Association of sleep duration with obesity in older adults: A systematic review and meta-analysis.

BACKGROUND: Research on sleep duration and obesity is extensive in children and young individuals but limited and inconsistent for older adults. Our study aims to clarify the current status of this association in the elderly population. METHODS: We searched six English and four Chinese databases up to January 25, 2024, for observational studies on sleep duration and obesity in older adults. Two researchers independently conducted the literature search and data extraction. Study quality was assessed using the Newcastle-Ottawa Scale for cohort studies and the Agency for Healthcare Research and Quality for cross-sectional studies. Meta-analyses were performed using Stata 15.0 software, using both random-effects and fixed-effects models to calculate pooled odds ratios with 95% confidence intervals (CIs). RESULTS: The meta-analysis of 15 studies found a correlation between short sleep duration and obesity in older individuals (pooled odds ratio, 1.40 [95% CI: 1.12-1.73]; P = 0.003). However, no significant correlation was found between long sleep duration and obesity among the elderly (pooled odds ratio, 1.04 [95% CI, 0.95-1.13]; P = 0.426). CONCLUSIONS: Short sleep duration in the elderly was associated with obesity. More prospective studies need to be included in the future to improve the reliability of the conclusions. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2024; ••: ••-••.

The effect of Baduanjin on the insomnia of older adults: A systematic review and meta-analysis.

OBJECTIVE: Baduanjin is a traditional Chinese regimen involving flowing movements, breath control, and strengthening to benefit health and well-being. We investigated the effectiveness of Baduanjin for older adults with insomnia. METHODS: We assessed eight databases for methodological quality according to the Cochrane Handbook for Evaluation of Interventions, and analyzed by Stata 16.0 software. RESULTS: Participants (N = 789) of ten studies were included. The meta-analysis showed that Baduanjin was effective for older adults with insomnia as measured by the Pittsburgh Sleep Quality Index (PSQI)[WMD =-2.20, 95 %CI (-2.87, -1.74), P = 0.000], and 12 weeks or more of treatment effect was superior to <12 weeks. Moreover, there were significant differences in all dimensions of the PSQI between experimental and control groups. CONCLUSIONS: Baduanjin is a complementary therapy option for older adults with insomnia. However, high-quality research is still needed to investigate the optimal exercise intensity, duration and frequency for older adults with insomnia.

Mediating effect of social support and resilience between loneliness and depression in older adults: A systematic review and meta-analytic structural equation modeling.

BACKGROUND: Loneliness is a powerful stressor for depression in older adults, and resilience and social support may mediate this relationship, while the evidence is limited. Hence, our study aims to explore the mediating role of social support and resilience between loneliness and depression and to test possible moderators. METHODS: We searched 12 databases without language and publish time restrictions and obtained the correlation coefficients. This review constructed two-stage meta-analytical structural equality modeling (MASEA) to test the mediating effect of social support and resilience. Additionally, use one-stage MASEA to test the moderator effect of women proportion, published year, and country of study. RESULTS: This study included 53 studies and 40, 929 older adults. Loneliness directly affected depression (ß = 0.28, 95 % CI: 0.20, 0.36). Social support (ß = 0.06, 95 % CI: 0.02, 0.09) and resilience (ß = 0.15, 95 % CI: 0.12, 0.18) mediated the relationship. The proportion of women in the sample was moderator (χ2(5) = 11.10, p = 0.05). When the proportion exceeded 60 %, the path coefficient of loneliness and social support (ß = -0.45, SE = 0.055) was larger than that of the subgroup below 60 % (ß = -0.32, SE = 0.041). LIMITATIONS: It was indefinite whether the evidence would be supported in longitudinal designs. Influenced by the original research data, it is impossible to calculate the model parameters of gender discrepancy. CONCLUSIONS: Health aging policy-makers adopting social support and resilience intervention will help strengthen the coping skills of older adults confronting loneliness and reduce the risk of depression.

Associated factors of osteoporosis in Chinese patients with rheumatoid arthritis: A systematic review and meta-analysis.

BACKGROUND: The aim of this systematic review and meta-analysis was to analyze the factors associated of osteoporosis in patients with rheumatoid arthritis (RA) in China. METHODS: PubMed, Embase, Web of Science, Cochrane Library, CINAHL, and four Chinese electronic databases were searched for observational studies without language restrictions that reported the factors associated of osteoporosis from inception to February 2023. A modified Newcastle-Ottawa Scale evaluated the risk of bias. Statistical heterogeneity among the included studies was analyzed using Cochran Q and I2 tests. Begg and Egger tests were used to assess the publication bias. RESULTS: A total of 15 studies were finally included. The meta-analysis showed that 10 factors were grouped into three themes with statistical significance: (1) demographics theme: age ≥50 (odds ratio [OR] = 1.161; 95% CI, 1.111-1.231; p < 0.001), low body mass index (BMI) (OR = 1.248; 95% CI, 1.192-1.312; p < 0.001), female (OR = 5.174; 95% CI, 3.058-7.290; p < 0.001), and menopause (OR = 4.917; 95% CI, 1.558-15.523; I2 = 0.0%; p = 0.007); (2) RA-related factor theme: disease duration (OR = 1.083; 95% CI, 1.038-1.127; p < 0.001), and glucocorticoids (OR = 2.740; 95% CI, 2.000-3.750; p < 0.001); (3) relevant physiological indicators or scores theme: low 25(OH)D 3 (OR = 1.009; 95% CI, 1.003-1.016; p < 0.001), erythrocyte sedimentation rate (ESR) (OR = 1.489; 95% CI, 1.041-2.130; p = 0.029), high Disease Activity Score in 28 joints (DAS28) score (OR = 2.5991; 95% CI, 1.094-6.138; p < 0.001); and ß-isomerized C-terminal telopeptide (ß-CTx) (OR = 1.009; 95% CI, 1.003-1.016; p = 0.005). CONCLUSION: Osteoporosis in patients with RA is associated with various factors. Therefore, patients with RA should be monitored in a timely manner and targeted interventions should be taken. In addition, further longitudinal studies are needed to confirm the direct link between multiple factors and osteoporosis.

Perceived Social Support and Presenteeism Among Nurses: Mediation of Psychological Capital.

OBJECTIVE: The aim of this study was to explore the mediating role of psychological capital in the relationship between perceived social support and presenteeism among nurses. BACKGROUND: The concept of presenteeism explored in this study refers to the behavior of nurses who hold on to their jobs despite poor physical or mental health, manifested in poor work productivity and loss of productivity. Perceived social support and psychological capital may help reduce presenteeism. However, there is limited knowledge about the association between perceived social support, psychological capital, and presenteeism among nurses. METHODS: Data were collected through questionnaires from 468 RNs. Data analysis used Pearson's correlation analysis, multiple linear regression, and structural equation model. RESULTS: The results indicated that perceived social support and psychological capital were significantly negatively correlated with nurses' presenteeism. Structural equation modeling revealed that psychological capital mediated the relationship between perceived social support and presenteeism, with a partial mediating effect of -0.191, accounting for 28% of the total effect. CONCLUSIONS: These results identified structural relationships between the 3 variables of perceived social support, psychological capital, and presenteeism and provided a theoretical reference for developing strategies to decrease nurses' presenteeism.

Prevalence and incidence of skin tear in older adults：A systematic review and meta-analysis.

BACKGROUND: Skin tear (ST) is a public health problem in older adults; they substantially increase the risk of complications and cause serious adverse consequences and health care burden. AIM: To estimate the pooled prevalence and incidence of ST among older adults. METHODS: Ten databases were systematically searched from their inception to July 27, 2023. Two researchers performed a systematic review independently according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All inconsistencies were resolved by a principal researcher. The pooled prevalence and incidence of ST were estimated in R 4.3.1 program. RESULTS: Thirteen studies were included in this review. The pooled prevalence of ST was 6.0 % (95 % confidence interval (CI): 3.0%-11.0 %, I2 = 98 %), and the pooled incidence was 11.0 % (95 % CI: 5.0%-19.0 %, I2 = 94 %). The prevalence of ST was 11.0 % (95 % CI: 5.0%-19.0 %, I2 = 95 %) in long-term care facilities, 5.0 % (95 % CI: 3.0%-9.0 %, I2 = 86 %) in Europe, and 7.0 % (95 % CI: 1.0%-16.0 %, I2 = 82 %) in the Skin Tear Audit Research classification system (STAR). It has stabilized at 6.0 % since 2021. The incidence of ST was 15.0 % (95 % CI: 11.0%-20.0 %, I2 = 66 %) in long-term care facilities in Japan and 4.0 % (95 % CI: 2.0%-6.0 %) in Canada. CONCLUSIONS: Older adults are at a high risk for ST. Our findings emphasize the importance of epidemiologic studies and further exploring assessment tools for ST. Healthcare professionals should pay attention to ST, identify high-risk individuals and associated factors, and implement targeted prevention strategies for older adults.

Association between fear of falling and mortality in middle-aged and older adults: A systematic review and meta-analysis.

BACKGROUND: Fear of falling (FOF) has emerged as a significant public health issue, contributing to excess disability among middle-aged and older adults. The association between FOF and mortality remains unclear. METHODS: Prominent electronic databases (PubMed, Web of Science, the Cochrane Library, Embase, CINHAL, PsycINFO, Scopus, China National Knowledge Infrastructure, China Biology Medicine disc, and Wanfang Database) were searched from inception until October 21, 2023 (data updated on June 9, 2024), for cohort or longitudinal studies investigating the association between FOF and mortality. The heterogeneity between studies was quantitatively assessed using I2. A fixed-effect model calculated the pooled effect size. RESULTS: A total of seven cohort studies, including 27,714 participants, were analyzed in this systematic review and meta-analysis. The meta-analysis results demonstrated a positive association between FOF and mortality, with a significant increase in the risk of mortality for those with FOF (hazard ratio [HR]:1.29, 95 % confidence interval [CI]: 1.19-1.41, p < 0.05). Subgroup analysis indicated that age, male sex, clinical diagnosis of depression, number of chronic diseases, activity restriction due to FOF, and FOF levels were associated with mortality. CONCLUSIONS: FOF and mortality have a positive association, which needs to be confirmed by further prospective studies with large samples and long-term follow-up to provide evidence for clinicians to intervene in FOF to reduce mortality in middle-aged and older adults.

The Association between Adverse Childhood Experiences and Frailty: A Systematic Review.

OBJECTIVE: Based on life-course theory, adverse childhood experiences (ACEs) have emerged as risk factors for health in later life. This study aimed to explore the association between ACEs and frailty. DESIGN: Systematic review. SETTING AND PARTICIPANTS: Frail older adults who have experienced ACEs. METHODS: We searched 7 databases: PubMed, Cochrane Library, Embase, Web of Science, Scopus, PsycINFO, and China National Knowledge Infrastructure (CNKI). The last searched date was October 27, 2023. Included studies should have investigated the association between exposure to at least 1 ACE and frailty. Two researchers independently assessed the risk of bias in the included studies using the Newcastle-Ottawa Scale (NOS) and an adapted version of the NOS scale and also extracted relevant characteristics and outcomes of the included studies. RESULTS: A total of 14 studies were finally included. Consistent associations with increased risk of frailty were only shown in studies that assessed family members with mental illness, low neighborhood quality, emotional abuse, sexual abuse, and combinations of ACEs. In addition, women exposed to ACEs were more likely to be at risk for frailty than men, and greater numbers or types of exposure to ACEs were associated with higher odds of frailty. The results of the quality assessment showed a moderate risk of bias in half of the studies. CONCLUSIONS AND IMPLICATIONS: This study summarizes for the first time the evidence for an association between ACEs and frailty. Considered collectively, increased attention to ACEs may be one way to prevent frailty, and unhealthy lifestyles resulting from ACEs may serve as a breakthrough in developing interventions.

Narcolepsy and cardiovascular disease: A two-sample Mendelian randomization study.

BACKGROUND: Observational findings suggest that patients with narcolepsy are at higher risk for cardiovascular diseases (CVDs), but the potential causal relationship between narcolepsy and CVDs is unclear. Therefore, Mendelian randomization (MR) was used to explore the association between narcolepsy and CVDs. METHODS: Summary statistics related to narcolepsy, coronary artery disease (CAD), myocardial infarction (MI), heart failure (HF), any stroke (AS), and any ischemic stroke (AIS) were extracted from the public database of relevant published genome-wide association studies (GWAS). Independent single nucleotide polymorphisms were selected as instrumental variables under strict quality control criteria. Inverse variance-weighted (IVW) was the main analytical method to assess causal effects. In addition, we conducted MR pleiotropy residual sum and outlier (MR-PRESSO), weighted median, MR-Egger, and leave-one-out sensitivity analysis to verify the robustness and reliability of the results. RESULTS: The results of the MR study revealed that narcolepsy was significantly associated with an increased risk of HF (OR = 1.714; 95%CI [1.031-2.849]; P = 0.037), CAD (OR = 1.702; 95%CI [1.011-2.864]; P = 0.045). There was no statistically significant causal association between narcolepsy and MI, AS, and AIS. In addition, further sensitivity analysis showed robust results. CONCLUSIONS: The results of the two-sample MR study reveal a potential causal relationship between the increased risk of HF and CAD in narcolepsy. These findings emphasize the importance of early monitoring and assessment of cardiovascular risk in patients with narcolepsy.

The role of robot-assisted training on rehabilitation outcomes in Parkinson's disease: a systematic review and meta-analysis.

PURPOSE: The study aims to assess the efficacy of robot-assisted rehabilitation training on upper and lower limb motor function and fatigue in Parkinson's disease (PD), and to explore the best-acting robotic rehabilitation program. METHODS: We searched studies in seven databases and the search period was from the build to 30 June 2023. Two researchers independently screened studies and assessed the quality of the studies for data extraction. RESULTS: A total of 21 studies were included, 18 studies related to lower limbs rehabilitation and 3 studies related to upper limbs rehabilitation, involving a total of 787 participants. The results showed that robot-assisted rehabilitation significantly improved indicators of lower limb motor function UPDRS Part III (WMD = -3.58, 95% CI = -5.91 to -1.25, p = 0.003) and BBS (WMD = 4.24, 95% CI = 2.88 to 5.54, p < 0.001), as well as non-motor symptoms of fatigue (WMD = -13.39, 95% CI = -17.92 to -8.86, p < 0.001) in PD patients. At the level of upper limb function, there was no statistically significant difference in the outcome measures of PFS (WMD = -0.25, 95% CI = -4.44 to 3.93, p = 0.9) and BBT (WMD = 1.73, 95% CI = -2.85 to 6.33, p = 0.458). CONCLUSION: Robot-assisted rehabilitation significantly improved motor function, fatigue, and balance confidence in PD patients, but current evidence doesn't show that intelligent rehabilitation systems improve upper limb function. In particular, robotics combined with virtual reality worked best.

Robot-assisted rehabilitation significantly improves motor symptoms, lower limb motor function, fatigue, and balance confidence in Parkinson's disease (PD) patients.Robotics combined with virtual reality is the most effective application and should be encouraged.In the robotic rehabilitation of PD patients, the focus needs to be on the duration of the training and the long-term benefits it provides.

Efficacy and safety of Danggui Niantong Decoction in patients with gout: a systematic review and meta-analysis.

Background: This study aims to evaluate the efficacy and safety of Danggui Niantong Decoction (DGNT) systematically on gout treating. Methods: This study was registered in PROSPERO, and the registration number was CRD42021271607. By the end of December, 2022, literature research was conducted among eight electronic databases. Main results of this study were blood uric acid (BUA) and Creactive protein (CRP). Secondary outcomes were erythrocyte sedimentation rate (ESR), serum creatinine (Scr), urinary protein quantified at 24 h (Upro), and interleukin-8 (IL-8). Study screening, data collection, as well as quality assessment were performed by two reviewers independently, and analysis was completed using Stata (SE15.0) and Review Manager (5.4). Results: A total number of 13 studies were included in our meta-analysis (n = 1,094 participants). Results showed DGNT combined with conventional western medicine (CWM) was more effective than WM alone in BUA (weighted mean differences (WMD) = -3.49, 95% confidence interval (CI) [-50.36, -32.59], p = 0.000), CRP (WMD = -41.48, 95% CI [-4.32, -2.66], p = 0.017), ESR (WMD = -6.23, 95% CI [-9.28, -3.17], p = 0.019), Scr (WMD = -18.64, 95% CI [-23.09, -14.19], p = 0.001), Upro (WMD = -0.72, 95% CI [-0.91, -0.53], p = 0.000), and IL-8 (WMD = -4.77, 95% CI [-11.48, 1.94], p = 0.000). None of the adverse effects noted were severe, and no life-threatening event was reported. Conclusion: This study shows that DGNT combined with CWM seems to have an effective clinical therapeutic potential. In addition, it also provides a scientific basis for better clinical application of DGNT in the future. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021271607; Identifier: PROSPERO, CRD42021271607.

Secondary traumatic stress and posttraumatic growth in newly graduated nurses: the mediating role of compassion satisfaction.

BACKGROUND: Nurses' secondary traumatic stress, compassion satisfaction and posttraumatic growth are closely related, but for newly graduated nurses, there are few reports to evaluate the specific path between these three. The aim of this study was to investigate examine the mediating role of compassion satisfaction in secondary traumatic stress and posttraumatic growth among newly graduated nurses. METHODS: From March 2021 to May 2021, a total of 330 newly graduated nurses from five tertiary hospitals in China were enrolled, and asked to complete questionnaires regarding secondary traumatic stress, compassion satisfaction and posttraumatic growth. Descriptive statistics, independent-samples T-test, one-way analysis of variance (ANOVA), Pearson correlation analysis and structural equation model were used in this study. A STROBE checklist was used to report findings. RESULTS: The scores of secondary traumatic stress, compassion satisfaction and posttraumatic growth of newly graduated nurses were 27.11 ± 4.94 (score range: 10-50), 31.89 ± 6.22 (score range: 10-50) and 56.47 ± 20.41 (score range: 0-100), respectively. Additionally, structural equation modeling showed that compassion satisfaction mediated the relationship between secondary traumatic stress and posttraumatic growth with the partial mediating effect of 0.089. CONCLUSIONS: Newly graduated nurses may experience moderate secondary traumatic stress, but their posttraumatic growth is at a low level, and compassion satisfaction significantly affects the relationship between the two. Nursing managers should strengthen psychological evaluation, and promote their posttraumatic growth by improving their level of compassion satisfaction.

Potentially inappropriate medication and frailty in older adults: A systematic review and meta-analysis.

OBJECTIVES: The purpose of this study was to systematically assess existing studies to demonstrate the association between potentially inappropriate medication (PIM) and frailty. DESIGN: Systematic review and meta-analysis. METHODS: We searched major electronic databases (PubMed, Web of Science, the Cochrane Library, Embase, CINHAL, PsycInfo, China National Knowledge Infrastructure, China Biology Medicine disk, Weipu, and Wanfang) from their inception until February 25, 2023 (data updated on May 4, 2023), for observational studies investigating PIM and frailty. I2 was used to measure the heterogeneity between studies quantitatively. A random effect model calculated pooled effect size owing to high heterogeneity. Subgroup analysis was conducted to explore sources of heterogeneity. Additionally, the studies' quality was evaluated using the Newcastle Ottawa Scale (a modified Newcastle Ottawa Scale was used to evaluate cross-sectional studies). RESULTS: Twenty-four studies were included for systematic review, 14 of which were included in the meta-analysis. After pooling the effect size, the odds ratio with PIM as the dependent variable was 1.12 (95%CI: 1.01-1.25), and that with frailty as the dependent variable was 1.75 (95%CI: 1.25-2.43), indicating a bidirectional association between PIM and frailty. CONCLUSIONS: PIM and frailty interact with each other and have a bidirectional association, thus providing additional information for early clinical identification and prevention of frailty, and medication safety management.

High-intensity interval training improves the outcomes of patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials.

BACKGROUND: Pulmonary exercise is an important part in the treatment of chronic obstructive pulmonary disease (COPD). We aimed to evaluate the effects and safety of high-intensity interval training (HIIT) in patients with COPD, to provide insights to the COPD treatment and care. METHODS: Two investigators searched PubMed, Medline, Embase, web of Science, Cochrane library, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases up to Sept 15, 2022 for randomized controlled trials (RCTs) on the effects and safety of HIIT for COPD patients. RevMan5.3 software was used for statistical analysis. RESULTS: A total of 20 RCTs involving 962 COPD patients were finally included. 514 patients underwent HIIT interventions. Meta-analysis showed that HIIT increased the peak oxygen consumption (SMD = 0.30, 95%CI:0.14-0.46), peak minute ventilation (SMD = 0.26, 95%CI: 0.05-0.47), peak work rate (SMD = 0.34, 95%CI: 0.17-0.51), 6-min walking distance (SMD = 0.39, 95%CI: 0.23-0.55) in COPD patients (all P < 0.05). HIIT improved the quality of life (SMD = 0.30, 95%CI: 0.06-0.54) and reduced the dyspnea (SMD = -0.27, 95%CI: -0.51∼-0.03) in COPD patients (all P < 0.05). There were no significant differences in the forced expiratory volume in 1 s/forced vital capacity (SMD = 0.28, 95%CI: -0.01-0.56) and St. George's Respiratory Questionnaire score (SMD = -0.35, 95%CI: -0.73-0.03) between HIIT and control group (all P > 0.05). There was no publication bias analyzed by the Egger test and funnel plots (all P > 0.05). CONCLUSIONS: HIIT may be beneficial to improve the pulmonary function, exercise capacity and quality of life of patients with COPD, which is worthy of clinical promotion for COPD treatment and care.

Prevalence of motoric cognitive risk syndrome among older adults: a systematic review and meta-analysis.

OBJECTIVE: Motoric cognitive risk syndrome (MCR) is a newly proposed pre-dementia syndrome. Several studies on the prevalence of MCR have been published; however, the data vary across studies with different epidemiological characteristics. Thus, this study aimed to quantitatively analyse the overall prevalence and associated epidemiological characteristics of MCR among older adults aged ≥ 60 years. METHODS: The Cochrane Library, PubMed, Web of Science, CINAHL, Embase, Scopus, PsycInfo, China National Knowledge Infrastructure, Weipu Database, China Biology Medicine disc and Wanfang Database were searched from their inception to January 2022. A modified Newcastle-Ottawa Scale evaluated the risk of bias. Statistical heterogeneity among the included studies was analysed using Cochran's Q and I2 tests. A random effect model calculated pooled prevalence owing to study heterogeneity. Begg's and Egger's tests were used to assess the publication bias. Additionally, subgroup analysis and meta-regression were performed based on different epidemiological characteristics to determine heterogeneity sources. RESULTS: Sixty-two studies comprising 187,558 samples were obtained. The pooled MCR prevalence was 9.0% (95% confidence interval: 8.3-9.8). A higher MCR prevalence was observed in females, older adults with a low educational level, depression and cardiovascular risk factors, South American populations, and studies with small sample sizes and cross-section designs. Furthermore, subjective cognitive complaint using scale score and gait speed using instrument gait showed higher MCR prevalence. CONCLUSION: MCR is common in older adults, and various epidemiological characteristics influence its prevalence. Thus, preventive measures are required for older adults with higher MCR prevalence.

Factors Associated With Social Isolation in Older Adults: A Systematic Review and Meta-Analysis.

OBJECTIVE: Social isolation is a global health issue that affects older adults throughout their lives. This study aimed to identify the factors associated with social isolation in older adults. DESIGN: Systematic review and meta-analysis. SETTING AND PARTICIPANTS: Adults aged 60 years and older. METHODS: We searched for observational studies without language restrictions in 11 databases from inception to August 2022. Pooled odds ratio (OR) and 95% CI were calculated using the R software (version 4.2.1). The modified Newcastle-Ottawa Scale was used to evaluate the risk of bias. RESULTS: Eighteen factors were grouped into 5 themes. The following 13 factors were statistically significant: (1) demographics theme: aged 80 years and older (OR: 2.41; 95% CI: 1.20-4.85), less than or equal to a high school degree (OR: 1.68; 95% CI: 1.44-1.97), smoking (OR: 1.43; 95% CI: 1.18-1.73), and male (OR: 1.38; 95% CI: 1.01-1.89); (2) environment theme: low social support (OR: 7.77; 95% CI: 3.45-17.50) and no homeownership (OR: 1.38; 95% CI: 1.25-1.51); (3) role theme: no social participation (OR: 3.18; 95% CI: 1.30-7.80) and no spouse (OR: 2.61; 95% CI: 1.37-4.99); (4) physical health: hearing loss (OR: 2.78; 95% CI: 1.54-5.01), activities of daily living impairment (OR: 2.38; 95% CI: 1.57-3.61), and poor health status (OR: 1.52; 95% CI: 1.32-1.74); and (5) mental health: cognitive decline (OR: 1.85; 95% CI: 1.40-2.45) and depression (OR: 1.72; 95% CI: 1.21-2.44). CONCLUSIONS AND IMPLICATIONS: Social isolation in older adults is associated with various factors. Hence, focused intervention should be adopted for older adults. In addition, further longitudinal studies are required to confirm a direct link between multiple factors and social isolation.

Levels of psychological capital among nurses: A systematic review and meta-analysis.

AIM: To systematically evaluate the available literature about overall levels of psychological capital among nurses. BACKGROUND: Psychological capital is described as a positive mental state associated with nurses' mental health, quality of care and patient outcomes. METHODS: A search was carried out using PubMed, Web of Science, EMBASE, CINAHL, PsycINFO, Cochrane Library and Chinese Database, including China National Knowledge Infrastructure (CNKI), Chinese Biological Medical (CBM), WanFang and Weipu Database from the inception of the databases until October 2021. Subsequently, two researchers identified and reviewed the literature and assessed the risk of bias. A random-effects model was conducted to achieve pooled estimates of psychological capital scales. RESULTS: The pooled mean score of the psychological capital scale was 4.21 (95% CI, 4.07-4.35). For subdimensions such as hope, optimism, self-efficacy and resilience, the score was 4.12 (95% CI, 4.11-4.12), 4.34 (95% CI, 4.34-4.34), 4.50 (95% CI, 4.50-4.51) and 4.34 (95% CI, 4.33-4.34), respectively. Subgroup analyses indicated that nurses practising in Asia and intensive care units might have experienced lower psychological capital levels. In addition, significant differences were noted in studies with sample size and publication year. Studies with a large sample size reported a higher psychological capital than those with a small sample size. The pooled mean scores of psychological capital were higher in 2014-2018 than in 2019-2021. Meta-regression further revealed that geographic regions of participants might be a source of heterogeneity, and the Asian region had 32.23% of the heterogeneity between studies, and the African region had 18.71%. CONCLUSION: This review is the first to synthesize published research and calculate a pooled score of psychological capital in nurses. These findings indicated that nurses reported a medium-high level of psychological capital, and there was significant heterogeneity. IMPLICATIONS FOR NURSING POLICY: Administrators and policymakers should concentrate on nurses' psychological capital and tactically integrate psychological capital into nursing vocational training programs.

The relationship between organizational commitment and work engagement among clinical nurses in China: A cross-sectional study.

AIM: This study aims to investigate the levels of organizational commitment and work engagement among clinical nurses in tertiary hospitals and explore the relationship between them. BACKGROUND: The nursing literature supports the idea that organizational commitment plays an important role in positively influencing job performance. However, the relationship between organizational commitment and work engagement among clinical nurses remains unclear. METHODS: This was a cross-sectional study. A convenience sample of clinical nurses (n = 621) was selected from five tertiary hospitals in Sichuan Province of China. Survey instruments included a general information questionnaire about organizational commitment and work engagement. Univariate analysis, correlation analyses and linear regression analysis were used to examine the association between organizational commitment and work engagement. RESULTS: The mean scores for organizational commitment and work engagement were 3.85 ± 0.59 and 4.58 ± 1.46, respectively. A moderate degree of positive correlation was found between them. Gender, monthly income and retention commitment were significantly associated with work engagement, and they accounted for 39.0% of the total variance. CONCLUSIONS: Clinical nurses had a moderate level of organizational commitment and a high level of work engagement. Organizational commitment positively influenced work engagement; that is, organizational commitment is a significant determinant of nurses' work engagement. IMPLICATIONS FOR NURSING MANAGEMENT: Hospital organizations should focus on assessing and strengthening nurses' organizational commitment to promote increased work engagement and, ultimately, improved quality of care. This may include, but is not limited to, increasing rest time for nurses, implementing a performance appraisal system and focusing on nurses' psychological state.

Chinese Herbal Medicine for Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis.

Objectives: To evaluate the efficacy and safety of Chinese herbal medicine (CHM) for type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD) with current evidence. Methods: This study was registered in PROSPERO as CRD42021271488. A literature search was conducted in eight electronic databases from inception to December 2021. The primary outcomes were lipid indices and liver functions, including triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine transaminase (ALT), and aspartate transaminase (AST). Review Manager 5.2 and Stata v14.0 were applied for analysis. Results: The research enrolled 18 RCTs with 1,463 participants. Results showed CHM combined with western medicine (WM) was more effective than WM alone in TG (weighted mean differences (WMD) = -0.35.95% confidence interval (CI) [-0.51, -0.19], p < 0.0001), TC (WMD = -0.58.95%CI [-0.80, -0.36], p < 0.00001), LDL-C (WMD = -0.37, 95%CI [-0.47, -0.26], p < 0.00001), HDL-C (WMD = 0.20, 95%CI [0.10, 0.29], p < 0.0001), ALT (WMD = -4.99, 95%CI [-6.64, -3.33], p < 0.00001), AST (WMD = -4.76, 95%CI [-6.35, -3.16], p < 0.00001), homeostatic model assessment of insulin resistance (WMD = -1.01, 95%CI [-1.22, -0.79], p < 0.00001), fasting blood glucose (WMD = -0.87, 95%CI [-1.13, -0.61], p < 0.00001), 2-h postprandial glucose (WMD = -1.45.95%CI [-2.00, -0.91], p < 0.00001), body mass index (WMD = -0.73.95%CI [-1.35, -0.12], p = 0.02), and overall effective rate (risk ratio (RR) = 1.37.95%CI [1.29, 1.46], p < 0.00001). Conclusion: The CHM in combination with WM seems to be more beneficial in T2DM with NAFLD patients in improving lipid and glucose metabolism, liver function, and insulin resistance as well as improving overall efficiency and reducing body weight. Given the poor quality of reports from these studies and uncertain evidence, these findings should be interpreted cautiously. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021271488, identifier CRD42021271488.