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Background: Misconceptions about male nurses not only exacerbate the gender imbalance in the nursing profession but also negatively impact male nurses embarking on their careers. Currently, no tool exists to measure the gender biases toward males in nursing among nursing students in China. Consequently, the primary objective of this study is to assess the validity and reliability of the Chinese translation of the Gender Misconceptions of Men in Nursing (GEMINI) scale among nursing students. Methods: This cross-sectional study involved 1,102 nursing students from China who participated online. We utilized the Brislin translation technique with a forward-backward approach. To determine the factor structure within the Men in Nursing Gender Misconceptions Scale's Chinese version, both exploratory (EFA) and confirmatory factor analysis (CFA) were applied. The scale's internal consistency was measured through the Cronbach's alpha coefficient, corrected item-total correlation, and a retest reliability assessment. Results: The scale showed a content validity index of 0.938 and a retest reliability of 0.844. EFA indicated a two-factor structure for the translated instrument. CFA revealed a chi-square/degree of freedom of 3.837, an incremental fit index (IFI) of 0.952, a goodness-of-fit index (GFI) of 0.910, a comparative fit index (CFI) of 0.952, and an RMSEA of 0.073, all of which were within acceptable limits. The scale's Cronbach's α was 0.953, and the corrected item-total correlations ranged between 0.539 and 0.838. Gender-based misconceptions about men in nursing among students appeared to be influenced by their gender and whether they considered a nursing program as their first choice when applying for a major. Misconceptions about male nurses are greater among men and those who do not consider nursing programs as their first choice when applying for a major. Conclusions: The Chinese adaptation of the GEMINI scale showcased high reliability and validity. It stands as a potential instrument to gauge gender misconceptions concerning male nurses among Chinese nursing students. [ABSTRACT FROM AUTHOR]

Coptis chinensis Franch (RC), has historically been used for the treatment of "Xiao Ke" and "Xia Li" symptoms in China. "Xia Li" is characterized by abdominal pain and diarrhea, which are similar to the clinical symptoms of ulcerative colitis (UC). For the first time, this study aims to compare the anti-colitis effects of berberine (BBR) and total RC alkaloids (TRCA) and investigate the underlying metabolites and gut microbiota biomarkers. Metabolomics results showed that several colitis-related biomarkers, including lysophosphatidyl ethanolamine, lysophosphatidylcholine, scopolamine-methyl-bromide, N1-methyl-2-pyridone-5-carboxamide, 4-hydroxyretinoic acid, and malic acid, were significantly improved in model mice after BBR and TRCA treatments. High-dose BBR and TRCA treatments reversed the mouse colon shortening caused by dextran sodium sulfate (DSS), alleviated bowel wall swelling, and reduced inflammatory cell infiltration. BBR and TRCA restored the damaged mucosa integrity in colitis mice by upregulating claudin 1 and occludin, preventing colon epithelium apoptosis by inhibiting the cleavage of caspase 3. Additionally, BBR and TRCA significantly decreased the richness of the pathogenic bacteria Bacteroides acidifaciens but increased the abundance of the probiotic Lactobacillus spp. Notably, TRCA exhibited superior anti-colitis effects to those of BBR. Thus, this agent warrants further study and application in the treatment of inflammatory bowel disease in the clinic. [ABSTRACT FROM AUTHOR]

Aim: The aims of the present study are to describe the status of selfmanagement behaviors and illness perception, and explore the relationship between illness perception and self-management behaviors among Chinese diabetic foot patients. Methods: A cross-sectional study was conducted at the endocrinology department of a comprehensive tertiary hospital in Guangzhou, China. Data were collected on illness perception, self-management behaviors, and demographic and clinical characteristics over 9 months among 156 subjects. Data were analyzed using Pearson correlation analysis, univariate analysis and multiple linear regression analysis. Results: Only 3.2% of participants maintained excellent self-management behaviors. Additionally, the participants perceived diabetic foot as chronic and could be well controlled through treatment. Multiple linear regression analysis revealed that illness perception was associated with self-management behaviors. Conclusions: Patient illness perception is an important factor influencing self-management behaviors. It may be helpful to improve self-management behaviors by tailoring the content of the intervention to fit the patients' illness perceptions. [ABSTRACT FROM AUTHOR]

Aims: To investigate the relationships between transformational leadership, psychological empowerment and innovative behaviour among nurses in China. Background: The innovative behaviour of nurses is important to adapt to the changing medical environment. However, there is currently a limited understanding of the relationship between nurses' innovative behaviour and transformational leadership and psychological empowerment during the pandemic. Methods: Convenience sampling was used to conduct an investigation involving 1317 nurses from 10 hospitals in China from January 2022 to April 2022. Data analysis was performed using correlation analysis, univariate analysis and multiple regression analysis. The STROBE checklist was followed when writing this manuscript. Results: High transformational leadership and high psychological empowerment were associated with high innovative behaviour. The results of the multiple linear regression analysis showed that physical condition, whether or not you have attended academic conferences or whether or not you have participated in fund research projects, transformational leadership and psychological empowerment were the main factors on nurses' innovative behaviour, together explaining 64.5% of the total variance. Conclusion: Promotion of transformational leadership and psychological empowerment is vital for nurses to promote innovation, thereby meeting the urgent demand for innovative nurses and the rapid development of nursing disciplines. Implications for Nursing Management: This study highlights the importance of transformational leadership in developing nurses' innovative behaviours. Understanding the role of psychological empowerment can help nurse managers formulate relevant intervention strategies and cultivate nurses' innovative behaviour. [ABSTRACT FROM AUTHOR]

Aims: To describe adult intensive care nurses' experiences and attitudes towards intrahospital transport (IHT) of critically ill patients and to assess the relationship between nurses' characteristics, attitudes and experiences. Design Cross‐sectional survey. Methods: Factor analysis identified factors within the attitudinal and experience domains. Univariate analysis was performed to demonstrate the relationship between attitudinal and experience factors and demographic and professional characteristics of the participants. Multiple regression equations were applied to determine associations between nurses' experiences and attitudes. The study took place from July to August 2019. Results: A total of 480 nurses from 12 adult intensive care units in China participated, with a response rate of 65%. Most respondents had a baccalaureate nursing degree (75%). The majority (80%) had participated in IHT of critically ill more than five times in the previous 12 months and 90% agreed that checklists led to an improvement in patient safety during transport. However, 75% of respondents expressed that transport increased the workload of the nurses who accompany patients off unit and those who remained in the intensive care unit (66%). Variables that were associated with a favourable perception of transport competency and checklists/tool use were nurses' prior transport experiences and knowledge/training. Conclusion: Nurses perceived IHT was a sourse of stress and increased workload. Checklists and training were beneficial for patient safety during IHT. Impact The findings point out a clear need for ICU nurse training, standardised policy/procedure and customisation of existing intrahospital transfer checklists according to hospital procedures and local circumstances. New research is needed to evaluate the impact of novel IHT interventions on patient safety and nurses' stress. [ABSTRACT FROM AUTHOR]

The study aimed to explore the potential effect of short-term visual perceptual training based on virtual reality (VR) and augmented reality (AR) platforms in postoperative strabismic patients. We enrolled 236 postoperative strabismic patients, among whom 111 patients received VR-based training, and 125 patients received AR-based training. The stereoacuity of 1.5 m and dynamic stereopsis were improved by VR training; meanwhile, AR training exhibited more improvement in stereoacuity of 0.8 and 1.5 m, dynamic and coarse stereopsis. It was suggested that the visual perceptual training based on VR and AR technology can be potentially applied in postoperative strabismus treatment to promote the recovery of binocular vision. [ABSTRACT FROM AUTHOR]

Aim: To analyse junior nurses' transition shock status and its associated factors. Background: When nurses experience transition shock, turnover intentions followed by turnover behaviour are likely, which is unfavourable for the stable development of nursing teams. Methods: Using convenience sampling, 1,148 Chinese junior nurses were recruited. Those recruited completed a demographic questionnaire and the head nurses' humanistic care behaviour for nurses, feedback‐seeking behaviour and transition shock of nurses scales. Data and associated factors of transition shock were analysed using SPSS and univariate and multivariate analyses, respectively. Results: Head nurses' humanistic care behaviour and nurses' feedback‐seeking behaviour were significantly and negatively correlated with junior nurses' transition shock (mean score: 2.87 ± 0.85). Income satisfaction, head nurses' humanistic care behaviour, night shift frequency and educational background entered the regression equation. Conclusions: Transition shock exists not only in new nurses but also in junior nurses with ≤5‐year service. Those dissatisfied with their income have frequent night shifts, and higher education backgrounds have higher levels of transition shock. Implications for Nursing Management: Head nurses need to reduce transition shock of nurses with ≤5‐year service by integrating humanistic care into nursing management and creating a friendly environment to stimulate feedback‐seeking behaviour. [ABSTRACT FROM AUTHOR]

Aim: Nurses are considered a major source of professional support for patients. However, little is known about what cancer patients need from nurses regarding professional support and the provision of services in China. The purpose of this study is to investigate professional nursing supportive care needs, perceived supply, and the possible gaps between the two for patients with cancer in mainland China. Methods: A total of 390 inpatients with different types of cancer were recruited. The professional nursing supportive care scale was used to assess the needs for and perceived supply of various types of support. Results: The information aspect was one of the most critical needs for supportive care, and the technical aspect was the one with the highest perceived level of supply. Significant mismatches between actual needs and perceived supply were identified. Conclusions: Significant gaps existed between actual needs and perceived supply. Nurses should pay more attention to the higher actual needs and lower perceived levels of supply regarding supportive care for cancer patients. [ABSTRACT FROM AUTHOR]

Aim: To describe the levels of work engagement, and to analyse the reciprocal relationships between social support, empathy, resilience and work engagement among haemodialysis nurses in China. Background: Work engagement is a critical workplace health indicator. Previous studies have examined work engagement perceived by nurses working in diverse hospital wards, or a specialty area (emergency care or intensive care), no previous studies have highlighted work engagement and its affecting factors among haemodialysis nurses. Methods: Participants in the cross‐sectional study were 345 haemodialysis nurses employed in 17 hospitals in Chengdu, China. Hierarchical regression analyses were carried out to analyse the relationships between social support, empathy, resilience and work engagement in haemodialysis nurses. Results: Resilience was the strongest positive significant contributor to work engagement, followed by other support and perspective taking (cognitive empathy). Nurses with longer occupational tenure reported higher levels of work engagement. Male nurses also reported greater work engagement than female nurses. Discussion: Influence of work engagement was explored by social support, empathy and resilience, reflecting the need of haemodialysis nurses to understand the significance of focusing on their personal and environmental factors. Conclusions: Positive resilience, other support and cognitive empathy can result in increased work engagement. Implications for nursing: Training programs, such as mindfulness meditation training and empathy skills training, are recommended for nursing managers to enhance resilience and empathic capacity in nurses. Implications for nursing policy: Nursing policies should be developed to establish supportive work environments in clinical practice settings and to support the education and training of psychological resilience and empathic capacity in order to foster work engagement. [ABSTRACT FROM AUTHOR]

Purpose: To compare mobile phone addiction (MPA) patterns between Tibetan and Han adolescents in China. Design and Methods: The study was carried out in two provinces of China. The Mobile Phone Addiction Scale (MPAS) was used to assess MPA. Findings: Seven hundred and five Tibetan and 606 Han students participated in the study. The MPAS total score was 24.4 ± 11.4 in the whole sample; 27.3 ± 10.8 and 20.9 ± 11.2 in Tibetan and Han students, respectively. Quality of life (QOL) in the physical, psychological, social, and environmental domains was negatively associated with MPA. Practice Implications: Compared with Han students, Tibetan students were found to have more severe MPA. Given its negative impact on QOL, appropriate measures for the prevention of MPA should be developed, particularly for Tibetan middle school students. [ABSTRACT FROM AUTHOR]

Research on perceptions and attitudes regarding intimate partner violence (IPV), a prominent predictor of IPV, is limited, and surveys on the relationships of the influencing factors are even rarer. Using a convenience sample of 2,057 students and assessed by the Revised Conflict Tactics Scale, this study explored Chinese university students' perceptions and attitudes concerning IPV to improve IPV prevention programs. It focused on the existences of the different perceptions and attitudes regarding gender, residence, major, and age under the same condition of educational attainment. Significant gender differences were found, with female students possessing better perceptions, which indicated that with the same education levels, the perceptions of females were better than those of males. Significant differences were also found for the first time in the literature between science students and arts students, with the latter holding better attitudes. No significant differences were seen between students from rural areas and students from urban areas, suggesting that with the same educational attainment, there were no perception differences between rural and urban residents. No significant perception differences were found among freshmen, sophomores, juniors, and seniors, which revealed that neither university education nor urban life had a significant effect on perceptions and attitudes concerning IPV for students who had finished high school education. In conclusion, the results of the current study indicated that among the other factors such as gender, residence, and age, education was the most powerful factor influencing perceptions and attitudes concerning IPV. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyse the association between social determinants and the presence of essential hypertension in type 2 diabetes mellitus patients in one rural county (Jintan) of China. A health survey of Jintan residents was conducted in 2013, applying a cluster sampling method. Three hundred and fifty-seven type 2 diabetes mellitus patients were selected as research subjects. Among the patients selected, essential hypertension prevalence was 45.4% (n = 162). After univariate analyses and logistic regression analyses, an association was observed between the presence of essential hypertension in type 2 diabetes mellitus patients and marital status, described as 'others (unmarried, divorce, widower, etc.)', and participating in active physical activity. Both of these two significant variables were positively associated with the higher prevalence of essential hypertension in type 2 diabetes mellitus patients. In conclusion, the patients suffering from type 2 diabetes mellitus combined with essential hypertension often reported an association with more negative social determinants (with the exception of participation in physical activity). Further strengthening the comprehensive multi-disease management to control and reduce the prevalence of essential hypertension in type 2 diabetes mellitus patients is required. [ABSTRACT FROM AUTHOR]

Nursing students' beliefs about etiology and manifestation of mental illness will impact on their professional attitudes in future clinical practice. The aims of the present study were to examine and compare US and Chinese undergraduate nursing students' recognition of, and beliefs about, causes of depression and schizophrenia. A total of 310 US (n = 152) and Chinese (n = 158) nursing students completed the Australian National Mental Health Literacy Survey questionnaire between April 2016 and April 2017. Although nursing students in the USA and China were highly accurate in recognizing depression and schizophrenia, the US students were more likely to nominate multiple items alongside the correct diagnosis than the Chinese students. The Chinese students were more likely to view depression and schizophrenia as multi‐causally‐determined mental disorders than the US students. The findings highlight the need for the incorporation of mental health issues, including symptomatology of different mental disorders and their application to patient care, into various aspects of the US nursing curriculum. In China, opportunities can be created for nursing students to discuss the impact of personal beliefs on care delivery and social stigma during clinical placement. [ABSTRACT FROM AUTHOR]

This is a single centre study in mainland China aiming to evaluate the reliability, validity and responsiveness of the Chinese version of EORTC QLQ‐BN20, designed by The European Organization for Research and Treatment of Cancer Quality of Life Group to evaluate the life quality of patients with brain tumour, cancer or metastases. One hundred and eighty‐eight patients with primary or secondary brain cancer from Hunan Provincial Tumor Hospital during September 2013 to June 2014 completed the Chinese EORTC QLQ‐C30/BN20 questionnaires developed by translation, back translation and cultural adaptation. Results were statistically analysed using SPSS17.0. The internal consistency (Cronbach's α coefficient) was between .753 and .869, the correlation coefficients among items and its own dimension were bigger than .4, and all items had a better correlation with its own dimension. The Spearman was used to analyse the correlation of each dimension between EORTC QLQ‐BN20 and EORTC QLQ‐C30, and the result showed that individual dimensions were moderately correlated, other dimensions were weakly correlated. In conclusion, the Chinese version of EORTC QLQ BN20 questionnaire had great relevance, reliability, convergent validity and discriminant validity. It provides a valuable tool for the assessment of health‐related quality of life in clinical studies of Chinese patients with primary or secondary brain cancer. [ABSTRACT FROM AUTHOR]

Increasing evidence indicates unmet supportive need as a detrimental effect on patients’ well‐being. However, the unmet needs and correlations with quality of life (QOL) in mainland Chinese cancer patients remain unclear. This study aimed to assess the unmet needs and QOL in Chinese cancer patients, and further explore the influencing factors. A cross‐sectional descriptive study design was applied. Using a convenience sampling method, 300 cancer patients, including 176 females and 124 males were recruited from five tertiary hospitals in Xi'an city during April to July 2015. Self‐administered questionnaires including general information, Comprehensive Needs Assessment Tool (CNAT) and the 36‐item Short‐Form Health Survey (SF‐36) were used for data collection. The mean age of the participants was 52.96 ± 13.45 years. The total score of CNAT was 46.37 ± 21.87, and the most unmet comprehensive needs were healthcare staff, information and health facilities and services domain. The total score of QOL was 48.95 ± 18.80 and 50.35 ± 19.77 for physical and mental QOL respectively. Multiple regression analysis revealed that age, employment status (employed), marital status (unmarried/divorced/widowed) and high needs in physical symptoms were associated with physical QOL. In addition, gender (female), marital status (unmarried/divorced/widowed), and needs in health and psychological problem and physical symptoms domains are significant factors to the mental QOL. These findings from the study provide useful information for care providers to identify and meet specific needs for cancer patients to improve QOL. [ABSTRACT FROM AUTHOR]

Objectives: China's economic reforms have led to millions of citizens being relocated to support infrastructure development, reduce poverty, and address ecological, disaster-related and other concerns. This study expands on previous research on the implications of relocation in China by examining the impact of rural elders' relocation on the perceived availability of emotional, instrumental, and financial support. Methods: Data were drawn from the Ankang Study of Aging and Health conducted with a representative sample of 1,062 rural residents aged 60 and over living in Ankang, China. Two-stage probit and least squares regression models assessed the impact of relocation on familial and nonfamilial emotional, instrumental, and financial support. Results: Relocation was negatively associated with the number of social support resources that older adults perceived as being available. Although this was the case with regard to both familial and nonfamilial support, it was particularly evident with regard to family support and, within families, with regard to instrumental rather than financial or emotional support. Discussion: Relocation has negative implications for the number of social support resources perceived to be available by older adults in rural China. China will need to come to terms with how to provide for the instrumental support needs of an aging society. [ABSTRACT FROM AUTHOR]

The aim of this study is to examine the burden of family caregivers of patients with retinoblastoma in China and the relationships between depression, caregiver burden and social support. A descriptive and correlational survey was conducted with 117 Chinese family caregivers of outpatient patients with retinoblastoma from the Department of Ophthalmology of a tertiary hospital in Shanghai, China. Family caregivers of outpatient patients with retinoblastoma were asked to respond to four questionnaires including sociodemographic questionnaire, Becker Depression Inventory, Caregiver Burden Inventory and Social Support Rating Scale. The incidence of depression in this study was 51.3%; the average score for social support indicated moderate social support available to the caregivers, although their level of caregiver burden was heavy. Depression scores were significantly positively correlated with caregiver burden scores and significantly negatively correlated with the social support scores. Heavy caregiver burden was associated with lower monthly income, low subjective social support and less use of social support. [ABSTRACT FROM AUTHOR]

High-risk sexual behaviours (HRSBs), such as having male casual sexual partners (MCSPs) and unprotected anal intercourse (UAI), are combined with a high prevalence of HIV infection among gay/bisexual men. Sexual sensation seeking (SSS) and sexual compulsivity (SC), which are intrapersonal factors, were observed to have associations with HRSB among gay/bisexual men in Western nations. The aim of the study was to examine the relationships between SSS, SC, sociodemographic factors, and HRSB (defined as having MCSP and UAI with MCSP) among selfidentified gay and bisexual men in Southwest China. The study was cross-sectional, with a sample of 436 respondents. And their mean age was 24.5 years. The results confirmed that SSS, SC, and sexual attitude are associated with both having MCSP and UAI with MCSP in the Chinese cultural context, among the subgroup of men who have sex with men. Being older, not a student, and having transactional sex in the last 6 months were independently associated with having MCSP. Lower educational level, unemployed, having a relationship with a man, and an unsure HIV status were independently associated with UAI with MCSP. This study indicates that SSS and SC are cross-cultural personality traits related to HRSB. The results of this study may shed light on HIV prevention among gay/bisexual men in China. [ABSTRACT FROM AUTHOR]

Purpose: To determine the dose-response of vitamin D3 supplementation on serum 25-hydroxyvitamin D [25(OH)D] among Chinese adults. Methods: In this 5-arm, randomized, double-blinded controlled trial, 76 healthy participants were assigned to orally administrate 0, 400, 800, 1200 or 2000 IU/d of vitamin D3 for 16 weeks. Serum 25(OH)D, parathyroid hormone, calcium, biomarkers of liver and renal function were measured at multiple time points. Results: The mean (SD) serum 25(OH)D at baseline was 31.6 (8.7) nmol/L, and the dose-response relationship was curvilinear with a plateau around 6 weeks for all doses. At week 16, 25(OH)D was increased by 6.0 (6.5), 21.7 (15.8), 26.3 (12.6), 32.0 (12.8) and 36.3 (26.0) nmol/L for 0, 400, 800, 1200 and 2000 IU/d (all P ≤ 0.002), corresponding to approximately 19, 53, 67, 77 and 80 % of reversion of vitamin D deficiency, respectively. Daily intake of 800 IU vitamin D3 reached a targeted 25(OH)D ≥ 30 nmol/L in at least 97.5 % of Chinese, but not a targeted 25(OH)D ≥ 50 nmol/L even with 2000 IU/d. Change of 25(OH)D was inversely associated with change of PTH concentration ( r = −0.39, P < 0.001) after controlling for age and sex. No between-group differences were observed in terms of the change in serum calcium, alanine transaminase, aspartate aminotransferase, gamma-glutamyltransferase and creatinine ( P ≥ 0.22). Conclusions: Supplementation with 400, 800, 1200 or 2000 IU/d vitamin D could improve the vitamin D deficiency with various degrees. Whether 2000 IU/d vitamin D3 would generate a better result without side effect requires more studies with larger samples in future. [ABSTRACT FROM AUTHOR]

Aims and objectives The primary aim of this study was to examine the correlations between patient and caregiver characteristics with caregiver burden, anxiety and depression in Alzheimer's Disease. Secondary aim was to determine which behavioural and psychological symptoms had the greatest impact on caregiver burden, anxiety and depression in Alzheimer's Disease. Background Caregivers of individuals with Alzheimer's Disease experience high levels of burden, both psychologically and physically. Previous studies have examined caregiver burden, anxiety and depression separately. However, no paper has examined these three psychological conditions simultaneously. Design A cross-sectional design. Methods A total of 310 patients with probable Alzheimer's Disease and their primary caregivers were assessed. Cognitive impairment and neuropsychiatric symptoms were assessed with the Mini Mental State Examination, Montreal Cognitive Assessment, Clock Drawing Test and Neuropsychiatric Inventory, respectively. Caregiver burden, anxiety and depression were assessed with the ZBI, Generalised Anxiety Disorder Scale-7 and Patient Health Questionnaire-9, respectively. Results All 12 neuropsychiatric symptoms in the Neuropsychiatric Inventory were significantly correlated with caregiver burden, anxiety and depression, with the top three neuropsychiatric predictors being depression, apathy and anxiety. Furthermore, higher levels of caregiver anxiety were associated with a longer duration of being a caregiver. Within caregivers, higher levels of depression were independently associated with higher numbers of additional caregivers, lower educational background and being the spouse of the patient. Higher levels of burden were associated with a longer duration of being a caregiver and being the spouse of the patient. Caregiver burden, anxiety or depression were not significantly correlated with hours/day of caring for the patient. Conclusions Caregiver burden, anxiety and depression were significantly correlated with different neuropsychiatric symptoms in the Neuropsychiatric Inventory. Relevance to clinical practice Practitioners are able to identify caregivers at risk for burden, anxiety and depression. Understanding which Neuropsychiatric Inventory symptom is more closely associated with distress in caregivers will help practitioners to be more specific and effective in detecting caregiver distress. [ABSTRACT FROM AUTHOR]

Background: Patients on maintenance hemodialysis suffer from diminished physical health. Directly supervised exercise programs have been shown to be effective at improving physical function and optimizing well-being. However, nurses seldom include an exercise intervention in the care plan for hemodialysis patients. Objectives: The purpose of this study was to examine the effects of a 12-week nurse-led case management program on home exercise training for hemodialysis patients. Design: The study was a randomized, two-parallel group trial. Settings: Hemodialysis units in two tertiary hospitals in Nanjing, mainland China. Participants: One hundred and thirteen adult patients who have been in stable condition while on dialysis treatment for more than 3 months were recruited and randomly assigned to either the study group (n = 57) or the control group (n = 56). Methods: Both groups underwent a brief weekly in-center exercise training session before their dialysis sessions for the first 6 weeks. The study group received additional nurse case management weekly for the first 6 weeks and biweekly for the following 6 weeks. The intervention was to facilitate patients in performing regular exercise at home. Outcome measures, including gait speed, 10-repetition sit-to-stand performance, and quality of life were collected at baseline, and at 6 and 12 weeks into the program. Results: The results revealed that patients in the study group demonstrated greater increases in normal gait speed [F(1,111) = 4.42, p = 0.038] than the control group. For the study group, a mean increase of 12.02 (±3.03) centimeters/second from baseline to week 12 was found. With regard to the fast gait speed, there was a marginally significant between-group effect [F(1,111) = 3.93, p = 0.050]. The study group showed a mean improvement of 11.08 (±3.32) cm/s, from baseline to week 12. Patients from both groups showed improvements in their 10-repetition sit-to-stand performance. The between-group differences approached significance [F(1,111) = 3.92, p = 0.050], with the study group showed greater improvement than the control group. The time taken by the patients in the study group to complete the 10-STS test increased by 5.75 (±3.88) s from baseline to week 12. Significant improvements in quality of life across three time points were found only in the study group. Conclusions: Home exercise using a nurse-led case management approach is practical and effective in improving the physical function and self-perceived health of stable hemodialysis patients. [ABSTRACT FROM AUTHOR]

Background Resilience has been identified as a personal construct that may contribute to the process of healthy ageing in older people. To date, no measurement instrument has been tested to evaluate resilience in Chinese older people. Aim To examine the psychometric testing and clinical application of the Chinese version of the Resilience Scale ( RS) in Chinese older people. Methods A descriptive cross-sectional study design was used. Forward and backward translation procedures were used to obtain semantic equivalence of the original English version of the RS. Content validity was examined by identified experts, followed by exploratory factor analysis, item-to-total correlation, Cronbach's α coefficients and test-retest reliability. Results The 25-item Chinese version of Resilience Scale ( RS-CN) was fully completed by 461 Chinese older people. Cronbach's α for the total Chinese version of the Revised Resilience Scale was 0.95, with a range of 0.85-0.89 for the sub-scales. Item-to-total correlation coefficients ranged from 0.51 to 0.75 and items were excluded with item-to-total correlations coefficients lower than 0.4. The test-retest reliability of the total scale was 0.80, sub-scale test-retest reliability ranged from 0.61 to 0.620. The exploratory principal component analysis with varimax rotation revealed RS-CN to have a four-factor structure. Conclusion The RS-CN is a valid and reliable instrument for the measurement of the concept of resilience in Chinese older people. The results of this study provide cross-cultural evidence for the potential application of this scale in Chinese older people. Implications for nursing and health policy Greater insight into the psychological constructs of resilience in Chinese older people can lead to international comparisons and to the potential development of interventions for this population around the world. [ABSTRACT FROM AUTHOR]

Objectives: To explore the effects of combined intervention with education and progressive muscle relaxation (PMR) on quality of life (QoL), functional disability, and positive symptoms of patients with acute schizophrenia. Methods: This randomized controlled study took place in an acute schizophrenia ward in Changsha, China. Sixty-four patients with acute schizophrenia were randomly assigned to four groups: control, education, PMR, and education plus PMR. QoL was assessed with the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form. Functional disability was assessed with the Sheehan Disability Scale. Severity of positive schizophrenia symptoms was assessed with the Scale for the Assessment of Positive Symptoms. All patients were evaluated at baseline (within 72 hours before the interventions) and at the end of weeks 5 (when the interventions ended) and week 15 (a 10-week follow-up after the interventions). Results: The sociodemographic and clinical characteristics of all four study groups were similar at baseline. Repeated-measures analysis of variance showed significant differences among the interventions in improving QoL, functional disability, and positive symptoms over time in the patients. Education and PMR alone resulted in sustained improvement of QoL during the intervention period and a 10-week follow-up but had no significant effects on functional disability or positive schizophrenia symptoms. In contrast, combined intervention with education and PMR showed better effects on improving QoL than did education or PMR alone throughout the 15-week study. It also statistically significantly improved functional disability and positive schizophrenia symptoms during the intervention period and led to sustained improvement of functional disability during the 10-week follow-up. Conclusions: A combined intervention with education and PMR is effective in improving QoL, functional disability, and positive symptoms in patients with acute schizophrenia. The combined intervention model could be a new paradigm of adjunctive treatment for acute schizophrenia. [ABSTRACT FROM AUTHOR]

Background It is important to integrate adolescent health domains into pre-service nursing education in order to enhance undergraduate nursing students' competencies in promoting adolescent health. Aim To determine the effectiveness of a structured adolescent health summer programme for Chinese undergraduate nursing students. Methods A quasi-experimental design was used to evaluate differences in the Chinese undergraduate nursing students' perceived competency in promoting adolescent health. A stand-alone adolescent health course was implemented as an intervention with pre- and post-tests of a 2-week intensive summer programme in 2010. The questionnaire included demographics, adolescent health competency checklist and programme evaluation. Descriptive statistics with the Wilcoxon signed-ranks test and the Mann- Whitney U-test were used for data analysis. Results Of the 113 nursing students, seniors perceived higher adolescent health competence mean scores than the juniors in the post-test phase. Majority of nursing students revealed the increasing awareness of the importance in promoting healthy lifestyle behaviours and psychosocial well-being after attending the summer programme. They agreed that nurses do have a role to play. Limitations This 2-week summer programme may only have short-term impacts on students' perception. Conclusions A stand-alone adolescent health summer programme can prepare nursing students to respond to the health issues of adolescents by enhancing their competence in health need assessment and service delivery. Implications for nursing and health policy Nurses serve in a leadership role for health policies and programmes. In nursing education, it is important for students to understand how to put in place policies to resolve adolescent health issues. [ABSTRACT FROM AUTHOR]

Objectives To estimate the prevalence of mild cognitive impairment ( MCI) in Beijing, China, and to explore the potential protective and risk factors for MCI. Design Population-based survey. Setting The Beijing Ageing Brain Rejuvenation Initiative ( BABRI). Participants Participants randomly recruited from BABRI (N = 1,211). Measurements Participants underwent a battery of neuropsychological examinations to determine cognitive function and answered a series of personal questions. The prevalence of MCI and its subtypes were computed using Petersen's criteria. Influencing factors for MCI were estimated based on participant medical history, lifestyle, diet, and leisure activities. Results One thousand twenty (aged >55, mean 63.9 ± 6.6; 36.7% male) subjects completed the neuropsychological tests. The overall prevalence of MCI was 15.7%, with single-domain amnestic, multiple-domain amnestic, and nonamnestic subtype prevalences of 6.4%, 3.7%, and 5.6%, respectively. Eight hundred sixty-four subjects were used for the case-control analysis. Hypertension, diabetes mellitus, and cerebrovascular disease were found to be associated with MCI. Healthy diet and greater involvement in physical, intellectual, and social activities were associated with a lower risk of MCI. Conclusion The prevalence of MCI was compatible with that found in previous published reports, and the information on the epidemiology of MCI, especially risk factors, may help to explore therapeutic strategies and preventive approaches to delay conversion to dementia. [ABSTRACT FROM AUTHOR]

The objectives of this study were to determine reliability of Chinese version of Acceptance and Action Questionnaire-II ( AAQ-II), the relationship between psychological acceptance (PA), and burnout syndrome and their risk factors among nurses in China. The reliability of AAQ-II in Chinese was evaluated first by testing on 111 doctors and 108 nurses in China. On the number of 845 nurses selected from nine city hospitals by using stratified cluster sampling method, the Maslach Burnout Inventory- General Survey was administered to establish the presence of burnout, and the AAQ-II was used to measure their PA. Results showed that the AAQ-II in Chinese had a good test-retest reliability. PA was statistically significantly negatively correlated to the three dimensionalities of burnout among nurses in China. Male and female nurses had a significant difference in PA. Risk factors for burnout were age (25-44 years), marital status (married), gender (male), hospital department (emergency) and position (primary title) as well as PA. The findings provide insights into the risk factors of burnout in Chinese nurses and may have clinical implications in preventing burnout in Chinese nurses. [ABSTRACT FROM AUTHOR]

Background and Objective: Postmortem studies indicate that the number and density of glial cells are reduced in different brain regions of patients with depression. Glial cell line-derived neurotrophic factor (GDNF) plays an important role in the pathogenesis of depressive disorder (DD) and might be a biomarker for damage to nerve cells. In this study, we compared the therapeutic effects of electroacupuncture (EA) and fluoxetine, a serotonin reuptake inhibitor, on DD patients, focusing on the serum level of GDNF. Design: This was a prospective, randomized clinical trial. Setting: Seventy-five patients with DD from the Department of Acupuncture, Beijing Hospital of Traditional Chinese Medicine, were recruited. Intervention: Twenty patients were treated with acupuncture for 6 weeks on the acupoints of Baihui (DU20) and Zusanli (ST36). Sixteen patients were treated with acupuncture for 6 weeks on the acupoints of Taichong (LR3), Sanyinjiao (SP6), Neiguan (PC6), and Shenmen (HT7), and constituted the electroacupuncture control group. The patients received acupuncture treatment five times per week. Twenty-five patients were treated with oral fluoxetine (20 mg/day) for 6 weeks. Outcome measures: All subjects were evaluated by the Hamilton Depression Rating Scale at four time points (0 [baseline], 2, 4, and 6 weeks after treatment). Serum GDNF was quantified in duplicate by enzyme-linked immunosorbent assay (ELISA). Results: EA and fluoxetine had similar curative effects on DD patients. EA had a faster onset of action, better response rate, and better improvement rate than fluoxetine. Both fluoxetine and EA treatment restored the normal concentration of GDNF in the serum of DD patients. Conclusion: EA treatment for depression is as effective as a recommended dose of fluoxetine. However, EA demonstrates an advantage in the regulation of the production of GDNF compared with fluoxetine. [ABSTRACT FROM AUTHOR]

Background: The Iowa Infant Feeding Attitude Scale (IIFAS) is used to evaluate maternal infant feeding attitude. The breastfeeding rate has declined but no validated instruments to assess infant feeding attitudes or related studies have been available in mainland China. Aims: The purpose of this study was to assess the reliability and validity of a mainland Chinese version of the IIFAS among postpartum women. Methods: Postpartum women (N = 660) were recruited from three university hospitals in Guangzhou in mainland China. The participants completed an IIFAS questionnaire before being discharged and accepted telephone follow-up sessions at 6 weeks and 3 months postpartum. The reliability of the scale was evaluated using intra-class correlations (ICC) for test-retest reliability, correlated item-total correlations and Cronbach's a. The validity of the scale was evaluated using the content validity index (CVI), construct validity using exploratory factor analysis and predictive validity using independent t-tests. Results: The ICC was 0.861. The correlated item-total correlations ranged from 0.262-0.691. Cronbach's a was 0.623. The CVI was 0.996. Four factors were extracted using exploratory factor analysis and they contributed to 48.69% of the total variance. Conclusions: The mainland Chinese version of the IIFAS scale can be considered a reliable, valid and predictive scale for assessing infant feeding attitudes among women in mainland China. In-hospital scores on the scale were significant predictors of the infant feeding method and breastfeeding duration at 3 days, 6 weeks and 3 months postpartum. Construct validity was confirmed and showed four factors. However, future studies are required to improve the lower level internal consistency of the IIFAS. [ABSTRACT FROM AUTHOR]

Background. Herb-derived compound andrographolide sulfonate (called Xiyanping injection) recommended control measure for severe hand, foot, and mouth disease (HFMD) by the Ministry of Health (China) during the 2010 epidemic. However, there is a lack of good quality evidence directly comparing the efficacy of Andrographolide Sulfonate combination therapy with conventional therapy. Methods. 230 patients were randomly assigned to 7-10 days of Andrographolide Sulfonate 5-10mg/Kg/day and conventional therapy, or conventional therapy alone. Results. The major complications occurred less often after Andrographolide Sulfonate (2.6% versus 12.1%; risk difference [RD], 0.94; 95% CI, 0.28-1.61; P = 0.006). Median fever clearance times were 96 hours (CI, 80 to 126) for conventional therapy recipients and 48 hours (CI, 36 to 54) for Andrographolide Sulfonate combination-treated patients (X² = 16.57, P < 0.001). The two groups did not differ in terms of HFMD-cause mortality (P = 1.00) and duration of hospitalization (P = 0.70). There was one death in conventional therapy group. No important adverse event was found in Andrographolide Sulfonate combination therapy group. Conclusions. The addition of Andrographolide Sulfonate to conventional therapy reduced the occurrence of major complications, fever clearance time, and the healing time of typical skin or oral mucosa lesions in children with severe HFMD. [ABSTRACT FROM AUTHOR]

Objectives: This study assessed the importance of the Traditional Chinese Medicine (TCM) pattern on an acupoint-specific effect. Design: This was a TCM pattern subdivision analysis of the first intervention data from a multicenter, randomized, controlled trial (ISRCTN24863192) (the main trial). Settings: The main trial recruited participants from six hospitals in three provinces in China. Subjects: Five hundred and one (501) participants diagnosed with primary dysmenorrhea (PD) were enrolled in the main trial. Interventions: The main trial randomly and equally divided participants into three treatment groups with bilateral electroacupuncture at three sites, respectively: Sanyinjiao (SP6), Xuanzhong (GB39), and an adjacent nonacupoint. Participants were diagnosed with TCM patterns before the treatment. The intervention was carried out when the visual analogue scale (VAS) score of participant's menstrual pain was ≥40 mm on the first day of menstruation and lasted for 30 minutes. Outcome measures: The immediate improvement of pain was measured with a 100-mm VAS before the intervention, at 5 minutes, 10 minutes, and 30 minutes during the intervention, and at 30 minutes after the completion of this intervention. Results: Three (3) TCM patterns ( n=320) were eligible for analysis, including Cold and Dampness Stagnation pattern ( n=184), Qi and Blood Stagnation pattern ( n=84), and Qi and Blood Deficiency pattern ( n=52). In Cold and Dampness Stagnation pattern, the SP6 group had a significant reduction in VAS scores compared with the GB39 group (mean difference −7.6 mm) and the nonacupoint group (mean difference −8.2 mm), respectively. There was no difference between the latter two groups. There were no group differences in VAS scores in the other two patterns. Conclusions: It suggested that TCM pattern might affect acupoint specific effect on the immediate pain relief obtained for participants with PD. [ABSTRACT FROM AUTHOR]

To investigate the fluid intake and knowledge on water and health in Chinese adults, and to provide a scientific basis for the development of adequate water intake values for people in China. A total of 1,483 adults aged 18-60 years were selected from four provincial capital cities using a multiple-stage random sampling method. The information on the amounts and types of daily fluid intake was collected using a 24-h fluid intake record for 7 consecutive days. Trained interviewers used a questionnaire to assess knowledge on water. The median of daily total fluid intake was 1,488 mL, with a wide range from 86 mL to 7,036 mL. Significant differences were found for fluid intake among the four cities. The medians of daily intakes of plain water, tea, and beverages were 786 mL, 109 mL, and 186 mL, respectively. Approximately 32% of the subjects drank less water than the amount recommended by the Chinese Nutrition Society (1,200 mL/day) and 71.6% of participants lacked knowledge of these recommendations. Moreover, 48.3% of them drank water only when they felt thirsty. [ABSTRACT FROM AUTHOR]

This study assessed a targeted continuing osteoporosis educational program and investigated awareness and prevention of osteoporosis in Chinese female pre-internship nurse students. A quasi-experimental study was conducted. The program was presented to 256 nurse students. The baseline knowledge score of the nurse students was low (9.78 ± 3.13). They had inadequate osteoporosis health beliefs, self-efficacy and related behaviors. The educational program significantly augmented osteoporosis knowledge (Student's paired t = −13.42, P < 0.001), total osteoporosis health beliefs (Student's paired t = −4.46, P < 0.001), and the subscale ( P < 0.001) except for the perceived barriers to exercising and calcium intake. Participants showed a significant increase in self-efficacy (Student's paired t = −6.45, P < 0.001) post intervention. Those who completed the program were better prepared to prevent and manage osteoporosis. Additionally, nurse students became more concerned about bone health of family members, subjects and themselves because of attending the program. Results of this study reinforce the need for osteoporosis-related continuing education in nurse students before clinical internship. [ABSTRACT FROM AUTHOR]

Study design:Lithium has attracted much attention as a neuroregenerative agent for spinal cord injury in animal models. We hypothesized that the lithium can be beneficial to patients with spinal cord injury. The safety and pharmacokinetics of lithium has been studied in our earlier phase I clinical trial, indicating its safety. This is a phase II clinical trial to evaluate its efficacy on chronic spinal cord injury patients.Objectives:The aim of this study was to investigate the efficacy of lithium on chronic spinal cord injury patients.Setting:A major spinal cord injury rehabilitation center in Beijing, China.Methods:Randomized, double-blind, placebo-controlled 6-week parallel treatment arms with lithium carbonate and with placebo. A total of 40 chronic spinal cord injury subjects were recruited. Oral lithium carbonate was titrated or placebo was simulated to maintain the serum lithium level of 0.6-1.2 mmol l−1 for 6 weeks, followed by a 6-month follow-up. The functional outcomes and the neurological classifications, as well as the safety parameters, adverse events and pharmacokinetic data were carefully collected and monitored.Results:No significant changes in the functional outcomes and the neurological classifications were found. The only significant differences were in the pain assessments using visual analog scale comparing the lithium and the placebo group. No severe adverse event was documented in the study.Conclusion:The lithium treatment did not change the neurological outcomes of patients with chronic spinal cord injury. It is worth to investigate whether lithium is effective in the treatment of neuropathic pain in chronic spinal cord injury.Sponsorship:China Spinal Cord Injury Network Company Limited. [ABSTRACT FROM AUTHOR]

Objective:Peroxisome proliferator activated receptor gamma is a ligand-dependent transcription factor with an important role in insulin resistance and obesity. We investigated the associations between the Pro12Ala polymorphism of this receptor, obstructive sleep apnoea hypopnoea syndrome and hyperlipidaemia risk factors, in a Chinese cohort.Subjects and methods:We recruited 420 obstructive sleep apnoea hypopnoea syndrome patients and 190 healthy controls. Genetic analysis was conducted by restriction fragment length polymorphism. The hyperlipidaemia risk in both the study and control groups was analysed.Results:Comparison of genotype and allele frequencies revealed no significant differences between patients and controls (p > 0.05). In patients, there was no correlation between genotype and clinical parameters (p > 0.05), apart from a significant association between the Ala12 allele and hyperlipidaemia (odds ratio = 2.181; p = 0.017; 95 per cent confidence interval = 1.133–4.198).Conclusion:In this Chinese cohort, the Pro12Ala polymorphism of peroxisome proliferator activated receptor gamma was not associated with obstructive sleep apnoea hypopnoea syndrome, but was associated with increased hyperlipidaemia risk. [ABSTRACT FROM PUBLISHER]

Healthcare settings provide a major arena for administering smoking cessation interventions. However, few studies have reported differences in the frequency of practice in healthcare professionals by gender and smoking status. This might also be influenced by a difference in smoking prevalence by gender, especially in China and other developing countries. This study examined factors associated with the frequency of cessation intervention practices by smoking status among Chinese physicians in men and women. A cross-sectional survey was conducted in 2006 in physicians with direct patient contact from nine hospitals in Guangzhou with a response rate of 60.8%. Significantly more female physicians who were non-smokers (79.7%) reported 'initiation and/or advice' smoking cessation interventions than male physicians who were smokers (71.2%) and non-smokers (71.6%). Factors significantly associated with 'initiation and/or advice' were prior smoking cessation training (OR = 4.2, 95% CI 1.8-9.6) and lack of knowledge to help patients to quit (OR = 0.4, 95% CI 0.2-0.9) among male physicians who smoked; and organisational support (OR = 1.7, 95% CI 1.3-2.2) and successful past experience (OR = 0.4, 95% CI 0.2-1.0) among male physicians who did not smoke. Among female physicians who did not smoke, significant factors were agreeing that quitting smoking is the most cost-effective way to prevent chronic disease and cancer (OR = 3.0, 95% CI 1.4-6.1), helping patients stop smoking is part of expected role and responsibility (OR = 2.0, 95% CI 1.0-3.7), lack of knowledge to help patients to quit (OR = 0.5, 95% CI 0.2-1.0) and organisational support (OR = 1.3, 95% CI 1.0-1.6) for non-smoking female physicians. This study is the first to show that male physicians were less likely to provide smoking cessation counselling regardless of their smoking status while non-smoking female physicians were more active in advising patients on quitting. The findings highlight the need for developing tailored smoking cessation training programmes for physicians according to their smoking status and gender in China. [ABSTRACT FROM AUTHOR]

This cross-sectional survey explored the depression status of new migrant women and its relationship with self-rated health in the Hong Kong Chinese context. A convenience sample of 68 migrant women volunteered to participate in the study. The data were collected by using the Problem Solving Inventory, the Center for Epidemiological Studies-Depression questionnaire, and a self-rated health scale. The respondents were found to have a lesser degree of problem-solving appraisal, compared with other populations, and almost half of the volunteers were found to be depressed. Approximately 50% of the women reported their general health as “excellent”, “very good”, or “good”. The Pearson's correlation showed a positive significant correlation between problem-solving appraisal, depression, and self-rated health. The results of the regression analysis showed that family income, self-rated health, and problem-solving confidence are predictive factors of depression. Community nurses could consider using multidisciplinary interventions that focus on life-skills training in order to promote the psychological and general wellness of migrant women in addition to the use of counseling or medication interventions. [ABSTRACT FROM AUTHOR]

Objective: Psychometrically rigorous and comprehensive needs assessment measures for Chinese general cancer caregivers are relatively scarce. We described the development and psychometric evaluation of the Chinese version of the Cancer Support Person's Unmet Needs Survey‐Short Form (SPUNS‐SFC). Methods: A forward–backward translation method was utilised to develop the SPUNS‐SFC. The construct validity, internal consistency, convergent validity and discriminant validity of the SPUNS‐SFC were evaluated. Results: A total of 1,026 Chinese cancer caregivers completed the SPUNS‐SFC. Items 10, 11, 13, 24 and 26 were removed as more than 80% of respondents reported having no unmet needs on these items. Exploratory factor analysis revealed a five‐factor structure, which accounted for 78.47% of the total variance, and consisted of the following domains: information, healthcare access and continuity, personal and emotional needs, worries about the future, and financial needs. Internal consistency of the measure was high, with Cronbach's alpha coefficients ranging from 0.87 to 0.95 for the five domains. The measure illustrated adequate evidence of convergent validity, demonstrated by significant correlations with multiple measures of psychological well‐being. Known‐groups validity was established, as 87.5% of the hypotheses were supported. Conclusion: This study indicates the SPUNS‐SFC is a reliable and valid measure of the unmet needs of Chinese cancer caregivers. [ABSTRACT FROM AUTHOR]