Objectives:This study aimed to explore the level of stress,types of stressors,type of coping styles,and factors influencing stress levels and coping styles among nursing students during the initial period of the clini...Objectives:This study aimed to explore the level of stress,types of stressors,type of coping styles,and factors influencing stress levels and coping styles among nursing students during the initial period of the clinical practicum.Methods:A cross-sectional survey design was used.In September 2017,participants were recruited from a tertiary hospital in Zhejiang Province,China,using a convenience sampling method.A demographic characteristics questionnaire,the Intern Nursing Student Stressor Scale,and the Simple Coping Style Questionnaire were used to collect data.Data were analyzed using descriptive analysis,independent sample t-tests,one-way analysis of variance,Pearson’s correlation analysis,and multiple linear regres-sion analysis.Results:A total of 158 nursing students were recruited,most of whom were female,undergraduates,and from rural areas.The nursing students perceived a moderate level of stress during the initial period of the clinical practicum.The need for knowledge and skills was the most common source of stress.Positive coping styles were most commonly adopted.Nursing students who were undergraduates,only children,and chose nursing major involuntarily experienced higher stress levels than those who were junior college students,not only children,and chose nursing major voluntarily.Nursing undergraduates were more likely to use positive coping styles than junior college students.Male nursing students and those experiencing higher stress levels related to the“environment and equipment of the wards”and the“nature and content of the work”were more likely to use negative coping styles.Conclusion:Nursing educators should offer targeted guidance based on the stress reported during the clinical practicum and the demographic characteristics of the nursing students.Guidance should be provided to encourage nursing students to adopt effective coping strategies and reduce stress.展开更多
Heart failure （HF） with preserved ejection fraction （HFpEF） is the most common form of HF in older adults, and is increasing in preva- lence as the population ages. Furthermore, HFpEF is increasing out of proporti...Heart failure （HF） with preserved ejection fraction （HFpEF） is the most common form of HF in older adults, and is increasing in preva- lence as the population ages. Furthermore, HFpEF is increasing out of proportion to HF with reduced EF （HFrEF）, and its prognosis is worsening while that of HFrEF is improving. Despite the importance of HFpEF, our understanding of its pathophysiology is incomplete, and optimal treatment remains largely undefined. A cardinal feature of HFpEF is reduced exercise tolerance, which correlates with symptoms as well as reduced quality of life. The traditional concepts of exercise limitations have focused on central dysfimction related to poor cardiac pump function. However, the mechanisms are not exclusive to the heart and lungs, and the understanding of the pathophysiology of this dis- ease has evolved. Substantial attention has focused on defining the central versus peripheral mechanisms underlying the reduced functional capacity and exercise tolerance among patients with HF. In fact, physical training can improve exercise tolerance via peripheral adaptive mechanisms even in the absence of favorable central hemodynamic function. In addition, the drug trials performed to date in HFpEF that have focused on influencing cardiovascular function have not improved exercise capacity. This suggests that peripheral limitations may play a significant role in HF limiting exercise tolerance, a hallmark feature of HFpEF.展开更多
Objectives:Globally,informal caregivers caring for cancer patients meet challenges within their caregiving role,which significantly influence their quality of life.This qualitative systematic review aimed to analyze h...Objectives:Globally,informal caregivers caring for cancer patients meet challenges within their caregiving role,which significantly influence their quality of life.This qualitative systematic review aimed to analyze how cancer caregiving influence the quality of life of informal caregivers and the management strategies of informal caregivers for their role as cancer caregivers.Methods:Following the enhancing transparency in reporting the synthesis of qualitative research(ENTREQ)statement,Wanfang database,the China National Knowledge Infrastructure(CNKI),CINAHL,MEDLINE,PubMed,Cochrane Library,PsycARTICLES and PsycINFO,and grey literature in English and Chinese from 1 May 2009 to 31 December 2019 were searched.Quality of included studies was assessed by the Critical Appraisal Skills Programme(2018)Qualitative Checklist and thematic synthesis was conducted.Results:Of the 8,945 studies identified,6 studies met the inclusion criteria.One analytical theme relating to the QoL of informal caregivers following cancer caregiving was identified:"challenges of caregiving".In terms of the management strategies to the role of cancer caregivers,two analytical themes were identified:"self-adjustment"and"seeking for formal and informal support".Conclusions:Cancer caregiving influences informal caregivers'QoL significantly and informal caregivers develop diverse coping strategies to deal with the difficulties occurred while balancing the relationship between their own lives and caregiving.However,professional and policy support remain inadequate for informal caregivers that require the need for improvement in terms of health care professionals and policymakers.展开更多
After several years of intense study, the most urgent problem those college students must face is employment, what＇ s more, with the sustaining development of China＇ s economy and the accelerating pace of social pro...After several years of intense study, the most urgent problem those college students must face is employment, what＇ s more, with the sustaining development of China＇ s economy and the accelerating pace of social progress, the society shows much more need for the comprehensiveness and adaptation ability of talents. However, under the influence of long-term examination-oriented education, college students are only content with the courses required now which leads to the lack of large scope of expertise and ability to solve practical problems, being narrow-minded, and having poor flexibility, creativity and manipulative ability. With the addition of the significant differences between the campus and the society, many college graduates always have the feeling of maladjuslanent when entering the society, for example, they are usually lack of effective learning methods, strong social responsibilities and self-learning abilities and have poor understanding and mastery of professional knowledge, poor unity consciousness, poor manipulative ability in social practices and poor cognitive competence, furthermore ,they tend to have great intercommunicative obstacles and can not evaluate themselves and others correctly.展开更多
Good psychological quality is an integral part of the overall quality of the contemporary college students, which is also an important foundation for their healthy growth and success. However, according to the investi...Good psychological quality is an integral part of the overall quality of the contemporary college students, which is also an important foundation for their healthy growth and success. However, according to the investigation, in reality, many college students have various degrees of psychological problems, seriously affecting their normal learning and living. This article makes an in-depth discussion based on the analysis of contemporary college students＇ psychological quality system; in order to strengthen the mental health education and improve the students＇ adaptability.展开更多
Identifying the causes of diversification is central to evolutionary biology. The ecological theory of adaptive diversi- fication holds that the evolution of phenotypic differences between populations and species--and...Identifying the causes of diversification is central to evolutionary biology. The ecological theory of adaptive diversi- fication holds that the evolution of phenotypic differences between populations and species--and the formation of new spe- cies-stems from divergent natural selection, often arising from competitive interactions. Although increasing evidence suggests that phenotypic plasticity can facilitate this process, it is not generally appreciated that competitively mediated selection often also provides ideal conditions for phenotypic plasticity to evolve in the first place. Here, we discuss how competition plays at least two key roles in adaptive diversification depending on its pattern. First, heterogenous competition initially generates heterogeneity in resource use that favors adaptive plasticity in the form of ＂inducible competitors＂. Second, once such competitively induced plas- ticity evolves, its capacity to rapidly generate phenotypic variation and expose phenotypes to alternate selective regimes allows populations to respond readily to selection favoring diversification, as may occur when competition generates steady diversifying selection that permanently drives the evolutionary divergence of populations that use different resources. Thus, competition plays two important roles in adaptive diversification---one well-known and the other only now emerging--mediated through its effect on the evolution ofphenotypic plasticity展开更多
基金supported by Wenzhou Medical University School-level Educational Reform Project(No.YBJG2019006).
文摘Objectives:This study aimed to explore the level of stress,types of stressors,type of coping styles,and factors influencing stress levels and coping styles among nursing students during the initial period of the clinical practicum.Methods:A cross-sectional survey design was used.In September 2017,participants were recruited from a tertiary hospital in Zhejiang Province,China,using a convenience sampling method.A demographic characteristics questionnaire,the Intern Nursing Student Stressor Scale,and the Simple Coping Style Questionnaire were used to collect data.Data were analyzed using descriptive analysis,independent sample t-tests,one-way analysis of variance,Pearson’s correlation analysis,and multiple linear regres-sion analysis.Results:A total of 158 nursing students were recruited,most of whom were female,undergraduates,and from rural areas.The nursing students perceived a moderate level of stress during the initial period of the clinical practicum.The need for knowledge and skills was the most common source of stress.Positive coping styles were most commonly adopted.Nursing students who were undergraduates,only children,and chose nursing major involuntarily experienced higher stress levels than those who were junior college students,not only children,and chose nursing major voluntarily.Nursing undergraduates were more likely to use positive coping styles than junior college students.Male nursing students and those experiencing higher stress levels related to the“environment and equipment of the wards”and the“nature and content of the work”were more likely to use negative coping styles.Conclusion:Nursing educators should offer targeted guidance based on the stress reported during the clinical practicum and the demographic characteristics of the nursing students.Guidance should be provided to encourage nursing students to adopt effective coping strategies and reduce stress.
文摘Heart failure （HF） with preserved ejection fraction （HFpEF） is the most common form of HF in older adults, and is increasing in preva- lence as the population ages. Furthermore, HFpEF is increasing out of proportion to HF with reduced EF （HFrEF）, and its prognosis is worsening while that of HFrEF is improving. Despite the importance of HFpEF, our understanding of its pathophysiology is incomplete, and optimal treatment remains largely undefined. A cardinal feature of HFpEF is reduced exercise tolerance, which correlates with symptoms as well as reduced quality of life. The traditional concepts of exercise limitations have focused on central dysfimction related to poor cardiac pump function. However, the mechanisms are not exclusive to the heart and lungs, and the understanding of the pathophysiology of this dis- ease has evolved. Substantial attention has focused on defining the central versus peripheral mechanisms underlying the reduced functional capacity and exercise tolerance among patients with HF. In fact, physical training can improve exercise tolerance via peripheral adaptive mechanisms even in the absence of favorable central hemodynamic function. In addition, the drug trials performed to date in HFpEF that have focused on influencing cardiovascular function have not improved exercise capacity. This suggests that peripheral limitations may play a significant role in HF limiting exercise tolerance, a hallmark feature of HFpEF.
文摘Objectives:Globally,informal caregivers caring for cancer patients meet challenges within their caregiving role,which significantly influence their quality of life.This qualitative systematic review aimed to analyze how cancer caregiving influence the quality of life of informal caregivers and the management strategies of informal caregivers for their role as cancer caregivers.Methods:Following the enhancing transparency in reporting the synthesis of qualitative research(ENTREQ)statement,Wanfang database,the China National Knowledge Infrastructure(CNKI),CINAHL,MEDLINE,PubMed,Cochrane Library,PsycARTICLES and PsycINFO,and grey literature in English and Chinese from 1 May 2009 to 31 December 2019 were searched.Quality of included studies was assessed by the Critical Appraisal Skills Programme(2018)Qualitative Checklist and thematic synthesis was conducted.Results:Of the 8,945 studies identified,6 studies met the inclusion criteria.One analytical theme relating to the QoL of informal caregivers following cancer caregiving was identified:"challenges of caregiving".In terms of the management strategies to the role of cancer caregivers,two analytical themes were identified:"self-adjustment"and"seeking for formal and informal support".Conclusions:Cancer caregiving influences informal caregivers'QoL significantly and informal caregivers develop diverse coping strategies to deal with the difficulties occurred while balancing the relationship between their own lives and caregiving.However,professional and policy support remain inadequate for informal caregivers that require the need for improvement in terms of health care professionals and policymakers.
文摘After several years of intense study, the most urgent problem those college students must face is employment, what＇ s more, with the sustaining development of China＇ s economy and the accelerating pace of social progress, the society shows much more need for the comprehensiveness and adaptation ability of talents. However, under the influence of long-term examination-oriented education, college students are only content with the courses required now which leads to the lack of large scope of expertise and ability to solve practical problems, being narrow-minded, and having poor flexibility, creativity and manipulative ability. With the addition of the significant differences between the campus and the society, many college graduates always have the feeling of maladjuslanent when entering the society, for example, they are usually lack of effective learning methods, strong social responsibilities and self-learning abilities and have poor understanding and mastery of professional knowledge, poor unity consciousness, poor manipulative ability in social practices and poor cognitive competence, furthermore ,they tend to have great intercommunicative obstacles and can not evaluate themselves and others correctly.
文摘Good psychological quality is an integral part of the overall quality of the contemporary college students, which is also an important foundation for their healthy growth and success. However, according to the investigation, in reality, many college students have various degrees of psychological problems, seriously affecting their normal learning and living. This article makes an in-depth discussion based on the analysis of contemporary college students＇ psychological quality system; in order to strengthen the mental health education and improve the students＇ adaptability.
基金Acknowledgements We thank Zhi-Yun Jia for inviting us to submit this paper to a special column on phenotypic plasticity. Three anonymous reviewers provided valuable commentary that encouraged us to improve this work. We also wish to ac- knowledge the long term funding for plasticity research pro- vided by the U.S. National Science Foundation to DP, and the Natural Sciences and Engineering Research Council of Can- ada to BR. Finally, collaboration on this specific project was directly supported through a short-term fellowship to BR by the National Evolutionary Synthesis Center （NESCent funded by NSF #EF-0905606）.
文摘Identifying the causes of diversification is central to evolutionary biology. The ecological theory of adaptive diversi- fication holds that the evolution of phenotypic differences between populations and species--and the formation of new spe- cies-stems from divergent natural selection, often arising from competitive interactions. Although increasing evidence suggests that phenotypic plasticity can facilitate this process, it is not generally appreciated that competitively mediated selection often also provides ideal conditions for phenotypic plasticity to evolve in the first place. Here, we discuss how competition plays at least two key roles in adaptive diversification depending on its pattern. First, heterogenous competition initially generates heterogeneity in resource use that favors adaptive plasticity in the form of ＂inducible competitors＂. Second, once such competitively induced plas- ticity evolves, its capacity to rapidly generate phenotypic variation and expose phenotypes to alternate selective regimes allows populations to respond readily to selection favoring diversification, as may occur when competition generates steady diversifying selection that permanently drives the evolutionary divergence of populations that use different resources. Thus, competition plays two important roles in adaptive diversification---one well-known and the other only now emerging--mediated through its effect on the evolution ofphenotypic plasticity
