Self-reported confidence in patient safety competencies among Chinese nursing students: a multi-site cross-sectional survey.

BACKGROUND: Nursing interns are an important backup force for nursing professionals, so efforts to strengthen their patient safety (PS) competencies are a major priority. To do so requires assessing the strengths and weaknesses of Chinese nursing students' PS competence and identifying the influencing factors. METHODS: This was a multi-site, cross-sectional, web-based study that was carried out between September 2018 and January 2019. A national online survey was completed by 732 Chinese undergraduate nursing students. Our primary outcome factor was the Health Professional Education in Patient Safety Survey score. We also collected socio-demographic and clinical practice-related characteristics as independent variables. Multiple stepwise linear regression was performed to identify predictors of PS competence. RESULTS: Chinese undergraduate nursing students were fairly confident in their clinical safety skills but less confident in what they learned about sociocultural or context-dependent aspects of PS and speaking up about PS, including effective communication and understanding human and environmental factors. Less than half of the students felt that they could approach someone engaging in unsafe practice and were reluctant to voice concern about adverse events. We observed significant differences in PS competence between students from different regions, across different PS learning styles (self-study and classroom theoretical study), with different self-assessed PS competence levels, and with experiences of adverse events (p < 0.05). These factors accounted for almost 15% of the total variance in PS competence scores (adjusted R2 = 0.15, p = 0.00). CONCLUSIONS: The results of this study provide a better understanding of PS competence among final-year nursing students in China. Our findings may help nursing educators or healthcare organizations to cultivate and improve PS competence by establishing documented policies or by improving the efficacy of intervention.

Comprehension of figurative language in Taiwanese children with autism: The role of theory of mind and receptive vocabulary.

First-order theory of mind (ToM) is necessary for comprehension of metaphors, and second-order ToM is necessary for comprehension of irony. This study investigated the role of ToM and language ability in comprehending figurative language in 50 Taiwanese children with high-functioning autism spectrum disorders (HFASDs) compared with 50 typically developing children. Results showed that the No-ToM HFASDs group performed worse than the first-order ToM HFASDs group and the second-order ToM HFASDs group in comprehension of metaphors, irony, sarcasm and indirect reproach, but not for indirect request. Receptive vocabulary correlated only with metaphor comprehension. The volatility of results seen among studies in terms of the relationship between ToM and figurative language comprehension is discussed.

[Project to attain the ideal caloric intake level in critical patients within a 72-hour period].

BACKGROUND & PROBLEMS: Early enteral nutrition and receiving more than 70% of the ideal caloric intake level has been shown to reduce patient infection rates, duration of hospital stays, and mortality. Only 40.6% of patients in our surgical intensive care unit were achieving the ideal caloric intake level. PURPOSE: This project was designed to raise the ratio of those achieving an ideal caloric intake level from 40.6% to 70%. RESOLUTIONS: Strategies included: (1) providing education related to nutrition, (2) establishing an enteral nutrition flowchart and popularizing and carrying out the enteral nutrition flowchart, (3) discussing together with doctors and nutritionists about feeding conditions, and (4) revising standard procedures for the NG feeding of critical patients. RESULTS: Seventy percent of patients in the surgical intensive care unit achieved their ideal caloric intake level after implementation of this intervention. CONCLUSIONS: This project used interdisciplinary cooperation to improve caloric intake among patients in the surgical intensive care unit. The intervention and results may be used as a reference by hospitals for improving patient caloric intake and hospital quality of care.

Responses to Wh-, Yes/No-, A-not-A, and choice questions in Taiwanese children with high-functioning autism spectrum disorder.

The present study investigated the hypothesis that children with high-functioning autism spectrum disorder (HFASD) have a greater difficulty in responding to Wh- than Yes/No questions across languages. Conversations between Taiwanese children and their mothers were investigated and the children's response adequacy to maternal questions in a semi-structured setting were examined. Twelve Taiwanese children with HFASD, ranging in age from 7.1 to 14.9 years old, were compared with 12 typically developing (TD) children matched on age, sex, IQ and mean length of utterance in syllable (MLUs). Compared to TD children, HFASD children produced more inadequate or inappropriate responses to Wh- and Yes/No questions than to A-not-A and Choice questions. Taiwanese HFASD children share a greater difficulty in responding to maternal Wh-questions with their Japanese counterparts and do not show a relative ease in responding to Yes/No questions, while A-not-A and Choice questions were easier to respond to for the Taiwanese children.

Sleeping and Dietary Factors Associated with Chronic Fatigue Syndrome in Taiwanese Preschoolers.

The purpose of this research was to investigate the sleeping and dietary factors associated with the prevalence of chronic fatigue syndrome among Taiwanese preschoolers. Five-year-old preschoolers were randomly selected using a stratified multistage random cluster sampling method. The parents of the preschoolers completed a questionnaire containing items related to symptoms of fatigue and sleeping and dietary habits among the preschoolers. A total of 1536 valid questionnaires were returned. After obtaining the data, the researchers analyzed them using descriptive statistics and a chi-square test. The following results were obtained: (1) chronic fatigue syndrome was typically indicated by yawning during the day, feeling tired, and appearing sleepy; (2) the preschoolers with high sleep quality, adequate sleeping time, and a regular sleep schedule exhibited a lower degree of fatigue; (3) half of the preschoolers who ate three nutritionally balanced meals a day at a regular time exhibited a lower degree of fatigue. Among the three dimensions studied, fatigue was most strongly associated with the "sleepy and inactive/blunted responses/lacking in energy" dimension, followed by the "difficulty concentrating" dimension, and, finally, the "localized pain" dimension. In this study, the association between sleeping habits and symptoms of fatigue in preschool children was verified. The associations of dietary factors with symptoms of fatigue were not confirmed. It is suggested that parents establish a good sleep schedule for preschool children based on the study findings.

Study on Sports, Extracurricular Activities, Electronic Device Usage Factors Associated with Chronic Fatigue Syndrome in Taiwanese Preschoolers.

Under the impact of the pandemic, electronic device usage has become the primary tool for learning. Due to social distancing restrictions, many sports facilities have been forced to close, resulting in changes in daily activities for preschool children. This research aimed to investigate the sports, extracurricular activities, and electronic device usage factors associated with chronic fatigue syndrome among Taiwanese preschoolers. Five-year-old preschoolers were randomly selected using a stratified multi-stage random cluster sampling method. The parents of the preschoolers completed the questionnaires, which contained items related to the symptoms of fatigue, extracurricular activities, and electronic device usage of their preschoolers. A total of 1536 valid questionnaires were returned. The data were then analyzed using descriptive statistics and the chi-square test. The following results were obtained: (1) the preschoolers who exercised at least three times per week, engaged in sweating exercise for at least 30 min at a time, had a continuous rhythmic exercise habit, and participated in a variety of exercise types experienced a lower degree of fatigue; (2) the preschoolers who engaged in extracurricular activities every day exhibited a higher degree of fatigue; (3) the preschoolers who watched television or used smartphones to pass the time due to boredom, watched television or used smartphones on holidays, played video games or surfed the Internet due to boredom, and played video games or surfed the Internet on holidays displayed a higher degree of fatigue. This research verified that regular exercise with various sports, extreme extracurricular activities, and laissez-faire electronic device usage are factors associated with fatigue syndrome in preschoolers. It is suggested to develop children's regular exercise habits, avoid excessive extracurricular activities, and guide their electronic device usage.

Analysis of mental health status and related factors in patients with acute cerebral infarction.

BACKGROUND: Acute cerebral infarction (ACI) is characterized by a high incidence of morbidity, disability, recurrence, death and heavy economic burden, and has become a disease of concern in global researchers. As ACI has serious effects on patients' physical status, life and economy, often causing anxiety, depression and other psychological problems, these problems can lead to the aggravation of physical symptoms; thus, it is very important to understand the factors affecting the mental health of these patients. AIM: To understand the elements that affect the mental health of patients who have suffered an ACI. METHODS: A questionnaire survey was conducted among patients with ACI admitted to three tertiary hospitals (Quanzhou First Hospital, Fuqing City Hospital Affiliated to Fujian Medical University, and the 900 Hospital of the Joint Service Support Force of the People's Liberation Army of China) in Fujian Province from January 2022 to December 2022 using the convenience sampling method. ACI inpatients who met the inclusion criteria were selected. Informed consent was obtained from the patients before the investigation, and a face-to-face questionnaire survey was conducted using a unified scale. The questionnaire included a general situation questionnaire, Zung's self-rating depression scale and Zung's self-rating anxiety scale. All questionnaires were checked by two researchers and then the data were input and sorted using Excel software. The general situation of patients with ACI was analyzed by descriptive statistics, the influence of variables on mental health by the independent sample t test and variance analysis, and the influencing factors on psychological distress were analyzed by multiple stepwise regression. RESULTS: The average age of the 220 patients with ACI was 68.64 ± 10.74 years, including 142 males and 78 females. Most of the patients were between 60 and 74 years old, the majority had high school or technical secondary school education, most lived with their spouse, and most lived in cities. The majority of patients had a personal income of 3001 to 5000 RMB yuan per month. The new rural cooperative medical insurance system had the largest number of participants. Most stroke patients were cared for by their spouses and of these patients, 52.3% had previously smoked. Univariate analysis showed that gender, age, residence, course of disease, number of previous chronic diseases and smoking history were the main factors affecting the anxiety scores of patients with ACI. Age, living conditions, monthly income, course of disease and knowledge of disease were the primary variables influencing the depression score in patients with ACI. The findings of multivariate analysis revealed that the course of disease and gender were the most important factors influencing patients' anxiety scores, and the course of disease was also the most important factor influencing patients' depression scores. CONCLUSION: Long disease course and female patients with ACI were more likely to have psychological problems such as a high incidence of emotional disorders. These groups require more attention and counseling.

Pachymic acid stimulates glucose uptake through enhanced GLUT4 expression and translocation.

In an effort to investigate the effect and mechanism of Poria cocos on glucose uptake, six lanostane-type triterpenoids were isolated and analyzed. Among them, pachymic acid displayed the most significant stimulating activity on glucose uptake in 3T3-L1 adipocytes. The effect of pachymic acid on the expression profile of glucose transporters in differentiated 3T3-L1 adipocytes was also analyzed. Our results demonstrated that pachymic acid induced an increase in GLUT4, but not GLUT1, expression at both the mRNA and protein levels. The role of GLUT4 was further confirmed using the lentiviral vector-derived GLUT4 short hairpin RNA (shRNA). The stimulating activity of pachymic acid on glucose uptake was abolished when the endogenous GLUT4 expression was suppressed in 3T3-L1 adipocytes. In addition to increased GLUT4 expression, pachymic acid stimulated GLUT4 redistribution from intracellular vesicles to the plasma membrane in adipocytes. Exposure of the differentiated adipocytes to pachymic acid increased the phosphorylation of insulin receptor substrate (IRS)-1, AKT and AMP-activated kinase (AMPK). The involvement of PI3K and AMPK in the action of pachymic acid was further confirmed as PI3K and AMPK inhibitors completely blocked the pachymic acid-mediated activities in adipocytes. In addition, pachymic acid was shown to induce triglyceride accumulation and inhibit lipolysis in differentiated adipocytes. Taken together, we demonstrated the insulin-like activities of this compound in stimulating glucose uptake, GLUT4 gene expression and translocation, and promoting triglyceride accumulation in adipocytes. Our study provides important insights into the underlying mechanism of hypoglycemic activity of P. cocos.

Effect and mechanism of ginsenosides CK and Rg1 on stimulation of glucose uptake in 3T3-L1 adipocytes.

The glucoregulatory activities of ginsenosides compound K (CK) and Rg1 were investigated in 3T3-L1 adipocytes. Both compounds significantly enhanced glucose uptake in 3T3-L1 adipocytes in a dose-response manner, which is correlated with increased GLUT4 translocation from intracellular vesicles to the plasma membrane in adipocytes. The stimulating effects of CK and Rg1 on glucose uptake and GLUT4 translocation are associated with activation of AMP-activated protein kinase (AMPK) and phosphatidylinositol 3-kinase (PI3K) signaling pathways; both are key pathways in mediating glucose uptake in animal cells. In addition to the acute stimulus effect of glucose uptake, prolonged incubation of CK and Rg1 significantly induced GLUT4, but not GLUT1, expression at both the mRNA and protein levels in 3T3-L1 adipocytes. Further studies showed that CK inhibited and Rg1 enhanced triglyceride accumulation in adipocytes, suggesting that the mechanism of action of these ginsenosides may not be completely identical. In summary, this study demonstrated insulin-like activities of CK and Rg1 in adipocytes. These findings are important in understanding the hypoglycemic properties and potential applications of ginseng and ginsenosides.