期刊：
Journal of the American Medical Directors Association,2023年24(1):29-37.e9 ISSN：1525-8610
通讯作者：
Xie, Xiaohua;Wu, Xinjuan
作者机构：
[Wu, Xinjuan; Zhang, Xiao-Ming] Peking Union Med Coll Hosp, Chinese Acad Med Sci Peking Union Med Coll, Dept Nursing, Dongdan Campus, Beijing, Peoples R China.;[Cao, Simin] Guangzhou Med Univ, Sch Nursing, Guangzhou, Peoples R China.;[Xie, Xiaohua; Xiao, Shiyan; Gao, Maofeng; Cao, Simin] Shenzhen Univ, Affiliated Hosp 1, Shenzhen Peoples Hosp 2, Dept Nursing, Shenzhen, Peoples R China.;[Gao, Maofeng] Anhui Med Univ, Sch Nursing, Hefei, Peoples R China.;[Xiao, Shiyan] Univ South China, Sch Nursing, Hengyang, Peoples R China.
通讯机构：
[Xie, Xiaohua; Wu, Xinjuan] D;Department of Nursing, The First Affiliated Hospital of Shenzhen University / Shenzhen Second People's Hospital, Shenzhen, China. Electronic address:;Department of Nursing, Chinese Academy of Medical Sciences Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, China. Electronic address:
关键词：
Social frailty;older adults;prevalence;meta-analysis;systematic review
摘要：
Objective: To report the overall prevalence of social frailty among older people and provide information for policymakers and authorities to use in developing policies and social care.Design: A systematic review and meta-analysis.Setting and participants: We searched 4 databases (PubMed, Embase, Web of Science, and Google Scholar) to find articles from inception to July 30, 2022. We included cross-sectional and cohort studies that provided the prevalence of social frailty among adults aged 60 years or older, in any setting.Methods: Three researchers independently reviewed the literature and retrieved the data. A risk of bias tool was used to assess each study's quality. A random-effect meta-analysis was performed to pool the data, followed by subgroup analysis, sensitivity analysis, and meta-regression. Results: From 761 records, we extracted 43 studies with 83,907 participants for meta-analysis. The pooled prevalence of social frailty in hospital settings was 47.3% (95% CI: 32.2%-62.4%); among studies in community settings, the pooled prevalence was 18.8% (95% CI: 14.9%-22.7%; P < .001). The prevalence of social frailty was higher when assessed using the Tilburg Frailty Indicator (32.3%; 95% CI: 23.1%-41.5%) than the Makizako Social Frailty Index (27.7%; 95% CI: 21.6%-33.8%) or Social Frailty Screening Index (13.4%; 95% CI: 8.4%-18.4%). Based on limited community studies in individual countries using various instruments, social frailty was lowest in China (4.9%; 95% CI: 4.2%-5.7%), followed by Spain (11.6%; 95% CI: 9.9%-13.3%), Japan (16.2%; 95% CI: 12.2%-20.3%), Korea (26.6%; 95% CI: 7.1%-46.1%), European urban centers (29.2%; 95% CI: 27.9%-30.5%), and the Netherlands (27.2%; 95% CI: 16.9%-37.5%). No other subgroup analyses showed any statistically significant prevalence difference between groups.Conclusion and Implications: The prevalence of social frailty among older adults is high. Settings, country, and method for assessing social frailty affected the prevalence. More valid comparisons will await consensus on measurement tools and more research on geographically representative populations. Nevertheless, these results suggest that public health professionals and policymakers should seriously consider social frailty in research and program planning involving older adults.O 2022 The Authors. Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
摘要：
BACKGROUND: Neurogenic bowel dysfunction (NBD) is a prevalent complication among stroke patients, significantly affecting their quality of life, duration of hospitalization, medical expenses, and even mortality. Although current guidelines suggest a conservative strategy for addressing bowel dysfunction, which includes techniques such as digital rectal stimulation (DRS) and abdominal massage, the availability of interventions remains limited in healthcare facilities. METHODS: This study follows a prospective randomized controlled parallel-group clinical trial design. The control group will receive standard care, while the intervention group will undergo a program that combines DRS and abdominal massage in addition to standard care. The duration of the intervention for both groups will be 6weeks. The primary outcome measures will be the Wexner score. Furthermore, secondary outcomes measure will be assessed, including Bristol score, Patient Assessment of Constipation-Quality of Life (PAC-QoL), and Fecal Incontinence Quality of Life (FI-QoL). DISCUSSION: This study aims to evaluate the effectiveness and safety of a bowel rehabilitation program for stroke patients with NBD. The findings will provide information that can contribute to the formulation of bowel management strategies. TRIAL REGISTRATION: The study has been registered in the Chinese Clinical Registry under the number ChiCTR2300071709. This registration was completed on May 23, 2023. All items from the World Health Organization Trial Registration Data set are described in this manuscript.
作者机构：
[Pan, Rong-jia; Zeng, Gu-qing; Zeng, GQ; Wu, Jing-jing; Wang, Man-yi; Nian, Fang] Univ South China, Sch Nursing, Hengyang Med Sch, 28 West Changsheng Rd, Hengyang 421001, Hunan, Peoples R China.;[Peng, Dan; Ni, Xiao-Yan; Gui, Si-jie; Peng, D] Cent South Univ, Dept Orthoped, Xiangya Hosp 2, Changsha 410011, Hunan, Peoples R China.;[He, Yu-Lian; Zhou, Yan-hui] Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Dept Orthoped & Trauma, Hengyang 421001, Hunan, Peoples R China.;[Liang, Jing-hong] Sun Yat Sen Univ, Sch Publ Hlth, Dept Maternal & Child Hlth, 74 Zhongshan 2nd Rd, Guangzhou 510080, Peoples R China.
通讯机构：
[Peng, D ] C;[Zeng, GQ ] U;[Liang, JH ] S;Univ South China, Sch Nursing, Hengyang Med Sch, 28 West Changsheng Rd, Hengyang 421001, Hunan, Peoples R China.;Cent South Univ, Dept Orthoped, Xiangya Hosp 2, Changsha 410011, Hunan, Peoples R China.
摘要：
The implementation of exercise intervention (EI) presents a promising and economical way for patients with hip fracture. However, the optimal type of EIremains unclear. The objective of this study is to evaluate the efficacy of various EI approaches and identify the optimal intervention for improving the prognosis of patients with hip fracture. A comprehensive search of Medline (via PubMed), Web of Science, Embase, Cochrane Central Register of Controlled Trials, CINAHL, CNKI, Wan Fang, VIP, and CBM was conducted from their earliest records to June 2022. The included randomized controlled trials (RCTs) included at least one type of exercise for patients with hip fracture. The methodological quality of these trials was assessed using the Cochrane Collaboration Risk of Bias Tool. All direct and indirect comparisons were analyzed by Stata 14.0 and OpenBUGS3.2.3 software. The primary outcome was hip function, and the secondary outcomes were activity of daily living (ADL), walking capacity and balance ability of patients. Based on the ranking probabilities, resistance exercise (RE) was ranked as the most effective among all exercise interventions (surface under cumulative ranking curve values [SUCRA]: 94.8%, [MD]: -11.07, [Crl]: -15.07 to -7.08) in improving the efficacy of patients' hip function, followed by balance exercise (BE) ([SUCRA]:81.1%, [MD]: -8.79, [Crl]: -13.41 to -4.18) and muscle strength exercise ([SUCRA]:57.6%, [MD]: -5.35, [Crl]: -9.70 to -0.95). For the improvement of ADL for patients with hip fracture, BE ([SUCRA]:98.4%, [MD]: -17.38, [Crl]: -23.77 to -11.04) may be the best EI. The findings of this study indicate that RE and BE might be the best approach to improve prognosis for patients with hip fracture. However, further rigorous and meticulously planned RCTs are required to substantiate the conclusions drawn from this study.
作者机构：
[Zhu, Na; Gao, Hong] Univ South China, Affiliated Hosp 2, Hengyang Med Sch, Nursing Dept, Hengyang 421001, Peoples R China.;[Zhu, Na; Gao, Hong] Univ South China, Sch Nursing, Hengyang 421001, Peoples R China.;[Tang, Peng; Deng, Shuxiang; Yang, Fei; Tang, Yan] Univ South China, Sch Basic Med, Sch Publ Hlth, Hengyang Med Sch,Dept Epidemiol & Hlth Stat,Key La, Hengyang 421001, Peoples R China.;[Du, Can; Xu, Shuaishuai; Liu, Wenya; Shen, Minxue] Cent South Univ, Xiangya Sch Publ Hlth, Dept Social Med & Hlth Management, Hunan Prov Key Lab Clin Epidemiol, Changsha 410000, Peoples R China.;[Xiao, Xinhua; Yang, Fei] Univ South China, Affiliated Hosp 1, Hengyang Med Sch, Dept Metab & Endocrinol, Hengyang 421001, Peoples R China.
通讯机构：
[Minxue Shen; Fei Yang] A;Authors to whom correspondence should be addressed.<&wdkj&>Hunan Provincial Key Laboratory of Clinical Epidemiology, Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha 410000, China<&wdkj&>Authors to whom correspondence should be addressed.<&wdkj&>Department of Metabolism and Endocrinology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang 421001, China<&wdkj&>Department of Epidemiology and Health Statistics, The Key Laboratory of Typical Environmental Pollution and Health Hazards of Hunan Province, School of Basic Medicine, School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, China
摘要：
Evidence has shown that exposure to environmental pollutants such as microcystins (MCs), arsenic (As), and cadmium (Cd) can lead to the occurrence and development of chronic kidney disease (CKD). There is a synergistic effect between MCs and Cd. However, the combined effect of MCs and As exposures on CKD remains unclear. In Hunan province, China, 135 controls and 135 CKD cases were enrolled in a case-control study. Serum MCs, plasma As and Cd concentrations were measured for all participants. We investigated the association between MCs/As and CKD risk using conditional logistic regression. The additive model explored the interaction effect, and the Bayesian kernel machine regression (BKMR) models investigated the combined effects of MCs, As, and Cd on CKD. The results showed that MCs and As were significantly associated with CKD risk. Participants in the highest MCs concentration had a 4,81-fold increased risk of CKD compared to those in the lowest quartile (95% confidence interval [CI]: 1,96 to 11,81). The highest quartile of As concentrations corresponded to an adjusted odds ratio of 3.40 (95% CI: 1.51, 7.65) relative to the lowest quartile. MCs/As and CKD risk exhibited significant dose-response correlations (all p for trend < 0.01). In addition, a positive interaction effect of MCs and As on CKD was also reported. The CKD risk due to interaction was 2.34 times (95% CI: 0.14, 4.54) relative to the CKD risk without interaction, and the attributable proportion of CKD due to interaction among individuals with both exposures was 56% (95% CI: 0.22, 0.91). In the BKMR, the combined effect of MCs, As, and Cd was positively associated with CKD. In conclusion, both MCs and As are independent risk factors for CKD, exerting a synergistic effect between them. Combined exposure to MCs, As, and Cd can increase the risk of CKD.
摘要：
AIMS: This study aims to explore the experiences of rehabilitation specialist nurses in providing bowel care to stroke patients and to identify the factors that either facilitate or hinder their practice. DESIGN: This was a descriptive qualitative design study. METHODS: Between May 2022 and October 2022, we conducted in-depth and semi-structured interviews with 12 rehabilitation specialist nurses from two tertiary hospitals in Changsha, China. Thematic analysis was employed to analyse the interview transcripts. FINDINGS: Three key themes were revealed from our analysis: (1) acceptance of bowel care as a process, (2) high level of recognition improves the experience and (3) challenges stemming from limited knowledge and rights. Acceptance of bowel care as a dynamic process, coupled with a high level of recognition, enabled nurses to prioritize the health and safety of patients over personal feelings and achieve professional accomplishments. However, they encountered challenges in terms of professional development and restricted prescribing rights for bowel care. CONCLUSION: The experiences of rehabilitation specialist nurses in providing bowel care are dynamic. These findings have important implications for healthcare improvement, including the need for collaboration with healthcare professionals and nurturing nurses' self-identity, comprehensive training plans, innovative programs and expanding the scope of rehabilitation specialist nurses' rights. IMPACT: This study enhances our understanding of the challenges faced by rehabilitation specialist nurses caring for stroke patients with neurogenic bowel dysfunction. The findings provide insights into how to enhance bowel care experience and develop further in this field. REPORTING METHOD: This study adhered to the EQUATOR guideline and utilized the COREQ checklist. PATIENT OR PUBLIC CONTRIBUTIONS: This study involved participants who were registered nurses, and there were no contributions from patients or public.
期刊：
Open Journal of Social Sciences,2023年11(5):50-62 ISSN：2327-5952
作者机构：
School of Economics, Management and Law, University of South China, Hengyang, China;School of Nursing, University of South China, Hengyang, China
关键词：
Hypercycle Theory;Symbiosis Theory;Self-Organization Theory;Department of Efficiency
摘要：
This paper gets rid of the thinking pattern of “linear
command” department management, and discusses
the new mode of innovating department work fundamentally from the
perspective of mutual benefit and symbiosis of multi-level management of
student department. By comprehensively applying the supercycle theory,
self-organization theory and symbiosis theory, taking the student work of the
School of Economics, Management and Law of the University of South China as an
example, this paper analyzes the unreasonable phenomena existing in the current
student work, analyzes the influencing variables
and formation mechanism of the department work efficiency, and analyzes
the interaction among counselors, ministers, vice ministers and secretaries. Therefore, the supercycle symbiosis system
of “counselor-minister-Deputy minister-secretary” and its operating mechanism are
constructed. The fundamental way to improve the efficiency of students’ work is
not within the department, but to form a super cycle of students and teachers
of multiple grades into a mutually beneficial symbiosis system and change the situation of independence of the four, so
as to promote the efficient operation of students’ work.
