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BackgroundsAimMethodsResultsConclusionsPhysical activity is crucial in health promotion. Exercise in groups can strengthen the benefits of exercise itself. However, the scale measuring the motivation for group exercise is scare.To develop and preliminarily validate the Group Exercise Motivation Scale (GEMS) in a global Asian population.A total of 1021 participants from seven regions across the world were recruited. Based on the theory of planned behavior, we developed an initial 20-item scale for the measurement of group exercise motivation and conducted an exploratory factor analysis (EFA). Then, a confirmatory factor analysis (CFA) was performed to replicate the factor structure obtained through EFA with a refined 15-item scale, among 510 and 511 participants, respectively.Four dimensions have been derived including personal attitude, subjective norms, perceived behavioral control, and behavioral intention. The GEMS showed acceptable factorial validity, satisfactory reliability (Cronbach’s α 0.779 and McDonald’s omega 0.745), and no floor/ceiling effect. The scale was developed in Chinese language.The GEMS has utility as an assessment for group exercise motivation. This study provides evidence for future longitudinal studies to evaluate the effectiveness of group exercise in the field of public health. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsDiscussionIncreasing research has shown that heavy metal as a neurotoxicant affects cognitive function across the lifespan. Nutritional status may modify susceptibility to heavy metal exposures, which further impacts cognition.We conducted a comprehensive search for cross-sectional studies, longitudinal studies, case-control studies and clinical trials on the interaction between nutrient and heavy metal, as well as mixed heavy metal exposure, in relation to cognition across the lifespan.Six cross-sectional studies, 20 longitudinal studies, two case-control studies and two clinical trials were identified. Studies confirmed the interactions between heavy metals (e.g. iron, lead, mercury, cadmium, copper and manganese) and various nutrients (e.g. protein, minerals, vitamins and polyunsaturated fatty acids) in relation to cognition. Sufficient essential nutrients may attenuate the adverse effect of heavy metals on cognitive performance while nutritional deficiency could increase metal toxicity. These interactions can be found in infants, children, adolescents and adults. However, current studies are limited and generate mixed results across different age groups. Potential mechanisms include nutrients reducing the bioaccumulation of metal in the same food source and lowering the toxicity of metal by moderating neurochemistry.Further longitudinal study is necessary to explore different types of interactions, elucidate further physiological mechanisms and adjust more confounding variables to increase confidence in causal effect. A comprehensive understanding of metal-nutrient interaction in human cognition could help facilitate earlier detection and prevention. [ABSTRACT FROM AUTHOR]

Ischemia reperfusion (I/R) was considered as one of main causes of acute kidney injury (AKI). However, the exact mechanism remains unclear. Here, this study aimed to investigate the role and mechanism of the m6A demethylase fat mass and obesity‐associated (FTO) protein in I/R‐induced AKI. HK‐2 cells and SD rats were utilized to establish hypoxia/reoxygenation (H/R) or I/R induced AKI models. The changes of RNAs and proteins were quantified using RT‐qPCR, western blot, and immunofluorescence assays, respectively. Cell proliferation and apoptosis were assessed by CCK‐8 and flow cytometry. Interactions between molecules were investigated using RIP, ChIP, Co‐IP, RNA pull‐down, and dual luciferase reporter assays. Global m6A quantification was evaluated by kits. TUNEL and HE staining were employed for histopathological examinations. Oxidative stress‐related indicators and renal function were determined using ELISA assays. The FTO expression was downregulated in H/R‐induced HK‐2 cells and renal tissues from I/R‐induced rats. Overexpression of FTO improved the cell viability but repressed apoptosis and oxidative stress in H/R‐treated HK‐2 cells, as well as enhanced renal function and alleviated kidney injury in I/R rats. Notably, the FTO overexpression significantly increased autophagy‐related LC3 and ULK1 levels. When autophagy was inhibited, the protective effects of FTO in AKI were diminished. Notably, Ambra1, a crucial regulator of autophagy, was repressed in H/R‐induced HK‐2 cells. However, the FTO overexpression restored the Ambra1 expression by reducing m6A modification of its mRNA. SP1, acting as an upstream transcription factor, directly interacts with the FTO promoter to enhance FTO expression. Knockdown of SP1 or Ambra1 suppressed the beneficial effects of FTO upregulation on autophagy and oxidative stress injury in H/R‐stimulated cells. FTO, transcriptionally activated by SP1, promoted autophagy by upregulating Ambra1/ULK1 signaling, thereby inhibiting oxidative stress and kidney injury. These findings may provide some novel insights for AKI treatment. [ABSTRACT FROM AUTHOR]

Background: Ethical conflict is embedded in healthcare and is common in critical care setting. However, there is a paucity of research on the nature of ethical conflict in China. Ethical conflict has cultural and context sensitivity. Therefore, evidence is needed from different backgrounds to help discuss this issue across borders. Aim: This study aimed to qualitatively identify the experience of ethical conflict in critical care professionals in China. Study design: From December 2021 to February 2022, we performed semi‐structured, face‐to‐face interviews with 21 critical care professionals from five intensive care units in a tertiary general hospital in China. A thematic analysis approach was used to analyse the data. Results: Five themes and 14 sub‐themes emerged from the data. Critical care professionals probably felt unable to navigate uncertainty, torn by family issues, outraged by unprofessional behaviours of medical staff, being trapped in a socioeconomic dilemma when having experience of ethical conflict. In addition, they also perceived that they could turn struggle into growth. Conclusions: The experience of ethical conflict in critical care professionals involved a mixture of feelings. This study builds a comprehensive understanding of how ethical conflict affected their perceptions of themselves and their profession and provides implications to develop effective coping strategies. Relevance to Clinical Practice: The identification of critical care professionals' experience of ethical conflict would help identify what might trigger the ethical issues and what would be the potential target to optimize in critical practice. [ABSTRACT FROM AUTHOR]

Although pressure ulcers are related to substantial health burdens, they may be preventable. Since nurses play a fundamental role in pressure ulcer prevention, their knowledge and attitude are of great importance. This study aims to investigate the current situation and associated factors of nurses' knowledge and attitude on the prevention of pressure ulcers from both tertiary and secondary hospitals. A total of 11 347 nurses were recruited including 7108 nurses (62.6%) from tertiary hospitals and 4239 nurses (37.4%) from secondary hospitals. The median (interquartile range) of the pressure ulcer knowledge score was 51% (38%, 90%) for all the participants with the lowest scores on prevention of pressure ulcers (51.33%). The mean (standard deviation) of attitude towards pressure ulcer prevention was 39.64 (4.65) with the lowest scores on personal competency to prevent pressure ulcers (mean 3.09). The results of multivariate linear regression showed that hospital level, nurses' age, years of work experience, initial education level at work and time of last training significantly associated with nurses' knowledge of pressure ulcer prevention. Meanwhile, hospital level, job title, previous training, time of last training and subjective needs for further training had significant association with nurses' attitude towards pressure ulcer prevention (all p < 0.05). Results showed inadequate knowledge but relative positive attitudes in nurses indicating the importance to deliver continuing education and training regarding pressure ulcer prevention in practice to improve the quality of care. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The purpose of this paper was to clarify the concept of ethical conflict in nursing and highlight the importance of tackling this issue. Background: Ethical conflict is on the rise in the nursing context. It is associated with the compromise of nurses' well‐being and patient care. However, there is no thorough conceptual understanding of this concept. Design: Concept analysis. Methods: Databases (PubMed, PsycINFO, CINAHL, Scopus, Embase, Web of Science and SocINDEX) were searched for studies between 1984 and 2021. Both quantitative and qualitative studies related to ethical conflict in nursing were included. Walker and Avant's method of concept analysis was used to identify the defining attributes, antecedents and consequences of the concept of ethical conflict in nursing. We followed the PRISMA‐ScR checklist to report the study. Results: Thirty studies were included for conceptualization. Defining attributes were divided into four categories: (1) emotional responses, (2) incompatible values, (3) competing interests and (4) ambiguous obligations. The antecedents were (1) ethical sensitivity, (2) negative ethical climate, (3) insufficient authority, (4) unrealistic expectations, (5) poor collaboration and (6) inadequate resources. The consequences were identified as (1) moral residue, (2) loss of identity, (3) professional burnout and (4) poor patient care. Conclusions: A unified conceptual model of ethical conflict in nursing shed light on the ethical issues nurses might come across in practice. Despite the fact that ethical conflict is inherently negative, we conceptualised this concept as a neutral fact and an opportunity for nursing action. The construct identification provides basis for both the development of practice and the development of staff support and education. Relevance to Clinical Practice: A clearer understanding of such an important facet of nursing practice helps nurses raise awareness of ethical conflict and implement effective coping strategies to improve their well‐being and patient care. No Patient or Public Contribution: This is a review article conducted by the researchers, so there is no patient or public contribution. [ABSTRACT FROM AUTHOR]