Psychometric testing of the cross-culturally adapted Thai version of the Self-Care Self-Efficacy Scale version 3.0 in individuals with chronic illnesses

Objective:To assess the psychometric properties of the Thai version of the Self-Care Self-Efficacy Scale version 3.0(SCSES-v3.0)in individuals with chronic illnesses.Although originally developed and tested in a Western context,its applicability in Asian populations,including Thailand,remains inadequately explored.Methods:Psychometric tests were guided by COSMIN principles.This included the translation of the English version into Thai based on the ISPOR framework.Nine nursing experts evaluated the content validity.Data were obtained from a multicenter cross-sectional study conducted between July and November 2022.This study included individuals with chronic conditions from 16 primary care centers in Thailand.We tested the structural validity using exploratory factor analysis(EFA)and confirmatory factor analysis(CFA),and concurrent validity in relation to the Self-Care of Chronic Illness Inventory version 4.c(SC-CII-v4.c).We tested the scale’s reliability with McDonald’s u,Cronbach’s a,and the intraclass correlation coefficient(ICC).Results:The Thai SCSES-v3.0 demonstrated excellent content validity(k¼1.00).Thefinal analysis included a total of 385 participants.The EFA with thefirst split-half subsample(n¼193)extracted a twofactor structure.One reflected SCSES for maintenance and monitoring behaviors and another captured SCSES for management behaviors(item 6e10).CFA with the second split-half subsample(n¼192)and the overall sample(n¼385)supported the scale’s two-factor model with high factor loadings.Each dimension and the overall SCSES-v3.0 positively correlated with each scale and the overall SC-CII-v4.c.McDonald’s u and Cronbach’s a(both ranged 0.91e0.94)and ICC(ranged 0.95e0.96),indicated excellent internal reliability and test-retest reliability,respectively.Conclusions:The identification of a valid and reliable two-factor model for the Thai SCSES-v3.0 renders it a valuable tool for clinicians and investigators,facilitating the assessment of self-efficacy in self-care across diverse contexts.

Evaluating the feasibility and preliminary effects of an online compassion training program for nursing students:A pilot randomized controlled trial

Objectives:This study aimed to assess the feasibility of an online compassion training program for nursing students and preliminarily investigate its effects on mindfulness,self-compassion,and stress reduction.Methods:This study employed a randomized controlled trial design.Second-year students from a nursing college in Guangzhou,China,were recruited as research participants in August 2023.The intervention group participated in an 8-week online compassion training program via the WeChat platform,comprising three stages:mindfulness(weeks 1e2),self-compassion(weeks 3e5),and compassion for others(weeks 6 e8).Each stage included four activities:psychoeducation,mindfulness practice,weekly diary,and emotional support.Program feasibility was assessed through recruitment and retention rates,program engagement,and participant acceptability.Program effectiveness was measured with the Mindful Attention Awareness Scale,Self-Compassion Scale-Short Form,and Perceived Stress Scale.Results:A total of 28 students completed the study(13 in the intervention group,15 in the control group).The recruitment rate was 36.46%,with a high retention rate of 93.3%.Participants demonstrated high engagement:69.2%accessed learning materials every 1e2 days,93.3%practiced mindfulness at least weekly,with an average of 4.69 diary entries submitted per person and 23.30 WeChat interactions with instructors.Regarding acceptability,all participants expressed satisfaction with the program,with 92.4%finding it“very helpful”or“extremely helpful.”In terms of intervention effects,the intervention group showed a significant increase in mindfulness levels from pre-intervention(51.54±10.93)to postintervention(62.46±13.58)(P<0.05),while no significant change was observed in the control group.Although there were no statistically significant differences between the two groups in post-intervention self-compassion and perceived stress levels,the intervention group showed positive trends:selfcompassion levels increased(35.85±8.60 vs.40.85±5.54),and perceived stress levels slightly decreased(44.77±8.65 vs.42.00±5.77).Conclusions:This pilot study demonstrated the feasibility of an online compassion training program for nursing students and suggested its potential effectiveness in enhancing mindfulness,self-compassion,and stress reduction.Despite limitations such as small sample size and lack of long-term follow-up,preliminary evidence indicates promising prospects for integrating such training into nursing education.Further research is warranted to confirm thesefindings and assess the sustained impact of this approach on nursing education and practice.

Optimization and coordination model of information system security investment for interdependent risk

The impact of risk correlation on firm＇s investments in information system security is studied by using quantification models combining the ideas of the risk management theory and the game theory. The equilibrium levels of self-protection and insurance coverage under the non- cooperative condition are compared with socially optimal solutions, and the associated coordination mechanisms are proposed. The results show that self-protection investment increases in response to an increase in potential loss when the interdependent risk is small; the interdependent risk of security investments often induce firms to underinvest in security relative to the socially efficient level by ignoring marginal external costs or benefits conferred on others. A subsidy on self-protection investment from the government can help coordinate a firm＇s risk management decision and, thereby, improve individual security level and overall social welfare.

Optimization and Application of SRAM in 90nm CMOS Technology

This paper presents an optimized SRAM that is repairable and dissipates less power. To improve the yield of SRAMs per wafer,redundancy logic and an E-FUSE box are added to the SRAM and an SR SRAM is set up. In order to reduce power dissipation,power on/off states and isolation logic are introduced into the SR SRAM and an LPSR SRAM is constructed. The optimized LPSR SRAM64K × 32 is used in SoC and the testing method of the LPSR SRAM64K × 32 is also discussed. The SoC design is successfully implemented in the Chartered 90nm CMOS process. The SoC chip occupies 5. 6mm× 5. 6ram of die area and the power dissipation is 1997mW. The test results indicate that LPSR SRAM64K ×32 obtains 17. 301% power savings and the yield of the LPSR SRAM64K × 32s per wafer is improved by 13. 255%.

Molecular mimicry in Helicobacter pylori infections

Gram-negative bacteria Helicobacter pylori(H. pylori) colonize gastric mucosa in humans and increase the risk of serious diseases such as gastric and duodenal ulcers, stomach cancers and mucosa associated lymphoid tissue lymphoma. The role of H. pylori infection in the pathogenesis of several extragastric diseases has been suggested including immune thrombocytopenic purpura, iron deficiency anemia, vitamin D deficiency, cardiovascular diseases,diabetes mellitus and dermatological disorders. Also neurological diseases and even lung cancer have attracted researchers concern. The relation between H. pylori infection and a growth retardation in children has also been suggested. Many mechanisms of molecular mimicry between H. pylori and the host have been proposed as a pathogen strategy to manipulate the immune system of the host in order to remain unrecognized and avoid eradication. A lot of effort has been put into the demonstration of homologous sequences between H. pylori and host compounds. However, knowledge about how often autoantibodies or autoreactive T lymphocytes induced during H. pylori infections cause pathological disorders is insufficient. This review provides data on H. pylori antigenic mimicry and possible deleterious effects due to the induction of immune response to the components common to these bacteria and the host.

Comparative Analysis of Five Different Homologous Feeder Cell Lines in the Ability to Support Rhesus Embryonic Stem Cells

In our previous study, five homologous feeder cell lines, Monkey ear skin fibroblasts （MESFs）, clonally derived fibroblasts from the MESFs （CMESFs）, monkey oviductal fibroblasts （MOFs）, monkey follicular granulosa fibroblast-like （MFGs） cells, monkey follicular granulosa epithelium-like （MFGEs） cells, were developed for the maintenance of rhesus embryonic stem cells （rESCs）. We found that MESFs, CMESFs, MOFs and MFGs, but not MFGEs, support the growth of rhesus embryonic stem cells. Moreover, we detected some genes that are upregulated in supportive feeder cell lines by semi-quantitative PCR. In the present study, we applied the GeneChip Rhesus Macaque Genome Array of Affymetrix Corporation to study the expression profiles of these five feeder cell lines, in purpose to find out which cytokines and signaling pathways were important in maintaining the rESCs, mRNAs of eight genes, including GREM2, bFGF, KITLG, DKK3, GREM1, AREG, SERPINF1 and LTBP1, were found to be upregulated in supportive feeder cell lines, but not in MFGE. The results indicate that many signaling pathways may play redundant roles in supporting the undifferentiated growth and maintenance of pluripotency in rESCs.

Activation of canonical Wnt signaling pathway promotes proliferation and self-renewal of rat hepatic oval cell line WB-F344 in vitro

AIM： To investigate the effect of activation of canonical Wnt signaling pathway on the proliferation and differentiation of hepatic oval cells in vitro. METHODS： WB-F344 cells were treated with recombinant Wnt3a （20, 40, 80, 160, 200 ng/mL） in serum-free medium for 24 h. Cell proliferation was measured by Brdu incorporation analysis; untreated WB-F344 cells were taken as controls. After treatment with Wnt3a （160 ng/mL） for 24 h, subcellular localization and protein expression of p-catenin in WB-F344 cells treated and untreated with Wnt3a were examined by immunofluorescence staining and Western blot analysis. CyclinD1 mRNA expression was determined by semi-quantitative reverse-transcript polymerase chain reaction （RT-PCR）. The mRNA levels of some phenotypic markers （AFP, CK-19, ALB） and two hepatic nuclear factors （HNF-4, HIVF-6） were measured by RT-PCR. Expressions of CK-19 and AFP protein were detected by Western blot analysis. RESULTS： Wnt3a promoted proliferation of WB-F344 cells. Stimulation of WB-F344 cells with recombinant Wnt3a resulte^l in accumulation of the transcriptional activator β-catenin, together with its translocation into the nuclei, and up-regulated typical Wnt target gene CyclinD1. After 3 d of Wnt3a treatment in the absence of serum, WB-F344 cells retained their bipotential to express several specific phenotypic markers of hepatocytes and cholangiocytes, such as AFP and CK-19, following activation of the canonical Wnt signaling pathway. CONCLUSION： The canonical Wnt signaling pathway promotes proliferation and self-renewal of rat hepatic oval cells.

Hsp90 inhibition results in autophagy-mediated proteasome-independent degradation of IκB kinase(IKK)

Autophagic and proteasomal proteolysis are two major pathways for degradation of cellular constituents. Current models suggest that autophagy is responsible for the nonselective bulk degradation of long-lived proteins and organelles while the proteasome specifically degrades short-lived proteins including misfolded proteins caused by the absence of Hsp90 function. Here, we show that the IκB kinase （IKK）, an essential activator of NF-κB, is selectively degraded by autophagy when Hsp90 is inhibited by geldanamycin （GA）, a specific Hsp90 inhibitor showing highly effective anti-tumor activity. We find that in this case inactivation of ubiquitination or proteasome fails to block IKK degradation. However, inhibition of autophagy by an autophagy inhibitor or knockout of Atg5, a key component of the autophagy pathway, significantly rescues IKK from GA-induced degradation. These findings provide the first evidence that an Hsp90 client may be degraded by a mechanism different from the proteasome pathway and establish a molecular link among Hsp90, NF-κB and autophagy

The strength model of self-control revisited:Linking acute and chronic effects of exercise on executive functions

Since the 1960＇s, hundreds of articles have been published on the effects of exercise on cognition and more recently on executive functions. A large variety of effects have been observed： acute or long-lasting, facilitating or debilitating. Several theoretical frameworks have been proposed to explain these effects with plausible mechanisms. However, as yet none of these models has succeeded in unifying all the observations in a single framework that subsumes all effects. The aim of the present review is to revisit the strength model of self-control initiated by Baumeister and his colleagues in the 1990＇s in order to extend its assumptions to exercise psychology. This model provides a heuristic framework that can explain and predict the effects of acute and chronic exercise on effortful tasks tapping self-regulation or executive functions. A reconsideration of exercise as a self-control task results from this perspective. A new avenue for future research is delineated besides more traditional approaches.

CD133^+ gallbladder carcinoma cells exhibit self-renewal ability and tumorigenicity

AIM： To identify cancer stern cells （CSCs） in human gallbladder carcinomas （GBCs）. METHODS： Primary GBC cells were cultured under serum-free conditions to produce floating spheres. The stem-cell properties of the sphere-forming cells, including self-renewal, differentiation potential, chemoresistance and tumorigenicity, were determined in vitro or in vivo. Cell surface expression of CD133 was investigated in primary tumors and in spheroid cells using flow cytometry. The sphere-colony-formation ability and tumorigenicity of CD133＋ cells were assayed.floating spheroids were generated from primary GBC cells, and these sphere-forming cells could generate new progeny spheroids in serum-free media. Spheroid cells were differentiated under serum-containing conditions with downregulation of the stem cell markers Oct-4, Nanog, and nestin （P 〈 0.05）. The differentiated cells showed lower spheroid-colony-formation ability than the original spheroid cells （P 〈 0.05）. Spheroid ceils were more resistant to chemotherapeutic reagents than the congenetic adherent cells （P 〈 0.05）. Flow cytometry showed enriched CD133＋ population in sphereforming cells （P 〈 0.05）. CD133＋ cells possessed high colony-formation ability than the CD133 population （P 〈 0.01）. CD133＋ cells injected into nude mice revealed higher tumorigenicity than their antigen-negative counterparts （P 〈 0.05）. CONCLUSION： CD133 may be a cell surface marker for CSCs in GBC.

Prophylactic stenting for esophageal stricture prevention after endoscopic submucosal dissection

Endoscopic submucosal dissection (ESD) of superficial esophageal cancer has been increasingly used as an alternative to surgery because it is minimally invasiveand has a high rate of en bloc resection. However, a high rate of esophageal stricture is observed after ESD for large lesions, which can dramatically decrease the patient's quality of life. Stricture prevention is necessary to allow for endoscopic therapy to expand. We, herein, review the most recent evidence and discuss the role of the metallic self-expandable stent and the biodegradable stent in esophageal stricture prevention. Limited studies suggested that prophylactic stenting could reduce the stricture rate without increasing the number of complications. In addition, the number of bougie dilation procedures was significantly lower with stent placement. Esophageal stenting is a promising option for post-ESD stricture prevention. However, current evidence is too preliminary to formulate practice standards. Future studies are needed to further validate the efficacy and safety of prophylactic stenting and determine the best strategy for stricture prevention. Stent migration is the most common complication. A new stent that has advantages of a low migration rate and minimal tissue reaction will need to be developed. Therefore, randomized controlled trials with long-term follow-up periods are required before prophylactic stenting could be considered a valid option to prevent post-ESD stricture.

Independent and combined effects of environmental factors and miR-126, miR-143, and miR-145 on the risk of coronary heart disease

Objective To evaluate the effects of environmental factors and microRNAs （miRNAs） （miR-126, miR-143, and miR-145） on the risk of coronary heart disease （CHD）. Methods A frequency-matched case-control study （450 patients, 450 controls） was conducted from April 2014 to December 2016 in Fuzhou City, China. Environmental factors were investigated using a self-administered questionnaire, and the expression levels of miR-126, rniR-143, and miR-145 were determined by quantitative real-time Polymerase Chain Reaction （PCR） in pe- ripheral blood mononuclear cells. Unconditional logistic regression models were used for statistical evaluation. Results Alcohol consumption, high-salt diets, high-intensity work, and lack of physical activity were significantly associated with increased CHD risk, whereas light diet was significantly associated with decreased risk. MiR-126, miR-143, and miR-145 were highly expressed in the CHD group compared with the control group. After adjustment for other environmental factors, unconditional logistic regression results revealed that miR-126, miR-143, and depression were the independent risk factors of CHD, and light diet was the independent protective factor of CHD. Conclusions Our data suggest that a family history of CHD, anxiety, and alcohol consumption was significantly associated with increased CHD risk, whereas light diet was significantly associated with decreased risk. Furthermore, miR-126 and miR-143 in combination with several risk factors, could play a joint role in the development of CHD. Therefore, it is necessary to manage patients with CHD in all directions and multiple level.

Self-management of coronary heart disease in older patients after elective percutaneous transluminal coronary angioplasty

Objective To explore how older patients self-manage their coronary heart disease （CHD） aider undergoing elective percutaneous transluminal coronary angioplasty （PTCA）. Methods This mixed methods study used a sequential, explanatory design and recruited a convenience sample of patients （n = 93） approximately three months after elective PTCA. The study was conducted in two phases. Quantitative data collected in Phase 1 by means of a self-administered survey were subject to univariate and bivariate analysis. Phase 1 findings in- formed the purposive samplhag for Phase 2 where ten participants were selected from the original sample for an in-depth interview. Qualita- tive data were analysed using thematic analysis. This paper will primarily report the findings from a sub-group of older participants （n = 47） classified as 65 years of age or older. Results 78.7% （n = 37） of participants indicated that they would manage recurring angina symptoms by taking glyceryl trinitrate and 34% （n = 16） thought that resting would help. Regardless of the duration or severity of the symptoms 40.5% （n = 19） would call their general practitioner or an emergency ambulance for assistance during any recurrence of angina symptoms. Older participants weighed less （P = 0.02） and smoked less （P = 0.01） than their younger counterparts in the study. Age did not seem to affect PTCA patients＇ likelihood of altering dietary factors such as fruit, vegetable and saturated fat consumption （P = 0.237）. Conclusions The findings suggest that older people in the study were less likely to know how to correctly manage any recurring angina symptoms than their younger counterparts but they had fewer risk factors for CHD. Age was not a factor that influenced participants＇ likelihood to alter lifestyle factors.

Role of illness perception and self-efficacy in lifestyle modification among non-alcoholic fatty liver disease patients

To describe the relationships between non-alcoholic fatty-liver disease (NAFLD) patient’s disease consequences and treatment perceptions, self-efficacy, and healthy lifestyle maintenance.METHODSA cross-sectional study among 146 ultrasound diagnosed NAFLD patients who visited the fatty liver clinic at the Tel-Aviv Medical Center. Eighty-seven of these individuals, participated in a clinical trial of physical activity and underwent fasting blood tests, analyzed at the same lab. Exclusion criteria included positivity for serum HBsAg or anti-HCV antibodies; fatty liver suspected to be secondary to hepatotoxic drugs; excessive alcohol consumption (≥ 30 g/d in men or ≥ 20 g/d in women) and positive markers of genetic or immune-mediated liver diseases. Patients were asked to complete a self-report structured questionnaire, assembled by the Israeli Center for Disease Control. Nutrition habits were measured using six yes/no questions (0 = no, 1 = yes) adopted from the national survey questionnaire. Participants in the clinical trial completed a detailed semi-quantitative food frequency questionnaire (FFQ) reporting their habitual nutritional intake during the past year. Self-efficacy was assessed by the Self-Efficacy Scale questionnaire, emotional representation, degree of illness understanding, timeline perception, treatment perception and symptoms were measured by the Brief Illness Perception questionnaire. Illness consequences were measured by the Personal Models of Diabetes Interview questionnaire. A path analysis was performed to describe the interrelationships between the patients’ illness perceptions, and assess the extent to which the data fit a prediction of nutritional habits.RESULTSThe study sample included 54.1% men, with a mean age of 47.76 ± 11.68 years (range: 20-60) and mean body mass index of 31.56 ± 4.6. The average perceived nutrition habits score was 4.73 ± 1.45 on a scale between 0-6, where 6 represents the healthiest eating habits. Most of the study participants (57.2%) did not feel they fully understood what NAFLD is. Better nutritional habits were positively predicted by the degree of illness understanding (β = 0.26; P = 0.002) and self-efficacy (β = 0.25; P = 0.003). Perceptions of more severe illness consequences were related with higher emotional representation (β = 0.55; P < 0.001), which was related with lower self-efficacy (β = -0.17; P = 0.034). The perception of treatment effectiveness was positively related with self-efficacy (β = 0.32; P < 0.001). In accordance with the correlation between self-efficacy and the perceived nutrition habits score, self-efficacy was also correlated with nutrient intake evaluated by the FFQ; negatively with saturated fat (percent of saturated fat calories from total calories) (r = -0.28, P = 0.010) and positively with fiber (r = 0.22, P = 0.047) and vitamin C intake (r = 0.34, P = 0.002). In a sub analysis of the clinical trial participants, objectively measured compliance to physical activity regimen was positively correlated with the self-efficacy level (r = 0.34, P = 0.046).CONCLUSIONSelf-efficacy and illness understanding are major determinants of lifestyle-modification among NAFLD patients. This information can assist clinicians in improving compliance with lifestyle changes among these patients.

Type D personality negatively associated with self-care in Chinese heart failure patients

Background Little is known about the association between type D personality and self-care behaviors in heart failure （HF） patients. We examined the effect of type D personality on self-care behaviors and self-efficacy among Chinese HF patients. Methods A cross-sectional study with a convenience sample was conducted. All participants completed the questionnaires of the self-care of HF index （V6） and type D personality scale. Demographic and clinical variables were obtained from medical records and patient interviews. The me- thods used for data analysis included descriptive analysis, independent-sample t-test, Z2 test, and multiple linear regression. Results A total of 127 HF patients were included and 61.4% of them were male. The average age for this study sample was 64.9± 12.34 years. The majority of the participants were in a New York Heart Association class III or IV （87%）, and the average length of living with HF was 38.24 ± 41.1 months. A total of 33.1% of the participants were identified as having type D personality. No significant differences were determined in the demographic and clinical variables between type D and non-type D patients, except for the mean age and the length of living with HF. Type D patients were younger and had a shorter time of living with HF than their non-type D counterparts. Multiple regression demonstrated significant associations between type D personality and self-care maintenance and self-efficacy after adjusting the demographic and clinical factors. However, type D personality was not significantly associated with self-care management behaviors. Conclusions Type D personality was negatively related to self-care maintenance and self-efficacy in Chinese HF patients. Future study is warranted to develop a tailored intervention to improve engagement in self-care behaviors in HF patients with type D personality.

Development and validation of a self-management behavior questionnaire for Chinese enterostomy patients

Objectives:This study aimed to develop a self-management behavior questionnaire for Chinese enter-ostomy patients and examine its reliability and validity.Methods:Guided by the theory of self-management,an initial questionnaire was generated through literature review,group meetings,and two rounds of an expert consultation.Finally,the reliability and validity of the questionnaire were validated through a questionnaire survey of 200 enterostomy patients were selected from the Affiliated Hospital of Medical University from June 2016 to March 2017.Results:The content validity index was 0.80e1.00.The exploratory factor analysis yielded a five-factor(dietary behavior,psychosocial behavior,symptom management behavior,medical compliance behavior,information management behavior),consisting of 40 items.The cumulative variance contri-bution rate was 65.42%.The Cronbach’s a coefficient for the total questionnaire was 0.972,and for the five factors ranged from 0.797 to 0.939,indicating a good internal consistency.The test-retest reliability was 0.867(P<0.01).The self-management behavior questionnaire score was negatively related to the Ostomy Skin Tool score(r=-0.800,P<0.01).Conclusions:The self-management behavior questionnaire developed in this study showed good reli-ability and validity and can be used to assess the self-management behavior of Chinese enterostomy patients.

Chronic morphine drinking establishes morphine tolerance, but not addiction in Wistar rats

Objective： Some animal models apply morphine in the drinking water to generate addiction, but related reports are not free of conflicting results. Accordingly, this study aimed to figure out if chronic consumption of morphine in the drinking water can induce morphine addiction in Wistar rats. Methods： For 3 weeks, the animals received a daily morphine dose of 35 mg/kg by offering a calculated volume of sugar water （5% sucrose） with morphine （0. l mg/ml） to each rat; animals receiving just sugar water served as controls. Immediately after the treatment phase, the tail immersion test was used to check for morphine tolerance, and all animals were then kept on tap water for one week （withdrawal phase）. Afterwards, all rats were allowed to choose their drinking source by offering two bottles, containing sugar water without and with morphine, simultaneously for two days （preference phase）. Results： While the chronic consumption of morphine led to a reduction in body weight and to morphine tolerance, the morphine-treated Wistar rats did not show any preference for the opiate-containing sugar water. Conclusion： Body weight loss and tolerance do not reveal a condition of drug craving, and current animal models should be re-evaluated regarding their potential to establish morphine addicted animals.

Efficacy and safety of limited endoscopic sphincterotomy before self-expandable metal stent insertion for malignant biliary obstruction

To evaluate the safety and efficacy of limited endoscopic sphincterotomy (ES) before placement of self-expandable metal stent (SEMS).METHODSThis was a retrospective analysis of 244 consecutive patients with unresectable malignant biliary obstruction, who underwent placement of SEMSs following limited ES from December 2008 to February 2015. The diagnosis of malignant biliary obstruction and assessment of patient eligibility for the study was established by a combination of clinical findings, laboratory investigations, imaging and pathological results. All patients were monitored in the hospital for at least 24 h following endoscopic retrograde cholangio pancreatography (ERCP). The incidence of immediate or early post-ERCP complications such as post-ERCP pancreatitis (PEP) and bleeding related to limited ES were considered as primary outcomes. Also, characteristics and complications according to the cancer type were classified.RESULTSAmong the 244 patients included, the underlying diagnosis was cholangiocarcinoma in 118 patients, pancreatic cancer in 79, and non-pancreatic or non-biliary malignancies in the remaining 47 patients. Early post-ERCP complications occurred in 9 patients (3.7%), with PEP in 7 patients (2.9%; mild, 6; moderate, 1) and mild bleeding in 2 patients (0.8%). There was no significant association between the incidence of post-ERCP complications and the type of malignancy (cholangiocarcinoma vs pancreatic cancer vs others, P = 0.696) or the type of SEMS used (uncovered vs covered, P = 1.000). Patients who had more than one SEMS placed at the first instance were at a significantly higher risk of post-ERCP complications (one SEMS vs two SEMS, P = 0.031). No other factors were predictive of post-ERCP complications.CONCLUSIONLimited ES is feasible and safe, and effectively facilitates the placement of SEMS, without any significant risk of PEP or severe bleeding.

Frequency and barriers of reporting workplace violence in nurses:An online survey in China

Objectives:This study aimed to explore the reporting of workplace violence against nurses and the reasons why they did not reported.Methods:A self-designed questionnaire regarding workplace violence and reporting was used to conduct a cross-sectional survey on nurses who submitted a manuscript to a Chinese nursing journal from 2016 to 2017.A total of 324 nurses agreed to participate in this study and 266 participants from 165 hospitals in 72 cities returned questionnaires.Results:A total of 172 nurses(64.7%)experienced violent incidents during the past year.Of these incidents,45.5%were reported;and the reporting rate of physical assaults(69.0%)was higher than those of verbal abuse(36.9%),threatening behavior(51.7%),and sexual harassment(60.0%).Formal reporting accounted for 25.4%(15.4%in written form and 10.0%through a computer-assisted reporting system).Almost half of the nurses(49.6%)stated that the hospital had no reporting system or they were uncertain about the reporting system.For reasons of not reporting,51.9%of the nurses were unware of how and what types of violence to report,and 50.6%of the nurses believed that the hospital paid greater attention to patients rather than staff.Conclusions:A clear definition of workplace violence and reporting procedures,establishment of a facile system for reporting,and supervisory support following a reporting are urgently required.

Qualitative analysis of compassion fatigue and coping strategies among nurses

Objectives:Nurses are considered to be at risk of experiencing compassion fatigue,which can affect their personal and professional lives.The aim of this study was to investigate stressful factors contributing to the development of compassion fatigue in nurses,their experiences of compassion fatigue,and the coping strategies they used to cope with compassion fatigue.Methods:The convenience sample of 86 nurses fromCentral Europewas recruited via social networking sites during the pandemic of COVID-19.Data collection was conducted via an online battery of questionnaires which included open-ended questions on the stressful factors,experiences,and coping strategies for compassion fatigue.The data were analysed using a theoretical thematic analysis based on Figley’s descriptions of compassion fatigue.The initial datawas read several times to identify recurring statements.Each statement was then categorized into the emerging domains,subdomains,categories,and subcategories.Results:The results of our study show that stressful factors,experiences,and coping strategies for compassion fatigue in nurses in Central Europe could be related to cognitive,emotional,behavioural,somatic,personal relations,spiritual,and work-related symptoms of compassion fatigue as identified by Figley and that these may resemble experiences of nurses in North America,Japan,and Spain.Conclusion:This study provides a detailed overview of the stressful factors,experiences,and coping strategies for compassion fatigue,which could be used to develop an early screening tool and interventions for alleviating compassion fatigue and for preventive adaptation of the health care system.