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Aims and Objectives: The aim was to identify latent trajectories in physical activity (PA) and their determinants in adults with chronic obstructive pulmonary disease (COPD) based on the socio‐ecological model. Background: PA has been linked to poor long‐term outcomes in patients with COPD. However, few studies have explored their PA trajectories and their predictors. Design: Cohort study. Methods: We used data from a national cohort and included 215 participants. PA was quantified using a short PA questionnaire, and group‐based trajectory modelling was used to explore the PA trajectories. Multinomial logistic regression was conducted to identify the predictors of PA trajectories. Generalised linear mixed models were used to elucidate the associations between predictors and PA during follow‐up. A STROBE checklist was used to guide the reporting of this study. Results: Three PA trajectory patterns were identified among 215 COPD participants with an average age of 60.51 ± 8.87: stable inactive group (66.7%), sharp decline group (25.7%) and stable active group (7.5%). The logistic regression showed that age, sex, income, peak expiratory flow, upper limb capacity, depressive symptoms, the frequency of contact with children were PA predictors. Upper limb capacity weakness and depressive symptoms were found to be associated with a sharp decline in PA during follow‐up. Conclusions: This study revealed three PA trajectories among patients with COPD. In addition to strengthening the physical functions and mental health of patients, support from the family, community and society also play a crucial role in promoting PA of patients with COPD. Relevance to Clinical Practice: It is essential to identify distinct PA trajectories in patients with COPD to develop future interventions that promote PA. No Patient or Public Contribution: A national cohort study was used and no patients or the public were involved in the design and implementation of this study. [ABSTRACT FROM AUTHOR]

Aims and objectives: To systematically review and compare the efficacy of different exercise interventions on bone mineral density (BMD, g/cm2) in patients with osteoporosis and osteopenia. Background: It is vitally important to prevent and treat bone loss in patients with osteoporosis and osteopenia. Exercise can effectively increase bone density and slow down bone loss in middle‐aged and older people. However, it is still unclear which type of exercise intervention is the most effective on bone mineral density. Design: Systematic review and network meta‐analysis (NMA) according to PRISMA. Methods: Randomised controlled trials of different exercise treatments for osteopenia and primary osteoporosis were included. A Frequentist network meta‐analysis was conducted to appraise the efficacy of different types of exercise. The outcome was bone mineral density of different parts of the body. Results: Ninety‐seven studies were included. The network meta‐analysis showed that combined exercise, resistance exercise, aerobic exercise and mind‐body exercise had a significant effect in improving the bone density of lumbar spine. The surface under the cumulative ranking area (SUCRA) values for mind‐body exercise was 0.99 and ranked first. For BMD of the femoral neck, all kinds of exercise interventions increased the bone density significantly compared with no exercise and the optimal type was mind‐body exercise (SUCRA = 0.99). In terms of the total hip bone mineral density, aerobic exercise and resistance exercise could improve hip bone density, with the resistance exercise (SUCRA = 0.95) ranking as first. Conclusions: This NMA demonstrated the mind–body exercise might be the optimal exercise type to increase the BMD of the lumbar spine and femoral neck and resistance exercise is the most promising type for total hip BMD. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate turnover intention among newly licensed registered nurses and to clarify the impact pathways of organisational justice, work engagement and nurses' perception of care quality on turnover intention. Background: Nurse shortage is an ongoing and urgent issue worldwide, in which nurse turnover could exacerbate the situation. Newly licensed registered nurses will become the main nursing workforce in the future; however, previous studies have not revealed the specific reasons underlying their turnover intentions. Design: A descriptive cross‐sectional design. Methods: A total of 569 newly licensed registered nurses undertaking direct care were recruited from thirteen hospitals from October to November 2018 across Beijing, China. Based on the job demands–resources model, we advanced a hypothetical model, linking the paths between organisational justice, work engagement, nurses' perception of care quality and turnover intention. Structural equation modelling was used to examine the hypothetical model. The study adhered to the STROBE statement for observational studies. Results: In total, 22.3% of newly licensed registered nurses had a high turnover intention. The final model had an acceptable fit and could explain 58% of the variance in turnover intention. The organisational justice was directly related to high work engagement, great nurses' perception of care quality and low turnover intention. Additionally, organisational justice also had indirect effects on great nurses' perception of care quality and low turnover intention, which were partially mediated by work engagement. However, the effect of nurses' perception of care quality on turnover intention was not significant. Conclusion: The improvement of organisational justice could enhance work engagement, and nurses' perception of care quality, and reduce turnover intention, which is crucial to improving care quality and addressing the shortage of nurses. Relevance to clinical practice: This study provides evidence for policymakers and hospital administrators to take targeted measures to enhance work engagement, foster high‐quality care and create better defences against losing nurses. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify the situation of organisational justice, organisational support, work engagement and turnover intention among community nurses and clarify the relationship among them. Background: Nurse shortage has become a worldwide issue, and the shortage of community nurses is more serious. Nurse turnover is one important factor for this situation. While previous studies about turnover intention mostly focused on hospital nurses, few involved community nurses. Design: A descriptive, cross‐sectional design was adopted. Methods: Questionnaire investigation was implemented among 410 community nurses to collect data about organisational justice, organisational support, work engagement and turnover intention. Structural equation modelling was applied to test the hypothesised model. The STROBE statement for observational studies was followed. Results: Results showed the average score of turnover intention was 2.50 ± 0.75. The final model indicated: (a) work engagement had a direct negative effect on turnover intention; (b) organisational support had both direct and indirect effects on turnover intention, and the indirect effect was mediated by work engagement; and (c) organisational justice had an indirect effect on turnover intention mediated by organisational support. Conclusion: Turnover intention could be reduced directly or indirectly by improving work engagement, organisational support and organisational justice. Relevance to clinical practice: This study provides evidence for community health centre managers and policymakers to improve the level of nurses' engagement and to retain more nurses in primary healthcare service. [ABSTRACT FROM AUTHOR]