A study to untangle the puzzle of urinary incontinence and frailty co-occurrence among older adults: The roles of depression and activity engagement.

AIMS: To explore the co-occurrence of urinary incontinence and frailty by testing the roles of depression and activity engagement guided by the mechanisms of common cause and interaction pathways. DESIGN: A secondary analysis of a 1-year three-wave panel data collected from older nursing home residents in China. METHODS: Changes in depression and activity engagement were regressed on urinary incontinence and frailty incidence underpinned by the common cause mechanism of chronic conditions co-occurrence, and these changes were also taken as mediators linking from frailty to urinary incontinence incidence supported by the interaction pathways' mechanism. RESULTS: A total of 348 older adults were included in this study, and 55.7% were women. The co-occurrence of urinary incontinence and frailty was found in 16.7% of the participants at baseline. Older adults with sole frailty at baseline had almost twice the rate of incident urinary incontinence (32.7%) compared with those without (16.7%) over a 1-year period. The subsample analyses showed that changes in depression and activity engagement failed to significantly predict the incidence of urinary incontinence and frailty. The mediating roles of these changes linking frailty to urinary incontinence incidence were also not statistically significant. CONCLUSION: The co-occurrence of urinary incontinence and frailty is prevalent in older nursing home residents. Older adults with frailty at baseline are more likely to develop urinary incontinence a year later. The common cause and interaction pathways mechanisms for the co-occurrence of urinary incontinence and frailty were not verified with changes in depression and activity engagement. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The phenomenon of urinary incontinence and frailty co-occurrence should be given extreme emphasis. Although statistically significant findings on the roles of depression and activity engagement were not inferred, this study provides multiple possibilities for future studies to test and depict a clear picture of this co-occurrence. IMPACT: What problem did the study address? This study was designed to test the roles of depression and activity engagement in predicting the incidence of urinary incontinence and frailty, and the mediating roles in linking frailty to urinary incontinence incidence. What were the main findings? Despite the methodological pitfalls in literature have been addressed, neither depression nor activity engagement would significantly predict the incidence of urinary incontinence and frailty in older adults. Their mediating roles in linking frailty to urinary incontinence incidence were also not significant. Where and on whom will the research have an impact? Our findings add important pieces of evidence to promote researchers' understanding and provide an important basis for untangling the puzzle of urinary incontinence and frailty co-occurrence. REPORTING METHOD: The report of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Associations between perceived overqualification, organisational commitment and work passion of nurses: A multicentre cross-sectional study.

AIM: To investigate the associations between perceived overqualification, organisational commitment and work passion of nurses. BACKGROUND: Few studies have considered the effects of perceived overqualification and organisational commitment on work passion of nurses, especially in developing countries. METHODS: This is a multicentre cross-sectional study. A total of 4511 nurses from eight tertiary hospitals were recruited. The Scale of Perceived OverQalification (SPOQ), the Organizational Commitment Scale (OCS) and the Work Passion Scale (WPS) were used to collect the data. Hierarchical multiple regression were employed. RESULTS: Perceived overqualification and organisational commitment were the main predictors for both harmonious and obsessive passions (each p < .001). The unique effect of organisational commitment (ßharmonious  = .608, ßobsessive  = .556) on work passion were six to eight times larger than these of perceived overqualification (ßharmonious = -.079, ßobsessive = .085). CONCLUSION: Our findings indicate that high perceived overqualification clearly reduces nurses' harmonious passion and increases their obsessive passion, whereas high organisational commitment significantly promotes nurses' harmonious and obsessive passions. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should distinguish the different effects of perceived overqualification and organisational commitment on work passion. Effective intervention should be developed to release nurses' potential abilities and improve their organisational commitment and work passion. Chinese Clinical Trial Registry: ChiCTR2100047974.

Quality of life in cancer patients with different preferences for nurse spiritual therapeutics: The role of psychological capital.

AIM: To explore the status of quality of life and psychological capital and analyse the different effects of psychological capital on the quality of life of cancer patients with different preferences for nurse spiritual therapeutics. DESIGN: A cross-sectional survey was used. METHODS: Two hundred and eight cancer patients were recruited using convenience sampling from a tertiary Chinese hospital, between March and July 2019. Data on preferences for nurse spiritual therapeutics (PNST), psychological capital (PsyCap) and quality of life (QoL) were collected using paper questionnaires. Hierarchical multiple regression was employed to investigate the different influences of PsyCap on QoL of cancer patients with various levels of PNST. RESULTS: Compared with patients having high PNST, patients with mild-moderate PNST experienced lower self-efficacy, hope, optimism, PsyCap and social/family well-being. PsyCap significantly explained the variance on QoL of patients with various levels of PNST. Age, gender, presence of caregiver were significant factors influencing physical, social/family and emotional well-being of patients with high PNST. CONCLUSION: The present study demonstrates disparities in PsyCap and QoL between cancer patients with mild-moderate and high PNST. It is essential to be aware of the positive influences of PsyCap on QoL and develop effective interventions for patients to improve their QoL, especially for those with mild-moderate PNST. IMPACT: It is necessary to realize the benefits of PsyCap on QoL of cancer patients with various levels of PNST. Appropriate training for nurses needs to be developed to promote their spiritual care competencies. Moreover, supportive interventions should be developed for cancer patients to improve their PsyCap and QoL.

The role of indoleamine 2,3-dioxygenase (IDO) in immune tolerance: focus on macrophage polarization of THP-1 cells.

Macrophages can be divided into two groups as M1 and M2 phenotype. Our results and other groups revealed that IFN-γ can up-regulate the IDO expression and differentiate THP-1 cells to M1 phenotype. Therefore we hypothesized that IDO may play potential roles in macrophage differentiation. Interesting, our results indicated that the ectopic IDO increases the expression of M2 markers such as IL-10 and CXCR4 while decreases the M1 markers such as CCR7 and IL-12p35. In contrast, the knockdown of IDO expression in THP-1 cells resulted in increased M1 markers and lower M2 markers. Our results suggested that the expression intensity of IDO modulates macrophages differentiation. These finding support the counter-regulatory role for IDO with regarding to the polarization of macrophages to restrain excessive or inappropriate immune activation in inflammatory or tumor microenvironment. It throws new light on the mechanisms about the immunosuppressive effect of IDO in tumor or inflammatory diseases.

Nodal promotes the generation of M2-like macrophages and downregulates the expression of IL-12.

Nodal, a member of the TGF-ß superfamily, is an embryonic morphogen that is upregulated in different types of tumors. Nodal increases the tumorigenesis by inducing angiogenesis and promoting metastasis. Importantly, Nodal inhibition suppresses the growth and invasion of tumor. Since tumor-associated macrophages (TAMs) are the major infiltrating leukocytes in most cancers, we investigated whether Nodal is involved in the differentiation of TAMs. Our results revealed that Nodal inhibition in tumor microenvironment upregulated the production of IL-12 in macrophages and reversed TAMs to classically activated macrophage phenotype. In contrast, treatment with recombinant Nodal (rNodal) decreased the expression of IL-12 in murine macrophages. Furthermore, rNodal promoted macrophage polarization to an alternatively activated macrophage-like/TAM phenotype and modulated its function. These results suggest that Nodal may play an important role in macrophage polarization and downregulation of IL-12. The rescued antitumor function of TAMs via the inhibition of Nodal expression could be a new therapeutic strategy for cancer treatment.

[Pregnancy outcomes of 103 women with pulmonary arterial hypertension].

OBJECTIVE: To evaluate the pregnancy outcome of women with pulmonary arterial hypertension (PAH). METHODS: The medical records of 103 pregnant women with PAH admitted to Beijing Anzhen Hospital from January 2007 to March 2011 were studied retrospectively. RESULTS: (1) Degree of PAH and cardiac function. Among the 103 PAH, 92 cases were patients with congenital heart disease and 13 cases were with rheumatic heart disease. They were divided by color doppler ultrasound into mild PAH group (34 cases), moderate PAH group (22 cases) and severe PAH group (47 cases). Per heart function classification, 21 cases (20.4%, 21/103) were class I, 44 cases (42.7%, 44/103) were class II, 27 cases (26.2%, 27/103) were class III and 11 cases (10.7%, 11/103) were class IV. More patients were class III and IV cardiac function in the severe PAH group than in the mild and moderate PAH groups, with statistically significant difference (P < 0.05). (2) Delivery mode. There were 44 term delivery and 23 preterm birth in the 103 PAH patients.Sixty-three cases (94%, 63/67) received cesarean section and 4 cases had vaginal delivery. There were 36 iatrogenic abortion (35.0%, 36/103). The iatrogenic abortion rate in the severe PAH group was significantly higher than those in the mild and moderate PAH groups (P < 0.05).(3) Perinatal outcomes. The full-term delivery rates in the mild and moderate PAH groups [80% (20/25) and 14/17] were significantly higher than the severe PAH group (40%, 10/25), respectively (P < 0.05). And the premature birth rate of the severe PAH group(60%, 15/25) was significantly higher than the mild and moderate PAH group [20% (5/25) and 3/17, P < 0.05]. There were 4 neonatal asphyxia. The birth weight of mild, moderate and severe PAH groups were (3071 ± 443), (2910 ± 619) and (2381 ± 589) g, respectively. The birth weight in the severe PAH group was significantly lower than the mild and moderate PAH groups (P < 0.05). (4) Mortality. Nine cases maternal death happened, with a mortality of 8.7% (9/103). All of them were severe pulmonary hypertension patients. CONCLUSIONS: PAH is a serious complication during pregnancy.Women with mild PAH and normal cardiac function could continue pregnancy to full-term.Women with moderate PAH might continue pregnancy to 32 weeks under intensive care, cesarean delivery is preferable. Pregnant women with severe PAH should terminate pregnancy because of the high mortality.

[Effect of reduced expression of Her2 by RNA interference on the biological characters of ovarian carcinoma cells].

OBJECTIVE: To observe the effects of short hairpin RNA (shRNA) targeting Her2 on its gene expression when the shRNA was stably transfected into human ovarian cell lines, SKOV3 and SKOV3.ip1, which have different extent of malignancy and investigate the changes of the biological characters of the two cell lines after the stable transfection. METHODS: The plasmids expressing shRNA targeting Her2 gene were transfected into SKOV3 and SKOV3.ip1 cells. The stably transfected cells were gained by antibiotic screening. The expression of Her2 before and after the transfection was detected by RT-PCR and western blot. The transwell experiment was used to observe the invasion ability of the cancer cells before and after the transfection, and the parent and the transfected cells were injected into nude mice to observe the tumor growth. RESULTS: After the stable transfection with Her2 shRNA, mRNA and protein levels of Her2 gene in SKOV3 and SKOV3.ip1 cells were remarkably reduced. The expression of mRNA were (68.0 +/- 3.1)%, (40.8 +/- 2.0)%, (99.9 +/- 1.3)%, (42.4 +/- 2.5)%. The expression of protein were (72.1 +/- 3.4)%, (36.4 +/- 1.5)%, (98.2 +/- 1.7)%, (40.7 +/- 2.1)%. The invasion ability into basilar membrane of the transfected cells was greatly reduced compared with the parent cells. The invasion cell numbers were 7.6 +/- 1.1, 1.8 +/- 0.8, 36.2 +/- 9.7, 15.7 +/- 7.2. The growth rate of the planted tumors was lower in transfected groups than that of the parent groups. CONCLUSIONS: (1) The expression of Her2 gene in SKOV3 and SKOV3.ip1 cells was remarkably reduced by RNA interference targeting Her2. (2) The biological characters of SKOV3 and SKOV3.ip1 cells are changed when the expression of Her2 gene is reduced by RNA interference.