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Aims: To examine the mediating effects of self‐efficacy, coping, burnout, and social support in the link between job stress and depression and anxiety among young Chinese nurses. Design: A cross‐sectional survey was used. Methods: Full‐time young nurses (N = 1,029) who worked in nine tertiary grade A hospitals in Chengdu China were recruited from December 2016–March 2017. Structural equation modelling was applied to analyse the mediating effects. Results: Job stress had a direct positive effect on anxiety (β = 0.054) and it also exerted indirect positive effects on depression (β = 0.337) and anxiety (β = 0.325) through mediating factors. Emotional exhaustion and social support were the main mediating variables, accounting for 72.0% of the variation in anxiety and nearly 43.4% in depression. Conclusion: Emotional exhaustion and social support may have significant mediating effects in the link between job stress and depression and anxiety. Strategies including deceasing emotional exhaustion, enhancing social support in work environment, and reducing job stressors would be useful to prevent depression and anxiety among young nurses. Impact: What problems did the study address? Depression and anxiety have great impact on professional performance of nurses and even patient safety. Factors such as coping, burnout, etc., may have different mediating effects in the paths from job stress to depression and anxiety. What were the main findings? Job stress had direct and indirect positive effects on anxiety and it only had indirect positive effect on depression. Emotional exhaustion and social support were the main mediating variables in the link between job stress and depression and anxiety. Where and on whom will the research have impact? Nursing managers should be more cognizant of the impact of job stress on the development of depression and anxiety. The significant mediating effect of emotional exhaustion and social support in the link between job stress and depression and anxiety should be emphasized by nursing administrators and effective targeted measures need to be adopted. [ABSTRACT FROM AUTHOR]

[Display omitted] • Seasonal variation and uncertainties in parameterization of habitat suitability can lead to changes in habitat area and pattern of South China tiger. • Minor changes in landscape area or structure may result in disparate priority patches and corridor. • Assessment of priority sites based on dPC connector index was vulnerable to the changes in landscape area and pattern. Improving connectivity is the most commonly used approach employed in biodiversity conservation to mitigate habitat fragmentation. Graph-based networks relying on species-oriented definitions of nodes and edges are powerful tools for evaluating landscape connectivity. However, few studies have examined the effects of seasonal variation and uncertainty in parameterization of habitat suitability on the identification of priority sites. Here, a combination of the habitat suitability index, morphological spatial pattern analysis (MSPA), and graph-network analysis were combined to assess the influence of habitat variability on the identification of priority sites for reintroduction of South China tiger (Panthera tigris amoyensis). The combined approach was applied to the Hupingshan and Houhe National Nature Reserve and neighbourhood that are considered the most suitable places to harbour small populations of South China tigers. Six spatial or temporally static assessment scenarios for habitat suitability were used to account for uncertainties in the habitat requirement parameterizations of wild boars as the main prey for South China tigers. For each assessment scenario, three classification schemes (i.e., the P50, P70, and P90 schemes) were adopted to explain uncertainties in priority sites evaluation. In the static scenario, the minimum area of priority sites in the P50, P70, and P90 schemes was 321, 354, and 2,371 km2, respectively, while the areas encompassed by priority sites in the P50, P70, and P90 schemes considering the seasonal variability and habitat uncertainty were 0.2, 1.6, and 229.5 km2, respectively. These results suggest that priority areas with high conservation value differed among the six assessment scenarios. Conservation planning of landscapes consequently should consider the impacts of changes in landscape structures caused by seasonal variation and uncertainty in the parameterization of habitat suitability for the assessment of landscape priority sites rather than relying on purely spatial or temporally static connectivity analyses. [ABSTRACT FROM AUTHOR]

Objectives: To describe data from patients undergoing thyroid surgeries for malignant disease in a District General Hospital in Shanghai. Methods: Discharge data were collected from January 2010 to December 2014 with a searching strategy based on diagnosis of malignant thyroid disease and patients undergoing thyroid surgery . Results: During the study period, 3882 cases of thyroid cancer were performed with thyroidectomy, 10.25% of patients (398 cases) stayed less than 24 hours, 32.99% of patients (1281 cases) stayed less than48 hours, 56.75% stayed (2203 cases) more than 48 hours. Various factors that contribute to length of stay (LOS) of surgery were analysed, medical economic parameters (drug cost, medical disposable materials cost, and total cost) were also studied. Conclusion: This is the largest series reporting of short-stay hospitalisation outcomes of malignant thyroid surgery from China. The duration of hospitalization of the malignant thyroid surgery should be determined in accordance with chronic general and/ or comorbid conditions, Tumor size and sides, surgery procedure, and complication. Short-stay hospitalization model for malignant thyroid surgery is safe, cost-effective, and highly agreeable for patients in China. [ABSTRACT FROM AUTHOR]

Aim. To develop a set of infectious disease emergency response competencies specific to frontline nurses in China. Background. Nurses play an important role in the infectious disease emergency response. Competency-based training is the cornerstone of the professionalization of disaster rescue, including the infectious disease emergency response. Accordingly, reaching a consensus on a set of core competencies is essential. However, information regarding the competencies needed for nurses in the infectious disease emergency response is limited. Methods. A literature review and in-depth expert interviews were conducted to establish a draft of competencies, which consisted of 53 items, including 3 first-level index items, 12 second-level index items, and 38 third-level index items. Eighteen experts with the knowledge of infectious disease management and experience with infectious disease emergency rescue from different regions in China were recruited for Delphi consultation. A two-round Delphi survey was conducted via email. Consensus was defined as a mean importance value >4.5 and the coefficient of variation <0.25 among the experts. Finally, the analytic hierarchy process was used to determine the weight of each index on which consensus had been reached. Results. An index system of infectious disease emergency response competencies for nurses was constructed, including 3 first-level indices (knowledge, attitudes, and skills), 10 second-level indices, and 32 third-level indices. The response rates of the two rounds of the Delphi survey were both 100%, and the authority coefficient of the 18 experts was 0.903. The weighted value of each index was established with a consistency ratio <0.1, demonstrating that skill (0.5396) ranked first among the three first-level indices, followed by knowledge (0.2970) and attitudes (0.1634). Conclusion. The study developed a consensus on infectious disease emergency response competencies required for nurses in China, which provides guidance for the assessment and training of nurses on infectious disease emergency response. Implications for Nursing Management. According to the competency index system, nursing managers could develop effective training programs of infectious disease emergency response competency for nurses and select competent nurses for emergency response to infectious diseases. [ABSTRACT FROM AUTHOR]

Context In light of the call for humanistic caring in the contemporary health care system globally and in China, the issue of improving the caring skills that are essential to student success, high-quality nursing practice and positive patient outcomes is at the forefront of nursing education. Objectives The aim of this mixed-methods quantitative and qualitative study was to investigate baccalaureate nursing students' caring ability in the context of China and to explore the role of clinical practice learning in the development of students' caring skills. Methods A two-phase, descriptive study utilising a mixed methodology consisting of a caring ability survey and focus group interviews was conducted. In the quantitative phase, 598 baccalaureate nursing students at two colleges in Yunnan Province in southwest China were surveyed using the Caring Ability Inventory ( CAI). In the qualitative phase, 16 of the students who had participated in the quantitative phase were interviewed. Results Students obtained lower scores on the CAI than have been reported elsewhere by other researchers. In addition, students in the clinical stage of training scored lower than students in the pre-clinical stage. Three themes concerning facilitation by and three themes concerning the obstructive effects of clinical practice learning in the development of caring ability were identified. Themes pertaining to facilitation were: (i) promoting a sense of professional responsibility and ethics; (ii) providing an arena in which to practise caring, and (iii) learning from positive role models. Themes pertaining to obstruction were: (i) a critical practice learning environment; (ii) encountering inappropriate clinical teachers, and (iii) experiencing shock at the contrast between an idealised and the real environment. Conclusions The key to developing students' ability to care lies in highlighting caring across the entire health care system. By diminishing exposure to negative role models, and adopting appropriate pedagogical ideas about education in caring, such as truth telling and helping students to think in a critical manner, educators can help students to improve their caring ability. [ABSTRACT FROM AUTHOR]

Objective. To investigate the clinical characteristics, surgical experience, and surgical outcomes of external auditory canal cholesteatoma (EACC) surgery under endoscopic otolaryngoscopy. Methods. A retrospective analysis of 85 EACC cases admitted to the Department of Otolaryngology, Renji Hospital, Shanghai Jiaotong University School of Medicine, from January 2016 to February 2021 was performed, followed by retrospective analysis of clinical data to explore the feasibility and clinical characteristics of all-oral endoscopic EACC surgery. A total of 85 EACC patients (90 ears) with a mean age of 49.93 ± 14.87 years were included in the study. According to Udayabhanu staging, 43 ears (47.78%) were stage I, 40 ears (44.44%) were stage II, and 7 ears (7.78%) were stage III. All patients underwent transendoscopic surgery. Results. 79 ears (87.78%) underwent endoscopic EACC resection alone (+external auditory canal tumor resection/tympanostomy tube insertion), 9 ears (10%) underwent endoscopic EACC resection+tympanostomy+tympanoplasty, 1 ear (1.11%) underwent endoscopic EACC resection+tympanoplasty, and 2 ears (2.22%) underwent EACC resection+otolaryngotomy+tympanoplasty+auditory chain reconstruction endoscopically. Of these, 7 ears (7.78%) underwent auricular cartilage-chondroplasty and 2 ears (2.22%) underwent auricular cartilage membrane repair. All patients were reviewed at 1 week, 2 weeks, 1 month, 3 months, 6 months, and 1 year postoperatively. One patient with stage II external auditory atresia had a recurrence after 6 months and underwent endoscopic ear surgery (ESS) again. One patient with stage 2 atresia recurred after 1 year and again underwent endoscopic ear surgery. The rest of the patients recovered well after the surgery, and the grafts healed well. Conclusion. EACC surgery through the external ear canal under a dedicated endoscope is a safe, reliable, and effective method. Patients with stage I and II external auditory canal cholesteatoma surgery under endoscopy have a rapid postoperative recovery with significant hearing improvement, and stage IIIA patients can also achieve good results under strict evaluation of indications. [ABSTRACT FROM AUTHOR]

Aim. To evaluate the effect of community-nurse-led multidisciplinary team management on glycosylated hemoglobin (HbA1c), quality of life (QOL), hospitalization, and help-seeking behavior in people with type 2 diabetes mellitus (DM). Methods. A quasi-experimental trial was conducted among people with type 2 DM from two community centers in China. The intervention group (n = 88) received community-nurse-led multidisciplinary team management for 2 years, while the control group (n = 91) received usual care. Data regarding HbA1c, QOL (assessed by the SF-36), hospitalization, and help-seeking behavior were collected at baseline and at 6, 12, and 24 months. Results. During the 24-month project, the intervention group demonstrated 1.08% reduction in HbA1c, whereas the control group achieved an increase of 0.45%. The differences between the two groups were statistically significant (P < 0.001). The intervention group showed greater increased in QOL scores (from 66.43 to 70.47, P < 0.001), more decrease in hospitalization (OR = 2.981 , 95% CI: 1.016, 8.752 versus OR = 1.189 , 95% CI: 0.411, 3.444; P = 0.028) when compared with the control group. The percentage increase of seeking help from nurses in the intervention group (from 12.5% to 57.3%, P < 0.001) was significantly greater than that in the control group after the intervention. Conclusions. Nurse-led multidisciplinary team management is an effective intervention for improving glycemic control, QOL, hospitalization, and help-seeking behavior for people with DM in a community. [ABSTRACT FROM AUTHOR]

Aim: We aimed to identify the risk factors for delayed discharge in a day surgery centre in west China. Background: Delayed discharge affected by various factors is a key indicator for healthcare quality of day surgery. However, few studies have focused on this issue in developing countries where the day surgery started much later. Design A retrospective case–control design. Method: A random sample of 169 delayed discharge cases and 514 normal discharge cases was randomly selected from 38,021 day surgery cases from May 2011 to May 2019 in a tertiary teaching hospital in west China. Socio‐demographic and clinical characteristics of patients were collected through the hospital electronic database and a chart review. A multivariate logistic regression was conducted to identify the risk factors for delayed discharge. Results: The urban employee basic medical insurance, comorbidity, general anaesthesia, pain, fever, bleeding and metabolic disorder were identified as the risk factors for delayed discharge. Living in the city where the hospital located was a protective factor for delayed discharge. Conclusion: Post‐operative complications including fever, pain, bleeding and metabolic disorder were the most important risk factors for delayed discharge. The pre‐operative prevention, careful monitoring and rapid reactions to post‐operative complications may reduce delayed discharge. Summary statement: What is already known about this topic? Day surgery is conducted worldwide due to its time‐saving, cost‐effectiveness and low risk for post‐operative infection.Delayed discharge is considered as one of the most important indicators for healthcare quality of a day surgery centre.Most of the identified risk factors for delayed discharge are from the developed countries' experience of day surgery and remain controversial. What this paper adds? The insurance reimbursement rate influenced patients' willingness for discharge.Living in the same city where the hospital is located was a protective factor for delayed discharge.Post‐operative metabolic disorder was a risk factor for delayed discharge. The implications of this paper: Reducing the insurance reimbursement rate of patients who meet discharge criteria but ask for longer hospital stays may be helpful to reduce delayed discharge.Careful monitoring and rapid response to post‐operative complications may be simple but useful measures to reduce the risk of delayed discharge. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the difference in serum uric acid(SUA)levels between subtypes of depression and normal population, and whether SUA can be used to identify bipolar disorder depressive episode and major depressive disorder and predict the length of hospital stay. Methods: 1543 depression patients and 1515 healthy controls were obtained according to the entry and exclusion criteria from one mental health center of a tertiary hospital in southwestern China. The diagnosis and classification of depression was in accordance with ICD-10. The SUA value was derived from fasting plasma samples analysis. The level of SUA of all the participants was quantified using Roche cobas8000-c702-MSB automatic biochemical analyzer. Data were analyzed by SPSS18.0 statistical software package. Results: Overall, the level of SUA in patients with depression was lower than that in normal control. Specifically, males' SUA levels were in the interval of [240, 323.3) and [323.3, 406.6), and women were in the [160, 233.3] levels. The SUA level of bipolar disorder depressive episode was higher compared to major depressive disorder level. Interestingly, male patients who were hospitalized for two weeks had higher SUA than those who were hospitalized for three weeks or four weeks. Conclusions: Our results suggest that the length of hospital stay may be associated with SUA, and when it is difficult to make a differential diagnosis of bipolar disorder depressive episode and major depressive disorder, the level of SUA may be considered. The adjustment of SUA as a method for treating depression needs to be carefully assessed. [ABSTRACT FROM AUTHOR]

Aims: To collect information about the current status of community nurses in China and explore the roles and activities that they perform in their daily community setting. Background: Community health services are central to efforts to improve public health in China. Clarifying who performs which community nursing services can help assess the contributions of community nursing and guide future practices. However, specific information is limited in China. Methods: A descriptive, cross‐sectional survey was conducted from March to November 2014. Information was collected on demographics, work roles, and activities of community nurses. Results: Most community nurses in our survey were young with a low educational level. Their daily routine most frequently involved immunization and basic medical services, while their main roles were caregiver, educator, organiser and manager. Conclusion: Although community nurses cover nearly all areas of service that the national government requires, some roles and their associated activities are neglected. The quantity and quality of community nurses may be hindering their ability to fulfill all roles and activities envisioned by the national government. Implications for Nursing Management: Further training should be provided to increase the ability of community nurses to perform frequent functions as well as activities that are currently neglected. [ABSTRACT FROM AUTHOR]

The article presents a study that examined the associations of gene polymorphisms and gene-environment interactions with the risk of developing posttraumatic distress disorder (PTSD) among adolescent earthquake survivors in China. Topics include study measures such as a questionnaire about demographic characteristics and earthquake exposure, the PTSD Checklist-Civilian Version and the Structured Clinical Interview for "Diagnostic and Statistical Manual of Mental Disorders, fourth edition."

Dengue is one of the most important pervasive diseases in many regions of the world, including China. There is an urgent need for new repellents, including plant derivatives, due to the resistance, toxicity, and non-degradability of synthetic insecticides. Traditional plant-based remedies may provide potential avenues for developing new strategies. The aims of this study were to 1) document the traditional mosquitoes repellent plants used by the Dai people of Xishuangbanna, China; 2) screen out new efficient mosquito repellent plants as candidates for further study. During the period August 2016 to July 2017, five field surveys were conducted in 16 villages of Xishuangbanna. A total of 81 informants (44 males and 37 females) were interviewed using semi-structured questions to collect detailed information on the plants they use to prevent mosquito bites. Ten plants with higher popularity and larger resource were collected and extracts were prepared by hydro-distillation or with petroleum ether. Extracts were tested for adult Aedes albopictus repellency using a human-bait cage. Firstly, repellency was determined as the Minimum Effective Dosage (MED) per minute at which 1% of the mosquito bite through the treated cloth. Secondly, five plant extracts with lower MEDs were tested the repellent longevity of different concentrations. Eighteen plants were documented as being used in traditional remedies against mosquitoes. The methods for controlling mosquitoes were diverse: direct burning was used for most plants (16 species), followed by smearing (5 species), and placing (5 species). Laboratory analyses confirmed that ten plants did exhibit mosquito repellent activity. Of them, Artemisia indica, Nicotiana tabacum , Blumea balsamifera , Vitex trifolia , and Chromolaena odorata showed good mosquito repellency with MEDs of 0.015, 0.061, 0.090, 0.090, and 0.105 mg/cm2, respectively. The protection rate provided by A. indica is also the highest among five plants. Although it provides complete protection time of only 30 min at 0.45 mg/cm2 concentration, its repellency within 2 h is not significantly different from that of DEET. Dai villagers in Xishuangbanna have a rich, diverse and scientific knowledge of plant-based mosquito repellents. Laboratory experiments screened out several plants as candidates for mosquito repellents, of which Artemisia indica was the most promising candidate plant. Image 1 [ABSTRACT FROM AUTHOR]

Aim: China is reforming its health care system, which aimed to strengthen primary health care through building community health centers (stations) and assigning a "gate‐keeper" role to primary care providers. Community nurses play a key role in the reform. Little is known about the level of job stress among community nurses. Thus, this study aims to explore the level of perceived job stress and its influencing factors among community nurses. Method: A cross‐sectional design was used to conduct a survey with 1015 nurses from 56 community health centers in Sichuan province. Job stress was measured by the Community Nurses Stress Scale. Data were collected between March and November 2015. Results: Community health nurses in China perceived high levels of job stress. The job stress was related to nurses' individual characteristics and work environments. Permanently employed nurses, shift workers, and those older than 45 years age and with less training related to community nursing and involvement in childcare were more likely to experience high levels of stress. Conclusion: Reform is required of the community nursing personnel system, and development of continuing education programs and stress‐alleviating measures to reduce community nurses' job stress. The results of this study favour future advanced practice community health nursing practice and education. SUMMARY STATEMENT: What is already known about this topic? Nursing is a highly stressful occupation and job stress among clinical nurses is well‐recognized.Nurses in different workplaces may perceive different job‐related stresses.There is limited evidence regarding community health nurses' job stress, especially from different geographical areas. What this paper adds? Community health nurses perceived high levels of job stress.The nursing profession and working duties were the major job stress of community health nurses.Type of employment, shift work, age, training related to community nursing, and involvement in childcare predicted community health nurses' job stress. Contrary to existing literature, type of employment was the strongest factor related to community health nurses' job stress. The implications of this paper: Occupational health education and training programmes may be necessary to improve the knowledge and ability of nurses to cope with work demands, and reduce job stress.Findings could inform policy and practice through the development of interventions aimed at creating better work environments and reforming the community health nursing personnel system, whereby nurses can successfully perform their jobs.Further research is needed to generate interventions for the management of occupational stress. [ABSTRACT FROM AUTHOR]