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Aim: To clarify the concept of oral frailty to provide a clear and standardized conceptual basis for further research in older people. Design: Rodgers and Knafl's evolutionary concept analysis approach. Methods: The narrative analysis detailedly extracted and synthesized the attributes of oral frailty, as well as its antecedents, consequences and related terms under the guidance of Rodgers' evolutionary method. Data Sources: Multiple databases including Pubmed, CINAHL and Cochrane were searched using selected search terms 'oral frail*', 'oral health' and 'aged' respectively. Articles written between 2013 and 2023 were included, and grey literature was excluded. Results: A total of 32 articles were included for further analysis and synthesis. The attributes of oral frailty were hypofunction, predisposing in nature, non‐specific and multidimensional. Antecedents of prefrailty were classified into four categories, namely, sociodemographic characteristics, comorbidity, physical function and psychosocial factors. Consequences of oral frailty include three themes: increased risk of adverse outcomes, poor nutritional status and possibility of social withdrawal. Related terms that had shared attributes with oral frailty were oral health, functional dentition, oral hypofunction and deterioration of oral function. Conclusions: Oral frailty is an age‐related phenomenon reflected in decreased oral function. The findings of this concept analysis are conducive to understanding and clarifying the oral frailty, which can help clinicians or other healthcare providers to consider how to distinguish oral frailty in older adults and further promote the development of this field. Impact: Oral frailty is increasingly recognized as an age‐related phenomenon reflected in decreased oral function. As it is newly proposed, no consensus has been reached regarding the theoretical and operational concept of it. Through clarifying the concept, this paper will guide future healthcare research on oral frailty regarding the influencing factors, mechanisms and interventions, thus raising the awareness with regard to oral health among older adults. What does this paper contribute to the wider global clinical community?: In the context of older adults, oral frailty is a concept that requires further research to guide future theoretical development, and the influencing factors, mechanisms and interventions need to be further studied.Raise awareness with regard to oral health among older people and more attention will be paid to the early identification and intervention of oral frailty, so as to further improve the quality of life of older adults. [ABSTRACT FROM AUTHOR]

Aims: To systematically identify the risk factors for cognitive impairment in maintenance haemodialysis patients and to assess its prevalence in included studies. Design: Systematic review and meta‐analysis about observational studies. Data Sources: Systematic search of seven databases, including PubMed, Web of Science, Scope, Wanfang Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and Weipu Chinese Science and Technology Journal Database, from inception until October 2021. Review Methods: Observational studies reporting the risk factors for cognitive impairment in maintenance haemodialysis patients in English and Chinese language were included. Meta‐analysis was performed to identify risk factors and prevalence of cognitive impairment in maintenance haemodialysis patients with STATA 15.0 software. Results: Overall, 37 eligible studies encompassing 129,849 cases were included. The risk factors with statistical significance after meta‐analysis were older age, female sex, fewer years of education, hypertension, diabetes, cerebrovascular accident, multiple comorbid conditions, systolic blood pressure variability, arterial stiffness and low haemoglobin and albumin level. The overall prevalence of cognitive impairment in maintenance haemodialysis patients was 49.1%. Conclusion: The current analysis indicated a high prevalence of cognitive impairment in maintenance haemodialysis patients. Eleven risk factors for cognitive impairment in maintenance haemodialysis patients were identified, among which more attention should be paid to modifiable factors such as cardiovascular disease risk factors and specific kidney and dialysis‐related factors. Impact: This paper provides an updated estimate of the pooled prevalence of cognitive impairment in maintenance haemodialysis patients. Identification of risk factors associated with cognitive impairment may assist in developing targeted prevention strategies for maintenance haemodialysis patients at high risk. No Patient or Public Contribution: This study was a systematic review completed by the authors in accordance with relevant guidelines and processes and did not include the participation of patients, service users, caregivers or the general public. [ABSTRACT FROM AUTHOR]

The study's aims were to translate the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire to Chinese and examine its psychometric properties. Adapting it for use in China involved forward translation, synthesis, back translation, expert review, and pretesting. A convenience sample of 201 Chinese older adults completed the Chinese version (CHAMPS-C) to evaluate its construct validity index and associations with physiological, psychosocial, and energy expenditure measures. The construct validity index of the CHAMPS-C was 0.95, and it had fair to moderate associations with physiological and psychosocial measures, other scales of physical activity, and accelerometer measurements. Our structured, stepwise process of cross-cultural adaptation produced a scale (i.e., CHAMPS-C), with items equivalent in meaning to the English version, for use with Chinese older adults. The findings of this study indicate that the CHAMPS-C has acceptable reliability and validity to assess the physical activity of older Chinese adults. [ABSTRACT FROM AUTHOR]

Aim: To test the relationships among staff nurses' work engagement, nurse managers' ambidextrous leadership and staff nurses' clinical leadership and workload. Design: A multicentre cross‐sectional survey design was used. Methods: The study was conducted in eight medical centres from six representative provinces of China in October 2019. The participants completed electronic questionnaires that measured ambidextrous leadership, clinical nurse leadership, workload and work engagement. We used structural equation modelling to test a hypothetical model. Results: The hypothetical model had a good fit to the actual data. Ambidextrous leadership was positively associated with clinical nurse leadership and work engagement, and clinical nurse leadership had a significant positive relationship with work engagement, which partially mediated the path from ambidextrous leadership to work engagement. In addition, workload moderated the relationship between ambidextrous leadership and clinical nurse leadership. Conclusion: This study makes a timely contribution to the nursing literature by demonstrating that nurse managers' ambidextrous leadership and clinical nurse leadership are important determinants of work engagement. Improving the level of ambidextrous leadership and clinical nurse leadership helps to enhance work engagement. Impact: This study provides a new strategy to increase nurses' work engagement from a new perspective of nursing leadership. Enhancing nurse managers' ambidextrous leadership and clinical nurse leadership can increase work engagement. Nurse managers should value the role of ambidextrous leadership and clinical nurse leadership in promoting work engagement, especially when nurses perceive they have a low workload. [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]

Dementia is prevalent in worldwide, and increases the care burden and potential costs. Physical activity (PA) has been increasingly shown to be beneficial for them. This was a cross-sectional observational study aiming to investigate the status of PA among community-dwelling older adults with dementia in Beijing or Hangzhou, China, and verify the relationships between neuropsychiatric symptoms, activities of daily living (ADL), caregivers' fear of patients' falling and their PA using a path analysis approach. The level of PA among 216 included people with dementia was low. PA was related to the neuropsychiatric symptoms, with ADL and caregivers' fear of patients' falling have mediation roles. The findings indicated that person-centered strategies related to the management of these symptoms might be helpful to improve ADL, relieve caregivers' concerns about them falling and consequently foster positive participation in PA. [ABSTRACT FROM AUTHOR]