Conservative Interventions for Urinary Incontinence on Postpartum Women: A Systematic Review and Meta-Analysis.

INTRODUCTION: Urinary incontinence (UI) is common in postpartum women and can lead to a reduced quality of life and withdrawal from fitness and exercise activities. Conservative management interventions such as pelvic floor muscle training (PFMT), use of vaginal cones, and biofeedback have been recommended as first-line treatment. We aimed to explore the effects of conservative interventions on UI rate, severity, and incontinence-specific quality of life in postpartum women with UI. METHODS: Nine databases were searched from inception to August 2022: PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, Wanfang, China National Knowledge Infrastructure, China Biological Medicine, and VIP Journal Integration Platform. Randomized controlled trials examining the effects of conservative interventions on postpartum UI were included. RESULTS: Initial searches produced 1839 results, of which 17 studies were eligible. All included studies had a low to moderate risk of bias. Supervised PFMT and use of a vaginal cone were more effective than individual PFMT in decreasing rates of UI (odds ratio, 0.29; 95% CI, 0.14-0.61). Individual PFMT combined with acupuncture (mean difference, -1.91; 95% CI, -2.46 to -1.37) or electroacupuncture and supervised PFMT combined with moxibustion were more effective than individual supervised PFMT alone in improving the severity of symptoms. Furthermore, electrical stimulation and biofeedback combined with acupoint stimulation or core training were more effective than electrical stimulation and biofeedback alone. For improving the incontinence-specific quality of life, supervised PFMT was more efficacious than individual PFMT; electrical stimulation and biofeedback plus core training were more beneficial than electrical stimulation and biofeedback alone. DISCUSSION: Supervised PFMT and use of a vaginal cone were more beneficial in decreasing rates of UI compared with individual PFMT. Superior effects in decreasing UI severity may be achieved by combining PFMT or electrical simulation and biofeedback with other therapies. Electrical stimulation and biofeedback plus core training, as well as supervised PFMT, are most effective in improving incontinence-specific quality of life. Further research is required to provide more evidence on the efficacy of these therapies.

A scale for measuring nursing digital application skills: a development and psychometric testing study.

BACKGROUND: The adoption of digitization has emerged as a new trend in the advancement of healthcare systems. To ensure high-quality care, nurses should possess sufficient skills to assist in the digital transformation of healthcare practices. Suitable tools have seldom been developed to assess nurses' skills in digital applications. This study aimed to develop the Nursing Digital Application Skill Scale (NDASS) and test its psychometric properties. METHODS: The Nursing Digital Application Skill Scale was developed in three phases. In Phase 1, an item pool was developed based on previous literature and the actual situation of nursing work. Phase 2 included 14 experts' assessment of content validity and a focus group interview with 30 nurses to pretest the scale. In phase 3, 429 registered nurses were selected from March to June 2023, and item analysis, exploratory factor analysis, and confirmatory factor analysis were used to refine the number of items and explore the factor structure of the scale. Additionally, reliability was determined by internal consistency and test-retest reliability. RESULTS: The final version of the NDASS consisted of 12 items. The content validity index of NDASS reached 0.975 at an acceptable level. The convergent validity test showed that the average variance extracted value was 0.694 (> 0.5) and the composite reliability value was 0.964 (> 0.7), both of which met the requirements. The principal component analysis resulted in a single-factor structure explaining 74.794% of the total variance. All the fitting indices satisfied the standard based upon confirmatory factor analyses, indicating that the single-factor structure contributed to an ideal model fit. The internal consistency appeared high for the NDASS, reaching a Cronbach's alpha value of 0.968. The test-retest reliability was 0.740, and the split-half coefficient was 0.935. CONCLUSION: The final version of the NDASS, which possesses adequate psychometric properties, is a reliable and effective instrument for nurses to self-assess digital skills in nursing work and for nursing managers in designing nursing digital skill training.

A qualitative study exploring partner involvement in the management of gestational diabetes mellitus: The experiences of women and partners.

AIMS: The aims of the study were to explore the experiences of women with gestational diabetes mellitus (GDM) and their partners and examine the factors influencing partner involvement in GDM management, seeking to inform a targeted couple-based intervention. DESIGN: A descriptive qualitative study. METHODS: We conducted semi-structured interviews with 14 women with GDM and their partners. Participants were recruited through convenience sampling from a tertiary hospital in Xi'an, China. Data were analysed using thematic analysis. RESULTS: Three themes and 12 subthemes were identified. Theme I: Women's expectations of their partner's involvement in GDM management-practical support and emotional support. Theme II: Partner involvement in GDM management-constructive involvement, unhelpful involvement with good intentions and insufficient involvement. Theme III: Factors that influence partner involvement in GDM-knowledge of GDM, GDM risk perception, health consciousness, attitudes towards the treatment plan, couple communication regarding GDM management, family roles and appraisal of GDM management responsibility. CONCLUSION: Women desired practical and emotional support from partners. The types of partner involvement in GDM management varied. Some partners provided constructive support, while some partners' involvement was limited, non-existent or actively unhelpful. By combining these results with the factors influencing partner involvement, our findings may help healthcare professionals develop strategies to involve partners in GDM care and enhance women's ability to manage GDM. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: Partner involvement in GDM care may help them understand and better attend to women's needs, thus improving their experience and potential outcomes. This study highlights novel factors that need to be considered in developing couple-based interventions for this population. REPORTING METHOD: The reporting follows the COREQ checklist. PATIENT OR PUBLIC CONTRIBUTION: Some patients were involved in data interpretation. There is no public contribution.

The effects of a couple-based gestational diabetes mellitus intervention on self-management and pregnancy outcomes: A randomised controlled trial.

AIMS: To estimate the effectiveness of the Couples Coping with Gestational Diabetes Mellitus (GDM) Programme on GDM self-management and pregnancy outcomes. METHODS: A randomised controlled trial among pregnant women with suboptimal GDM self-management and their partners was undertaken. Couples recruited from three hospitals in China were randomly allocated to either intervention (n = 70) or control (n = 70) conditions. Couples in the intervention group underwent the couple-based intervention (GDM education, shared illness appraisals, initiation of collaborative action and consolidation of collaborative action). Women in the control group received individual GDM education. Data were analysed using the independent samples t-test, chi-square test, and generalised estimating equations. RESULTS: GDM knowledge for the women and their partners and GDM self-management significantly improved in both the intervention and control groups, with stronger improvement in the intervention group. Women in the intervention group gained significantly less weight than those in the control group (11.2 kg ± 2.8 kg vs 13.1 kg ± 2.6 kg, p = 0.008). Infant birth weights were significantly lower in the intervention group (3.2 kg ± 0.3 kg vs 3.4 kg ± 0.4 kg, p = 0.008). There were no significant differences in other pregnancy outcomes. CONCLUSIONS: The Couples Coping with GDM Programme was associated with improvements in GDM knowledge of women and their partners and in women's self-management, and with lower gestational weight gain and infant birth weight.

Adaptation and validation of the Evidence-based Practice Profile Questionnaire (EBP2Q) for clinical postgraduates in a Chinese context.

BACKGROUND: Evidence-based practice (EBP) is an essential approach of optimizing patient outcomes and driving progress in clinical practice. As an important reserve talent of medical staff and researchers, the clinical postgraduates are expected to become the backbones of supporting the implementation of EBP in clinical units after graduation. The assessment of their EBP learning outcomes is an important issue, yet few tools have been developed specifically in Mainland China. The purpose of this study is to adapt the Evidence-Based Practice Profile Questionnaire (EBP2Q) to Mainland China's cultural context and to evaluate the psychometric properties of the Chinese EBP2Q in clinical postgraduates. METHODS: Cross-cultural modification, including translating the original EBP2Q into Chinese was implemented according to established guidelines. A pilot study was carried out in Mainland China among 30 clinical postgraduates. A subsequent validation study was conducted among 633 clinical postgraduates majoring in clinical medicine, stomatology and nursing from Mainland China. Construct validity was assessed by exploratory factor analysis (n = 313), together with confirmatory factor analysis (n = 320). Reliability was determined by internal consistency and test-retest reliability. RESULTS: The Chinese EBP2Q consisted of 40 items. The content validity index of the Chinese EBP2Q achieved 0.938 at an acceptable level. Principal component analysis resulted in a four-factor structure explaining 61.586% of the total variance. All fitting indices satisfied the standard based upon confirmatory factor analyses, indicating that the four-factor structure contributed to an ideal model fit. The internal consistency appeared high for the Chinese EBP2Q, reaching a Cronbach's alpha value of 0.926. Test-retest reliability was 0.868 and the split-half coefficient was 0.925. CONCLUSION: Chinese version of EBP2Q possesses adequate validity, test-retest reliability and internal consistency. It is a promising questionnaire to be adopted by Chinese medical educators in designing their course and curriculum, or by clinical postgraduates for self-assessment of EBP learning.

Analysis of the influential factors of the emotional health of patients with cancer based on the structural equation model: the role of social media and emotional support.

PURPOSE: To explore the mental health status of patients with cancer and related influential factors and provide a scientific basis to reduce serious emotional problems, improve the quality of life of cancer survivors and adopt targeted interventions. METHODS: A total of 517 patients who attended the oncology departments of six grade-A tertiary hospitals from July 2022 to September 2022 were selected by convenience sampling. The effects of emotional support, social media, patient-centred communication, health self-efficacy and cancer beliefs on the emotional well-being of patients with cancer were analysed based on the structural equation model. RESULTS: A Spearman correlation analysis showed a significant positive correlation among the six latent variables (P<0.01). The structural equation model path analysis showed that health self-efficacy (ß=0.374, P<0.001), cancer belief (ß=0.214, P=0.003) and emotional support (ß=0.104, P=0.031) all had positive effects on emotional health. The mediating effect results showed that cancer beliefs had a mediating effect on mental health in social media use (ß=0.106, P=0.001), emotional support (ß=0.028, P=0.002) and patient-centred communication (ß=0.050, P=0.002). Further, health self-efficacy had mediating effects on mental health in emotional support (ß=0.084, P=0.001) and patient-centred communication (ß=0.098, P=0.001). CONCLUSION: By constructing structural equation models, this study found that emotional support, cancer beliefs and health self-efficacy showed a positive effect on the emotional well-being of patients with cancer. Further, it found a mediating role of health cancer beliefs on the impact of emotional support, social media use and patient-centred communication on mental health. Additionally, health self-efficacy has a mediating role regarding the effects of emotional support and patient-centred communication on mental health.

Effect of the physical rehabilitation program based on self-care ability in patients with acute ischemic stroke: a quasi-experimental study.

Introduction: It is the most practical goal of limb rehabilitation for stroke patients to make the upper limb, trunk, and lower limb joints link together as a whole and restore the ability to self-care. However, many previous studies focused on the single joint or single muscle group movement of stroke patients and did not integrate self-care ability training into the whole process of rehabilitation, which lacks accuracy, integrity, and systematization. Methods: A quasi-experimental study was conducted in a tertiary hospital. Eligible patients were recruited according to the inclusion criteria and exclusion criteria and then divided into an experimental group (n = 80) and a control group (n = 80) by the medical district. The control group received the routine physical rehabilitation intervention. The experimental group adopted the physical rehabilitation program based on self-care ability led by the nurses specializing in stroke rehabilitation to carry out the multi-joint coordinated exercise based on the control group. The training time and frequency were the same in both groups (45 min per session, one session per day for three consecutive months). The primary outcome was myodynamia. Secondary outcomes were the modified Barthel Index (MBI) and Stroke Specific Quality of Life Scale (SS-QOL). The primary and secondary outcomes were assessed before the intervention and at 1 and 3 months of intervention. In this study, the TREND checklist was followed for non-randomized controlled trials. Results: A total of 160 participants completed the study. The physical rehabilitation program based on self-care ability was better than the routine rehabilitation program. With the prolongation of intervention time, all outcomes improved gradually in the experimental group (P < 0.05), and the myodynamia of lower limbs recovered faster than that of upper limbs. In the control group, the myodynamia of the affected limb was not significantly improved (P > 0.05), with only a small increase in MBI and SS-QOL scores (P < 0.05). Conclusion: The physical rehabilitation program based on self-care ability after stroke was beneficial for acute ischemic stroke patients and improved the patient's myodynamia, quality of life, and self-care ability within the third month.

Validation and application of the 2019 International Working Group on the Diabetic Foot risk stratification for diabetic foot in Chinese patients.

AIMS/INTRODUCTION: The purpose of the present study was to evaluate the validation and application of the 2019 International Working Group on the Diabetic Foot (IWGDF) risk stratification system among Chinese patients with diabetes. MATERIALS AND METHODS: A retrospective cohort study was carried out with 254 patients with diabetes, but without an active diabetic foot (DF) ulcer. Patients hospitalized from January to May 2017 were enrolled, and the follow-up period was from January to May 2020. Patients were stratified into four risk groups based on the 2019 IWGDF risk stratification system. RESULTS: Of the 254 patients, four of 31 patients at risk 1 were diagnosed with DF within 3 years, whereas 12 of 26 patients at risk 2 and 16 of 20 patients at risk 3 developed DF. The area under the curve was 0.919 (P < 0.01, 95% confidence interval 0.893-0.945). Because DF risk 2 and greater (risk 2 + risk 3) was the optimal cut-off point, we simplified the risk stratification system by using two tiers, namely, low risk (risk 0 + 1) and high risk (risk 2 + 3). For the simplified risk stratification system, the sensitivity, specificity, positive likelihood ratio, percent agreement, positive predictive value and negative predictive value were 87.5%, 91.8%, 10.607, 91.3%, 60.8% and 98.1%, respectively. The χ2 -test showed that the odds ratio of the high-risk group (risk 2 + 3) was 29.33-fold that of the low-risk group (risk 0 + 1). CONCLUSIONS: The 2019 IWGDF risk stratification system showed high validity and primary screening value in Chinese patients with diabetes. Thus, a simplified, two-tiered IWGDF stratification might be more efficient and cost-effective for predicting DF ulcers.

Effect of an online resourcefulness training in improving psychological well-being of front-line medical staff: a quasi-experimental study.

BACKGROUND: The global COVID-19 pandemic is still not under effective control, and strong workplace supports with comprehensive mental health interventions are urgently needed to help medical staff effectively respond to the pandemic. This study aimed to verify the effect of an online resourcefulness training program on the resourcefulness, and psychological variables of front-line medical staff working in the COVID-19 isolation ward. DESIGN: A pre-test and post-test quasi-experimental design with control group was employed. PARTICIPANTS: A total of 60 participants working in two isolation wards were recruited via convenience sampling. The two isolation wards were randomly assigned to the control group (isolation ward 1, n = 30) and the intervention group (isolation ward 2, n = 30). INTERVENTION: The participants were trained online by video conferences and WeChat. The control group received conventional training (e.g., psychological training, psychological counseling), while the intervention group received a 4-h online resourcefulness training. Both groups learned updated guidelines of COVID-19 simultaneously via video conference. The primary outcomes (resourcefulness, anxiety, depression and coping styles) and the secondary outcome (psychological resilience) were measured before intervention and three time points after intervention. RESULTS: After the intervention and one week after the intervention, the resourcefulness, resilience, and positive response scores of the participants in the intervention group were significantly higher than those of the control group. The anxiety and negative response scores in the intervention group were significantly lower than those of the control group (all p < 0.05). One month after the intervention, the scores of resourcefulness, tenacity, and positive response of the intervention group were higher than those of the control group (all p < 0.05). Repeated measures analysis of variance showed that the two groups of participants had statistically significant changes in the time-based effect and group-based effect in resourcefulness, resilience, anxiety scores and coping styles (p < 0.01). CONCLUSION: The results showed that our online resourcefulness training can significantly improve the resourcefulness, resilience, and positive response scores and effectively reduce anxiety and depression scores of front-line medical staff. This demonstrates that online resourcefulness training would be an effective tool for the psychological adjustment of front-line medical staff in fighting against COVID-19.

Effect of "timing it right" on comprehensive unmet needs and psychological pain in patients with head and neck cancer undergoing radiotherapy: a randomized controlled trial.

PURPOSE: We assessed the effectiveness of "timing it right" (TIR) applications in patients undergoing radiotherapy for head and neck cancer through a carefully designed TIR intervention program. The assessment in this study emphasized the impact of the TIR intervention on the unmet needs and psychological pain of patients with head and neck cancer at different stages of radiotherapy. METHODS: In total, 140 radiotherapy patients were randomly recruited into two study groups: (1) the TIR intervention group received routine nursing follow-up and comprehensive nursing intervention based on TIR, and (2) the control group received routine nursing care. Assessments were conducted at baseline, before discharge, and 3 months and 6 months after discharge. The comprehensive needs and psychological pain of patients with radiotherapy were measured using the Comprehensive Needs Assessment Tool in Cancer for Patients (CNAT) and the Distress Thermometer (DT), respectively. A linear mixed model was applied to analyze the effects. RESULTS: A total of 137 patients completed the study. Compared to the control group, the TIR group showed significant improvements in information needs, health and psychological problems, healthcare staff, physical symptoms, health facilities and services, religious/spiritual support, and psychological pain (F=8.503, p=0.004; F=1.896, p=0.003; F=12.422, p<0.001; F=9.634, p=0.001; F=7.310, p=0.006; F=1.684, p=0.009; F=1.692, p=0.041). In addition to practical support, the remaining indicators differed significantly by time point, group, and group-time interaction. CONCLUSIONS: The patient support application based on TIR can effectively address unmet needs and improve psychological pain, supporting TIR as an effective psychological management and intervention strategy for radiotherapy patients in the early stage of long-term rehabilitation. TRIAL REGISTRATION: Chictr.org.cn Chi CTR2100047960.

Development of the Applied Mindfulness Process Scale as a Process Evaluation Measure for Mindfulness Practice in a Chinese Context.

With the rising popularity of mindfulness practice, it is necessary and crucial to evaluate mindfulness using comprehensive and objective measures. The instruments to assess mindfulness in China mainly evaluate mindfulness as a state or trait mode. Few process measures have been developed to clarify effective therapy benefits of the alterations obtained using mindfulness practice. Therefore, this study aims to adapt the Applied Mindfulness Process Scale (AMPS) into Mandarin and explore in detail the reliability and validity of this novel-translated measure. Following cross-cultural modification for original AMPS into Mandarin as per established guidelines, psychometric evaluation was performed on a cohort of 234 Chinese adults. Construct validity was analyzed through exploratory factor analysis (n = 115), together with confirmatory factor analysis (n = 119). Reliability was assessed by internal consistency together with test-retest reliability. Findings indicated that the internal consistency was high, with Cronbach's alpha being 0.936. The principal component analysis led to a three-factor structure that explained 67.374% of all variations. The three-factor model was consistent with the original scale model. Based upon confirmatory factor analyses, all fitting indices satisfied the standard, which showed a close fit to the data. Therefore, the newly multi-culturally modified AMPS has sufficient validity, test-retest reliability, together with internal consistency. Chinese AMPS may offer researchers and clinicians a psychometrically optimized tool for evaluating the application of mindfulness and change process within mindfulness-based interventions (MBIs) in Mainland China.

Effect of virtual reality simulation training on the response capability of public health emergency reserve nurses in China: a quasiexperimental study.

OBJECTIVE: To develop a virtual reality simulation training programme, and further verify the effect of the programme on improving the response capacity of emergency reserve nurses confronting public health emergencies. DESIGN: A prospective quasiexperimental design with a control group. PARTICIPANTS: A total of 120 nurses were recruited and randomly divided into the control group and the intervention group. INTERVENTION: Participants underwent a 3-month training. The control group received the conventional training of emergency response (eg, theoretical lectures, technical skills and psychological training), while the intervention group underwent the virtual reality simulation training in combination with skills training. The COVID-19 cases were incorporated into the intervention group training, and the psychological training was identical to both groups. At the end of the training, each group conducted emergency drills twice. Before and after the intervention, the two groups were assessed for the knowledge and technical skills regarding responses to fulminate respiratory infectious diseases, as well as the capacity of emergency care. Furthermore, their pandemic preparedness was assessed with a disaster preparedness questionnaire. RESULTS: After the intervention, the scores of the relevant knowledge, the capacity of emergency care and disaster preparedness in the intervention group significantly increased (p<0.01). The score of technical skills in the control group increased more significantly than that of the intervention group (p<0.01). No significant difference was identified in the scores of postdisaster management in two groups (p>0.05). CONCLUSION: The virtual reality simulation training in combination with technical skills training can improve the response capacity of emergency reserve nurses as compared with the conventional training. The findings of the study provide some evidence for the emergency training of reserve nurses in better response to public health emergencies and suggest this methodology is worthy of further research and popularisation.

Integration of miRNAs, Degradome, and Transcriptome Omics Uncovers a Complex Regulatory Network and Provides Insights Into Lipid and Fatty Acid Synthesis During Sesame Seed Development.

Sesame (Sesamum indicum L.) has always been known as a health-promoting oilseed crop because of its nutrient-rich oil. In recent years, studies have focused on lipid and fatty acid (FA) biosynthesis in various plants by high-throughput sequencing. Here, we integrated transcriptomics, small RNAs, and the degradome to establish a comprehensive reserve intensive on key regulatory micro RNA (miRNA)-targeting circuits to better understand the transcriptional and translational regulation of the oil biosynthesis mechanism in sesame seed development. Deep sequencing was performed to differentially express 220 miRNAs, including 65 novel miRNAs, in different developmental periods of seeds. GO and integrated KEGG analysis revealed 32 pairs of miRNA targets with negatively correlated expression profiles, of which 12 miRNA-target pairs were further confirmed by RT-PCR. In addition, a regulatory co-expression network was constructed based on the differentially expressed gene (DEG) profiles. The FAD2, LOC10515945, LOC105161564, and LOC105162196 genes were clustered into groups that regulate the accumulation of unsaturated fatty acid (UFA) biosynthesis. The results provide a unique advanced molecular platform for the study of lipid and FA biosynthesis, and this study may serve as a new theoretical reference to obtain increased levels of UFA from higher-quality sesame seed cultivars and other plants.

Preparation and Characterization of Bio-Nanocomposites Film of Chitosan and Montmorillonite Incorporated with Ginger Essential Oil and Its Application in Chilled Beef Preservation.

In this study, bio-nanocomposite films containing different proportions of ginger essential oil (GEO), chitosan (Ch), and montmorillonite (MMT) were prepared and characterized, and the antibacterial effect of bio-nanocomposite films on chilled beef was evaluated. Fourier transform infrared analysis showed a series of intense interactions among the components of the bio-nanocomposite films. The infiltration of GEO increased the thickness of the film, reduced the tensile strength of the film, and increased the percentage of breaking elongation and the water vapor permeability. The migration of phenols in the films began to increase exponentially and reached equilibrium at about 48 h. The bio-nanocomposite films (Ch +0.5% GEO group, and Ch + MMT + 0.5% GEO group) effectively delayed the rise of pH, hue angle, and moisture values of chilled beef with time and slowed down the lipid oxidation and the growth of surface microorganisms on chilled beef. Altogether, the prepared biological nanocomposites can be used as promising materials to replace commercial and non-degradable plastic films.

Three-dimensional non-isothermal numerical model for predicting semi-volatile organic compound transport process in a room.

In this paper, a three-dimensional non-isothermal computational model for predicting indoor SVOC distribution is proposed, considering the effects of turbulence diffusion and suspended particles. The realizable k-ε model is introduced for turbulent flow simulation in a room. The Euler-Euler method is adopted to deal with the gas-particle two-phase flow coupled problem. Inertia slip velocity and irreversible first-order absorption boundary are employed for more accurate prediction of particle motion. The simulated curve of outlet gas-phase di-2-ethylhexyl phthalate (DEHP) concentration with emission time is verified by available experimental data. The emission process of DEHP in a 15 m2 room in Beijing during 100 days with or without air cleaner is simulated by the developed model considering air leak through window and door gaps. It is found that if the air cleaner keeps on all the time during 100 days the gas-phase DEHP concentration in the room will tend to be uniform, while the emission process is far from equilibrium without an air cleaner even the emission lasts 100 days. Results also suggest that floor heating, decrease of particle concentration, weaken of heat transfer, enhancement of mass transfer, and air infiltration in window gap contribute to decrease DEHP concentration.

Development of a Cadre of Evidence-Based Practice Mentors for Nurses: What Works?

BACKGROUND: Development of a critical mass of evidence-based practice (EBP) mentors for healthcare professionals is pivotal in facilitating and sustaining system-wide implementation of evidence-based care, especially for nurses. Empirical evidence shows that organizational factors are strongly associated with EBP. However, the understanding of organizational support to promote EBP competency is found lacking, especially in Mainland China. AIMS: The purposes of this study were to (1) establish a baseline assessment of EBP nursing leadership and work environment support as well as EBP competency for EBP mentors of nurses in Western China, and (2) explore how nursing leadership and work environment impact the EBP competencies of mentors. METHODS: A cross-sectional study was conducted. The study population was 286 EBP mentors for nurses from six urban general hospitals in Xi'an City, Shanxi Province. The EBP Nursing Leadership Scale and the EBP Work Environment Scale were used to evaluate their perceived organizational support. EBP competency was measured by the Evidence-Based Practice Questionnaire. RESULTS: There was insufficient time for EBP mentors of nurses to engage in EBP. Lack of experts in EBP and educational offerings about EBP were identified as the two lowest workplace organizational supports for EBP. The respondents reported themselves as not competent in EBP, especially for the knowledge/skills. EBP nursing leadership and work environment support were key predictors of the self-reported EBP competency in the stepwise multiple linear regression models (ß = .211-.345, p < .01). LINKING EVIDENCE TO ACTION: It is imperative to provide EBP mentors for nurses with the knowledge and skills to achieve the expected level of EBP competency. Strategies for developing a cadre of EBP mentors for nurses who have competency in EBP need to be multipronged and target the cultivation of an organizational culture that supports EBP.

Anti-Symmetric Mode Vibration of Electrostatically Actuated Clamped-Clamped Microbeams for Mass Sensing.

This paper details study of the anti-symmetric response to the symmetrical electrostatic excitation of a Micro-electro-mechanical-systems (MEMS) resonant mass sensor. Under higher order mode excitation, two nonlinear coupled flexural modes to describe MEMS mass sensors are obtained by using Hamilton's principle and Galerkin method. Static analysis is introduced to investigate the effect of added mass on the natural frequency of the resonant sensor. Then, the perturbation method is applied to determine the response and stability of the system for small amplitude vibration. Through bifurcation analysis, the physical conditions of the anti-symmetric mode vibration are obtained. The corresponding stability analysis is carried out. Results show that the added mass can change the bifurcation behaviors of the anti-symmetric mode and affect the voltage and frequency of the bifurcation jump point. Typically, we propose a mass parameter identification method based on the dynamic jump motion of the anti-symmetric mode. Numerical studies are introduced to verify the validity of mass detection method. Finally, the influence of physical parameters on the sensitivity of mass sensor is analyzed. It is found that the DC voltage and mass adsorption position are critical to the sensitivity of the sensor. The results of this paper can be potentially useful in nonlinear mass sensors.

Developing Student Evidence-Based Practice Questionnaire (S-EBPQ) for undergraduate nursing students: Reliability and validity of a Chinese adaptation.

RATIONALE, AIMS, AND OBJECTIVES: The assessment of evaluating undergraduate nursing students' evidence-based practice engagement is an important issue, yet few tools have been developed specifically in Mainland China. The purpose of this study was to adapt the Student Evidence-based Practice Questionnaire (S-EBPQ) to Mainland China's cultural context and to evaluate the psychometric properties of the newly adapted Chinese S-EBPQ. METHODS: Cross-cultural adaptation, including translation of the original S-EBPQ into Mandarin Chinese language, was performed according to published guidelines. A pilot study was conducted in Mainland China with 25 Chinese undergraduate nursing students. A subsequent validation study was conducted with 400 undergraduate nursing students from Mainland China. Construct validity was assessed by exploratory factor analysis (n = 190) and confirmatory factor analysis (n = 210). Reliability was determined using internal consistency and test-retest reliability. RESULTS: The split-half coefficient for the overall Chinese S-EBPQ was 0.858. A content validity index of 0.986 was achieved. Principal component analysis resulted in a 4-factor structure explaining 68.285% of the total variance. The comparative fit index was 0.927, and the root mean squared error of approximation was 0.072 from the confirmatory factor analysis. Known-group validity was supported by the significant differences according to various characteristics of participants. Internal consistency was high for the Chinese S-EBPQ reaching a Cronbach α value of 0.934. Test-retest reliability was 0.821. CONCLUSION: The newly cross-culturally adapted S-EBPQ possesses adequate validity, test-retest reliability, and internal consistency and therefore may be utilized in nursing education to assess EBP of undergraduate nursing students in Mainland China.

Psychometric Testing of the Evidence-Based Practice Nursing Leadership Scale and the Work Environment Scale After Cross-Cultural Adaptation in Mainland China.

Implementation and sustainability of the evidence-based practice (EBP) approach within systems of health-care delivery require leadership and organizational support, yet few instruments have been developed specifically in Mainland China. The purpose of this study was to adapt the EBP Nursing Leadership Scale and the EBP Work Environment Scale to Mainland China's cultural context and to evaluate the psychometric properties of the newly adapted Chinese version. A pilot study was conducted in Mainland China with 25 clinical nurses. A subsequent validation study was conducted with 419 nurses from Mainland China. A content validity index of .985 and .982 was achieved. The split-half coefficient was .890 for the EBP Nursing Leadership Scale and .892 for the EBP Work Environment Scale. Test-retest reliability was .871 and .855, respectively. Principal component analysis resulted in a one-factor structure explaining 62.069% of the total variance for the EBP Nursing Leadership Scale and 62.242% of the total variance for the EBP Work Environment Scale. Both of the newly cross-culturally adapted scales possess adequate internal consistency and test-retest reliability and validity and therefore may be utilized in health-care environments to assess leadership and organizational support for EBP in Mainland China.

Expression of E-prostanoid receptors in nasal polyp tissues of smoking and nonsmoking patients with chronic rhinosinusitis.

BACKGROUND: Different inflammatory reactions have been observed in the polyp tissues of nonsmokers and smokers with chronic rhinosinusitis (CRS). E-prostanoid (EP) receptors play a role in the inflammatory processes. Cigarette smoke (CS) exposure regulates EP-receptor expression levels promoting inflammatory mediator release from various inflammatory cells. In this study, we characterize the EP-receptor expression profiles in the polyps of nonsmoking and smoking CRS patients to explore the possible role of CS in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). METHODS: Polyp biopsies were obtained from 28 non-smoking and 21 smoking CRSwNP patients. Histopathological characteristics were observed under a light microscope. The prostaglandin E2 (PGE2), TNF-α, and IL-8 contents in polyp tissues were detected using enzyme-linked immunosorbent assay. Immunostaining was used to locate EP receptors in polyps. Messenger RNA and protein expression of EP receptors were examined using quantitative real-time polymerase chain reaction and Western blot, respectively. RESULTS: More severe inflammatory reactions occurred in polyp tissues of smoking CRSwNP patients. The PGE2, TNF-α, and IL-8 in tissue homogenate levels were significantly higher in smoking CRSwNP patients than those in nonsmoking CRSwNP patients. Moreover, the distribution of each EP receptor subtype was similar in both groups. Compared with the EP-receptor expression in nonsmokers, messenger RNA and protein of EP2 and EP4 receptor were significantly down-expressed in smoking patients, but EP1 and EP3 receptors did not show significant differences. CONCLUSION: CS exposure downregulates the expression levels of EP2 and EP4 receptors and stimulates the production of PGE2 and the proinflammatory cytokine IL-8 and TNF-α in polyp tissues of CRS patients. The down-expressed EP2 and EP4 receptors might be associated with severe inflammatory reactions in smoking CRSwNP patients.