Efficacy of non-pharmacological interventions for sleep quality in Parkinson's disease: a systematic review and network meta-analysis.

Background: Sleep disorders are one of the most common non-motor symptoms in PD. It can cause a notable decrease in quality of life and functioning in PD patients, as well as place a huge burden on both patients and caregivers. Currently, there are numerous non-pharmacological interventions available to improve sleep quality in PD, with disagreement as to which intervention is most effective. This network meta-analysis was performed to compare and rank non-pharmacological interventions to explore their efficacy in improving sleep quality in PD and to select the best interventions, with a view to providing references and bases for the development of clinical treatments and care programs. Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases were searched from inception to December 6, 2023. Two authors independently screened all studies, extracted the data, and evaluated risk of bias of included studies. STATA software version 17.0 was used to conduct the network meta-analysis. Results: Our network meta-analysis included 29 studies involving 1,477 participants and 16 non-pharmacological interventions. Although most nonpharmacological interventions showed non-significant effects, the surface under the cumulative ranking curve (SUCRA) values indicated that the best non-pharmacological intervention for sleep disorders was massage therapy (97.3%), followed by music therapy (94.2%), and Treadmill training (85.7%). Conclusion: Massage therapy can be considered as an effective therapy for improving sleep quality in patients with PD. Due to limited quantity and quality of the included studies, more high quality studies are required to verify the conclusions of this network meta-analysis. Systematic review registration: identifier CRD42023429339, PROSPERO (york.ac.uk).

Nurses' assessment of subsyndromal delirium and barriers to assessment: A cross-sectional survey in the intensive care unit.

AIMS: The aims of the study are to investigate the current status of nurses' assessment of subsyndromal delirium (SSD) in the intensive care unit (ICU) and explore possible barriers to assessment. BACKGROUND: SSD is a dynamic, recognizable disorder commonly seen in the ICU that can lead to poor patient outcomes. Timely recognition and management can prevent its progression. METHODS: A cross-sectional survey design was used to collect data from ICU registered nurses in southwest China. The online survey containing an analysis of the current status of SSD assessment and barriers was completed by 237 nurses. RESULTS: A total of 51.5% of nurses chose to assess SSD using an assessment tool, the most commonly used being the Confusion Assessment Method for the Intensive Care Unit; the frequency of assessment was mostly once a day (66, 41.0%) and often at shift change (178, 87.3%). There were statistically significant differences in the barrier factor scores by assessment frequency, assessment method, status of training in SSD, ability of SSD-related knowledge to meet clinical needs and willingness to receive SSD training. CONCLUSION: Our study confirms that the current state of assessment of SSD in the ICU is unsatisfactory, with nurses' lack of assessment knowledge and skills, poor organization and management, and the complexity of patients' conditions being barriers. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers should systematically conduct training programmes on effective SSD assessment knowledge and skills, incorporate SSD assessment into the daily workflow, have standardized assessment tools, develop standardized processes and assign dedicated staff to monitor, audit and provide feedback on SSD assessments.

Effect of Continuous Nursing Model Based on WeChat Public Health Education on Self-Management Level and Treatment Compliance of Stroke Patients.

Background: To analyze the effect of continuous nursing model based on WeChat public health education on self-management level and treatment compliance of stroke patients. Methods: Overall, 98 stroke patients admitted to the Second Affiliated Hospital of Chongqing Medical University, ChongQing, 400000,China from Feb 2018 to Feb 2019 were enrolled as the research objects. They were randomly and equally divided into experimental group and control group. The control group received routine nursing management model while the experimental group received continuous nursing model based on WeChat public health education to compare the self-management level, treatment compliance, life quality and other indexes between the two groups. Results: The overall self-management level in the experimental group was significantly higher than that in the control group (P<0.05). The life quality scores in both groups after nursing intervention increased, and the scores in the experimental group after nursing intervention were significantly higher than those in the control group (P<0.001). The total treatment compliance rate in the experimental group was higher than that in the control group (P=0.001). After nursing intervention, the readmission rate and complication rate in the experimental group were significantly lower than those in the control group (P<0.05). Conclusion: The implementation of continuous nursing model based on WeChat public health education for stroke patients can significantly enhance the self-management level, improve the cognitive level on stroke related-health knowledge, improve treatment compliance of patients in the nursing process, promote their physical and mental health, improve the life quality and effectively reduce the complication rate and readmission rate.

The prevalence and associated factors of dysphagia in Parkinson's disease: A systematic review and meta-analysis.

Background: The prevalence and associated factors of dysphagia in Parkinson's disease (PD) are different in studies conducted in different countries. The purpose of our systematic review and meta-analysis was to evaluate the prevalence of dysphagia in PD and to clarify its associated factors. Methods: Two researchers systematically searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Database, SinoMed and VIP databases and manually searched references in the retrieved articles to identify potential research subjects. The last search was conducted on June 28, 2022. Finally, a total of 58 studies including 60 observations with 20,530 PD patients were included in our meta-analysis. Results: The meta-analysis estimated that the pooled prevalence rate of dysphagia in PD was 36.9% (95% CI: 30.7-43.6%) and instrumental examination showed a higher prevalence (57.3%, 95% CI: 44.3-69.1%). Oceania showed the highest prevalence of dysphagia in PD (56.3%) compared to Africa (39.5%), Asia (38.6%), Europe (36.1%) and America (28.9%). Dysphagia in PD was associated with older age, lower body mass index, longer disease duration, higher Hoehn and Yahr stage and levodopa equivalent daily dose, PIGD subtype, severe motor symptoms, drooling and higher levels of depression, and lower quality of life. Conclusions: In conclusion, our meta-analysis showed that dysphagia occurs in more than one-third of PD patients and was associated with several demographic characteristics and PD-related characteristics, motor symptoms, non-motor symptoms, as well as decreased quality of life. It deserves early screening, diagnosis, and treatment in clinical practice to prevent serious complications from dysphagia.

Overexpression of ARID4B predicts poor survival in patients with hepatocellular carcinoma.

AT-rich interaction domain 4B (ARID4B), which belongs to the ARID family, is heavily involved in cell growth and differentiation and is closely associated with many types of tumors. However, the role of this protein in hepatocellular carcinoma (HCC) remains unknown. In this study, we used data from The Cancer Genome Atlas and Gene Expression Omnibus to analyze ARID4B expression in HCC. We subjected 15 pairs of fresh-frozen tissue samples to quantitative real-time polymerase chain reaction and Western blotting analyses to investigate ARID4B expression. We also subjected 157 formalin-fixed, paraffin-embedded HCC tissue samples to immunohistochemical analysis to detect ARID4B expression and to determine the clinical significance of ARID4B expression in HCC. The bioinformatics analysis, quantitative real-time polymerase chain reaction, and Western blotting results showed that ARID4B was highly expressed in HCC tissues compared with adjacent normal liver tissues. High ARID4B expression was strongly correlated with tumor number (P = .02), vascular invasion (P = .004), Edmondson-Steiner grades (P = .000), and tumor-node-metastasis stages (P = .001). Moreover, Kaplan-Meier and Cox proportional-hazards analyses indicated that high ARID4B expression was significantly associated with poor survival in patients with HCC and that ARID4B was an independent prognostic factor for overall survival and disease-free survival in patients with HCC. In conclusion, our results suggest that ARID4B acts as an oncogene in HCC and can therefore serve as a biomarker for the prognoses of patients with HCC.