Development of a prediction model for predicting the prevalence of nonalcoholic fatty liver disease in Chinese nurses: the first-year follow data of a web-based ambispective cohort study.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) is gradually becoming a huge threat to public health. With complex working characteristics, female nurses had been found with high risk of NAFLD. To develop and validate a prediction model to predict the prevalence of NAFLD based on demographic characteristics, work situation, daily lifestyle and laboratory tests in female nurses. METHODS: This study was a part of the Chinese Nurse Cohort Study (The National Nurse Health Study, NNHS), and data were extracted from the first-year follow data collected from 1st June to 1st September 2021 by questionnaires and physical examination records in a comprehensive tertiary hospital. The questionnaires included demographic characteristics, work situation and daily lifestyle. Logistic regression and a nomogram were used to develop and validate the prediction model. RESULTS: A total of 824 female nurses were included in this study. Living situation, smoking history, monthly night shift, daily sleep time, ALT/AST, FBG, TG, HDL-C, UA, BMI, TBil and Ca were independent risk factors for NAFLD occurance. A prediction model for predicting the prevalence of NAFLD among female nurses was developed and verified in this study. CONCLUSION: Living situation, smoking history, monthly night shift, daily sleep time, ALT/AST, FBG, TG, UA, BMI and Ca were independent predictors, while HDL-C and Tbil were independent protective indicators of NAFLD occurance. The prediction model and nomogram could be applied to predict the prevalence of NAFLD among female nurses, which could be used in health improvement. TRIAL REGISTRATION: This study was a part of the Chinese Nurse Cohort Study (The National Nurse Health Study, NNHS), which was a ambispective cohort study contained past data and registered at Clinicaltrials.gov ( https://clinicaltrials.gov/ct2/show/NCT04572347 ) and the China Cohort Consortium ( http://chinacohort.bjmu.edu.cn/project/102/ ).

The role of family support in diabetes self-management among rural adult patients.

AIMS AND OBJECTIVES: This study aimed to investigate the role of the family in supporting diabetes self-management and explore the possible mechanisms between family and diabetes self-management among rural patients in China. BACKGROUND: The prevalence of Type 2 diabetes mellitus (T2DM) is growing rapidly in rural areas of China, where healthcare resources remain relatively poor and family members play an important role in chronic disease self-management. DESIGN: This was a multicentre cross-sectional study. METHODS: A total of 276 adults with T2DM were recruited from nine county hospitals in China. Diabetes self-management, family support, family function, and family self-efficacy were evaluated using the mature scales. A theoretical model was built based on the social learning family model and previous studies and then verified using a structural equation model. The STROBE statement was used to standardise the study procedure. RESULTS: Family support and general family factors, including family function and self-efficacy, were positively correlated with diabetes self-management. Family support fully mediates the relationship between family function and diabetes self-management and partially mediates the relationship between family self-efficacy and diabetes self-management. The model explained 41% of the variability in diabetes self-management and had a good model fit. CONCLUSION: General family factors can explain nearly half of the change in diabetes self-management in rural areas of China, while family support is a mediator between general family factors and diabetes self-management. Family self-efficacy, a potential intervention point of family based diabetes self-management education, can be improved by building special lessons for family members. RELEVANCE TO CLINICAL PRACTICE: This study emphasises the role of family in diabetes self-management and proposes suggestions for diabetes self-management intervention among patients with T2DM in rural areas of China. PATIENT OR PUBLIC CONTRIBUTION: Patients and their family members completed the questionnaire which was used for data collection.

Eating window and eating habits of adults in China: A cross-sectional study.

Objective: Previous studies have demonstrated that eating time and habits play key roles in human health. However, there is a paucity of research on the epidemiology of eating window and eating habits in China. This study aimed to investigate the relationship between eating window and eating habits among adults in mainland China and explore the factors influencing these parameters. Design: Cross-sectional study. Setting: A questionnaire comprising demographic data, metabolic index, eating window and eating habits was administered via the Internet. Participants: 1596 adults from mainland China. Results: Eating window of all participants was 13.03 ± 2.02 h (mean ± standard deviation [SD]), which was longer than previously reported in smaller more controlled studies from China. Area of residence and occupation were significant factors influencing eating window after controlling for other factors (area of residence: ß, -0.499; 95% confidence interval [CI], -0.897 to -0.101, p = 0.014; occupation: ß, -0.309, 95% CI, -0.496 to -0.121, p = 0.001). Participants typically commenced eating at 08:00 h (interquartile range [IQR]: 8:00-9:00) and ceased eating at 20:00 h (IQR: 20:00-22:00). Regular meals which mean two or three meals per day regularly constituted the dominant eating pattern of participants (n = 1233, 77.3%) and 819 (51.1%) participants preferred cooking for themselves. Conclusion: This study revealed that eating window of adults in China generally around 13 h. Area of residence and occupation were the main factors influencing eating window. Our data provide a foundation for future studies on eating window and eating habits in China.

What Frequency of Ankle Pump Exercise is Optimal to Improve Lower Limb Hemodynamics? A Systematic Review and Network Meta-analysis.

PURPOSE: Ankle pump exercises (APE) have been widely used in clinical practice. However, best practices for APE have not been established. Recognize the most effective frequency of APE for improving lower extremity hemodynamics and establish recommendations in clinical practice. METHODS: Therefore, a systematic review and network meta-analysis (NMA) was performed according to PRISMA-NMA. Six English databases (Pubmed, Medline, CINAHL, Embase, the Cochrane library and ProQuest) and four Chinese databases (CNKI, Wanfang, VIP and Sinomed) were searched. Randomized controlled trials (RCTs) and quasi-experimental studies investigating the effects of different frequencies of APE on lower limb hemodynamics published before July 2022 were included. The reference list was also searched. Seven studies (one RCTs and six quasi-experimental studies) were included in the systematic review and five studies (one RCTs and four quasi-experimental studies) were included in the NMA. The risk of bias was assessed using the Cochrane and Joanna Briggs Institute tools. The NMA was performed using the R software (version 4.2.1) and OpenBUGS (version 3.2.3). RESULTS: The results of the NMA showed that a frequency of every 3-4 s the most effective in improving lower extremity hemodynamics (P =.85), followed by every 1-2 s (P = .81), every 5-6 s (P=.32) and less than every 10 s (P =.02). Subgroup analysis failed to find a difference between healthy participants and those with unilateral total hip arthroplasty or fracture (MD = -0.23, 95% CI-5.92 to 4.61). CONCLUSIONS: Consequencely, for adult patients, with or without lower extremity disease, a frequency of every 3-4 s can be recommended as the optimal frequency of APE in clinical care practice. REGISTERED NUMBER ON PROSPERO: CRD42022349365. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=349365.

The effectiveness of a self-efficacy-focused structured education programme on adults with type 2 diabetes: A multicentre randomised controlled trial.

AIMS AND OBJECTIVES: To evaluate the effectiveness of a self-efficacy-focused structured education programme on outcomes in adults with type 2 diabetes (T2DM) without insulin therapy. BACKGROUND: Structured education regarding metabolic control in T2DM adults without insulin therapy has not always been effective, and this lack of effectiveness might be due to overlooking self-efficacy. Whether a self-efficacy-focused structured education programme could improve metabolic and psychosocial outcomes for T2DM adults more effectively remains unknown. DESIGN: A multicentre parallel randomised controlled concealed label trial. METHODS: The study conducted in outpatients of four hospitals in China. A total of 265 T2DM adults without insulin therapy were randomly assigned to an intervention group of a self-efficacy-focused structured education programme (n = 133), or to a control group of routine education (n = 132). The differences in metabolic and psychosocial outcomes were investigated at baseline, three- and 6-month follow-ups. RESULTS: The primary outcome of A1C and the secondary outcomes of weight, body mass index, waist circumference, diastolic pressure, self-efficacy, self-management behaviours and knowledge improved significantly in the intervention group compared with the control group at 6-month follow-up. The differences in A1C between groups for patients with a low educational background at 6-month follow-up were significant. No significant differences were found in other secondary outcomes of systolic pressure, the blood lipid profile and diabetes distress between groups at 6-month follow-up. CONCLUSIONS: This programme can improve glycaemic control, weight control, diastolic pressure, self-efficacy, self-management behaviours and diabetes knowledge for T2DM adults. RELEVANCE TO CLINICAL PRACTICE: This self-efficacy-focused structured education programme is effective and can be incorporated into regular clinical care and led by trained staff (e.g. nurses), and it can be implemented in patients with low educational backgrounds.