Factors associated with poor sleep quality in patients with pre-dialysis chronic kidney disease: A systematic review.

AIMS: To determine factors associated with poor sleep quality among patients with pre-dialysis chronic kidney disease. DESIGN: This is a systematic review study guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements and checklist. DATA SOURCES: Empirical evidence was sought in major electronic databases, including Embase, MEDLINE, CINAHL and Airiti library from March to September 2022. REVIEW METHODS: Studies investigating factors associated with poor sleep quality among adult patients with chronic kidney disease were included. Study participants who received renal replacement therapy and had sleep disorders and serious illnesses such as cancer were excluded. Of the 526 studies that resulted from the search after removing duplicate articles, 20 studies were assessed for quality by using Joanna Briggs Institute and Newcastle-Ottawa Scale by two doctorial prepared nursing scientists. RESULTS: A total of 20 studies were included in this review. The prevalence of poor sleep quality in these studies ranged from 11% to 97.5%. Demographics (older age and female), physiological conditions (higher body mass index, higher hip circumferences, higher systolic blood pressure, poor cardiovascular function, dyspnoea, pain, cramps, itchiness or moderate to extreme pruritus, lower fasting plasma glucose, electrolyte imbalance, higher total cholesterol and gastrointestinal symptoms), depression, smoking, arousal-related and cognitive arousal behaviours were associated with poor sleep quality. CONCLUSION: Poor sleep quality was prevalent and influenced kidney function, increased mortality as well as decreased quality of life in patients with pre-dialysis chronic kidney disease. This review synthesizes factors associated with poor sleep quality. Managing these factors can mitigate and prevent poor sleep quality. IMPACT: Healthcare providers, especially nurses, can assess the risk factors of poor sleep quality and reinforce patients' self-management. Future research should elucidate the assessment and management of risk factors and transfer these into widespread use in the routine care of patients with chronic kidney disease.

[Applying an Exercise Snack-Based Health Promotion Strategy].

Lack of time, lack of access to equipment, and environmental constraints are generally perceived as barriers to regular physical activity. Moreover, insufficient activity is known to promote sedentary behavior, which is a factor in many chronic diseases, negatively affects mental health, and reduces quality of life. Exercise snacks, defined as short and efficient bursts of exercise, are convenient and easy to implement, reduce sedentary time, increase physical activity, and promote the development of good exercise habits. Previous studies have found exercise snacks to be safe and feasible for the elderly, promoting physical function and reducing the incidence of falls and metabolic diseases. Exercise snacks have also been found to be effective in healthy adults as well as in patients with obesity and diabetes, helping decrease blood sugar and promoting cardiorespiratory fitness. Depending on the participant's age and tolerance, exercise snack patterns may be extended and distinguished into two forms: 10-minute bouts of gentle intermittent exercise twice a day and 60-second bouts of vigorous exercise 3 to 8 times a day. The main considerations for exercise snacks include: multi-joint exercise is better than single-joint exercise, lower body exercise is better than upper body exercise, and dynamic and rapid movement that pushes away from the ground promotes osteogenesis and helps prevent osteoporosis and fractures. Exercise snacks may be applied in healthcare practice and related research to promote health and improve quality of life for all.

Fabricating High-Thermal-Conductivity, High-Strength, and High-Toughness Polylactic Acid-Based Blend Composites via Constructing Multioriented Microstructures.

The massive accumulation of plastic waste has caused a serious negative impact on the human living environment. Replacing traditional petroleum-based polymers with biobased and biodegradable poly(l-lactic acid) (PLLA) is considered an effective way to solve this problem. However, it is still a great challenge to manufacture PLLA-based composites with high thermal conductivity and excellent mechanical properties via tailoring the microstructures of the blend composites. In the present work, a melt extrusion-stretching method is utilized to fabricate biodegradable PLLA/poly(butylene adipate-co-butylene terephthalate)/carbon nanofiber (PLLA/PBAT/CNF) blend composites. It is found that the incorporation of the extensional flow field induces the formation of multioriented microstructures in the composites, including the oriented PLLA molecular chains, elongated PBAT dispersed phase, and oriented CNFs, which synergistically improve the thermal conductivity and mechanical properties of the blend composites. At a CNF content of 10 wt %, the in-plane thermal conductivity, tensile strength, and elongation at break of the blend composite reach 1.53 Wm-1 K-1, 66.8 MPa, and 56.5%, respectively, which increased by 31.9, 73.5, and 874.1% compared with those of the conventionally hot-compressed sample (1.16 Wm-1 K-1, 38.5 MPa, and 5.8%, respectively). The main mechanism for the improved thermal conductivity is that the multioriented structure promotes the formation of a CNF thermal conductive network in the composites. The strengthening mechanism is attributed to the orientation of both PLLA molecular chains and CNFs in the stretching direction, restricting the movement of PLLA molecular segments around CNFs, and the toughening mechanism is due to the transformation of PLLA molecular chains from low-energy gt conformers to high-energy gg conformers induced by extensional flow field. More interestingly, after the extrusion-stretched samples are annealed, the oriented PLLA molecular chains form oriented crystal structures such as extended-chain lamellae, common "Shish-kebabs," and hybrid Shish-kebabs, which further enhance the thermal conductivity and heat resistance of the samples. This work reveals the effects of the orientation of the matrix molecular chains and crystallites on the thermal conductivity and mechanical properties of composites and provides a new way to prepare high-performance PLLA-based composites with high thermal conductivity, excellent mechanical properties, and high heat resistance.

A comparison of the learning effects between TGfU-SE and TGfU on learning motivation, sport enjoyment, responsibility, and game performance in physical education.

Background: Both the Sport Education (SE) model and Teaching Games for Understanding (TGfU) have been connected to the theory of situated learning, which is a game-centered curricular model. TGfU emphasizes tactical awareness, decision making, and skill execution. The SE model provides a complete season during physical education (PE) lessons. Therefore, it is worth exploring the integration of TGfU with SE (TGfU-SE) model in PE courses, and whether the hybrid TGfU-SE model can achieve better learning effects for students than the TGfU model alone. Purpose: The purpose of the study was to compare the difference in learning effects between the TGfU-SE model and the TGfU model on students' learning motivation, sport enjoyment, responsibility, and game performance. Methods: This study used a quasi-experimental design to compare different learning effects between the experimental group (TGfU-SE) and the control group (TGfU). The participants lived in Taiwan, including two junior high school PE teachers and four PE classes with a total of 90 students (TGfU-SE group, n = 46; TGfU group, n = 44). Each teacher taught two PE classes, one with an experimental group and one with a control group. This study used four research instruments, including the Responsibility Scale in Physical Education (RSPE), Learning Motivation Scale in Physical Education (LMSPE), Sport Enjoyment Scale in Physical Education (SESPE), and Game Performance assessment instrument (GPAI). Analysis of covariance (ANCOVA) and the independent t-test were used to analyze the data. Results: The results of this study showed that the TGfU-SE model had more positive learning effects on students' learning motivation, sport enjoyment, responsibility, and game performance than the TGfU model. Conclusion: we concluded that the TGfU-SE model had a more positive influence on students' learning performance than the TGfU model. It is suggested that the hybrid TGfU-SE model could be implemented effectively in the PE curriculum.

Constructing A/B-Side Heterogeneous Asynchronous Structure with Ag2Se Layers and Bushy-like PPy toward High-Performance Flexible Photo-Thermoelectric Generators.

The enthusiasm for environmental energy harvesting has triggered a boom in research on photo-thermoelectric generators (PTEGs), and the relevant applications are mainly focused on self-energy supply sensors owing to the limitations of their output performances. For this purpose, high-output hierarchical heterogeneous PTEGs were constructed by assembling separately optimized thermoelectric (TE) and photothermal (PT) layers. The pressure and temperature conditions of Ag2Se films during the pressing process were first explored, and the sample with the optimal performance and least defects was selected as the TE layer. At the same time, different morphologies of polypyrrole (PPy) PT layers were electrochemically synthesized. It is found that the three-dimensional structure of Bushy-PPy could effectively improve the light absorption and thus enhance the PT conversion performance. The final assembled PTEG can produce an output voltage of -9.03 mV and an output power of 3.53 µW under the irradiation of a near-infrared light source of 300 mW cm-2 without a cooling source, and it can also achieve considerable output power under visible light irradiation of different intensities. Combining its high retentions of electrical conductivity (99%) and output performance (97%) after 1000 bending-tension cycles, it is proven to be a promising next-generation wearable flexible energy harvesting device.

Development of the Adherence to Healthy Behaviors Scale.

Adherence to healthy behaviors is a protective factor in the disease progression of chronic kidney disease (CKD). Measuring adherence can lead to the recognition of unhealthy behaviors and the suggestion of programs to prevent poor health outcomes. An assessment measurement for patients with CKD not requiring dialysis was developed and psychometrically tested. A convenience sample (n = 330) of patients with CKD attending a nephrology clinic in southern Taiwan completed the 13-item Adherence to Healthy Behaviors Scale (AHBS). A principal axis factor analysis and a parallel analysis demonstrated a three-factor structure accounting for 47.16% of the total variance. Confirmatory factor analysis indicated a good model fit. The criterion-related validity was adequate (r = .51; p < .000), with a Cronbach's alpha of .70; the test-retest reliability demonstrated good stability (r = .70; p < .000). The AHBS is a valid, reliable instrument to assess adherence to healthy behaviors among patients with CKD.