FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerTus fuentes RSS

Statistical Reporting in Nursing Research: Addressing a Common Error in Reporting of p Values (p = .000)

Abstract

Purpose

The confidence in a study will be reduced due to the incorrect representation of statistical results. However, it is unknown to what extent p values are incorrectly represented in published nursing journals. The study aims to evaluate the articles in 30 nursing journals in terms of the error in reporting of p values (p = .000).

Design and Methods

This was a bibliometric analysis. All papers published in 10 leading nursing journals (between 2015 and 2019), the 10 bottom nursing journals (2019), and 10 selected key nursing journals (2019) indexed in the Science Citation Index Journal Citation Reports were reviewed to detect errors in reporting of p values (p = .000).

Results

A total of 3,788 papers were reviewed. Notably, it was found that 93.3% (28/30) of the nursing journals contained incorrect representation of p values (p = .000). The reporting rate of these journals ranges from 0% to 57.1%, with an overall rate of 12.8% (486/3,788). In addition, the rate of incorrect representation of p values (p = .000) showed no statistically significant difference between different publication years (Χ2 = 4.976, p = .290). However, the rate of reporting was different between study types, journals, and regions (p = .007, p = .020, and p < .001, respectively).

Conclusions

The incorrect representation of p values is common in nursing journals.

Clinical Relevance

We recommend that both publishers and researchers be responsible for preventing statistical errors in manuscripts. Furthermore, various kinds of statistical training methods should be adopted to ensure that nurses and journal reviewers have enough statistical literacy.

Family member eating assistance and food intake in long‐term care: A secondary data analysis of the M3 Study

Abstract

Aim

To determine if protein and energy intake is significantly associated with a family member providing eating assistance to residents in long‐term care homes as compared with staff providing this assistance, when adjusting for other covariates.

Background

Who provides eating support has the potential to improve resident food intake. Little is known about family eating assistance and if this is associated with resident food intake in long‐term care.

Design

Cross‐sectional, secondary data analysis.

Methods

Between October and January 2016, multilevel data were collected from 32 long‐term care homes across four Canadian provinces. Data included 3‐day weighed/observed food intake, mealtime observations, physical dining room assessments, health record review, and staff report of care needs. Residents where family provided eating assistance were compared with residents who received staff‐only assistance. Regression analysis determined the association of energy and protein intake with family eating assistance versus staff assistance while adjusting for covariates.

Results

Of those residents who required any physical eating assistance (N = 147), 38% (N = 56) had family assistance during at least one of nine meals observed. Residents who received family assistance (N = 56) and those who did not (N = 91) were statistically different in several of their physiological eating abilities. When adjusting for covariates, family assistance was associated with significantly higher consumption of protein and energy intake.

Conclusion

Energy and protein intake is significantly higher when family provides eating assistance. Family are encouraged to provide this direct care if it is required.

Impact

Residents who struggle with independent eating can benefit from dedicated support during mealtimes. Findings from this study provide empirical evidence that family eating assistance is associated with improved resident food intake and provides strong justification to encourage families to be active partners in the care and well‐being of their relatives. Home administrators and nursing staff should support the specialized care that families can provide at mealtimes.

Gestational weight gain and adverse pregnancy outcomes: a prospective cohort study

Por: Wu · Y. · Wan · S. · Gu · S. · Mou · Z. · Dong · L. · Luo · Z. · Zhang · J. · Hua · X.
Objective

To assess the associations of gestational weight gain (GWG) in early and late pregnancy with subsequent risks of adverse pregnancy outcomes in Chinese women.

Design

Prospective cohort study.

Setting

Shanghai, China.

Participants

We studied 2630 nulliparous singleton pregnant women with complete data on weight gain in early (≤17 weeks of gestation) and late (>17 weeks) pregnancy in the Shanghai Birth Cohort.

Methods

GWG was standardised into z-scores by gestational age and categorised as low (z-score 1). The adjusted relative risks (aRRs) and 95%CIs were estimated through log-binomial regression models. Interaction effects between GWG and some other adjustment factors were tested, further stratified analyses were performed separately where interaction terms were significant.

Outcome measures

Adverse maternal and neonatal outcomes.

Results

Independent from GWG in late pregnancy, higher GWG in early pregnancy was associated with higher risks of gestational diabetes mellitus (aRR: 1.66; 95% CI: 1.11 to 2.48), caesarean section (aRR: 1.21; 95% CI: 1.05 to 1.39) and prolonged hospitalisation (aRR: 1.56; 95% CI: 1.03 to 2.38). Higher GWG in late pregnancy was independently associated with higher risks of caesarean section (aRR: 1.24; 95% CI: 1.09 to 1.41), large for gestational age (aRR: 2.01; 95% CI: 1.50 to 2.7) and macrosomia (aRR: 1.90; 95% CI: 1.30 to 2.78). In addition, the risk of gestational hypertension increased significantly with increased total GWG (aRR: 1.78; 95% CI: 1.14 to 2.76). The effects of GWG in late pregnancy on maternal and neonatal outcomes were significantly different between the women bearing a female and the women bearing male fetus.

Conclusion

The GWG associations with adverse pregnancy outcomes differ at early and late pregnancy, and there may be effect modification by fetal sex in the association of GWG in late pregnancy with some pregnancy outcomes.

Classification of multicategory edible fungi based on the infrared spectra of caps and stalks

by Rui Gao, Cheng Chen, Hang Wang, Chen Chen, Ziwei Yan, Huijie Han, Fangfang Chen, Yan Wu, Zhiao Wang, Yuxiu Zhou, Rumeng Si, Xiaoyi Lv

As a characteristic edible fungus with a high nutritional value and medicinal effect, the Bachu mushroom has a broad market. To distinguish among Bachu mushrooms with high value and other fungi effectively and accurately, as well as to explore a universal identification method, this study proposed a method to identify Bachu mushrooms by Fourier Transform Infrared Spectroscopy (FT-IR) combined with machine learning. In this experiment, two kinds of common edible mushrooms, Lentinus edodes and club fungi, were selected and classified with Bachu mushrooms. Due to the different distribution of nutrients in the caps and stalks, the caps and stalks were studied in this experiment. By comparing the average normalized infrared spectra of the caps and stalks of the three types of fungi, we found differences in their infrared spectra, indicating that the latter can be used to classify and identify the three types of fungi. We also used machine learning to process the spectral data. The overall steps of data processing are as follows: use partial least squares (PLS) to extract spectral features, select the appropriate characteristic number, use different classification algorithms for classification, and finally determine the best algorithm according to the classification results. Among them, the basis of selecting the characteristic number was the cumulative variance interpretation rate. To improve the reliability of the experimental results, this study also used the classification results to verify the feasibility. The classification algorithms used in this study were the support vector machine (SVM), backpropagation neural network (BPNN) and k-nearest neighbors (KNN) algorithm. The results showed that the three algorithms achieved good results in the multivariate classification of the caps and stalks data. Moreover, the cumulative variance explanation rate could be used to select the characteristic number. Finally, by comparing the classification results of the three algorithms, the classification effect of KNN was found to be the best. Additionally, the classification results were as follows: according to the caps data classification, the accuracy was 99.06%; according to the stalks data classification, the accuracy was 99.82%. This study showed that infrared spectroscopy combined with a machine learning algorithm has the potential to be applied to identify Bachu mushrooms and the cumulative variance explanation rate can be used to select the characteristic number. This method can also be used to identify other types of edible fungi and has a broad application prospect.

Surgical results in acute type A aortic dissection with preoperative cardiopulmonary resuscitation: Survival and neurological outcome

by Chun-Yu Lin, Chi-Nan Tseng, Cheng-Hui Lu, Tao-Hsin Tung, Feng-Chun Tsai, Meng-Yu Wu

Background

Acute type A aortic dissection (ATAAD) is a life-threatening disease that requires emergent surgical intervention. This retrospective study aimed to clarify the individual characteristics, short-term and mid-term outcomes, and prognostic factors of patients who underwent surgical repair of ATAAD with preoperative cardiopulmonary resuscitation (CPR).

Methods

Between January 2007 and January 2020, 656 consecutive patients underwent ATAAD repair at our institution; 22 (3.4%) of these patients underwent CPR prior to surgery. Patients who underwent preoperative CPR were classified as the survivor group (n = 9) and non-survivor group (n = 13), according to whether they survived to hospital discharge. Clinical features, surgical information, and postoperative complications were analyzed and compared. Three-year cumulative survival rates and cerebral performance categories (CPC) scores are presented.

Results

In patients undergoing CPR prior to ATAAD surgery, the in-hospital mortality rate was 59.1%. A total of 72.7% of patients underwent concomitant surgical resuscitation procedures during CPR such as emergent subxiphoid pericardiotomy and/or emergent cardiopulmonary bypass. The survivor group had a higher rate of return of spontaneous heartbeat (ROSB) compared to the non-survivor group (100% versus 53.8%; P = 0.017). The 3-year cumulative survival rates were 35.1% (95% confidence interval [CI], 27.6%–42.6%) and 85.7% (95% CI, 81.9%–88.8%) for overall patients and for survivors, respectively. As for the neurological outcome, 77.8% (7/9) of patients had full cerebral performance (CPC-1) at the 3-month follow-up examination after discharge.

Conclusions

Patients with ATAAD undergoing preoperative CPR, especially those without ROSB after CPR, are at high risk for in-hospital mortality. However, the short-term and mid-term outcomes, including the cerebral performance after discharge and 3-year survival rate, are promising for patients who survived to discharge.

Efficacy of different surgical approaches on survival outcomes in patients with early-stage cervical cancer: protocol for a multicentre longitudinal study in China

Por: Chao · X. · Wu · M. · Ma · S. · Tan · X. · Zhong · S. · Song · X. · Li · L.
Introduction

Recent studies have revealed that the oncological survival outcomes of minimally invasive radical hysterectomy (MIRH) are inferior to those of abdominal radical hysterectomy (ARH) in early-stage cervical cancer, but the potential reasons are unclear.

Methods and analysis

Each expert from 28 study centres participating in a previously reported randomised controlled trial (NCT03739944) will provide successive eligible records of at least 100 patients who accepted radical hysterectomy for early-stage cervical cancer between 1 January 2009 and 31 December 2015. Inclusion criteria consist of a definite pathological evaluation of stages IA1 (with positive lymphovascular space invasion), IA2 and IB1 according to the International Federation of Gynecology and Obstetrics 2009 staging system and a histological subtype of squamous cell carcinoma, adenocarcinoma or adenosquamous carcinoma. The primary endpoint is 5-year disease-free survival between the MIRH and ARH groups. The secondary endpoints include the MIRH learning curves of participating surgeons, 5-year overall survival between the MIRH and ARH groups, survival outcomes according to surgical chronology, surgical outcomes and sites of recurrence and potential risk factors that affect survival outcomes. A subgroup analysis in patients with tumour diameter less than 2 cm will follow the similar flow diagram.

Ethics and dissemination

This study has been approved by the Institutional Review Board of Peking Union Medical College Hospital (registration no. JS-1711), and is also filed on record by all other 27 centres. The results will be disseminated through community events and peer-reviewed journals.

Trial registration number

NCT03738969

Protocol of a multicenter, single-blind, randomised, parallel controlled feeding trial evaluating the effect of a Chinese Healthy Heart (CHH) diet in lowering blood pressure and other cardiovascular risk factors

Por: Xie · W. · Wang · Y. · Sun · J. · Zeng · G. · Zhu · H. · Yang · Z. · Gao · P. · Yang · J. · Feng · L. · Lin · P.-H. · Li · M. · Xu · J. · Chen · J. · Wu · Y.
Introduction

Unhealthy diet has been identified as the number one attributor of total mortality in China, accounting for more than 20% of total deaths. Although the Dietary Approach to Stop Hypertension (DASH) and Mediterranean diets have been proven beneficial in managing cardiovascular risk factors in Western countries, whether healthy diets with similar cardiovascular benefits can be developed that are consistent with Chinese food culture remains unknown.

Methods/design

The Diet, ExerCIse and CarDiovascular hEalth (DECIDE)-Diet trial is a multicentre, single-blind, randomised controlled feeding trial to evaluate the effect of the Chinese Healthy Heart (CHH) diet, in comparison with the Chinese usual diet, in lowering cardiovascular risk factors among community residents with the increased cardiovascular risk. A total of 360 adults aged between 25 and 75 years old and with systolic blood pressure between 130 and 159 mm Hg will be recruited from four centres located in four areas representing four major Chinese cuisines: Beijing, Shanghai, Guangzhou and Chengdu. After 1 week of run-in period with local usual diet, the compliant participants will be randomised to the intervention group with the CHH diet or the control group with the usual local diet, on a 1:1 ratio, for 4 weeks. Body weight of study participants will be maintained during the entire study period. The primary outcome is the change in SBP from the baseline to the end of the study. DECIDE-Diet trial will be the first randomised controlled feeding trial to evaluate the effect of a CHH diet in lowering cardiovascular risk factors. This trial will provide compelling evidence on the CHH diet in effect of improving cardiovascular health among Chinese food consumers all around the world.

Ethics and dissemination

This trial adheres to the Declaration of Helsinki and guidelines of Good Clinical Practice. Signed informed consent will be obtained from all participants. The trial has been approved by the Peking University Institutional Review Board (approval number: IRB00001052-18094). The results will be disseminated through academic conferences and publications in international peer-reviewed journals.

Trail registration number

ClinicalTrials.gov Registry (NCT03882645); Pre-results.

Low-density lipoprotein cholesterol and all-cause mortality: findings from the China health and retirement longitudinal study

Por: Zhou · L. · Wu · Y. · Yu · S. · Shen · Y. · Ke · C.
Objectives

To investigate the relationship between low-density lipoprotein cholesterol (LDL-C) and all-cause mortality among middle-aged and elderly Chinese population.

Design

Prospective cohort study.

Setting

This study used data from the China Health and Retirement Longitudinal Study.

Participants

Middle-aged and elderly participants with complete data were enrolled for a 4-year follow-up of total mortality and plasma levels of LDL-C, including 4981 male respondents and 5529 female respondents.

Results

During a 4-year follow-up, there were 305 and 219 deaths in men and women, respectively. Compared with the first quintile (Q1) of LDL-C, the adjusted HRs (95% CIs) were 0.818 (0.531 to 1.260) for Q2, 0.782 (0.507 to 1.208) for Q3, 0.605 (0.381 to 0.962) for Q4 and 0.803 (0.506 to 1.274) for Q5 in men. The results from restricted cubic spine (RCS) showed that when the 20th percentile of LDL-C levels (84 mg/dL) was used as the reference, a lower LDL-C concentration (

Conclusions

Compared with moderately elevated LDL-C (eg, 117–137 mg/dL), a lower plasma level of LDL-C (eg, ≤84 mg/dL) was associated with an increased risk of 4-year all-cause mortality in middle-aged and elderly Chinese men. The results suggest the potential harmful effect of a quite low level of LDL-C on total mortality.

Breast feeding after caesarean delivery on maternal request: protocol of a systematic review and meta-analysis

Por: Mu · W. · Huang · Y. H. · Chaumont · A. · Letourneau · I. · El-Chaar · D. · Xia · T. · Wu Wen · S.
Introduction

Caesarean delivery under maternal request (CDMR) is a major factor contributing to the rising global rates of caesarean section (CS) procedure. The choice of CDMR without medical indications could provide a sense of assured safety by avoiding the experiences and complications of vaginal birth, and the risks related to an emergency CS. However, it might adversely influence women’s breast feeding patterns and produce a long-lasting impact on maternal and neonatal health. This study aims to systematically review the current evidence relating to the effects of intentions of performing CDMR on breast feeding.

Methods and analysis

A comprehensive literature search will be performed in three English-language electronic databases, major clinical study registries and other sources for original studies reporting the breast feeding outcomes after a planned CDMR or vaginal delivery. The three databases Medline, Embase and the Cochrane Central Register of Controlled Trials will be searched via Ovid from inception to February 2020. Randomised controlled trials (RCTs), pseudo-RCTs, cohort studies and case–control studies on this topic will be included. Participants in the experimental or case group should meet the Robson criteria of classes 2B or 4B and have experienced planned CS undertaken for no maternal or foetal indication, whereas participants in the control group have undergone scheduled vaginal delivery. All kinds of breast feeding outcomes will be included. Meta-analyses will be attempted to provide an estimate of the pooled effect and will be stratified by different study designs. A qualitative description will be provided if quantitative synthesis proves to be fruitless.

Ethics and dissemination

This study is a secondary literature review that does not need ethical approval. No primary data will be collected from the participants. Findings of this study will be presented at scientific conferences and be published in scientific journals.

PROSPERO registration number

CRD42020160303.

Microwave ablation versus radiofrequency ablation for the treatment of severe complicated monochorionic pregnancies in China:protocol for a pilot randomised controlled trial

Por: Xie · J. · Cheng · Z. · Wu · T. · Wei · Y. · Wang · X.
Introduction

Complicated monochorionic twin pregnancies are often associated with high perinatal morbidity and mortality, some of which are severe enough to require a gestational reduction surgery to improve fetal survival and reduce disabilities. While radiofrequency ablation is currently the most commonly used procedure with higher fetal survival and fewer maternal and fetal complications compared with other surgical methods, the therapeutic effect of microwave ablation (MWA) is reported to be better, presumably due to the higher thermal effect and fewer restrictions. Currently there is limited evidence to prove the feasibility of MWA for selective reduction. The aim of this pilot study is to explore the feasibility, efficacy and safety of MWA reduction for severe complicated monochorionic pregnancies and may provide evidence for using the MWA in intrauterine surgeries extensively.

Methods and analysis

This is a study protocol for a parallel-design pilot randomised controlled trial. 60 eligible patients with severe complicated monochorionic pregnancies will be randomised in a ratio of 1:1 to MWA group and radiofrequency group. Patients will be followed up until 6 months of age of the retained fetal. The primary analysis will compare the rates of neonatal survival at 28 days to evaluate the effect of MWA. The study will also evaluate the safety profile of MWA including the occurrence of postoperative adverse events and maternal and fetal complications. Additional secondary outcomes to be explored include the condition of neonatal asphyxia and the growth of surviving fetus at 6 months. Outcomes will be analysed by both a frequentist and the Bayesian statistical approach.

Ethics and dissemination

This study was approved by the ethical review committee of the Peking University Third Hospital (Beijing, China). The results of this study will be published in peer-reviewed scientific journals and presented at relevant academic conferences.

Trial registration number

NCT04014452; Pre-results.

Experiences of young women who underwent female genital mutilation/cutting

Abstract

Aim and objectives

To describe the FGM/C experiences of young women living in Nigeria.

Background

Globally, several activities have been targeted at ending female genital mutilation/cutting (FGM/C). However, the practice is ongoing, especially in countries such as Nigeria, which is reported to be having a population boom. Therefore, there is a need to investigate the FGM/C experiences of young women in such countries so that efforts towards ending it can be accelerated using evidence‐based, community‐led interventions.

Design

A qualitative descriptive design.

Methods

The study took place in two states of south‐eastern Nigeria with a high prevalence of FGM/C. The snowball sampling method was used to recruit 22 women, aged 20–40, who had undergone FGM/C. Participant’s experiences were explored through semi‐structured interviews, and the qualitative content analysis was used for data analysis. The consolidated checklist for reporting of qualitative studies guided the reporting of this study.

Findings

Three themes and seven subthemes emerged from the data. The themes were as follows: cultural issues, life as a circumcised woman and the future with FGM/C. Half of the participants could not recall their experiences on the day of their circumcision, as they were circumcised at infancy. However, those who were older when circumcised experienced it as a painful, traumatic experience forced upon them. Some of the participants experienced sexual and childbirth problems due to this procedure, and this was of great concern to them.

Conclusion

Female genital mutilation/cutting was a traumatic experience forced on the participants. They felt helpless as they could not choose and had to do the “right thing.” Despite the trauma and complications caused by the cutting, some still supported the continuation of the practice.

Relevance to clinical practice

Understanding the experiences of genitally mutilated women could assist healthcare practitioners in rendering quality, and contextualised services to these women.

Healthcare professionals' dementia knowledge and attitudes towards dementia care and family carers' perceptions of dementia care in China: An integrative review

Abstract

Aims and objectives

To establish an understanding of healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' perceptions of dementia care in China.

Background

Healthcare professionals and family carers of people with dementia deliver most of the dementia care in China. However, little research on healthcare professionals' dementia knowledge and attitudes towards dementia care, and family carers' dementia care perceptions has been conducted in China.

Methods

An integrative review was conducted and reported based on the PRISMA guidelines and Whittemore and Knafl's framework. Eight English databases were searched without date restriction: CINAHL Plus with Full Text, MEDLINE, PubMed, Web of Science, Cochrane Library, Embase, PsycINFO and Scopus; and three Chinese databases: China National Knowledge Infrastructure, Chongqing Weipu and Wanfang, plus a manual search of reference lists.

Results

Thirty‐eight primary research papers were included in the review. Three themes were identified from the synthesis: (a) knowledge and competency; (b) attitudes towards dementia care; and (c) carers' burden and unmet needs. Healthcare professionals' dementia knowledge ranged from low to moderate levels and attitudes towards dementia care were generally negative. With low levels of knowledge of dementia and negative attitudes including stigma, family carers were under stress with insufficient support, and they expected more support from community nurses.

Conclusions

There is an apparent need for a national policy on healthcare professional education and training to improve dementia care practice in China. Such a policy may improve support services for family carers.

Relevance to clinical practice

Nurses, and particularly community nurses, are well‐positioned to support family carers in China. However, healthcare professionals in China are not prepared for this. Therefore, education and training on dementia care should be integrated into medical and nursing undergraduate programmes and provided for healthcare professionals after commencing employment, and strategies to reduce stigma are needed.

Prevalence and temporal trends of presarcopenia metrics and related body composition measurements from the 1999 to 2006 NHANES

Por: Li · J.-B. · Wu · Y. · Gu · D. · Li · H. · Zhang · X.
Objective

To evaluate the prevalence and temporal trends of presarcopenia and related body composition measurements.

Design

Cross-sectional study.

Setting

National Health and Nutrition Examination Survey (NHANES) 1999–2006.

Methods

Presarcopenia was defined according to the guidelines from the European Working Group on Sarcopenia. Logistic or linear regression models were used to evaluate the linear trend of the prevalence of presarcopenia, obesity and related body composition measurements.

Participants

A total of 29 947 participants aged 18–90 years from five waves of the NHANES were included in the analysis.

Outcome measures

Presarcopenia was sex-specifically defined as having a skeletal mass index ≤7.26 kg/m2 in men and ≤5.5 kg/m2 in women. Body composition measurements, including total body fat percentage, total body fat mass, total lean body mass, appendicular skeletal muscle mass and bone mineral density, were obtained by dual-energy X-ray absorptiometry.

Results

The overall prevalence of presarcopenia ranged from 16.4% in 1999–2000 to 14.8% in 2005–2006 (p for trend=0.78). Presarcopenia was stable in both males (p for trend=0.36) and females (p for trend=0.20). The presarcopenia prevalence was significantly elevated among the age group of 18–39 years old (from 11.3% to 14.1%, p for trend=0.04) and among non-Hispanic blacks (p for trend

Conclusions

The prevalence of presarcopenia increased among young individuals over time. Non-Hispanic blacks also demonstrated an increasing trend in the prevalence over time.

Cost-effectiveness analysis of cinacalcet for haemodialysis patients with moderate-to-severe secondary hyperparathyroidism in China: evaluation based on the EVOLVE trial

Por: Liu · L. · Hong · D. · Ma · K. · Wu · B. · Lu · X.
Objective

As the cost-effectiveness evaluation of cinacalcet and conventional therapy in China has not been reported, the objective of this study was to make a pharmacoeconomic evaluation of cinacalcet specific to the Chinese healthcare setting in patients with moderate-to-severe secondary hyperparathyroidism (SHPT) undergoing dialysis.

Designs

Data from Evaluation of Cinacalcet Therapy to Lower Cardiovascular Events trial were used for this analysis. A semi-Markov model was constructed to estimate quality-adjusted life years (QALYs) and lifetime costs in cinacalcet plus conventional therapy (cinacalcet strategy) compared with conventional therapy (standard strategy), in patients with moderate-to-severe SHPT undergoing dialysis. Treatment effect estimates from the unadjusted intent-to-treat (ITT) analysis and covariate-adjusted ITT analysis were used as the main analyses. Model sensitivity to variations in individual inputs and overall decision uncertainty were assessed through probabilistic sensitivity analyses.

Primary and secondary outcome measures

Incremental cost-effectiveness ratio (ICER) as measured by cost per QALY gained.

Results

The ICER for cinacalcet strategy was US$44 400 per QALY gained using the covariate-adjusted ITT analysis. Probabilistic sensitivity analysis suggested a 46.2% chance of the ICER being below a willingness-to-pay threshold of US$26 508. Treatment effects from unadjusted ITT analysis yielded an ICER of US$87 210 per QALY. The model was most sensitive to the treatment effect on mortality.

Conclusions

Existing evidence does not support the cost-effectiveness of cinacalcet strategy in patients with moderate-to-severe SHPT undergoing dialysis when applying a willingness-to-pay threshold of US$26 508 per QALY, whether it is using the treatment effect from covariate-adjusted ITT analysis or unadjusted ITT analysis.

Effectiveness of a couple‐based psychosocial intervention on patients with prostate cancer and their partners: A quasi‐experimental study

Abstract

Aims

To understand the effectiveness of a couple‐based psychosocial information package (PIP) and multimedia psychosocial intervention (MPI) on patients with prostate cancer and their partners.

Design

A random assignment and quasi‐experimental design were used.

Methods

From August 2015–March 2018, 103 newly diagnosed patients with prostate cancer and their partners were divided into a control group (CG) (N = 50), PIP group (N = 25) and MPI group (N = 28). The CG received usual care, the PIP group received information manuals and telephone counselling for 6‐week and the MPI group received multimedia films and manuals and professional support for 6 weeks. The three groups were posttested 6, 10, 18 and 24 weeks after the pre‐test. The outcome measurements included disease appraisals, emotion status, relationship satisfaction, health‐related quality of life (HRQOL) and satisfaction with MPI.

Results/Findings

Partners in the MPI and PIP groups experienced significant improvements in positive and negative affect or mental HRQOL as compared with the CG. The effectiveness of MPI and PIP on negative affect, mental HRQOL, however, were not statistically significant in patients with prostate cancer. Nevertheless, patients were satisfied with the MPI.

Conclusion

Nurses can provide different types of interventions for partners, depending on personal preferences and available resources.

IMPACT

There is a lack of studies that focus on the effectiveness of couple‐based psychosocial intervention on both the patients with prostate cancer and their partners in Asia. Partners in the multimedia psychosocial intervention group and psychosocial information package group experienced improvements in positive affect, negative affect or health‐related quality of life as compared with the control group. Patients in both intervention groups experienced similar negative affect and health‐related quality of life as compared with the control group. The couple‐based psychosocial interventions can be provided by nurses based on partners’ preferences and available resources.

Analysis of miRNAs and their target genes associated with mucosal damage caused by transport stress in the mallard duck intestine

by Hao Zhang, Fang Chen, Zhenhua Liang, Yan Wu, Jinsong Pi, Lixia Wang, Jinping Du, Jie Shen, Ailuan Pan, Yuejin Pu

Bowel health is an important factor for duck rearing that has been linked to feed uptake and growth and death rates. Because the regulatory networks associated with acute stress-mediated injury in the duck gastrointestinal tract have not clearly elucidated, we aimed to explore potential miRNA-mRNA pairs and their regulatory roles in oxidative stress injury caused by transport stress. Here, 1-day-old mallard ducklings from the same breeder flock were collected and transported for 8 h, whereas the control group was not being transported. Various parameters reflecting oxidative stress and the tissue appearance of the intestine were assessed. The data showed that the plasma T-AOC and SOD concentrations were decreased in the transported ducklings. The intestine of the transported ducklings also displayed significant damage. High-throughput sequencing of the intestine revealed 44 differentially expressed miRNAs and 75 differentially expressed genes, which constituted 344 miRNA-mRNA pairs. KEGG pathway analysis revealed that the metabolic, FoxO signaling, influenza A and TGF-β signaling pathways were mainly involved in the mechanism underlying the induction of intestinal damage induced by simulated transport stress in ducks. A miRNA-mRNA pair, miR-217-5p/CHRDL1, was selected to validate the miRNA-mRNA negative relationship, and the results showed that miR-217-5p could influence CHRDL1 expression. This study provides new useful information for future research on the regulatory network associated with mucosal damage in the duck intestine.

Effects of HMW-GSs on quality related traits in wheat (<i>Triticum aestivum</i> L.) under different water regimes

by Jiajia Zhao, Xingwei Zheng, Ling Qiao, Chuan Ge, Bangbang Wu, Shuwei Zhang, Linyi Qiao, Zhiwei Feng, Jun Zheng

Alleles at the Glu-1 loci play important roles in the functional properties of wheat flour. The effects of various high-molecular-weight glutenin subunit (HMW-GS) compositions on quality traits and bread-making properties were evaluated using 235 doubled haploid lines (DHs). The experiment was conducted in a split plot design with two water regimes as the main plot treatment, and DH lines as the subplot treatments. Results showed that the presence of subunit pair 5+10 at the Glu-D1 locus, either alone or in combination with others, appears to provide an improvement in quality and bread-making properties. At the Glu-A1 locus, subunit 1 produced a higher Zeleny sedimentation value (Zel) and stretch area (SA) than subunit 2* when subunits 14+15 and 5+10 were expressed at the Glu-B1 and Glu-D1 loci, and 2* had a positive effect on the maximum dough resistance (Rmax) when subunits 14+15 and 5'+12 were expressed at the Glu-B1 and Glu-D1 loci, respectively. Given subunit 1 at the Glu-A1 locus and 5'+12 at the Glu-D1 locus, the effects of Glu-B1 subunits 14+15 on the tractility (Tra), dough stability time (ST), and dough development time (DT) under the well-watered regime were significantly higher than those of Glu-B1 subunits 13+16. However, 13+16 had a positive effect on SA under the rain-fed regime when subunits 2* and 5+10 were expressed at the Glu-A1 and Glu-D1 loci, respectively. Multiple comparisons analysis revealed that the Zel and Rmax of the six subunits and eight HMW-GS compositions were stable under different water regimes. Overall, subunit compositions 1, 13+16 and 5+10 and 1, 14+15 and 5+10 had higher values for quality traits and bread-baking properties under the two water regimes. These results could play a positive guiding role in selecting and popularizing varieties suitable for production and cultivation in local areas.

Psychosocial Bullying Among Nurse Educators: Exploring Coping Strategies and Intent to Leave

Abstract

Purpose

To examine the incidence of workplace bullying among nurse educators and explore potential relationships between workplace bullying, professional demographics, coping strategies, and intent to leave.

Design

The investigator used a cross‐sectional, descriptive, correlational design and Bronfenbrenner’s Process‐Person‐Context‐Time model to examine workplace bullying among nurse educators in the northeastern United States.

Methods

A web‐based survey was utilized to collect data from a final sample of 470 nurse educators from nine states in the northeastern United States. The instruments included a demographic section, followed by the Negative Acts Questionnaire‐Revised (NAQ‐R), the Coping Strategy Indicator (CSI), and a three‐item job intent turnover questionnaire. Descriptive and parametric statistics were generated for data analysis.

Findings

Forty‐five percent (n = 212) of participants self‐identified as targets of bullying in the workplace within the preceding 6 months. The most frequently reported negative acts encountered among the nurse educators surveyed were being excluded, having one’s opinion ignored, and being exposed to an unmanageable workload. Furthermore, statistically significant relationships were identified between workplace bullying and coping strategies (r = .53: p < .01) and intent to leave (r = .58: p < .01) among nurse educators.

Conclusions

Workplace bullying among nurse educators is a serious problem impacting the profession. Heightened awareness and diverse initiatives targeting workplace bullying can positively impact retention of qualified nurse educators.

Clinical Relevance

Findings from this study may contribute to the development of strategies to mitigate the effects of psychosocial bullying and enhance retention of nurse educators.

A new surgical approach of direct perineal wound full‐thick closure for perineal wound of abdominoperineal resection for rectal carcinoma: A prospective cohort trial

Abstract

Perineal wound complications after APR have high morbidity in the colorectal surgical department. Although some approaches have been figured out to solve this clinical focus, the outcomes are still not satisfied. Herein, this prospective comparative clinical trial has been designed to evaluate a new surgical procedure of direct perineal wound full‐thick closure (DPWC), compared with conventional perineal wound closure (CPWC), with hopes of making wound healing with less complications. In addition, an evaluation of an incision negative wound pressure therapy, as another focus in this field, was also analysed in the DPWC group. A total of 44 participants in our department were recruited from March 2018 to March 2020, divided into two groups randomly, CPWC group and DPWC group. The patients' characteristics, such as age, gender, BMI, smoking, alcohol consumption, comorbidities, CEA level, and high‐risk of invasion, were recorded without statistical significance between the CPWC group and DPWC group. After the same standard abdominal phase, these two groups were performed in different perineal phases. And then, operative and postoperative outcomes were analysed with different statistical methods. Data on wound healing time and length of stay in the DPWC group were shorter than those in the CPWC group (P < .05). Furthermore, cases of wound infection within 30 days in the DPWC group were also less than that in the CPWC group (P < .05). However, no difference was found between the incisional negative pressure wound therapy assisted group (NPA group) and non‐ incisional negative pressure wound therapy assisted group (non‐NPA group). During this study, hypoalbuminemia, as an independent high‐risk factor, impacted perineal wound healing. (P = .0271) In conclusion, DPWC is a new surgical approach, which can lead to a better outcome than DPWC, and it can be another surgical procedure for clinicians. In addition, hypoalbuminemia should be interfered for avoiding perineal wound complications.

Self‐management programmes for cirrhosis: A systematic review

Abstract

Background and aims

Liver cirrhosis severely decreases patients' quality of life. Since self‐management programmes have improved quality of life and reduce hospital admissions in other chronic diseases, they have been suggested to decrease liver cirrhosis burden.

Methods

We performed a systematic review and meta‐analysis to evaluate the clinical impact of self‐management programmes in patients with liver cirrhosis, which followed the Preferred Reporting for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Primary outcomes include health‐related quality of life (HRQOL) and hospitalisation. We searched MEDLINE, CENTRAL, Embase, CINAHL, PsycINFO and two trial registers to July 2017.

Results

We identified four randomised trials (299 patients) all rated at a high risk of bias. No difference was demonstrated for HRQOL (standardised mean difference −0.01, 95% CI: −0.48 to 0.46) and hospitalisation days (incidence rate ratio 1.6, 95% CI: 0.5–4.8). For secondary outcomes, one study found a statistically significant improvement in patient knowledge (mean difference (MD) 3.68, 95% CI: 2.11–5.25) while another study found an increase in model for end‐stage liver disease scores (MD 2.8, 95% CI: 0.6–4.9) in the self‐management group. No statistical difference was found for the other secondary outcomes (self‐efficacy, psychological health outcomes, healthcare utilisation, mortality). Overall, the quality of the evidence was low. The content of self‐management programmes varied across studies with little overlap.

Conclusions

The current literature indicates that there is no evidence of a benefit of self‐management programmes for people with cirrhosis.

Relevance to clinical practice

Practitioners should use self‐management programmes with caution when delivering care to patients living with cirrhosis. Further research is required to determine what are the key features in a complex intervention like self‐management. This review offers a preliminary framework for clinicians to develop a new self‐management programme with key features of effective self‐management interventions from established models.

❌