Attitudes toward depression among rural primary healthcare providers in hunan areas, China: a cross sectional study.

BACKGROUND: Mental health services are not sufficient for depression patients in rural areas of China, training in mental health knowledge for primary healthcare providers has been encouraged, but the effect of this encouragement has rarely been reported. METHODS: A cross-sectional survey was conducted in primary healthcare facilities that sought to include all the primary healthcare providers (registered physicians and nurses) in two cities in Hunan province, China by administering questionnaires that covered depression symptoms, typical depression cases, and the Revised Depression Attitude Questionnaire. RESULTS: In total, 315 primary healthcare providers agreed to participate in the study and finished the questionnaires, of which 12.1% had training in depression. In addition, 62.9% of the rural primary healthcare providers were able to recognize most general depression symptoms, and 8.3% were able to recognize all general depression symptoms. The primary healthcare providers in the survey held a neutral to slightly negative attitude towards depression as indicated by their professional confidence (mean scores 16.51 ± 4.30), therapeutic optimism/pessimism (mean scores 29.02 ± 5.98), and general perspective (mean scores 18.12 ± 3.12) scores. Fewer rural primary healthcare providers knew (28.3%) or applied (2.9%) psychological intervention in the clinic. CONCLUSIONS: Our study indicated that primary healthcare providers knew about general depression symptoms, but lacked psychological intervention skills and held low confidence in and pessimistic attitudes toward depression care. We therefore speculate that existing psychological training for primary healthcare providers is insufficient in quantity and quality, making the need to explore more effective types of training urgently.

Apatinib Inhibits Angiogenesis in Intrahepatic Cholangiocarcinoma by Regulating the Vascular Endothelial Growth Factor Receptor-2/Signal Transducer and Activator of Transcription Factor 3/Hypoxia Inducible Factor 1 Subunit Alpha Signaling Axis.

INTRODUCTION: Intrahepatic cholangiocarcinoma (ICC), which is difficult to diagnose and is usually fatal due to its late clinical presentation and a lack of effective treatment, has risen over the past decades but without much improvement in prognosis. OBJECTIVE: The study aimed to investigate the role of apatinib that targets vascular endothelial growth factor receptor-2 (VEGFR2) in ICC. METHODS: MTT assays, cell scratch assays, and tube formation assays were used to assess the effect of apatinib on human ICC cell line (HuCCT-1) and RBE cells proliferation, migration, and angiogenic capacity, respectively. Expression of vascular endothelial growth factor (VEGF), VEGFR2, signal transducer and activator of transcription factor 3 (STAT3), pSTAT3, and hypoxia inducible factor 1 subunit alpha (HIF-1α) pathway proteins was assessed using Western blotting and mRNA expression analysis in HuCCT-1 was performed using RT-qPCR assays. The pcDNA 3.1(-)-VEGFR2 and pcDNA 3.1(-)-HIF-1α were transfected into HuCCT-1 and RBE cells using Lipofectamine 2,000 to obtain overexpressed HuCCT-1 and RBE cells. RESULTS: We found that apatinib-inhibited proliferation, migration, and angiogenesis of HuCCT-1 and RBE cells in vitro in a dose-dependent manner. We also proved that apatinib effectively inhibits angiogenesis in tumor cells by blocking the expression of VEGF and VEGFR2 in these cells. In addition, we demonstrated that apatinib regulates the expression of STAT3 phosphorylation by inhibiting VEGFR2. Finally, we showed that apatinib regulates ICC angiogenesis and HIF-1α/VEGF expression via STAT3. CONCLUSIONS: Based on the above findings, we conclude that apatinib inhibits HuCCT-1 and RBE cell proliferation, migration, and tumor angiogenesis by inhibiting the VEGFR2/STAT3/HIF-1α axis signaling pathway. Apatinib can be a promising drug for ICC-targeted molecular therapy.

Knowledge, attitude and practice regarding nursing interruptions among Chinese nurses: A nationwide cross-sectional survey.

OBJECTIVES: To explore the knowledge, attitude and practice of Chinese nurses regarding nursing interruptions and related factors. METHODS: A total of 6,400 nurses from 31 hospitals in China were investigated by using the Knowledge, Attitude and Practice (KAP) Questionnaire of Nursing Interruptions. The questionnaire consists of three dimensions, knowledge, attitude and practice, containing 10, 9 and 7 items, with full score of 50, 45 and 28, respectively. RESULTS: The mean overall KAP score regarding nursing interruptions of Chinese nurses was 74.05 ± 16.65 (range: 26-123), with scores for the knowledge, attitude, and practice component being 21.74 ± 9.80, 34.83 ± 6.98, and 17.49 ± 4.97, respectively. Among the nurses, 70.8% of them experienced an average level of KAP toward nursing interruptions while 15.5% were at a poor level. The knowledge, attitude, and practice of nursing interruptions were better in chief nurses, managers, nurses with a master degree or above, nurses ever received training, and nurses with a strong agreement to leadership compared to nurses in other groups (P < 0.05). In addition, employment type, professional title, position, standardized training and leaders' attention were predictors of KAP in nurses. CONCLUSION: Chinese nurses have a moderate level of KAP regarding nursing interruptions. Leaders' attention, standardized training, position, professional title and employment type could predict nurses' KAP state of nursing interruptions. Thus, a targeted training program should be implemented for clinical nurses by nursing leaders, with a particular focus on feasibility and professionalism.

Time management disposition and related factors among nursing managers in China: A cross-sectional study.

AIM: The purpose of this study was to gain a general overview of the time management disposition of clinical nursing managers in China and its related factors. BACKGROUND: Effective time management is important for managers to achieve organizational goals. However, there is a lack of big-sample research exploring the impact of psychological and socio-demographic characteristics on time management disposition. METHOD: The study adopted a cross-sectional and descriptive design; 531 nursing managers from seven regions of China were recruited. RESULTS: The nursing managers performed best on sense of time's value, followed by time monitoring ability and sense of time efficacy. Time management disposition was predicted by self-efficacy, SDS scores, managerial experience, the character strength of self-control and number of children. CONCLUSION: The "norm" level of the Chinese clinical nursing managers' time management disposition was at a favourable level, but these managers performed poorly in the aspect of time monitoring. It is recommended that actions be taken to improve nursing managers' time management disposition in order to maximize their time-use efficiency and enhance the quality of nursing management. IMPLICATIONS FOR NURSING MANAGEMENT: A greater understanding of nursing managers' time management disposition will provide a reference for subsequent actions to improve nursing managers' time management behaviour, which in turn will improve the quality and efficiency of nursing management.

Apatinib affect VEGF-mediated cell proliferation, migration, invasion via blocking VEGFR2/RAF/MEK/ERK and PI3K/AKT pathways in cholangiocarcinoma cell.

BACKGROUND: Cholangiocarcinoma (CCA) is a form of cancer that easily aggress to contiguous structures. Vascular endothelial growth factor (VEGF) and VEGF receptor 2 (VEGFR2) are increased in majority species of cancers and suppress tumor progression by blocking VEGF/VEGFR2. Apatinib is a highly selective VEGFR2 antagonist which has inhibitive effect on antiapoptotic and cell growth in CCA. While, the effect of apatinib cell migration and invasion in CCA is still unknown. METHODS: CCA cell lines QBC939 and TFK-1 were transfected with siKDR to establish the KDR function loss cell model, and recombined human VEGF (rhVEGF) protein was added into the culture medium to enhance the VEGF expression. RT-qPCR and western bloting were used to detect the mRNA and protein expression levels of VEGFR2 to investigate whether it was effectively repressed or activated with rhVEGF or apatinib treatment. Then, MTT, wound healing assay, and transwell matrix assay were applied to measure the effect of apatinib and rhVEGF on cell viability, migration and invasion, respectively. RESULTS: The mRNA and protein expressions of VEGFR2 were significantly reduced with KDR RNAi in both QBC939 and TFK-1 cells, and rhVEGF treatment increased these expression levels (p < 0.05). Apatinib dramatically suppressed VEGF-mediated cell migration and invasion at the concentration of 100 nM treatment and significantly decreased the expression of metastasis-associated protein such as Slug, snail and MMP9. Moreover, all of these inhibiting effects of apatinib depended on the VEGFR2 existence. In addition, VEGFR2/RAF/MEK/ERK and PI3K/AKT signal pathways were enhanced by the introduction of rhVEGF, but were dramatically suppressed after the apatinib treatment. CONCLUSION: Apatinib inhibit VEGF-mediated cell migration and invasion in CCA cell lines via inhibiting the VEGFR2/RAF/MEK/ERK and PI3K/AKT pathways. It will be a potentially effective targeted drug for CCA.

A safety culture training program enhanced the perceptions of patient safety culture of nurse managers.

Positive perceptions of patient safety culture are associated with lower rates of adverse events, but they have not been widely established in many health care organizations. The purpose of this study is to examine the impacts of a safety culture training program (SCTP) on enhancing the perceptions of patient safety in nurse managers. This was a quasi-experimental design. 83 nurse managers were recruited from five randomly selected 2nd level hospitals. Sixty-seven nurse managers received training under the educational SCTP. The Hospital Survey on Patient Safety Culture (HSPSC) and Chinese Safety Attitudes Questionnaire (C-SAQ) were administered just before and six months after the educational program. The data of hospital-acquired pressure ulcers, patient falls, and unplanned extubations were collected. The total positive scores of HSPSC were significantly improved and four dimensions of C-SAQ significantly increased six months after SCTP. The rate of patient falls and rate of hospital-acquired pressure ulcers decreased significantly six months post SCTP. In conclusion, nurse manager participation in a SCTP can enhance the perceptions of patient safety and reduce the rates of adverse events. More rigorous trials with larger numbers of participants and a control group are needed to strengthen the conclusions.

Mental health is the most important factor influencing quality of life in elderly left behind when families migrate out of rural China.

OBJECTIVES: to investigate the quality of life and the associated factors on left behind elderly in rural China. METHOD: the research was conducted cluster sampling to select 456 elderly left behind when family members migrated out of rural China to participate in a cross-sectional study by completing a general data questionnaire and Quality of Life questionnaire. RESULTS: 91.5% of the elderly requested psychological counseling and education. For the elderly, scores for mental health (39.56±13.73) were significantly lower compared with Chinese standard data (61.6±13.7) (P<0.001). Age, chronic disease type, gender, residence pattern and economic support from children were the main psychological factors influencing this population. CONCLUSION: mental health is the most important factor influencing quality of life of elderly left behind when family members migrated out of rural China. Our study suggested a need to widely establish a general practitioner team for psychological intervention for improving rural elderly people's Quality of Life level, especially in the psychological domain.

Mental health is the most important factor influencing quality of life in elderly left behind when families migrate out of rural China / A saúde mental é o fator mais importante que influencia a qualidade de vida de idosos deixados para trás quando as famílias emigram da China rural / La salud mental es el factor más importante que influye en la calidad de vida en los adultos mayores que se quedan cuando las familias emigran fuera de las zonas rurales de China

OBJECTIVES: to investigate the quality of life and the associated factors on left behind elderly in rural China. METHOD: the research was conducted cluster sampling to select 456 elderly left behind when family members migrated out of rural China to participate in a cross-sectional study by completing a general data questionnaire and Quality of Life questionnaire. RESULTS: 91.5% of the elderly requested psychological counseling and education. For the elderly, scores for mental health (39.56±13.73) were significantly lower compared with Chinese standard data (61.6±13.7) (P<0.001). Age, chronic disease type, gender, residence pattern and economic support from children were the main psychological factors influencing this population. CONCLUSION: mental health is the most important factor influencing quality of life of elderly left behind when family members migrated out of rural China. Our study suggested a need to widely establish a general practitioner team for psychological intervention for improving rural elderly people's Quality of Life level, especially in the psychological domain. .

OBJETIVOS: investigar a qualidade de vida e fatores associados de idosos deixados para trás na China rural. MÉTODO: foi realizada amostragem por conglomerado para selecionar 456 idosos deixados para trás quando os membros da família emigram da China rural. Este é um estudo transversal com preenchimento de um questionário de dados gerais e de qualidade de vida. RESULTADOS: 91,5% dos idosos convidados solicitaram aconselhamento e educação psicológicos. Para os idosos, os escores de saúde mental (39,56±13,73) foram significativamente menores em comparação aos dados padrões chineses (61,6±13,7) (p<0,001). A idade, tipo de doença crônica, gênero, tipo de moradia e suporte econômico dos filhos foram os principais fatores psicológicos que influenciaram essa população. CONCLUSÃO: a saúde mental é o fator mais importante que influencia a qualidade de vida de idosos deixados para trás quando os familiares emigraram da China rural. Este estudo sugere a necessidade de criação de ampla equipe de generalistas para intervenção psicológica, com o intuito de melhorar o nível de qualidade de vida de idosos de áreas rurais, especialmente no domínio psicológico. .

OBJETIVOS: investigar la calidad de vida y los factores asociados a los adultos mayores que se quedan en las zonas rurales de China. MÉTODO: la investigación se realizó por medio de muestreo por conglomerados para seleccionar 456 adultos mayores que se quedaron cuando los miembros de la familia emigraron de zonas rurales de China, para participar en un estudio de corte transversal, completando un cuestionario de datos generales y cuestionario de calidad de vida. RESULTADOS: el 91.5% de los adultos mayores solicitó asistencia psicológica y educación. Para los adultos mayores, las puntuaciones de salud mental (39.56±13.73) fueron significativamente más bajos en comparación con los datos estándar de China (61.6±13.7) (p<0.001). La edad, el tipo de enfermedad crónica, el género, el patrón de residencia y el apoyo económico de los hijos fueron los principales factores psicológicos que influencian esta población. CONCLUSIÓN: la salud mental es el factor más importante que influye la calidad de vida de los adultos mayores que se quedan cuando los miembros de la familia emigran de las zonas rurales de China. Nuestro estudio sugiere la necesidad de establecer ampliamente un equipo médico general para la intervención psicológica para mejorar el nivel de la Calidad de Vida de la población rural de edad avanzada, sobre todo en el dominio psicológico. .

[Early recognition of deteriorating patient program in department of cardiac surgery].

OBJECTIVE: To explore the application and the effect of early recognition of deteriorating patient program in department of cardiac surgery. METHODS: We used the early recognition of deteriorating patient program in the cardiac surgery groups, including cardiac surgeons, nurses in ward, ICU and operation rooms of the cardiac surgery department, and compared the satisfaction of nurses and doctors, handover time, handover score of critical patients, and rate of unplanned ICU admission before and after the intervention. RESULTS: After using the early recognition of deteriorating patient program, the satisfaction of doctors and nurses was increased, the handover time was lowered 0.56 min/time (t=2.22, P<0.05), the handover score of critical patients enhanced by 19.59 points (t=30.57, P<0.001), the rate of unplanned ICU readmission after the operation reduced by 4.8% (χ2=4.14, P<0.05). CONCLUSION: Early recognition of deteriorating patient program can improve the safety of cardiac patients, enhance the self-confidence of nurses and work efficiency.

Thrombocytopenia induces multiple intracranial hemorrhages in patients with severe burns: A review of 16 cases.

The aim of this study was to explore the etiology and diagnosis of multiple intracranial hemorrhages (ICHs) following severe burns, with a retrospective review of 16 cases of severe burns further complicated by multiple ICHs. Using cranial CT scans of the brains, we identified that all patients presented with low platelet counts and coagulation abnormalities prior to intracranial hemorrhaging. Following conventional treatment and various supporting treatments, five cases succumbed following a progressive reduction in blood platelet levels and the ICHs were cured in 11 cases following the restoration of normal platelet levels. We conclude that low platelet counts and coagulation abnormalities may cause multiple ICHs following severe burns and early diagnosis and treatment is the key to successful treatment.