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OBJECTIVE: The aim of this study was to investigate the level of diabetes self-management ability in older patients with type 2 diabetes and analyse its relationship with patient activation. Besides, the mediating effect of self-efficacy on the relationship between the two was assessed in the study. METHODS: Using a cross-sectional design, 200 elderly patients with type 2 diabetes were recruited from the community of Yangzhou, China. The Patient Activation Measure (PAM), The Self-efficacy for Diabetes (SED), and The Summary of Diabetes Self-Care Activities Measure (SDSCA) were used in the questionnaires. Data analysis was performed using SPSS 27.0 and PROCESS macro. RESULTS: Pearson correlation analysis revealed a significant positive correlation (p< 0.01) between diabetes self-management ability and patient activation (r=0.312) and self-efficacy (r=0.367). Self-efficacy partially mediated the effect between patient activation and self-management ability in older patients with type 2 diabetes, and the mediating effect accounted for 49.33% of the total effect (p< 0.001). CONCLUSIONS: Older patients with type 2 diabetes in the community have a moderate level of self-management ability. Patient activation can improve patients' self-management ability through self-efficacy.
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Diabetes Mellitus Tipo 2 , Autogestão , Humanos , Idoso , Diabetes Mellitus Tipo 2/terapia , Autoeficácia , Participação do Paciente , Estudos Transversais , Inquéritos e Questionários , AutocuidadoRESUMO
AIM: This study aims to identify the role that spiritual climate has in reducing burnout and intentions to leave amongst clinical nurses. BACKGROUND: Both shortages and the high turnover of nurses are challenging problems worldwide. Enhancing the spiritual climate amongst nurses can enhance teamwork, organisational commitment and job satisfaction and can play a role in reducing burnout and turnover intention. METHODS: A total of 207 clinical nurses working at a tertiary university hospital were included in this cross-sectional, single-site study. Independent-samples t test and ANOVA, Pearson correlation analysis and hierarchical regression analysis were used to explore the relationships amongst related factors. RESULTS: Most clinical departments showed a moderate spiritual climate (60.24 ± 0.82) with high job burnout (33.62 ± 0.28) and turnover intention (2.37 ± 0.57). A good spiritual climate was correlated with high job satisfaction (r = 0.412, p < 0.01), low burnout and turnover intention (r = -0.423, p < 0.01 and r = -0.292, p < 0.01, respectively). Spiritual climate could also indirectly influence nurses' job burnout and turnover intention (R2 = 10.31%). CONCLUSIONS: Different departments have different spiritual climates. The findings from this study indicate that spiritual climate may impact nursing burnout and turnover. IMPLICATIONS FOR NURSING MANAGEMENT: Using a spiritual climate scale provides health care decision-makers with clear information about staff spirituality well-being. Interventions to improve spiritual climate can benefit teamwork in clinical departments.
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Esgotamento Profissional/complicações , Satisfação no Emprego , Cultura Organizacional , Espiritualidade , Adulto , Atitude do Pessoal de Saúde , Esgotamento Profissional/psicologia , China , Estudos Transversais , Feminino , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Reorganização de Recursos Humanos/tendências , Inquéritos e Questionários , Local de Trabalho/psicologia , Local de Trabalho/normasRESUMO
AIMS AND OBJECTIVES: To examine whether and how stigma influences attitudes towards seeking treatment for urinary incontinence, and whether its effect varies by symptom severity. BACKGROUND: Urinary incontinence is prevalent among women, but few seek treatment. Negative attitudes towards urinary incontinence treatment inhibit from seeking care. Urinary incontinence is a stigmatised attribute. However, the relationship between stigma and attitudes towards seeking treatment for urinary incontinence has not been well understood. DESIGN: This was a cross-sectional community-based study. METHODS: We enrolled a sample of 305 women aged 40-65 years with stress urinary incontinence from three communities in a Chinese city between May-October in 2011. Data were collected on socio-demographic characteristics, urinary incontinence symptoms, stigma and attitudes towards seeking treatment for urinary incontinence using a self-reported questionnaire. Effects of stigma were analysed using path analysis. RESULTS: Attitudes towards seeking treatment for urinary incontinence were generally negative. For the total sample, all the stigma domains of social rejection, social isolation and internalised shame had direct negative effects on treatment-seeking attitudes. The public stigma domain of social rejection also indirectly affected treatment-seeking attitudes through increasing social isolation, as well as through increasing social isolation and then internalised shame. The final model accounted for 28% of the variance of treatment-seeking attitudes. Symptom severity influenced the strength of paths: the effect of internalised shame was higher in women with more severe urinary incontinence. CONCLUSIONS: Stigma enhances the formation of negative attitudes towards seeking treatment for urinary incontinence; public stigma affects treatment-seeking attitudes through internalisation of social messages. RELEVANCE TO CLINICAL PRACTICE: Stigma reduction may help incontinent women to form positive treatment-seeking attitudes and engage them in treatment. Interventions should specifically target the self-stigma domains of social isolation and internalised shame in women with urinary incontinence to most efficiently increase their use of health care.
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Povo Asiático/psicologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Estigma Social , Incontinência Urinária/terapia , Adulto , Idoso , China , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Vergonha , Inquéritos e Questionários , Incontinência Urinária/etnologia , Incontinência Urinária/psicologiaRESUMO
AIMS AND OBJECTIVES: To examine the association between disease stigma and quality of life and whether disease stigma mediates the relationship between symptom severity and quality of life among community-dwelling women with stress urinary incontinence in China. BACKGROUND: Urinary incontinent patients perceived great stigma, which inhibited from seeking medical help. There is evidence that stigma associated with some other diseases had a complex relationship with illness severity and quality of life. However, little empirical research has examined the role that stigma plays among urinary incontinent population. DESIGN: A cross-sectional, descriptive design was used. METHODS: A purposive sample of 333 women with stress urinary incontinence from a Chinese city was enrolled. Data were collected on symptom severity, disease stigma and quality of life using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, Social Impact Scale and Incontinence Quality-of-Life Measure, respectively. The mediate effect of disease stigma was analysed using a series of hierarchical regression models. RESULTS: Disease stigma negatively correlated with quality of life among stress urinary incontinent women. Social isolation and internalised shame, but not social rejection, the domains of disease stigma, partially mediated the effect of symptom severity on quality of life, attenuating the effect by 34·3% together. CONCLUSIONS: Disease stigma impairs quality of life of women with stress urinary incontinence and mediates the association between symptom severity and quality of life. Health workers may improve their quality of life by addressing perceived stigma. RELEVANCE TO CLINICAL PRACTICE: Our findings suggest that in clinical practice, stigma reduction may have the potential to not only improve quality of life, but also mitigate the impact of the severity on quality of life among urinary incontinent women. Social isolation and internalised shame should be more concerned in targeted interventions.
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Aceitação pelo Paciente de Cuidados de Saúde , Qualidade de Vida , Estigma Social , Incontinência Urinária por Estresse/psicologia , Adolescente , Adulto , China , Cidades , Enfermagem em Saúde Comunitária , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Casas de Saúde , Índice de Gravidade de Doença , Inquéritos e Questionários , Incontinência Urinária por Estresse/enfermagem , Adulto JovemRESUMO
AIMS: To explore the inter-predictive role and causal relationship between family functioning, self-perceived burden and loneliness in people with type 2 diabetes. METHODS: In this study, patients with type 2 diabetes admitted to two tertiary care hospitals in China were selected for an 8-month follow-up, and the patients' scores on the Family Functioning, Self-perceived Burden, and Loneliness scales were measured repeatedly at three time periods: during hospitalisation (T1), 1 month after discharge (T2), and 3 months after discharge (T3). RESULTS: The results showed that family function at the T1 time point had a negative predictive effect on self-perceived burden at the T2 time point, ß = - 0.43, P = 0.005. Loneliness at the T1 time point had a positive predictive effect on self-perceived burden at the T2 time point, ß = 0.08, P = 0.021. Unlike the pathway at time point T1, family functioning at time point T2 negatively predicted loneliness at time point T3, ß = - 0.32, P = 0.013. Loneliness at time point T2 positively predicted family functioning at time point T3, ß = 0.025, P = 0.013. Loneliness at time point T2 negatively predicted self-perceived burden at time point T3 (P = 0.011). CONCLUSIONS: The results of the cross-lagged analysis show that there is a mutually predictive and moderating relationship between family functioning and loneliness in patients with type 2 diabetes. Loneliness can predict the level of self-perceived burden at the next time point.
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Diabetes Mellitus Tipo 2 , Humanos , Solidão , China/epidemiologiaRESUMO
To explore the impact of the Mediterranean diet on cardiovascular risk factors, glycemic control and weight loss in patients with type 2 diabetes(T2D) by a meta-analysis of randomized controlled trials (RCTs). We systematically searched PubMed, Cochrance Library, EMBASE and four Chinese databases to identify RCTs that compared the Mediterranean diet with control diets in patients with T2D up to December 2021. The Risk of Bias of the included studies was assessed using the version 2 of the Cochrane risk-of-bias tools for randomized trials (ROB 2). Seven RCTs with 1371 patients met the eligibility criteria and entered into the meta-analysis. Compared to control diets, the beneficial effects of Mediterranean diet were not statistically significant in high-density lipoprotein (MD = 2.33; 95% CI: -0.27 to 4.92), low-density lipoprotein (MD = -2.34; 95% CI -5.67 to 0.99) and total cholesterol (MD = 2.60; 95% CI: -0.95 to 6.15). But Mediterranean diet led to reduce the level of diastolic blood pressure (MD = -1.20; 95% CI: -2.21 to -0.19) and systolic blood pressure (MD = -4.17; 95% CI: -7.12 to -1.22). Meanwhile, Mediterranean diet showed beneficial effects in glycemic control (HbA1[%]: MD = -0.39, 95% CI: -0.58 to -0.20; fasting plasma glucose: MD = -15.12, 95% CI: -24.69 to -5.55) and weight loss (BMI: MD = -0.71, 95% CI: -1.30 to -0.78; WC: MD = -1.69; 95% CI: -3.35 to -0.02) compared to the control diets. The meta-analysis presented evidence supporting the beneficial effects of the Mediterranean diet on blood pressure, glycemic control, and weight loss. However, the impact of the Mediterranean diet on the lipid profile was not found to be significant, warranting further verification. This Meta-analysis was registered on the INPLASY website (Registration number: INPLASY 202160096).
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BACKGROUND: Living with stroke poses many psychosocial challenges. Interventions for improving stroke survivors' psychosocial outcomes are lacking. Peer support interventions may contribute to recovery after stroke. However, current evidence is insufficient to suggest their application in enhancing stroke survivors' psychosocial well-being. OBJECTIVE: This study aimed to evaluate the effectiveness of a nurse-led peer support intervention for improving the psychosocial outcomes of stroke survivors. DESIGN: An assessor-blinded two-arm randomised controlled trial with an attention control group. SETTINGS: A community health centre and a rehabilitation unit in Yangzhou, China. PARTICIPANTS: First-ever or recurrent ischaemic or haemorrhagic stroke survivors. METHODS: A convenience sample of 120 stroke survivors was recruited with 60 participants randomly assigned to each of the intervention and control groups. Intervention group participants received the nurse-led peer support intervention. Control group participants received attention care. The primary outcomes were social participation and participation self-efficacy. The secondary outcomes were psychological distress, perceived social support, stigma towards diseases, and quality of life. Data were collected at baseline (T0), immediately post-intervention (T1) and three months post-intervention (T2). Generalised estimating equations models were used to determine the effects of the intervention on the outcomes. RESULTS: The intervention significantly improved social participation (T1: adjusted mean differenceâ¯=â¯-18.45, 95â¯% CI: -22.89 to -14.01, pâ¯<â¯0.001; T2: adjusted mean differenceâ¯=â¯-14.71, 95â¯% CI: -22.36 to -7.05, pâ¯<â¯0.001), participation self-efficacy (T1: adjusted mean differenceâ¯=â¯47.92, 95â¯% CI: 37.56 to 58.27, pâ¯<â¯0.001; T2: adjusted mean differenceâ¯=â¯39.58, 95â¯% CI: 17.88 to 61.28, pâ¯<â¯0.001) and perceived social support (T1: adjusted mean differenceâ¯=â¯7.56, 95â¯% CI: 4.93 to 10.19, pâ¯<â¯0.001; T2: adjusted mean differenceâ¯=â¯7.41, 95â¯% CI: 4.01 to 10.80, pâ¯<â¯0.001), and reduced psychological distress (T1: adjusted mean differenceâ¯=â¯-4.97, 95â¯% CI: -6.25 to -3.69, pâ¯<â¯0.001; T2: adjusted mean differenceâ¯=â¯-4.67, 95â¯% CI: -6.24 to -3.11, pâ¯<â¯0.001) and stigma towards diseases (T1: adjusted mean differenceâ¯=â¯-3.83, 95â¯% CI: -5.14 to -2.51, pâ¯<â¯0.001; T2: adjusted mean differenceâ¯=â¯-3.19, 95â¯% CI: -5.20 to -1.19, pâ¯<â¯0.001) at both T1 and T2. The intervention significantly improved quality of life at T1 only (adjusted mean differenceâ¯=â¯0.12, 95â¯% CI: 0.06 to 0.19, pâ¯=â¯0.02). CONCLUSIONS: The results provide empirical support for the effectiveness of the nurse-led peer support intervention in improving the psychosocial outcomes of stroke survivors and provide additional evidence to support their inclusion in stroke rehabilitation. REGISTRATION: ChiCTR.org.cn (ChiCTR2100050853), Start of recruitment: October 2021.
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AIMS: To examined the relationship between fear of hypoglycemia and certain variables in people with type 2 diabetes mellitus (T2DM) based on the Capability, Opportunity, Motivation, and Behavior model, combined with the context unique to people with diabetes to provide a basis for developing targeted nursing interventions. METHODS: In this cross-sectional study, 212 people with T2DM were recruited from February 2021 to July 2021. Data were collected using the Hypoglycaemia Fear Survey, Gold score, Patient Assessment of Chronic Illness Care (PACIC) scale and Diabetic Self-Management Attitudes Scale. Multiple linear regression analysis was performed to determine the predictors of fear of hypoglycemia using SPSS 26.0. RESULTS: The mean fear of hypoglycemia score was 74.88 ± 18.28 (range: 37.00-132.00). In people with T2DM, the frequency of blood glucose monitoring, the frequency of hypoglycemia in the past half-year, degree of understanding of hypoglycemia, impaired awareness of hypoglycemia, PACIC, and self-management attitude of diabetes were the influencing factors of fear of hypoglycemia (adjusted R2 = 0.560, F[21,190] = 13.800, P < 0.001). These variables explained 56.0% of the variance in the fear of hypoglycemia. CONCLUSIONS: The level of fear of hypoglycemia in people with T2DM was relatively high. In addition to paying attention to the disease characteristics of people with T2DM, medical staff should also pay attention to patients' own perception and handling ability of disease and hypoglycemia, attitude toward self-management behavior and external environment support, all of which have a positive effect on improving the fear of hypoglycemia in people with T2DM, optimizing the self-management level and improving quality of life.
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Diabetes Mellitus Tipo 2 , Hipoglicemia , Humanos , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/terapia , Estudos Transversais , Qualidade de Vida , Motivação , Automonitorização da Glicemia , Glicemia , MedoRESUMO
With the accelerated aging of the population, orthopedic injuries have become more collective. Among them, the incidence of ankle fractures remains high. Surgery is an effective way to treat ankle fractures by utilizing special surgical site, complex anatomical structure, and specific surgical methods. With surgical approach, it is easy for basis postoperative blood loss, pain, swelling, and other problems. After surgery, most patients suffer from symptoms of fear, increased pain sensitivity, and excessive irrational concerns about physical movement or activity. Compression cold therapy combines cold therapy with air pressure therapy to ease local exudation, constrict blood vessels, improve circulation, relieve pain, and control inflammation through the effects of low temperature and pressure. Application during the rehabilitation period can prevent joint swelling, reduce muscle soreness, and promote the functional recovery of limbs, which provides an effective guarantee for postoperative rehabilitation of patients with orthopedic dyskinesia. Based on this, it is very important to evaluate the application and effect of self-made compression cold therapy in postoperative rehabilitation of patients with orthopedic dyskinesia. This work proposes a one-dimensional deep convolutional neural network-based method; DenseNet for analyzing the rehabilitation effect of patients with orthopedic dyskinesia after ankle fracture surgery. The approach is to evaluate the rehabilitation effect of self-made compression cold therapy from the perspectives of feature reuse, attention mechanism, and feature decoupling. Experiments on the dataset show that the proposed neural network has better efficacy evaluation performance. The proposed systematic assessment based on the emerging deep learning network has great significance in healthcare domain, particularly in assessing applicability, side effects, and noninvasiveness of treatment methods.
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Fraturas do Tornozelo , Bandagens Compressivas , Crioterapia , Discinesias , Fraturas do Tornozelo/reabilitação , Fraturas do Tornozelo/cirurgia , Aprendizado Profundo , Humanos , Procedimentos Ortopédicos/efeitos adversos , Dor , Dor Pós-Operatória/prevenção & controle , Cuidados Pós-Operatórios , Resultado do TratamentoRESUMO
INTRODUCTION: Many stroke survivors have unmet psychosocial needs during the recovery phase following a stroke. There is emerging evidence that peer support interventions may play a valuable role in managing stroke. However, evidence regarding the effectiveness of peer support interventions on the psychosocial outcomes of stroke survivors is uncertain. This study aims to develop a nurse-led peer support intervention for stroke survivors based on the Person-Environment-Occupation-Performance Model and evaluate its effects on the psychosocial outcomes of stroke survivors. METHODS AND ANALYSIS: This is an assessor-blinded two-arm randomised controlled trial. A convenience sample of 120 stroke survivors will be recruited from two community centres and one rehabilitation unit in Yangzhou, a medium-sized city in eastern China, with 60 participants each in the intervention and control groups. The participants allocated to the intervention group will receive the nurse-led peer support intervention, which includes 6 weekly peer support sessions facilitated by a nurse and at least one peer facilitator. Participants randomised to the control group will receive the same dose of interpersonal interaction as intervention participants, including weekly individual face-to-face session for 6 weeks. The primary outcomes are social participation and participation self-efficacy. The secondary outcomes are psychosocial distress, social support, stigma towards disease, self-efficacy in managing chronic conditions and quality of life. Data will be collected at baseline, immediately after the intervention and 3 months after the intervention. A process evaluation will be conducted qualitatively and quantitively to examine the mechanism by which the intervention impacts the psychosocial outcomes of stroke survivors. All outcomes will be analysed following the intention to treat principle. Generalised Estimation Equation models will be used to assess the intervention effect. ETHICS AND DISSEMINATION: This protocol was approved by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (CREC Ref. No.: 2021.196-T). All participants will be required to provide written informed consent. Results of the study will be disseminated through publication in peer-reviewed journals and presentation at local or international conferences. TRIAL REGISTRATION NUMBER: ChiCTR2100050853.
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Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Papel do Profissional de Enfermagem , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Sobreviventes/psicologiaRESUMO
Introduction: Telemedicine interventions are gradually being used in primary health care to help patients with type 2 diabetes receive ongoing medical guidance. The purpose of this study was to analyze the effectiveness of using telemedicine in primary health care for the management of patients with type 2 diabetes. Methods: A systematic search was conducted from database inception to August 2021 in nine databases, including PubMed, Web of Science, Cochrane Library, EMBASE, EBSCO, CNKI, Wanfang Data, VIP, and CBM. Data extraction and quality assessment were performed for studies that met the inclusion criteria. The meta-analysis was performed using Review Manager 5.4 (Cochrane) and Stata v.16.0SE (College Station, TX, USA). Results: A total of 32 articles were included in this study. Analysis showed a reduction in glycated hemoglobin, fasting glucose, and postprandial glucose after the telemedicine intervention. Systolic blood pressure and self-efficacy improved significantly, but there was no significant improvement in weight, lipid metabolism, or diabetes awareness. Subgroup analysis based on the duration of intervention showed significant improvement in glycated hemoglobin at 6 months of intervention. Conclusions: Telemedicine interventions may help patients with type 2 diabetes to effectively control blood glucose and improve self-management in primary health care. There is only moderate benefit, and the benefit may not be sustained beyond 6 months. However, the evidence for the improvement in lipid metabolism is insufficient and further studies are needed.
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Diabetes Mellitus Tipo 2 , Telemedicina , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/terapia , Hemoglobinas Glicadas/metabolismo , Humanos , Atenção Primária à SaúdeRESUMO
Purpose: To explore the mediating effect of self-efficacy in the relationship between glycated haemoglobin (HbA1c) levels and health beliefs in community elderly patients with type 2 diabetes. Patients and Methods: From January to March 2022, convenience sampling was adopted to investigate 200 elderly patients with type 2 diabetes in a community in Yangzhou, China. Data were collected using the Health Beliefs Questionnaire, Self-efficacy for Diabetes, and Medication Compliance Questionnaire. Laboratory parameters included HbA1c, fasting blood glucose, postprandial blood glucose, total cholesterol, triglyceride, high-density-lipoprotein cholesterol, and low-density-lipoprotein cholesterol levels. Correlation, linear regression, and mediation analyses were performed using SPSS 27.0. Results: HbA1c levels were higher in men (women vs men: 6.80% [6.08%, 7.73%] vs.7.30% [6.30%, 9.18%]) and employed (employed vs not employed vs retired: 7.60% [6.90%, 10.45%] vs 5.85% [5.40%, 6.95%] vs 7.10% [6.20%, 8.20%]) and low self-efficacy (low vs high: 13.1% [6.55%, 13.85%] vs 6.8% [6.10%, 7.70%]). HbA1c levels were negatively associated with health beliefs (r = -0.246) and self-efficacy (r = -0.240; p<0.01). Linear regression showed that perceived susceptibility, severity, benefit, and barriers, cues to action, and self-efficacy explained 50% of the variance in HbA1c levels after adjusting for sex and current work status. The mediation effect of self-efficacy was partial between health beliefs and HbA1c levels and accounted for 24.65% of the total effect (p < 0.001). Conclusion: Health beliefs influenced the improvement of self-efficacy in older patients with type 2 diabetes mellitus, which in turn could improve HbA1c control. Self-efficacy plays a partial mediating role between health beliefs and Hba1c levels in elderly patients with type 2 diabetes.
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AIM: This study aims to develop a reliable and validate Chinese version of Oldenburg Burnout Inventory (OLBI). DESIGN: A cross-sectional validation design was adopted in this study. METHODS: After obtaining the copyright by contacting with the author, the original English OLBI was developed to Chinese by forward translation, back-translation, cultural adaptation and a pre-test (20 nurses). The Chinese OLBI and Maslach Burnout Inventory (MBI) were administered to 641 clinical nurses during July and August, 2020. Internal consistency (Cronbach's α coefficient), split reliability (split half coefficient), construct validity (confirmatory factor analysis) and criterion validity (comparison with MBI, using Pearson correlation analysis) were assessed. RESULTS: The Chinese OLBI included 16 items. Exploratory factor analysis extracted two factors with a cumulative contribution of 62.245%. Two-dimensional structure (exhaustion and disengagement) was confirmed. It has good internal consistency (Cronbach's α coefficient values of 0.905, 0.933 and 0.876 for the total questionnaire, exhaustion dimension and disengagement dimension, respectively), split half reliability (split half coefficient = 0.883, p < .01) and criterion validity (r = 0.873, p < .01). Pearson coefficients between 16 items and the scale varied from 0.479-0.765. An acceptable model fit (χ2 /df = 2.49, RMSEA = 0.068, TLI = 0.906, CFI = 0.922, SRMR = 0.061) was achieved.
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Esgotamento Psicológico , China , Estudos Transversais , Humanos , Psicometria/métodos , Reprodutibilidade dos TestesRESUMO
BACKGROUND: High level of unmet needs were reported by stroke survivors after hospital discharge. Peer support interventions may play a valuable role in the management of stroke, but the evidence is unclear. OBJECTIVES: To determine the effects of peer support interventions on physical and psychosocial outcomes of stroke survivors; and to identify the key characteristics of peer support interventions for stroke survivors.cv DESIGN: A systematic review and meta-analysis. REVIEW METHODS: Seven English databases and four Chinese databases were searched to identify eligible articles. Two reviewers screened the eligible studies, appraised the risk of bias, and extracted the data independently. Version 2 of the Cochrane risk-of-bias tool was used to evaluate the risk of bias for randomized controlled trials, while the Risk of Bias in Non-randomized Studies of Interventions tool was used for the quasi-experimental studies. The Grading of Recommendations Assessment, Development and Evaluation profiler Guideline Development Tool was used to assess the quality of evidence. Meta-analyses were conducted using Review Manager 5.3, and narrative analyses were performed when meta-analysis was inappropriate. RESULTS: Eleven studies were included. Peer support interventions could improve the activities of daily living (MD = 15.53, 95% CI: 1.39 to 29.68; P = 0.03, I2 = 99%; very low quality of evidence), limb function, depression (SMD = -1.27, 95% CI: -2.18 to -0.36; P = 0.006, I2 = 91%; very low quality of evidence) and anxiety. Although pooled analysis showed that social participation (SMD= 0.74, 95% CI: 0.09 to 1.39; P = 0.03, I2 = 69%; low quality of evidence) and quality of life (SMD = 0.41, 95% CI: 0.09 to 0.73; P = 0.01, I2 = 0%; low quality of evidence) improved after peer support interventions, the studies which were not pooled due to insufficient data drew inconsistent results. CONCLUSIONS: Stroke survivors may benefit from peer support interventions to improve their physical and psychological outcomes. The evidence about the impact of peer support interventions on social participation and quality of life is very uncertain. It should be noted that the quality of evidence ranged from very low to low, thus highlighting the need for more research of higher quality to substantiate these findings.
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Qualidade de Vida , Acidente Vascular Cerebral , Atividades Cotidianas , Ansiedade , Humanos , Acidente Vascular Cerebral/terapia , SobreviventesRESUMO
Melt spinning has proven effective in maintaining chemical homogeneity and introducing multiscale microstructures that can reduce the lattice thermal conductivity and consequently enhance the thermoelectric performance of consolidated bulk materials. In this work, p-type Bi0.52Sb1.48Te3 bulk alloys are fabricated by melt spinning (MS) followed by subsequent plasma activated sintering (PAS). The influence of different MS atmospheres (air, Ar, N2, and He) on the morphologies of MS ribbons and the thermoelectric properties of MS-PAS bulk materials has been investigated systematically. Because of the relatively high thermal conductivity, a He atmosphere expedites the heat dissipation in the MS process and results in severe sublimation of tellurium and thus inferior thermoelectric performance. In contrast, an Ar atmosphere can essentially prevent heat loss of the fusant and suppress the sublimation of tellurium. Consequently, the corresponding Bi0.52Sb1.48Te3 sample (MS in Ar atmosphere) presents the highest peak ZT and average ZT values of 1.09 (at 340 K) and 0.81 (in 300-500 K), respectively. The average ZT of the sample prepared using an Ar atmosphere is almost three times the one prepared using a He atmosphere. This reflects the importance of using the appropriate atmosphere during the melt-spinning process. This result, which indicates that melt spinning in an Ar atmosphere is preferable to avoid heat loss, can also be extended to other materials.
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OBJECTIVE: To determine the Km, Vmax, and Ki of BOC-Leu-Ser-Thr-Arg-pNA (B3644) in the determination of kallikrein, and then to establish the procedure for plasma prekallikrein/kallikrein determination. Method Chromogenic substrate assays on a semi-auto spectrophotometer were employed. RESULTS: The apparent activities of seven substrates: B3644, S2238, S2251, ChromozymPCa, T6140, ChromozymPK, and T1637, for porcine kallikrein were 0.788, 0.691, 0.659, 0.636, 0.438, 0.396, and 0.145, respectively, that of B3644 being the highest. Amidolysis caused by kaolin activated human normal plasma was independent of coagulation factors II, X, XI, and protein C, but dependent on prekallikrein and to some extent on factor XII. The kallikrein's, thrombin's, and plasmin's Km and Vmax for the B3644 were determined and calculated to be 235 micromol/L and 337 nmol x s(-1) x U(-1), 469 micromol/L and 63 nmol x s(-1) x U(-1), and 70 micromol/L and 358 nmol x s(-1) x U(-1), respectively. At the same time, the kallikrein, thrombin, and plasmin Ki values for antithrombin III (AT-III) or limabean trypsin inhibitor (LBTI) were detected to be 840 or 2.50. 32 or 0.32, and, 108 or 1.55 U/L, [d1] respectively. With B3644, the recovery percentages of kallikrein and kaolin activated plasma were 100%. Intra-assay CV values ranged from 2.3% to 4.6%. By using B3644 and introducing AT-III or LBLI into the determination system, an optimized procedure for prekallikrein/kallikrein determination was obtained. With this procedure, the mean percentage values of plasma prekallikrein in normal subjects, pregnant women (gestation > or =24 weeks), and in patients with hypertension, hepatic failure, or with advanced cancers were determined to be 113.5, 151.6 (P<0.01), 173.2 (P<0.01), 43.5 (P<0.005), and 88.7 (P<0.05), respectively. CONCLUSION: B3644 was identified as a suitable substrate for the determination of plasma prekallkrein/kallikrein activity. A sensitive and reliable chromogenic substrate assay for human plasma prekallikrein was developed by using this novel substrate.
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Compostos Cromogênicos/metabolismo , Peptídeos/metabolismo , Calicreína Plasmática/metabolismo , Pré-Calicreína/metabolismo , Adulto , Idoso , Animais , Calibragem , Feminino , Fibrinolisina/metabolismo , Humanos , Cinética , Masculino , Pessoa de Meia-Idade , Gravidez , Reprodutibilidade dos Testes , Espectrofotometria , Suínos , Trombina/metabolismoRESUMO
CdS nanoparticles were successfully coated on multi-walled carbon nanotubes (MWNTs) via electron beam irradiation in the water system. The resulting products were analyzed by XRD, FT-IR, UV-vis, TEM and AFM all kinds of characterization techniques. The results showed that cadmium cations were introduced to the surface of MWNTs through ion exchange, and by chemical reaction between cadmium cations on the carbon nanotubes and sodium thiosulfate pentahydrate under electron beam irradiation, cadmium sulfide nanoparticles were densely deposited on carbon nanotubes.
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Lead zirconate titanate (PZT) films have been extensively investigated for many applications: the nonvolatile memory devices based on their remarkable ferroelectric properties, the microelectromechanical system (MEMS) based on their piezoelectricity as well in sensors as in actuators. In this paper, we inject charges into PZT thin films, and then the charge storage and transportation through PZT thin films were observed by electric force microscopy (EFM). Results were studied and charging mechanisms were proposed.
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It has been shown that IGF-1 secretion is influenced by dietary protein or amino acid. However, whether the dipeptides elicit regulatory effects on IGF-1 secretion remains largely unclear. Thus, this study aimed to investigate the effects of the dipeptide Pro-Gly on IGF-1 expression and secretion in HepG2 cells and mice, and explore the underlying mechanisms. The in vitro results indicated that Pro-Gly, but not Pro plus Gly, promoted the expression and secretion of IGF-1 in HepG2. Meanwhile, the expression of the peptide transporter 1 (PepT1) was elevated by Pro-Gly, whereas knockdown of PepT1 with siRNA eliminated the increase of IGF-1 expression induced by Pro-Gly. In addition, Pro-Gly activated JAK2/STAT5 signaling pathway in a PepT1-dependent manner. Furthermore, Pro-Gly enhanced the interaction between JAK2 and STAT5, and the translocation of phospho-STAT5 to nuclei. Moreover, inhibition of JAK2/STAT5 blocked the promotive effect of Pro-Gly on IGF-1 expression and secretion. In agreement with the in vitro results, the in vivo findings demonstrated that Pro-Gly, but not Pro plus Gly, stimulated the expression and secretion of IGF-1 and activated JAK2/STAT5 signaling pathway in the liver of mice injected with Pro-Gly or Pro+Gly acutely or chronically. Besides, acute injection of JAK2/STAT5 inhibitor abolished the elevation of IGF-1 expression and secretion induced by Pro-Gly in mice. Collectively, these findings suggested that the dipeptide Pro-Gly promoted IGF-1 expression and secretion in HepG2 cells and mice by activating JAK2/STAT5 signaling pathway through PepT1. These data provided new insights to the regulation of IGF-1 expression and secretion by the dipeptides.