Search

Background: Although theoretical frameworks exist to guide social media interventions, few of them make it explicit how social media is supposed to work to improve the knowledge use by health care providers. This study aimed to synthesize literature to understand how and under what circumstances social media supports knowledge use by health care providers in clinical practice. Methods: We followed the realist review methodology described by Pawson et al. It involved six iterative steps: (1) develop an initial program theory; (2) search for evidence; (3) select and appraise studies; (4) extract data; (5) synthesize data; and (6) draw conclusions. Results: Of the 7,175 citations retrieved, 32 documents were prioritized for synthesis. We identified two causal explanations of how social media could support health care providers' knowledge use, each underpinned by distinct context-mechanism-outcome (CMO) configurations. We defined these causal explanations as: (1) the rationality-driven approach that primarily uses open social media platforms (n = 8 CMOs) such as Twitter, and (2) the relationality-driven approach that primarily uses closed social media platforms (n = 6 CMOs) such as an online community of practice. Key mechanisms of the rationality-driven approach included social media content developers capabilities and capacities, in addition to recipients' access to, perceptions of, engagement with, and intentions to use the messages, and ability to function autonomously within their full scope of practice. However, the relationality-driven approach encompassed platform receptivity, a sense of common goals, belonging, trust and ownership, accessibility to expertise, and the fulfillment of needs as key mechanisms. Conclusion: Social media has the potential to support knowledge use by health care providers. Future research is necessary to refine the two causal explanations and investigate their potential synergistic effects on practice change. [ABSTRACT FROM AUTHOR]

Background: Decision coaching is non-directive support delivered by a trained healthcare provider to help people prepare to actively participate in making healthcare decisions. This study aimed to understand how and under what circumstances decision coaching works for people making healthcare decisions.Methods: We followed the realist review methodology for this study. This study was built on a Cochrane systematic review of the effectiveness of decision coaching interventions for people facing healthcare decisions. It involved six iterative steps: (1) develop the initial program theory; (2) search for evidence; (3) select, appraise, and prioritize studies; (4) extract and organize data; (5) synthesize evidence; and (6) consult stakeholders and draw conclusions.Results: We developed an initial program theory based on decision coaching theories and stakeholder feedback. Of the 2594 citations screened, we prioritized 27 papers for synthesis based on their relevance rating. To refine the program theory, we identified 12 context-mechanism-outcome (CMO) configurations. Essential mechanisms for decision coaching to be initiated include decision coaches', patients', and clinicians' commitments to patients' involvement in decision making and decision coaches' knowledge and skills (four CMOs). CMOs during decision coaching are related to the patient (i.e., willing to confide, perceiving their decisional needs are recognized, acquiring knowledge, feeling supported), and the patient-decision coach interaction (i.e., exchanging information, sharing a common understanding of patient's values) (five CMOs). After decision coaching, the patient's progress in making or implementing a values-based preferred decision can be facilitated by the decision coach's advocacy for the patient, and the patient's deliberation upon options (two CMOs). Leadership support enables decision coaches to have access to essential resources to fulfill their role (one CMOs).Discussion: In the refined program theory, decision coaching works when there is strong leadership support and commitment from decision coaches, clinicians, and patients. Decision coaches need to be capable in coaching, encourage patients' participation, build a trusting relationship with patients, and act as a liaison between patients and clinicians to facilitate patients' progress in making or implementing an informed values-based preferred option. More empirical studies, especially qualitative and process evaluation studies, are needed to further refine the program theory. [ABSTRACT FROM AUTHOR]

Introduction and aims: Much attention has been paid to scaling-up evidence-based interventions (EBIs) in previous implementation science studies. However, there is limited research on how stakeholders perceive factors of the scaling-up of EBIs. This study aimed to identify the barriers and facilitators of scaling-up the nurse-led evidence-based practice of post-stroke dysphagia identification and management (EBP-PSDIM) from the stakeholders' perspective, and to assess their importance and feasibility. Methods: This study was conducted using concept mapping. Through purposive sampling, 18 stakeholders were recruited for brainstorming in which they responded to the focus prompt. Here, statements regarding perceived barriers and facilitators to EBI scaling-up were elicited and then sorted by similarity before being rated based on the importance and feasibility. Cluster analysis, multidimensional scaling, and descriptive statistics were utilized to analyze the data. Results: Ultimately, 61 statements perceived to influence the scaling-up were grouped into four primary clusters, that is, community-related factors, resource team-related factors, evidence-based practice program-related factors, and scaling-up strategy-related factors. The 'perceived needs of the community' was rated as the most important and feasible factor to address, whereas 'costs/resource mobilization' was rated as the least important and feasible one. Conclusion: From the stakeholders' perspective, factors involved in the EBP-PSDIM program scaling-up were initially validated as being multidimensional and conceptually distinct;The importance and feasibility ratings of the barriers and facilitators could be used to help decision-makers to prioritize the most appropriate factors to be considered when developing implementation strategies. [ABSTRACT FROM AUTHOR]

Background: Knowledge translation (KT) theories, frameworks, and models (TFMs) can help guide and explain KT processes, and facilitate the evaluation of implementation outcomes. They play a critical role in conducting KT research and practice. Currently, little is known about the usage of TFMs in KT in Chinese healthcare settings. The aim of this scoping review is to identify which TFMs had been used for KT in healthcare settings in China, and how these TFMs were used. Methods: The protocol for this scoping review is in accordance with the Arksey and O'Malley framework and further enhanced by the recommendations suggested by Levac et al. We will search 8 databases (4 Chinese and 4 English) to identify relevant studies. Four reviewers (2 for Chinese, 2 for English) will independently screen studies based on the eligibility criteria. The basic characteristic of studies and the TFMs utilization (i.e., what, why, and how) will be extracted. Methodological quality and reporting quality will be assessed using the Mixed Method Appraisal Tool (MMAT) and the Standards for Reporting Implementation Studies (StaRI) (or Standards for Quality Improvement Reporting Excellence, SQUIRE 2.0 for quality improvement studies), respectively. All the retrieved TFMs will be categorized into Nilsen's classifications of TFMs for KT research. We will employ the qualitative content analysis approach to summarize how these TFMs have been used, and the rationale. A consultation will be conducted through a 1-h interactive virtual meeting with an expert panel of knowledge users. Discussion: By conducting this scoping review, we expect to gain a comprehensive and in-depth understanding of why and how TFMs have been used in KT research and practice in China, and to identify gaps and provide recommendations for more efficient and meaningful use of TFMs in the future. Systematic review registration: This review has been registered with the Open Science Framework (10.17605/OSF.IO/8NXAM). [ABSTRACT FROM AUTHOR]

To fabricate hydrophilic and anti-fouling PVDF ultrafiltration membrane, a kind of tailor-made symmetrical amphiphilic triblock copolymer, polyacryloylmorpholine- b -poly (methyl methacrylate)- b -polyacryloylmorpholine (PACMO- b -PMMA- b -PACMO, termed as PAMA), was prepared via RAFT polymerization and employed as an in situ surface segregation modifier. FTIR, 1H NMR, and GPC were used to verify the well-defined chemical structure of PAMA. The hydrophilic PACMO segments of PAMA were enriched on the surface of membrane skin and interior pores as confirmed by ATR-FTIR, XPS, EDX, and water contact angle tests, endowing the blend membranes with outstanding hydrophilicity. The different cross-sectional and surface morphologies of the PVDF/PAMA blend membranes indicated that the introduction of PAMA modifiers could manipulate membrane structure due to their strong pore-forming ability. Compared with the pure PVDF membrane, PVDF/PAMA blend membranes showed higher permeability for water (28.1 times higher), excellent rejection for bovine serum albumin (up to 98.3%), and enhanced fouling resistance with a higher flux recovery ratio (up to 98.1%). Therefore, the approach of in situ surface segregation employed the RAFT mediated well-defined amphiphilic PAMA triblock copolymer modifiers for the preparation of anti-fouling PVDF membranes showed a great potential in water purification. [ABSTRACT FROM AUTHOR]

Graphical abstract Abstract Multifunctional nanoparticles (NPs) with high blood-stability, tumor-targeting ability, and stimuli-bioresponsive drug release behaviors are urgently demanded. Herein, folic acid (FA) and galactose (GAL) functionalized, core-crosslinked NPs (CC NPs) with dual-targeting and pH/redox-bioresponsive properties were developed based on amphiphilic FA-poly(6-O-methacryloyl- d -galactopyranose)- b -poly[2-(diisopropylamino) ethyl methacrylate- co -pyridyl disulfide methylacrylate] [FA-PMAgGP- b -P(DPA- co -PDEMA), termed as FA-PMgDP] block copolymers, and then investigated for facilitated hepatoma-targeting delivery of doxorubicin (DOX). A series of PMgDP copolymers were synthesized though two-step RAFT copolymerization followed by acid-induced acetal deprotection reaction. Their well-defined chemical structures and compositions were characterized by 1H NMR and gel permeation chromatography. Nano-sized, non-crosslinked PMgDP NPs (PMgDP NC NPs) with sizes of less than 25 nm in aqueous solution were self-assembled via the solvent exchange method, and PMgDP CC NPs were readily prepared in the presence of dithiothreitol. The drug-loading content of PMgDP CC NPs was up to 15.8% and its entrapment efficiency was 89.0%. In normal physiological conditions, 11.6% of DOX was released from DOX-loaded PMgDP CC NPs at 25 h, whereas in analogous intracellular microenvironment, 95.5% was released at 11 h owing to the acid-induced protonation of tertiary amine and reductive cleavage of disulfide bond in the hydrophobic core. In a cellular uptake study, FA and GAL-mediated, active, dual-targeted DOX-loaded FA-PMgDP CC NPs showed a 3.54-fold increase in cellular uptake efficiency to HepG2 cells compared to that of shown by single GAL-targeted, DOX-loaded PMgDP NC NPs. Results of in vitro cytotoxicity study showed that blank FA-PMgDP CC NPs exhibited good biocompatibility, whereas dual-targeting DOX-loaded FA-PMgDP CC NPs increased cell apoptosis. Therefore, the above results indicated that the well-constructed FA-PMgDP CC NPs with multi-synergistic effect may serve as new nanocarriers in the field of precise hepatoma-targeting drug delivery. [ABSTRACT FROM AUTHOR]

Abstract: Background: Evidence‐based nursing has been highlighted and highly developed in recent decades in mainland China. Nevertheless, little is known about its overall development. Aims: To gain insights on the overall development of evidence‐based nursing in the most recent 5 years and to inform future evidence‐based nursing research in mainland China. Method: Four Chinese and four English databases were searched with the search terms “evidence‐based practice,” “nurse or nursing,” and “China or Chinese” from 2012 to 2016. Bibliometric and co‐word cluster analysis were conducted with the final included publications. Results: A total of 9036 papers published by 13 808 authors in 606 journals were included. Publication numbers were increasing. None of the top ten journals publishing evidence‐based nursing papers were core nursing journals. The research hot spots on evidence‐based nursing in the recent five years were cardiovascular disease, mental health, and complication prevention. However, little attention has been paid to education for evidence‐based nursing. Conclusion: Evidence‐based nursing has penetrated into various nursing branches in mainland China and become a well‐recognized and relatively mature research domain. More importance should be attached to the study design, methodological, and reporting quality of evidence‐based nursing projects. [ABSTRACT FROM AUTHOR]

The pH-responsive micelles have enormouspotential as nanosizeddrug carriers for cancer therapy due to their physicochemical changesin response to the tumor intracellular acidic microenvironment. Herein,a series of comb-like amphiphilic copolymers bearing acetal-functionalizedbackbone were developed based on poly[(2,4,6-trimethoxybenzylidene-1,1,1-tris(hydroxymethyl)ethane methacrylate-co-poly(ethylene glycol) methylether methacrylate] [P(TTMA-co-mPEGMA)] as effectivenanocarriers for intracellular curcumin (CUR) release. P(TTMA-co-mPEGMA) copolymers with different hydrophobic–hydrophilicratios were prepared by one-step reversible addition fragmentationchain transfer (RAFT) copolymerization of TTMA and mPEGMA. Their molecularstructures and chemical compositions were confirmed by 1H NMR, Fourier transform infrared spectroscopy (FT-IR) and gel permeationchromatography (GPC). P(TTMA-co-mPEGMA) copolymerscould self-assemble into nanosized micelles in aqueous solution anddisplayed low critical micelle concentration (CMC). All P(TTMA-co-mPEGMA) micelles displayed excellent drug loading capacity,due to the strong π–π conjugate action and hydrophobicinteraction between the PTTMA and CUR. Moreover, the hydrophobic PTTMAchain could be selectively hydrolyzed into a hydrophilic backbonein the mildly acidic environment, leading to significant swellingand final disassembly of the micelles. These morphological changesof P(TTMA-co-mPEGMA) micelles with time at pH 5.0were determined by DLS and TEM. The in vitro CUR release from themicelles exhibited a pH-dependent behavior. The release rate of CURwas significantly accelerated at mildly acidic pH of 4.0 and 5.0 comparedto that at pH 7.4. Toxicity test revealed that the P(TTMA-co-mPEGMA) copolymers exhibited low cytotoxicity, whereasthe CUR-loaded micelles maintained high cytotoxicity for HepG-2 andEC-109 cells. The results indicated that the novel P(TTMA-co-mPEGMA) micelles with low CMC, small and tunable sizes,high drug loading, pH-responsive drug release behavior, and good biocompatibilitymay have potential as hydrophobic drug delivery nanocarriers for cancertherapy with intelligent delivery. [ABSTRACT FROM AUTHOR]

Abstract: A fluorinated monomer of 2-(2,2,2-trifluoroethoxy)ethyl methacrylate (FEMA) was prepared by a “one pot” process and then a novel fluorinated methacrylate polymer, poly[2-(2,2,2-trifluoroethoxy)ethyl methacrylate] (PFEMA), was successfully synthesized via miniemulsion polymerization using cetyltrimethyl ammonium bromide (CTAB) as emulsifier, hexadecane (HD) as co-stabilizer and 2,2′-azobisisobutyronitrile (AIBN) as initiator. The chemical structure of PFEMA was characterized by FT-IR, 1H NMR and 19F NMR. GPC results show that the number average molecular weight (M n) of PFEMA was as high as 8.5×105 g/mol and the polydispersity index (PDI) was only 1.3. SEM and DLS characterizations showed that the morphology of PFEMA latex was uniform spheres with the diameter of about 110–125nm. It was also found that PFEMA has high thermo-stability (T d >200°C), low glass transition temperature (T g =13.0°C), and nice hydrophobicity (θ water =99.9°). Comparison studies on PFEMA and poly(2,2,2-trifluoroethyl methacrylate) show that an introduced functional group (–CH2CH2O–) has a significant effect on lowering T g and improving hydrolysis resistance without impairing surface properties. [Copyright &y& Elsevier]

Background: Co-production is a collaborative approach to prepare, plan, conduct, and apply research with those who will use or be impacted by research (knowledge users). Our team of knowledge users and researchers sought to conduct and evaluate co-production of a systematic review on decision coaching. Methods: We conducted a mixed-methods case study within a review to describe team co-production of a systematic review. We used the Collaborative Research Framework to support an integrated knowledge translation approach to guide a team through the steps in co-production of a systematic review. The team agreed to conduct self-study as a study within a review to learn from belonging to a co-production research team. A core group that includes a patient partner developed and conducted the study within a review. Data sources were surveys and documents. The study coordinator administered surveys to determine participant preferred and actual levels of engagement, experiences, and perceptions. We included frequency counts, content, and document analysis. Results: We describe co-production of a systematic review. Of 17 team members, 14 (82%) agreed to study participation and of those 12 (86%) provided data pre- and post-systematic review. Most participants identified as women (n = 9, 75.0%), researchers (n = 7, 58%), trainees (n = 4, 33%), and/or clinicians (n = 2, 17%) with two patient/caregiver partners (17%). The team self-organized study governance with an executive and Steering Committee and agreed on research co-production actions and strategies. Satisfaction for engagement in the 11 systematic review steps ranged from 75 to 92%, with one participant who did not respond to any of the questions (8%) for all. Participants reported positive experiences with team communication processes (n = 12, 100%), collaboration (n = 12, 100%), and negotiation (n = 10–12, 83–100%). Participants perceived the systematic review as co-produced (n = 12, 100%) with collaborative (n = 8, 67%) and engagement activities to characterize co-production (n = 8, 67%). Participants indicated that they would not change the co-production approach (n = 8, 66%). Five participants (42%) reported team logistics challenges and four (33%) were unaware of challenges. Conclusions: Our results indicate that it is feasible to use an integrated knowledge translation approach to conduct a systematic review. We demonstrate the importance of a relational approach to research co-production, and that it is essential to plan and actively support team engagement in the research lifecycle. [ABSTRACT FROM AUTHOR]

• Quaternary ammonium and zwitterion dual-functionalized PDB- b -PSB brushes on MF membrane surface were fabricated. • The membrane pore size was not significantly changed by the coating. • Surface hydrophilicity of M/PDB- b -PSB membrane enhanced obviously. • M/PDB- b -PSB membrane with passive anti-adhesive and upper active biocidal properties. • Modification strategy for ant-biofouling membrane was facile and promising. In order to improve permeability and biofouling resistance of microfiltration (MF) membranes, quaternary ammonium and zwitterion dual-functionalized diblock polyelectrolyte copolymers, poly(dimethylaminoethyl methacrylate-butylammonium bromide)- b -poly(sulfobetaine methacrylate) (PDB- b -PSB) prepared via RAFT polymerization, were immobilized on commercial poly(vinylidene fluoride) (PVDF) MF membrane surface via using a versatile and facile mussel-inspired method to fabricate hierarchical copolymer brushes. Hierarchical PDB- b -PSB brushes contained bottom passive anti-adhesive zwitterionic PSB layer and upper active biocidal quaternary ammonium PDB layer. The surface chemical composition and morphology characterizations of pure and modified membranes demonstrated that PDB- b -PSB copolymers were successfully grafted to the dopamine-modified membrane surface via thiol mediated Michael addition reaction, which did not significantly change the membrane pore structure. However, the initial contact angle of PDB- b -PSB modified membrane (M/PDB- b -PSB) was changed from 128° for pure membrane (M/pure) to 43.2° and became 0° within 10 s, indicating the enhanced hydrophilicity. More importantly, the M/PDB- b -PSB membrane exhibited active biocidal effects against E. coli and S. aureus with inhibition rates over 98% and the E. coli and S. aureus suspension fluxes of M/PDB- b -PSB membranes were 1.61 times and 1.35 times higher than those of M/pure membranes. The M/PDB- b -PSB membrane had excellent anti-biofouling property with a better water flux recovery rate of 72%, which was 30% higher than that of the M/pure membrane. Moreover, PDB- b -PSB brushes showed a good immobilization stability. Therefore, the approach of poly(dopamine)-assisted fabrication of anti-biofouling MF membranes with quaternary ammonium and zwitterion dual-functionalized diblock copolymers had a prospect application in membrane-based separation technology and water purification. [ABSTRACT FROM AUTHOR]

• Three kinds of comb-shaped amphiphilic PEME triblock copolymers were synthesized. • Effects of PEME with different hydrophilic block length on membrane structure-property relationship. • M-2 membrane exhibited high BSA solution flux (150 L·m−2·h−1) and excellent rejection (99.99%). • M-2 membrane overcame the permeability-selectivity trade-off for BSA solution separation. In order to reduce membrane fouling and fabricate highly selective membranes with high water permeability, three kinds of comb-shaped amphiphilic triblock copolymers, poly[poly(ethylene glycol) methacrylate]- b -poly(methyl methacrylate)- b -poly[poly(ethylene glycol) methacrylate] (PPEGMA- b -PMMA- b -PPEGMA, named as PEME), were synthesized via RAFT polymerization and used as modifiers to prepare poly(vinylidene fluoride) (PVDF) blend membranes by the non-solvent induced phase separation (NIPS) method. The effects of PEME with different hydrophilic PPEGMA length on the surface chemical structure, morphology, permeability and antifouling properties of the blend membranes were investigated detailedly. The results from ATR-FTIR and XPS tests confirmed that hydrophilic PPEGMA segments in PEME were enriched on the membrane surface due to PEME induced surface segregation. With the increase of the hydrophilic chain length in PEME, the mean pore size, porosity and roughness of the blend membrane increased gradually, indicating the modifier had the ability to adjust the membrane pore structure. Compared with pure membrane, the hydrophilicity of blend membranes was enhanced and the protein adsorption of representative bovine serum albumin (BSA) decreased obviously. After three cycles of the water-BSA-water, the M-2 blend membrane exhibited high BSA solution flux (150 L·m−2·h−1), excellent rejection (up to 99.99%) and satisfactory antifouling performance. In addition, compared with the recently published PVDF blend ultrafiltration membranes prepared by NIPS method, the M-2 membrane with surface small pore size, high flux, high selectivity and low fouling properties overcame the permeability-selectivity trade-off for BSA solution separation and showed a good application prospect for efficiently protein separation. [ABSTRACT FROM AUTHOR]

For most breast cancer (BC) patients who have undergone a mastectomy, the decision whether to proceed with breast reconstruction (BR) is complicated and requires deliberation. Shared decision-making (SDM) helps to address those needs and promote informed value-based decisions. However, little is known about the SDM status for BR in BC patients. This scoping review describes: 1) basic characteristics of studies on BR SDM in BC patients; 2) factors influencing BR SDM in BC patients; 3) experience and perception of BR SDM in BC patients; and 4) outcome measures reported. This review was performed in accordance with the Arksey and O'Malley methodology. A total of 5 English and 4 Chinese databases were searched, as well as different sources from grey literature. The data extraction form was developed by referring to the objectives and the Ottawa Decision Support Framework (ODSF). Data was analyzed using thematic analysis, framework analysis and descriptive statistics, with findings presented in the tables and diagrams. A total of 1481 records were retrieved and 42 of these included after screening. In 21 (21/42, 50%) of the studies, patient decision aids (PDAs) were utilized, and in 17 (17/42, 40.48%) of the studies, the factors influencing the implementation of SDM were explored. Of these 17 studies, the factors influencing the implementation of SDM were categorized into the following: the patient level (17/17, 100%), the healthcare level (2/17, 11.76%) and the organizational and system level (7/17, 41.18%). A total of 8 (19.05%) of the 42 studies focused on patients' experiences and perceptions of SDM, and all studies used qualitative research methods. Of these 8 studies, a total of 7 (7/8, 87.50%) focused on patients' experiences of SDM participation, and 4 (4/8, 50.00%) focused on patients' perceptions of SDM. A total of 24 studies (24/42, 57.14%) involved quantitative outcome measures, where 49 items were divided into three classifications according to the outcomes of ODSF: the quality of the decision (17/24, 70.83%), the quality of the decision-making process (20/24, 83.33%), and impact (13/24, 54.17%). Although researchers have paid less attention to other research points in the field of SDM, compared to the design and application of SDM interventional tools, the research team still presents some equally noteworthy points through scoping review. For instance, the various factors influencing BC patients' participation in SDM for BR (especially at the healthcare provider level and at the organizational system level), patients' experiences and perceptions. Systematic reviews (SRs) should be conducted to quantify the impact of these different factors on BR SDM. Implementation of scientific theories and methods can inform the exploration and integration of these factors. [ABSTRACT FROM AUTHOR]

Aim. To explore academic and clinical nurses' perceptions and experiences on academic-practice partnership in evidence-based practice. Background. Academic-practice partnership could promote evidence-based practice which is crucial for high-quality care. Academic and clinical nurses are the foundation of the partnerships; however, there is little knowledge of their perceptions and experiences on academic-practice partnership in evidence-based practice. Methods. This is an interpretive description study. Twenty-two eligible participants were interviewed through face-to-face or online videoconferencing meetings. Guiding questions for the interviews focused on the perceptions and experiences of academic-practice partnership in the context of evidence-based practice. Interviews were recorded, transcribed, and checked verbatim. We used constant comparative analysis to analyze the qualitative data. Results. Four themes with fifteen subthemes were generated: necessities, modes, challenges, and benefits of the academic-practice partnership in evidence-based practice. Participants believed that academic-practice partnership was a necessary strategy to promote evidence-based practice and could be built through different modes. Nevertheless, most academic-practice partnerships were superficial because of specific types of challenges. However, a good academic-practice partnership could create a win-win situation for both nursing academia and clinical practice. Conclusion. Academic-practice partnership is a win-win strategy for both the academic side and clinical side to promote evidence-based practice. Different modes of academic-practice partnership provide academic and clinical nurses with more opportunities to promote evidence-based practice with a higher likelihood of successful implementation. However, related challenges require multilevel measures to provide better environments to initiate, build, and maintain intensive collaborations between academic and clinical nurses. Implications for Nursing Management. Academic and clinical organizations, leaders, and individuals should take multilevel measures to initiate, build, and maintain a close academic-practice partnership to promote evidence-based practice, which is crucial for high-quality nursing care, patient safety, and nursing discipline development. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the evidence‐based nursing practice (EBNP) competencies of clinical and academic nurses and their collaboration needs for supporting EBNP. Background: Academic‐practice partnerships have strong potential to overcome the key barriers to EBNP. However, there is little known about the collaboration needs of clinical and academic nurses for EBNP. Design: A cross‐sectional study. Methods: We recruited clinical and academic nurses online during November 2021 to January 2022. Using a reliable and validated scale and adapted questionnaires, data were collected relating to demographic information, EBNP‐related resources availability, EBNP competencies and EBNP collaboration needs. These data were described using descriptive statistical methods. The t test, χ2 test and Mann–Whitney U test were used to evaluate if the different responses between clinical and academic nurses were statistically significant. This study was reported following the STROBET checklist. Results: Two 240 clinical nurses and 232 academic nurses submitted questionnaires. There was no difference in overall EBNP competence between clinical and academic nurses. However, clinical nurses reported lower levels of competence and stronger intentions to collaborate with academic nurses when searching for, appraising, and synthesising evidence. Academic nurses reported lower levels of competence and stronger intentions to collaborate with clinical nurses for disseminating and implementing evidence. Conclusion: Clinical and academic nurses both reported high needs for collaborating to overcome their perceived role limitations. Clinical and academic nurses have different strengths and limitations in EBNP. These role differences and intentions to collaborate for different dimensions of EBNP competence suggest that clinical and academic nursing roles could be complementary to each other, offering opportunities for synergistic collaborations to better support overall EBNP. Relevance to clinical practice: Healthcare and academic institutions should promote academic‐practice partnerships as opportunities to gain complementary expertise on different dimensions of EBNP, and to improve nurses' competencies and confidence in EBNP overall. [ABSTRACT FROM AUTHOR]

Superhydrophilic and underwater superoleophobic membranes have recently attracted significant interest as materials for effective oil-water emulsion separation. In this work, a superwetting membrane with a spider web structured gel layer was designed for efficient oil-water separation. Biomaterial, carboxymethyl cellulose (CMC), was used as the raw material, a spider web structured gel layer was constructed on the PVDF membrane surface by heat-treatment and chemical cross-linking. The hydrophilic gel layer imparted excellent superhydrophilic and underwater superoleophobic properties to the membrane, while the special spider web structure improved the membrane mechanical stability. The fabricated membrane exhibited superhydrophilicity and underwater superoleophobicity. Among different CMC concentration-modified membranes, the M-0.5 membrane containing 0.5 wt% CMC exhibited a flux of 612 L·m−2 h−1 during dichloromethane oil-water emulsion separation, which was 4.2-fold higher than that of the pristine PVDF membrane, while the membrane showed efficient oil-water separation capacity. Additionally, the water flux recovery reached as high as 93.3 %, and oil rejection attained 99.1 %. Meanwhile, the spiderweb-structured gel layer on the membrane surface displayed good mechanical stability. In summary, this novel membrane-modification method, inspired by the spider web structure, was simple, cost effective and environmentally friendly, thereby making it promising for future preparation of highly efficient oil-water emulsion separation membranes. [Display omitted] • The natural biomaterial CMC was used as a gel material to modify the membrane. • Bionic-inspired construction of spider web-like gel layer on membranes. • The ultrathin gel layer on the membrane surface did not block the membrane pores. • The membrane exhibited separation performance and anti-fouling properties for oil-water emulsions. • The special spider web structure gel layer enhanced the membrane mechanical properties. [ABSTRACT FROM AUTHOR]

Background: Headache accompanying ischemic stroke is considered an independent predictor of neurological deterioration. This meta-analysis aims to estimate the prevalence of ischemic stroke-related headaches and identify its risk factors in China. Methods: PubMed, Embase, Cochrane Library database, Web of Science, PsycINFO, and four Chinese databases for the related publications were searched. Two researchers independently selected the literature, extracted the relevant data, and assessed its methodological quality. The meta-analysis applied a random-effects model with R software to calculate the pooled prevalence of ischemic stroke-related headaches in Chinese patients, and to merge the odds ratio (OR) of risk factors. Subgroup analysis, sensitivity analysis, and meta-regression analysis were conducted. Publication bias was assessed by a funnel plot and Egger test. Results: Ninety-eight studies were eligible for inclusion. The overall pooled prevalence of ischemic stroke-related headache was 18.9%. Subgroup analysis showed that the prevalence of ischemic stroke related-headaches was higher among studies using self-report to diagnosis headache (18.9%; 95%CI, 8.9% to 40.2%), and those focused on age ≥ 55 years (19.7%; 95%CI, 14.9% to 25.9%), rural settings (24.9%; 95%CI, 19.7% to 31.6%). There were no significant differences in the headache prevalence between studies in the south and north, and inland and coastal studies. The prevalence of pre onset headache (13.9%) and tension-type headache (15.5%) and was higher compared with other types. History of headache (OR = 3.24; 95%CI, 2.26 to 4.65.), female gender (OR = 2.06; 95%CI, 1.44 to 2.96.), midbrain lesions (OR = 3.56; 95%CI, 1.86 to 6.83.), and posterior circulation stroke (OR = 2.13; 95%CI, 1.14 to 4.32) were major risk factors. Conclusion: The prevalence of ischemic stroke-associated headache is high in China. In addition, women, presence of midbrain lesions, posterior circulation stroke and a history of migraine were high-risk factors for ischemic stroke-related headaches. Designing effective interventions to prevent or alleviated headaches is necessary to promote patients' neurological recovery and quality of life. [ABSTRACT FROM AUTHOR]

Traditional thin film composite polyamide nanofiltration (NF) membranes are difficult to simultaneously achieve high rejection for salts that are divalent anionic and cationic, and their separation selectivity for mono-/di-valent salt separation is usually poor. Herein, novel polyesteramide NF membranes were developed by interfacial polymerization on modified poly(vinylidene fluoride) (PVDF) substrates containing tannic acid (TA) self-assembled coating (TC@PVDF). TC@PVDF substrates were firstly fabricated via non-solvent induced phase separation technology using amphiphilic hyperbranched poly(methyl methacrylate- co -N-methylacrylamide) (HPMH) copolymers as in situ modifiers and TA aqueous solution as coagulation bath. The self-assembly behavior between TA and HPMH results in the increase of substrate surface hydrophilicity, electronegativity and pore size, which would facilitate the storage and uniform distribution of aqueous monomer piperazine on the substrate surface. For these reasons, TA coating interlayered NF (TCi-NF) membrane exhibits a thick polyesteramide layer with crisscrossing ridge surface morphology, a low molecular weight and a small pore size. The TCi-NF membrane not only demonstrates high rejection toward Na 2 SO 4 (99.3 %) and MgCl 2 (95.7 %), but also displays exceptional separation selectivity for both mono-/di-valent anions [α(Cl−/SO 4 2−) = 49] and mono-/di-valent cations [α(Na+/Mg2+) = 52]. Since the surface charge property of TCi-NF membrane is close to weak negativity, electrostatic effect between charged ions and membrane surface would be weakened, so the separation mechanism mainly depends on the size exclusion effect. Specifically, the TCi-NF membrane displays stable long-term separation performance and high salt concentration resistance. Therefore, this research provides a new preparation strategy for improving the precise desalination performance of thin film composite NF membranes. [Display omitted] • Tannic acid (TA) aqueous solution as coagulation bath adjusts structure of substrates by surface self-assembly. • TA coating interlayer (TCi) plays multiple roles in interfacial polymerization process. • Weakly negative TCi-NF membrane with low MWCO and small pore size. • Outstanding separation selectivity for both Cl−/SO 4 2− and Na+/Mg2+. • Excellent long-term stability and high salt concentration resistance. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the health status of nurses in China and explore the impact of work‐related stress, work environment and lifestyle factors on their health outcomes. Design: The Chinese Nurses' Health Study is a multicentred, prospective cohort study. Methods: We plan to recruit approximately 80,000 registered nurses aged between 18 and 65 years. Eligible nurses will be introduced to complete a series of web‐based questionnaires after obtaining their informed consent. Follow‐up questionnaires will be completed at 2‐year interval to continuously track subsequent exposures. Health‐related indicators will be obtained through self‐reporting by nurses and the provincial and national registry platforms such as National Central Cancer Registry. The funding was approved in July 2020 and Research Ethics Committee approval was granted in February 2021. Discussion: The study is the first multicentred prospective cohort study that aims to assess the impact of work‐related stress, work environment and lifestyle factors on the health of Chinese nurses. The results of the Chinese Nurses' Health Cohort Study will potentially draw a picture of the current situation of general health and well‐being among nurses in China and their health risks. This will be critical in recommending locally tailored strategic preventive measures and policies to reduce health and well‐being threats for nurses and potentially general public, thereby promoting the quality of healthcare in China and globally. Impact This study will help to understand the health status and working environment characteristics of Chinese nurses, and provide valuable epidemiological evidence for improving working environment and promoting well‐being. The results of this study are potentially of great significance for formulating targeted nursing strategies to promote the nurses' health, nursing quality and patient safety in China and even around the world. Clinical Trial Registration Number and name of trial register: ChiCTR.org (ID:ChiCTR2100043202), The Nurses' Health Cohort Study of Shandong. [ABSTRACT FROM AUTHOR]

To explore breast cancer (BC) patients' participation in breast reconstruction (BR) decision-making and specific decisional needs, especially the manifestations and causes of decisional conflicts, in China. A mixed-methods study was conducted using triangulation of data from interviews and a questionnaire survey with health care professionals (HCPs) and BC patients with BR decision-making experience at 5 Beijing centers. The Ottawa Decision Support Framework guided (ODSF) the qualitative and quantitative data analyses. A total of 82.53% of Chinese BC patients would consider BR. Seven themes captured patients' BR decisional needs per the ODSF: inadequate support/resources (100%, 58.82%) and knowledge (75%, 52.94%) were most frequently cited. Health beliefs (unclear values) reflected Chinese characteristics. Patients had inadequate knowledge (M=19.99/50, SD=8.67) but positive BR attitudes (M=59.48/95, SD=10.45). BR decisions for Chinese BC patients are complex and often accompanied by decisional conflicts. Inadequate knowledge and inadequate support and resources contribute to these conflicts, emphasizing the need for culturally tailored information and support to promote SDM. HCPs need specialized training in SDM to guide patients in decision-making. It is essential to provide relevant resources and support that are culturally and clinically appropriate for Chinese patients. • Chinese breast cancer patients face decisional conflicts and lack knowledge/support for breast reconstruction (BR). • Cultural characteristics and health beliefs influence the decision-making process for BR among Chinese patients. • Tailored information and support are vital to promote shared decision-making (SDM) and meet individual patient needs. [ABSTRACT FROM AUTHOR]

Background: Endotracheal suctioning is one of the most frequently performed invasive procedures by intensive care nurses. Nurses should have adequate knowledge and skills to perform endotracheal suctioning based on the best evidence. Little is known about intensive care nurses' knowledge and practice of evidence-based endotracheal suctioning in Chinese hospitals. The purpose of this study was to investigate intensive care nurses' knowledge and practice of evidence-based recommendations regarding endotracheal suctioning. Specifically, the study aimed to examine (1) intensive care nurses' awareness of and adherence to endotracheal suctioning guidelines and (2) factors influencing their level of awareness and adherence. Methods: A cross-sectional survey of 310 staff nurses working in intensive care units was carried out at Changsha, China. Data on participants' characteristics, awareness of, and adherence to the endotracheal suctioning guidelines were collected through online questionnaires. Following univariate descriptive statistics, the Mann–Whitney U test and Kruskal–Wallis H test were performed using Software Package Statistical Analysis Version 23.0. Results: A total of 281 nurses completed and returned the survey (response rate = 90.6 %). One-half to three-quarters of the nurses knew 21 of the 26 evidence-based practices and believed their practices followed the guidelines. Over half of them were unaware of the difference between open and close suctions and the pros and cons of using hyperinflation. Almost 50 % of nurses believed some of their clinical practices did not follow the evidence-based recommendations, such as not routinely using normal saline and using 80–120 mmHg suction pressure during endotracheal suctioning. Nurses with endotracheal suctioning training demonstrated significantly higher awareness of endotracheal suctioning recommendations and higher adherence levels than untrained nurses. Conclusions: The study findings revealed that Chinese intensive care nurses lacked awareness of several essential evidence-based endotracheal suctioning practices, and there were gaps between their current practice and the guideline recommendations. Further research should emphasize revealing barriers and facilitators of implementing evidence-based endotracheal suctioning practices as well as developing context-suitable interventions for guideline implementation. [ABSTRACT FROM AUTHOR]

Objective: To explore nurse managers' perceptions of the frequency and importance of professional activities performed in their daily work in public hospitals in Hunan, China. Background: Nurse managers are responsible for the management of almost all nursing activities in Chinese hospitals. Understanding how nurse managers operationalize their role and their perceptions of the importance of each activity is essential for clarification of their role and the competencies required to perform it. Methods: A cross‐sectional questionnaire survey. Results: A total of 1,371 nurse managers in Hunan Province completed the survey. Nursing quality/safety management and patient management were performed most frequently and perceived as most important. Nurse managers performed nursing information management frequently while perceiving it as less important. They seldom performed nursing research management and placed low value on it. Conclusions: Patient‐centred care remains central to nursing management. Nursing managers can create a leadership culture in their hospital settings that includes the effective management of information and facilitation of research knowledge to benefit nurse managers, staff and patients. Implications for nursing management: The results provide evidence for standardization of roles and job descriptions of nurse managers and for developing their knowledge and skills to ensure quality patient care. [ABSTRACT FROM AUTHOR]

Inspired by trimethylamine N -oxide (TMAO) secreted by saltwater fish, a novel ultra-low fouling material of N -oxide zwitterion (PTMAO) was introduced to the membrane surface via a dual-biomimetic strategy for efficient oil–water separation at near "zero pressure". [Display omitted] • Synthesized a novel N -oxide zwitterionic (PTMAO) material with ultra-low fouling. • Direct linkage of positive and negative charges (N+-O−) in PTMAO provided excellent hydrophilicity. • Bioinspired PTMAO was introduced into the membrane surface by biomimetic co-deposition chemistry. • PTMAO was introduced to endow the membrane with super-hydrophilic and oil repellent properties. • Membrane prepared by dual-biomimetic strategy showed efficient oil–water separation property. Superwetting membranes have good prospective for treatment of oil-containing wastewaters. However, development of simple and environment-friendly membranes with efficient oil–water separation performance remains a great challenge that needs to be addressed urgently. In this study, inspired by the secretion of trimethylamine- N -oxide (TMAO) by saltwater fish, we report a novel N ‑oxide zwitterionic polymer (PTMAO) with ultralow fouling property possessing directly linked opposite charges in their molecules and superior hydrophilicity, as compared to conventional zwitterionic ones. Using biomimetic co-deposition technique of dopamine (DA) and PTMAO, a zwitterionic polymer network was formed via self-polymerization of DA and followed by hydrogen bonding and cation-π effects between the oxidatively generated polydopamine (PD) and PTMAO. As expected, the fabricated membrane exhibited excellent superhydrophilicity and underwater superoleophobicity. The M–PD/PT/2:2 membrane achieved high efficiency of oil–water separation performance under ultra-low-pressure conditions, with an oil–water emulsion flux of 1121.1 L/m2 h, a recovery rate of 93.1%, and oil rejection as high as 99.2% in the cyclic oil–water emulsion separation process. Meanwhile, the M–PD/PT/2:2 membrane showed excellent stability. Therefore, this work provides a new idea for the preparation of superwetting membranes using dual-biomimetic techniques for effective separation of oil–water emulsion. [ABSTRACT FROM AUTHOR]

Two novel environmentally friendly fluorinated surfactants, disodium monofluoroalkyl phosphates were synthesized using phosphorus pentoxide, i.e. H(CF)CHOPO(ONa) and H(CF)CHOCHCHOPO(ONa). The novel synthesized fluorinated surfactants have a high thermal stability on the basis of Thermogravimetric Analysis. Their surface properties were also examined with the aim to have similar surface tensions of dilute aqueous solutions when compared with the conventional fluorocarbon surfactants, ammonium perfluorooctanoate. The two synthesized monofluoroalkyl phosphates can respectively reduce the surface tension of water to 23.73 mN/m at 78.3 mmol/L and 21.38 mN/m at 20.93 mmol/L. In addition, the Krafft points are both below 0 °C. [ABSTRACT FROM AUTHOR]

Resveratrol (RES) is a plant extract with excellent antioxidant, biocompatibility, anti-inflammatory and inhibition of platelet aggregation. RES-modified polysulfone (PSF) hemodialysis membranes have been fabricated using an immersion phase transformation method. The antioxidant properties of the blend membranes were evaluated in terms of their 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azinobis-(3-ethylbenzothiazoline-6-sulfonate) (ABTS+), reactive oxygen species (ROS) free radicals scavenging, total antioxidant capacity (T-AOC) of serum and lipid peroxidation inhibition. The observed results of decreasing DPPH and ABTS+ levels, scavenging ROS, significant inhibition of lipid peroxidation and improving the T-AOC of serum all contribute to the recovery of oxidative balance and the use of RES as an antioxidant modifier. The antioxidant stability of PSF/RES blend membranes was also studied. Moreover, the results of blood compatibility experiments showed that the addition of RES improved the blood compatibility of PSF membrane, inhibited the adhesion of red blood cells and platelets; inhibited complement activation; and reduced the blood cells deformation rate. The dialysis simulation experiment indicated that PSF/RES membrane (M-3) can clear 90.33% urea, 89.50% creatinine, 74.60% lysozyme and retention 90.47% BSA. All these results showed the new PSF/RES blend membranes have potential to be used in the field of hemodialysis to improve oxidative stress status in patients. [Display omitted] • Resveratrol, a natural plant-based antioxidant, was introduced into polysulfone dialysis membrane. • The modified membranes had strong oxidation resistance that could scavenge free radicals and inhibit lipid peroxidation. • The antioxidant activity of modified membranes was extraordinary stable for 60 d preservation. • The modified membranes had excellent blood compatibility, cytocompatibility and dialysis performance. [ABSTRACT FROM AUTHOR]

Hydrophilic polymers with low affinity for foulants were broadly utilized as functional membrane surface modifiers to mitigate fouling owing to superior hydration capability. Herein, novel hydrophilic hyperbranched poly(N-acryoyl morpholine) (HPA) synthesized through one-step RAFT polymerization was immobilized onto commercial PVDF microfiltration membrane surface using biomimetic adhesion polydopamine as an intermediate reaction platform. The surface composition and morphology of HPA decorated membranes (M-PD/HPA) were examined, demonstrating that the nano-sized HPA was facilely anchored on the membrane surface without obviously changing membrane pore size and distribution. In comparision with hydrophobic pure membrane (M-PVDF), hydrophilic and underwater superoleophobic M-PD/HPA exhibited excellent multiple defense capability toward oil, protein and bacteria due to the presence of a steric repulsive barrier of hydrated HPA layer. For model hexane-in-water emulsion separation at 0.02 MPa, permeation flux of M-PD/HPA up to 149.8 L m−2 h−1 was improved by three times and the rejection was up to 99.5%. Importantly, for the separation of complex artificial oily wastewater, relevant flux reduction of M-PD/HPA was decreased from 60.9% of M-PVDF to 36.8% and flux recovery ratio of M-PD/HPA was increased from 34.8% to 82.6%. Therefore, M-PD/HPA has a promising prospect for emulsified oil separation and water purification. Unlabelled Image • Novel hydrophilic hyperbranched Poly(N-acryoyl morpholine) (HPA) synthesized by one-pot RAFT. • HPA was immobilized on membrane surface via biomimetic adhesive chemistry. • HPA coating simultaneously enhanced surface hydrophilicity and roughness. • HPA modified membrane with enhanced separation and antifouling performance. [ABSTRACT FROM AUTHOR]

• Schizophrenia exhibited reduced theta-band power and graph measures. • Clozapine treatment can significantly reduce task-related theta-band power. • Schizophrenia exhibited weaker frontal-occipital and temporal-occipital connections. • A classification accuracy of 84.48% was obtained between schizophrenia and healthy controls. Previous studies have reported that schizophrenia (SZ) patients showed selective reinforcement learning deficits and abnormal feedback-related event-related potential (ERP) components. However, how the brain networks and their topological properties evolve over time during transient feedback-related cognition processing in SZ patients has not been investigated so far. In this paper, using publicly available feedback-related ERP data which were recorded from SZ patients and healthy controls (HC) when they performed a reinforcement learning task, we carried out an event-related network analysis where topology of brain functional networks was characterized with some graph measures including clustering coefficient (C), global efficiency (E global) and local efficiency (E local) on a millisecond timescale. Our results showed that the brain functional networks displayed rapid rearrangements of topological properties during transient feedback-related cognition process for both two groups. More importantly, we found that SZ patients exhibited significantly reduced theta-band (time window of 170–350 ms after stimuli onset) brain functional connectivity strength, E global , E local and C in response to negative feedback stimuli compared to HC group. The network based statistic (NBS) analysis detected one significantly decreased theta-band subnetwork in SZ patients mainly involving in frontal-occipital and temporal-occipital connections compared to HC group. In addition, clozapine treatment seemed to greatly reduce theta-band power and topological measures of brain networks in SZ patients. Finally, the theta-band power, graph measures and functional connectivity were extracted to train a support vector machine classifier for classification of HC from SZ, or Cloz + SZ or Cloz- SZ, and a relatively good classification accuracy of 84.48%, 89.47% and 78.26% was obtained, respectively. The above results suggested a less optimal organization of theta-band brain network in SZ patients, and studying the topological parameters of brain networks evolve over time during transient feedback-related processing could be useful for understanding the pathophysiologic mechanisms underlying reinforcement learning deficits in SZ patients. [ABSTRACT FROM AUTHOR]

Overexpression of lysine specific demethylase 1 (LSD1) has been found in many cancers. New anticancer drugs targeting LSD1 have been designed. The research on irreversible LSD1 inhibitors has entered the clinical stage, while the research on reversible LSD1 inhibitors has progressed slowly so far. In this study, 41 stilbene derivatives were studied as reversible inhibitors by three-dimensional quantitative structure–activity relationship (3D-QSAR). Comparative molecular field analysis (CoMFA q 2 = 0.623, r 2 = 0.987, r pred 2 = 0.857) and comparative molecular similarity indices analysis (CoMSIA q 2 = 0.728, r 2 = 0.960, r pred 2 = 0.899) were used to establish the model, and the structure–activity relationship of the compounds was explained by the contour maps. The binding site was predicted by two different kinds of software, and the binding modes of the compounds were further explored. A series of key amino acids Val288, Ser289, Gly314, Thr624, Lys661 were found to play a key role in the activity of the compounds. Molecular dynamics (MD) simulations were carried out for compounds 04, 17, 21, and 35, which had different activities. The reasons for the activity differences were explained by the interaction between compounds and LSD1. The binding free energy was calculated by molecular mechanics generalized Born surface area (MM/GBSA). We hope that this research will provide valuable information for the design of new reversible LSD1 inhibitors in the future. [ABSTRACT FROM AUTHOR]