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.

Precision health: A nursing perspective

Precision health refers to personalized healthcare based on a person's unique genetic,genomic,or omic composition within the context of lifestyle,social,economic,cultural and environmental influences to help individuals achieve well-being and optimal health.Precision health utilizes big data sets that combine omics(i.e.genomic sequence,protein,metabolite,and microbiome information)with clinical information and health outcomes to optimize disease diagnosis,treatment and prevention specific to each patient.Successful implementation of precision health requires interprofessional collaboration,community outreach efforts,and coordination of care,a mission that nurses are well-positioned to lead.Despite the surge of interest and attention to precision health,most nurses are not well-versed in precision health or its implications for the nursing profession.Based on a critical analysis of literature and expert opinions,this paper provides an overview of precision health and the importance of engaging the nursing profession for its implementation.Other topics reviewed in this paper include big data and omics,information science,integration of family health history in precision health,and nursing omics research in symptom science.The paper concludes with recommendations for nurse leaders in research,education,clinical practice,nursing administration and policy settings for which to develop strategic plans to implement precision health.

The Impact of Cervical Cancer Treatment on Sexual Function and Intimate Relationships: Is Anyone Listening?

The purpose of this research was to describe women’s narrative accounts of the impact of cervical cancer treatment on their sexual function and intimate relationships, and to evaluate what changes in care and education are needed to enhance quality of life and intimacy after treatment. The research approach was a narrative design, using semi-structured, in-depth interviews. Narratives were examined within and across interviews, and thematic content analysis completed. The study was done in a gynecologic oncology clinic at a public hospital in the Midwest United States. The sample consisted of twelve women, ranging in age from 27 to 59, who had completed the cervical cancer treatment with chemo-radiation or radiation and surgery, and were now followed by their gynecologic oncologists. Across narratives, five major themes were identified, including unexpected physical complications, not “getting back to normal,” emotional pain and isolation, lack of available information, and inadequate health care provider response to treatment complications and sexual relationship problems. Women’s stories reveal that sex and intimacy issues for cervical cancer survivors remain within a culture of silence. In many situations, health professionals did not provide information that realistically prepared women and partners for probable consequences of treatment, did not assess sexual issues before or after treatment, did not recognize various symptoms as being complications of cancer treatment, did not make referrals, and/or recognized complications, but accepted them as “normal” and without solution. Ethical implications for health professionals and the need for education, communication, and the development of new lines of research are discussed.

Effects of Ving Tsun sticking-hand training on upper-limb sensorimotor performance in community-dwelling middle-aged and older adults: A randomized controlled trial

Objective:To evaluate the effects of Ving Tsun(VT)sticking-hand training on upper-limb joint position sense and muscular performance in community-dwelling middle-aged and older adults.Methods:Thirty-three adults were randomly allocated to either a VT group or a control group.The VT group received VT sticking-hand training twice per week for 3 months.Measurements were taken before and after the intervention period.The primary outcome was elbow-joint repositioning error,which was measured by an elbow-joint passive positioning and active repositioning test using a universal goniometer.Secondary outcomes were upper-limb muscles'peak force and time taken to reach peak force as measured by a hand-held dynamometer.Results:No significant time,group or time-by-group interaction effects were found for elbow-joint repositioning error or upper-limb muscle peak force outcomes.Shoulder flexor time to peak force decreased by 33.8%from pre-test to post-test in the VT group(P=0.007).Shoulder abductor,internal and external rotator,and elbow extensor times to peak force decreased by 30.0%-35.9%in the VT%roup(P<0.05)and by 30.4%-37.1%in the control group(P<0.05).Conclusions:VT sticking-hand training does not improve elbow-joint position sense or the maximum strength of upper-limb muscles in middle-aged and older adults.However,VT can improve shoulder flexor muscles'time to reach peak force in these populations.VT had no obvious effect on the time required to reach peak force in other shoulder muscles and elbow extensors.

Role of angiotensin receptor-neprilysin inhibitor in diabetic complications

Diabetes mellitus is a prevalent disorder with multi-system manifestations,causing a significant burden in terms of disability and deaths globally.Angio-tensin receptor-neprilysin inhibitor(ARNI)belongs to a class of medications for treating heart failure,with the benefits of reducing hospitalization rates and mortality.This review mainly focuses on the clinical and basic investigations related to ARNI and diabetic complications,discussing possible physiological and molecular mechanisms,with insights for future applications.

Effects of therapeutic horseback riding on post-traumatic stress disorder in military veterans

Background:Large numbers of post-deployment U.S.veterans are diagnosed with post-traumatic stress disorder(PTSD)and/or traumatic brain injury(TBI),leading to an urgent need for effective interventions to reduce symptoms and increase veterans’coping.PTSD includes anxiety,flashbacks,and emotional numbing.The symptoms increase health care costs for stress-related illnesses and can make veterans’civilian life difficult.Methods:We used a randomized wait-list controlled design with repeated measures of U.S.military veterans to address our specific aim to test the efficacy of a 6-week therapeutic horseback riding(THR)program for decreasing PTSD symptoms and increasing coping self-efficacy,emotion regulation,social and emotional loneliness.Fiftyseven participants were recruited and 29 enrolled in the randomized trial.They were randomly assigned to either the horse riding group(n=15)or a wait-list control group(n=14).The wait-list control group experienced a 6-week waiting period,while the horse riding group began THR.The wait-list control group began riding after 6 weeks of participating in the control group.Demographic and health history information was obtained from all the participants.PTSD symptoms were measured using the standardized PTSD Checklist-Military Version(PCL-M).The PCL-M as well as other instruments including,The Coping Self Efficacy Scale(CSES),The Difficulties in Emotion Regulation Scale(DERS)and The Social and Emotional Loneliness Scale for Adults-short version(SELSA)were used to access different aspects of individual well-being and the PTSD symptoms.Results:Participants had a statistically significant decrease in PTSD scores after 3 weeks of THR(P≤0.01)as well as a statistically and clinically significant decrease after 6 weeks of THR(P≤0.01).Logistic regression showed that participants had a 66.7%likelihood of having lower PTSD scores at 3 weeks and 87.5%likelihood at 6 weeks.Under the generalized linear model(GLM),our ANOVA findings for the coping self-efficacy,emotion regulation,and social and emotional loneliness did not reach statistical significance.The results for coping self-efficacy and emotion regulation trended in the predicted direction.Results for emotional loneliness were opposite the predicted direction.Logistic regression provided validation that outcome effects were caused by riding longer.Conclusion:The findings suggest that THR may be a clinically effective intervention for alleviating PTSD symptoms in military veterans.

Dysglycemia and arrhythmias

Disorders in glucose metabolism can be divided into three separate but interrelated domains,namely hyperglycemia,hypoglycemia,and glycemic variability.Intensive glycemic control in patients with diabetes might increase the risk of hypoglycemic incidents and glucose fluctuations.These three dysglycemic states occur not only amongst patients with diabetes,but are frequently present in other clinical settings,such as during critically ill.A growing body of evidence has focused on the relationships between these dysglycemic domains with cardiac arrhythmias,including supraventricular arrhythmias(primarily atrial fibrillation),ventricular arrhythmias(malignant ventricular arrhythmias and QT interval prolongation),and bradyarrhythmias(bradycardia and heart block).Different mechanisms by which these dysglycemic states might provoke cardiac arrhythmias have been identified in experimental studies.A customized glycemic control strategy to minimize the risk of hyperglycemia,hypoglycemia and glucose variability is of the utmost importance in order to mitigate the risk of cardiac arrhythmias.

Experience of Drug Abusers Participating in Community-Based Drug Rehabilitation Services Provided by the Counselling Centres for Psychotropic Substance Abusers (CCPSAs) in Hong Kong

Despite the official statistics showing that the number of drug users has been declining, the problem of drug abuse remains serious in Hong Kong. This problem is evidenced by the trend of hidden and prolonged drug abuse. The recovery of drug abusers is an important process, because the misuse of drugs can cause many bio-psycho-social complications. Therefore, 11 Counselling Centres for Psychotropic Substance Abusers (CCPSAs) in different districts in Hong Kong play an important role on those drug abusers [1]. As a core community-based drug rehabilitation service in Hong Kong, studies about CCPSAs are limited. This study uses a descriptive qualitative approach to explore the experience of drug abusers participating in community-based drug rehabilitation services provided by CCPSAs. Five CCPSA users, who utilized the services for more than two months, participated in the semi-structured face-to-face interviews. Data collected were then analysed by thematic analysis, and five themes were generated: 1) receiving supportive counselling service in CCPSAs, 2) revealing variance towards nonmandatory services in CCPSAs, 3) encountering intrapersonal conflicts when participating in CCPSAs, 4) expanding social network through integration in group activities and 5) wishing to be a companion to other drug abusers. Findings of this study provide valuable insights towards services modification and the enhancement of drug rehabilitation and drug abusers’ wellbeing over the collaboration of healthcare workers, services providers and the media. However, this study has some limitations, and it presents suggestions for future research.

Improved Interpretive Accuracy of Sugar Content on Beverage Labels Following an Educational Intervention for Children

To address childhood obesity, it is important to help children make better choices with regards to intake of sugary drinks and snacks. The purpose of this study was to evaluate the validity of a novel educational intervention designed to convert grams of sugar into teaspoons on labeled beverages. A convenience sample of children （n = 21） at a charter elementary school in Washington, D. C was studied. A pre-test required an estimation of teaspoons of sugar on labels, followed by a practice demonstration and song. A post-test was given requiring estimation of teaspoons of sugar in on the same labels. Two weeks later, a retention test as well as qualitative questions assessed participant learning and information usage. Test scores revealed increased accuracy from pre-test （26.2%） to post-test （79.8%）. Estimations were more accurate after the demonstration, as evidenced by the decreased range in average variation of responses （＋25.6 tsp to ＋1.8 tsp）. Two-week recall maintained accuracy （66.7%）, with an average variance of ＋3.8 teaspoons. Qualitative responses revealed participants had learned and used the conversion concepts. These results suggest that the educational intervention was effective. Qualitative data suggest behavior change, increased awareness, and the potential for change extending to caregivers.

Prognostic value of cardiovascular magnetic resonance in immune checkpoint inhibitor-associated myocarditis:A systematic review and meta-analysis

Background:The role of surgery in metastatic breast cancer(MBC)is currently controversial.Several novel statistical and deep learning(DL)methods promise to infer the suitability of surgery at the individual level.Objective:The objective of this study was to identify the most applicable DL model for determining patients with MBC who could benefit from surgery and the type of surgery required.Methods:We introduced the deep survival regression with mixture effects(DSME),a semi-parametric DL model integrating three causal inference methods.Six models were trained to make individualized treatment recommendations.Patients who received treatments in line with the DL models'recommendations were compared with those who underwent treatments divergent from the recommendations.Inverse probability weighting(IPW)was used to minimize bias.The effects of various features on surgery selection were visualized and quantified using multivariate linear regression and causal inference.Results:In total,5269 female patients with MBC were included.DSME was an independent protective factor,outperforming other models in recommend-ing surgery(IPW-adjusted hazard ratio[HR]=0.39,95%confidence interval[CI]:0.19–0.78)and type of surgery(IPW-adjusted HR=0.66,95%CI:0.48–0.93).DSME was superior to other models and traditional guidelines,suggesting a higher proportion of patients benefiting from surgery,especially breast-conserving surgery.The debiased effect of patient characteristics,including age,tumor size,metastatic sites,lymph node status,and breast cancer subtypes,on surgery decision was also quantified.Conclusions:Our findings suggested that DSME could effectively identify patients with MBC likely to benefit from surgery and the specific type of surgery needed.This method can facilitate the development of efficient,reliable treatment recommendation systems and provide quantifiable evidence for decision-making.

Novel molecular targets in hepatocellular carcinoma

Globally,hepatocellular carcinoma(HCC)is a leading cause of cancer and cancerrelated deaths.The therapeutic efficacy of locoregional and systemic treatment in patients with advanced HCC remains low,which results in a poor prognosis.The development of sorafenib for the treatment of HCC has resulted in a new era of molecular targeted therapy for this disease.However,the median overall survival was reported to be barely higher in the sorafenib treatment group than in the control group.Hence,in this review we describe the importance of developing more effective targeted therapies for the management of advanced HCC.Recent investigations of molecular signaling pathways in several cancers have provided some insights into developing molecular therapies that target critical members of these signaling pathways.Proteins involved in the Hedgehog and Notch signaling pathways,Polo-like kinase 1,arginine,histone deacetylases and Glypican-3 can be potential targets in the treatment of HCC.Monotherapy has limited therapeutic efficacy due to the development of inhibitory feedback mechanisms and induction of chemoresistance.Thus,emphasis is now on the development of personalized and combination molecular targeted therapies that can serve as ideal therapeutic strategies for improved management of HCC.

健康行为改善常规的概念分析

目的慢性病患者常常有不健康的生活习惯,他们需要明确的指导,以建立和维持健康行为改善常规。本研究旨在根据文献中健康行为改善常规的应用情况,对其概念进行综合定义。方法于2022年1一5月,检索CINAHL、Medline、Scopus和谷歌学术中包含健康行为改善情景下常规的定义的英文文献,未限定发表日期。采用系统分析方法和Rodgers演化概念分析法,描述健康行为改善常规的属性、前置因素和后续影响,形成该概念的定义。结果共纳人24篇文章。改善健康行为常规概念的属性为重复的模式、患者的可控制性、以目标为导向的健康及融入整个生活方式。前置因素为个体特征和环境因素。后续影响为个体和环境层面的心理、身体和社会健康。结论健康行为改善常规的明确定义可为未来研究提供启发,并为支持慢性病患者建立和保持健康生活习惯的临床护理干预提供依据,从而改善患者结局。

Cardiovascular disease burden in patients with urological cancers:The new discipline of uro-cardio-oncology

Cancer remains a major cause of mortality worldwide,and urological cancers are the most common cancers among men.Several therapeutic agents have been used to treat urological cancer,leading to improved survival for patients.However,this has been accompanied by an increase in the frequency of survivors with cardiovascular complications caused by anticancer medications.Here,we propose the novel discipline of uro-cardio-oncology,an evolving subspecialty focused on the complex interactions between cardiovascular disease and urological cancer.In this comprehensive review,we discuss the various cardiovascular toxicities induced by different classes of antineoplastic agents used to treat urological cancers,including androgen deprivation therapy,vascular endothelial growth factor receptor tyrosine kinase inhibitors,immune checkpoint inhibitors,and chemotherapeutics.In addition,we discuss possible mechanisms underlying the cardiovascular toxicity associated with anticancer therapy and outline strategies for the surveillance,diagnosis,and effective management of cardiovascular complications.Finally,we provide an analysis of future perspectives in this emerging specialty,identifying areas in need of further research.

Retinal tissue hypoperfusion in patients with clinical Alzheimer’s disease

Background:It remains unknow whether retinal tissue perfusion occurs in patients with Alzheimer’s disease.The goal was to determine retinal tissue perfusion in patients with clinical Alzheimer’s disease(CAD).Methods:Twenty-four CAD patients and 19 cognitively normal(CN)age-matched controls were recruited.A retinal function imager(RFI,Optical Imaging Ltd.,Rehovot,Israel)was used to measure the retinal blood flow supplying the macular area of a diameter of 2.5 mm centered on the fovea.Blood flow volumes of arterioles(entering the macular region)and venules(exiting the macular region)of the supplied area were calculated.Macular blood flow was calculated as the average of arteriolar and venular flow volumes.Custom ultra-high-resolution optical coherence tomography(UHR–OCT)was used to calculate macular tissue volume.Automated segmentation software(Orion,Voxeleron LLC,Pleasanton,CA)was used to segment six intra-retinal layers in the 2.5 mm(diameter)area centered on the fovea.The inner retina(containing vessel network),including retinal nerve fiber layer(RNFL),ganglion cell-inner plexiform layer(GCIPL),inner nuclear layer(INL)and outer plexiform layer(OPL),was segmented and tissue volume was calculated.Perfusion was calculated as the flow divided by the tissue volume.Results:The tissue perfusion in CAD patients was 2.58±0.79 nl/s/mm^(3)(mean±standard deviation)and was significantly lower than in CN subjects(3.62±0.44 nl/s/mm^(3),P<0.01),reflecting a decrease of 29%.The flow volume was 2.82±0.92 nl/s in CAD patients,which was 31%lower than in CN subjects(4.09±0.46 nl/s,P<0.01).GCIPL tissue volume was 0.47±0.04 mm^(3) in CAD patients and 6%lower than CN subjects(0.50±0.05 mm^(3),P<0.05).No other significant alterations were found in the intra-retinal layers between CAD and CN participants.Conclusions:This study is the first to show decreased retinal tissue perfusion that may be indicative of diminished tissue metabolic activity in patients with clinical Alzheimer’s disease.