standard glycated hemoglobin tests were performed on the adolescents. Structural equation modeling was applied to analyze the data. RESULTS: The ecological resilience model for adolescents with type 1 diabetes was a good model with a high level of variance in resilience (62%). Family functioning was the most important predictor of resilience, followed by peer support, positive coping, and peer stress. Moreover, positive coping was the mediator of the relationship between family functioning and resilience. Positive coping and peer stress co-mediated the association between peer support and resilience. CONCLUSIONS: Family functioning, peer relationships, and positive coping are interrelated, which may jointly influence resilience. The findings provide a theoretical basis for developing resilience-promotion interventions for adolescents with type 1 diabetes, which may lead to health improvements during a vulnerable developmental period.

Effects of motor imagery training on gait performance in individuals after stroke: a systematic review and meta-analysis.

PURPOSE: This review systematically explores and summarise the effects of motor imagery training (MIT) compared to conventional therapy on gait performance in individuals after stroke. MATERIALS AND METHODS: Randomised controlled trials (RCTs) were systematically searched in five electronic databases (PubMed, EMBASE, PsycINFO, OVID Nursing and CINAHL) from inception to 30 December 2022. Studies investigating MITs, targeted at individuals after stroke were eligible. Data were extracted related to study and intervention characteristics. RESULTS: Sixteen studies were included. Compared with 'routine methods of treatment or training', the meta-analyses showed that MIT was more effective in improving cadence immediately post intervention (SMD: 1.22, 95% CI: 0.59, 1.85, p = 0.0001, I2 = 25%) and at 1- or 2-months post intervention (SMD: 0.78, 95% CI: 0.35, 1.20, p = 0.0004, I2 = 46%). The results also showed that MIT improves the step length of the affected side and the unaffected side at 1- or 2-months post intervention. Separate meta-analyses were also conducted on different tests of walking endurance (assessed by the 6-Minute Walk Test) and functional mobility (assessed by the Timed-Up-and-Go test). CONCLUSIONS: MIT effectively improved gait performance. The findings in individuals after stroke remain inconclusive due to significant heterogeneity in included studies.

Restoring gait performance and daily functional abilities is an important goal of post-stroke rehabilitation.Motor imagery training (MIT) may be a promising method to improve gait restoration and is expected to provide another option for the effective rehabilitation of stroke patients.This review highlights the limited research on MIT and thus the limited evidence to guide clinical rehabilitation.In the stroke rehabilitation, clinical specialists may consider incorporating MIT into the treatment programme to improve patients' gait performance and ensure effective early lower limb rehabilitation.

Characterization and function of PTEN-induced putative kinase 1 (PINK1) in process of Zinc alleviates hepatic lipid deposition of yellow catfish (Pelteobagrus fulvidraco).

PTEN-induced putative kinase 1 (PINK1) is a key regulator of mitophagy, however, the relevant information remains poorly understood on aquatic animals. Here, a PINK1 gene was cloned, characterized and functionally studied in yellow catfish. PINK1 encoded a protein containing 570 amino acids, 2 functional domains. High fat (15.66%) fed fish showed a downregulation trend of liver PINK1 expression than that of normal fat (10.14%) group, and was reversed by the addition of Zn. In the in vitro study, high fat (HF) can increase lipid deposition and decrease by addition Zn (HFZ) in hepatocytes, whereas above phenomena reversed by overexpression/interference of PINK1, respectively. In addition, the addition of Zn can significantly affect mitochondrial activity, increase mitophagy, and improve the antioxidant activity of hepatocytes. Together, these findings illustrated that yellow catfish PINK1 is conserve, and it participated in mitochondria control of fish. These findings indicate Zn could alleviate high fat-induced hepatic lipid deposition of fish by activating PINK1-mediated mitophagy and provide basis for further exploring new approach for decreasing lipid deposition in fish products during aquaculture.

ARRDC3 regulates the targeted therapy sensitivity of clear cell renal cell carcinoma by promoting AXL degradation.

AXL plays crucial roles in the tumorigenesis, progression, and drug resistance of neoplasms; however, the mechanisms associated with AXL overexpression in tumors remain largely unknown. In this study, to investigate these molecular mechanisms, wildtype and mutant proteins of arrestin domain-containing protein 3 (ARRDC3) and AXL were expressed, and co-immunoprecipitation analyses were performed. ARRDC3-deficient cells generated using the CRISPR-Cas9 system were treated with different concentrations of the tyrosine kinase inhibitor sunitinib and subjected to cell biological, molecular, and pharmacological experiments. Furthermore, immunohistochemistry was used to analyze the correlation between ARRDC3 and AXL protein expressions in renal cancer tissue specimens. The experimental results demonstrated that ARRDC3 interacts with AXL to promote AXL ubiquitination and degradation, followed by the negative regulation of downstream signaling mechanisms, including the phosphorylation of protein kinase B and extracellular signal-regulated kinase. Notably, ARRDC3 deficiency decreased the sunitinib sensitivity of clear cell renal cell carcinoma (ccRCC) cells in a manner dependent on the regulation of AXL stability. Overall, our results suggest that ARRDC3 is a negative regulator of AXL and can serve as a novel predictor of sunitinib therapeutic response in patients with ccRCC.

The specially designed nudging tableware promotes healthy food choices: Evidence from a randomized crossover trial in normal-weight young adults.

PURPOSE: To evaluate the effects of the specially designed nudging tableware, including a plate and bowl, on individual food choices in normal-weight young adults and preliminarily explore its mechanisms. We hypothesized that the toolset could increase the choice of vegetables and decrease that of rice. METHODS: A randomized, single-blind, two-period crossover trial was carried out among 40 normal-weight university students in China. All subjects completed two buffets separated by an interval of one week, wearing the eye tracker. Vegetable choice, evaluated through the proportion of vegetables, was the primary outcome, and the weight of vegetables and rice were the secondary outcomes. The mechanisms of the decision-making process were preliminarily explored through eye tracking. RESULTS: The usage of the nudging tableware significantly increased the proportion of vegetables and decreased the amount of rice taken (P<0.05), while insignificantly increased the weight of vegetables (P = 0.079). Eye tracking shows that the nudging plate significantly prolonged the food-choosing process and fixation duration on vegetables (P<0.05), and the latter was positively correlated to the increased quantity of vegetables while using the nudging plate (r = 0.493, P<0.01). CONCLUSION: The specially designed nudging tableware might be an effective and practical tool to promote the choice of less rice and more vegetables. Mechanisms behind this change might include automatic and unconscious processes with the inconspicuously smaller capacity of the bowl and larger portion size of the vegetable segment, and increased attention triggered by the vegetable patterns and larger green underpainting.

Weight Management during Pregnancy and the Postpartum Period in Women with Gestational Diabetes Mellitus: A Systematic Review and Summary of Current Evidence and Recommendations.

BACKGROUND: Weight management during pregnancy and the postpartum period is an important strategy that can be utilized to reduce the risk of short- and long-term complications in women with gestational diabetes mellitus (GDM). We conducted a systematic review to assess and synthesize evidence and recommendations on weight management during pregnancy and the postpartum period in women with GDM to provide evidence-based clinical guidance. METHODS: Nine databases and eighteen websites were searched for clinical decisions, guidelines, recommended practices, evidence summaries, expert consensus, and systematic reviews. RESULTS: A total of 12,196 records were retrieved and fifty-five articles were included in the analysis. Sixty-nine pieces of evidence were summarized, sixty-two of which focused on pregnancy, including benefits, target population, weight management goals, principles, weight monitoring, nutrition assessment and counseling, energy intake, carbohydrate intake, protein intake, fat intake, fiber intake, vitamin and mineral intake, water intake, dietary supplements, sugar-sweetened beverages, sweeteners, alcohol, coffee, food safety, meal arrangements, dietary patterns, exercise assessment and counseling, exercise preparation, type of exercise, intensity of exercise, frequency of exercise, duration of exercise, exercise risk prevention, and pregnancy precautions, and seven focused on the postpartum period, including target population, benefits, postpartum weight management goals, postpartum weight monitoring, dietary recommendations, exercise recommendations, and postpartum precautions. CONCLUSIONS: Healthcare providers can develop comprehensive pregnancy and postpartum weight management programs for women with GDM based on the sixty-nine pieces of evidence. However, because of the paucity of evidence on postpartum weight management in women with GDM, future guidance documents should focus more on postpartum weight management in women with GDM.

Strong and Tough Antifreezing Hydrogel Sensor via the Synergy of Coordination and Hydrogen Bonds.

Hydrogel sensors are fascinating as flexible sensors and electronic skin due to their excellent biocompatibility and structure controllability. However, developing conductive hydrogels possessing both excellent mechanical and antifreezing properties for environmental-adaptive sensors remains a challenge. Herein, a strategy of combining betaine and metal ions to construct poly(acrylic acid) (PAA)-based high-conductive hydrogels has been reported. PAA-Al3+/betaine hydrogels with high toughness and antifreezing property were prepared by a one-step UV curing method. Their high toughness is attributed to the coordination of metal ions with the carboxylic groups in PAA, the interaction of betaine with PAA, and the formation of hydrogen bonds between them and water molecules. Moreover, the significant antifreezing property is due to the reduction of free water in the hydrogel. This, in turn, is attributed to the hydration of metal ions and the synergistic hydrogen bonding between betaine and water. The experiments demonstrate that the hydrogel has excellent mechanical property, high conductivity, superior transparency, antiswelling property, antipuncture as well as shape memory properties, and especially, low cytotoxicity. It can be used as a sensor for motion detection and information recognition. This work provides new insights into the application of flexible sensors and human-machine interfaces in multienvironmental conditions.

Developing a prediction model of career plateau for nurses: A cross-sectional study.

AIM: The study aimed to understand the current situation regarding career plateaus experienced by nurses. The objectives were to analyze factors influencing career plateau, and develop a prediction model for career plateau for nurses. DESIGN: A cross-sectional survey was conducted using convenience sampling. METHODS: Participants were 2680 nurses from six tertiary hospitals. Univariable and multivariable logistic regression analyses were carried out to investigate the influencing factors and develop a prediction model of career plateau. RESULTS: The overall incidence rate of nurses reaching a career plateau was 34%. Logistic regression analysis showed that age, position, whether specialized nurses, life satisfaction, organizational support, personal ability and selection tendency were the factors influencing career plateau. The prediction model indicates that older nurses are more likely to reach a career plateau than their younger counterparts, and those who think they have strong personal ability and do not value their work very much are more likely to have a career plateau. Giving nurses more promotion space and learning opportunities, improving life satisfaction, and organizational support are conducive to reducing the occurrence of career plateau.

Enhanced Mechanical Strength of Metal Ion-Doped MXene-Based Double-Network Hydrogels for Highly Sensitive and Durable Flexible Sensors.

Development of conductive hydrogels with high sensitivity and excellent mechanical properties remains a challenge for constructing flexible sensor devices. Herein, a universal strategy is presented for enhancing the mechanical strength of Mxene-based double-network hydrogels through metal ion coordination effects. Polyacrylamide (PAM)/sodium alginate (SA)/Mxene double-network (PSM-DN) hydrogels were prepared by metal ion impregnation of PAM/SA/Mxene (PSM) hydrogels. High electrical conductivity is achieved due to MXene nanosheets, while the strong coordination bond between metal ions and SA constructs a second network that increases the mechanical strength of the hydrogel by an order of magnitude. Mechanical tests demonstrated that the elastic modulus of hydrogels matches that of human tissues. Hence, they can be used as a highly sensitive electronic skin sensor to recognize the movement of different joints in humans and also as a pressure sensing interface to recognize characters for anticounterfeiting and information transfer. This work can promote the practical application of conductive hydrogels in high-tech fields, such as flexible electronic skin and interface interaction.

Effect of Artificial Intelligence-based Health Education Accurately Linking System (AI-HEALS) for Type 2 diabetes self-management: protocol for a mixed-methods study.

BACKGROUND: Patients with type 2 diabetes (T2DM) have an increasing need for personalized and Precise management as medical technology advances. Artificial intelligence (AI) technologies on mobile devices are being developed gradually in a variety of healthcare fields. As an AI field, knowledge graph (KG) is being developed to extract and store structured knowledge from massive data sets. It has great prospects for T2DM medical information retrieval, clinical decision-making, and individual intelligent question and answering (QA), but has yet to be thoroughly researched in T2DM intervention. Therefore, we designed an artificial intelligence-based health education accurately linking system (AI-HEALS) to evaluate if the AI-HEALS-based intervention could help patients with T2DM improve their self-management abilities and blood glucose control in primary healthcare. METHODS: This is a nested mixed-method study that includes a community-based cluster-randomized control trial and personal in-depth interviews. Individuals with T2DM between the ages of 18 and 75 will be recruited from 40-45 community health centers in Beijing, China. Participants will either receive standard diabetes primary care (SDPC) (control, 3 months) or SDPC plus AI-HEALS online health education program (intervention, 3 months). The AI-HEALS runs in the WeChat service platform, which includes a KBQA, a system of physiological indicators and lifestyle recording and monitoring, medication and blood glucose monitoring reminders, and automated, personalized message sending. Data on sociodemography, medical examination, blood glucose, and self-management behavior will be collected at baseline, as well as 1,3,6,12, and 18 months later. The primary outcome is to reduce HbA1c levels. Secondary outcomes include changes in self-management behavior, social cognition, psychology, T2DM skills, and health literacy. Furthermore, the cost-effectiveness of the AI-HEALS-based intervention will be evaluated. DISCUSSION: KBQA system is an innovative and cost-effective technology for health education and promotion for T2DM patients, but it is not yet widely used in the T2DM interventions. This trial will provide evidence on the efficacy of AI and mHealth-based personalized interventions in primary care for improving T2DM outcomes and self-management behaviors. TRIAL REGISTRATION: Biomedical Ethics Committee of Peking University: IRB00001052-22,058, 2022/06/06; Clinical Trials: ChiCTR2300068952, 02/03/2023.

The role of family support in diabetes self-management among rural adult patients.

AIMS AND OBJECTIVES: This study aimed to investigate the role of the family in supporting diabetes self-management and explore the possible mechanisms between family and diabetes self-management among rural patients in China. BACKGROUND: The prevalence of Type 2 diabetes mellitus (T2DM) is growing rapidly in rural areas of China, where healthcare resources remain relatively poor and family members play an important role in chronic disease self-management. DESIGN: This was a multicentre cross-sectional study. METHODS: A total of 276 adults with T2DM were recruited from nine county hospitals in China. Diabetes self-management, family support, family function, and family self-efficacy were evaluated using the mature scales. A theoretical model was built based on the social learning family model and previous studies and then verified using a structural equation model. The STROBE statement was used to standardise the study procedure. RESULTS: Family support and general family factors, including family function and self-efficacy, were positively correlated with diabetes self-management. Family support fully mediates the relationship between family function and diabetes self-management and partially mediates the relationship between family self-efficacy and diabetes self-management. The model explained 41% of the variability in diabetes self-management and had a good model fit. CONCLUSION: General family factors can explain nearly half of the change in diabetes self-management in rural areas of China, while family support is a mediator between general family factors and diabetes self-management. Family self-efficacy, a potential intervention point of family based diabetes self-management education, can be improved by building special lessons for family members. RELEVANCE TO CLINICAL PRACTICE: This study emphasises the role of family in diabetes self-management and proposes suggestions for diabetes self-management intervention among patients with T2DM in rural areas of China. PATIENT OR PUBLIC CONTRIBUTION: Patients and their family members completed the questionnaire which was used for data collection.

Interventions targeting psychosocial adaptation in people with stroke: A scoping review.

OBJECTIVE: This scoping review aimed to describe and map interventions targeting psychosocial adaptation in people with stroke. METHODS: A scoping review was conducted using the Joanna Briggs Institute methodology and reported according to Systematic Review and Meta-Analyses Extension for Scoping Reviews guidelines. We included original studies with interventions targeting psychosocial adaptation (concept) on people with stroke (population) in any setting (context). We searched five online electronic databases (PubMed, Embase, CINAHL, PsycINFO, and Cochrane Central Registry of Controlled Trials). We described interventions in terms of design characteristics, theoretical basis, details of interventions, and quantitative outcomes indicated in psychosocial adaptation. RESULTS: Forty-three studies were identified. Five intervention categories were identified to describe the interventions targeting psychosocial adaptation. Quantitative outcomes indicated psychosocial adaptation in our review were grouped into four domains: global adaptation, psychological adaptation, social adaptation, and others. CONCLUSIONS: The mapping and description brought to light the large heterogeneity of interventions targeting psychosocial adaptation in people with stroke. PRACTICE IMPLICATIONS: Deepening understanding of psychosocial adaptation can help health professionals further develop effective interventions aiming at promoting psychosocial adaptation and reducing negative health sequelae, such as risk of reduced psychosomatic recovery post stroke.

Prediction Models for Prognosis of Hypoglycemia in Patients with Diabetes: A Systematic Review and Meta-Analysis.

OBJECTIVE: To systematically summarize the reported prediction models for hypoglycemia in patients with diabetes, compare their performance, and evaluate their applicability in clinical practice. METHODS: We selected studies according to the PRISMA, appraised studies according to the Prediction model Risk of Bias Assessment Tool (PROBAST), and extracted and synthesized the data according to the CHARMS. The databases of PubMed, Web of Science, Embase, and Cochrane Library were searched from inception to 31 October 2021 using a systematic review approach to capture all eligible studies developing and/or validating a prognostic prediction model for hypoglycemia in patients with diabetes. The risk bias and clinical applicability were assessed using the PROBAST. The meta-analysis of the performance of the prediction models were also conducted. The protocol of this study was recorded in PROSPERO (CRD42022309852). RESULTS: Sixteen studies with 22 models met the eligible criteria. The predictors with the high frequency of occurrence among all models were age, HbA1c, history of hypoglycemia, and insulin use. A meta-analysis of C-statistic was performed for 21 prediction models, and the summary C-statistic and its 95% confidence interval and prediction interval were 0.7699 (0.7299-0.8098), 0.7699 (0.5862-0.9536), respectively. Heterogeneity exists between different hypoglycemia prediction models (τ2 was 0.00734≠0). CONCLUSIONS: The existing predictive models are not recommended for widespread clinical use. A high-quality hypoglycemia screening tool should be developed in future studies.

Effectiveness of resilience-promoting interventions in adolescents with diabetes mellitus: a systematic review and meta-analysis.

BACKGROUND: This study aimed to analyze the efficacy of resilience-promoting interventions among adolescents and youth aged 10-24 years with any type of diabetes. METHODS: A systematic literature search was performed using the PubMed, Web of Science, Embase, Cochrane Library, CINAHL, and PsycINFO databases from inception to May 25, 2022. The Cochrane risk of bias tool (version 2) was used to assess the quality of the included studies. A meta-analysis was performed to calculate the pooled effects of resilience-promoting interventions. RESULTS: Nineteen articles were included covering an overall sample of 2048 adolescents with diabetes. When analyzing the effectiveness of resilience-promoting interventions, hemoglobin A1c (HbA1c) at six months [mean difference = - 0.47, 95% confidence interval (CI) = - 0.83 to - 0.12, P = 0.009] after the intervention was improved. However, long-term (≥ 12 months) improvement in HbA1c was not significant. In addition, comparing the control group, there were significant differences in the effect size for stress [standardized mean difference (SMD) = - 0.87, 95% CI = - 1.25 to -0.48, P < 0.05], self-efficacy (SMD = 0.50, 95% CI = 0.02-0.98, P = 0.04) and quality of life (SMD = 0.27, 95% CI = 0.03-0.51, P = 0.03). CONCLUSIONS: Resilience-promoting intervention is a promising way for adolescent diabetes management to improve HbA1c, stress, self-efficacy, and quality of life. Incorporating resilience-promoting components into diabetes education and re-enforcing these contents every six months are recommended for implementation in clinical practice.

The effectiveness of lifestyle interventions for diabetes remission on patients with type 2 diabetes mellitus: A systematic review and meta-analysis.

BACKGROUND: Conventional wisdom affirmed that diabetes was irreversible, but current research shows that lifestyle interventions may achieve diabetes remission among patients with type 2 diabetes mellitus. Recently, many original studies have examined the effectiveness of lifestyle interventions. However, great heterogeneity in intervention approaches resulted in inconsistent intervention effects. AIMS: The aim of this study was to determine the effectiveness of lifestyle interventions for diabetes remission among patients with type 2 diabetes mellitus. METHODS: PubMed, CINAHL, Embase, Web of Science Core Collection, and Cochrane Library were searched for relevant articles from their inceptions to March 26, 2021. Reference lists and a relevant journal were searched manually as well. Both randomized controlled trials and quasi-experimental studies were included. The quantitative data extracted from the selected studies included diabetes remission rate, weight, and quality of life score. The risk of bias was assessed by the Cochrane and Joanna Briggs Institute's tool. RevMan version 5.3. was used to carry out the meta-analysis. RESULTS: This systematic review included 12 studies involving 3997 patients with type 2 diabetes mellitus. Lifestyle interventions included in the studies were mainly divided into diet-only interventions and diet combined with physical activity interventions. Among them, there were three types of diet: (1) low-energy diet, (2) low carbohydrate diet, and (3) Mediterranean diet. Moderate-intensity aerobic and resistance physical activity, walking, and maintaining habitual physical activity were the three types of physical activity interventions employed in the included studies. The results indicated that lifestyle interventions were effective for achieving diabetes remission, reducing weight, and improving quality of life in patients with type 2 diabetes mellitus. LINKING EVIDENCE TO ACTION: Lifestyle interventions were associated with significant effects on diabetes remission, reducing weight, and improving quality of life. As an important part of lifestyle interventions, diet and physical activity have a significant effect on blood glucose and weight control in patients with type 2 diabetes mellitus. It is therefore suggested that the contents of lifestyle interventions should focus on diet and physical activity.

Development of an evidence­based, theory­driven, and culturally appropriate character strengths-based intervention for breast cancer patients, following the Medical Research Council Framework.

PURPOSE: To design and develop a complex, evidence­based, theory­driven, and culturally appropriate character strengths-based intervention (CSI) for breast cancer patients, following the Medical Research Council (MRC) framework. METHODS: From 2018 September to 2020 November, a complex intervention perspective was adopted. The rationale, methods, and processes employed in carrying out the study were reported. The acceptability and feasibility of intervention program were evaluated as a part of subsequent pilot study. Based on piloting, a refined and optimized definitive intervention was obtained. The development of the intervention is an iterative process involving input from three key stakeholders: experts, medical staff, and patient representatives. RESULTS: The systematic review revealed CSIs were effective and the selected theory served as a guide and indicated theory-inspired modifications. A representative team of breast cancer patients and oncology nurses collaboratively developed and tailored the intervention content and format with attention to the acceptability and feasibility. Five main strategies, including peripheral, evidential, linguistic, constituent-involving, and sociocultural strategies, were used to achieve and strengthen the cultural appropriateness. After the pilot phase, several refinements were made on the CSI program, such as editorial changes in the booklet or alternative suggestions for difficult strengths-based activities (e.g., outdoor activities). All participants not only expressed satisfaction with the program in process evaluation, but also reported perceived benefits such as enjoyable and sociable experience, better well-being, and increased confidence. CONCLUSION: Consideration of the MRC framework, theory guidance, and suggestions from stakeholders during intervention development can optimize uptake and sustainability in the clinical setting. It is recommended that randomized controlled trial be used in future studies to assess the intervention, the process and the mechanisms of the intervention. Our approach may offer implications for the design and implementation of similar initiatives to support cancer patients. TRIAL REGISTRATION: ClinicalTrials.gov Register Identifier: NCT04219267, 07/01/2020, retrospectively registered.

A CiteSpace-Based Analysis of the Development Trends Affecting Clinical Research Nurses in China: A Systematic Review.

Objective: To examine the developmental characteristics and trends affecting clinical research nurses (CRNs) in China and provide a reference for the training and employment of nursing talents in this specialty. Methods: Literature pertaining to CRNs published from the year in which the database was constructed to 2020 was searched. The databases used were the China National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature and Weipu, while CiteSpace software was used to conduct a bibliometric analysis of literature quantity, annual distribution, literature journals and regional distribution, literature authors, subject funding status and literature type and keywords. The characteristics and trends affecting CRNs in China were then evaluated using a descriptive analysis. Results: A total of 3735 pieces of literature were retrieved, and after deduplication and screening, 199 pieces of literature were retained for this study. Overall, the number of publications increased year-on-year. Of these publications, 17 papers (8.5% of the retained papers) were published in the Chinese Journal of Modern Nursing and 9138 papers (69.3%) were published in the top 10 regions according to the location of the first author (of these, 31 [15.6%] were published in Beijing and 42 [21.1%] were funded by scientific research funds). The research fell mainly in the experience summary category, with 107 articles (53.8%) taking this approach. The top five research hotspots were clinical research, good clinical practice (GCP), research nurses, management and clinical trials. The practice and exploration of CRNs were regionalised, accounting for varying degrees of development. CRNs were found to be at the forefront of developments in oncology specialties. Conclusion: In China, CRNs are currently in a period of rapid development. Research into CRNs mainly involves single-centre studies and lacks financial support. In the future, it will be necessary to increase capital investment, strengthen cross-regional cooperation between authors and institutions to narrow the regional development gap, and promote strict and standardised CRN training models and qualification certification to improve the quality of clinical research nursing.

Stressors, coping strategies and intention to leave the nursing profession: A cross-sectional nationwide study in China.

AIMS: This study aims to investigate the association between stressors, coping strategies and intention to leave the nursing profession among nurses. BACKGROUND: Job stressors and coping strategies are believed to affect turnover intention among nurses, but no large-scale study has been conducted on these associations in China yet. METHOD: A cross-sectional secondary analysis was conducted among 51,406 nurses from 1858 hospitals. Univariable and multivariable logistic regression analyses were carried out, and odds ratios were reported. RESULTS: Overall, 49.58% nurses had an intention to leave the profession. It is found that stress from health condition, family, occupational injuries, nurse-patient tension, high job demands, strict leaders and colleague relationships were significantly associated with higher intention to leave. Coping strategies such as talking to family and friends, talking to leaders, doing outdoor activities, engaging in hobbies and attending on-the-job training were significantly associated with lower intention, but social gathering, psychological counselling and suffering in silence had an opposite effect. CONCLUSIONS: Our study provides new insights into the association between stressors, coping strategies and turnover intention among nurses in China. IMPLICATIONS FOR NURSING MANAGEMENT: Evidence from this study indicates that policies promoting a safe and supportive work environment should be developed to help nurses cope with stress.

Experiences and perception of character strengths among patients with breast cancer in China: a qualitative study.

OBJECTIVE: To explore the patients' experiences on character strengths that Chinese patients experience after the diagnosis of breast cancer. DESIGN: A qualitative, exploratory study using semistructured interviews based on the patients' lived experience after being diagnosed with breast cancer. Ethics approval was granted. Interviews were audiorecorded and transcribed verbatim. Values in Action Classification of Strengths provided conceptual framework for analysing strengths. Directed content analysis based on the classification of strengths and framework analysis were used to analyse transcribed data. The Standards for Reporting Qualitative Research guideline was followed. SETTING: The Second Affiliated Hospital of Zhengzhou University and Henan Provincial Cancer Hospital in China. PARTICIPANTS: Adult patients over 18 years, diagnosed with breast cancer between October 2019 and December 2020 were recruited. We used purposive sample method to collected data from 24 participants diagnosed with breast cancer. RESULTS: Six themes (virtues) emerged from our analysis. In addition, two new subthemes (character strengths) emerged in this study, selflessness and pragmatism, respectively. Patients with breast cancer described a large repertoire of character strengths they used or wished for during survivorship, including gratitude, hope, humility, kindness, humour, honesty and forgiveness. Cultural values (eg, collectivism, familyism, Confucianism and Buddhist beliefs) helped structure the experiences of Chinese patients' character strengths. Patients wanted their character strengths to be more noticed, appreciated and encouraged by others and reported their psychological trajectory of using personal strengths. CONCLUSION: The findings indicated that patients with breast cancer believing character strengths are important to them. Medical staff should pay more attention to motivating and cultivating character strengths of patients with breast cancer. Attention to make strength-based practices workable in clinical health promotion programmes is necessary. The healthcare system should develop tailored individualised psychological services that specifically address patients' needs for the application of personalised character strengths. TRIAL REGISTRATION NUMBER: NCT04219267, Pre-results.

Effects of peer support and mobile application-based walking programme on physical activity and physical function in rural older adults: a cluster randomized controlled trial.

PURPOSE: Increased physical activity maintains functional fitness and prevents aging-related declines in muscle mass for older adults. However, physical inactivity is prevalent in aging population, particularly in those living in rural areas. In this study we assessed the effectiveness of a 3-month peer support and mobile application-based walking programme on physical activity and physical function in rural older Chinese adults. METHODS: This was a cluster randomized control trial recruiting adults aged ≥ 60 years. Participants were randomized into intervention and control groups (4 clusters with 36 participants for each group). The intervention included face-to-face physical activity group sessions, peer-led walking, and mobile application-based feedback. Primary outcome was pedometer-measured daily walking steps, and secondary outcomes mainly included physical function and body composition. Both intention-to-treat and per-protocol analyses were performed. RESULTS: Of the included 72 participants (mean age 66.9 years, male 36.1%), 64 completed the study. Intention-to-treat analysis showed that after 3-month walking programme, physical activity was increased by 408 steps/day and grip strength by 1.25 kg in the intervention group compared with the control group. However, no significant outcomes were observed on gait speed, chair-rising time, or body composition. Per-protocol analysis showed similar results. Linear regression analyses showed that changes in daily steps were associated with changes in gait speed (ß = 0.63, P < 0.001) and chair-rising time (ß = - 0.31, P = 0.01). CONCLUSIONS: The 3-month peer support and mobile application-based walking programme could improve physical activity and physical function in rural older adults. TRIAL REGISTRATION: ChiCTR2000034842, registered on 2020/07/21.