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Background Breast cancer has become the most prevalent cancer worldwide, which leads to both physical symptom burden and psychological distress among patients. Although available literature has demonstrated the effect of physical activity in improving psychological health among breast cancer survivors, the underlying psychosocial mechanism is relatively understudied. Objective To investigate the association of walking with positive and negative affect among breast cancer patients, and examine the potential mediating effects of different dimensions of posttraumatic growth between them. Methods From April to July, 2019, 256 breast cancer patients receiving community-based management were recruited using convenience sampling from Shanghai Pengpuxincun Community Health Center to attend a household survey. Two hundred and thirty-five of them who completed the survey were included as final participants (achieving a response rate of 91.8%) . Levels of walking were measured using International Physical Activity Questionnaire-Long Form (IPAQ-long) , posttraumatic growth was assessed using Posttraumatic Growth Inventory-Short Form (PTGI-SF) , emotional health was assessed using the 20-item Positive and Negative Affect Scale (PANAS) . Structural equation modeling was conducted to test the parallel mediating effects of different dimensions of posttraumatic growth between walking and positive and negative affect. Results The result of intermediary effect analysis show that, walking was associated with greater positive affect through facilitating the personal strength dimension of posttraumatic growth among breast cancer patients, with an indirect effect of 0.07〔95%CI (0.02, 0.13) 〕. Moreover, walking was associated with lower level of negative affect through facilitating the appreciation for life dimension of posttraumatic growth, with an effect size of -0.13〔95%CI (-0.21, -0.05) 〕. The result of the intermediary model show that, the level of walking activity promoted positive emotions (β=0.34, P

BackgroundThe general practice team leader is not only a community health practitioner, but also a manager, commander and coordinator of a general practice team. So choosing an eligible person for the post of general practice team leader is of primary importance.ObjectiveTo develop and verify a competency evaluation system for general practice team leaders, providing a reference for scientifically assessing the competencies of a general practice team leader, and for selecting an eligible person as a general practice team leader.MethodsBy use of literature review and semi-structured reviews, we collected data regarding competencies for an eligible general practice team leader, and used them to initially develop a competency evaluation system for general practice team leaders. Then from July to October 2020, we conducted a three-round Delphi survey with a purposive sample of 20 experts (in the field of general medicine, medical education, public health management, or administrative management) to improve the system, and assess the indicators of the system using the analytic hierarchy process, and test the logic consistency among indicators, then the final system was formed. To assess values of the three-level indicators in the system, from November 1 to 30, 2020, we carried out a survey on wjx.cn (an online questionnaire survey platform) using a self-administered questionnaire developed by us, and selected a stratified random sample of 32 cases (16 directors of community health centers, and 16 general practice team leaders from 8 central urban districts of Shanghai) to anonymously complete the survey via scanning the WeChat RQ code using a mobile phone or computer. The survey data were collected to input into a database, and analyzed for understanding the inter-rater differences in the importance of the top 15 indicators.ResultsThe response rate, authority coefficient, and Kendall's W were 90.0%, 0.912, and 0.183 (χ2=42.516, P0.05) .ConclusionThe system developed by us has high scientificity and practicability with a rational structure and well-targeted indictors, which may be used as a tool for the selection and training of general practice team leader.

Hypertension has been associated with risk of cognitive impairments. The American Heart Association recommended the use of the harmonized neuropsychological protocol suggested by the National Institute of Neurologic Disorders and Stroke and the Canadian Stroke Network (NINDS-CSN) for studying related cognitive impairments. Initially designed for vascular cognitive impairment, empirical data of results from NINDS-CSN protocol has not been well-established in hypertension. The present study recruited 58 adults diagnosed with hypertension and 44 normotensive controls. Tests from the NINDS-CSN protocol were given in three lengths, including neuropsychological tests and neuropsychiatric inventories. The results showed higher proportions of hypertensive adults with impairments on tests of memory and executive functions and that they performed worse as a group on several tests from the 30-minute protocol, but not on the other additional tests in the full-length version, nor on cognitive screening test in the 5-minute protocol such as the Mini-Mental State Examination or the Montreal Cognitive Assessment. There was no significant group difference on neuropsychiatric symptoms. These findings suggested that the 30-minute version of the NINDS-CSN protocol with the two supplemental tests was able to reveal selective cognitive deficits in hypertensive adults and provide a practical solution for related studies, balancing between the requirement of sensitivity, domain variety, and brevity. [ABSTRACT FROM AUTHOR]