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AIMS: To identify the multiple mediating effects of resilience and depression between social support and self-care ability among patients with breast cancer during rehabilitation to provide reference for developing and implementing targeted interventions. DESIGN: A cross-sectional study reported according to the STROBE checklist. METHODS: A convenience sample of 320 patients with breast cancer during rehabilitation was recruited from one hospital in China. Data were collected from April to August 2022 using a self-report questionnaire, including the demographic and clinical information, Appraisal of Self-Care Agency Scale-Revised, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale-10 item, and Patient Health Questionnaire-9. The mediation analysis was conducted using the SPSS Process macro. RESULTS: Self-care ability was positively associated with social support (ß = .229) and resilience (ß = .290), and negatively associated with depression (ß = -.208). The relationship between social support and self-care ability was mediated by resilience and depression, respectively, and together in serial. The multiple mediating effects accounted for 34.0% of the total effect of social support on self-care ability. CONCLUSION: Our findings identify resilience and depression as multiple mediators between social support and self-care ability and highlight the important roles of social support, resilience and depression in improving self-care ability. RELEVANCE TO CLINICAL PRACTICE: Healthcare providers should pay great attention to the underlying mechanisms of how social support affects patients' self-care ability during breast cancer rehabilitation. Integrated intervention programmes targeted at enhancing social support, building resilience and alleviating depression might be beneficial to the improvement of self-care ability. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. REPORTING METHOD: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies was applied to report the results.
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AIMS: To comprehensively synthesise existing evidence from systematic reviews regarding the effects of exercise interventions on physical, psychological and social outcomes in frail older adults to provide reference for clinical practice. BACKGROUND: Frailty is highly prevalent in older adults and associated with increased adverse health outcomes. Some systematic reviews have assessed the effectiveness of exercise interventions in frail older adults with varied inclusion criteria, methodology quality, types of exercise and outcome measures. DESIGN: An overview of systematic reviews reported following the PRISMA checklist. METHODS: PubMed, Embase, CINAHL, Web of Science and Cochrane database were searched from inception until June 2023 to identify relevant systematic reviews with or without meta-analysis of randomised controlled trails. Two reviewers independently selected articles, extracted data, assessed quality and summarised findings. RESULTS: A total of 17 systematic reviews were included, with methodology quality varying from moderate to critically low. The most frequent types of exercise were multicomponent exercise and resistance-based exercise in community and long-term care facilities, respectively. Exercise interventions had positive effects on most physical outcomes and depression, but inconsistent effects on cognitive function and quality of life. The quality of the evidence for most outcomes was low and very low. CONCLUSIONS: This overview highlights the importance of exercise interventions to improve physical, psychological and social aspects in frail older adults and provides evidence on characteristics of exercise interventions for frailty in various settings. RELEVANCE TO CLINICAL PRACTICE: Multicomponent exercise and resistance-based exercise should be recommended for frail older adults. There is a need of more well-designed research with large sample size and validated definition of frailty. Long-term effects, adherence during and after exercise interventions, adverse events and cost-effectiveness should be emphasised in future studies. TRIAL AND PROTOCOL REGISTRATION: The overview protocol was registered on the International Prospective Register of Systematic reviews (CRD 42021281327). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. REPORTING METHOD: The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were applied to report the results.
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BACKGROUND: As the recipients of home care services, patients have the most direct and profound experience of service quality. There is limited knowledge as to quality indicators for home care services from patients' perspective. This study aimed to identify quality indicators for home care services based on the Service Quality model and determine the weights of these indicators. METHODS: A two-round Delphi survey and Analytic Hierarchy Process consultation were conducted to gather opinions from national experts on quality indicators for home care services developed on the basis of the Service Quality model. Consensus was defined as at least 80% agreement on the importance (important and very important) of indicators among experts. The Analytic Hierarchy Process was used to calculate the weight coefficients of the identified indicators. RESULTS: The response rate was 95.0% and 97.4% in the first and second round, respectively. After two rounds, five first-level (tangibility, reliability, responsiveness, assurance and empathy) and 23 second-level indicators were identified. The Kendall's W values were 0.54 and 0.40 for the first-level and second-level indicators (p < 0.001). The weight coefficients for the first-level and second-level indicators were 0.110-0.298 and 0.019-0.088, respectively. CONCLUSION: Quality indicators for home care services were identified based on the Service Quality model. These indicators can be used to evaluate the service quality of home care from patients' perspective and facilitate to determine work priorities and improve the quality of home care.
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There is a paucity of evidence on exercise interventions for frail older adults with diabetes. This scoping review aims to identify the scope of the current literature on the characteristics and effects of exercise interventions for frail older adults with diabetes. A search without time limitation was conducted in eight databases. 14 studies were finally included. Resistance exercise and multicomponent exercise were the most common types of exercise. There was considerable variation in the frequency, duration and intensity of exercise interventions. Studies reported improvements in frailty status, physical function, blood glucose and lipid levels and economic effectiveness. The most frequent combined interventions involved nutrition and education. Although evidence was limited, the potential benefits of exercise interventions for frail older adults with diabetes were substantial. Further high-quality studies are needed to explore the most effective and cost-saving exercise interventions for frail older adults with diabetes.
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Diabetes Mellitus , Terapia por Exercício , Idoso Fragilizado , Humanos , Idoso , Terapia por Exercício/métodos , Diabetes Mellitus/terapia , Exercício FísicoRESUMO
AIMS: Cognitive frailty can increase the risk of adverse health outcomes in older adults. Estimates of the prevalence of cognitive frailty among older adults with diabetes varied widely in literature. This study aimed to conduct a systematic review and meta-analysis to assess the pooled prevalence of cognitive frailty and risk factors in community-dwelling older adults with diabetes, providing evidence for healthcare professionals to better understand the status of cognitive frailty and help develop effective interventions. METHODS: Databases of PubMed, Web of Science, Cochrane Library, Embase, Cumulative Index of Nursing and Allied Health, Proquest, China National Knowledge Infrastructure and China Biology Medicine were searched from inception to February 10th, 2022. The reviewers independently selected studies, extracted data and assessed the quality of studies. Pooled prevalence of cognitive frailty and risk factors were estimated. Subgroup analysis, meta-regression analysis, sensitivity analysis and publication bias were also conducted. RESULTS: A total of 15 studies with 6391 participants were included in this review. The pooled prevalence of cognitive frailty was 11% (95%CI = 7.9-14%) in community-dwelling older adults with diabetes. Pooled estimates showed that increasing age, higher level of HbA1c, shorter night sleep duration and depression were risk factors, and regular exercise was the protective factor of cognitive frailty in community-dwelling older adults with diabetes. CONCLUSION: Cognitive frailty was common in community-dwelling older adults with diabetes. Routine screening of cognitive frailty and effective interventions should be implemented for this population in community settings. REGISTRATION: PROSPERO ID CRD42021276973.
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Diabetes Mellitus , Fragilidade , Humanos , Idoso , Fragilidade/epidemiologia , Vida Independente , Idoso Fragilizado , Prevalência , Fatores de Risco , Diabetes Mellitus/epidemiologia , CogniçãoRESUMO
There is limited evidence on the diagnostic accuracy of the FRAIL scale in community-dwelling older adults with diabetes. This study aimed to validate the diagnostic accuracy and determine the optimal cutoff point of the FRAIL scale in community-dwelling older adults with diabetes using the Fried Frailty Phenotype as the reference standard. A total of 489 community-dwelling older adults with diabetes aged 60 or above were recruited in this cross-sectional study. The FRAIL scale showed good diagnostic accuracy for frailty screening. The optimal cutoff point for frailty screening in older adults with diabetes was 2. The agreement between the FRAIL scale and the Fried Frailty Phenotype was substantial. The FRAIL scale classified more participants as frail (29.24%) than the Fried Frailty Phenotype (22.09%). These findings provide evidence that the FRAIL scale is a valid tool that can be applied to community-dwelling older adults with diabetes.
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Diabetes Mellitus , Fragilidade , Idoso , Humanos , Fragilidade/diagnóstico , Idoso Fragilizado , Vida Independente , Estudos Transversais , Avaliação Geriátrica , Diabetes Mellitus/diagnósticoRESUMO
AIMS AND OBJECTIVES: To investigate the relationship between illness uncertainty, self-perceived burden and quality of life and explore the mediating role of self-perceived burden between illness uncertainty and quality of life in patients with chronic myeloid leukaemia. BACKGROUND: Patients with chronic myeloid leukaemia need long-term, potentially lifelong therapy to control the disease, which affects their quality of life. There is a need for exploring potentially changeable factors to develop interventions. Little is known about the effects of illness uncertainty and self-perceived burden on quality of life in this population. DESIGN: A cross-sectional study. METHODS: A convenience sample of 248 patients with chronic myeloid leukaemia was recruited from four university hospitals from February to August 2020. Participants were assessed with the Mishel Uncertainty in Illness Scale, Self-Perceived Burden Scale, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. The STROBE checklist was used to report the results. RESULTS: Illness uncertainty and self-perceived burden were negatively associated with quality of life in patients with chronic myeloid leukaemia. Self-perceived burden partially mediated the relationship between illness uncertainty and quality of life. The indirect effect was -0.101, accounting for 22.9% of the total effect. CONCLUSION: The findings revealed the relationship between illness uncertainty, self-perceived burden and quality of life in patients with chronic myeloid leukaemia. Self-perceived burden exerted a mediating role between illness uncertainty and quality of life in this population. RELEVANCE TO CLINICAL PRACTICE: This study alerts healthcare providers to pay attention to patients' illness uncertainty and self-perceived burden, which can contribute to develop effective interventions to improve the quality of life among patients with chronic myeloid leukaemia in the clinical practice.
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Leucemia Mielogênica Crônica BCR-ABL Positiva , Qualidade de Vida , Doença Crônica , Estudos Transversais , Humanos , Inquéritos e Questionários , IncertezaRESUMO
AIMS: To assess the prevalence and associated factors of psychological distress among patients with chronic hepatitis B receiving oral antiviral therapy and explore the association between psychological distress and self-management behaviours among this population. DESIGN: A cross-sectional study. METHODS: A convenience sample of 188 patients with chronic hepatitis B receiving oral antiviral therapy was recruited from March-October 2018 to complete a self-report questionnaire including the Chinese version of Depression Anxiety Stress Scale-21 and Chronic Hepatitis B Self-Management Scale. Logistic regression analysis and hierarchical multiple regression analysis were used to determine the factors associated with psychological distress and the association between psychological distress and self-management behaviours respectively. RESULTS: The prevalence of depression, anxiety, and stress symptoms were 33.0%, 38.3% and 17.6% respectively. Depression was associated with older age, female gender, lower education level and longer treatment duration; anxiety was associated with female gender and longer treatment duration; and stress was associated with age of 31-40 years, female gender and unmarried status. There were significant associations between depression and anxiety symptoms and self-management behaviours. CONCLUSION: Psychological distress was prevalent among patients with chronic hepatitis B receiving oral antiviral therapy and had a negative impact on self-management. Interventions targeting depression and anxiety symptoms may be beneficial to improve self-management behaviours for this population. IMPACT: This study explored the factors associated with psychological distress in patients with chronic hepatitis B receiving oral antiviral therapy. The findings showed psychological distress was more common in patients who were with older age, female, less educated, unmarried and receiving longer duration of treatment and psychological distress was significantly associated with self-management behaviours. Nurses and other healthcare providers should provide interventions to reduce the risk of psychological distress and improve self-management behaviours for this population.
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Hepatite B Crônica , Angústia Psicológica , Autogestão , Adulto , Idoso , Antivirais/uso terapêutico , Ansiedade/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Hepatite B Crônica/tratamento farmacológico , Humanos , Estresse Psicológico , Inquéritos e QuestionáriosRESUMO
Migrant older adults become more disadvantaged in health due to aging and migration-related problems. This study aimed to examine the mediating role of resilience in the relationship between perceived social support and health self-efficacy, and to test whether gender moderated the mediating effect of resilience between perceived social support and health self-efficacy among migrant older adults. A total of 184 migrant older adults were recruited from five communities. Resilience played a partial mediating role in the relationship between perceived social support and health self-efficacy. Moreover, age moderated the relationship between resilience and health self-efficacy. The relationship between resilience and health self-efficacy was stronger in male older adults than female ones. These findings provide a better understanding of the effects of perceived social support and resilience on health self-efficacy, which could guide targeted interventions for community health nurses to promote health self-efficacy among migrant older adults.
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Autoeficácia , Migrantes , Idoso , Estudos Transversais , Feminino , Promoção da Saúde , Humanos , Masculino , Análise de Mediação , Apoio SocialRESUMO
Migrant older adults are influenced by an accumulation of aging and adversities related to migration. This study aimed to evaluate the effects of psychological resilience and social support on health-related quality of life (HRQOL) among migrant older adults, and examine the mediating effect of psychological resilience between social support and HRQOL. A total of 149 migrant older adults were recruited from five communities in Chongqing, China. Social support and psychological resilience were positively associated with physical and mental HRQOL among migrant older adults. Psychological resilience had a partial mediating effect on the relationship between social support and physical and mental HRQOL. These findings provide a better understanding of how social support and psychological resilience work together to affect HRQOL, and it could guide the interventions to promote HRQOL among migrant older adults in the community.
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Resiliência Psicológica , Migrantes , Idoso , China , Estudos Transversais , Humanos , Qualidade de Vida , Apoio SocialRESUMO
AIMS: To assess the effect of peer support intervention on diabetes distress in people with type 2 diabetes. BACKGROUND: Diabetes distress may be decreased by peer support intervention, but findings about the effect of peer support on diabetes distress have been mixed. DESIGN: A systematic review and meta-analysis of randomized controlled studies. DATA SOURCES: PubMed, Embase, CENTRAL, PsycINFO, Web of Science, and CINAHL databases were searched for randomized controlled trials from inception to 30 June 2018. REVIEW METHODS: Investigators assessed eligibility, extracted data, and assessed methodological quality. Standardized mean difference and 95% confidence intervals were calculated for pooled effect size. RESULTS: A total of 13 studies included in systematic review and 10 in meta-analysis. In the random-effects model, the pooled effect size showed current peer support intervention did not significantly reduce diabetes distress in type 2 diabetes population compared with usual care. CONCLUSION: High quality and well-designed studies targeting at reducing diabetes distress are needed to further test the effect of peer support intervention on diabetes distress.
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Diabetes Mellitus Tipo 2/psicologia , Grupo Associado , Estresse Psicológico/terapia , Aconselhamento , Humanos , Qualidade de VidaRESUMO
BACKGROUND: Peer support has been suggested as a promising approach for diabetes management. No conclusive evidence exists on the effects of peer support on self-efficacy and quality of life in adults with type 2 diabetes. OBJECTIVE: To assess the effectiveness of peer support on self-efficacy and the quality of life in adults with type 2 diabetes. DESIGN: A systematic review and meta-analysis of randomized controlled studies. DATA SOURCES: We searched PubMed, Embase, Cochrane Central Register of Controlled Trials and Allied Health Literature database guide for relevant literatures from inception to 30 September 2017. REVIEW METHODS: The review was conducted according to the guidelines of Cochrane Collaboration. The outcomes were self-efficacy and quality of life. The standardized mean difference and 95% confidence intervals were calculated for pooled results. RESULTS: A total of 15 studies met the inclusion criteria. The pooled results revealed that peer support did not significantly improve self-efficacy and quality of life in adults with type 2 diabetes, but significantly improved self-efficacy and quality of life in studies with intervention duration ≤6 months. There was no evidence of publication bias. CONCLUSION: Peer support intervention did not lead to better effects on the improvement in self-efficacy and quality of life among adults with type 2 diabetes. However, peer support with intervention duration not more than 6 months had positive effects on self-efficacy and quality of life. More high-quality studies with large sample size are needed to support or counter the results.
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Diabetes Mellitus Tipo 2/psicologia , Qualidade de Vida , Autoeficácia , Diabetes Mellitus Tipo 2/terapia , Humanos , Grupo Associado , Ensaios Clínicos Controlados Aleatórios como Assunto , Autocuidado , Apoio SocialRESUMO
AIMS AND OBJECTIVES: To assess the self-management activities among rural patients with chronic hepatitis B (CHB), and the influence of psychosocial and demographic factors on their self-management activities. BACKGROUND: Chronic hepatitis B is a serious public health concern. Rural patients may have limited access to healthcare services. Although self-management is important for controlling chronic hepatitis B, few studies focus on the self-management activities among rural patients with chronic hepatitis B. Understanding self-management activities and related factors in this population are important to design and implement appropriate intervention strategies. DESIGN: A cross-sectional study. METHODS: From June-December 2017, totally 236 rural patients with chronic hepatitis B were recruited from hepatology department in two hospitals in Chongqing, China. The questionnaire included demographic characteristics, Chronic Hepatitis B Self-Management Scale, Self-Efficacy for Managing Chronic Disease, and Social Support Rating Scale. The study followed the STROBE checklist. RESULTS: Rural patients with chronic hepatitis B reported poor self-management activities for the score indexes of symptom management (57.36%), lifestyle management (54.89%), psychosocial coping (54.84%) and disease information management (53.11%) were all below 60%. Self-efficacy, objective support, subjective support, gender, education level and marital status showed significant effect on self-management activities. CONCLUSION: Rural patients with chronic hepatitis B were found to perform insufficient self-management activities. Self-efficacy, social support, gender, education level and marital status were identified to influence their self-management activities. RELEVANCE TO CLINICAL PRACTICE: Self-management activities should be promoted among rural patients with chronic hepatitis B. The factors that were identified in this study should be addressed when developing interventions to promote the performance of self-management activities for rural patients with chronic hepatitis B.
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Hepatite B Crônica/terapia , População Rural/estatística & dados numéricos , Autogestão/estatística & dados numéricos , Adulto , China , Estudos Transversais , Feminino , Hepatite B Crônica/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Autoeficácia , Autogestão/psicologia , Inquéritos e QuestionáriosRESUMO
The current study aimed to examine the relationships among social support, coping strategy, and depressive symptoms in older adults with diabetes, and the mediating role of coping strategy in the relationship between social support and depressive symptoms. Participants were 152 older adults with diabetes from two community health service centers in Chongqing, China. Self-reported questionnaires were used to assess social support, coping strategy, and depressive symptoms. Data were analyzed using descriptive statistics, hierarchical multiple regression, and mediation analysis. Subjective support, support utilization, and coping strategy were significantly associated with depressive symptoms. Positive and negative coping had significant mediating effects on the relationship between subjective support or support utilization and depressive symptoms. To alleviate depressive symptoms in older adults with diabetes, assessment and enhancement of social support and facilitation of positive coping strategy are integral to nursing care for older adults with diabetes. [Journal of Gerontological Nursing, 45(4), 40-46.].
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Adaptação Psicológica , Doença Crônica/psicologia , Transtorno Depressivo/psicologia , Diabetes Mellitus/psicologia , Apoio Social , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
The older adults with chronic disease usually show poor mental health and experience low quality of life (QOL). This study aimed to examine the mediating role of social support in the relationship between depression and QOL in community-dwelling older adults with chronic disease. A total of 387 Chinese older adults aged 60 or above with chronic disease were included in this cross-sectional study. Social support was negatively associated with depression and positively associated with physical component scale (PCS) and mental component scale (MCS). Depression and social support were all predictors of PCS and MCS. Mediation analysis suggested that social support partially mediated the impact of depression on PCS and MCS. Understanding the mediating role of social support might be beneficial in reducing the adverse impact of depression on QOL in community-dwelling older adults with chronic disease.
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Doença Crônica , Depressão/psicologia , Vida Independente/psicologia , Qualidade de Vida/psicologia , Apoio Social , Idoso , Povo Asiático , China , Estudos Transversais , Feminino , Humanos , Masculino , Saúde Mental , Inquéritos e QuestionáriosRESUMO
AIM: The aim of this study was to determine the effectiveness of exercise on fall prevention in nursing home residents. BACKGROUND: Nursing home residents have a high risk of falling. No conclusive evidence exists on the effectiveness of exercise on fall prevention in nursing home residents. DESIGN: Systematic review and meta-analysis of randomized controlled trials. DATA RESOURCES: Databases of PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature and China Biology Medicine were searched from inception to March 2017, with no language limitation. REVIEW METHODS: The review was conducted according to the guidelines of the Cochrane Collaboration. Studies on exercise interventions to prevent falls in nursing home residents were eligible. The primary outcome was the odds ratio with 95% confidence intervals of falls. RESULTS: Nine studies were included in the meta-analysis where exercise was compared with daily routine, social activities, and other methods in preventing falls. About falls, the pooled effect size of seven studies showed that exercise had no effect on fall prevention in nursing home residents. There was low heterogeneity. No significant publication bias was observed. CONCLUSIONS: The results of the systematic review and meta-analysis suggested that exercise did not play a role in preventing falls. Further studies with high quality and larger samples are required to support or counter the results.
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Acidentes por Quedas/prevenção & controle , Terapia por Exercício/métodos , Idoso Fragilizado , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
BACKGROUNDS: Chronic hepatitis B (CHB) patients may face many problems resulted from their conditions. To delay the progress of CHB, patients should be responsible for the management of their conditions. There is no dedicated scale for assessing self-management behaviors of CHB patients. OBJECTIVES: This study aimed to develop and validate a self-report measure designed to assess the self-management behaviors for CHB patients (CHBSMS). DESIGN: A cross-sectional descriptive study design. SETTING: Participants were recruited from the infectious disease department of two hospitals in China. PARTICIPANTS: A sample of 248 and 346 CHB patients for item analysis and test for validity and reliability, respectively. METHODS: An initial 45-item scale developed based on item generation and a two-round Delphi survey was assessed by CHB patients for item analysis to develop a final scale. Construct validity was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The Chronic Disease Self-Management Behavior Scale (CDSMBS) was used to test the criterion validity. Internal consistency and test-retest reliability were assessed by Cronbach's α coefficient and intraclass correlation coefficient (ICC), respectively. RESULTS: A 25-item scale was developed. EFA indicated a four-factor structure (symptom management, lifestyle management, psychosocial coping and disease information management), which accounted for 58.149% of the total variance. CFA indicated appropriate fit of the four-factor model. The total scores of CHBSMS was correlated with that of CDSMBS (râ¯=â¯0.634, Pâ¯<â¯0.01). The Cronbach's α coefficient (αâ¯=â¯0.887) and the test-retest correlation coefficient (ICCâ¯=â¯0.871) showed good internal consistency and stability of the scale. CONCLUSIONS: The 25-item CHBSMS is a reliable and valid measure that can be used to assess the self-management behaviors of CHB patients for improving patient education and health-related outcomes.
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Doença Crônica/enfermagem , Doença Crônica/psicologia , Hepatite B Crônica/enfermagem , Hepatite B Crônica/psicologia , Autogestão/psicologia , Adolescente , Adulto , Idoso , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Autogestão/estatística & dados numéricos , Inquéritos e Questionários , Adulto JovemRESUMO
In our previous work, we found that the expression of ubiquitin-specific protease 18 (USP18), also known as UBP43, is associated with the efficiency of interferon alpha (IFN-α) treatment in patients with chronic hepatitis B (CHB). To elucidate the influence of USP18 on hepatitis B virus (HBV) replication and the mechanism of this activity, we silenced USP18 by introducing short hairpin RNA (shRNA) into Hepg2.2.15 cells. To identify the changed genes and pathways in Hepg2.2.15-shRNA-USP18 cells, we performed a microarray gene expression analysis to compare the Hepg2.2.15 stably expressing USP18-shRNA cells versus control cells using the Affymetrix Human Transcriptome Array (HTA) 2.0 microarrays. Microarray analysis indicated that genes involved in regulation of thyroid hormone signaling pathway, complement, and coagulation cascades, PERK-mediated unfolded protein response, and insulin-like growth factor-activated receptor activity were significantly altered after USP18 knockdown for 72 h. Furthermore, genes involved in hepatocyte proliferation, liver fibrosis, such as cell cycle regulatory gene CCND1, were also altered after USP18 knockdown in Hepg2.2.15 cells. In conclusion, USP18 is critical for regulating the replication of HBV in Hepg2.2.15 cells, which suggest that USP18 may be a candidate target for HBV treatment.
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Endopeptidases/genética , Endopeptidases/metabolismo , Técnicas de Silenciamento de Genes , Vírus da Hepatite B/fisiologia , Transcriptoma , Ciclina D1/genética , Endopeptidases/deficiência , Regulação da Expressão Gênica , Células Hep G2 , Humanos , Interferon-alfa/farmacologia , Análise em Microsséries , Interferência de RNA , Transdução de Sinais/genética , Ubiquitina Tiolesterase , Replicação ViralRESUMO
BACKGROUND AND AIMS: Previous studies examining the relationship between hepatitis B virus (HBV) genotype B and C and response to interferon therapy in Hepatitis B e antigen (HBeAg)-positive chronic hepatitis B patients have yielded conflicting results. We aim to summarize data to reach firm conclusions on the role of HBV genotype B and C in response to interferon therapy. METHODS: PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for relevant articles published up to March 2013. Odds ratios (ORs) and 95% confidence intervals (CI) were calculated by fixed- or random-effects models. Heterogeneity, sensitivity analysis, and publication bias were also assessed. RESULTS: Fifteen studies were identified. All studies except for those evaluating the rate of end-of-treatment HBeAg seroconversion exhibited significant heterogeneity. There were significant differences in rates of end-of-treatment alanine aminotransferase (ALT) normalization, HBV DNA negative, and HBeAg seroconversion between the genotype B and genotype C groups, but not in HBeAg clearance. The pooled results showed higher rates of sustained ALT normalization (OR = 2.24, 95%CI 1.53-3.27), HBV DNA negative (OR = 2.60, 95%CI 1.65-4.12), HBeAg clearance (OR = 2.13, 95%CI 1.29-3.52) and HBeAg seroconversion (OR = 1.95, 95%CI 1.27-2.98) in patients with genotype B than those with genotype C. The sensitivity analysis did not alter the effects observed in the primary analysis. There was no evidence of publication bias except for HBeAg clearance rate. CONCLUSIONS: The results of the current meta-analysis indicate that HBV genotype B patients receiving interferon therapy respond better to treatment compared with genotype C patients, but this needs to be further examined.
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Antivirais/uso terapêutico , Bases de Dados Bibliográficas , Genótipo , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/virologia , Interferon-alfa/uso terapêutico , Antígenos E da Hepatite B/imunologia , Humanos , Resultado do TratamentoRESUMO
Objectives: Burnout influences students' academic performance and mental health. This study analyzed the relationship between professional identity, self-directed learning ability, and burnout, and examined the mediating effect of self-directed learning ability between professional identity and burnout among nursing students. Methods: 884 nursing students were recruited at two medical universities in China. Demographic information, Academic Burnout Scale, Professional Identity Questionnaire for Nursing Students, and Self-directed Learning Instrument were distributed to collect data. Results: Both professional identity (ß = -0.17) and self-directed learning ability (ß = -0.43) showed negative associations with students' burnout. Meanwhile, there was a partial mediating effect of self-directed learning ability between professional identity and burnout (-0.24, 95% CI = -0.30, -0.20). Conclusions: Nursing educators should emphasize on developing effective strategies to improve nursing students' professional identity and self-directed learning ability to prevent or reduce their burnout.