The factors of job crafting in emergency nurses: regression models versus qualitative comparative analysis.

BACKGROUND: Job crafting is defined as a series of proactive behaviors exhibited by employees in order to balance work resources and needs, which has a significant positive impact on the nurses. It is necessary to find the core factors that influence the job crafting, as emergency nurses deal with the most complex tasks, so as to improve their job satisfaction. OBJECTIVES: To investigate the core factors of job crafting among emergency nurses. METHODS: A cross-sectional design was used in the study. A total of 255 nurses were recruited from two hospitals in Zhengzhou and Shenzhen, China in December 2021. 255 nurses completed an online questionnaire. Hierarchical regression models and fsQCA models were used to explore the factors influencing job crafting among emergency nurses and helped us to identify core factors. RESULTS: The hierarchical regression model and the fsQCA model found that the occupational benefit, psychological empowerment, and research experience were the core factors affecting their job crafting. Job involvement was not significant in the regression model, but the QCA model indicated that it needs to be combined with other factors to impact on job crafting. The QCA model uncovered seven key conditional configurations that led to high and low job crafting among emergency nurses, explaining 80.0% of the results for high job crafting and 82.6% of the results for the low job crafting, respectively. CONCLUSIONS: The results of this study provide valuable insights into the job crafting experienced by emergency nurses. Junior emergency nurses should be granted a high level of psychological empowerment without assigning them overly complex tasks, such as research tasks, as these challenges can stop their job crafting. Intermediate and senior emergency nurses, on the other hand, can be assigned research tasks coupled with high psychological empowerment to enhance their job crafting.

Psychosomatic mechanisms of heart failure symptoms on quality of life in patients with chronic heart failure: A multi-centre cross-sectional study.

AIMS: To determine the contributions of different kinds of symptoms to the quality of life and mediating effect of psychological and physical symptoms between heart failure symptoms and quality of life. DESIGN: A multi-centre cross-sectional study. METHODS: 2006 chronic heart failure patients from four cities were recruited in China from January 2021 to December 2022. Patients' symptoms and quality of life were self-reported, and data were analysed using correlation analysis, dominance analysis and mediating effects analysis. RESULTS: The dominance analysis revealed that the overall mean contributions of heart failure, psychological and physical symptoms were .083, .085 and .111; 29.5%, 30.2% and 39.5% of the known variance. And heart failure symptoms could negatively affect quality of life through psychological and physical symptoms, accounting for 28.39% and 22.95% of the total effect. Heart failure symptoms could also affect quality of life through the chain-mediated effect of physical and psychological symptoms, accounting for 16.74%. CONCLUSIONS: Physiological symptoms had the strongest effect on quality of life and heart failure symptoms had the weakest. Most of the effect for heart failure symptoms on quality of life in chronic heart failure patients was mediated by psychological and physiological symptoms. RELEVANCE TO CLINICAL PRACTICE: It is important to design non-pharmacological intervention plans for the enhancement of physical and psychological symptoms' management skills, to reduce the adverse impact of heart failure symptoms on quality of life. REPORTING METHOD: Study methods and results reported in adherence to the STROBE checklist. NO PATIENT OR PUBLIC CONTRIBUTION: No patients or members of the public were involved in the study.

[Management of helicopter medical transport in 36 patients with critical cardiac disease].

OBJECTIVE: To summarize the management experience of helicopter medical transport in patients with critical heart disease, so as to provide reference for transport of patients with critical heart disease under the background of major natural disasters. METHODS: The clinical and transport data of 36 critically ill cardiac patients in Fuwai Central China Cardiovascular Hospital from 16:30 on July 21 to 19:30 on July 22, 2021 due to historically rare heavy rainstorms were collected. All 36 critically ill cardiac patients were transported by helicopter. The safe transportation was implemented under the measures of quickly forming a transport leadership and coordination group, clarifying responsibilities and division of labor, doing a good job in the pretreatment of the patient's condition, pipeline assessment and mechanical circulation support (MCS) equipment, simulating and practicing the transfer process, improving the safety of the transfer implementation process, and effectively handing over with the target hospital. The gender, age, disease type, MCS, transport and outcome of patients were collected. RESULTS: Thirty-six patients with cardiac critical illness were from adult extracardiac intensive care unit (ICU), adult cardiac care unit (CCU), children's CCU, comprehensive ICU and department of neurology. There were 24 males and 12 females; age (50.93±20.86) years old. There were 12 patients using respirator, 7 patients needing MCS, 2 of whom needed both extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump (IABP), and 7 patients with post-cardiac surgery. The total distance of transportation of 36 patients was 1 638.4 km, the transit time was 10.5 hours, one way flight time of helicopter was about 8 minutes, and the average transport time per patient was about 17.5 minutes. The vital signs of 36 patients during transport were basically stable, without complications, and all of them reached the target hospital safely. CONCLUSIONS: Under the seamless connection of the rapid establishment of the transfer leadership coordination group, assessment of the patient's condition and pretreatment, the simulation of the transfer process, and the effective handover with the receiving hospital, the use of helicopter for medical transport for critically ill heart patients is feasible and safe, which can buy valuable time for saving patients' lives and further treatment.

The relationship between mutuality and contributions to self-care in family caregivers of patients with heart failure: multiple mediating effects of resilience and self-efficacy.

AIMS: Previous studies have indicated a positive association between mutuality and caregiver contributions to heart failure self-care (CC-HFSC). However, little is known about the underlying mechanisms in the relationship. This study aimed to determine whether resilience and self-efficacy play multiple mediating roles in the association between mutuality and CC-HFSC. METHODS AND RESULTS: In this cross-sectional, correlational study, a self-reported survey was conducted in 259 patient-caregiver dyads recruited from two hospitals in China using a convenience sampling method. Better mutuality (r = 0.27, P < 0.01), resilience (r = 0.23, P < 0.01), and self-efficacy (r = 0.34, P < 0.01) were correlated with greater CC-HFSC maintenance. Better mutuality (r = 0.29, P < 0.01), resilience (r = 0.20, P < 0.01), and self-efficacy (r = 0.35, P < 0.01) were correlated with greater CC-HFSC management. In multiple mediation models, self-efficacy independently [effect = 0.061, 95% confidence interval (CI) (0.024-0.119)] and resilience and self-efficacy serially [effect = 0.017, 95% CI (0.007-0.036)] mediated the association between mutuality and CC-HFSC maintenance. Meanwhile, self-efficacy independently [effect = 0.058, 95% CI (0.020-0.113)] and resilience and self-efficacy serially [effect = 0.018, 95% CI (0.007-0.038)] mediated the association between mutuality and CC-HFSC management. CONCLUSIONS: Resilience and self-efficacy were multiple mediators in the association between mutuality and CC-HFSC. Interventions targeting the facilitation of mutuality, and then increasing resilience and self-efficacy may be beneficial for improving CC-HFSC.

Betulinic acid prevents high glucose­induced expression of extracellular matrix protein in cardiac fibroblasts by inhibiting the TGF­ß1/Smad signaling pathway.

The proliferation and differentiation of cardiac fibroblasts (CFs) is central to cardiac fibrosis. Betulinic acid (BA) is an active compound isolated from the bark of the birch tree Betula spp. (Betulaceae) and has been shown to attenuate hepatic fibrosis. However, the effect of BA on the high glucose­induced fibrosis response in CFs remains to be elucidated, therefore, the present study investigated the effect of BA on high glucose­induced CFs and examined the possible mechanism underlying the effect of BA on CF transdifferentiation. CFs were pre­incubated with various concentrations of BA for 24 h and then stimulated with high glucose (25 mM) for various times. Cell proliferation was evaluated using an MTT assay. The mRNA expression levels of α­smooth muscle actin (SMA) and transforming growth factor (TGF)­ß1 were determined using reverse transcription­quantitative polymerase chain reaction analysis. The protein expression levels of α­SMA, collagen I, collagen III, fibronectin, TGF­ß1, small mothers against decapentaplegic (Smad)2/3, phosphorylated (p)­Smad2 and p­Smad3 and were detected using western blot analysis. The data revealed that BA attenuated the CF proliferation and myofibroblast differentiation induced by high glucose. In addition, BA inhibited the expression of extracellular matrix (ECM) in the CFs induced by high glucose. It was also found that BA inhibited the high glucose­induced phosphorylation of Smad2/3 in the CFs. Taken together, BA suppressed the high glucose­induced increase in the proliferation of CFs and expression of ECM via inhibition of the TGF­ß1/Smad signaling pathway. Thus, BA may offer therapeutic potential towards the treatment of cardiac fibrosis.

Cyano-bridged FeIII2CuII3 and FeIII4NiII4 complexes: syntheses, structures, and magnetic properties.

Two tricyanometallate precursors, (Bu4N)[(Tp4Bo)Fe(CN)3].H2O.2MeCN (1) and (Bu4N)[(pzTp)Fe(CN)3] (2) [Bu4N+ = tetrabutylammonium cation; Tp4Bo = tris(indazolyl)hydroborate; pzTp = tetrakis(pyrazolyl)borate], with a low-spin FeIII center have been synthesized and characterized. The reactions of 1 or 2 with [Cu(Me3tacn)(H2O)2](ClO4)2 (Me3tacn = N,N',N' '-trimethyl-1,4,7-triazacyclononane) afford two pentanuclear cyano-bridged clusters, [(Tp4Bo)2(Me3tacn)3Cu3Fe2(CN)6](ClO4)4.5H2O (3) and [(pzTp)2(Me3tacn)3Cu3Fe2(CN)6](ClO4)4.4H2O (4), respectively. Assembly reactions between 2 and [Ni(phen)(CH3OH)4](ClO4)2 (phen = 1,10-phenanthroline) or Zn(OAc)2.2H2O afford a molecular box [(pzTp)4(phen)4Ni4Fe4(CH3OH)4(CN)12](ClO4)4.4H2O (5) and a rectangular cluster [(pzTp)2Zn2Fe2(OAc)2(H2O)2(CN)6] (6). Their molecular structures were determined by single-crystal X-ray diffraction. In complexes 1 and 2, the central FeIII ions are coordinated by three cyanide carbon atoms and three nitrogen atoms of Tp4Bo- or pzTp-. Both complexes 3 and 4 show a trigonal-bipyramidal geometry, in which [(L)Fe(CN)3]- units occupy the apical positions and are linked through cyanide to [Cu(Me3tacn)]2+ units situated in the equatorial plane. Complex 5 possesses a cubic arrangement of eight metal irons linked through edge-spanning cyanide bridges, while complex 6 shows Zn2Fe2(CN)4 rectangular structure, in which FeIII and ZnII ions are alternately bridged by the cyanide groups. Intramolecular ferromagnetic couplings are observed for complexes 3-5, and they have S = 5/2, 5/2, and 6 ground states and appreciable magnetic anisotropies with negative D values equal to -0.49, -2.39, and -0.39 cm-1, respectively.

Cyano-bridged pentanuclear Fe(III)3M(II)2 (M = Ni, Co, Fe) clusters: synthesis, structures, and magnetic properties.

The reactions of [M(II)(Tpm(Me))(H2O)3]2+ (M = Ni, Co, Fe; Tpm(Me) = tris(3,5-dimethyl-1-pyrazoyl)methane) with [Bu4N][(Tp)Fe(III)(CN)3] (Bu4N+ = tetrabutylammonium cation; Tp = tris(pyrazolyl)hydroborate) in MeCN-Et2O afford three pentanuclear cyano-bridged clusters, [(Tp)3(Tpm(Me))2Fe(III)3M(II)2(CN)9]ClO4.15H2O (M = Ni, 1; M = Co, 2) and [(Tp)3(Tpm(Me))2Fe(III)3Fe(II)2(CN)9]BF4.15H2O (3). Single-crystal X-ray analyses reveal that they show the same trigonal bipyramidal structure featuring a D3h-symmetry core, in which two opposing Tpm(Me)-ligated M(II) ions situated in the two apical positions are linked through cyanide bridges to an equatorial triangle of three Tp-ligated Fe(III) (S = 1/2) centers. Magnetic studies for complex 1 show ferromagnetic coupling giving an S = 7/2 ground state and an appreciable magnetic anisotropy with a negative D(7/2) value equal to -0.79 cm(-1). Complex 2 shows zero-field splitting parameters deducted from the magnetization data with D = -1.33 cm(-1) and g = 2.81. Antiferromagnetic interaction was observed in complex 3.