Parenting self-efficacy and parenting stress mediates the effects of the association of perceived social support and readiness for discharge among parents of children with primary nephrotic syndrome.

PURPOSE: To investigate the level of readiness for discharge among parents of children with primary nephrotic syndrome and to explore the mediating role of parenting self-efficacy and parenting stress between perceived social support and readiness for discharge. DESIGN AND METHODS: A cross-sectional study was conducted in five large tertiary general hospitals in Hunan, China. Data related to demographics, perceived social support, parenting self-efficacy, parenting stress, and readiness for discharge were collected from 350 parents of children diagnosed with primary nephrotic syndrome. Path analysis was used to determine the mediating roles of parenting self-efficacy and parenting stress in the relationship between perceived social support and readiness for discharge. RESULTS: Parents of children with nephrotic syndrome in China experienced low perceived social support, low readiness for discharge, and high parenting stress. Factors influencing readiness for discharge include the child's age, duration of illness, first episode or relapse, parental literacy and marital status. Parenting self-efficacy and parenting stress mediated the effects of the association of perceived social support and readiness for discharge. CONCLUSION: Perceived social support influences the readiness of parents of children with nephrotic syndrome. Parenting self-efficacy and parenting stress have a chain mediating effect of the association of perceived social support and readiness for discharge. PRACTICE IMPLICATIONS: This study emphasizes the mediating role of the psychological state of the child's parents. Nurses should take steps to increase perceived social support and parenting self-efficacy of the child's parents and to reduce parenting stress in order to improve readiness for discharge.

Chemical characteristics of long-term acid rain and its impact on lake water chemistry: A case study in Southwest China.

The chemical composition of acid rain and its impact on lake water chemistry in Chongqing, China, from 2000 to 2020 were studied in this study. The regional acid rain intensity is affected jointly by the acid gas emissions and the neutralization of alkaline substances. The pH of precipitation experienced three stages of fluctuating decline, continuous improvement, and a slight correction. Precipitation pH showed inflection points in 2010, mainly due to the total control actions of SO2 and NOx implemented in 2011. The total ion concentrations in rural areas and urban areas were 489.08 µeq/L and 618.57 µeq/L, respectively. The top four ions were SO42-, Ca2+, NH4+ and NO3-, which accounted for more than 90% of the total ion concentration, indicating the anthropogenic effects. Before 2010, SO42- fluctuated greatly while NO3- continued to rise; however, after 2010, both SO42- and NO3- began to decline rapidly, with the rates of -12.03 µeq/(L·year) and -4.11 µeq/(L·year). Because the decline rate of SO42- was 2.91 times that of NO3-, the regional acid rain has changed from sulfuric acid rain to mixed sulfuric and nitric acid rain. The lake water is weakly acidic, with an average pH of 5.86, and the acidification frequency is 30.00%. Acidification of lake water is jointly affected by acid deposition and acid neutralization capacity of lake water. Acid deposition has a profound impact on water acidification, and nitrogen (N) deposition, especially reduced N deposition, should be the focus of future research.

Feasibility and effect of emotional freedom therapy on sleep quality in patients with end-stage renal disease receiving maintenance hemodialysis: A pilot study.

OBJECTIVE: To explore the feasibility and efficacy of emotional freedom therapy (EFT) in improving sleep quality and managing negative emotions in end-stage renal disease patients on maintenance hemodialysis. METHODS: Between May 2021 and February 2022, 66 maintenance hemodialysis patients with sleep problems were recruited and randomized into an intervention and control group. The intervention group underwent a 12-week intervention of EFT. Two groups' hospital anxiety depression scale (HADS) scores, Pittsburgh sleep quality index (PSQI), and interdialysis weight gain (IDWG) before and one week after the formal intervention were collected and compared. Feasibility analysis was performed using a feasibility questionnaire and in-depth interviews with patients. RESULTS: Before the intervention, there was no statistical difference in the anxiety, depression, PSQI scores and IDWG between the two groups. After balancing the effects of gender and pre-intervention scores, two-way ANCOVA results showed that there were statistically significant differences between the two groups after the intervention in terms of anxiety, depression, sleep quality, sleep duration, daytime dysfunction and PSQI total score. However, interactions effect for IDWG was statistically significant. Simple effects analysis revealed a difference in post-intervention IDWG between the intervention and control groups for patients over 65 (p < 0.05). Most patients agreed or strongly agreed that the EFT was easy to schedule and they did not experience difficulties during learning the EFT process (respectively 75% and 71.88%). And 75% of the participants were willing to continue practicing EFT. Qualitative content analysis identified five prominent categories related to feasibility and acceptability: affirmation, benefits, communication, support and trust. CONCLUSION: EFT can relieve anxiety and depression, enhance sleep quality, and improve the physical condition of patients with end-stage renal disease receiving maintenance hemodialysis. As well, the EFT intervention is practicable, acceptable, and perceived as being beneficial to the patient.

ABCDEF pulmonary rehabilitation program can improve the mid-term lung function of lung cancer patients after thoracoscopic surgery: A randomized controlled study.

Background Pulmonary rehabilitation is recommended for most patients with lung diseases. However, some previous studies have shown that pulmonary rehabilitation has no obvious effect on short-term lung function in patients with lung cancer. Objective The purpose of this study was to evaluate the effect of the ABCDEF pulmonary rehabilitation program on lung cancer patients who have undergone surgery. Design This was a randomized controlled trial with repeated measures. Settings The study was conducted in the Cardiothoracic Surgery Department of a 4000-bed comprising training and research hospital from 2019 to 2020. Participants A total of 90 patients who underwent thoracoscopic pneumonectomy were divided into two groups of 45, using a completely randomized model. Methods Patients in the experimental group participated in an ABCDEF program (Acapella positive vibration pressure training, breathing exercise, cycling training, dance in the square, education, and follow-up) after surgery. In contrast, the regular care provided to the control group focused on breathing and expectoration guidance. The study outcomes were the first second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, 6 min walking distance, Borg score, incidence of postoperative complications, length of indwelling chest tube, and length of postoperative stay. Generalized estimating equation models were used to compare the changes in the outcomes between the groups over time. Results The ABCDEF pulmonary rehabilitation program for patients who underwent thoracoscopic pneumonectomy was found to be more effective in increasing lung function at 3 months after discharge (p<0.05). However, there was no statistically significant difference on the day of discharge (p>0.05). Exercise tolerance was different at both time points (p<0.05). The incidence of postoperative complications in the experimental group was lower than that in the control group (p<0.05). The length of postoperative stay in the experimental group was also shorter (p<0.05), however, the length of the indwelling chest tube was not significantly different between the intervention and control groups (p>0.05). Conclusions This study showed that the ABCDEF pulmonary rehabilitation program could effectively improve mid-term lung function and exercise tolerance in patients after thoracoscopic pneumonectomy, and reduce the incidence of postoperative complications along with the length of postoperative hospital stay.

Utilization and professionalism toward social media among undergraduate nursing students.

BACKGROUND: Social media has become an integrated part of nursing profession, requiring nursing students to develop confidentiality and professional fitness to practice. The aim of this study was to investigate nursing students' usage, professionalism and attitudes toward social media. METHODS: A cross-section study was conducted online among undergraduate nursing students (n = 654). Questionnaires of self-directed learning, self-efficacy and usage and views toward social media were administered. ETHICAL CONSIDERATIONS: Ethical approval was obtained from the Hubei University of Chinese Medicine. RESULTS: All participants were social media users. QQ (93.2%) was the most frequently used. 74.5% respondents spent 2-6 h on social media daily. The majority held positive attitudes toward social media. Year group and gender had influence on perceptions and attitudes toward social media. Furthermore, 81.5% students believed that social media positively influenced self-directed learning. Self-directed learning and learning motivation acted as predictors of the attitudes toward social media. Meanwhile, 67.3% students had posted personal photos and videos online, and 82.4% of them did not have privacy setting on social media. In addition,13.8% students attacked others or posted improper photos online. 22.9% participants witnessed improper posts from schoolmates or teachers, such as complaints about schoolmates or teachers (22.2%), foul language (11.1%), violence (3.9%), sexually suggestive photos (2.6%) and patient confidentiality (0.7%). In all, 15.0% respondents accepted "friend request" from patients. A total of 58.2% students were not aware of professional standards of behavior online for health care providers. In addition, 52.3% participants insisted that it is essential to develop social media and professionalism course for nursing students. CONCLUSION: Nursing students use social media extensively. Some students are at risk of carrying out unprofessional behavior which have detrimental effects on students' future opportunities. This suggests that best practices and training in nurse education should be implemented to help students to be informed of professionalism.

[Emotion Recognition Based on Multiple Physiological Signals].

Emotion is a series of reactions triggered by a specific object or situation that affects a person's physiological state and can, therefore, be identified by physiological signals. This paper proposes an emotion recognition model. Extracted the features of physiological signals such as photoplethysmography, galvanic skin response, respiration amplitude, and skin temperature. The SVM-RFE-CBR(Recursive Feature Elimination-Correlation Bias Reduction-Support Vector Machine) algorithm was performed to select features and support vector machines for classification. Finally, the model was implemented on the DEAP dataset for an emotion recognition experiment. In the rating scale of valence, arousal, and dominance, the accuracy rates of 73.5%, 81.3%, and 76.1% were obtained respectively. The result shows that emotional recognition can be effectively performed by combining a variety of physiological signals.

Societal and individual determinants in the enrollment of personal health records: A preliminary investigation from China.

BACKGROUND: Although personal health records (PHRs) have many benefits, how to effectively enroll them is a worldwide concern, especially in developing countries, and there has been little research targeting both societal and individual factors that affect the enrollment of PHRs. OBJECTIVE: To provide evidence and recommendations for the sustainable development of PHRs combined societal and individual determinants. METHODS: A cross-sectional door-to-door survey was conducted with a sample of 1100 individuals aged 15 and older in central China. The main measure was whether residents had enrolled in PHRs through the CHS. RESULTS: While the overall rate of PHR enrollment was only 27.93%, the willingness to enroll in PHRs among survey participants was much higher (75.86%). Statistically significant variables among societal level were proportion of acquaintances with PHRs and informed consent (OR = 17.09, OR = 31.06, respectively) and among individual level were age, education level, presence of doctor-diagnosed hypertension, and willingness to enroll in PHRs. CONCLUSIONS: Societal determinants would reveal the positive role of psychological bandwagon effect and the ethical principle of informed consent in enrolling PHRs, and individual determinants would reveal the priority demographics for enrolling PHRs, notably the elderly, those with a higher education level and hypertensive patients.

The effects of family structure and function on mental health during China's transition: a cross-sectional analysis.

BACKGROUND: Social change, intensified by industrialization and globalization, has not only changed people's work lives but also their personal lives, especially in developing countries. The aim of this study was to provide evidence and recommendations regarding family structure, function, and mental health to actively respond to rapid social change. METHODS: A cross-sectional survey was conducted face-to-face and door-to-door from July 2011 to September 2012 in Hubei Province, central China. Family structure comprised alone, couple, nuclear family, and extended family; family function was measured using the family APGAR (Adaptation, Partnership, Growth, Affection, and Resolve) scale, and mental health was measured using the Chinese version of the 12-item General Health Questionnaire (GHQ-12). RESULTS: The urban-vs-rural difference of family structure among alone, couple, nuclear family, and extended family was statistically significant (5.21% vs 4.62%; 27.36% vs 13.14%; 33.22% vs 27.74%; 34.20% vs 54.50%, respectively; p < 0.0001); and those difference of family function was not statistically significant (8.11 ± 2.13 vs 8.09 ± 2.27, p = 0.9372). The general linear regression showed that the effect of family structure on mental health, whether urban or rural, was not significant, however, the effect of family function was significant, especially regarding better family functioning with better mental health. CONCLUSIONS: Combined the effects of family structure and function on mental health, the external form of family (family structure) may not be important; while the internal quality of role (family function) might be key. Improving the residents' family function would be a priority strategy for family practice with their mental health.

Understanding the rise of Yinao in China: A commentary on the little known phenomenon of healthcare violence.

Yinao (healthcare disturbance) refers to violent incidents directed against healthcare staff and facilities for financial benefit. In China, incidences of Yinao are widespread and increasing, but little is known of this phenomenon in the wider global community. This commentary investigates the factors behind Yinao to achieve a deeper understanding. Causes include a lack of trust in medical staff, fueled by costly medical expenses; difficulties in accessing treatment; poor treatment outcomes; high patient expectations; a misunderstanding or rejection of medical ethics; misleading media reports; and a complex appeals process. Both doctors and nurses have been the targets of violent and distressing Yinao events, resulting in emotional pain, physical injury, and even death. In response, hospitals have established a series of preventative measures and and the government has increased the penalties for perpetrators of acts of Yinao. The situation is a salient reminder to policymakers worldwide of the importance of an accessible, affordable, and equitable health system.

Work characteristics and psychological symptoms among GPs and community nurses: a preliminary investigation in China.

OBJECTIVE: To determine the effect of work characteristics on the psychological symptoms of general practitioners' (GPs) and community nurses. DESIGN, SETTING AND PARTICIPANTS: A stratified sampling cross-sectional survey was performed at the 12 community health services centres involved 233 GPs and 202 community nurses in three cities of Hubei Province in central China. The independent variables were career prospects, superior recognition, salary fairness, professional-patient relationship and self-perceived workload. The dependent variables were the General Health Questionnaire. RESULTS: The generalized linear regression showed the career prospects had a significant association with GPs' psychological health, whereas career prospects, self-perceived workload and superior recognition had significant association on the psychological health of community nurses. However, salary fairness and professional-patient relationship were not statistically significant for GPs or community nurses. CONCLUSIONS: A better understanding of the effects of career prospects on the psychological health of GPs and community nurses, and improvements in superior recognition and workload on the psychological health of community nurses, would improve psychological symptoms of primary-level medical staff.

Effect of intergenerational and intragenerational support on perceived health of older adults: a population-based analysis in rural China.

BACKGROUND: The family, together with the individual and society, and the state and market are the three pillars of well-being and social security over the life course, with responsibility for the health of older adults. OBJECTIVE: The aim of current study was to explore the effect of intergenerational and intragenerational support on perceived health of older adults. METHODS: A cross-sectional survey with 64.36% (1318/2048) response rate was conducted door to door in rural China with a sample of 1318 individuals aged 60 years and older. There were three sets of independent variables: intergenerational support from children as well as intragenerational spousal support and intragenerational sibling support, sociodemographic variables, and behaviour variables. Multiple logistic regression analysis was used to analyse the influence of family member support on physical and psychological health. RESULTS: After adjusting for potential confounding variables (sociodemographic variables and behaviour variables), it was observed that intergenerational support from children had a significant effect on the self-rated physical health and psychological health of older adults [odds ratios (OR) = 1.48, 95% confidence interval (CI): 1.10-2.00; OR = 1.82, 95% CI: 1.36-2.44, respectively]. However, intragenerational support from spouse and siblings was not significant. CONCLUSION: The importance of intergenerational support from children would suggest that family practice and health-related policy of older adults may need to be extended to their children. With the rapid development of global population movements, family practices need to pay attention to the changes of family support among migrant families.

[Determination of metal elements in PM2. 5 by ICP-OES with microwave digestion].

In the present work, a method was developed for determining lead, zinc, copper, cadmium, znd chromium in PM2. 5 by inductively coupled plasma-optical emission spectrometry (ICP-OES) analysis with microwave digestion and glass fibre filter collection of samples. The microwave digestion systems were investigated and the experimental conditions were optimized. The results show that (1) HNO3-H2O02 digestion system is more stable and complete than HNO3-HCl and HNO3-H2 SO4 digestion systems; (2) The most sensitive emission wave length of lead, zinc, copper, cadmium, and chromium are 220.353, 213.857, 327.393, 228.802, and 267.716 nm, respectively; (3) The highest signal-to-noise ratios were observed under the conditions: RF power of 1 300 W, peristaltic pump flow rate of 1.5 mL x min(-1), cooling gas flow rate of 15 L x min(-1), and carrier gas flow rate of 0.8 L x min(-1). In addition, the detection limit for these elements ranged between 2.02 x 10(-3) and 8.20 x 10(-3(µg x mL(-1), the relative standard deviations (RSD, n = 6) for the samples were in the range of 1.86%-2.82%, and the recovery for the elements determined was from 91.6% to 103.7%. The proposed method was used for determination of the above five elements in atmospheric fine particulate matter at Wanzhou Monitoring Site of Chongqing Institute of Green and Intelligent Technology. The results revealed that the atmospheric fine particulate matter at this monitoring site was not polluted by cadmium and chromium, lead was at the level of potential contamination, while zinc and copper were at the level of slight pollution.

Leaching kinetics and bioaccumulation potential of additive-derived organophosphate esters in microplastics.

Considerable research has been conducted to evaluate microplastics (MPs) as vehicles for the transfer of hazardous pollutants in organisms. However, little effort has been devoted to the chemical release of hazardous additive-derived pollutants from MPs in gut simulations. This study looked at the leaching kinetics of organophosphate esters (OPFRs) from polypropylene (PP) and polystyrene (PS) MPs in the presence of gut surfactants, specifically sodium taurocholate, at two biologically relevant temperatures for marine organisms. Diffusion coefficients of OPFRs ranged from 1.71 × 10-20 to 4.04 × 10-18 m2 s-1 in PP and 2.91 × 10-18 to 1.51 × 10-15 m2 s-1 in PS. The accumulation factors for OPFRs in biota-plastic and biota-sediment interactions ranged from 1.52 × 10-3-69.1 and 0.02-0.7, respectively. Based on B3LYP/6-31G (d,p) calculations, the biodynamic model analysis revealed a slight increase in the bioaccumulation of OPFRs at a minor dose of 0.05% MPs. However, at higher concentrations (0.5% and 5% MPs), there was a decrease in bioaccumulation compared to the lower concentration for most OPFR compounds. In general, the ingestion of PE MPs notably contributed to the bioaccumulation of OPFRs in lugworms, whereas the contribution of PP and PS MPs was minimal. This could vary among sites exhibiting varying levels of MP concentrations or MPs displaying stronger affinities towards chemicals.

Determination of major drive of ozone formation and improvement of O3 prediction in typical North China Plain based on interpretable random forest model.

O3 pollution in China has become prominent in recent years, and it has become one of the most challenging issues in air pollution control. We used data on atmospheric pollutants and meteorology from 2019 to 2021 to build an interpretable random forest (RF) model, applying this model to predict O3 concentration in 2022 in five cities in the Southwest North China Plain. The model was also used to identify and explain the influence of various factors on O3 formation. The correlation coefficient R2 between the predicted O3 concentration and observed O3 concentration was 0.82, the MAE was 15.15 µg/m3, and the RMSE was 20.29 µg/m3, indicating that the model can effectively predict O3 concentration in the studying area. The results of correlation analysis, feature importance, and the driving factor analysis from SHapley Additive exPlanations (SHAP) model indicated that temperature (T), NO2, and relative humidity (RH) are the top three features affecting O3 prediction, while the weights of wind speed and wind direction were relatively low. Thus, O3 in the southwestern North China Plain may mainly come from the formation of local photochemical activities. The dominant factors behind O3 also varied in different seasons. In spring and autumn, O3 pollution is more likely to occur under high NO2 concentration and high-temperature conditions, while in summer, it is more likely to occur under high-temperature and precipitation-free weather. In winter, NO2 is the dominant factor in O3 formation. Finally, the interpretable RF model is used to predict future O3 concentration based on features provided by Community Multiscale Air Quality (CMAQ) and Weather Research & Forecast (WRF) model, and the simulation performance of CMAQ on O3 concentration is enhanced to a certain extent, improving the prediction of future O3 pollution situations and guiding pollution control.

Correlations between activation, family adaptation, and self-perceived burden in breast cancer patients with an implanted venous access port: A cross-sectional study.

We found that activation and family adaptation on the self-perceived burden of breast cancer patients with an implanted venous access port (IVAP), and to analyze the correlations among these scores. A total of 256 patients completed a general data questionnaire, the Patient Activation Measure (PAM), the Family adaptation and Cohesion Scale II-Chinese version (FACES-II-CV), and the Self-perceived Burden Scale (SPBS). The total scores for activation, family adaptation, and self-perceived burden were 63.31 ± 18.92, 42.72 ± 7.937, and 28.55 ± 7.89, respectively. We analyzed activation and family adaptation were associated with self-perceived burden (P < .05) the patients' self-perceived burden main factors is included Main caregiver, disease stage, complications, Type of health insurance, activation, and family adaptation. The activation, family adaptation, and self-perceived burden of breast cancer patients with an IVAP are closely related, which suggests that clinical workers should consider the patient family to formulate an intervention plan to improve patient activation, and thus reduce the self-perceived burden. For example, hospitals regularly conduct breast cancer health education activities, or invite psychological counselors to provide services to patients.

Age and sex-specific differences of mindfulness traits with measurement invariance controlled in Chinese adult population: A pilot study.

Objectives: To examine the relationships of age and sex with mindfulness traits among Chinese adults with controlling for measurement invariance. Methods: A total of 1777 participants completing the Five-Facet Mindfulness Questionnaire were included for analysis. Their age and sex information were also collected. Descriptive analysis, Pearson's Chi-Square test and analysis of variance were performed to test the age- and sex-specific differences, measurement invariance was examined by confirmatory factor analysis. Results: Excellent data fit to the model indicated configural, metric, and scalar invariance across age and sex. Participants aged 60 or above scored significantly higher in dimensions of acting with awareness, nonjudging of inner experience, nonreactivity to inner experience, and the total scores than younger individuals, who had higher scores in the observing domain. In addition, females scored higher in describing and observing than males, while the latter had higher score in nonreactivity to inner experience. Conclusions: The Five-Facet Mindfulness Questionnaire Mindfulness showed acceptable measurement invariance across age and sex in Chinese adult population. The old and the young differs in the traits of awareness, observing, nonjudging of inner experience, nonreactivity to inner experience and the total mindfulness level, while males and females varied in describing, observing and nonreactivity to inner experience. Individual differences should be considered and well addressed in future studies on mindfulness.

Fus3/Kss1-MAP kinase and Ste12-like control distinct biocontrol-traits besides regulation of insect cuticle penetration via phosphorylation cascade in a filamentous fungal pathogen.

BACKGROUND: Homolog of the yeast Fus3/Kss1 mitogen-activated protein kinase (MAPK) pathway and its target transcription factor, Ste12-like, are involved in penetration of host cuticle/pathogenicity in many ascomycete pathogens. However, details of their interaction during fungal infection, as well as their controlled other virulence-associated traits, are unclear. RESULTS: Ste12-like (BbSte12) and Fus3/Kss1 MAPK homolog (Bbmpk1) interacted in nucleus, and phosphorylation of BbSte12 by Bbmpk1 was essential for penetration of insect cuticle in an insect fungal pathogen, Beauveria bassiana. However, some distinct biocontrol-traits were found to be mediated by Ste12 and Bbmpk1. In contrast to ΔBbmpk1 colony that grew more rapid than wild-type strain, inactivation of BbSte12 resulted in the opposite phenotype, which was consistent with their different proliferation rates in insect hemocoel after direct injection of conidia bypass the cuticle. Reduced conidial yield with decreased hydrophobicity was examined in both mutants, however they displayed distinct conidiogenesis, accompanying with differently altered cell cycle, distinct hyphal branching and septum formation. Moreover, ΔBbmpk1 showed increased tolerance to oxidative agent, whereas the opposite phenotype was seen for ΔBbSte12 strain. RNA sequencing analysis revealed that Bbmpk1 controlled 356 genes depending on BbSte12 during cuticle penetration, but 1077 and 584 genes were independently controlled by Bbmpk1 and BbSte12. CONCLUSION: BbSte12 and Bbmpk1 separately participate in additional pathways for control of conidiation, growth and hyphal differentiation, as well as oxidative stress response besides regulating cuticle penetration via phosphorylation cascade. © 2023 Society of Chemical Industry.

The effects of body scan meditation: A systematic review and meta-analysis.

Standardized mindfulness-based stress reduction (MBSR) has been proved to be effective across many populations while the time commitment for the standardized intervention leads to high attrition rate. To address the problem, there has been a growing interest in conducting a single component of MBSR such as body scan. However, the impact of a sole mindfulness-based intervention (MBI) remains unclear. The aim of this study was to investigate the effects of body scan meditation. A search of databases, including PubMed, Embase, EBSCO, Cochrance, Proquest Dissertations, and Theses, was conducted for randomized controlled trials with no population restriction. Fourteen independent articles were identified and outcomes were divided into seven categories. A meta-analysis with robust variance estimation was conducted separately for different outcome categories. Body scan only had small effect on mindfulness when compared with passive control (Hedge's g = .268, 95% CI = [0.032, 0.504], p < .05). The attrition rate of long-term interventions was low. The quality of these studies was low. There was high heterogeneity across studies. A sole body scan meditation is not effective enough to improve health-related outcomes.

Influences of Heider Balance on Knowledge, Attitude, Practice, and Quality of Life in Bladder Cancer Patients after Urinary Diversion.

Objective: To explore the influences of Heider balance on knowledge, attitude, practice (KAP), and quality of life in bladder cancer patients after urinary diversion. Methods: A set of bladder cancer patients after urinary diversion in our hospital from January 2016 to December 2020 were included in this study. Patients who received out-hospital intervention based on Heider balance were included in the observation group (85 cases). Meanwhile, patients who received routine out-hospital intervention were included in the control group (85 cases), and these patients matched with the observation group by gender, age, and education level. The scores of KAP, WHO quality of life-100 (WHOQOL-100) before discharge and at 6 months after discharge, and the rate of complications were compared in the two groups. Results: At 6 months after discharge, the score of these items of KAP including basic knowledge of disease, procedure of pouch replacement, dealing with pouch leakage, skin care of stoma, purchase and storage of pouch, dealing with stoma complications, optimistic mentality for disease, optimistic mentality for stoma, trust in medical staff, willingness to correct bad habits, confidence in maintaining health behavior, maintaining in health dietary habit, maintaining in health behavior, learning from relevant books, learning from relevant videos, experienced in pouch replacement, and experienced in care of stoma of the observation group were significantly higher than those of the control group (t = 6.144, 9.366, 3.129, 3.809, 4.173, 5.923, 2.788, 8.871, 3.291, 10.797, 7.067, 7.805, 3.828, 9.454, 2.827, 4.059, and 8.662, respectively, all P < 0.05). The scores of 16 items of WHOQOL-100 such as energy and fatigue, sleep and rest, positive feelings, thinking, learning, memory and concentration, self-esteem, body image and appearance, negative feelings, mobility, activities of daily living, dependence on medical support, personal relationships, social support, health and social care: availability and quality, opportunities to get new information/skills, opportunities for recreation and leisure, and quality of life from viewpoint in the observation group were significantly higher than those in the control group (t = 2.666, 2.571, 2.961, 3.453, 4.279, 2.781, 3.775, 4.807, 5.850, 4.194, 3.324, 3.873, 5.118, 3.244, 2.956, and 4.218, respectively, all P < 0.05). The rate of complications of the observation group was significantly lower than that of the control group (x 2 = 5.829, P < 0.05). Conclusion: The Heider balance can help to reduce the rate of complications, improve knowledge, attitude, practice, and quality of life in urinary diversion patients. These merits make it an attractive approach in guidance of out-hospital intervention.

The efficacy and safety of microwave ablation versus conventional open surgery for the treatment of papillary thyroid microcarcinoma: a systematic review and meta-analysis.

Background: Microwave ablation (MWA) technology has been applied to the treatment of papillary thyroid microcarcinoma (PTMC); however, its use as an alternative to conventional open surgery (OS) remains controversial, because it belongs to non-tumor radical treatment. Our article sought to compare the efficacy and safety of MWA and OS in the treatment of PTMC. Methods: We searched seven databases for studies evaluating the treatment of patients with PTMC using MWA as intervention group and OS as control group, the main outcome contained intra-operative, post-operative and follow-up outcomes. Review Manager 5.4 was used to estimate the effects of the results of the included articles and Cochrane Risk of Bias 2.0 was used to assess the risk of bias. The data were pooled to calculate the mean differences (MD) with 95% confidence intervals (CIs) for the continuous data and the odds ratio (OR) with 95% CIs for the dichotomous data. Results: A total of 13 studies, comprising 1,088 and 1,081 patients in the MWA and OS groups, respectively, were identified that compared the results of MWA to OS in the treatment of PTMC. All of the articles were at low risk of bias. There were no differences in terms of the recurrence rate (OR =0.80, 95% CI: 0.37 to 1.77; P=0.59) or lymph node metastasis (OR =0.71, 95% CI: 0.26 to 1.95; P=0.51) between the 2 groups. However, compared to the OS group, the MWA group had a shorter operation time (MD =-44.85, 95% CI: 5.73 to 20.68; P<0.00001), less intra-operative blood loss (MD =-23.37, 95% CI: -29.57 to -17.17; P<0.00001), a smaller surgical incision (MD =-47.04, 95% CI: -81.93 to -12.14; P=0.008), a shorter postoperative hospital stay (MD =-4.19, 95% CI: -5.46 to -2.92; P<0.00001), lower hospitalization expenses (MD =-85.65, 95% CI: -133.86 to -37.45; P<0.00001), and fewer complications (OR =0.23, 95% CI: 0.16 to 0.33; P<0.00001). Conclusions: This meta-analysis suggests that MWA is better than OS at treating PTMC in terms of both intra-operative and post-operative outcomes. Due to the quality and number of the included studies, the long-term effects and suitability of MWA in the treatment of PTMC need to be further studied.