Experiences of the Older Adults After Being Abused: A Qualitative Meta-synthesis.

Elder abuse is a global public health problem with severe social costs. Research on elder abuse has gradually increased; however, less attention has been paid to older adults' perceptions and experiences of abuse. This review aimed to integrate older adults' perceptions and experiences of abuse to provide a theoretical basis for developing interventions that meet their authentic needs. Six electronic databases were searched to include qualitative studies examining perceptions and experiences of abuse among adults aged 60 years or older, and 22 studies were included. This study used the Joanna Briggs Institute meta-aggregation approach to integrate the qualitative findings, which identified four themes: (a) changes resulting from elder abuse, (b) causes of abuse, (c) barrier factors and facilitating factors to the disclosure of abusive behavior, and (d) adopting different response strategies. The findings revealed that older adults experience persistent physical and psychological burdens and financial stress following abuse. Multiple factors influence the emergence of abuse and older adults search for help from the outside world, especially social support and perceptions of abuse. Older adults can deal with abuse by accepting the status quo or taking steps to change it. These findings have important implications for helping older adults prevent and cope with abuse experiences.

Moral courage level of nurses: a systematic review and meta-analysis.

BACKGROUND: Moral distress occurs in daily nursing work and plagues nurses. Improving the level of moral courage is one of the main strategies to reduce moral distress, and low levels of moral courage may lead to nurse burnout, increased turnover, and reduced quality of care. METHODS: Nine electronic databases in Chinese and English were searched for the level of moral courage among nurses, including PubMed, Web of Science, EMBASE, CINAHL, CNKI, Wan fang, Wei pu, CBM and Cochrane Library, for the period from the date of database creation to April 5, 2023. The Agency for Healthcare Research and Quality (AHRQ) was used to assess the methodological quality of the included studies, followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Meta-analysis and Systematic Reviews of Observational Studies guidelines, and data from the included studies were meta-analyzed in STATA version 15 using a fixed-effects model. RESULTS: Seventeen cross-sectional studies of moderate or high quality met the eligibility criteria and involved 7718 nurses, and the Nurses' Moral Courage Scale (NMCS) was used to measure the self-assessed moral courage level of nurses. Eleven of these studies reported total scores for nurses' moral courage, and the meta-analysis results showed a pooled mean score of 78.94 (95% CI: 72.17, 85.72); Fourteen studies reported mean entry scores for nurses' moral courage, and the meta-analysis results showed a pooled mean score of 3.93 (95% CI: 3.64, 4.23). CONCLUSION: The results of the meta-analysis showed that nurses' moral courage levels were in the medium to high range, among the nurses who seemed to be male, non-nursing managers, high school education, had not experienced ethical issues, and considering resignation had lower levels of moral courage. The results of the meta-analysis may provide some reference for nursing managers and even hospital administrators to develop strategies to optimize nursing quality.

The relationship between major depression and migraine: A bidirectional two-sample Mendelian randomization study.

Background: Previous epidemiological and other studies have shown an association between major depressive disorder (MDD) and migraine. However, the causal relationship between them remains unclear. Therefore, this study aimed to investigate the causal relationship between MDD and migraine using a bidirectional, two-sample Mendelian randomization (MR) approach. Methods: Data on MDD and migraine, including subtypes with aura migraine (MA) and without aura migraine (MO), were gathered from a publicly available genome-wide association study (GWAS). Single nucleotide polymorphisms (SNPs) utilized as instrumental variables (IVs) were then screened by adjusting the intensity of the connection and removing linkage disequilibrium. To explore causal effects, inverse variance weighting (IVW) was used as the primary analysis method, with weighted median, MR-Egger, simple mode, and weighted mode used as supplementary analytic methods. Furthermore, heterogeneity and pleiotropy tests were carried out. Cochran's Q-test with IVW and MR-Egger was used to assess heterogeneity. Pleiotropy testing was carried out using the MR-Egger intercept and MR-PRESSO analysis methods. A leave-one-out analysis was also used to evaluate the stability of the findings. Finally, we used migraine (MA and MO) levels to deduce reverse causality with MDD risk. Results: Random effects IVW results were (MDD-Migraine: odds ratio (OR), 1.606, 95% confidence interval (CI), 1.324-1.949, p = 1.52E-06; MDD-MA: OR, 1.400, 95%CI, 1.067-1.8378, p = 0.015; MDD-MO: OR, 1.814, 95%CI, 1.277-2.578, p = 0.0008), indicating a causal relationship between MDD levels and increased risk of migraine (including MA and MO). In the inverse MR analysis, the findings were all negative, while in sensitivity analyses, the results were robust except for the study of MA with MDD. Conclusion: Our study confirms a causal relationship between MDD levels and increased risk of migraine, MA, and MO. There was little evidence in the reverse MR analysis to suggest a causal genetic relationship between migraine (MA and MO) and MDD risk levels.

Efficacy of Cold Atmospheric Plasma Therapy on Chronic Wounds: An Updated Systematic Review and Meta-Analysis of RCTs.

Objective: A previous meta-analysis has revealed that cold atmospheric plasma (CAP) might not be clinically beneficial to chronic wounds. However, several new randomized controlled trials (RCTs) reported that CAP was an effective treatment option for accelerating wound healing in chronic wounds. The purpose of this review is to incorporate these new results and evaluate the efficacy of CAP in chronic wounds. Methods: The major databases, including PubMed, Embase, Cochrane Library, and Web of Science, were searched for articles related to CAP treatment in chronic wounds until March 21, 2022. The literature retrieval and evaluation were carried out by two independent researchers. Result: A total of 13 randomized clinical trials published between 2010 and 2022 were finally included. CAP therapy showed to be more effective in reducing the area of wounds (mean difference (MD): -1.74, 95%; confidence interval (CI): [-3.14, -0.33], p = 0.02), compared with non-CAP treatments. The immediate reduction of the bacterial load was higher in the CAP group than in the control group. (MD: -0.37, 95%; CI: [-0.7, -0.05], p = 0.02). Conclusion: No significant changes were found in long-term antibacterial efficacy and pain perception between the two groups. However, more RCTs of excellent methodological quality are required to confirm technical details of the source of AP and the appropriate duration of the treatment with plasma.

Characteristics of surface water quality and stable isotopes in Bamen Bay watershed, Hainan Province, China.

Bamen Bay is located at the intersection of the Wenjiao River and Wenchang River in Hainan Province (China), where mangroves have been facing a threat of water quality deterioration. Therefore, it is imperative to study the characteristics of the surface water quality on a watershed scale. Water samples were collected three times from 36 monitoring sites from 2015 to 2016. It was found that nitrate was the main inorganic nitrogen form and all the surface water types were alkaline. Meanwhile, aquaculture water had high content of nitrogen, total phosphorus, chlorophyll a (Chl.a), total organic carbon (TOC), and chemical oxygen demand (COD). Significant spatial and temporal variations were found for most parameters. However, stable isotopes of δD and δ18O indicated that river water mainly originated from atmospheric precipitation and experienced strong evaporation. The water chemistry and isotopes of the Bamen Bay, mangroves, and aquaculture water were initially affected by the mixing of fresh water and seawater, followed by evaporation. The river and reservoir water chemistry were mainly controlled by water-rock interactions and cation exchange as deduced from the ionic relationships and Gibbs plots. These interactions involved the dissolution of calcite-, bicarbonate-, carbonate-, and calcium-containing minerals. Oxidized environments (river, reservoir, and Bamen Bay) were conducive for nitrification, while anaerobic conditions (mangrove and aquaculture water) were beneficial to the reduced nitrogen forms.

Contrasting fine-scale genetic structure of two sympatric clonal plants in an alpine swampy meadow featured by tussocks.

Tussocks are unique vegetation structures in wetlands. Many tussock species mainly reproduce by clonal growth, resulting in genetically identical offspring distributed in various spatial patterns. These fine-scale patterns could influence mating patterns and thus the long-term evolution of wetland plants. Here, we contribute the first genetic and clonal structures of two key species in alpine wetlands on the Qinghai-Tibet Plateau, Kobresia tibetica and Blysmus sinocompressus, using > 5000 SNPs identified by 2b-RAD sequencing. The tussock-building species, K. tibetica, has a phalanx (clumping) growth form, but different genets could co-occur within the tussocks, indicating that it is not proper to treat a tussock as one genetic individual. Phalanx growth does not necessarily lead to increased inbreeding in K. tibetica. B. sinocompressus has a guerilla (spreading) growth form, with the largest detected clone size being 18.32 m, but genets at the local scale tend to be inbred offspring. Our results highlight that the combination of clone expansion and seedling recruitment facilitates the contemporary advantage of B. sinocompressus, but its evolutionary potential is limited by the input genetic load of the original genets. The tussocks of K. tibetica are more diverse and a valuable genetic legacy of former well-developed wet meadows, and they are worthy of conservation attention.

[Spatial characteristics of grain size of surface sediments in mangrove wetlands in Gaoqiao of Zhanjiang, Guangdong province of South China].

Mangrove wetland is an important type of coastal wetlands, and also, an important sediment trap. Sediment is an essential medium for mangrove recruitment and development, which records the environmental history of mangrove wetlands and can be used for the analysis of material sources and the inference of the materials depositing process, being essential to the ecological restoration and conservation of mangrove. In this paper, surface sediment samples were collected along a hydrodynamic gradient in Gaoqiao, Zhanjiang Mangrove National Nature Reserve in 2011. The characteristics of the surface sediments were analyzed based on grain size analysis, and the prediction surfaces were generated by the geo-statistical methods with ArcGIS 9.2 software. A correlation analysis was also conducted on the sediment organic matter content and the mangrove community structure. In the study area, clay and silt dominated the sediment texture, and the mean content of sand, silt, and clay was (27.8 +/- 15.4)%, (40.3 +/- 15.4)%, and (32.1 +/- 11.4)%, respectively. The spatial gradient of the sediment characteristics was expressed in apparent interpolation raster. With increasing distance from the seawall, the sediment sand content increased, clay content decreased, and silt content was relatively stable at a certain level. There was a positive correlation between the contents of sediment organic matter and silt, and a negative correlation between the contents of sediment organic matter and sand. Much more sediment organic matter was located at the high tide area with weak tide energy. There existed apparent discrepancies in the characteristics of the surface sediments in different biotopes. The sediment characteristics had definite correlations with the community structure of mangroves, reflecting the complicated correlations between the hydrodynamic conditions and the mangroves.