The enteric nervous system deficits in autism spectrum disorder.

Gastrointestinal (GI) disorders are common comorbidities in individuals with autism spectrum disorder (ASD), and abnormalities in these issues have been found to be closely related to the severity of core behavioral deficits in autism. The enteric nervous system (ENS) plays a crucial role in regulating various aspects of gut functions, including gastrointestinal motility. Dysfunctional wiring in the ENS not only results in various gastrointestinal issues, but also correlates with an increasing number of central nervous system (CNS) disorders, such as ASD. However, it remains unclear whether the gastrointestinal dysfunctions are a consequence of ASD or if they directly contribute to its pathogenesis. This review focuses on the deficits in the ENS associated with ASD, and highlights several high-risk genes for ASD, which are expressed widely in the gut and implicated in gastrointestinal dysfunction among both animal models and human patients with ASD. Furthermore, we provide a brief overview of environmental factors associated with gastrointestinal tract in individuals with autism. This could offer fresh perspectives on our understanding of ASD.

Effects of family-centered positive psychological intervention on psychological health and quality of life in patients with breast cancer and their caregivers.

PURPOSE: Positive psychological intervention could improve individual's psychological health and quality of life. This study aimed to examine the effectiveness of family-centered positive psychological intervention on resilience, hope, perceived benefits, and quality of life in breast cancer patients and their caregivers. METHODS: A two-group, randomized controlled study, including 98 dyads of breast cancer patients and caregivers, was conducted. Dyads were randomly assigned to intervention (n = 49) and control (n = 49) groups. Both the control and intervention groups received 4 weeks of health education, while the intervention group additionally received a 4-week family-centered positive psychological intervention. Outcome measures compared at baseline (T1), immediately after the intervention (T2), and at 1-month follow-up (T3), included validated measures of resilience (Connor-Davidson Resilience Scale), hope (Herth Hope Index), perceived benefits (Perceived Benefits of Diagnosis and Treatment of Breast Cancer, Positive Aspects of Caregiving), and quality of life (Functional Assessment of Cancer Therapy-Breast, Caregiver Quality of Life Scale). RESULTS: Resilience, hope, perceived benefits, and quality of life of dyads were significantly higher in the intervention group than those in the control group at T2 and T3 (all p < 0.05). Linear mixed model analysis demonstrated a significant interaction effect of group × time × role (p = 0.007) on hope and a significant difference in the improvement of hope (p < 0.05) between patients and their caregivers. CONCLUSIONS: Our family-centered positive psychological intervention was effective in improving psychological health and quality of life for breast cancer patients and caregivers. This study provides evidence for the effectiveness of positive clinical psychological interventions. TRIAL REGISTRATION: ChiCTR2300072809.

Nurses' preparedness to respond to COVID-19 and associated factors after the outbreak in China.

AIM: Nurses are key staff in the response to the COVID-19 epidemic. The aim of present study was to assess Chinese clinical nurses' preparedness levels for COVID-19 after the outbreak, as well as the associated demographic factors. DESIGN: The design was a cross-sectional survey. METHODS: We distributed an online questionnaire to nurses from five eastern coastal area hospitals. The questionnaire collected demographic information, and included the nurses' preparedness to respond to COVID-19 questionnaire (NPR COVID-19). RESULTS: The total mean NPR COVID-19 score was 200.99 (standard deviation = 33.60), and the psychological approaches subscale had the lowest mean score. Education and training were positively associated with the NPR COVID-19 score. Nurses' characteristics, such as seniority, job category and educational level, were entered into the NPR COVID-19 regression model, and seniority (≤5 years) showed the strongest negative association with NPR COVID-19 scores (standard coefficient = -0.20). CONCLUSIONS: Chinese nurse's preparedness to respond to COVID-19 was adequate. Nurses with less than 5 years of work experience, nursing researchers and diploma-educated nurses reported feeling a low preparedness to respond to COVID-19. These nurses should receive specific training.

Management of neuropsychiatric adverse events in a prostate cancer patient undergoing chimeric antigen receptor T-cell immunotherapy (a phase I clinical trial): A case report.

In previous clinical trials, chimeric antigen receptor T-cell immunotherapy has shown preliminary efficacy in patients with malignant solid tumors. However, the occurrence of adverse events, particularly neuropsychiatric adverse events (eg, anxiety) and cognitive dysfunction, during the course of treatment may reduce patient compliance and pose a threat to their safety. Nurses are in a unique position to promptly identify and manage such complications, thereby facilitating early diagnosis and treatment, as well as improving clinical and patient outcomes. Moreover, nurses can promote compliance through the provision of psychological support to patients.

Construction of a cutoff and fusion model of breast cancer patients in family: a grounded theory study.

PURPOSE: To construct a coping model for interactions between breast cancer patients and their families across the disease trajectory using the patients' voice, and to establish a mechanism for restoring family balance when faced with stresses related to breast cancer. METHODS: This study employed a longitudinal qualitative study design using constructivist grounded theory. We divided breast cancer trajectory into four periods: suspicion, diagnosis, treatment, and rehabilitation. We then interviewed patients during each of these periods. RESULTS: Twenty patients with breast cancer were interviewed. A cutoff and fusion model of the breast cancer patient's interactions with her family contained three coping themes: independence, coexistence, and interconversion. The coping trajectory of breast cancer patients in their families has specific themes in each period, such as anxiety, information, emotion, and experience. CONCLUSION: We constructed a cutoff and fusion model of breast cancer patients' coping trajectory in their families. This model not only explains the opposite, coexistent, and interconvertible relationship between cutoff and fusion but also the specific challenges requiring cutoff and fusion during the four periods. Our findings highlight the dynamic balance of cutoff and fusion for patients' coping in their families. IMPLICATIONS FOR PRACTICE: This model helps clinical staff understand the coping of breast cancer patients in their families. When providing family education, clinical staff should suggest that they not only provide support to the patient but give each other space as well.

Assessing Information Available for Health Professionals and Potential Participants on Lung Cancer Screening Program Websites: Cross-sectional Study.

BACKGROUND: Lung cancer is the leading cause of cancer death worldwide. The US Preventive Services Task Force (USPSTF) updated recommendations for lung cancer screening in 2021, adjusting the age of screening to 50 years (from 55 years) and reducing the number of pack-years used to estimate total firsthand cigarette smoke exposure to 20 (from 30). With many individuals using the internet to find health care information, it is important to understand what information is available for individuals contemplating lung cancer screening. OBJECTIVE: This study aimed to assess the eligibility criteria and information available on lung cancer screening program websites for both health professionals and potential screening participants. METHODS: A descriptive cross-sectional analysis of 151 lung cancer screening program websites of academic (n=76) and community medical centers (n=75) in the United States with information for health professionals and potential screening participants was conducted in March 2021. Presentation of eligibility criteria for potential screening participants and presence of information available specific to health professionals about lung cancer screening were the primary outcomes. Secondary outcomes included presentation of information about cost and smoking cessation, inclusion of an online risk assessment tool, mention of any clinical guidelines, and use of multimedia to present information. RESULTS: Eligibility criteria for lung cancer screening was included in nearly all 151 websites (n=142, 94%), as well as age range (n=139, 92.1%) and smoking history (n=141, 93.4%). Age was only consistent with the latest recommendations in 14.5% (n=22) of websites, and no websites had updated smoking history. Half the websites (n=76, 50.3%) mentioned screening costs as related to the type of insurance held. A total of 23 (15.2%) websites featured an online assessment tool to determine eligibility. The same proportion (n=23, 15.2%) hosted information specifically for health professionals. In total, 44 (29.1%) websites referred to smoking cessation, and 46 (30.5%) websites used multimedia to present information, such as short videos or podcasts. CONCLUSIONS: Most websites of US lung cancer screening programs provide information about eligibility criteria, but this is not consistent and has not been updated across all websites following the latest USPSTF recommendations. Online resources require updating to present standardized information that is accessible for all.

Effect of a group-based acceptance and commitment therapy programme on the mental health of clinical nurses during the COVID-19 sporadic outbreak period.

AIM: To develop and implement of a group-based acceptance and commitment therapy programme in helping clinical nurses with mental health problems during the sporadic COVID-19 outbreak period. BACKGROUND: In the face of the continuing COVID-19 pandemic, clinical nurses have a high risk of mental health issues. METHODS: A quasi-experimental design was used. Two hundred twenty-six nurses were recruited from four general hospitals to receive 10 sessions of acceptance and commitment therapy programme. The Symptom Checklist-90, Perceived Stress Scale and Connor-Davidson Resilience Scale were used to assess nurses' mental health symptom, perceived stress and psychological resilience at pre-intervention and 4-week post-intervention. RESULTS: The mean attendance sessions was 5.78. The Symptom Checklist-90 score was significantly lower at post-intervention than pre-intervention (P < 0.01), and there were no significant changes of perceived stress and psychological resilience. There were significant correlations among the changed rates of mental health, perceived stress and psychological resilience (P < 0.01). CONCLUSION: The acceptance and commitment therapy programme was effective in relieving mental health symptoms for clinical nurses and could protect clinical nurses' perceived stress and psychological resilience. However, a randomized controlled trial is needed to confirm the findings. IMPLICATION FOR NURSING MANAGEMENT: To facilitate clinical nurses' psychological health in crisis situation, nursing management team should provide and allocated appropriate resources to support the healthcare providers.

[Illness cognition and related factors in patients with prostate cancer].

OBJECTIVE: To study the illness cognition and related factors in patients with prostate cancer (PCa). METHODS: Using the convenience-sampling method, we selected 231 PCa patients treated in a general hospital in Xuzhou from October 2019 to October 2020. We conducted a cross-sectional study of the cases based on the general data of the patients and their scores on the Illness Cognition Questionnaire (ICQ). RESULTS: The PCa patients showed a high negative and a low positive illness cognition. The ICQ scores of the patients were high on "helplessness" (13.70 ± 3.54) and low on "acceptance" (16.64 ± 3.37) and "perceived benefits" (13.93 ± 3.76). Age, disease duration, disease stage and number of children were the four factors included in the regression equation of the participants' illness cognition. CONCLUSION: Negative illness cognition is high in PCa patients, higher in those at a younger age, with a longer disease duration, or with more than one child than in those at an older age, with a shorter disease duration, or with only one or no child.

[Benefits of community-based reproductive health service to middle-aged and elderly men].

OBJECTIVE: To explore the role of community-based reproductive health service in improving male reproductive health-related knowledge, behavior and psychology in middle-aged and elderly men. METHODS: We recruited 136 men aged 40－69 years from 5 community health service centers in Xuzhou for this self-control study from July to August 2019. We carried out a 4-item health education among the subjects concerning reproductive health knowledge, reproductive system diseases, healthy life, and enjoying health. Before and at 6 months after education, we evaluated the effects of intervention using the General Condition Questionnaire, Reproductive System Symptoms Questionnaire, Male Reproductive Health-Related Knowledge, Attitude and Behavior Questionnaire, and the Chinese version of Connor-Davidson Resilience Scale. RESULTS: At 6 months after intervention, the subjects showed significantly increased scores on healthy eating habits, male reproductive health cognation and psychological resilience, and decreased unhealthy behaviors and positive rate of reproductive system symptoms as compared with those before intervention (all P < 0.05). The cost-effectiveness ratio of the study was 7.75. CONCLUSIONS: Community-based reproductive health service can effectively improve the reproductive health-related knowledge and psychology, eating habits and healthy behaviors of middle-aged and elderly men. And it has a high cost-effectiveness ratio and is worthy of promotion in other communities.

The Mediating Effect of Positive Illness Cognitions on Experiential Avoidance and Quality of Life in Breast Cancer Patients.

OBJECTIVE: Illness cognition plays an essential role during physical, psychological, and social adjustment among patients with cancer. The present study aims to explore the mediating effects of positive illness cognition on experiential avoidance and quality of life (QOL) in this population. METHODS: Between August 2017 and June 2019, we recruited 312 patients with breast cancer in the treatment period from a general tertiary hospital's breast department using convenience sampling. We used the Illness Cognition Questionnaire, the Acceptance and Action Questionnaire II, and the Functional Assessment of Cancer Therapy-Breast Scale. RESULTS: The mean score of QOL was 93.39 (SD: 18.60) for patients with breast cancer. Positive illness cognition was closely related to the QOL and experiential avoidance. Experiential avoidance significantly negatively correlated with QOL (r = -0.59, P < 0.01) and positive illness cognition (r = -0.60, P < 0.01), while positive illness cognition significantly positively correlated with QOL (r = 0.82, P < 0.01). Positive illness cognition had a mediating effect between experiential avoidance and QOL (effect size: -0.56), accounting for 87.14% of the total effect. CONCLUSIONS: The QOL was low in Chinese patients with breast cancer. Positive illness cognition had a mediating effect between experiential avoidance and QOL. Caregivers should indirectly improve patients' QOL with breast cancer by improving their positive illness cognition levels.