STROBE Guidelines Research Articles

Genetic and clinical study of PARK7 in Japanese Parkinson's disease

BackgroundBiallelic variants in PARK7, which encodes protein-nucleic acid deglycase DJ-1, can cause early-onset Parkinson's disease (PD). Although many patients with PARK7 variants have been identified from European and Middle Eastern ethnic groups, there have been no reports in the Japanese population. ObjectivesTo determine the prevalence and clinical features of patients with PD harboring PARK7 variants in Japan. MethodsWe performed a molecular genetic analysis of PD patients with PARK7 variants identified using comprehensive panel sequencing, to explore the details of variants. Moreover, clinical neurological features were investigated, including neuroimaging analyses. This study followed STROBE guidelines. ResultsFour patients with biallelic rare variants of PARK7 were identified in the cohort. All four patients presented with levodopa-responsive parkinsonism, with an age at onset in the early 30s. Furthermore, two of the four patients had psychiatric complications. Dopamine transporter imaging revealed nigrostriatal pathway dysfunction. ConclusionsTo our knowledge, this is the first report of Japanese patients with PARK7 variants. We identified a relatively low frequency of PARK7 variants in patients in Japan. As opposed to typical patients with sporadic PD, the identified patients developed the disease in their 30s and presented with a variety of non-motor symptoms and complications. Further studies are needed to identify the clinical features related to PARK7 variants in Japanese patients with PD, and to analyze the pathophysiology of how the variants identified in the present study might affect DJ-1 function.

Bullying Victimization is Associated with Heightened Rates of Anxiety and Depression Among Autistic and ADHD Youth: National Survey of Children's Health 2016-2020.

Autistic youth and youth with ADHD have heightened rates of bullying victimization, anxiety, and depression. The purpose of this research is to use nationally representative US data to 1) estimate the prevalence of anxiety and depression among bullied neurodivergent youth and 2) investigate whether the association between bullying victimization and anxiety or depression is significantly greater among autistic youth and youth with ADHD. For this research, we used five years of data (2016-2020) from the nationally representative National Survey of Children's Health (NSCH), youth ages 12-17years (n = 71,973). Data were analyzed with R and the R survey package to estimate average marginal percentages, risk differences, and additive interactions as recommended by STROBE guidelines. The study identified heightened anxiety and depression among bullied autistic or ADHD youth. Results also showed that the increase in the rate of anxiety or depression associated with bullying victimization was significantly greater among autistic youth and youth with ADHD relative to non-autistic non-ADHD youth; interactions were significant among both male and female youth. Autistic youth, youth with ADHD, and youth with co-occurring autism and ADHD are particularly vulnerable to bullying victimization and associated depression and anxiety. Future research is needed to understand why the association between bullying victimization and depression/anxiety is significantly greater among autistic and non-autistic ADHD youth. Recommendations include exploring school-wide anti-stigma initiatives to stop the reciprocal bullying-anxiety/depression cycle, routine bullying and mental health screening of autistic and ADHD youth, and clinical management of bullied autistic and ADHD youth with anxiety or depression.

Measuring the relationship between reciprocity behaviour and technology readiness of nursing staff working in residential care and community nursing: A cross-sectional study.

The aim of this study is to measure how collaborative factors are associated with the technology readiness of nursing staff working in residential care and community nursing. The Reciprocity Instrument and Technology Readiness Index 2.0 were applied to measure this association. A cross-sectional survey was conducted between October 2020 and January 2021. The Technology Readiness Index 2.0 was translated into Dutch, administered together with the Reciprocity Instrument and linguistically validated. And 1660 Registered Nurses and Nursing Assistants received an invitation to the online survey. Descriptive statistics and regression analyses were used to analyse the data. A total of 475 nursing staff responded, a response rate of 28.6%. The following factors have a statistically significant association with technology readiness: age, education level, years of working experience, type of organization, reciprocity behaviour and conditions of reciprocity behaviour: digital communication usage to reach one another, multilayeredness and future perspective. This study shows that reciprocity behaviour is positively associated with technology readiness. The influencing factor reciprocity remains intact after the correction of the other factors that were measured. This confirms the relevance of collaborative factors that influence the technology adoption process of nursing staff working in residential care and community nursing. This study offers insights into how collaboration based on reciprocity behaviour positively impacts the technology readiness of nursing staff engaged in residential care and community nursing and could be used in the education of nursing staff and healthcare teams. Being aware of the impact that collaborative factors have on the adoption process of ICT among nursing staff could be used to support the desired preparatory activities as part of ICT implementation for healthcare managers, innovators, and nursing work groups charged with implementing technology in the healthcare process. The study has adhered to STROBE guidelines. No Patient or Public Contribution.

The moderating role of ethical awareness in the relationship between nurses’ artificial intelligence perceptions, attitudes, and innovative work behavior: a cross-sectional study

BackgroundArtificial intelligence is rapidly advancing and being integrated into healthcare, potentially revolutionizing patient care and improving outcomes by leveraging large datasets and complex algorithms.AimInvestigate the moderating role of ethical awareness between nurses’ artificial intelligence perceptions, attitudes, and innovative work behaviors.Design and MethodsA cross-sectional descriptive correlational design adhering to STROBE guidelines. A non-probability convenience sample of 415 Alexandria Main University Hospital nurses was analyzed. Statistical methods included one-way ANOVA, the student t-test, and the Pearson coefficient, with results evaluated for significance at the 5% level and internal consistency assessed via Cronbach’s α. Linear regression assessed the predicting and moderating effect between ethical awareness, nurses’ artificial intelligence perceptions, attitudes, and innovative work behavior. The perceptions of using the Artificial Intelligence Scale, general attitudes towards the Artificial Intelligence Scale, ethical awareness of Using Artificial Intelligence, and the Employee Innovative Behavior Scale were used to respond to the research aim.ResultsThe study revealed that perception of AI use among nurses has a mean score of 50.25 (SD = 3.49), attitudes towards AI have a mean score of 71.40 (SD = 4.98), ethical awareness regarding AI use shows a mean score of 43.85 (SD = 3.39), and nurses innovative behavior exhibits a mean score of 83.63 (SD = 5.22). Attitude and ethical awareness were statistically significant predictors of innovation. Specifically, for every one-unit increase in attitude, innovative work behaviors increase by 1.796 units (p = 0.001), and for every one-unit increase in ethical awareness, innovative work behaviors increase by 2.567 units (p = 0.013). The interaction effects between perception, ethical awareness, attitude, and ethical awareness were also examined. Only the interaction between attitude and ethical awareness was found to be significant (p = 0.002), suggesting that the effect of attitude on innovative work behaviors depends on the level of ethical awareness. In other words, ethical awareness moderates the relationship between attitudes and innovative work behaviors rather than perception and innovation.ConclusionThere is a statistically significant correlation between attitude, ethical awareness, and creativity, highlighting that ethical awareness moderates the relationship between attitudes and innovative work behaviors. These findings emphasize the importance of ethical awareness in fostering positive attitudes towards AI and enhancing innovative practices in nursing, ultimately contributing to nurses’ well-being.

Nurse judgements of hospitalized patients' safety concerns are affected by patient, nurse and event characteristics: A factorial survey experiment.

To test the influences of patient, safety event and nurse characteristics on nurse judgements of credibility, importance and intent to report patients' safety concerns. Factorial survey experiment. A total of 240 nurses were recruited and completed an online survey including demographic information and responses to eight factorial vignettes consisting of unique combinations of eight patient and event factors. Hierarchical multivariate analysis was used to test influences of vignette factors and nurse characteristics on nurse judgements. The intraclass coefficients for nurse judgements suggest that the variation among nurses exceeded the influence of contextual vignette factors. Several significant sources of nurse variation were identified, including race/ethnicity, suggesting a complex relationship between nurses' characteristics and their potential biases, and the influence of personal and patient factors on nurses' judgements, including the decision to report safety concerns. Nurses are key players in the system to manage patient safety concerns. Variation among nurses and how they respond to scenarios of patient safety concerns highlight the need for nurse-level intervention. Complex factors influence nurses' judgement, interpretation and reporting of patients' safety concerns. Understanding nurse judgement regarding patient-expressed safety concerns is critical for designing processes and systems that promote reporting. Multiple event and patient characteristics (type of event and apparent harm, and patient gender, race/ethnicity, socioeconomic status, and communication approach) as well as participant characteristics (race/ethnicity, gender, years of experience and primary hospital area) impacted participants' judgements of credibility, degree of concern and intent to report. These findings will help guide patient safety nurse education and training. STROBE guidelines. Members of the public, including patient advocates, were involved in content validation of the vignette scenarios, norming photographs used in the factorial survey and testing the survey functionality.

Nurses' attitudes towards telehealth: The development and validation of the nurses' attitudes towards the use of telehealth scale.

To develop the nurses' attitudes towards use of a telehealth scale (NATUTS) and evaluate its psychometric properties. This methodological study involved two stages: the development of the NATUTS and the testing of the psychometric properties of NATUTS. We followed STROBE guidelines when reporting the study (File S1). Items for NATUTS were created using evidence from the literature and presented to eight experts. The scale was tested in a methodological study conducted through a face-to-face survey with nurses working in outpatient and inpatient units of a tertiary hospital in Türkiye. Psychometric properties of the scale, such as structural validity, content validity and internal consistency reliability, were tested. The sample, consisting of 630 nurses, was divided into two separate random groups. Exploratory factor analysis was conducted with the data of the first 330 people, and confirmatory factor analysis was conducted with the data of the remaining 300 people. A 19-item, three-factor structure (Satisfaction, Rejection, Development) was obtained in the newly developed scale. In NATUTS, Factor 1 (α = .93), Factor 2 (α = .86) and Factor 3 (α = .87) measured 64.4% of the total variance. The entire 19-item acceptability survey showed good internal consistency. NATUTS is a brief survey based on research evidence validated in a large Turkish sample. Findings show that NATUTS has acceptable content and structural validity and is reliable in measuring nurses' attitudes towards the use of telehealth. Further research can be conducted to develop the scale and strengthen its validity. No Patient or Public Contribution.

Association between patients with migraine and sarcopenia: A retrospective study.

Recently, interest in sarcopenia has been increasing in patients with various neurological diseases. Thus, we investigated the presence of sarcopenia in patients with episodic migraine (EM) based on temporal muscle thickness (TMT). This was a retrospectively observational study following STROBE guidelines. We enrolled patients with EM and healthy controls. Both groups underwent brain magnetic resonance imaging, including three-dimensional T1-weighted imaging. We calculated the TMT using T1-weighted imaging, which is a marker for sarcopenia. We compared TMT between patients with EM and healthy controls, and analyzed it according to presence of migraine aura. We retrospectively enrolled 82 patients with EM and 53 healthy controls. TMT was not different between patients with EM and healthy controls (10.804 ± 2.045 mm in patients with EM vs 10.721 ± 1.547 mm in healthy controls, P = .801). Furthermore, TMT was not different according to presence of migraine aura in patients with EM (10.994 ± 2.016 mm in patients with migraine aura vs 10.716 ± 2.071 mm in those without, P = .569). There were no correlations between TMT and clinical characteristics in patients with EM, including age, age of onset, duration of migraine, headache intensity, and headache frequency. This study found no statistical difference in TMT between patients with EM and healthy controls or between patients with EM with and without aura. These findings suggest that there is no evidence of sarcopenia in patients with EM.

Use of a risk-based intervention bundle to prescribe and implement interventions to prevent pressure injury: An observational study.

To explore the relationship between the prescription and implementation of pressure injury preventative interventions following risk assessment combined with a risk-stratified intervention bundle. Single-centre, cross-sectional, observational, prospective. The charts and bedsides of 341 adult inpatients were examined. Data collection included pressure injury risk level, prescribed preventative interventions and evidence of intervention implementation. Most patients (68.6%) were at risk of pressure injury, and most interventions were prescribed according to their risk level. However, evidence from direct observation and/or documentation indicated intervention implementation rates were relatively poor. Of nine interventions mandated for all patients, compliance with three patient-/carer-focused interventions was particularly poor, with evidence indicating they had been implemented for 3%-10% of patients. Also, nutritional screening-related interventions were implemented poorly. Clinically indicated implementation of heel-elevation devices and bariatric equipment was low for at-risk patients, and the implementation of interventions for patients with existing pressure injuries was suboptimal. Significant proportions of several interventions that were observed as having been implemented were not documented as such. While most interventions were prescribed according to patient risk level, the overall implementation of interventions was poor. However, the results may in part be due to failure to document interventions as opposed to omitting them. Documentation of interventions is crucial as it provides evidence of the care provided. An increased focus on documentation of pressure injury preventative interventions is required, with a clear distinction between prescription and implementation. The results highlighted several deficiencies in care, particularly relating to evidence of implementation, patient involvement and nutritional screening. The results from this study will be used to inform and improve future pressure injury prevention practice within the study hospital and should be used to inform and benchmark pressure injury preventative practices in other hospitals. The study adheres to STROBE guidelines. None.

Generic and disease-specific caregiver contribution to self-care in a population with multiple chronic conditions: A comparative study.

Describe and compare generic and disease-specific caregiver contribution (CC) to self-care behaviours in the dimensions of self-care maintenance, self-care monitoring and self-care management in multiple chronic conditions (MCCs). Multicentre cross-sectional study. We enrolled caregivers of patients with MCC, from April 2017 to November 2022, if they were (a) 18 years of age or older and (b) identified by the patient as the principal unpaid informal caregiver. The Caregiver Contribution to Self-Care of Chronic Illness Inventory, Caregiver Contribution to Self-Care of Heart Failure Index, Caregiver Contribution to Self-Care of COPD Inventory and Caregiver Contribution to Self-care of Diabetes Inventory were used to measure generic and disease-specific contribution to patient self-care. Descriptive statistics, Student's t-tests and Pearson's correlation coefficients were used. We found adequate generic CC for self-care monitoring but inadequate CC in self-care maintenance and management. All CC to disease-specific self-care maintenance, monitoring and management scales' scores were inadequate, except for caregivers of diabetic patients in which we observed an adequate score in the CC to self-care maintenance and self-care management scales in those practice insulin therapy. Caregivers experience difficulties in performing behaviours of contribution to their patients affected by chronic conditions. Caregivers of patients with MCCs contribute more to self-care in aspects related to provider prescriptions and less to lifestyle changes. Healthcare professionals have to know in which behaviours caregivers show gaps and reflect on the reasons for poor CC to self-care to develop interventions to enhance these behaviours. This study underlines the importance of choosing the most appropriate instrument for measuring CC to self-care, considering the caregiver's characteristics. We adhered to STROBE guidelines. Caregivers of patients affected by MCCs were enrolled.

The relationship between general self-efficacy and nursing practice competence for second-year nurses: Empirical quantitative research.

To examine the relationship between general self-efficacy and nursing practice competence for nurses in the second year of employment. A cross-sectional design was used. The study included 596 nurses in their second year of employment at 75 medical facilities across Japan and used an online questionnaire survey for data collection. The covariance structure analysis showed the path from general self-efficacy (latent variable) to nursing practice competence. Positive correlations were found between all factors on both scales. Multiple regression analysis results showed that the general self-efficacy factors of 'positivity in behavior' and 'confidence in social competence' affect nursing practice competence. This study emphasizes the importance of enhancing the general self-efficacy of second-year nurses to improve their nursing practice competence. To achieve this, it suggests developing strategies from the perspective of the factors that comprise general self-efficacy. The findings suggest that improving general self-efficacy can enhance nursing practice competence, which could inform the development of interventions to support nurses in improving their competence. The study provides basic data for improving nurses' practice competence. This study is the first to establish a relationship between general self-efficacy and nursing practice competence among second-year nurses. It demonstrates the significance of general self-efficacy in enhancing nursing practice competence, particularly for second-year nurses worldwide who may be struggling with their nursing practice competence and considering leaving the profession. The findings offer practical implications for stakeholders involved in nursing education and training programs, with potential applications in professional development. This manuscript adheres to the STROBE guidelines for the reporting of cross-sectional studies. There was no patient or public contribution.

Challenges in Diagnosis of Non-A Non-B Acute Aortic Dissection

ObjectiveNon-A non-B (NANB) aortic dissections are uncommon and frequently unrecognized diseases.However, their proper identification is crucial given the unpredictable behaviour of the dissected aorta with potential mortality and increased morbidity. We investigate the accuracy of radiological computed angio-tomography (CTA) reports in the diagnosis of acute NANB and the risk related to delayed recognition or misdiagnosis. MethodsThe pre-treatment contrast CTA of all consecutive patients admitted with acute aortic dissection (AAD) in a University Hospital in London (UK) between January 2017 and May 2023 were reviewed to retrospectively verify the accuracy of CTA reports in the diagnosis of NANB AAD (B1-2D The risk related to the delayed diagnosis (morbidity, mortality, and hospital re-admissions) were evaluated as secondary outcomes. The study was conducted according to the STROBE guidelines. ResultsOverall, 588 aortic CTAs were reviewed for a total of n=393 (66.8%) type A AADs, n=171 (29%) type B AADs and n=25(4.3%) NANB AADs (n=16, 64% men, mean age 60.56, DS+/- 14.6 years). While no case of misdiagnosis was identified in Type A or B AAD groups, in NANBs only about a third of cases (n=9, 36%) were immediately indicated as “NANB” (n=2, 8%) or “B with retrograde extension into the arch” (n=7, 28%), n=8 cases (32%) were described generically as “arch dissections” (n=6, 24%) or “type A and B” AAD (n=2, 8%). The remaining 32% of patients received a diagnosis that did not include mention of the arch, as n=6(24%) cases were reported to be “type A” and n=2(8%) to be “type B” AADs. Despite the heterogeneity of terms used to describe NANB AAD, no case of cardiac tamponade, new onset malperfusion nor neurological complications were reported, and no sudden death nor home-discharge and readmission while waiting for the proper diagnosis. ConclusionThe heterogeneity of terms used to describe NANB aortic dissection highlights the need for increased awareness, adoption of in guideline based classification systems, and further education to better understand and correctly address this challenging entity, minimizing misdiagnosis in ambiguous or difficult cases.

Clinical Assessment of Subjective Visual and Haptic Vertical Norms in Healthy Adults.

Accurate verticality perception is essential for daily life activities, such as correctly estimating object orientation in space. This study established normative data for the subjective visual vertical (SVV) and subjective haptic vertical (SHV) using the portable and self-constructable modified Bucket test and Rotating-Column test. Additionally, the contribution of age, sex, and starting position of the line/ column on SVV and SHV accuracy were evaluated. This study, part of the PRECISE project (ClinicalTrials.gov ID NCT05978596), was conducted following the STROBE guidelines. Healthy adults without visual/neurological/vestibular disorders were recruited. Subjective visual vertical and SHV accuracy were described in terms of constant errors (i.e., mean deviation from 0° [true vertical] respecting its direction), unsigned errors (i.e., mean deviation from 0° irrespective of direction), and variability (i.e., intra-individual standard deviation). Sixty participants were evaluated (mean age: 41.14 [SD = 16.74] years). Subjective visual vertical constant errors between -2.82° and 2.90°, unsigned errors up to 2.15°, and variability up to 1.61° are considered normal. Subjective haptic vertical constant errors ranged from -6.94° to 8.18°, unsigned errors up to 6.66° and variability up to 4.25°. Higher ages led to higher SVV unsigned errors and variability. SHV variability was higher in females compared to males. Certain starting positions led to higher SVV and SHV constants and SVV unsigned errors. Normative data are provided for affordable, self-constructable, and portable SVV and SHV tools. These norms are consistent with more sophisticated equipment and can be used to distinguish between normal and abnormal values.

Women's experience of adopting lateral positions during the second stage of labour compared with conventional lithotomy positions: A cross-sectional study

AimsMaternal positions during childbirth play an important role in safe vaginal births and might also influence women's childbirth experiences greatly. Lateral positions, as a potential position to reduce negative maternal and neonatal outcomes, have become popular in recent years, especially in China where the adoption of conventional lithotomy positions is still common. However, the childbirth experience of those who gave birth in lateral positions has been rarely studied. This study aimed to describe and compare women's childbirth experiences of adopting the newly introduced lateral positions and the conventional lithotomy positions during the second stage of labour. Study designA cross-sectional study was conducted in two tertiary hospitals in China involving a total of 658 primiparous and parous women who adopted lateral and lithotomy positions during the second stage of labour from July to November 2020. Sociodemographic characteristics, maternal and neonatal outcomes as well as childbirth experience assessed by the Childbirth Experience Questionnaire (CEQ) were collected. This study followed the STROBE guidelines. ResultsWomen who once adopted lateral positions during the second stage of labour had better positive childbirth experiences compared with those in the lithotomy positions group, as demonstrated by their overall higher CEQ scores. Women in the lateral position group also reported better participation and perceived safety, and a greater sense of control during childbirth. Lateral positions remained an influential factor in CEQ scores after controlling for potential confounders. In this study, adverse maternal and neonatal outcomes were rare. Women in lateral positions had comparatively better perineal outcomes. ConclusionThis study described and compared women's childbirth experiences of adopting conventional lithotomy positions and lateral positions during the second stage of labour using a valid instrument. Women who adopted lateral positions during the second stage of labour reported better childbirth experiences than those giving birth in the conventional lithotomy positions. Thus, assisting women in giving birth in lateral positions might be a promising way to improve women's childbirth experience.

The dual protective role of accountability: Mitigating missed nursing care and nurse moral distress in a nested diary study design.

To examine a novel moderated-mediation model, investigating whether personal accountability moderates the link between nurse workload and missed nursing care and whether missed nursing care mediates the association between workload and moral distress. Nested diary study. Data spanning from February 2019 to February 2023 were collected from 137 nurses working in various inpatient wards in two medium-sized hospitals. Nurses reported care given to specific patients on three to five occasions across different shifts, establishing nurse-patient dyads. Validated measures of missed nursing care, personal accountability, moral distress and workload were analyzed using mixed linear models to test the nested moderated-mediation model. Under high workload conditions, nurses with higher personal accountability reported lower frequencies of missed nursing care compared to those with lower personal accountability. In contrast, under low workload conditions, personal accountability did not significantly influence missed nursing care occurrences. Furthermore, the interaction between workload and personal accountability indirectly affected nurses' moral distress through missed nursing care. Specifically, higher personal accountability combined with lower missed nursing care contributed to reduced levels of moral distress among nurses. The study highlights accountability's dual role-safeguarding against care omissions and influencing nurses' moral distress amid rising workload pressures. Cultivating a culture of accountability within healthcare settings can serve as a protective factor against the negative effects of workload on patient care quality and nurse psychological distress, highlighting the need for organizational interventions to promote accountability among nursing staff. By recognizing accountability's pivotal role, organizations can implement targeted interventions fostering accountability among nurses, including training programs focused on enhancing responsibility/ownership in care delivery and creating supportive environments prioritizing accountability to achieve positive patient outcomes. The study has adhered to STROBE guidelines. No patient or public contribution.

The mediating effect of job embeddedness on the nursing work environment and transition shock among new nurses: A cross-sectional study

AimsThis study aims to investigate the status of transition shock and test the mediating effect of job embeddedness on the nursing work environment and transition shock among new nurses. BackgroundTransition shock, primarily experienced during the first two years of employment, manifests itself as an unsettling or discordant experience among new nurses, which is caused by the gap between theoretical learning and clinical practice. DesignThis is a cross-sectional survey study, following the STROBE guidelines. MethodsA cross-sectional study was conducted among 435 new nurses from November to December 2022 in Hunan Province, China. The participants were recruited to complete a sociodemographic information questionnaire and rank 3 standardized scales of transition shock (Cronbach's alpha = 0.918), job embeddedness (Cronbach's alpha = 0.890) and nursing work environment (Cronbach's alpha = 0.946). Then, the data were analysed by SPSS 26.0 and mediation testing was performed using Hayes’ PROCESS macro (Model 4). A p value of < 0.05 was deemed statistically significant. ResultsThe mean score with standard deviation of the transition shock scale in new nurses was 88.86 (22.50). The place of origin, working months and weekly working hours were the significant sociodemographic factors that affected the transition shock score in new nurses. Transition shock was found to be negatively related to both job embeddedness (r = −0.468, p < 0.001) and nursing work environment (r = −0.416, p < 0.001), while job embeddedness mediated the relationship between transition shock and nursing work environment (R2 = 0.262, F = 30.455, p < 0.001). ConclusionsNew nurses from rural areas and with longer weekly working hours are more prone to transition shock. Those with 6–12 months of employment experience more pronounced transition shock than those with less than 6 months. In addition, the nursing work environment can not only directly influence transition shock for new nurses but also indirectly influence it through job embeddedness. These findings provide a basis for hospitals to develop strategies to effectively address transition shock in new nurses and ultimately solve the nursing shortage issue.

Psychological distress symptoms in nurses and their intention to leave: A cross-sectional secondary data analysis.

This study aimed to examine the psychological symptoms of distress among nurses in relation to their intention to leave. This study was a secondary data analysis of a cross-sectional survey collected between November 2020 and March 2021. Chi-square was used to examine the associations between the demographic characteristics and intention to leave and psychological distress symptoms-feeling depressed, anxious and worried. Multiple linear regression analyses were performed to examine if work settings, position (staff, charge, administrators, educators/researchers and advanced practice registered nurses) and years of experience were associated with psychological distress and intention to leave. A mediation analysis examined if psychological distress mediated the relationship between years of experience and intention to leave. Overall, psychological distress was significantly positively associated with intention to leave and negatively associated with years of experience. Nurses with less than 2 years of experience had increased psychological distress, while nurses with >25 years of experience had decreased psychological distress. Both groups of nurses had increased intention to leave compared to those with 16-25 years of experience. Psychological distress partially mediated intention to leave in nurses with less than 2 years of experience and more so among nurses with >25 years of experience. This study suggests that nurses encounter psychological distress symptoms, such as feeling anxious, depressed and worried, that contribute to an increased intention to leave. Among the workplace locations, nurses practicing in nursing homes had the highest intention to leave. The study emphasizes that organizations need to focus on mitigating distress across all levels of nurses to promote retention efforts and intention to stay. The authors adhered to the STROBE guidelines. No patient contribution. Completion of the survey in the original study (NWWS) implied consent from the participating nurses.

Association between visceral adiposity index and infertility in reproductive-aged women in the United States

Over the years, obesity has become more commonplace and has had a substantial impact on several medical specialties, including reproductive medicine. The potential correlation between the visceral adiposity index (VAI) and infertility has yet to be determined. Women between the ages of 18 and 45 were included in this cross-sectional study, which was conducted as part of the National Health and Nutrition Examination Survey (NHANES) between 2015 and 2020. Three tertiles were used to group VAI levels. Subgroup analysis and weighted binary logistic regression were employed to investigate the independent relationship between VAI and infertility. Smooth curve fitting was used to explore nonlinear relationships. This cross-sectional study followed the criteria of the STROBE guidelines. Of the 1231 participants, 127 were infertile women aged 18–45 years. A higher VAI was associated with a higher prevalence of infertility (OR = 1.22, 95% CI:1.03–1.45), which remained consistent across all subgroups (p > 0.05 for all interactions). We demonstrated a positive nonlinear association between VAI and infertility using a smooth curve fit. A higher visceral adiposity index level is positively correlated with a higher incidence of infertility among women in the United States. Women who are infertile can be identified using the visceral obesity index, and controlling visceral obesity may help lower the chances of becoming infertile.

Symptom clusters and their impacts on the quality of life of patients with lung cancer receiving immunotherapy: A cross-sectional study.

The objective of this study was to identify symptom clusters in lung cancer patients receiving immunotherapy and explore their impact on the quality of life of patients. Immunotherapy is widely used in lung cancer; however, there is little understanding of symptom clusters and their impacts on the quality of life of this population. Cross-sectional study. The survey contained the Memorial Symptom Assessment Scale (MSAS), Quality of Life Questionnaire-Lung Cancer 43 and a self-designed General Information Evaluation Form. Symptom clusters were identified using exploratory factor analysis (EFA) based on the symptom scores. Spearman correlation analysis was performed to evaluate the associations between each symptom cluster and the patients' quality of life. Multiple linear regression analysis was employed to examine the impact of the symptom clusters on quality of life. This study adhered to the STROBE guidelines. In total, 240 participants completed the survey. Five symptom clusters were identified and named according to their characteristics: emotional-related symptom cluster, lung cancer-related symptom cluster, physical symptom cluster, skin symptom cluster and neural symptom cluster. All symptom clusters, except for the neural symptom cluster, had a significantly detrimental impact on patient quality of life. Lung cancer patients undergoing immunotherapy experience a range of symptoms, which can be categorized into five clusters. These symptom clusters have a negative impact on patients' quality of life. Future research should focus on developing interventions for each symptom cluster and their influencing factors. In the data collection phase, lung cancer patients undergoing immunotherapy were recruited to participate in the survey.

Comparison of Magnetic Resonance Imaging with Electrodiagnosis in the Evaluation of Clinical Suspicion of Lumbosacral Radiculopathy.

(1) Background: The diagnosis of lumbosacral radiculopathy involves anamnesis, an assessment of sensitivity and strength, diagnostic imaging-usually magnetic resonance imaging (MRI)-and electrodiagnostic testing (EDX), typically electromyography (EMG), and electroneurography (ENG). MRI evaluates the structures supporting the spinal cord, while EDX evaluates root functionality. The present study aimed to analyze the concordance of MRI and EDX findings in patients with clinically suspected radiculopathy. Additionally, we investigated the comparison between these two reference tests and various clinical variables and questionnaires. (2) Methods: We designed a prospective epidemiological study of consecutive cases with an observational, descriptive, cross-sectional, and double-blind nature following the STROBE guidelines, encompassing 142 patients with clinical suspicion of lumbosacral radiculopathy. (3) Results: Of the sample, 58.5% tested positive for radiculopathy using EDX as the reference test, while 45.8% tested positive using MRI. The comparison between MRI and EDX in the diagnosis of radiculopathy in patients with clinical suspicion was not significant; the overall agreement was 40.8%. Only the years with symptoms were comparatively significant between the positive and negative radiculopathy groups as determined by EDX. (4) Conclusion: The comparison between lumbar radiculopathy diagnoses in patients with clinically suspected pathology using MRI and EDX as diagnostic modalities did not yield statistically significant findings. MRI and EDX are complementary tests assessing different aspects in patients with suspected radiculopathy; degeneration of the structures supporting the spinal cord does not necessarily imply root dysfunction.

Incidence and risk factors of post-operative delirium in glioma patients: A prospective cohort study in general wards.

Glioma patients are at high risk for postoperative delirium (POD), yet studies focusing on this population in general neurosurgical ward settings are limited. This paper investigates the incidence of POD and related risk factors in glioma patients hospitalized in general wards. Prospective observational study. This prospective study included 133 adult glioma patients hospitalized in the general neurosurgery ward. In addition to collecting routine perioperative general clinical data, patients' psychological status was assessed preoperatively using the Hospital Anxiety and Depression Scale (HADS). POD was assessed within 3 days postoperatively using the Confusion of Consciousness Assessment method, twice daily. The incidence of POD was calculated, and risk factors were identified using logistic regression analysis. The incidence of POD in glioma patients admitted to the general ward was 31.6% (40/133). Multivariate regression revealed advanced age (age > 50 years), frontal lobe tumour, presence of preoperative anxiety or depression, retention of a luminal drain, postoperative pain, indwelling catheter these six factors were independent risk factors for the development of delirium in patients after surgery. In general ward settings, supratentorial glioma patients exhibit a high risk of POD. Critical risk factors include preoperative psychological conditions, as well as postoperative pain, drainage and catheterization. Rigorous preoperative evaluations, effective pain management strategies and the integration of humanistic care principles are essential in mitigating the risk of POD for glioma patients. In general ward settings, this study reveals the high occurrence of POD in glioma patients and identifies preoperative psychological states, age, tumour location and several postoperative factors as significant risk factors for POD, which provides a framework for targeted interventions. By integrating these insights into clinical practice, healthcare teams can better identify glioma patients at risk for POD and implement preventive measures, thereby enhancing recovery and overall care quality for glioma patients in general neurosurgical wards. This study adheres to the STROBE guidelines, ensuring a transparent and comprehensive reporting of the observational research methodology and results. Patients involvement was limited to the provision of data through their participation in the study's assessments and the collection of clinical information. The study did not involve a direct patient or public contribution in the design, conduct, analysis, or interpretation of the data, nor in the preparation of the manuscript.