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Aims and Objectives: This study aimed to investigate the current status of the core competencies and self‐directed learning ability of diabetes specialist nurses and to explore the relationship between these core competencies and their self‐directed learning ability. Design: A cross‐sectional survey design was used. Methods: This cross‐sectional study was conducted via a web‐based questionnaire platform in China from January 14 to April 24, 2023. The survey included a general information questionnaire, a diabetes specialist nurses' core competencies self‐assessment scale, and a nursing staff's self‐directed learning ability evaluation scale. The data was collected online. Descriptive, correlation and multiple linear regression analyses were conducted using SPSS 26.0 software. Results: 118 diabetes specialist nurses from 11 cities participated in this study. A positive correlation was observed between the core competencies of diabetes specialist nurses and their self‐directed learning ability. The characteristics affecting the core competencies of diabetes specialist nurses included age, participation in external learning and communication and self‐directed learning. Conclusions: The training of diabetes specialist nurses can focus on core competencies, and the ability to self‐direct learning can be used as an entry point to customize feasible theoretical and practical courses. The training system can further improve diabetes specialist nurses' core competencies and self‐directed learning abilities. Relevance to Clinical Practice: A reference can be established that nursing managers and nursing educators can use to develop training programs for specialist nurses by validating the link between their core competencies and self‐directed learning skills. Patient or Public Contribution: Participants were involved solely in the data collection process. No participant contributions were required for the study's design, outcome measurement or implementation. [ABSTRACT FROM AUTHOR]

Aim: To identify and appraise the quality of evidence of transitional care interventions on quality of life in lung cancer patients. Background: Quality of life is a strong predictor of survival. The transition from hospital to home is a high‐risk period for patients' readmission and death, which seriously affect their quality of life. Design: Systematic review and meta‐analysis. Methods: The PubMed, Embase, Cochrane Library, Web of Science and CINAHL databases were searched from inception to 22 October 2022. The primary outcome was quality of life. Statistical analysis was conducted using Review Manager 5.4, results were expressed as standard mean difference (SMD) with a 95% confidence interval (CI). The risk of bias of the included studies was assessed using the Cochrane risk of bias assessment tool. This study was complied with PRISMA guidelines and previously registered in PROSPERO (CRD42023429464). Results: Fourteen randomized controlled trials were included consisting of a total of 1700 participants, and 12 studies were included in the meta‐analysis. It was found that transitional care interventions significantly improved quality of life (SMD = 0.21, 95% CI: 0.02 to 0.40, p =.03) and helped reduce symptoms (SMD = −0.65, 95% CI: −1.13 to −0.18, p =.007) in lung cancer patients, but did not significantly reduce anxiety and depression, and the effect on self‐efficacy was unclear. Conclusions: This study shows that transitional care interventions can improve quality of life and reduce symptoms in patients, and that primarily educational interventions based on symptom management theory appeared to be more effective. But, there was no statistically significant effect on anxiety and depression. Relevance to Clinical Practice: This study provides references for the application of transitional care interventions in the field of lung cancer care, and encourages nurses and physicians to apply transitional care plans to facilitate patients' safe transition from hospital to home. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Tropical karst habitats are characterized by limited and patchy soil, large rocky outcrops and porous substrates, resulting in high habitat heterogeneity and soil moisture fluctuations. Xylem hydraulic efficiency and safety can determine the drought adaptation and spatial distribution of woody plants growing in karst environments. In this study, we measured sapwood-specific hydraulic conductivity (K s), vulnerability to embolism, wood density, saturated water content, and vessel and pit anatomical characteristics in the branch stems of 12 evergreen tree species in a tropical karst seasonal rainforest in southwestern China. We aimed to characterize the effects of structural characteristics on hydraulic efficiency and safety. Our results showed that there was no significant correlation between K s and hydraulic safety across the tropical karst woody species. K s was correlated with hydraulic vessel diameter (r  = 0.80, P  < 0.05) and vessel density (r  = −0.60, P  < 0.05), while the stem water potential at 50 and 88% loss of hydraulic conductivity (P 50 and P 88) were both significantly correlated with wood density (P  < 0.05) and saturated water content (P  = 0.052 and P  < 0.05, respectively). High stem water storage capacity was associated with low cavitation resistance possibly because of its buffering the moisture fluctuations in karst environments. However, both K s and P 50 /P 88 were decoupled from the anatomical traits of pit and pit membranes. This may explain the lack of tradeoff between hydraulic safety and efficiency in tropical karst evergreen tree species. Our results suggest that diverse hydraulic trait combination may facilitate species coexistence in karst environments with high spatial heterogeneity. [ABSTRACT FROM AUTHOR]

In clinical studies, it is often that the medical treatments take a period of time before having an effect on patients and the delayed time may vary from person to person. Even though there exists a rich literature developing methods to estimate the time-lag period and treatment effects after lag time, most of these existing studies assume a fixed lag time. In this paper, we propose a hazard model incorporating a random treatment time-lag effect to describe the heterogeneous treatment effect among subjects. The EM algorithm is used to obtain the maximum likelihood estimator. We give the asymptotic properties of the proposed estimator and evaluate its performance via simulation studies. An application of the proposed method to real data is provided. [ABSTRACT FROM AUTHOR]

Aim: To investigate the effectiveness of internet‐based self‐management interventions on pulmonary function in patients with chronic obstructive pulmonary disease (COPD). Design: Systematic review and meta‐analysis. Data Sources: Eight electronic databases including PubMed, Web of Science, Cochrane library, Embase, CINAHL, China National Knowledge Infrastructure, Wangfang and Weipu databases were systematically searched from inception of the database to January 10, 2022. Methods: Statistical analysis was performed using Review Manager 5.4 and results were reported as mean difference (MD) or standard mean difference (SMD) with 95% confidence intervals (CI). Outcomes were the forced expiratory volume in 1 second (FEV1), forced volume capacity (FVC) and percent of FEV1/FVC. The Cochrane Risk of Bias Tool was used to assess the risk of bias of included studies. The study protocol was not registered. Results: Eight randomized controlled trials (RCTs) including 476 participants met the inclusion criteria and were included in meta‐analysis. It was found that internet‐based self‐management interventions showed a significant improvement in FVC(L), while FEV1 (%), FEV1 (L), FEV1/FVC (%) and FVC (%) did not significantly improve. Conclusions: Internet‐based self‐management interventions were effective in improving pulmonary function in patients with COPD, caution should be exercised in interpreting the results. RCTs of higher quality are needed in the future to further demonstrate the effectiveness of the intervention. Relevance to Clinical Practice: It provides evidence for internet‐based self‐management interventions in improving pulmonary function in patients with COPD. Impact: The results suggested that internet‐based self‐management interventions could improve the pulmonary function in people with COPD. This study provides a promising alternative method for patients with COPD who have difficulty seeking face‐to‐face self‐management interventions, and the intervention can be applied in clinical settings. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]