Conectar
Glaucoma is an optic neuropathy caused by the gradual degeneration of retinal ganglion cells. This study aimed to investigate the knowledge, attitude and practice (KAP) towards glaucoma among ophthalmic inpatients.
A web-based questionnaire.
Local hospital.
Ophthalmic inpatients (n=1238).
The primary outcome was the patients’ KAP.
Multivariable logistic regression analysis showed that rural residence (OR=0.488, 95% CI 0.313 to 0.762, p=0.002), college education or above (OR=4.996, 95% CI 2.942 to 8.483, p
Ophthalmic inpatients might have moderate knowledge and attitude, but a proactive practice towards glaucoma. A history of glaucoma, previous glaucoma surgery, education level, residency and alcohol consumption were potentially associated with knowledge and attitudes towards glaucoma among ophthalmic inpatients.
To develop a comprehensive and psychometrically validated scale for evaluating the core competencies of community nurses for public health emergencies.
A study of instrument development and validation was conducted.
A total of 1057 community nurses provided valid responses for this study conducted in Shanghai, China. Building upon previous study findings of the adapted core competency model and integrating the World Health Organisation's Framework for Action, this study was conducted in two phases. First, scale items were developed through systematic review, qualitative research, stakeholder meeting, and Delphi survey, refined with cognitive interviews to establish version 1.0 of the scale. Second, item analysis was performed with item-total correlations, Cronbach's alpha, and exploratory factor analysis, resulting in version 2.0. The final scale was produced after assessing the validity (content validity, confirmatory factor analysis, known-groups validity) and reliability (internal consistency, test–retest reliability).
The final scale consisted of 47 items categorised into four competency factors: prevention, preparation, response, and recovery competency. Factor analysis results indicated adequate factor loadings, excellent model fit, and well-established construct validity. The overall scale and its sub-factors exhibited high internal consistency and good test–retest reliability.
The study presents a theoretically grounded and scientifically validated scale measuring the competencies that community nurses need for public health emergency response.
This study enhances the theoretical framework of community nurses' core competencies in public health emergencies, provides a validated assessment tool, and clarifies their role in enhancing preparedness and effectiveness.
The study addressed the need for a standardised tool for assessing community nurse core competency for public health emergencies and will impact policy initiatives to enhance early prevention, emergency response, and integrated recovery practices in crisis management.
Strengthening the Reporting of Observational studies in Epidemiology checklist.
No Patient or Public Contribution.
The aim of this study was to investigate factors affecting psychosocial adaptation in intestinal stoma patients and to identify central symptoms that might guide future interventions through network analysis.
A multicenter cross-sectional study.
All intestinal stoma patients were evaluated for psychosocial adaptation using the Ostomy Adjustment Inventory-20 (OAI-20). Univariate and multivariate linear regression were used to analyse the potential relationship between the level of psychological adjustment of intestinal stoma patients and individual factors. By network analysis, we calculated the centrality indicators for each node in the ostomy psychosocial adaptation network at different levels of low, medium and high, respectively.
This study ultimately enrolled a total of 19,909 intestinal stoma patients from 202 Chinese hospitals, out of which 6408 reported low psychosocial adaptation. It was found that there is a negative association between being female, partially self-care, completely dependent on others for care and having no medical insurance with psychosocial adaptation scores. In the low-level psychosocial adaptation network, no. OAI-14:limited activity, no. OAI-9: worried about ostomy, and no. OAI-11:always like a patient were identified as central indicators.
Being female, partially self-care, completely dependent on others for care, and having no health insurance can be considered characteristics of patients with lower psychosocial adaptation. Network analysis results provide intervention targets to improve adaptation.
Individualised and precise interventions can be carried out in terms of both the influencing factors and the most influential nodes of psychosocial adaptation in order to improve the level of psychosocial adaptation in intestinal stoma patients.
No patient or public contribution.
The treatment of chronic wounds in the Aged is often difficult. Masquelet technique is used for the treatment of infected large segmental bone defects as it provides an adequate blood supply for bone and soft tissue reconstruction. In this study, a two-stage wound management strategy was used, consisting of covering the initial wound with bone cement and skin grafting under induced membranes. From September 2020 to September 2022, 20 Aged patients with chronic refractory wounds of the lower extremities with exposed bone or tendons were recruited in the Department of Wound Repair Surgery of the Second Affiliated Hospital of Wenzhou Medical University. Each patient was reconstructed according to a two-stage process. In the first stage, while treating the patient's underlying disease, several debridements were first performed on the wound; subsequently, the Masquelet technique was applied to seal the wound with antibiotic bone cement. Four to 6 weeks later, the second stage was initiated—after confirming the sufficient formation of wound induced membranes, the bone cement was removed, and free skin grafts were finally used to cover the chronic refractory wounds on the extremities. The area of the defects ranged from 4.5 × 3.0 cm to 15.0 × 6.0 cm, and all soft tissue defects were associated with tendon or bone exposure. After the surgery, patients attended regular outpatient visits and were followed up by telephone and video to observe the healing of the wounds and whether there were any complications in the donor site. The Lower Extremity Function Scale (LEFS) score was used to evaluate the functional recovery of the lower extremities. We found that all implants survived without necrosis or infection. All 20 cases were followed up regularly after surgery for 3 to 12 months, with a mean of 7.6 months. In the first stage, Induced Membranes induction was performed 1–4 times, with an average of (1.3 ± 0.7) times, and in the second stage, free skin grafting was performed on the induction membrane, and all 20 cases of skin grafting survived without necrosis or infection; the appearance and texture of the skin in the grafted area were satisfactory, and the postoperative LEFS score was (69.83 ± 10.82). Finally, our strategy for the management of chronic refractory wounds in the Aged can achieve satisfactory clinical results, reduce surgical risk, be simple and reliable, and be an effective addition to the repair modality.
The study examines the associations between nursing competence, work environment, and health system resilience. It also analyzes how nursing competence and work environment relate to different patterns of health system resilience.
A multiple center cross-sectional study was conducted between December 2023 and January 2024 across 33 hospitals in eastern China, involving 2435 nurses.
Questionnaires measuring nursing competence, work environment resources, nurse disaster resilience, and organizational commitment to resilience were utilised, along with the collection of additional personal demographic data. Structural equation modelling and cluster analysis were performed to explore the underlying mechanisms within the overall model and across multiple groups. Multivariable regression was conducted to identify variables associated with resilience in different subgroups.
Structural equation modelling demonstrated significant influences of nursing competence and work environment support on system resilience. Cluster analysis identified four resilience patterns: strong, marginal, low, and critical vulnerability. Strong resilience correlated with balanced individual-organizational resources, while vulnerable systems relied heavily on environmental support.
Our findings support policymakers and managers in developing systematic strategies with distinct focal points—targeting nurse workforce investment and optimised work environment—to enhance health system resilience across varying levels of public health emergencies.
This study validated the framework connecting individual and organizational resilience, offering evidence-based insights for nurse training and resource allocation to enhance healthcare systems' adaptability during disasters.
The study addressed how nursing competence and work environment significantly influenced resilience during public health emergencies, identified four resilience patterns, and provided insights to guide policymakers and healthcare managers in developing targeted, effective strategies.
Strengthening the Reporting of Observational studies in Epidemiology checklist.
No patient or public contribution.
Ample evidence has shown the benefit of high-fidelity simulation (HFS) in promoting learning in pre-licensure nursing students, but the evidence for practising registered nurses has not been synthesised.
To evaluate the effects of HFS training on learning outcomes and satisfaction in practising registered nurses.
In this systematic review and meta-analysis, we searched PubMed, CINAHL, ERIC, Cochrane Library, Web of Science and China National Knowledge Infrastructure (CNKI) for studies published in English or Chinese from database inception to 31 May 2023 (updated on 20 April 2025). All randomised controlled trials (RCT) or quasi-experiments that compared HFS training with traditional methods (e.g., lecture) for practising registered nurses and reported learning outcomes and satisfaction were included. Risk of bias was assessed by the Cochrane risk-of-bias tool for randomised trials (RoB 2) and non-randomised trials (ROBINS-I). Inverse-variance random-effect models were used to calculate standardised mean differences (SMDs) with 95% confidence interval (CI). We followed the PRISMA 2020 guideline.
Of 1404 records, eight eligible studies (five RCTs and three quasi-experiments) involving 275 practising nurses were identified. Two RCTs had high risk of bias, while others showed some concerns or moderate risk of bias. Meta-analyses showed that HFS could promote knowledge acquisition (SMD = 0.65, 95% CI, [0.35, 0.95], p < 0.01, I2 = 0%), professional skills (SMD = 0.72, 95% CI, [0.41, 1.04], p < 0.01, I2 = 0%) and learning satisfaction (SMD = 1.24, 95% CI, [0.35, 2.13], p < 0.01; I2 = 67%), compared with traditional methods. The pooled effect on self-confidence was marginally insignificant (SMD = 0.59, 95% CI, [−0.04, 1.22], p = 0.07; I2 = 67%).
Compared with traditional training methods, HFS is effective in promoting knowledge acquisition, professional skills and learning satisfaction and may enhance self-confidence among practising nurses. To strengthen the evidence base, more rigorous RCTs with larger sample sizes, adequate reporting of HFS design, and standardised outcome measures are warranted.
PROSPERO (CRD42022358717). No Patient or Public Contribution.
by Wen-Qi Hou, Yu-Xin Li, Ming-Fei Luo, Wen-Ying Zhou, Mai Lu
Due to the diversification of media functions of mobile phones, users can make calls and access the internet simultaneously, which has significantly increased the usage time of mobile phones. The exposure dose of the users in the combined electromagnetic fields (EMF) should be further quantified to better evaluate the public exposure safety. Different from most conventional EMF safety studies that only focus on a single frequency, this work not only discusses the mobile phone simultaneously operated in fourth-generation (4G) and fifth-generation (5G) mobile communications radiation impact on users, but also verifies that the miniaturized mobile phone multiple-input multiple-output (MIMO) antenna array can significantly reduce the specific absorption rate (SAR) absorbed by users. In this article, a miniaturized mobile phone MIMO antenna array is employed as the radiation source, and multi-pose human models are established to simulate the practical utilization of a smartphone. A systematic analysis of the SAR absorbed by the human model is conducted in both single and combined EMF scenarios. The results indicate that the peak SAR in various tissues under multi-frequency exposure is 1.02 to 15.85 times higher than that under single-frequency exposure.A combination of chemotherapy and immune checkpoint inhibitor therapy has been demonstrated to be effective as a first-line treatment of gastric or gastro-oesophageal junction (G/GEJ) cancer. The conventional treatment strategy for patients with advanced/metastatic human epidermal growth factor receptor 2-negative G/GEJ cancer is recommended. However, the response rate and enhancements in survival are still significantly insufficient. The present study will investigate the efficacy and safety of incorporating a bevacizumab biosimilar IBI305 into chemotherapy and immunotherapy as a first-line treatment for advanced or metastatic G/GEJ cancer.
This single-arm, open-label, prospective phase Ib/II clinical study will involve 57 participants. In phase Ib of the trial, patients with advanced or metastatic G/GEJ cancer will receive capecitabine and oxaliplatin (CapeOX) together with sintilimab (200 mg intravenously every 3 weeks) and IBI305 (7.5, 10 or 15 mg/kg intravenously every 3 weeks) in a 3+3 dose-escalation design to evaluate dose-limiting toxicities (DLTs) within 6 weeks of treatment initiation. In phase II, the patients will receive CapeOX combined with sintilimab and IBI305 at the recommended phase II dose. The primary objectives will be to assess DLTs (phase Ib) and the objective response rate (phase II). The secondary objectives will include progression-free survival, overall survival, disease control rate, duration of response, adverse effects, quality of life and safety.
The trial protocol was approved by the Ethics Committee of West China Hospital and ClinicalTrials. The final results will be published in a peer-reviewed journal upon completion of the study.
Maternal thyroid function affects fetal birth weight and age is an important factor in regulating thyroid function. Thus, we aimed to explore the association between age-specific preconception thyroid-stimulating hormone (TSH) and birth weight.
Cohort study.
A total of 97 755 preconception Chinese women aged 20–39 years old from the National Free Preconception Checkups Project were included.
Participants were divided into four age groups: 20–25 years, 25–29 years, 30–34 years and 35–39 years. The preconception TSH levels within 6 months before pregnancy and fetal birth weight, including large for gestational age (LGA), small for gestational age (SGA) and appropriate for gestational age (AGA), were collected and analysed using restricted cubic spline regression. Logistic regression investigated the relationship between various TSH groups and birth weight.
(1) Preconception TSH levels differed among four age groups; (2) in the 20-24 years group, preconception TSH was associated with the incidence of LGA and AGA (p2.12 mIU/L) TSH were associated with a higher risk of LGA and lower incidence of AGA in 20–24 years.
Preconception TSH exhibited a significant association with LGA and AGA in the 20–24 years age group, but not in the 25–39 years age group. Young preconception women should not neglect paying attention to their thyroid function, associated with the risk of LGA.
Inflammatory bowel disease (IBD) patients in China exhibit critically low levels of physical activity, yet evidence for telemedicine-based aerobic exercise interventions remains scarce, particularly with objective physiological validation.
In this single-centre, open-labelled, semi-crossover randomised controlled trial, 28 inactive/mildly active adult IBD patients with low level of baseline physical activity will be randomly assigned to immediate or delayed 12-week telemedicine-based aerobic exercise training. The exercise prescription, stratified by baseline activity level, is designed to progressively elevate physical activity levels to moderate intensity. The telemedicine-based programme used fitness bands synchronised to a mobile app, WeChat-based real-time feedback and online group support and communication. The primary outcome is change in peak oxygen uptake measured by cardiopulmonary exercise testing (CPET). Secondary outcomes include other cardiorespiratory fitness parameters measured by CPET, physical activity level measured by International Physical Activity Questionnaire Short Form, Exercise Benefits/Barriers Scale, clinical disease activity, inflammatory markers, Inflammatory Bowel Disease Questionnaire, nutritional indices, Fatigue Severity Scale and Hospital Anxiety and Depression Score.
The trial has been approved by the Ethics Committee of the Affiliated Lihuili Hospital of Ningbo University (KY2024SL379-01). Results will be published in peer-reviewed journals and presented at scientific conferences.
by Yun Feng, Wei Chen, Yang Lu, Haifei Zhou
PurposeThe aim of this study is to evaluate the changes of white matter microstructure in breast cancer patients before and after chemotherapy based on automated fiber quantification (AFQ),as well as determine if these dispersion indexes are significantly correlated with clinical data.
Materials and MethodsTwenty-four breast cancer patients scheduled for chemotherapy were enrolled. Diffusion tensor imaging (DTI), neuropsychological tests and self-report measures, and hematological tests were conducted before chemotherapy(time 0,T0) and within one week after chemotherapy(time 1,T1). AFQ was used to track 20 fiber tracts in the brain. The correlation between average abnormal tracts and changes in neuropsychological tests and self-report measures and blood indicators was analyzed.
ResultsCompared to T0, subjects at T1 showed decreased scores on the verbal fluency test; increased scores on the self-rating anxiety scale(SAS)and self-rating depression scale (SDS). Estrogen concentration was lower while luteinizing hormone(LH), follicle-stimulating hormone, and triglyceride levels were higher. Mean fractional anisotropy (FA) value decreased in the right cingulum cingulate(CGC)while mean radial diffusivity (RD) increased in the right CGC; mean axial diffusivity (AD) value decreased in callosum forceps major and callosum forceps minor. Changes in FA with in the right CGC were positively correlated with changes in SDS and LH, while changes in RD with in the right CGC were negatively correlated with changes in SDS and LH.
ConclusionEarly changes observed in brain white matter fiber tracts, along with persistent hormone and triglyceride metabolism disorders, could potentially serve as neurobiological markers for monitoring chemotherapy-induced cognitive impairment.
To characterise the reporting practices of sequential multiple assignment randomised trials (SMARTs) in human health research.
Scoping review of protocol and primary analysis papers describing SMARTs published between January 2009 and February 2024.
SMARTs are innovative trial designs that allow for multiple stages of randomisation to treatment, with randomization potentially based on a patient’s response(s) to previous treatment(s). They are uniquely designed to develop sequential adaptive interventions (dynamic treatment regimes (DTRs)) to support personalized clinical decision-making over time. Previous reviews have identified inconsistencies in how the design, implementation and results of SMARTs have been reported in published studies. A comprehensive assessment of SMART reporting practices is lacking and necessary for developing standardised SMART-specific reporting guidelines.
We systematically searched multiple databases for SMART-related protocol and primary analysis papers published between January 2009 and February 2024. Title, abstract and full-text screenings were performed by pairs of reviewers, with disagreements resolved by consensus. Data extraction included study characteristics, design elements and analytical approaches for embedded or tailored DTRs. Results were synthesised qualitatively and presented descriptively.
From 5486 screened studies, 103 (59 protocol papers, 16 primary analysis papers, 14 protocol papers with corresponding primary analysis papers) met the inclusion criteria. Most studies targeted adults (62.7% protocols, 62.5% primary analyses, 42.9% protocol+primary analyses) and were primarily conducted in the USA. Behavioural and mental health constituted the most frequent therapeutic domain. While intervention descriptions and re-randomisation criteria were consistently reported, operational characteristics such as blinding (protocols: 64.4%, primary analyses: 62.5%, protocols+primary analyses: 71.4%) and randomisation details (protocols: 55.9%, primary analyses: 37.5%, protocols+primary analyses: 50.0%) were inconsistently documented. Only 46.7% of primary analyses evaluated embedded DTRs, and none explored deeply tailored DTRs.
Despite the increased adoption of SMART designs, substantial reporting variability persists. Most primary analyses underuse the capability of SMARTs to generate data for developing DTRs. SMART-specific standardised reporting guidelines can help accelerate the scientific and clinical impact of SMARTs.
Previous meta-analysis only focused on the safety and effectiveness of vagus nerve stimulation (VNS) in upper extremities motor function in stroke patients. The aim of this study was to systematically evaluate the efficacy and safety of VNS for more comprehensive functional rehabilitation in stroke patients.
This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The study protocol was registered in PROSPERO (CRD42024552624) and included randomised controlled trials (RCTs) investigating VNS-assisted rehabilitation in patients with stroke.
Searches were conducted in PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), and Wanfang Database, covering the period up to October 2025.
We included studies in which the intervention group received VNS, while the control group received either sham stimulation or conventional rehabilitation alone. Studies were required to report efficacy outcomes (such as upper extremity motor function and swallowing function) as well as safety outcomes.
Two researchers independently performed literature screening, data extraction and quality assessment. A meta-analysis was conducted using RevMan V.5.4 (The Cochrane Collaboration, London, United Kingdom) and STATA V.18.0(StataCorp LLC, College Station, TX, USA), using the standardised mean difference (SMD) for continuous outcomes and applying a random-effects model. To explore potential sources of heterogeneity, sensitivity and subgroup analyses were performed, while publication bias was assessed using funnel plots and Egger's test.
Overall, 18 RCTs involving 954 participants were included in this study. This meta-analysis indicated that VNS could improve Fugl-Meyer Assessment of Upper Extremity (SMD=0.89, 95% CI 0.59 to 1.20, I2=64%, pI2=81%, p=0.005), Motor Activity Log (SMD=0.44, 95% CI 0.18 to 0.70, I2=0%, p=0.0008), swallowing function (SMD=0.62, 95% CI 0.12 to 1.11, I2=0%, p=0.01), extensor carpi radialis muscle strength (SMD=1.07, 95% CI 0.67 to 1.47, I2=0%, pI2=48%, p≤0.0006), Modified Barthel Index (SMD=0.95, 95% CI 0.48 to 1.42, I2=75%, pI2=0%, p=0.00009) in stroke patients compared with the control group. Quality assessment using the Cochrane Risk of Bias tool indicated that most studies had a low risk of bias. Publication bias was low, as indicated by symmetric funnel plots and Egger's test results (p>0.05 for all key outcomes). According to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, five outcomes (eg, swallowing function) were rated as high quality, while two (WMFT and spasticity) were rated as low quality. Sensitivity analysis confirmed that no single study significantly influenced the pooled results. Subgroup analysis identified stimulation modality, treatment duration, region and age as the main sources of heterogeneity in this study.
The evidence supporting the use of VNS to improve function in stroke patients demonstrates reasonable reliability, a satisfactory degree of consistency and applicability, and suggests a potentially favourable clinical impact.
Depression is a significant global health burden, affecting over 300 million people worldwide and contributing substantially to disability and healthcare costs. Despite the widespread use of antidepressants, many patients experience limited efficacy or adverse effects. Non-invasive brain stimulation (NIBS) and acupuncture have emerged as promising non-pharmacological interventions for depression. However, the heterogeneity of treatment protocols and the lack of direct comparisons limit the development of optimal treatment strategies. This study seeks to perform a network meta-analysis (NMA) to compare and rank the comparative efficacy and acceptability of NIBS and acupuncture interventions for depression. This review is expected to inform evidence-based decision-making by comparatively evaluating efficacy and acceptability; any clinical implications will depend on the certainty and consistency of the evidence.
A comprehensive literature search will be conducted across 14 academic databases and registries (PubMed, Cochrane Library, Web of Science, Embase, OVID, Scopus, ProQuest, CNKI, Wanfang, CBM, VIP, ICTRP, ChiCTR and ClinicalTrials.gov) from inception to May 2025. Eligible studies will include randomised controlled trials assessing NIBS and/or acupuncture for depression. Two reviewers will independently conduct study selection, data extraction and risk of bias assessment using the Cochrane Risk of Bias 2 tool. Primary outcomes will include depressive symptom severity and acceptability (measured by all-cause discontinuation). Secondary outcomes will include response rate and adverse events. At the time of protocol submission, the literature search had been substantially completed, while study selection and data extraction had not yet commenced. Pairwise meta-analyses will be executed applying Review Manager V.5.4 and Stata V.17.0. A Bayesian NMA will be conducted via the GeMTC package in R V.4.2.2, and Stata will also be used for additional statistical analyses and visualisation. Subgroup and sensitivity analyses will explore sources of heterogeneity, and the certainty of evidence will be appraised using the Confidence in Network Meta-Analysis framework.
Ethical approval is not warranted since the study does not involve any confidential or private patient records. The results will be disseminated through publication in peer-reviewed journals.
CRD420250651706.
Urinary incontinence, often perceived as embarrassing, perpetuates the stigma that delays treatment and encourages concealment. This stigma significantly diminishes quality of life and imposes both financial and medical burdens. Although prior research has examined stigma reduction in urinary incontinence, it persists as a widespread issue. Most studies have focused on interviews, primarily addressing urine leakage, with a limited understanding of the factors influencing urinary incontinence stigma and their interrelations. More in-depth quantitative studies are crucial to inform targeted interventions.
(1) To develop targeted interventions aimed at alleviating urinary incontinence-related stigma in older adults. (2) To identify factors that mitigate stigma in older adults with urinary incontinence. (3) To examine the associations between these factors and stigma.
Cross-sectional survey.
A cross-sectional survey was conducted with 510 older adults across three hospitals in Guangdong from July 2022 to January 2024, utilising the SSCI-24 and Incontinence Severity Index. Three multivariate linear regression models, adjusted for covariates based on directed acyclic graphs, were employed to explore the relationships between variables and stigma. Additionally, subgroup analyses were performed.
Participants reported higher levels of self-stigma compared to perceived stigma. Multivariate analysis revealed significant associations between urinary incontinence type, severity, frequency of micturitions and stigma. Key factors contributing to stigma reduction include managing incontinence severity, reducing frequency of micturitions and preventing the progression to mixed incontinence.
The study identified associations between urinary incontinence characteristics—type, severity and frequency of micturitions—and stigma. Strategies for stigma reduction are proposed, underscoring the vital role of nurses in this process.
The findings of this study contribute to a deeper understanding of stigma surrounding urinary incontinence in older adults and provide insights for developing more effective interventions by healthcare professionals and community caregivers.
This study adhered to the STROBE checklist for observational studies.
No patient or public contribution.
To develop a comprehensive decision-making checklist for paediatric advance care planning tailored to the needs of terminally ill children and their families.
A Delphi Study.
Underpinned by Delphi methodology, a four-phase procedure was adopted: (1) drafting items by the working group, (2) refining items based on an experts' survey, (3) further refining based on the same experts, and (4) final adaptations and approval. This study was initiated by the Paediatric Palliative Care Subspecialty Group of the Paediatrics Society of the Chinese Medical Association. The process involved 60 healthcare providers (physicians, nurses, and social workers) from 14 paediatric palliative care teams.
The developed checklist included 5 topics, 24 subtopics, and 45 items. Five topics were (1) medical and nursing decision-making, (2) social support planning, (3) psychological support planning, (4) spiritual support planning, and (5) posthumous affairs planning. This checklist addresses symptom management for terminally ill children, integrating support for their psychological, social, and spiritual well-being, and addresses the care needs of their family members.
The study provided a paediatric advance care planning checklist derived from the expert consensus that includes key elements and items.
This checklist provides healthcare providers with a structured framework to set paediatric advance care planning and ensure that all aspects of children's well-being and their families' needs are considered. This study also lays an evidence-based foundation for the design of related documents.
This study developed a comprehensive paediatric advance care planning checklist with 5 topics, 24 subtopics, and 45 items. This study provides a comprehensive decision-making checklist for healthcare providers and families, ensuring that critical decisions are addressed timely.
This article is presented in accordance with the CREDES guidelines.
Limited patient and public involvement was incorporated, focusing on reviewing the initial checklist draft.
To conduct a comprehensive assessment of nursing interventions for patients with hypertension, diabetes, and dyslipidemia and analyse the components, delivery methods and outcomes of intervention programmes.
Scoping review.
Systematic searches were performed in four Chinese databases (WanFang, CNKI, Chinese Biomedical Literature Database, and the VIP database) and six English databases (CINAHL, MEDLINE, Web of Science, PubMed, Embase, The Cochrane Library) from their inception until October 2023. An updated search was performed on 6 August 2024.
Two reviewers independently retrieved full-text studies and conducted the initial screening of titles and abstracts, followed by full-text analysis and data extraction.
A total of 49 articles were included in this review. The nursing interventions consisted of various components, including fitness exercise, a balanced diet, mental health support, medication administration and others. The most commonly used delivery method was health education, with an increasing trend towards online interventions. However, the included studies did not provide details on delivery methods, including the team qualifications, subject areas or intervention duration and frequency. The nursing interventions achieved their research aims to varying degrees, as measured by subjective and/or objective indicators.
The nursing interventions for the three highs are diverse, including offline, online and combined methods, covering exercise, diet, and mental health. Future efforts can draw on these intervention components and methods and establish a nurse-led multidisciplinary team. The measurement of objective indicators, including blood lipids, should be taken seriously. Developing more diverse subjective measurement indicators can comprehensively assess patients' health.
This review offers clear guidance for the subsequent prevention and management of the three highs and consolidates evidence for healthcare professionals to devise targeted intervention strategies.
We followed Arksey's five-step framework and the PRISMA extension for scoping reviews (PRISMA-ScR).
No.
This study aims to assess the prevalence of cancer risk factors in China’s working population and provide evidence for formulating more targeted workplace cancer prevention strategies.
A cross-sectional study utilising the baseline data from the Comprehensive Workplace Intervention for Cancer Prevention in China (WECAN) project, a stepped-wedge cluster randomised controlled trial.
15 workplaces from three cities in China: Wuhai (Northern China), Nanchong (Western China) and Xiangtan (Southern China).
A total of 841 participants (56 employees per workplace) were recruited through stratified sampling based on sex and work type.
The prevalence of self-reported cancer risk factors, including smoking, alcohol consumption, physical inactivity, obesity, unhealthy diet, betel quid chewing, exposure to harmful gases or substances, biological screening and vaccination.
The study included 841 participants (mean age 40.5±8.9 years; 61.4% male, 57.4% blue-collar workers, 47.3% aged
The working population faces significant cancer risk factors, with variations across populations and regions highlighting the need for targeted interventions.
ChiCTR2200058680.
To investigate, in a prospective cohort study, the association between cognitive impairment and cardiovascular disease (CVD), to quantify the extent to which uncontrolled risk factors mediate this association, and to explore whether the mediation effect varies across sex and age groups.
Prospective cohort study.
UK Biobank, a large population-based cohort study in the UK.
A total of 152 155 participants without prevalent CVD or dementia at baseline were included. The mean age was 56.3±8.2 years, and 44.0% were male.
Cardiovascular death and composite cardiovascular outcomes, assessed using Cox proportional-hazards models and mediation analyses.
During a median follow-up of 13.03–13.87 years, 1474 cardiovascular deaths and 21 518 composite cardiovascular outcomes were recorded. Participants with cognitive impairment (n=23 146; 15.2%) exhibited higher proportions of lifestyle, metabolic and psychological risks (p
Cognitive impairment is associated with increased risks of cardiovascular death and composite cardiovascular outcomes. Uncontrolled lifestyle, cardiometabolic and psychological risk factors partially mediate this association, highlighting the importance of comprehensive management to improve cardiovascular prognosis in this population.
To summarise the incidence rate and identify the risk factors for oral endotracheal tube-related mucous membrane pressure injury (OETMMPI) in critically ill patients.
This systematic review and meta-analysis followed the PRISMA 2020 requirements. We searched the databases PubMed, Embase, Web of Science, the Cochrane Library, WanFang, China Science and Technology Journal Database (VIP), China National Knowledge Infrastructure (CNKI) and China Biomedical Literature Database (SinoMed) from conception to July 3, 2025. Two independent researchers read the publications, assessed them and extracted data. Stata 18.0 software was used to conduct the analyses.
This meta-analysis comprised 16 observational studies. Two studies recorded the number of days of tracheal intubation rather than the number of patients who required it, which totaled 274 days. The remaining 14 trials included a total of 6768 adult patients. The incidence rate of OETMMPI was 28.9% (95% CI = 0.177–0.417). Risk factors include tracheal catheter indwelling time (OR = 1.13), APACHE II score (OR = 1.39), use of hard bite blocks (OR = 1.88), prone ventilation (OR = 3.95), diabetes history (OR = 4.86), vasoconstrictor medication use (OR = 2.11) and albumin level (OR = 0.50).
The incidence rate of OETMMPI is relatively high in critically ill patients, and there are many influencing factors. Nursing staff should enhance their awareness of OETMMPI, accurately identify high-risk groups and risk factors, and formulate early, full-course, meticulous and personalised intervention measures for critically ill patients to prevent OETMMPI.
OETMMPI in critically ill patients brings pain to the patients, increases the risk of infection and affects the prognosis of the disease. Therefore, medical staff should regularly assess and address it. This study also identified specific related factors, and these results provided valuable insights for the ICU medical team to identify high-risk patients and offer personalised intervention measures to reduce their occurrence.
FreshRSS 