Influence of health education based on the transtheoretical model on kinesiophobia levels and rehabilitation outcomes in elderly patients undergoing total knee arthroplasty.

Objective: In this study, we evaluated the effectiveness of health education based on the transtheoretical model in reducing symptoms of kinesiophobia and enhancing rehabilitation outcomes among elderly patients post-total knee arthroplasty. Methods: Elderly patients post-knee replacement surgery were randomly divided into a control group, which received standard health education, and an experimental group, which received transtheoretical model-based health education. The intervention commenced on the day after surgery and continued for a duration of six months. Assessments of kinesiophobia scores, rehabilitation self-efficacy, and knee function were conducted before the intervention, and then at one, three, and six months postoperatively. Results: Between January 2022 and December 2022, 130 elderly patients who met the eligibility criteria were enrolled and subsequently randomly assigned into two groups of equal size. Comparable baseline characteristics were observed between the two groups The experimental group demonstrated lower kinesiophobia scores and higher scores in rehabilitation self-efficacy and knee function at one, three, and six months following surgery, compared to the control group. Conclusion: Health education based on a transtheoretical model reduces the symptoms of kinesiophobia and enhances rehabilitation self-efficacy and knee functions in elderly patients after knee replacement surgery.

Establishment and validation of the prediction model for postoperative delirium risk factors in older patients after total knee arthroplasty: A retrospective study.

This study aimed to establish an effective predictive model for postoperative delirium (POD) risk assessment after total knee arthroplasty (TKA) in older patients. The clinical data of 446 older patients undergoing TKA in the Orthopedics Department of our University from January to December 2022 were retrospectively analyzed, and the POD risk prediction model of older patients after TKA was established. Finally, 446 patients were included, which were divided into training group (n = 313) and verification group (n = 133). Logistic regression method was used to select meaningful predictors. The prediction model was constructed with nomographs, and the model was evaluated with correction curve and receiver operating characteristic curve. The logistic regression analysis showed that age, educational level, American Society of Anesthesiologists grade, accompaniment of chronic obstructive pulmonary disease, accompaniment of cerebral stroke, postoperative hypoxemia, long operation time, and postoperative pain were independent risk factors for POD after TKA (P < .05). The nomogram prediction model established. The area under receiver operating characteristic curve of the model group and the validation group were 0.954 and 0.931, respectively. The calibration curve of the prediction model has a high consistency between the 2 groups. The occurrence of POD was associated with age, educational level, American Society of Anesthesiologists grade, accompaniment of chronic obstructive pulmonary disease, accompaniment of cerebral stroke, postoperative hypoxemia, long operation time, and postoperative pain in TKA patients.

The correlation between CT features and insulin resistance levels in patients with T2DM complicated with primary pulmonary tuberculosis.

The aim is to investigate the correlation between computed tomography (CT) features and insulin resistance levels in patients with type 2 diabetes mellitus (T2DM) complicated with primary pulmonary tuberculosis (PTB). Nearly, 268 untreated PTB patients complicated with T2DM were divided into two groups according to the optimal cutoff value of HOMA-IR score for the Chinese population: HOMA-IR ≤ 2.69 (Group I: 74 patients), >2.69 (Group II: 194 patients). The basic characteristics and changes of CT manifestations were analyzed. In the two groups, the detection rate of large segmented leafy shadow was 39.2% and 78.9%; the air bronchogram sign detection rate was 40.5% and 80.9%; the discovery rate of mouth-eaten cavity was 33.8% and 73.7%; the thin-walled cavity detection rate was 2.7% and 16.0%; the rate of multiple cavities was 35.1% and 69.6%; and bronchial tuberculosis was found in 4.1% and 35.6%, respectively. The detection rates of lesions in Group II were significantly higher than in Group I (p < .05). HOMA-IR was found independently associated with large segmented leafy shadow, air bronchial sign, thin-walled cavity, and bronchial tuberculosis. The level of insulin resistance can effectively reflect the severity of PTB patients with T2DM. CT scan can directly provide image information in clinics. These two examinations can guide clinicians to accurately formulate subsequent treatment plans.

The effect of a nurse-led self-management program on outcomes of patients with chronic obstructive pulmonary disease.

PURPOSE: To examine the effectiveness of a nurse-led self-management program on outcomes of patients with chronic obstructive pulmonary disease (COPD). DESIGN: A randomized controlled, single-blind trial, carried out from October 2017 to December 2018, included 154 participants admitted with COPD to the Affiliated Hospital of Zunyi Medical University in Guizhou, (randomized into intervention (n = 77) and control groups (n = 77)). MATERIALS AND METHODS: Participants in the intervention group underwent a nurse-led self-management program in addition to routine care, and participants of the control group received only routine care. The main outcome measures were COPD-related readmission and emergency department visits, the 6-minute walk distance (6MWD) test for measurement of exercise capacity, the St George Respiratory Questionnaire (SGRQ) for measurement of health-related quality of life, and the COPD Transitional Care Patient Satisfaction Questionnaire (CTCPSQ) for measurement of satisfaction. Data collection was conducted at baseline (T1) and after 3 (T2), 6 (T3) and 12 mo (T4). Findings Compared to the control group, participants in the intervention group showed significantly fewer COPD-related hospital admissions (P = 0.03) and emergency department visits (P = 0.001) and higher total CTCPSQ scores (P = 0.001) at 12 mo. Meanwhile, analysis of variance showed a significantly greater improvement in exercise capacity and health status over time in the nurse-led program group than in the control group, P < 0.001. CONCLUSIONS: This study demonstrated that the nurse-led self-management program was effective in decreasing hospital readmissions and emergency department visits and improving exercise capacity, health-related quality of life and satisfaction for patients with COPD.

Effectiveness of a training program based on maker education for baccalaureate nursing students: A quasi-experimental study.

OBJECTIVES: Maker education is a dominant force in education reform and is viewed as a revolutionary way to learn. As innovative pedagogy is continuously explored in the field of nursing, the emerging role of maker education must be examined. This research aims to build a nursing bachelor education program based on maker education and to evaluate the effectiveness of this program. METHODS: Forty volunteer junior students majoring in nursing from a college were the subjects for this quasi-experiment. The training program for nursing students based on maker education was developed and implemented as an additional class for a period of 12 weeks. Before and after the experiment, two measures including the "Williams Creative Scale" and "Current Status Questionnaire of Nursing Students' Learning" were adopted for investigation, and corresponding statistical methods were used for analysis. The degree of satisfaction with this training program was investigated after the experiment. RESULTS: The average scores of creativity, learning interest, cooperative learning skill, scientific research ability, and information attainment of the nursing students after the implementation of maker education all improved. The differences in the above points before and after the experiment were all statistically significant (P < 0.05). Most of the students expressed satisfaction with this training program (72.5% were very satisfied, 15.0% were partially satisfied, and 12.5% were not satisfied). CONCLUSION: Implementing the training program based on maker education enhanced student creativity, learning interest, cooperative learning skill, scientific research ability, and information attainment. Comprehensive nursing talents were also cultivated. Our data suggested the importance of improving this program, adopting the method, and pursuing research in nursing education.

Prevalence of consistent condom use with various types of sex partners and associated factors among money boys in Changsha, China.

INTRODUCTION: Money boys with inconsistent condom use (less than 100% of the time) are at high risk of infection by human immunodeficiency virus (HIV) or sexually transmitted infection (STI), but relatively little research has examined their risk behaviors. AIM: We investigated the prevalence of consistent condom use (100% of the time) and associated factors among money boys. METHODS: A cross-sectional study using a structured questionnaire was conducted among money boys in Changsha, China, between July 2012 and January 2013. MAIN OUTCOME MEASURE: Independent variables included socio-demographic data, substance abuse history, work characteristics, and self-reported HIV and STI history. Dependent variables included the consistent condom use with different types of sex partners. RESULTS: Among the participants, 82.4% used condoms consistently with male clients, 80.2% with male sex partners, and 77.1% with female sex partners in the past 3 months. A multiple stepwise logistic regression model identified four statistically significant factors associated with lower likelihoods of consistent condom use with male clients: age group, substance abuse, lack of an "employment" arrangement, and having no HIV test within the prior 6 months. In a similar model, only one factor associated significantly with lower likelihoods of consistent condom use with male sex partners was identified in multiple stepwise logistic regression analyses: having no HIV test within the prior six months. As for female sex partners, two significant variables were statistically significant in the multiple stepwise logistic regression analysis: having no HIV test within the prior 6 months and having STI history. CONCLUSIONS: Interventions which are linked with more realistic and acceptable HIV prevention methods are greatly warranted and should increase risk awareness and the behavior of consistent condom use in both commercial and personal relationship.

Activated charcoal based diffusive gradients in thin films for in situ monitoring of bisphenols in waters.

Widespread use of bisphenols (BPs) in our daily life results in their elevated concentrations in waters and the need to study their environmental impact, which demands reliable and robust measurement techniques. Diffusive gradients in thin films (DGT) is an in situ passive sampling approach which provides time-integrated data. In this study we developed a new methodology, based on DGT with activated charcoal (AC) as a binding agent, for measuring three BPs (BPA, BPB, and BPF) which incorporated and tested its performance characteristics. Consistent elution efficiencies were obtained using methanol when concentrations of BPs were low and a methanol-NaOH mixture at high concentrations. The diffusion coefficients of BPA, BPB, and BPF in the diffusive gel, measured using an independent diffusion cell, were 5.03 × 10(-6), 5.64 × 10(-6), and 4.44 × 10(-6) cm(2) s(-1) at 25 °C, respectively. DGT with an AC binding gel had a high capacity for BPA, BPB, and BPF at 192, 140, and 194 µg/binding gel disk, respectively, and the binding performance did not deteriorate with time, up to 254 d after production. Time-integrated concentrations of BPs measured in natural waters using DGT devices with AC gels deployed in situ for 7 d were comparable to concentrations measured by an active sampling method. This study demonstrates that AC-based DGT is an effective tool for in situ monitoring of BPs in waters.

[Simultaneous determination of 6 pesticides in drinking water by high performance liquid chromatography-tandem mass spectrometry with solid phase extraction].

OBJECTIVE: To develop an analytical method for simultaneous determination of 6 pesticides, namely bentazone, 2,4-dichlorophenoxyacetic acid,carbofuran, carbaryl, atrazine and pentachlorophenol, in drinking water by high performance liquid chromatography-tandem mass spectrometry, and thereby to provide a reference to revise the Health Standards for Drinking Water (GB/T 5750-2006). Meanwhile, to evaluate the content of the above 6 pesticides in the drinking water samples supplied by 12 centralized water plants in Jiangsu province. METHODS: The 10 ml water sample was acidized by hydrochloric acid to pH ≤ 2, and then concentrated by solid phase extraction cartridge and eluted with acetone. The solvent was changed into methanol after drying by nitrogen blow. The target compounds were separated by C18 column using methanol/water as mobile phase, and detected by mass spectrometry with multi-reaction-monitoring(MRM) mode. The repeatability and sensitivity of the assay were evaluated. The drinking water samples from the 12 water plants were then detected. RESULTS: In this experimental method, the minimum detectable concentration were around 0.02-0.41 µg/L, with the recovery rate at 75%-115%, and the RSD between 2% and 10%. Under the experimental condition, there were no pesticides detected in the drinking water samples from the 12 centralized water plants. CONCLUSION: The method is efficient and environment-friendly, with little discharge of effluent, which could meet the requirement of the drinking water monitor.

Application of three-step epitaxial process to dual trench epitaxial diode array.

The application of three-step Epitaxial (EPI) process to dual trench epitaxial diode array for high density phase change random access memory (PCRAM) was reported in this paper. With three-step EPI process condition, both vertical and lateral Arsenic auto-doping were suppressed effectively from Arsenic heavily-doped substrate. It was found that EPI layer (- 300 nm) with high-quality single crystalline and good thickness uniformity within 200 mm diameter wafer could be achieved. It was also found that both lateral and vertical Arsenic auto-doping concentration could be reduced by 2-3 orders by adding high temperature and low deposition rate EPI step before main EPI process, as compared to the conventional CVD EPI process. As a result, diode breakdown voltage was improved above 11 V and the On/Off current ratio of diode is greater than 9 orders of magnitude.

[Degradation of diuron by persulfate oxidation activated by EDTA-ferrous ion in aqueous system].

The method of diuron [3-(3,4-dichlorophenyl)-1, 1-dimethylurea] degradation by persulfate oxidation activated by EDTA-ferrous ion in aqueous system was conducted. Based on both of the degradation performance and the operating costs, optimal reaction condition was proposed. Operating at K2S2O8 initial concentration 2.0 mmol x L(-1), Fe(II) initial concentration 1.0 mmol x L(-1), EDTA initial concentration 0.5 mmol x L(-1), reaction time 300 min and pH = 7.0, about 67.6% of 0.1 mmol x L(1) diuron was degradation. Hydroxyl radicals and sulfate radicals produced in the system were determined by molecular probes (ethanol and tert-butanol) methods. The degradation products of diuron were identified with LC/MS methods and the degradation pathways of diuron were discussed.