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Anemia is a global public health problem, especially common among children in developing countries, which affects their physical and mental health development. However, there is currently a lack of research on the relationship between anemia and academic performance. The objective of this study was to explore the association between anemia and academic performance, and the possible factors mediating this association among Chinese children. The data for this study came from the baseline survey of the Chinese Education Panel Survey Elementary School Cohort. The cohort was conducted from September 2018 to June 2019 in 160 elementary schools, covering 20 provinces and 40 counties/districts throughout China. Paper-based questionnaires were used, completed by 4th grade students, parents, head teachers, main teachers, and principals. The data used included questionnaire responses, physical measurements, and academic performance of 17,695 students. Based on students' hemoglobin levels and school altitude data, we grouped them into anemia and nonanemia categories using WHO criteria. The anemia group had 1,154 individuals, while the nonanemia group had 16,541 individuals. An ordinary least squares regression and mediation effect analysis were conducted. Our findings found the prevalence of anemia was 6.52% among Chinese Grade 4 students. Students without anemia had a higher average test score for three academic subjects than students with anemia (P < 0.001); their test scores for Chinese, Mathematics, and English were also higher (P < 0.05). Multivariate regression analysis showed a negative association between anemia and average test scores as well as individual test scores for the three subjects. Mediation analysis found that anemia affected academic performance directly (P < 0.05), and indirectly by decreasing the cognition score (P < 0.05). The indirect effect was 19.9% of the total effect. Findings highlighted anemia affected academic performance both directly and indirectly. Nutrition-related interventions should be implemented to prevent a decrease in academic performance among students with anemia. [ABSTRACT FROM AUTHOR]

This paper provides an in-depth analysis of timbre-speech spectrograms in instrumental music, designs a model analysis of rehabilitation occupational therapy techniques based on the analysis of timbre-speech spectrograms in instrumental music, and tests the models for comparison. Starting from the mechanism of human articulation, this paper models the process of human expression as a time-varying linear system consisting of excitation, vocal tract, and radiation models. The system's overall architecture is designed according to the characteristics of Chinese speech and everyday speech rehabilitation theory (HSL theory). The dual judgment of temporal threshold and short-time average energy realized the phonetic length training. Tone and clear tone training were achieved by linear predictive coding technique (LPC) and autocorrelation function. Using the DTW technique, isolated word speech recognition was achieved by extracting Mel-scale Frequency Cepstral Coefficients (MFCC) parameters of speech signals. The system designs corresponding training scenes for each training module according to the extracted speech parameters, combines the multimedia speech spectrogram motion situation with the speech parameters, and finally presents the training content as a speech spectrogram, and evaluates the training results through human-machine interaction to stimulate the interest of rehabilitation therapy and realize the speech rehabilitation training of patients. After analyzing the pre- and post-test data, it was found that the p -values of all three groups were <0.05, which was judged to be significantly different. Also, all subjects changed their behavioral data during the treatment. Therefore, it was concluded that the music therapy technique could improve the patients' active gaze communication ability, verbal command ability, and active question-answering ability after summarizing the data, i.e., the hypothesis of this experiment is valid. Therefore, it is believed that the technique of timbre-speech spectrogram analysis in instrumental music can achieve the effect of rehabilitation therapy to a certain extent. [ABSTRACT FROM AUTHOR]

To explore the effects of social support on the mental health of older adults in different age groups in China, and to provide reference for the development of social support policies to promote the mental health of older adults in China. This paper uses a random sampling method to conduct a questionnaire survey of 3,000 older adults aged 60 years or older in Nanjing and a dichotomous logistic regression model for empirical analysis. The two dimensions of mental health and social adjustment were used to measure the mental health status of the elderly. The results showed that the overall mental health status of the elderly in Nanjing city was more optimistic, and the nonempty nesters with male gender, higher education level, and partners were generally healthier; objective and subjective support had significant positive effects on the mental health of middle and high aged elderly, while the utilization of support had more significant effects on the health of low-aged elderly. This paper proposes that government departments should develop a localized elderly support system and social support policies adapted to the actual situation in Nanjing according to the quantitative distribution and demand characteristics of the mental health of elderly people in different age groups. The study is structured as follows: the second part contains data sources and statistical methods. The third part is the analysis of empirical results. The fourth part is the discussion and conclusion part of the article. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) which emerged in Wuhan, China, in December 2019, is widely controlled now in China. However, the global epidemic is still severe. To study and comment on Hubei's approaches for responding to the disease, the paper considered some factors such as suspected cases (part of them are influenza patients or common pneumonia patients, etc.), quarantine, patient classification (three types), clinically diagnosed cases, and lockdown of Wuhan and Hubei. After that, the paper established an S E L I H R model based on the surveillance data of Hubei published by the Hubei Health Commission from 10 January 2020 to 30 April 2020 and used the fminsearch optimization method to estimate the optimal parameters of the model. We obtained the basic reproduction number R 0 = 3.1571 from 10 to 22 January. R 0 was calculated as 2.0471 from 23 to 27 January. From 28 January to 30 April, R 0 = 1.5014. Through analysis, it is not hard to find that the patients without classification during the period of confirmed cases will result in the cumulative number of cases in Hubei to increase. In addition, regarding the lockdown measures implemented by Hubei during the epidemic, our simulations also show that if the lockdown time of either Hubei or Wuhan is advanced, it will effectively curb the spread of the epidemic. If the lockdown measures are not taken, the total cumulative number of cases will increase substantially. From the results of the study, it can be concluded that the lockdown, patient classification, and the large-scale case screening are essential to slow the spread of COVID-19, which can provide references for other countries or regions. [ABSTRACT FROM AUTHOR]

Aim. This paper aimed to examine the current state of nurse safety behavior, and the effect of work engagement on it, and to explore the mediating effect of self-efficacy between work engagement and nurse safety behavior in specialized cancer hospitals. Background. Nurse safety behavior affects the quality of care and outcomes for patients with cancer. The research proves that self-efficacy is associated with work engagement, but the relationship between self-efficacy, work engagement, and nurse safety behavior needs to be clarified. Methods. This study used a convenience sampling method to survey 957 nurses from January to February 2023. The survey included tertiary specialized cancer hospitals in five provinces in China. Sociodemography information, the Work Engagement Scale, the Self-Efficacy Scale, and the Nurse Safety Behavior Scale were used for the survey. A Questionnaire Star program collected all the data automatically. The Statistical Package for the Social Sciences version 24 was employed for Pearson correlation and multiple regression analysis to examine the association between work engagement, self-efficacy, and nurse safety behavior. Structural equation models were built using Analysis of Moment Structures version 24.0 software. Results. The results showed that the nurse safety behavior was at a high level in specialized cancer hospitals. There was a significant positive relationship between the variables work engagement, self-efficacy, and nurse safety behavior with coefficients ranging from 0.244 to 0.564. The results of structural equation modeling revealed that self-efficacy partially mediated the effect between work engagement and nurse safety behavior, accounting for 25.3% of the total effect. Conclusion. Self-efficacy mediates the relationship between work engagement and nurse safety behavior, and by increasing self-efficacy, nurse safety behavior can be improved, thus ensuring patient safety. Implications for Nursing Management. Managers should promote high work engagement and nurse safety behaviors by fostering nurses' self-efficacy. [ABSTRACT FROM AUTHOR]

Background. Necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) are the major contributors to mortality and morbidity in preterm infants. This updated meta-analysis was aimed to assess the effects of mother's milk on the incidence of NEC, LOS, and other clinical outcomes in preterm infants. Methods. PubMed, Embase, and the Cochrane library were searched for papers published up to October 2022. Results. A total of 13 RCTs with 1330 infants were included in the final analysis. Significant difference in NEC (stage 2 or 3) was found between the intervention group and the control group (RR = 0.508, 95% CI: 0.314–0.822, and P = 0.008). The incidence of proven LOS (RR = 0.809, 95% CI: 0.610–1.071, and P = 0.139) and death (RR = 0.800, 95% CI: 0.571–1.122, and P = 0.196) was comparable between the two groups. Statistical differences in the incidence of proven or probable LOS (RR = 0.705, 95% CI: 0.577–0.862, and P = 0.001) and length of hospitalization (WMD = −4.868, 95% CI: −6.608 to −3.128, and P < 0.001) between the intervention group and the control group were observed. Conclusions. The results of this updated meta-analysis showed that compared to the placebo, mother's milk provides better effects in reducing the incidences of NEC, proven or probable LOS, and the length of stay, whereas no significant benefit of mother's milk was observed in reducing the incidence of proven LOS and death. [ABSTRACT FROM AUTHOR]

At present, percutaneous nephrolithotomy has become an option for hospitals increasingly to treat calculus. However, due to the certain risk of percutaneous nephrolithotomy, it may lead to postoperative complications. Analyzing the preoperative factors of septic shock after percutaneous nephrolithotomy can provide guidance for reducing the incidence of septic shock after PCNL. This article establishes a logistic regression model based on preoperative factors, uses statistical methods, and uses the professional statistical software SPSS to create a database and analyze the data. The method of classification data analysis was used to determine various influencing factors including patient factors, stone factor, and preoperative factors and combined B-ultrasound guidance and percutaneous nephrolithotomy to reduce the risk of surgery. The experimental results found that the percutaneous nephroscope laser lithotripsy guided by the smart Internet of Things can effectively perform lithotripsy; in this paper, the preoperative data of different complications are obtained, and the risk of surgery is closely related to the operation time. The operation time exceeds 90 minutes and causes the risk of severe bleeding after PCNL. It is twice the operation time of less than 90 minutes and 5 times the operation time of less than 60 minutes. [ABSTRACT FROM AUTHOR]

Background. Observational studies from China suggest that Kangbingdu oral liquid (KBD) may be effective in treating the common cold. Objective. Reevaluation of efficacy and safety of Kangbingdu oral liquid after marketing and expanding population. Design. Prospective, Pragmatic randomized controlled trial (Chictr.org.cn registration number: chiCTR-TRC-12002399). Setting. Eleven hospitals from 3 provinces in China. Patients were recruited through 11 centers, including 7 teaching hospitals, 2 University health services, one military clinic, and one community hospital. Patients. 2647 persons aged 18 to 75 years with Common cold. Intervention. Patients were randomly allocated to 2 groups: the treatment group Kangbingdu oral liquid (composed of 9 Chinese herbal medicines and honey) and the placebo group were divided into a standard-dose group of 10 ml every time, a middle dose group of 20 ml every time, high dose group of 30 ml every time, 3 times daily. Interventions and control were given for 5 days. Measurements. The primary outcome is the mean amount of total scores measured by the 11-primary symptoms: to observe the change of main symptoms from severe to disappear and to calculate and compare the mean amount of total scores after the periods of observation. Secondary outcomes are the disappearance rate of each symptom and the median time of body temperature returned to normal. Results. On day 5, the Kangbingdu liquid group had significant reductions in the mean amount of total scores measured by the 11-primary symptoms (7.39 [95% CI 7.26 to 7.51] compared to the placebo group (6.43 [95%: CI 6.24 to 6.62]). The Kangbingdu liquid can improve the remission rate of accompanying symptoms on day 5 including aversion to wind, aversion to cold, fever, cough, stuffy, runny nose, sore throat, muscular aches, headache, fatigue, and sweat (P < 0.0001). Significant reductions in time of body temperature to return to normal in the Kangbingdu liquid group (P50, 48.33 [95% CI 46.00 to 52.50] compared with the control group (P50, 64.59 [95% CI 51.08 to 70.50] (P = 0.0022). 13 (0.7%) participants in the Kangbingdu liquid group and 1(0.2%) participants in the placebo group (P > 0.05) had treatment-related AEs, which mainly include diarrhea and dyspepsia in the Kangbingdu liquid group and constipation in the placebo group. Conclusion. The study's conclusion in this paper was based on the placebo, Kangbingdu oral liquid two groups which clinically diagnosed the common cold and flu. (1) Kangbingdu oral liquid can effectively improve the comprehensive clinical symptoms of common adult cold, also improved main symptoms, including sore throat, muscle aches, headache, and so on. (2) Kangbingdu oral liquid effectively shortens the time of body temperature to return to normal. [ABSTRACT FROM AUTHOR]

The incidence of cancer is increasing today, particularly lung and chest cancer. Employing novel methods to detect cancer in its earliest stages and discover painless, noninvasive treatments are urgently needed. The goal of the proposed study is to investigate the value of automated breast volume scanning (ABUS) in conjunction with contrast-enhanced ultrasonography (CEUS) in properly diagnosing breast cancer in its early stages and the effectiveness of neoadjuvant chemotherapy (NAC) in treating the disease. For the research study, information on 98 patients who had NAC and surgery in the breast surgery department of the Shaanxi Provincial Cancer Hospital has been gathered. All patients have received four cycles of NAC and underwent conventional ultrasound (HUSS), CEUS, ABUS, and pathological examination. At the same time, receiver operating characteristic (ROC) curve analysis, single factor, multiple linear regression, and other methods have also been used to analyze the diagnostic efficacy of breast cancer and NAC efficacy evaluation results. The study of this paper is totally based on the data collected from Shaanxi Provincial Cancer Hospital. The statistical and computational analyses are performed on the data collected for drawing inferences. When the findings are compared to the results of the pathological examination, HUSS has demonstrated a significant distinction between benign and malignant diagnoses with a statistical value of P < 0.05.ABUS combined with CEUS has shown no considerable differences in correlation study. Except for negative likelihood ratio, the diagnostic performance indexes of CEUS+ ABUS are substantially higher than HHUS with P < 0.05. ROC curve analysis is also performed which shows that CEUS and ABUS combination has higher precision in the analysis of breast cancer. ABUS pooled with CEUS shows great application value in the judgment of breast cancer as per the results obtained from the statistical analysis on data of 98 patients. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this paper is to analyse the correlation between cardiac ultrasound-related indicators and cardiac function in patients with coronary heart disease and heart failure. Methods. In this experiment, a total of 160 patients with coronary heart disease and heart failure who were diagnosed and treated in our hospital from June 2019 to March 2021 were recruited as the study group. All were examined by colour Doppler ultrasound instrument, SPSS statistical software was used to analyse the data obtained, and Spearman correlation was used to analyse the correlation between cardiac ultrasound-related indicators and cardiac function in patients with coronary heart disease and heart failure. Results. In the study group, there were 68 patients with grade II cardiac function, accounting for 42.50%; 74 patients with grade III, accounting for 46.25%; and 18 patients with grade IV, accounting for 11.25%. The ultrasound parameters of the patients in the study group were profiled and calculated, and then statistically analysed with cardiac function grading. Cardiac function classification was significantly positively correlated with LVMI, LAD, and LVEDd (r = 0.689/0.915/0.928, P = 0.001) and significantly negatively correlated with CI, LVFS, and LVEF (r = −0.689/−0.878/−0.912), P = 0.001). Conclusion. Cardiac ultrasound-related indicators are associated with patients with coronary heart disease and heart failure. With the decline of cardiac function in patients with coronary heart disease and heart failure, the patient's condition is aggravated. Therefore, cardiac ultrasound-related indicators play a major role in the diagnosis of clinical disease progression. [ABSTRACT FROM AUTHOR]

There are many thyroid diseases affecting people all over the world. Many diseases affect the thyroid gland, like hypothyroidism, hyperthyroidism, and thyroid cancer. Thyroid inefficiency can cause severe symptoms in patients. Effective classification and machine learning play a significant role in the timely detection of thyroid diseases. This timely classification will indeed affect the timely treatment of the patients. Automatic and precise thyroid nodule detection in ultrasound pictures is critical for reducing effort and radiologists' mistake rate. Medical images have evolved into one of the most valuable and consistent data sources for machine learning generation. In this paper, various machine learning algorithms like decision tree, random forest algorithm, KNN, and artificial neural networks on the dataset create a comparative analysis to better predict the disease based on parameters established from the dataset. Also, the dataset has been manipulated for accurate prediction for the classification. The classification was performed on both the sampled and unsampled datasets for better comparison of the dataset. After dataset manipulation, we obtained the highest accuracy for the random forest algorithm, equal to 94.8% accuracy and 91% specificity. [ABSTRACT FROM AUTHOR]

Objective. Intrahepatic cholestasis of pregnancy (ICP) significantly impacts the maternal and fetal safety. Research on the role of clinical pharmacists in guiding drug therapy for this condition remains limited. This study aimed to evaluate the effectiveness of graded pharmaceutical care for women with intrahepatic cholestasis of pregnancy and to provide a theoretical foundation for clinical pharmacist services. Study Design. This study comprises a pre‐and‐post analysis of women with intrahepatic cholestasis of pregnancy (ICP) treated between December 2019 and June 2023 at a tertiary hospital in Jiangsu province. Each group consisted of 102 participants. The control group received standard treatment, while the guardianship group received graded pharmacological care provided by a clinical pharmacist. The effectiveness of pharmacological monitoring by clinical pharmacists was assessed by comparing and analyzing clinical outcome indicators, quality management indicators, safety indicators, and economic factors. Results. The guardianship group exhibited a noteworthy 12.8% reduction in combined adverse pregnancy outcome and more effective management of total prenatal bile acids compared to the control group (16.05 µmol/L vs. 22.85 µmol/L, P < 0.05). The guardianship group displayed superior rationalization of therapeutic drugs and medication duration (P < 0.05). The cost‐benefit analysis revealed a favorable economic impact concerning medication costs but did not indicate economic significance regarding total inpatient costs. Conclusion. The implementation of a graded pharmaceutical care model by a clinical pharmacist holds the potential to enhance outcomes for women experiencing intrahepatic cholestasis during pregnancy, mitigate adverse pregnancy results, optimize the rational utilization of therapeutic medications, and yield positive economic results. [ABSTRACT FROM AUTHOR]

This study examined the associations between community social capital and self‐reported oral health among older adults in urban China, as well as the moderating effect of household income and the mediating role of depressive symptoms in these associations. Data were obtained from a community survey conducted in 2020 in Tianjin and Shijiazhuang City, China; the final analytical sample comprised 776 adults aged 60 years and above. To test the proposed moderation and mediation models, the data were analysed using binary logistic regression models and a path analysis, respectively. The findings showed that cognitive social capital and social participation (i.e., an indicator of structural social capital) were significantly associated with self‐reported oral health. Additionally, the results revealed that while income significantly moderated the association between cognitive social capital and self‐reported oral health, depressive symptoms significantly mediated it. The findings not only highlight the crucial role of community social capital in promoting oral health in later life among low‐income older adults but also provide important evidence for a psychosocial pathway between social capital and oral health. Given the impacts of income and depressive symptoms on the relationship between community social capital and oral health among older adults, future social policies and interventions to support oral health should target financially vulnerable older adults with poor psychological well‐being. [ABSTRACT FROM AUTHOR]

What Is Known and Objective. Tocolytic agents are used to prolong gestational age and prevent immediate preterm birth (PTB). This study aims to provide an overview of the use of tocolytics among patients with PTB in China through retrospectively analyzing trends in application, influencing factors, and inappropriate prescriptions. Methods. The prescription data of five tocolytic agents from 2016 to 2021 were extracted from the database of the Hospital Prescription Analysis Cooperation Project. Drug consumption was expressed as number of prescriptions, cost of prescriptions, and DDDs (defined daily doses). Pearson correlation analysis was used to examine the association between DDDs and DDC (defined daily cost). The appropriateness of prescriptions was analyzed in terms of drug dosage form, administration, clinical diagnosis, and combined medication. Results. The total number of tocolytic prescriptions and the total cost of tocolytic agents increased by 6.12% and 387.58%, respectively, over the six‐year duration of the study. From 2016 to 2021, the ranking of the number of prescriptions and DDDs of tocolytic agents was magnesium sulfate > ritodrine > nifedipine > indomethacin > atosiban. During the study period, the cost of tocolytic agents increased significantly, which was mainly related to the increased costs of magnesium sulfate in 2017 and atosiban in 2018 and 2019. The ranking of DDCs was atosiban > ritodrine > magnesium sulfate > nifedipine = indomethacin from 2016 to 2021. For atosiban, the DDC was negatively correlated with the DDDs. Inappropriate prescription, which accounted for 14.84% of all prescriptions, was mainly manifested in the inappropriate selection of nifedipine dosage form, low frequency of nifedipine and indomethacin, and overdosing of ritodrine. Furthermore, 22.87% of tocolytic prescriptions remained active after 34 weeks of gestation, and 7.24% of the prescriptions authorized the use of combination drugs, with magnesium sulfate and nifedipine being the most commonly prescribed combination. What Is New and Conclusion. Magnesium sulfate, ritodrine, and nifedipine were the top three tocolytic agents. As the inappropriate use of tocolytic agents continues to persist, it is important to intensify efforts to ensure the safety and the appropriateness of maternal medication. [ABSTRACT FROM AUTHOR]

Aim. The aim of this study was to understand the current status of knowledge-attitude-practice of ICU nurses in tertiary care hospitals regarding swallowing disorders after extubation of tracheally intubated patients and to analyse the influencing factors. Design. A cross-sectional study. Background. Most patients admitted to the ICU have an endotracheal tube, which may be the cause of acute and/or chronic problems after extubation. Therefore, training of ICU nurses and early extubation are essential to prevent these problems. Methods. A convenience sample of clinical nurses (n = 627) was selected from Grade A Hospitals in Northwest, North, and Central China as the study population. Survey instruments included the Questionnaire on ICU Nurses' Knowledge, Attitude, and Practice of Postextubation Swallowing Disorders in Patients with Tracheal Intubation. Data Sources. Data were sourced from structured questionnaire responses. Results. A total of 647 ICU nurses participated in this survey, with 627 valid questionnaires. The three dimensions of knowledge, attitude, practice, and the total score of the questionnaire on ICU nurses' knowledge, attitude, and practice of postextubation swallowing disorders in patients with tracheal intubation were (6.46±3.09), (7.53±1.69), (4.89±2.00), and (18.88±5.18), respectively. Multiple linear regression analysis showed that the factors affecting the total score of PED among ICU nurses were age, nationality, professional title, job satisfaction, and mode of employment. Gender, age, nationality, and job satisfaction were the factors that influenced the score of knowledge. The influencing factors of attitude score include gender, age, nationality, section, professional title, job satisfaction, and mode of employment. The influencing factors of the score of knowledge include professional title and job satisfaction. Conclusion. The current status of ICU nurses' knowledge-attitude-practice regarding postextubation dysphagia in tracheally intubated patients is generally at a moderate to low level, and the level of knowledge-attitude-practice needs to be further improved. Implications for Nursing Management. The results of the study showed that the knowledge, attitude, and practice of ICU nurses towards tracheal intubation patients' postextubation dysphagia were in the lower middle level. Therefore, it is necessary to improve the knowledge, attitude, and practice of ICU nurses towards tracheal intubation patients' postextubation dysphagia. This may include, but is not limited to, the development of tools for assessing PED, systematic and professional training, and the development of multidisciplinary collaborative models. [ABSTRACT FROM AUTHOR]

Objectives. To examine the effectiveness of a patient-family (carer) partnership intervention on the BP control, self-care and self-efficacy for hypertensive people, and dyadic-relationship quality, depressive and anxiety symptoms, and health-related quality of life for the family dyads (hypertensive people and family carers) in rural communities of mainland China. Design. A randomised controlled trial. Methods. A total of 110 family dyads were randomly recruited from village clinics and randomly allocated to the intervention group (n = 55) or control group (n = 55). Family dyads in the control group received usual care. In addition to the usual care, family dyads in the intervention group received the individual-based, five-session patient-family (carer) partnership intervention. The primary outcomes included SBP, DBP, and the proportion of people with normal controlled BP. EuroQol five-dimensional-five-level (EQ-5D-5L) was adopted to evaluate participants' health-related quality of life. Data were collected at the baseline (T0), one-month (T1), and three-month postintervention (T2). Generalised estimating equation model was adopted to test the study hypotheses on all study outcomes. Results. Compared with the control group, hypertensive people in the intervention group had a greater reduction in SBP by 10.10 mmHg and DBP by 4.66 mmHg and a larger proportion of people with normal BP at T2, as well as statistically significant improvements at T1 and T2 in dyadic relationship, self-care, antihypertensive drug-titration rate, anxiety symptoms, and health-related quality of life. The intervention also had statistically significant positive effects on family carer's dyadic relationship and health-related quality of life at T1 and T2. Conclusion. The patient-family (carer) partnership intervention has the potential to improve hypertensive people's BP control and family dyad's dyadic-relationship quality and mental health at short-to-medium term follow-ups. Implications for the Profession and/or Patient Care. This study provided evidence and direction to support healthcare providers in developing and implementing patient-family (carer) partnership intervention for hypertension care in rural areas. This trial is registered with ChiCTR1900027087. [ABSTRACT FROM AUTHOR]

Purpose. To evaluate the bioequivalence of two different tofacitinib citrate tablets formulations among healthy Chinese subjects under fasting and fed conditions and to observe the safety of test preparation and reference preparation in healthy subjects. Method. This randomized, open-label, 2-period, crossover, bioequivalence study included 64 healthy Chinese subjects (fasting: n = 32, fed: n = 32). The subjects were assigned to receive a single 5-mg dose of the test or a reference tofacitinib citrate tablets. Blood samples were collected at predose and up to 24 hours after dosing. Area under the plasma concentration time curve from zero to the last measurable concentration (AUC0-t), the area from time zero to infinite (AUC0-∞), and maximum plasma concentration ( C max ) were used for bioequivalence assessment. Safety assessment was conducted by vital signs, physical examination, laboratory examination, and 12-lead electrocardiogram during the study, from the time the subject receiving the test drug to the end of the last visit. Results. Under fed condition, the 90% CIs of the geometric mean ratios of the test/reference for tofacitinib citrate tablets were 98.40–104.16% for AUC0-t, 89.96–116.70% for C max , and 98.50–104.15% for AUC0-∞. Under fasting condition, the 90% CIs of the geometric mean ratios of the test/reference for tofacitinib citrate tablets were 93.65–101.60% for AUC0-t, 90.06–109.15% for C max , and 93.88–101.51% for AUC0-∞. There were no serious events. Conclusion. The 90% CI for the geometric mean ratio (test/reference) of C max , AUC0-t, and AUC0-∞ were within the range of 80.00%–125.00%, indicating that the test formulation was equivalent to the reference formulation in healthy Chinese subjects under both fasting and fed conditions. They are similar in terms of safety. This trial is registered with CTR20190366. [ABSTRACT FROM AUTHOR]

Aims. Building on conservation of resources theory, our study investigates how inclusive human resource management (IHRM) promotes nurses' innovative behavior through job crafting and further examines the moderating role of shared leadership. Background. Nurses' involvement in innovation is essential to improve nursing care delivery and accommodate changing medical environments, especially in the face of crisis events like the COVID-19 outbreak. However, knowledge about the relationship between human resource management and nurses' innovative behavior remains scarce. Methods. We collected three-wave data from 338 on-duty registered nurses at four public hospitals in China from November 2022 to January 2023. We used SPSS 22 to conduct hierarchical regressions to test our hypotheses. Results. IHRM positively predicted innovative behavior of nurses with the mediating role of job crafting. In addition, we found that IHRM was more effective in promoting job crafting and subsequent innovative behavior when nurses perceived high levels of shared leadership. Conclusion. IHRM initiated by the organization and shared leadership style are two collaborative approaches to facilitating nurses' job crafting, thereby responding to the imperative need to foster nurses' innovative behavior. Implications for Nursing Management. The present study emphasizes the important roles of IHRM and shared leadership in promoting nurses' job crafting and subsequent innovative behavior, providing theoretical and practical implications for nursing management in the current dynamic and challenging environment. [ABSTRACT FROM AUTHOR]

Aim. To compare the clinical characteristics of survival and nonsurvival patients with severe acute pancreatitis (SAP) and explore the risk of mortality in SAP patients. Methods. This was a single-center retrospective study performed in a severe acute pancreatitis diagnosis and treatment center. According to the outcome, SAP patients were divided into survival group and nonsurvival group. One-way ANOVA or independent t -test was used to compare the clinical characteristics of two groups of patients. Multivariate retrospective analysis was used to identify risk factors for mortality in SAP patients. Results. A total of 486 SAP patients were included in the study, and the 90-day mortality for SAP patients was 13.58%. The common etiologies of SAP are biliary tract diseases (69.75%) and hyperlipidemia (17.28%). The most common complications caused by SAP were organ failure (55.14%), ARDS (50.62%), AKI (30.45%), sepsis (27.16%), and abdominal fluid collection (27.57%). There were differences in age, complications, and medical intervention between the nonsurvival group and the survival group. The main causes of death were infection (46.97%), abdominal bleeding (28.79%), and organ failure (9.09%). The binary logistic regression analysis showed that there were significant differences in age, AKI, sepsis, abdominal hemorrhage, organ failure, laparotomy, creatinine, and APTT between the nonsurvival group and the survival group. Conclusion. Age, AKI, sepsis, abdominal hemorrhage, and organ failure are risk factors for mortality in SAP patients. SAP patients with high creatinine and prolonged APTT upon admission require doctors to be vigilant. The main cause of death in SAP patients is pancreatitis-related organ failure and secondary infection. [ABSTRACT FROM AUTHOR]

Aims. To develop an evidence-based practice (EBP) facilitating strategy informed by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework and evaluates the strategy's effectiveness on promoting EBP. Background. Nurses are increasingly expected to use research evidence in practice to improve patients' outcomes, but the application of such evidence is still unsatisfactory. The facilitation of EBP in nursing needs the organization and the individual levels. Methods. Based on an analysis of EBP-promoting strategies and expert consultation, the core team of the nursing department developed an EBP group-based and project-oriented strategy under the guidance of the i-PARIHS framework. The strategy was implemented for six years and evaluated by a longitudinal design. The validated Chinese version of the self-reported Evidence Based Practice Questionnaire (EBPQ) was used to assess the attitudes, knowledge, and practice of the nurses. Results. The mean score of the total EBPQ was 4.46 (SD = 0.92) after one year of the EBP strategy, and the scores for knowledge, attitudes, and practice of EBP members were higher than those of general nurses p < 0.05 . After four years, EBP members' scores continued to increase. EBP groups conducted 51 EBP projects in the areas of emergency nursing, surgical and medical nursing, critical care, and so forth. Of these, 33 projects improved nursing practice by changing nursing procedures, upgrading nursing tools, and developing nursing standards, resulting in improved patient outcomes. Conclusion. The EBP group-based and project-oriented strategy can promote EBP. The composition of the EBP group, the annual audit of EBP projects, and the roles of internal and external facilitators were key components of this EBP-facilitating strategy. Implications for Nursing Management. The strategy is an organizational-level EBP-facilitation approach which can improve nurses' academic preparation for EBP through ongoing training and sustained EBP behavior that involves annual projects. [ABSTRACT FROM AUTHOR]

Background. There was a remarkable downgrade in China's COVID-19 response strategies in January 2023. The COVID-19 infection rate grew rapidly in the early stages following the management policy shift. This study attempted to explore the associations between SARS-CoV-2 infection and mental or physical health status in pregnant and postpartum women and the role of perceived health risks and family members' SARS-CoV-2 infection status on these associations by capturing the impact of policy shifts in a short period of time. Methods. This cross-sectional study with a random sample from a convenience sample of hospitals was conducted in pregnant and postpartum women in January 2023. Standardized assessment tools were employed to assess anxiety, depressive and physical symptoms, and feelings of hopelessness. Hierarchical multiple logistic regressions were conducted to examine the mechanisms of associations of interests by including a range of sociodemographic factors, self-perceived health, SARS-CoV-2 infection status, and perceived health risks as covariates. Results. Of the 1,013 pregnant and postpartum women aged 32.0 ± 0.3 years, 58.2% (n = 590) were diagnosed with COVID-19, and 49.4% (n = 500) had family members who were infected with SARS-CoV-2. Nearly 98% of the included participants took measures to prevent SARS-CoV-2 infection. A COVID-19 diagnosis was positively associated with feelings of hopelessness (OR = 1.68, 95% CI: 1.20–2.35), probable anxiety (OR = 6.42, 95% CI: 2.18–24.61), possible depression (OR = 2.56, 95% CI: 1.07–6.70), and physical symptoms (OR = 6.28, 95% CI: 1.63–42.03) after adjusting for sociodemographic and health characteristics, while the associations presented no statistical significance when family members' SARS-CoV-2 infection status and perceived health risks were introduced into the models. Conclusions. Our results suggested that pregnant and postpartum women may experience physical and mental health challenges when they or their family members contracted COVID-19 in the context of a considerable shift in COVID-19 management. Early detection of poor health status and its risk factors for vulnerable groups during shifts in health policy and administrative practice is very necessary, and health services, including easy access to psychosocial support and obstetric counselling, should be prioritized. [ABSTRACT FROM AUTHOR]

Background. Nurses play a critical role in the medical workforce during the COVID-19 pandemic while facing various difficulties and challenges. Grit, social support, and self-esteem are important psychosocial factors influencing job performance. However, few studies have explored the relationships among these factors in nurses. Aim. This study aimed to examine the association between grit and nurses' job performance during the COVID-19 pandemic and to explore the potential chain mediation through perceived social support and self-esteem. Methods. A cross-sectional survey design was employed. From January 2021 to May 2022, a total of 709 Chinese nurses in Chengdu and Kunming completed a web-based cross-sectional survey, which included standard assessments on grit, perceived social support, self-esteem, and job performance as well as Big Five personalities. The chain mediation model was tested using the PROCESS macro program in the SPSS software. Results. There was a moderate-to-large correlation (r = 0.40, p < 0.001) between grit and job performance in Chinese nurses. Furthermore, grit was indirectly linked to job performance through the chain mediating effect of perceived social support and self-esteem (all p < 0.05). These findings persisted even when Big Five personalities were included as additional controlling variables. Conclusions. This study reveals a stable link between grit and job performance among Chinese nurses and highlights the potential role of perceived social support and self-esteem in mediating this link. Implications for Nursing Management. Nursing managers can improve nurses' grit level and provide a supportive organizational environment conducive to enhancing self-esteem and thereby promoting their job performance. [ABSTRACT FROM AUTHOR]

Background. Altered maternal serum lipid metabolism is associated with hypertensive disorders in pregnancy (HDP). However, its range in pregnancy and characteristic among different subgroups of HDPs are unclear. Methods. Pregnant women with HDP who underwent antenatal care and delivered in Obstetrics and Gynecology Hospital of Fudan University during January 2018 to August 2022 were enrolled. The levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), apolipoprotein (Apo)-A, B, and E, free fatty acids (FFA), and small and dense low-density lipoprotein cholesterol (sdLDL) were measured during 4–16 weeks and 28–42 weeks of pregnancy. Results. A total of 2648 pregnant women were diagnosed with HDP, 1,880 of whom were enrolled for final analysis, including 983 (52.3%) preeclampsia (PE), 676 (36.0%) gestational hypertension (GH), and 221 (11.7%) chronic hypertension (CH). For all HDPs, serum TC, TG, LDLC, HDLC, Apo-A, Apo-B, Apo-E, and sdLDL increased significantly during pregnancy, while FFA decreased significantly. Notably, the levels of TC, LDLC, Apo-B, and sdLDL in PE group were equal to or lower than those in CH group at 4–16 weeks of pregnancy, but increased greatly during pregnancy (P < 0.05). Conclusions. Maternal serum lipid levels changed through pregnancy among women with HDPs. Women complicated with PE seem to have undergone a more significant serum lipid change compared to those with GH or CH. [ABSTRACT FROM AUTHOR]

Objective. Perceived control refers to an individual's subjective perception, affective experience, or cognitive beliefs regarding their level of control. The objective of this study was to examine the relationship between perceived control and quality of life (QoL) among breast cancer (BC) patients using a structural equation model. Method. Participants (N = 80) completed questionnaire surveys on perceived control and QoL using the Cancer Experience and Efficacy Scale (CEES) and the Quality of Life Questionnaire Core 30 (EORTC QLQ-C30 V3.0), respectively. Structural equation modeling was employed to examine the associations between perceived control factors, including cancer experience and control efficacy, and QoL. Results. The QoL in BC patients was found to be significantly negatively correlated with physical symptoms, accounting for 51.6%. This indicates that the QoL of patients decreased by 51.6% with each unit increase in physical symptoms. In terms of perceived control among BC patients, socioeconomic strain exerted the greatest influence on cancer experience, accounting for 44.3%, followed by emotional strain and personal strain at 40.08% and 34.6%, respectively. Group efficacy had the highest impact on control efficacy at 43.0%, followed by individual efficacy and medical efficacy at 41.8% and 29.7%, respectively. QoL in BC patients decreased by 4.2% with every unit increase in cancer experience but improved by 3.5% with every unit increase in control efficacy. Conclusion. The structural equation model facilitates a comprehensive understanding of the interrelationships among various variables in perceived control and QoL among BC patients. The cancer experience in perceived control is negatively correlated with the QoL, whereas control efficiency demonstrates a positive correlation with QoL. Consequently, healthcare professionals should implement appropriate interventions to alleviate physical symptoms and enhance control efficiency, thereby improving both perceived control and QoL levels among BC patients. This trial is registered with ChiCTR2300069476. [ABSTRACT FROM AUTHOR]

Objective. As part of the efforts to build a practical, effective, and diversified medical insurance payment method, it is crucial for China to deepen the reform of ambulatory patient groups (APGs). This study was aimed to explore the mechanism and effect of this policy from three dimensions, including medical expenses, medical insurance funds, and medical services. Methods. In 2020, China's pilot reform of APG was initiated in Jinhua City, Zhejiang Province. Descriptive statistics, correlation analysis, and OLS regression analysis were utilized to evaluate the effect of the APG reform in Jinhua. Results. The implementation of the reform can contribute significantly to establishing a comprehensive medical service governance mechanism of classified settlement and coordinated promotion. It also plays a critical role in safeguarding people's lives and health by promoting the high-level development of medical insurance systems and public hospitals, optimizing the quality of medical services, and improving the efficiency of medical insurance funds. Conclusion. Through the lens of policy evaluation, our findings can provide useful experience for the implementation of the outpatient medical insurance payment method in developing countries. [ABSTRACT FROM AUTHOR]

Aims. This study was designed to investigate the impact of inclusive leadership on challenge-oriented citizenship behaviors and examine the mediating role of organizational justice on the relationship between inclusive leadership and challenge-oriented citizenship behaviors among nurses. Background. Leaders exhibiting an inclusive leadership style have the potential to create a positive work climate and motivate members of the organization. However, the mechanisms by which organizational justice contributes to this process remain to be explored, particularly in terms of how it motivates challenge-oriented organizational citizenship behaviors. Method. A cross-sectional questionnaire survey was conducted among nurses in China at the end period of the COVID-19 pandemic. A total of 527 registered nurses were enrolled and completed the self-report questionnaires including inclusive leadership scale, organizational justice scale, and challenge-oriented citizenship behavior scale. The hypotheses were tested using hierarchical multiple regression analyses and structural equation modelling. Results. The results of empirical tests revealed that nurse leader's inclusive leadership had a positive relationship on nurses' challenge-oriented organizational citizenship behaviors (β = 0.823, p < 0.001) after controlling several demographic covariates. Meanwhile, inclusive leadership was positively linked to organizational justice (β = 0.747, p < 0.001), and the indirect effect of inclusive leadership on nurses' challenge-oriented citizenship behaviors through organizational justice was statistically significant (β = 0.641, p < 0.001). Furthermore, the model fit indices were χ2/df = 1.952, RMSEA = 0.043, CFI = 0.979, and TLI = 0.977, indicating that the model had high quality. Conclusion. This study could help nurse leaders with inclusive leadership style have a better understanding and taking the advantages of the influence mechanism of organizational justice in inspiring nurses' challenge-oriented citizenship behaviors. While nurse managers can inspire challenge-oriented organizational citizenship behaviors through inclusive leadership, they should also emphasize the evaluative and behavioral-shaping effects of organizational justice. Both leadership and organizational justice are essential to motivate challenge-oriented organizational citizenship behaviors and to foster organizational development. Moreover, managers should focus on the process and conditions of implementing organizational justice to ensure fairness within the organization and to create a conducive environment for challenge-oriented organizational citizenship behaviors. [ABSTRACT FROM AUTHOR]

Background. Culturally relevant exercises may help improve health and address disparities faced by older immigrants due to language and cultural barriers. Few studies have focused on such exercise interventions among older Chinese immigrants at US daycare centers. Methods. We conducted a 10-week nonrandomized controlled trial in older Chinese immigrants in Philadelphia, US. The intervention group practiced Chinese Qigong (Baduanjin) 5 days a week guided by trained research assistants and video instructions. The control group maintained their usual daily activities. We collected self-report assessments on overall health, sleep, and fatigue and implemented two computerized cognitive tests measuring psychomotor vigilance task (PVT) and memory twice, preintervention and postintervention. Repeated measures general linear model (GLM) and paired samples t-tests were used for data analyses. Results. Eighty-eight older adults (Qigong, n = 53; control, n = 35) with an average age of 78.13 (SD = 5.05) were included. Groups showed no significant differences at baseline evaluation. After the 10-week exercise, the intervention group showed significant improvements in overall health (p = 0.032), fatigue (p < 0.001), and cognitive functions including memory (p = 0.01), response speed (p = 0.002), and response time (p = 0.012) on the PVT, as well as marginally significant benefits in sleep (p = 0.058). Between-group comparisons identified significant group-by-time interactions in health (p = 0.024), sleep (p = 0.004), fatigue (p = 0.004), and memory (p = 0.004). Conclusion. We revealed significant positive effects of Qigong in older Chinese immigrants across multiple health domains. Findings highlight the potential of a culturally relevant exercise in addressing health disparities. [ABSTRACT FROM AUTHOR]

Chinese government promoted a family physician contract service system in order to establish a tiered healthcare system in June 2016, but there was little evidence to assess the policy performance. This study aimed to examine the association of family physician contract services with the healthcare utilization of community residents in urban China. A cross-sectional face-to-face survey was conducted from July to September, 2019, in four advanced and exemplary cities for family physician contract services in China. A multistage cluster random sampling method was adopted to recruit residents aged 18 and above, and a total of 1508 participants were included in this study. The count model and logit regression were adopted to examine the associations between family physician contract service and healthcare utilization, and the potential bias was addressed using the propensity score matching (PSM) method. There was an increase in number of monthly primary care visits and annual referrals for contracted residents compared to noncontracted residents. Participants who had contracted with a family physician were more likely to choose a primary healthcare facility after illness than those who had not. However, no significant change was found in the number of annual hospital admissions between contracted and noncontracted residents. Family physician contract services may effectively strengthen the use of primary care facilities by community residents and promote the formation of a tiered healthcare system in China. [ABSTRACT FROM AUTHOR]

Taking care of people with dementia is stressful for informal caregivers. Respite care can provide a break for them. But it is often underused, and its acceptability can be low in China. One reason is that it fails to meet their needs. This study aimed to explore the preference of caregivers of people with dementia for respite care services. A discrete choice experiment was used. Attributes and levels of respite care were informed by a literature review and expert consultations. A fractional factorial design was used to reduce the number of choice sets. A questionnaire survey was conducted in Tianjin, China. A mixed logit model was used to compute coefficients for attributes and levels. Respite care packages differed in five attributes, which were content, provider, duration, frequency, and cost. 322 caregivers completed valid discrete choice experiment questionnaires. All five attributes were statistically significant. Two most preferred attributes were "providers" (coefficient 1.297, p < 0.001) and "frequency" (coefficient 1.169, p < 0.001). Caregivers prefer highly qualified service providers and frequent respite care. The desirable respite care for caregivers would be assistance with personal care for people with dementia which was provided by an experienced worker with attitudes of understanding and respect towards people with dementia more than 3 times per week regularly and more than 4 h every time with a lower cost. This study offered new information on Chinese dementia caregivers' preferences for respite care. Policymakers should pay attention to the frequency and quality of providers when designing respite care to improve service uptake and ultimately lighten the burden on caregivers of people with dementia. [ABSTRACT FROM AUTHOR]

Background. Adherence to complete decongestion therapy (CDT) is of utmost importance for patients with breast cancer-related lymphedema (BCRL). However, past studies have demonstrated that adherence to CDT in BCRL patients is less than satisfactory. Our study aimed to describe the level of adherence to CDT among BCRL patients and utilize the Health Belief Model to analyse the key factors that influence adherence. Methods. We employed a convenient sampling method to select 158 patients with BCRL who were in the maintenance stage of CDT in a grade A tertiary tumour hospital in Guangzhou. A questionnaire survey was used to investigate patients' adherence to CDT, as well as their sociodemographic characteristics, medical history characteristics, disease knowledge, and health beliefs. Results. The CDT adherence score of BCRL patients was 96.46 ± 18.46 points, with an average score of 2.61 ± 0.50 points per item. The adherence rate was 65.18 ± 12.47%, indicating a moderate level of adherence. Factors that significantly influenced CDT adherence in BCRL patients included age under 45 years, having 0 or 1 child, experiencing 9 lymphedema symptoms, and having low levels of disease knowledge and health beliefs (p < 0.05). Conclusions. The level of adherence to CDT in BCRL patients is moderate and requires improvement. To enhance adherence to CDT, medical professionals should focus on patients who are younger, have fewer children, exhibit fewer symptoms of lymphedema, possess limited disease knowledge, and have weak health beliefs. [ABSTRACT FROM AUTHOR]

Aim. To evaluate the knowledge, attitudes, and practices of Chinese bedside nurses regarding antimicrobial stewardship, as well as to identify factors that influence nurses' engagement in antimicrobial stewardship. Background. Antimicrobial resistance is a pressing global health threat. Antimicrobial stewardship is crucial in combating this issue. Nurses play a key role in implementing antimicrobial stewardship. However, little is known about the involvement of Chinese nurses in antimicrobial stewardship. Methods. An explanatory sequential mixed-methods design was employed. A self-developed questionnaire was administered between March and August 2021 (N = 463), followed by semi-structured interviews with 17 nurses between March and July 2022. Descriptive statistics and qualitative content analysis were used to analyze the data. Results. The study found that nurses scored 75% in knowledge, 82.8% in attitude, and 84.1% in practice domains. There was a moderate correlation between nurses' knowledge, attitudes, and practices. It revealed that knowing local antimicrobial stewardship programmes information and the frequency of receiving antimicrobial stewardship training had a significant impact on nurses' knowledge scores. The willingness to participate in related training influenced nurses' attitude scores. Being a clinical teacher and the frequency of receiving related training influenced nurses' practice scores. The qualitative phase identified three themes: insufficient knowledge of nurses' engagement, diverse attitudes towards engagement, and limited scopes and absence of standards in nurses' participation. Conclusions. Our findings emphasize the importance of enhancing nurses' perception and involvement in antimicrobial stewardship. While nurses exhibit positive attitudes and practices, addressing the existing knowledge gap is crucial. To achieve this, it is necessary to clarify the role and responsibilities of nurses in antimicrobial stewardship, provide regular training and innovative methods, strengthen communication and collaboration, and foster a positive work environment. Additionally, actively promoting the development of guidelines and evaluation criteria will enable nurses to more effectively participate. Implications for Nursing Management. Regular training of nurses in antimicrobial stewardship needs to be enhanced. Nursing managers should strive to create positive, empowering, and supportive work environments, participate in policy formulation and implementation, and provide clear expectations for nurses' engagement in antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

Aim. The aim of the study was to examine the effect of the length of working hours on missed nursing care, quality of nursing care, and perceptions of the nursing practice environment. Methods. A multicenter cross-sectional investigation using online questionnaires was conducted from April 2 to May 10, 2022, in twenty nine hospitals (13 Level-III hospitals and 16 Level-II hospitals). We collected data on the working hours of nurses and nurse-reported outcomes, including missed nursing care, quality of nursing care, and nursing practice environment. Restricted cubic spline (RCS) regression models were used to examine relationships between the hours per shift and nurse-reported outcomes. Results. We investigated 12,703 nurses with a response rate of 97.33%. Nurses worked on average 7.72 (SD = 1.16) hours on the day shift and 8.92 (SD = 2.20) hours on the night shift, respectively. On the day shift, working 7.5 hours shift showed minimal missed nursing care; meanwhile, working 7–7.5 hours were correlated with the highest satisfaction of the nursing practice environment and better quality of nursing care. On the night shift, the highest missed nursing care was found for a working duration of 12 hours to the working 7 hours, with the lowest satisfaction while better quality was observed. The percentage of nurses who reported working overtime was 30.33%. Nurses who worked overtime reported lower satisfaction and poorer quality of nursing care on all shifts; moreover, working overtime showed the positive correlation to missed nursing care on the day shift, while on night shift was not statistically significant. Conclusion. Positive outcomes were observed for nurses who reported working 7–7.75 hours on the day shift and 12 hours (no more than 15 hours) on the night shift. Implications of Nursing Management. The results reemphasized the need for managers to reduce the working hours, overtime work, and the frequency of the night shift. [ABSTRACT FROM AUTHOR]

Background. Primary angiosarcoma of the breast (PAS) is a rare aggressive tumor with no standardized treatment. The aim of this study was to investigate the characteristics of all primary angiosarcoma of the breast obtained from a single center and the features peculiar to Chinese patients. Methods. The medical records at Tianjin Medical University Cancer Institute and Hospital were retrospectively searched to identify all cases of PAS treated in 2000–2019. Results. Sixteen cases of PAS were identified, and most involved the left breast. Forty percent of young patients had a history of progressive tumor enlargement with localized pain and skin color changes. The diagnostic accuracy rate was 66.7% for MRI, 75% for core-needle aspiration, and 58.3% for intraoperative fast frozen pathology. The most common surgery was modified radical mastectomy (n = 9, 56.25%). All positive margins involved the pectoralis major muscle, and these tumors' mean size was 8.2 cm. All cases were CD34 positive, and the Ki-67 index was ≥30% in 37.5%. Median local or distant recurrence-free survival was 57.6 months for low-to-moderate-grade tumors and 23.5 months for high-grade tumors. Seventy-five percent of the patients were treated with chemotherapy. The average tumor size in patients with relapse-free survival longer than 3 years was 2.2 cm. Conclusion. Young patients may have larger and softer breast tumors with skin color changes. MRI and core-needle biopsy should be performed preoperatively. A positive surgical margin at pectoralis major should be noted. Breast prosthesis may be a better reconstruction option. Adjuvant chemotherapy and/or radiotherapy should be considered for large tumors with a high Ki-67 index or high-grade tumors. [ABSTRACT FROM AUTHOR]

Aims. To measure nursing clinical teachers' knowledge, attitudes, and practices about nursing students (NSs) suffering from workplace violence (WPV) in China. Background. The nursing clinical teacher is the most important person for NS during the clinical rotation. In contrast, there is a lack of investigation into the ability of nursing clinical teachers to manage NSs suffering from WPV. Method. A cross-sectional survey was conducted in Hubei province, China, between June and July 2022. Convenience sampling was employed to recruit clinical teachers in 9 tertiary hospitals who met the inclusion criteria. The survey was conducted using a self-designed questionnaire which has good reliability and validity. Questionnaires were collected through a web-based platform called Questionnaire Star in China. In July 2022, a total of 900 questionnaires were eventually distributed, and 869 valid questionnaires were returned. The software SPSS 26.0 was used to conduct descriptive and inferential statistical analyses. Result. The mean ± SD knowledge, attitudes, and practices scores of the nursing clinical teachers were 69.51 ± 12.78, 29.11 ± 4.38, and 82.84 ± 13.60, respectively. Also, the average score rate was 77.24%, 83.17%, and 87.20%, respectively. There are still deficiencies in the knowledge, attitudes, and practices index, such as knowledge about the sources of violence, perceptions about influencing factors, and behavioural practices for prevention. Factors affecting the knowledge index scores included teachers' age, highest academic degree obtained, years of work, the highest level of education that they could teach NSs, whether they had experienced WPV, whether they had witnessed NSs suffering from WPV, and whether their NSs had suffered from WPV. Factors affecting scores on the attitude index included the age, highest academic degree obtained, years of work, the highest level of education that they could teach NSs, and whether they had received training on prevention and coping with WPV. Factors influencing the score for the practice index included the working department, highest academic degree obtained, professional title, the highest level of education that they could teach NSs, and whether they had received training on prevention and coping with WPV. Conclusion. Nursing clinical teachers showed moderate levels of knowledge, attitudes, and practices about NSs suffering from WPV. The deficiencies mainly focused on the sources, manifestations, influencing factors, and preventive strategies of it. Also, nursing clinical teachers should be trained to better prevent and cope with WPV suffered by NSs. At the same time, in order to better protect and teach NSs, the selection criteria for nursing clinical teachers should be stricter, with requirements on age, education, years of working experience, and titles. Implications for Nursing Management. With nursing clinical teachers as the training target, health organizations and institutions should actively develop training related to preventing and coping with NSs suffering from WPV. Also, it should be incorporated into the preservice training system for nursing clinical teachers. The content of training could focus on the sources, manifestations, influencing factors, and prevention strategies of NSs suffering from WPV. The method could be online theoretical teaching combined with offline scenario simulation exercises. At the same time, strict admission criteria for nursing clinical teachers can be helpful in protecting the safety of NSs during the clinical rotation phase. For nursing managers, they should be kept abreast of organisational policies and adopt a zero-tolerance policy towards violence. It also can be recommended that nursing clinical teachers should be proactively involved in training to improve their own ability to protect NSs. [ABSTRACT FROM AUTHOR]

Objective. This study aimed to evaluate conjunctival vessels in patients with dry eye disease (DED) using optical coherence tomography angiography (OCTA). Methods. This was a cross-sectional, observational clinical study. Twenty-three eyes of 18 patients with DED and 28 eyes of 23 healthy controls were included for examination in this study. The evaluation included the application of an Ocular Surface Disease Index Questionnaire, Schirmer Basic Secretion Test, and anterior OCTA targeting the temporal conjunctiva. AngioTool software was used to quantify the total vessel length and vessel density in the 3 × 3 mm temporal region of interest. Results. Blood vessel density measurements were compared across the OCTA systems. The total vessel length within the conjunctiva of the DED group (4799.34 ± 834.36) exceeded that of the control eye (3864.89 ± 1455.70) group (P < 0.05). However, the difference in vessel density between the two groups was not statistically significant. Conclusion. Measurement and analysis of conjunctival blood vessels using OCTA exhibited robust repeatability. In dry eyes, the total number of conjunctival blood vessels increased in accordance with disease severity. Hypoxia of conjunctival tissue may be an important cause of dry eye disease. [ABSTRACT FROM AUTHOR]

Background. Reliable epidemiologic data on the present burden of hypertension are needed in developing region-specific strategies since previous studies have suggested that China is lagging in risk factor management. Objective. The study aimed at exploring the prevalence of hypertension and its associated factors among adult residents in Ganzhou, China. Methodology. A multistage, stratified, and cluster random sampling method was used to conduct the cross-sectional survey. The study selected four county-level districts in Ganzhou City, China, as the investigation area. Permanent residents aged ≥18 years who have settled in the area for 6 months or more were selected. A total of 7430 residents were involved in the study. Univariate and multivariate logistic regression analysis was carried out to identify predictors of hypertension. Results. The prevalence of hypertension in Ganzhou was 28.5%, and the age-standardized prevalence of hypertension was 22.4%. Univariate logistic regression analysis revealed that multiple variables have a statistically significant effect on the prevalence of hypertension. The elderly (odds ratio [95% CI]: 2.791 [2.594–3.004]), men (1.805 [1.583–2.058]), lower educated (0.848 [0.805–0.893]), a family history of hypertension (4.575 [3.900–5.368]), higher body mass index (1.344 [1.215–1.488]), central obesity (1.532 [1.304–1.799]), and less vegetable intake (1.150 [1.023–1.294]) were the major risk factors for hypertension. Conclusion. Hypertension is a major public health problem in Ganzhou and requires much effort to reduce its prevalence. An effective multifaceted implementation strategy is highly desirable to combat the emerging burden of hypertension. [ABSTRACT FROM AUTHOR]

Object. In order to achieve Healthy China 2030 and an effective and sequential diagnosis and treatment system, family doctor contracting is a crucial strategy for improving graded diagnosis and treatment and achieving universal health. Through the examination of data on community members' medical expenditures, this research investigates the influence of contracting on residents' primary care consultation behavior. Methods. Using a quantitative research approach based on information about residents' medical payment patterns, this study aims to examine the effect of family doctor contracting on residents' medical costs. Therefore, a two-part model and a Heckman two-stage model are used to explore the impact of contracting on residents' medical expenses in the community hospital based on the sample of contracted and noncontracted residents and the basic information and monthly checkout data of the residents provided by a community hospital in Beijing. Conclusion. Specifically, contracting increased residents' healthcare expenditures in community hospitals by increasing the number of departments and the frequency of visits, according to the results, which indicate that contracting significantly increased residents' healthcare costs in community hospitals. The frequency and number of departments in community hospitals for two target groups—the elderly and patients with chronic diseases—have increased significantly as a result of contracting, according to subgroup analysis. This finding suggests that family physicians make it possible for the daily care and treatment of these two priority groups to be met to a greater extent at the primary level. The empirical findings of this study reveal that the family doctor contracting system has a significant impact on how primary care and hierarchical treatment patterns are established. [ABSTRACT FROM AUTHOR]

We aim to provide an overview of clinical and demographical features and neuropathological research on frontotemporal dementia (FTD) from China over the past decade. We reviewed the demographic features, clinical presentations, and neuropathology of the FTD-spectrum disorders from the 49 cases in China published since 1998. On the basis of these findings, we retrospect the history and speculate on future progress in terms of FTD in China. We found that most published papers comprise case reports with a few retrospective studies with small sample sizes. Behavior variant FTD (bvFTD) was the most common diagnostic subtype, of which 35% were associated with amyotrophic lateral sclerosis or Parkinsonian syndrome. More than 47% patients with FTD had age onset before 65. There were no differences in age of onset and sex distribution between diagnostic subtypes. The spectrum of neuropathological diagnosis of bvFTD was frontotemporal lobe degeneration (FTLD) with tau protein or ubiquitin-immunopositive inclusions, and FTLD without intracellular inclusions. Median survival in bvFTD was 14 years. This paper provides an overview of the current status and pointers for future research directions of FTD in China. [ABSTRACT FROM AUTHOR]

Background. Acute coronary syndromes (ACSs) are clinically cardiovascular events associated with dyslipidemia in common. Single nucleotide polymorphisms (SNPs) and haplotypes in the APOA1/C3/A5 gene cluster are associated with diabetes and familial combined hyperlipidaemia (FCH). Little is known about whether the polymorphisms in these genes affect lipid homeostasis in patients with ACSs. The present paper aimed to examine these associations with 4 SNPs in the APOA1 -75G > A, the APOC3 -455T > C, and APOA5 -1131T > C, c.553G > T variant to ACSs in Chinese Han. Methods. Chinese Han of 229 patients with ACSs and 254 unrelated controls were analyzed. Four SNPs in APOA1/C3/A5 cluster were genotyped and lipid was determined. Results. Our data show that minor allelic frequencies of APOC3 -455T > C, APOA5 -1131T > C, and c.553G > T polymorphisms in patients with ACSs were significantly higher than control group (P < 0.05). Furthermore, the 3 polymorphic sites were strongly of linkage disequilibrium, and minor alleles of 3 SNP sites had higher TG level than wild alleles (P < 0.05), APOC3 -455C and APOA5 c.553T allele carriers also had lower level of HDL-C. Conclusions. The minor alleles of APOC3 -455T > C, APOA5 -1131T > C, and c.553G > T polymorphisms are closely associated with ACSs. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the main etiological factors and visual outcomes in patients with dense vitreous hemorrhage (DVH) aged ≥80 years. We retrospectively included patients with DVH aged ≥80 years who were admitted to our ophthalmology department between January 1, 2010, and December 31, 2019. All patients underwent pars plana vitrectomy (PPV). Data regarding demographic characteristics; preoperative and postoperative best-corrected visual acuity (BCVA), intraocular pressure (IOP), and ophthalmic B-scan ultrasonography findings; intraoperative conditions; and postoperative complications were collected and analyzed. A total of 44 patients (44 eyes) were enrolled, with a median age of 82 years; among them, 25 patients (56.82%) were men. The median preoperative BCVA was 2.3 (1.1–3.0). The main etiological factors included retinal vein occlusion (RVO) (20 eyes, 45.45%), polypoidal choroidal vasculopathy (PCV) (15 eyes, 34.09%), proliferative diabetic retinopathy (PDR) (7 eyes, 15.90%), retinal arterial macroaneurysm (RAM) (1 eye, 2.27%), and posterior vitreous detachment (PVD) (1 eye, 2.27%). The median final BCVA was 1.92 (0.5–2.6). There was a significant postoperative improvement in the BCVA; moreover, branch RVO (BRVO) had a better postoperative visual prognosis than central RVO (CRVO), PCV, and PDR (P < 0.05). The final postoperative BCVA was significantly better when the initial BCVA was above hand motion (HM) than when it was HM or lower (P < 0.05). Our findings indicate that RVO, PCV, and PDR were the main causes of DVH. Microinvasive PPV is a safe and effective method that can clarify diagnosis and improve BCVA. Patients with BRVO and preoperative BCVA > HM may have a relatively good visual prognosis. For patients aged ≥80 years who have an appropriate general condition, PPV can be timely performed to treat DVH. [ABSTRACT FROM AUTHOR]

Background. The high turnover rate of new nurses is significantly impacted by the transition issue. Practice readiness has been identified as a key factor in ensuring a smooth transition, but there is currently a lack of specific instruments available in China to measure it. Aims. To translate and adapt the Casey-Fink Readiness for Practice Survey and validate its psychometric properties in senior nursing students in the Chinese cultural context. Methods. The descriptive cross-sectional study design was used. The English version of the Casey-Fink Readiness for Practice Survey was translated into Chinese according to Brislin's translation guidelines. A total of 590 senior nursing students from three nursing schools in China were surveyed with the Chinese version of the Readiness for Practice Instrument. Data analyses were performed to assess the reliability and validity of the instrument. The STROBE guidelines were used as the reporting method. Results. The validated Chinese version of the Casey-Fink Readiness for Practice Survey contained 18 items in the same four dimensions as the original English version. The internal consistency was satisfactory, with Cronbach's α and composite reliability values for all four dimensions above 0.70. The final confirmatory factor analysis model also demonstrated good fit indices, with the average variance extracted values for all dimensions above 0.50. Conclusion. The validated Chinese version of the Casey-Fink Readiness for Practice Survey is a reliable and effective instrument for measuring the readiness for practice among senior nursing students in China. Implications for Nursing Management. This study presents a valuable contribution to adapting an effective and reliable tool to assess readiness for practice among Chinese senior undergraduate nursing students. This will enable the development of specific strategies based on cultural context to optimize the readiness for practice for senior nursing students and smooth the transition of new nurses in China. [ABSTRACT FROM AUTHOR]

Objective. This paper is aimed at investigating the role and value of the timing of balloon occlusion of the abdominal aorta during caesarean section in patients with pernicious placenta previa complicated with placenta accreta. Methods. 79 cases admitted to the Second Affiliated Hospital of Zhengzhou University from September 2015 to December 2016 were treated with ultrasound mediated abdominal aortic balloon occlusion. Among them, 42 cases, whose balloon occlusion time was selected before the delivery and transverse incision was taken, were group A. The other 37 cases were group B, whose timing of balloon occlusion was selected after the delivery and the uterine incision made trying to avoid the placenta or double incisions. The intraoperative blood loss, utilization of blood, and other indicators were compared between the two groups. Results. The intraoperative blood loss in groups A and B was 413.8 ± 105.9 ml and 810.3 ± 180.3 ml, and the utilization of blood products in groups A and B was 30.23% and 89.2%. The total hysterectomy rate was 2.53% (2/79), with no hysterectomies in groups A and 2 cases in group B. Conclusion. The balloon occlusion of the abdominal aorta before the delivery combined with a transverse incision is more effective. [ABSTRACT FROM AUTHOR]

Background. Burnout is a common psychological syndrome among nurses, especially in the first few years of working. However, limited studies have evaluated the factors related to burnout among junior nurses. Aims. To investigate the levels of psychological flexibility, stress, and burnout among junior nurses and examine the role of demographic and workplace relationship factors, psychological flexibility, and perceived stress on burnout among junior nurses. Materials and Methods. A convenience sample of 481 junior nurses was recruited from three tertiary hospitals in China from July 2021 to August 2022. Data were collected, including demographic data, workplace relationships, psychological flexibility (measured by experiential avoidance and cognitive fusion), perceived stress, and burnout. The Independent t-test, one-way ANOVA, Wilcoxon–Mann–Whitney test, Kruskal–Wallis test, Spearman correlation, and hierarchical regression were used to analyze the data. Results. Junior nurses had a high level of burnout in different dimensions. Nurses with an undergraduate education, nurses working in the first year, and a lack of support from supervisors and poor colleague (nurse-nurse and nurse-doctor) relationships had the lowest level of psychological flexibility and the highest level of perceived stress and burnout. Spearman correlation indicated that experiential avoidance, cognitive fusion, perceived stress, and burnout were positively associated with each other. The regression model showed that psychological flexibility (especially cognitive fusion) and perceived stress influenced burnout in junior nurses. Conclusions. Higher psychological flexibility and lower perceived stress appear to improve burnout in junior nurses. Therefore, interventions targeting these two factors may provide a viable direction for the reduction of burnout among junior nurses. Implications for Nursing Management. Hospital authorities should create a harmonious working environment and provide some psychology training programs for junior nurses. [ABSTRACT FROM AUTHOR]

Health education is one of the most effective and efficient ways to achieve the goal of universal health coverage and the sustainable development goals. The equity of access to health services (especially services from community healthcare centers) for internal migrants is an important issue of global concern. However, due to the registration system, long-term residence plan, education level, and other determinants, it is more difficult for internal migrants to enjoy equitable health education compared with local residents. At present, there is no research on signing up with family doctors mainly from community healthcare centers among internal migrants and their impact on access to health education services. In this nationwide cross-sectional study, we used the migrant population dynamic monitoring survey (MDMS) in 2018 to assess the disparities in signing up with a family doctor and its association with health education among internal migrants in China. Among the 151,892 participants, a total of 11.26% migrants had signed up with a family doctor and 81.37% internal migrants had received health education. There was a significant association between signing up with a family doctor and health education in the univariate model (aOR = 1.113; 95% CI: 1.095, 1.132) and the multivariate model (aOR = 1.107, 95% CI: 1.089, 1.126). Meanwhile, age (aORinteraction = 0.996, 95% CI: 0.994, 0.997), migration time (aORinteraction = 0.927, 95% CI: 0.907, 0.948), and migration range (aORinteraction = 0.994, 95% CI: 0.992, 0.997) also had an impact on the relationship between signing up with family doctors and health education. Due to the health education inequalities among internal migrants in China, we need to improve health education access and utilization of internal migrants. As signed up with family doctors was significantly associated with health education among migrants in China, we recommended that the government and healthcare facilities promote health education through family doctors. The number and professional ability of family doctors should also be improved especially in areas with weak healthcare service resources in the future. [ABSTRACT FROM AUTHOR]

Aim. To develop a valid, reliable assessment tool to measure risk factors associated to low back pain (LBP) in intensive care unit (ICU) nurses. Background. LBP is defined as the pain extending from the 12th rib to the iliac crest and often coexists with buttock pain. Nursing has been identified among the top professions at risk of LBP. A mean of 70% prevalence per year in ICU nurses was reported, exceeding those employed in heavy industry. Environmental factors in workplace were also most important risks related to LBP in this population except factors including individual, physical, psychosocial, and lifestyle. However, there is lack of tools to assess environmental risk related to LBP for nurse managers currently. Methods. Focus group interviews, field research, and panel discussion were used to develop item pool. Two-round expert reviews and preinvestigation were carried out to form initial scale named Environmental Risk Assessing Instrument-Occupational Low Back Pain in Nurses (ERAI-N). A cross-sectional survey with 188 ICU participants in Hunan Province in China was implemented to collect data. Cronbach's alpha, split-half reliability, and test-retest reliability were used to test ERAI-N's reliability. Expert review was performed to test ERAI-N's content validity, and confirmatory factor analysis (CFA) was performed to assess its construct validity, being carried out in IBM SPSS Amos 26 Graphics. Results. Final version of ERAI-N scale had five dimensions with 18 items that were space, equipment, belief, guideline, and safe culture. ERAI-N scale's score of Cronbach's alpha, Guttman split-half, and intraclass correlation coefficient (ICC) was 0.958, 0.927, and 0.994, respectively. Item-level content validity scores ranged from 0.89 to 1.0, and scale-level content validity was 0.983. Standardized factor loadings ranged from 0.567 to 0.974. Model adjusted fit statistics were as follows: the chi-square statistic and degrees of freedom (χ2/df) = 3.943, root mean square error of approximation (RMSEA) = 0.071, incremental fit index (IFI) = 0.905, comparative fit index (CFI) = 0.904, parsimony normed fit index (PNFI) = 0.641, and parsimonious comparative fit index (PCFI) = 0.661. Conclusions. ERAI-N scale had moderate reliability, content validity, and construct validity. Implications for Nursing Management. Designers may use ERAI-N scale to plan the interior layout when design a new ICU. Nurse managers might utilize this instrument as a managing tool to assess whether there is environmental risk factors related to LBP in ICU. [ABSTRACT FROM AUTHOR]

Background. In this meta-analysis, we aimed to systematically compare the efficacy and safety of phacoemulsification and laser peripheral iridotomy (LPI) in the treatment of primary angle-closure glaucoma (PACG). Method. We searched PubMed, MEDLINE, EMBASE, the Cochrane Library, the Chinese Journal Full-text Database (CNKI), the Wanfang database, and the China Science and Technology Journal Database for randomized controlled trials (RCTs) of phacoemulsification and LPI in the treatment of PACG published up to September 30, 2022. Postoperative intraocular pressure (IOP), anterior chamber depth (ACD), complications, corneal endothelial cell count, and best-corrected visual acuity (BCVA) were compared. The effective quantity of measurement data was measured by the mean difference (MD) and 95% confidence interval (CI). The effect of counting data was measured by the odds ratio (OR). Result. A total of 1731 potential studies were identified, and after screening, 8 RCT studies were included. The results of the meta-analysis showed that, compared to the LPI group, the patients in the phacoemulsification group showed lower IOP six and twelve months after operation (MD-3.39, 95% CI −4.15∼−2.63, P < 0.00001 ; −2.29, −3.52∼−1.06, 0.0003). The ACD in the phacoemulsification group was significantly deeper than that in the LPI group (1.59, 1.10∼2.09, 0.00001). Meanwhile, the incidence of complications in the phacoemulsification group was lower than that in the LPI group (OR = 0.46, 0.29∼0.72, 0.0006). There was no statistically significant difference between the phacoemulsification group and the LPI group in corneal endothelial cell count and BCVA at 6 and 12 months after operation (P = 0.38 ; 0.11; 0.81). Conclusion. Compared with LPI, phacoemulsification is safer and more effective in the treatment of PACG, especially in controlling IOP and minimizing postoperative complications. [ABSTRACT FROM AUTHOR]

Aging slows down the mechanisms behind skeletal muscle weakening and mobility. Increases in inflammation brought on by aging may contribute to some characteristics of sarcopenia. As a result of population aging worldwide, sarcopenia, an age-related disease, has become a huge burden on both individuals and society as a whole. The study of the morbidity mechanism and available sarcopenia treatments has received more attention. The inflammatory response may be one of the most important methods behind the pathophysiology of sarcopenia in the aged, according to the background of the study. This anti-inflammatory cytokine inhibits the ability of human monocytes and macrophages to induce inflammation as well as the production of cytokines like IL-6. Here, we investigate the association between sarcopenia and interleukin-17 (IL-17), an inflammatory cytokine in the aged. There were 262 subjects aged 61-90 years who were screened for sarcopenia in Hainan General Hospital. The subjects were divided into 45 males and 60 females aged 65-79 years (average age: 72.00 ± 4.31 years). 105 patients without sarcopenia were randomly selected among 157 participants. It included 50 males and 55 females, aged 61-76 years (mean age: 69.10 ± 4.55 years) as per the standard definition of the Asian Working Group for Sarcopenia (AWGS). The "skeletal muscle index" (SMI), "hand grip strength" (HGS), "gait speed" (GS), "biochemical indexes," "serum IL-17 level," nutritional status, and past medical history of the two groups were evaluated and compared. Compared with the participants without sarcopenia, sarcopenia patients had higher average age; less physical exercise; lower total scores of BMI, pre-ALB, IL-17, and SPPB; and a higher proportion of malnutrition risk (all P < 0.05). By "ROC curve analysis," the best critical point was IL-17 in the growth of sarcopenia. The area that comes under ROC (AUROC) value was 0.627 (95% CI = 0.552 , 0.702, P = 0.002). The ideal threshold value for IL-17 to estimate sarcopenia was 18.5 pg/mL. In the unadjusted model, IL-17 was considerably linked to sarcopenia (OR = 1.123 , 95% CI = 1.037 -1.215, P = 0.004). After the covariate adjustment observed in the complete adjustment model (OR = 1.111 , 95% CI = 1.004 -1.229, P = 0.002), this significance still exists. The results of this study suggest a strong relationship between sarcopenia and IL-17. This study will look at IL-17's potential to serve as a key sarcopenia indicator. This trial is registered with ChiCTR2200022590. [ABSTRACT FROM AUTHOR]

This study aimed to explore the effect of the Wuhan lockdown on body mass index (BMI) among Wuhan residents as well as factors including food habits affected and changes in physical activity mediating the association. As a survey of the Wuhan lockdown, a random digit dialing method was used to sample residents aged 18 years and older. A computer-aided telephone interview was applied to survey 11,223 residents in Wuhan City in July 2020. Ordinary least squares (OLS) regression and mediation analysis were used to analyze the influence of the Wuhan lockdown on BMI. Demographic characteristics, lifestyle characteristics, and health status differed statistically significantly between residents living in and those who left Wuhan during the lockdown (mean BMI, 23.05 ± 0.04 kg/m2 and 22.34 ± 0.06 kg/m2, respectively). The mean BMI among residents living in Wuhan was 0.42 kg/m2 higher (P < 0.001) than that of residents who left Wuhan during the lockdown, as determined by multivariate OLS regression analysis. Residents living in Wuhan during the lockdown had higher BMI among those aged 18–29 and 30–44 years (P < 0.001), with no difference among those aged 45+ years. The association between living in Wuhan and increased BMI was the strongest among residents who were overweight/obese. The mediation analysis results showed an indirect effect path with living in Wuhan (through decreased physical activity and increasing BMI) and the direct effect of living in Wuhan during the lockdown. The lack of association between living in Wuhan and increased BMI among residents aged 45+ years was due to the indirect influence of living in Wuhan affecting food habits. The findings indicated that the lockdown in Wuhan city increased residents' BMI, especially among those who were young or overweight/obese, partly because of decreased physical activity. [ABSTRACT FROM AUTHOR]

The drifting elderly are an interprovincial floating elderly population that is mainly composed of unemployed older parents in China. They have left their usual residence and relocated to urban areas, facing challenge about social integration. As a neighborhood has played important roles in the floating population's social integration, this study was designed to investigate the influence of neighborhood-based identity and social participation on the social integration of the drifting elderly. Five rounds of data collection and analysis were conducted in a continuous crossover sequence using grounded theory. Twenty-four participants were recruited from three districts in Shanghai, China. The neighborhood was shown to play a prominent role in the drifting elderly's perceptions of social integration. Good neighborhood relations help the drifting elderly establish effective social support networks, interact with inflowing society, get in touch with more human resources, and form social relationships and networks. Neighborhood-based participants and identity were more conducive to eliminating heterogeneity and creating homogeneity for the drifting elderly. Thus, the neighborhood affects the social integration of the drifting elderly, which directly impacts their social feelings, integrations, and networks. Management of social integration among the drifting elderly should be focused on creating general opportunities for them to participate in neighborhood-based social events with a reasonable identity. [ABSTRACT FROM AUTHOR]

Participation by patients with chronic diseases under primary health care requires more attention to achieve effective disease management and better health outcomes. In 2016, China proposed accelerating the establishment of a system of family doctors (FDs) and strengthening doctor-patient communication to better meet residents' health service needs. This study aimed to describe perceived participation in primary health care among patients with chronic diseases in northeastern China and explore the impact of FD contract services and patient's trust on patients' perceived participation. A cross-sectional survey of 847 patients with chronic diseases in 16 primary healthcare institutions was conducted in Jilin Province, China. Among all participants, 453 patients reported signing up for FD contract services (62.93%). The perceived participation of patients with chronic diseases was at a low level (mean = 6.71 and SD = 3.35). After controlling for sociodemographic variables and health-related variables, FD contract services directly and indirectly influenced patients' perceived participation. The patient's trust was a mediator in the relationship between FD contract services and perceived participation. This study confirmed the valuation of family doctor contract services and provided a theoretical basis for the formulation of primary health service policies. Health organizations should continue to enhance the capacity of primary health services and attract more chronic disease patients to contract with FD teams, thereby enhancing doctor-patient trust and increasing patient's participation in primary health care. [ABSTRACT FROM AUTHOR]