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Schools are key settings to intervene for the purpose of health promotion in children. However, the effectiveness of school-based interventions remains limited, potentially related to the obesogenic behaviours observed during holidays as posited by the structured days hypothesis. This study aims to evaluate the feasibility, process evaluation and preliminary efficacy of the keep moving in a structured summer (KEMOSS) intervention among Chinese children.
The KEMOSS intervention is an 8-week hybrid programme comprising two digitally supported home-based phases (weeks 1–2 and 7–8) and a structured school-based phase (weeks 3–6). The school-based phase will be a full-day scheduled programme that replicates the routine of regular school days, with a coach-led structured physical activity lesson and a free-play lesson embedded in the morning and afternoon, respectively. During the home-based phases, participants will be encouraged to complete prescribed exercises independently with support from mHealth reminders and instructional materials and to achieve a minimum of 10 000 steps per day. Feasibility, process evaluation and preliminary efficacy outcomes will be assessed using a mixed-methods approach. Quantitative data will be analysed using SPSS, while qualitative data from interviews and focus groups will be analysed thematically using NVivo.
Ethical approval has been obtained from the Ningbo University Ethics Committee (TY2026028). Findings will inform the refinement of the intervention and the design of a future definitive trial. Results will be disseminated through peer-reviewed publications and conference presentations.
ChiCTR2600126738.
Traditional approaches to designing decision aids have focused on providing completeness of information and quantitative detail. An alternative approach based on psychological research emphasises understanding the essence or ‘gist’ of the decision. Few gist-based decision aids exist. The objective of this study was to develop novel gist-based decision aids for prostate and breast cancer screening and evaluate their acceptability.
Men aged 40–60 years and women aged 40–49 years eligible for prostate or breast cancer screening were recruited from ResearchMatch (National Institutes of Health) and a public hospital located in New York City. Three rounds of semistructured interviews were performed to determine self-reported comprehensibility and acceptability, with iterative modifications after each phase, including: Phase 1: initial feedback; Phase 2, Round 1: evaluating our modifications; and Phase 2, Round 2: confirming final content.
A total of 80 participants were involved in the two-phase qualitative interview process; Phase 1 and Phase 2 included 32 and 48 participants, respectively. Racial distribution was 50% white, 30% black and 10% Asian; 9% of participants were Hispanic or Latino. Most participants were highly educated. Interview themes established content validity of the final decision aids. In a quantitative analysis of the final decision aids using a questionnaire with fixed response options, acceptability was high, with two-thirds finding the length and amount of information of the decision aid to be optimal. The majority found the decision aid visually appealing, easy to read and easy to get through, and indicated that it held their interest and did not require much mental effort to read. One-quarter said the tool made them feel somewhat nervous, and three-quarters not at all. Most participants could understand and relate to the images, graphs and patient stories in the decision aid. After Phase 2, 45 of the 48 participants (94%) said they would find the decision aid helpful when making a decision.
This study describes the iterative development and pilot testing of a novel gist-based decision aid for cancer screening, demonstrating high acceptability. Our findings provide a foundation for randomised trials comparing gist-based and traditional tools.
by Xiaodong Zhang, Lan Zou, Dunfu Zhang, Bangtao Yao, Junge Chen, Tianfeng Wei, Zhouping Fu, Xin Chang, Lijuan Chen, Yan Geng
BackgroundForearm radial artery occlusion (RAO) is a common complication after transradial coronary procedures. Traditional patent hemostasis, relying on operator-dependent assessment, results in labor-intensive processes and inconsistent RAO rates.
MethodsThis is a single-center, prospective, randomized, open-label, parallel-group superiority trial. We plan to enroll 818 patients scheduled for transradial coronary angiography. Participants will be randomly assigned (1:1) to either a novel balloon pressure monitoring system (integrating high-precision digital manometry with physiologically-phased decompression) or traditional patent hemostasis. The primary outcome is the incidence of ultrasound-confirmed forearm RAO at 24 hours post-procedure. Key secondary outcomes include rates of access-site vascular complications and bleeding events, as well as objective metrics of hemostasis efficiency. Recruitment Status: Recruitment commenced in September 2024 and is ongoing; the target sample size is anticipated to be reached by May 2026. Analysis will follow the intention-to-treat principle.
Results/ Trial StatusAs a protocol paper, no results are reported. The trial is currently in the recruitment phase.
ConclusionsThis trial will provide the first large-scale randomized evidence on whether digital manometry-guided compression reduces RAO, potentially bridging the efficacy-effectiveness gap between optimized research protocols and routine practice.
Trial registrationThe trial was registered with the Chinese Clinical Trial Registry (ChiCTR) in August 2024, under the registration number ChiCTR2400088258.
This study aimed to evaluate the factors associated with care modality among older adults with chronic disease and disability in rural China. We hypothesised that marital status, family structure, duration of disability and the number of chronic diseases would be significantly associated with care modality.
This was a cross-sectional observational study using survey data to identify demographic and health-related factors associated with care modality.
The study was conducted in a rural mid-sized county in China and focused on older adults with chronic disease and disability.
A total of 608 older adults aged ≥60 years with chronic disease and disability residing in Qinghe County, Hebei Province, China, completed the survey. Eligible participants had at least one chronic disease and partial or complete loss of self-care ability.
The primary outcome was care modality (home-based care vs institutional care). Secondary outcomes included specific chronic disease care needs.
Of the participants, 18.59% received institutional care. Divorced, widowed or unmarried participants had higher odds of institutional care use (OR=3.113, 95% CI 2.01 to 4.82, p
Marital status, number of children, duration of disability and number of chronic diseases were significantly associated with care modality in this population. These findings highlight the need to improve institutional care quality and availability and to better address the chronic disease management needs of this population. Future research should focus on longitudinal studies to explore the evolving care needs of this growing demographic.
To explore the relationship between sleep and cognitive frailty in older adults.
A systematic review and meta-analysis.
The Web of Science, Cochrane Library, CINAHL, Embase, PsycINFO and PubMed databases were searched from inception to October 28, 2024.
Two investigators independently conducted literature screening, data extraction and quality assessment. The Joanna Briggs Institute Critical Appraisal Tool and Newcastle–Ottawa Scale were used to evaluate methodological quality. This review followed PRISMA guidelines.
This review included 13 articles involving 14,223 individuals, and 10 studies included in the meta-analysis. Across 13 studies, the overall prevalence of cognitive frailty was 25%. Sleep problems were categorised into four categories; the results reported that poor sleep quality, long sleep time and insomnia were correlated with the presence of cognitive frailty. However, the relationship between short sleep time and cognitive frailty was not significant.
This review quantitatively suggested that sleep parameters such as long sleep time, insomnia and poor sleep quality were correlated with the presence of cognitive frailty. Future research should adopt longitudinal designs and use validated instruments to measure both quantitative and qualitative aspects of sleep, thereby facilitating a thorough examination of the strength of the relationship between sleep and cognitive frailty, as well as the direction of causality.
The review highlights the need to integrate comprehensive sleep assessments and targeted interventions into nursing care plans for older adults to enhance their sleep health. The findings will provide support for the development of effective interventions to prevent and manage cognitive frailty in the older population.
No patient or public contribution.
To examine the relationship among leadership, clinical teaching competencies, and structural empowerment of nursing clinical instructors in China.
A cross-sectional study.
A total of 152 nurses who come from three Grade A tertiary hospitals located in Beijing, Kunming, and Liaoning Province, China, completed an online questionnaire that included general information, clinical teaching information, the Conditions of Work Effectiveness Questionnaire-II, nurse leadership, and structural empowerment. SPSS 26.0 and AMOS 26.0 were used for normality test, descriptive statistics, correlation analysis, regression analysis, and structural equation model.
The study revealed that nurse leadership (r = 0.402) and structural empowerment (r = 0.568) both positively correlated with clinical teaching competencies. Specifically, the level of nurse leadership exhibited a low but direct positive effect on these competencies (β = 0.22), while the level of structural empowerment demonstrated a moderate direct positive effect (β = 0.56).
Enhancing nurse leadership and structural empowerment positively influence the clinical teaching competencies of nursing instructors.
Constructing a structural equation model to describe the relationship between leadership, structural empowerment, and teaching ability can provide the most intuitive direction for future research, so as to better improve the teaching ability of clinical nursing teachers.
No patient or public contribution.
This study aims to identify key antecedents of quiet quitting across industries through a three-level meta-analysis, evaluate their relevance to nursing and highlight aspects that have been under-explored in the nursing field, with the goal of guiding future research and interventions to improve nurse retention and engagement.
A three-level meta-analytic design incorporating subgroup analyses and moderator analyses was used to integrate quantitative evidence from studies across different industries and professions to examine the antecedents of quiet quitting.
Data were sourced from EBSCO, Web of Science, ScienceDirect, Scopus, JSTOR, ProQuest, SpringerLink, Emerald and Google Scholar for articles published between January 2020 and January 2025. Preprints from Research Square were also included.
Perceived workplace support reduces the likelihood of quiet quitting. Conversely, workplace conflicts, perceived injustice, burnout and stress are positively correlated with quiet quitting, with nurses exhibiting a higher tolerance for these factors compared to other sectors. Negative traits and passive work orientations exacerbate quiet quitting, whereas positive traits and proactive orientations show no significant effect across sectors. Additionally, organisational involvement, job satisfaction and well-being significantly reduce quiet quitting behaviours.
Quiet quitting is a widespread issue across various industries, including nursing. The findings call for nursing research to expand its focus beyond emotional exhaustion and workplace conflict to include nurses' psychological contracts breach and violations, nurses' individual traits, the degree of embeddedness within healthcare organisations and the maintenance of reciprocal exchanges.
This study identifies the key factors influencing nurses' quiet quitting, providing evidence to support the development of effective retention strategies for nursing leaders and policymakers. This is expected to improve nurse retention and job satisfaction, which, in turn, can enhance care quality and patient safety, thereby contributing to the sustainable development of healthcare systems.
PRISMA reporting method has been followed.
This study did not include patient or public involvement in its design, conduct or reporting.
A protocol for this study is preregistered at Open Science Framework (https://osf.io/4z5hs).
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