Influencing factors of self-management ability among dry eye patients in west China

AIM:To investigate the current situation and influencing factors of self-management ability in dry eye patients in west China.METHODS:A total of 265 patients clinically diagnosed with dry eye received a convenience survey questionnaire at West China Hospital of Sichuan University.All participants completed the rating scale of health self-management skill for adults(AHSMSRS),Huaxi Emotional-Distress Index(HEI),e-health literacy scale(e-HEALS)and Brief Illness Perception Questionnaire(Brief-IPQ).A generalized linear model was employed to establish a multivariate linear model with demographic data,psychological state,e-HEALS,and illness perception as independent variables and health selfmanagement skill score as the dependent variable.RESULTS:The mean score for health self-management skill was 165.58±15.79.Multivariate analysis revealed that advanced age,better illness perception and improved psychological state were associated with better health selfmanagement ability among dry eye patients.Furthermore,the health self-management ability of patients with a disease duration less than 1y was found to be higher compared to those with a disease duration exceeding 1y.CONCLUSION:The health self-management ability of dry eye patients in west China is relatively high.Age,duration of disease,illness perception and psychological state are the influencing factors on the health selfmanagement ability of dry eye patients.

Quantitative assessment of self-management in patients with nonalcoholic fatty liver disease: An unmet clinical need

In this editorial we comment on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al published in a recent issue of the World Journal of Gastroenterology.Non-alcoholic fatty liver disease(NAFLD)represents one of the current challenges in hepatology and public health,due to its continuous growing prevalence and the rising incidence of NAFLD-related fibrosis,non-alcoholic steatohepatitis and cirrhosis.The only effective therapeutic strategy for this dis-ease is represented by encouraging patients to improve their lifestyle through the modification of dietary intake and increased physical exercise,but the effective application of such modifications is often limited by various factors such as lack of information,psychological barriers or poor social support.While poor adherence to a healthy lifestyle can be decisive in determining the clinical outcome,in daily practice there is a lack of quantitative instruments aimed at identifying patients with the lowest adherence to lifestyle changes and higher risk of disease progre-ssion in the course of follow-up.In this article,Zeng et al propose a quantitative scale to assess the grade of adherence of patients with NAFLD to hea-lthy lifestyle intervention,called the Exercise and Diet Adherence Scale(EDAS).This scale,consisting of 33 items divided into 6 dimensions which relates to six subjective aspects in the self-management of NAFLD,has shown a good correlation with the identification of the sub-cohort of patients with the highest reduction in caloric intake,increase in physical exercise,probability of a reduction in liver stiffness measurement and alanine aminotransferase levels.The cor-relation among clinical outcomes and specific dimensions of this scale also highlights the pivotal role of a good and confidential doctor-patient relationship and of an effective communication.There is an urgent need for practical and effective instruments to assess the grade of self-management of NAFLD patients,together with the development of multidisciplinary teams with the aim of applying structured behavioral interventions.

Development and validation of a self-management ability questionnaire for patients with chronic periodontitis

Objective: This study aimed to develop and validate a self-management ability questionnaire for patients with chronic periodontitis.Methods: A questionnaire was developed through theoretical research,literature review,semistructured interview,and expert consultation.A total of 231 patients with chronic periodontitis from the Department of Periodontics in the Stomatological Hospital of Tianjin Medical University were recruited by convenient sampling.Validity and reliability were analyzed.Results: The questionnaire consisted of 24 items.Exploratory factor analysis identified three principal factors,which explained 66.949% of the total variance.The item-level content validity was between 0.800 and 1.000,and the scale-level content validity was 0.969.The coefficient of correlation between the gold standard and the whole questionnaire was 0.869.Cronbach's α of the whole questionnaire was 0.931,and the test-retest reliability coefficient was 0.825.Conclusion: The questionnaire developed in this study satisfies the measurement standard and has good reliability and validity.It is useful for clinical work to measure self-management among patients with chronic periodontitis.

Effect of Diabetes Self-Management Education on Glycaemic Control in Sudanese Adults with Type 2 Diabetes

Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social Sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m2 (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management behaviors. Patient education plays a critical role in enhancing glycemic control and self-management behaviors. It is essential for healthcare providers to adopt a patient-centered approach, taking into account the individual's beliefs, attitudes, and knowledge about their illness and treatment. Overcoming these challenges necessitates a comprehensive approach, including enhancing healthcare professionals’ knowledge and communication skills, offering accessible and culturally sensitive diabetes education programs, and addressing barriers to resources and support for self-management.

Patterns and drivers of avian taxonomic and phylogenetic beta diversity in China vary across geographical backgrounds and dispersal abilities

Geographical background and dispersal ability may strongly influence assemblage dissimilarity;however,these aspects have generally been overlooked in previous large-scale beta diversity studies.Here,we examined whether the patterns and drivers of taxonomic beta diversity(TBD)and phylogenetic beta diversity(PBD)of breeding birds in China vary across(1)regions on both sides of the Hu Line,which demarcates China’s topographical,climatic,economic,and social patterns,and(2)species with different dispersal ability.TBD and PBD were calculated and partitioned into turnover and nestedness components using a moving window approach.Variables representing climate,habitat heterogeneity,and habitat quality were employed to evaluate the effects of environmental filtering.Spatial distance was considered to assess the impact of dispersal limitation.Variance partitioning analysis was applied to assess the relative roles of these variables.In general,the values of TBD and PBD were high in mountainous areas and were largely determined by environmental filtering.However,different dominant environmental filters on either side of the Hu Line led to divergent beta diversity patterns.Specifically,climate-driven species turnover and habitat heterogeneity-related species nestedness dominated the regions east and west of the line,respectively.Additionally,bird species with stronger dispersal ability were more susceptible to environmental filtering,resulting in more homogeneous assemblages.Our results indicated that regions with distinctive geographical backgrounds may present different ecological factors that lead to divergent assemblage dissimilarity patterns,and dispersal ability determines the response of assemblages to these ecological factors.Identifying a single universal explanation for the observed pattern without considering these aspects may lead to simplistic or incomplete conclusions.Consequently,a comprehensive understanding of large-scale beta diversity patterns and effective planning of conservation strategies necessitate the consideration of both geographical background and species dispersal ability.

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

Self-management A concept analysis of self-management for cancer patients’ home-based rehabilitation

Objective： To explore and clarify the concept of self-management in the context of cancer patients’ home-basedrehabilitation. This concept analysis will provide a theoretical lens for nurses to help cancer patients to developself-management strategies and enables them to improve their ability in symptom self-management of home-basedrehabilitation. Method： Walker and Avant’s framework （2011） was used to analyse the concept of self-management.Results： Self-management is defined as a dynamic process that involves perception of one’s needs, resource utilisation,problem solving and active participation. Antecedents of self-management include self-efficacy, disease knowledge andsocial support. Improving cancer patients’ ability in symptom self-management can improve their health outcomes andquality of life and reduce healthcare expenditures. Although Strategy and Effectiveness of Symptom Self-Managementscale is perceived as an ideal instrument to measure self-management and thus it is used worldwide, whether thisinstrument fits to measure this concept for cancer patients in Chinese context has still not yet been verified and thusfurther research is needed. Conclusion： According to the concept analysis, nurses should encourage cancer patients toinvolve actively in making a home-based rehabilitation plan and promote their ability in symptom self-management ofhome-based rehabilitation so as to improve their health outcomes and reduce healthcare expenditures.

Self-management in patients with diabetic foot ulcer:a concept analysis

Objective:This paper presents an analysis of the concept of patient outcomes.Methods:The present study conducted searches on various databases,including Wanfang,Sinomed,CNKI,Pub Med,Cochrane Library,Embase,Web of Science,and Ovid.The paper followed the Walker and Avant concept-analysis approach.Results:Initially,899 pieces of literature were identified through the search process,and after screening,41 of them were ultimately included in the analysis.The identified attributes of the concept included(1)capability,(2)decision making,and(3)action.These antecedents were shaped by factors such as illness perception,self-efficacy,and family and social.The consequences included(1)physiological effects,(2)psychological effects,and(3)social influence.Conclusions:The concept analysis of self-management in patients with diabetic foot ulcers(DFUs)not only aids in clinical practice and suppor ts interventions,but also contributes to the development of self-management theory.The common goal of clinical medical staff is to assist DFU patients in improving cognitive ability,making correct self-management decisions,and enhancing self-management behavior.

Application Effect of WeChat Platform Continuity of Care Model Based on KAP Theory on Self-Management of Stroke Patients with Hypertension

Objective: To explore the impact of the WeChat platform continuity of care model based on the KAP (knowledge, attitudes, and practices) theory on the self-management of stroke patients with hypertension after discharge from the hospital. Methods: 62 stroke patients with hypertension discharged from the rehabilitation department of a tertiary A hospital in Nanning City, Guangxi Zhuang Autonomous Region, from October 2022 to April 2023 were sampled by convenience sampling method. Patients discharged from Rehabilitation I were included in the control group, and conventional nursing care was used;while patients discharged from Rehabilitation II were included in the observation group, and WeChat platform continuity of nursing care model based on the KAP theory was implemented. The intervention effect of the two groups was compared. Results: After 4 and 12 weeks of intervention, the diastolic and systolic blood pressure of the patients in the observation group were lower than those in the control group (P < 0.05);after 12 weeks of intervention, the rate of medication adherence and the score of adherence to hypertension treatment in the observation group were significantly higher than those in the control group (P < 0.05). Conclusion: The application of the WeChat platform continuity of care model based on KAP theory to stroke patients with hypertension can improve blood pressure, medication adherence rate, hypertension treatment adherence, and overall enhance the self-management level of these patients.

Conceptual Analysis of Self-Management in Patients with Hypertension

Objective:To clarify the concept of self-management in hypertensive patients by analyzing the definition,attributes,and measurement tools through a literature review.Methods:An Internet-based search of the databases was conducted using Academic Search Complete,Medical Line,CINAHL,Health Source:Nursing/Scholarly Edition,and Google Scholar.In the search process,keywords or free text were combined by using Boolean operators,with the search terms“self of management”or“self-management,”“concept*analysis”or“concept*definition,”and Walker and Avant’s concept analysis method was used.Results:Analysis of relevant literature summarized the conceptual attributes of self-management in hypertensive patients as the active participation of patients in the treatment process;the presence of interaction provided by patients and health care providers;the use of certain health management tools;and the aim of maintaining and improving the health status and living capacity of hypertensive patients.Conclusion:The concept of self-management for hypertensive patients was clarified,which helps to promote the application of hypertensive self-management in clinical work and improve outcomes and quality of life for patients with hypertension.

“I Am Getting Healthier”. Perceptions of Urban Aboriginal and Torres Strait Islander People in a Chronic Disease Self-Management and Rehabilitation Program

Chronic disease is a main contributor to the disproportionately high burden of illness experienced by Aboriginal and Torres Strait Islander Australians. However, there are very few programs addressing chronic disease self-management and rehabilitation which are designed specifically for urban Aboriginal and Torres Strait Islander people. This paper aims to explore client and staff perceptions of the Work It out Program, a chronic disease rehabilitation and self-management program designed for urban Aboriginal and Torres Strait Islander people. The study used a mixed methods approach to explore the success, barriers and self-reported outcomes of the program. Quantitative data were collected through a structured survey, comprising social and demographic data. Qualitative data were collected through interviews using Most Significant Change theory. Twenty-eight participants were recruited, 6 staff and 22 clients (M = 7, F = 21) with an age range between 21 and 79 years of age (Mean = 59.00, SD = 17.63). Interviews were completed in 2013 across four Work It out locations in Southeast Queensland. Semi-structured interviews were conducted either individually or in groups of two or three, depending on the participants’ preference. Thematic analysis of the data revealed six main themes;physical changes, lifestyle improvements, social and emotional well-being, perceptions about the successful features of the program, perceived barriers to the program and changes for the future. This exploratory study found that clients and staff involved in the Work It out Program perceived it as an effective self-management and rehabilitation program for urban Aboriginal and Torres Strait Islander Australians. Further evaluation with a larger sample size is warranted in order to establish further outcomes of the program.

A Strategy of Density-Based Partitioning for Scalability Problem in Network Self-management

A density-based partitioning strategy is proposed for large domain networks in order to deal with the scalability issue found in autonomic networks considering, as a scenario, the autonomic Quality of Service （QoS） management context. The approach adopted focus as on obtaining dense network partitions having more paths for a given vertices set in the domain. It is demonstrated that dense partitions improve autonomic processing scalability, for instance, reducing routing process complexity. The solution looks for a significant trade-off between partition autonomic algorithm execution time and path selection quality in large domains. Simulation scenarios for path selection execution time are presented and discussed. Authors argue that autonomic networks may benefit from the dense partition approach proposed by achieving scalable, efficient and near real-time support for autonomic management systems.

A Study of Meta-cognitive Strategy to Improve College Students’ Self-management Ability in College English Learning

The ability of college students’English learning self-management plays an important role in English learning.To improve college students’self-management,this paper first analyzed the problems and necessity for.Then it mainly explored how to im prove their self-management ability thus to help student’s improve the efficiency of self-management in college English learning.

A Study on English Majors' Abilities to Transmit Chinese Culture in English at Newly Upgraded Universities

The transmitting of Chinese culture in the intercultural communication is of great importance for English learners in China.English majors at newly upgraded universities are weak in their abilities to express Chinese culture in English and transmit Chinese culture.To find measures for the problems,some necessary changes in the syllabus,textbooks,testing and curriculum are suggested,compiling of a dictionary for the standard of Chinese culture items in English is discussed,and the roles of teachers,students and English Corner in the cultivation of the abilities of English majors' to express Chinese culture in English at newly upgraded universities are analyzed.

Effects of ball milling time on porous Ti-3Ag alloy and its apatite-inducing abilities

Ti and Ag powders were mixed with different ball milling time （1, 2, 5 and 10 h） and sintered into porous Ti-3Ag alloys. The samples were treated with hydrothermal treatment, and their apatite-inducing abilities were further evaluated by immersion in modified simulated body fluid. The results indicate that the high surface energy brought by powder refinement leads to the decline of Ag, but promotes the oxidation of Ti during the sintering process. Meanwhile, the hydrothermal treated porous Ti-3Ag alloys prepared by the powders ball milled for 10 h possess the best apatite-inducing ability.

Selection of female parents with high fertility and high combining abilities for cross-breeding Populus tomentosa

To select maternal parents with high fertility and high combining ability during cross breeding of Populus tomentosa Carr., the ploidy level of 75 female clones was determined using flow cytometry. In addition, genetic variations and phenotypic correlations of seed traits and early growth traits, as well as the general combining ability(GCA) for seedling height(SH) and basal diameter(BD) of all diploid half-sib families were examined. A total of 26 natural triploid clones were identified. For all diploid families, family effects were significant for inflorescence length(IL), thousand kernel weight(TKW), seedling emergence rate(SER), and for SH and BD. There was a positive correlation between TKW and other traits,excluding IL. The seed-bearing coefficient(NS 9 SER)ranged from zero to 32.4%. Clones 3-10-2, 2-8, 3119,3206, and 3-10-1 had the best performance of the GCA for SH and BD. Based on the fertility and GCA for SH and BD, clone 3-10-2 and clone 3119 could be used as female parents for controlled cross-breeding of P. tomentosa.

Impact of chronic disease self-management programs on type 2 diabetes management in primary care

AIM: To assess the effectiveness of the Chronic Disease Self-Management Program(CDSMP) on glycated hemoglobin A1c(HbA1c) and selected self-reported measures.METHODS: We compared patients who received a diabetes self-care behavioral intervention, the CDSMP developed at the Stanford University, with controls whoreceived usual care on their HbA1c and selected self-reported measures, including diabetes self-care activities, health-related quality of life(HRQOL), pain and fatigue. The subjects were a subset of participants enrolled in a randomized controlled trial that took place at seven regional clinics of a university-affiliated integrated healthcare system of a multi-specialty group practice between January 2009 and June 2011. The primary outcome was change in HbA1c from randomization to 12 mo. Data were analyzed using multilevel statistical models and linear mixed models to provide unbiased estimates of intervention effects.RESULTS: Demographic and baseline clinical characteristics were generally comparable between the two groups. The average baseline HbA1c values in the CDSMP and control groups were 9.4% and 9.2%, respectively. Significant reductions in HbA1c were seen at 12 mo for the two groups, with adjusted changes around 0.6%(P < 0.0001), but the reductions did not differ significantly between the two groups(P = 0.885). Few significant differences were observed in participants' diabetes self-care activities. No significant differences were observed in the participants' HRQOL, pain, or fatigue measures.CONCLUSION: The CDSMP intervention may not lower HbA1c any better than good routine care in an integrated healthcare system. More research is needed to understand the benefits of self-management programs in primary care in different settings and populations.

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.

Comparative Effects of Salt Stress and Extreme pH Stress Combined on Glycinebetaine Accumulation,Photosynthetic Abilities and Growth Characters of Two Rice Genotypes

Glycinebetaine （Glybet） accumulation, photosynthetic efficiency and growth performance in indica rice cultivated under salt stress and extreme pH stress were investigated. Betaine aldehyde dehydrogenase （BADH） activity and Glybet accumulation in the seedlings of salt-tolerant and salt-sensitive rice varieties grown under saline and acidic conditions peaked after treatment for 72 h and 96 h, respectively, and were higher than those grown under neutral pH and alkaline salt stress. A positive correlation was found between BADH activity and Glybet content in both salt-tolerant （P=0.71） and salt-sensitive （P=0.86） genotypes. The chlorophyll a, chlorophyll b, total chlorophyll and total carotenoids contents in the stressed seedlings significantly decreased under both acidic and alkaline stresses, especially in the salt-sensitive genotype. Similarly, the maximum quantum yield of PSII （Fv/Fm）, photon yield of PSII （ФPSII）, non-photochemical quenching （NPQ） and net photosynthetic rate （Pn） in the stressed seedlings were inhibited, leading to overall growth reduction. The positive correlations between chlorophyll a content and Fv/Fm, total chlorophyll content and ФPSII, and Pn as well as Pn and leaf area in both salt-tolerant and salt-sensitive genotypes were found. Saline acidic and saline alkaline soils may play a key role affecting vegetative growth prior to the reproductive stage in rice plants.

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.