Family resilience, patient-reported symptoms in young stroke dyads: The effect of caregiver readiness and social support.

AIMS AND OBJECTIVES: To investigate empirically the direct effect and potential mechanism of family resilience on patient-reported outcomes among young stroke dyads in China. BACKGROUND: Young patients with stroke have been becoming an important public health issue. According to relevant theories and previous studies, we found that family resilience might play an important role in patient's symptoms. However, it is less clear about the specific relationship and potential mechanisms of these two variables. DESIGN: We used a prospective cross-sectional design. METHODS: A multi-item questionnaire was used to assess the constructs of interest. Researchers progressively constructed and validated conditional process models. The PROCESS macro was used to verify the research hypotheses. RESULTS: A total of 560 questionnaires were collected in this study. We found that family resilience of stroke patients and their spouses had a direct effect on the physical, psychological and social aspects of patient-reported symptoms. We further revealed that caregiver preparedness partially mediated the relationship between family resilience and patient's symptoms in stroke patient-spouse dyads, while perceived social support moderated the relationship between caregiver preparedness and patient's symptoms. Finally, we observed that the impact of caregiver readiness and social support on patients' symptoms predominantly manifested in physical and physiological outcomes. CONCLUSIONS: Our research provides evidence about the positive impact of family resilience on patient-reported symptoms in young stroke dyads. Meanwhile, it further revealed how caregiver preparedness and perceived social support may play out in the relationship. PRACTICE IMPLICATIONS: Our research introduces a novel perspective and pathway to enhance short-term recovery outcomes for patients. It also furnishes clinicians and nurses with evidence to guide the implementation of interventions aimed at improving patient health outcomes and facilitating smoother transitions from the hospital to home. IMPACT: What problem did the study address? Families play a crucial role in a patient's recovery process from illness, with family resilience serving as an important force for families to overcome adversity. However, the impact on patient symptoms and the underlying mechanisms of this relationship are uncertain. Empirical research is required to validate these aspects. What were the main findings? Family resilience has a positive impact on the physical, psychological and social aspects of patient-reported symptoms in young stroke dyads. Both the actor effect and partner effect are supported. The impact of caregiver readiness and social support on patient-reported symptoms is primarily observed in physical and physiological outcomes. Where and on whom will the research have an impact? This study offers a novel approach to enhance the short-term recovery of stroke patients. The researchers believe that the findings of this study will play an even more significant role during patients' transition from the hospital to home. REPORTING METHOD: This study followed the STROBE statement of cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: The study was conducted by patients, their spouses, healthcare professionals and the research team.

Association between positive control in self-perceptions of aging and motoric cognitive risk syndrome among Chinese community-dwelling older adults: a cross-sectional study.

BACKGROUND: Self-perceptions of aging (SPA) are important psychosocial factors that lead to a wide range of outcomes including dementia. However, the relationships between positive SPA and motoric cognitive risk syndrome (MCR) which is a predementia syndrome are still unknown. This study aimed to reveal the associations of positive control and aging awareness of SPA with the risk of MCR and its components. METHODS: A cross-sectional design was conducted among 1137 Chinese community-dwelling older adults. Positive control and aging awareness were defined by two dimensions of SPA (Positive control and Timeline chronic). MCR was determined according to definition. Multivariable logistic regression was used to examine the associations. RESULTS: The overall prevalence of MCR was 11.5% (mean age = 71.62 ± 5.22). After adjusting for depression, anxiety, and cognitive function, positive control was associated with reduced risk of MCR (OR = 0.624, 95% CI 0.402-0.969, P = 0.036), subjective cognitive complaints (SCC) (OR = 0.687, 95% CI 0.492-0.959, P = 0.027), and gait speed (GS) (OR = 0.377, 95% CI 0.197-0.720, P = 0.003), respectively. Aging awareness was merely related to increased risk of MCR (OR = 1.386, 95% CI 1.062-1.810, P = 0.016). CONCLUSIONS: This study highlights the crucial associations of positive control and aging awareness with MCR and its components. Our results emphasize that positive belief in control and adaptive aging awareness might be promising targets for preventing MCR.

Cueing effect of attention among nurses with different anxiety levels: an EEG study.

The attention to cueing among nurses with anxiety affects their nursing quality seriously. Nevertheless, the neural mechanism of attention under anxiety among nurses has not been revealed. In this study, we utilized the event-related potential (ERP) and functional brain networks to investigate the neural mechanism of the cueing attention differences between anxiety and non-anxiety nurse groups (AG-20 nurses; NAG-20 nurses) in the spatial cueing task. The results revealed that in the invalid cues (144 trials), longer reaction times, larger P2 amplitudes, and more linkages between the right frontal and parietal areas were found in AG compared to NAG. In the valid cues (288 trials), there were no significant behavioral and neural differences between the two groups. The AG in the invalid cues showed slower response times, larger P2 and N5 amplitudes, and denser linkages originating from the occipital cortex than those in the valid cues. The convolutional neural network was trained for discriminating between the anxiety nurses and the normal ones, with the average accuracy being 0.76. The findings provided a potential physiological biomarker to predict the anxiety group who need to give more psychological attention. Nurse leaders maybe get more information for offering solutions to retain mental health among nurses.

Latent profile analysis of self-perceptions of ageing among Chinese community-dwelling older adults.

BACKGROUND: Self-perceptions of ageing (SPA) is an important predictor for physical and mental health of older adults in successful ageing. SPA is mainly studied from negative or positive perspectives using variable-centred methodologies. The aim of the current study was to explore distinct profiles of SPA among Chinese community-dwelling older adults using a person-centred method and validate the SPA profiles by examining associations with psychological outcomes. METHODS: Participants aged 65 and over were randomly divided into test and validation samples (n = 451, respectively). SPA was measured by the Brief Ageing Perceptions Questionnaire using latent profile analysis. RESULTS: Three SPA profiles were identified. One adaptive subgroup was designated as 'Low ageing awareness and high positive control' (LAPC, 84.7% and 75% in both samples, respectively). Two maladaptive SPA subgroups were designated as 'Low positive consequences and control' (LPCC, 3.9% and 8.2% in both samples, respectively), and 'High ageing awareness and negative control' (HANC, 11.4% and 16.8% in both samples, respectively). Similar to negative/positive SPA, the HANC and LAPC subgroups showed the highest and lowest levels of depressive symptoms and cognitive decline. Low cognitive function was found in the LPCC subgroup. CONCLUSIONS: These findings highlight the heterogeneity of older adults' SPA. SPA profiles may aid community healthcare providers in China to identify individuals with high risk of maladaptive SPA and to tailor targeted interventions for psychological health in later life. Distinct SPA profiles require different interventions targeting negative or positive control or both aspects. More positive control strategies might be beneficial for cognitive functioning in older adults from the LPCC subgroup.

The Moderating Role of Empathy Profiles in the Relationship Between Knowledge About Aging and Attitudes Toward Older Adults Among Nursing Students.

Knowledge about aging (KA) and empathy affect nursing students' attitudes toward older adults. However, little is known about the mechanisms underlying this phenomenon from an integrated, person-centered perspective. The purposes of the present study were (1) to identify empathy profiles based on the Interpersonal Reactivity Index (IRI) among Chinese nursing students and (2) to explore whether these latent empathy profiles moderate the association between KA and attitudes toward older people. A cross-sectional survey design was used, and a battery of questionnaires - including those on demographic information, the Chinese version of Palmore's Facts on Aging Quiz (C-FAQ), the Chinese version of Kogan's Attitude Toward Older People Scale (C-KAOP), and the IRI - was filled in by 622 Chinese nursing students (M age 21.76; SD = 1.33). The mean total scores on KAOP and C-FAQ were 164.96 ± 18.32 and 10.436 ± 3.015, respectively, indicating relatively positive attitudes toward older people but low KA among Chinese nursing students. Latent profile analysis was used to identify a three-profile solution characterized by distinct levels of four dimensions of empathy, namely average empathy (AE, n = 399), high empathy (HE, n = 42), and low empathy (LE, n = 181). Subsequent linear regression analysis revealed that the LE rather than the HE profile predicted positive attitudes toward older adults. It is worth noting that the LE profile played a remarkable moderating role in associations between KA and negative attitudes toward older adults after controlling for covariant variables. Both the identification of distinct empathy profiles and the interplay between the LE profile and KA are of significance in reducing negative attitudes toward older adults among Chinese nursing students. Nursing educators should combine improving nursing students' levels of KA and fostering greater empathy to reduce negative attitudes toward older adults. Such training should give priority to nursing students with LE.

Ischemic postconditioning confers cerebroprotection by stabilizing VDACs after brain ischemia.

Ischemic postconditioning provides robust neuroprotection, therefore, determining the molecular events may provide promising targets for stroke treatment. Here, we showed that the expression of functional mitochondrial voltage-dependent anion channel proteins (VDAC1, VDAC2, and VDAC3) reduced in rat vulnerable hippocampal CA1 subfield after global ischemia. Ischemic postconditioning restored VDACs to physiological levels. Stabilized VDACs contributed to the benefits of postconditioning. VDAC1 was required for maintaining neuronal Ca2+ buffering capacity. We found that microRNA-7 (miR-7) was responsible for postischemic decline of VDAC1 and VDAC3. Notably, miR-7 was more highly expressed in the peripheral blood of patients with acute ischemic stroke compared to healthy controls. Inhibition of miR-7 attenuated neuronal loss and ATP decline after global ischemia, but also diminished the infarct volume with improved neurological functions after focal ischemia. Thus, ischemic postconditioning protects against mitochondrial damage by stabilizing VDACs. MiR-7 may be a potential therapeutic target for ischemic stroke.

A Meta-Analysis of Concurrent Chemoradiotherapy for Advanced Esophageal Cancer.

BACKGROUND: Concurrent chemoradiotherapy is a standard treatment for local advanced esophageal cancer, but the outcomes are controversial. Our goals were to compare the therapeutic effects of concurrent chemoradiotherapy and radiotherapy alone in local advanced esophageal cancer using meta-analysis. METHODS: MEDLINE, EMBASE and the Cochrane library were searched for studies comparing chemoradiotherapy with radiotherapy alone for advanced esophageal cancer. Only randomized controlled trials were included, and extracted data were analyzed with Review Manager Version 5.2. The pooled relative risks (RR) and their 95% confidence intervals (CI) were calculated for statistical analysis. RESULTS: Nine studies were included. Of 1,135 cases, 612 received concurrent chemoradiotherapy and 523 were treated with radiotherapy alone. The overall response rate (complete remission and partial remission) was 93.4% for concurrent chemoradiotherapy and 83.7% for radiotherapy alone (P = 0.05). The RR values of 1-year, 3-year, and 5-year survival rates were 1.14 (95% CI: 1.04 - 1.24, P = 0.006), 1.66 (95% CI: 1.34 - 2.06, P < 0.001), and 2.43 (95% CI: 1.63 - 3.63, P < 0.001), respectively. The RR value of the merged occurrence rate of acute toxic effects was 2.34 (95% CI: 1.90 - 2.90, P <0.001). There was no difference in the incidence of late toxic effects, which had an RR value of 1.21 (95% CI: 0.96 - 1.54, P = 0.11). The RR level of persistence and recurrence was 0.71 (95% CI: 0.62 - 0.81, P <0.001), and for the distant metastasis rate, the RR value was 0.79 (95% CI: 0.61 - 1.02, P = 0.07). CONCLUSIONS: Concurrent chemoradiotherapy significantly improved overall survival rate, reduced the risk of persistence and recurrence, but had little effect on the primary tumor response, and increased the occurrence of acute toxic effects.