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Journal of Neurology, Neurosurgery, and... Dec 2023Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a disabling long-term condition of unknown cause. The National Institute for Health and Care Excellence... (Review)
Review
Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a disabling long-term condition of unknown cause. The National Institute for Health and Care Excellence (NICE) published a guideline in 2021 that highlighted the seriousness of the condition, but also recommended that graded exercise therapy (GET) should not be used and cognitive-behavioural therapy should only be used to manage symptoms and reduce distress, not to aid recovery. This U-turn in recommendations from the previous 2007 guideline is controversial.We suggest that the controversy stems from anomalies in both processing and interpretation of the evidence by the NICE committee. The committee: (1) created a new definition of CFS/ME, which 'downgraded' the certainty of trial evidence; (2) omitted data from standard trial end points used to assess efficacy; (3) discounted trial data when assessing treatment harm in favour of lower quality surveys and qualitative studies; (4) minimised the importance of fatigue as an outcome; (5) did not use accepted practices to synthesise trial evidence adequately using GRADE (Grading of Recommendations, Assessment, Development and Evaluations trial evidence); (6) interpreted GET as mandating fixed increments of change when trials defined it as collaborative, negotiated and symptom dependent; (7) deviated from NICE recommendations of rehabilitation for related conditions, such as chronic primary pain and (8) recommended an energy management approach in the absence of supportive research evidence.We conclude that the dissonance between this and the previous guideline was the result of deviating from usual scientific standards of the NICE process. The consequences of this are that patients may be denied helpful treatments and therefore risk persistent ill health and disability.
Topics: Humans; Fatigue Syndrome, Chronic; Surveys and Questionnaires; Exercise Therapy; Cognitive Behavioral Therapy
PubMed: 37434321
DOI: 10.1136/jnnp-2022-330463 -
Physical Chemistry Chemical Physics :... Aug 2022A SnS monolayer is a new two-dimensional material with a black phosphorous structure, with high carrier mobility and a large surface-to-volume ratio, and is an ideal...
A SnS monolayer is a new two-dimensional material with a black phosphorous structure, with high carrier mobility and a large surface-to-volume ratio, and is an ideal candidate material for gas sensors. The adsorption and sensing behaviors between the SnS monolayer and gas molecules are enhanced under the action of TM atoms with high catalytic performance. The adsorption behavior of CO and HS on intrinsic and transition metal atom modified SnS monolayers is investigated based on the first principles calculations. The adsorption structure, adsorption energy, electron transfer, density of states, electron local density, work function, and desorption properties are discussed to evaluate the potential applications of SnS monolayers as scavengers and gas sensors for CO and HS molecules. The results show that Ni, Pd, Pt and Cu atoms tend to be adsorbed on T sites, while Ag and Au atoms are more easily captured by T sites. Further studies have shown that all TM atoms can significantly enhance the sensing behavior between the SnS monolayer and the gas molecules. The adsorption performance of the CO molecule on the TM-mediated SnS (TM-SnS) monolayer is obviously better than that of the HS molecule. Furthermore, the effects of electric field and biaxial strain on the sensing properties of gas molecules on Ni-SnS monolayers are also investigated. Finally, the desorption time of gas molecules from the TM-SnS monolayer is estimated. This will provide experimenters with theoretical guidance for the application of SnS-based sensing materials, and our work is of great significance for predicting new monochalcogenide sensing materials.
PubMed: 35960000
DOI: 10.1039/d2cp02257e -
Frontiers in Psychology 2022With the continuous development and improvement of Internet media technologies in China, the influence of livestream e-commerce is becoming increasingly prominent, and...
With the continuous development and improvement of Internet media technologies in China, the influence of livestream e-commerce is becoming increasingly prominent, and an increasing number of people are engaging in consumption activities in this field. It is important to study consumer stickiness in livestream e-commerce to promote economic structure adjustment and innovation-driven development. Therefore, in this study, we adopted the expectation confirmation theory (ECT) as the theoretical framework and analyzed the ECT and stickiness. The study considered satisfaction as the previous influencing factor of user and consumer stickiness, replaced the continuance intention in the expectation confirmation model with consumer stickiness as the explanatory variable, introduced the variable of perceived playfulness as the value perception after user experience, and established a consumer stickiness factors model. A total of 262 valid questionnaires were collected in this study, and SmartPLS analysis along with interviews were used to justify the limitations of data analysis. The results of the study demonstrated a significant effect of perceived usefulness and confirmation on satisfaction, a significant effect of confirmation on perceived usefulness, a significant effect of satisfaction on stickiness, and a significant effect of confirmation on perceived playfulness. Based on findings from the data analysis and interviews, we further proposed rationalized recommendations, and aimed to provide some theoretical guidance for future research on live streaming.
PubMed: 36118462
DOI: 10.3389/fpsyg.2022.962786 -
Polymers Aug 2023For rubber-like materials, there are three popular methods of equibiaxial tension available: inflation tension, equibiaxial planar tension, and radial tension. However,...
For rubber-like materials, there are three popular methods of equibiaxial tension available: inflation tension, equibiaxial planar tension, and radial tension. However, no studies have addressed the accuracy and comparability of these tests. In this work, we model the tension tests for a hyperelastic electroactive polymer (EAP) membrane material using finite element method (FEM) and investigate their experimental accuracy. This study also analyzes the impact of apparatus structure parameters and specimen dimensions on experimental performances. Additionally, a tensile efficiency is proposed to assess non-uniform deformation in equibiaxial planar tension and radial tension tests. The sample points for calculating deformation in inflation tensions should be taken near the top of the inflated balloon to obtain a more accurate characteristic curve; the deformation simulation range will be constrained by the material model and its parameters within a specific limit ( ≈ 1.9); if the inflation hole size is halved, the required air pressure must be doubled to maintain equivalent stress and strain values, resulting in a reduction in half in inflation height and decreased accuracy. The equibiaxial planar tension test can enhance uniform deformation and reduce stress errors to as low as 2.1% (at = 4) with single-corner-point tension. For circular diaphragm specimens in radial tension tests, increasing the number of cuts and using larger punched holes results in more uniform deformation and less stress error, with a minimum value of 3.83% achieved for a specimen with 24 cuts and a 5 mm punched hole. In terms of tensile efficiency, increasing the number of tensile points in the equibiaxial planar tension test can improve it; under radial tension, increasing the number of cuts and decreasing the diameter of the punched hole on the specimen has a hedging effect. The findings of this study are valuable for accurately evaluating various equibiaxial tension methods and analyzing their precision, as well as providing sound guidance for the effective design of testing apparatus and test plans.
PubMed: 37688187
DOI: 10.3390/polym15173561 -
Plants (Basel, Switzerland) Dec 2023The legacy effects of invasive plant species can hinder the recovery of native communities, especially under nitrogen deposition conditions, where invasive species show...
The legacy effects of invasive plant species can hinder the recovery of native communities, especially under nitrogen deposition conditions, where invasive species show growth advantages and trigger secondary invasions in controlled areas. Therefore, it is crucial to thoroughly investigate the effects of nitrogen deposition on the legacy effects of plant invasions and their mechanisms. The hypotheses of this study are as follows: (1) Nitrogen deposition amplifies the legacy effects of plant invasion. This phenomenon was investigated by analysing four potential mechanisms covering community system structure, nitrogen metabolism, geochemical cycles, and microbial mechanisms. The results suggest that microorganisms drive plant-soil feedback processes, even regulating or limiting other factors. (2) The impact of nitrogen deposition on the legacy effects of plant invasions may be intensified primarily through enhanced nitrogen metabolism via microbial anaerobes bacteria. Essential insights into invasion ecology and ecological management have been provided by analysing how nitrogen-fixing bacteria improve nitrogen metabolism and establish sustainable methods for controlling invasive plant species. This in-depth study contributes to our better understanding of the lasting effects of plant invasions on ecosystems and provides valuable guidance for future ecological management.
PubMed: 38202380
DOI: 10.3390/plants13010072 -
Patient Education and Counseling Jul 2023To identify and synthesise the experiences and benefits of addressing vocational issues in the provision of healthcare for young people (YP) with long-term conditions... (Review)
Review
Addressing education and employment outcomes in the provision of healthcare for young people with physical long-term conditions: A systematic review and mixed methods synthesis.
OBJECTIVE
To identify and synthesise the experiences and benefits of addressing vocational issues in the provision of healthcare for young people (YP) with long-term conditions (LTCs).
METHODS
We searched 10 bibliographic databases. Restrictions were applied on publication date (1996-2020) and language (English). Two reviewers independently screened records against eligibility criteria. Articles reporting relevant qualitative and/or quantitative research were included. Quality appraisal was undertaken following study selection. Qualitative data were synthesised thematically, and quantitative data narratively. A cross-study synthesis integrated qualitative and quantitative findings.
RESULTS
43 articles were included. Thematic synthesis of qualitative studies (n = 23) resulted in seven recommendations for intervention (psychological support; information/signposting; skills training; career advice; healthcare-school/workplace collaboration; social support; flexible/responsive care). The narrative synthesis summarised results of 17 interventions (n = 20 quantitative studies). The cross-study synthesis mapped interventions against recommendations. Transitional care was the intervention type that most comprehensively met our proposed recommendations.
CONCLUSIONS
Evidence from YP perspectives highlights that vocational development is an important area to address in healthcare provision. Robust intervention studies in this area are lacking.
PRACTICE IMPLICATIONS
Our evidence-based recommendations for intervention can support health professionals to better address vocational issues/outcomes. With minimal adaptations, transitional care interventions would be particularly well suited to deliver this.
Topics: Humans; Adolescent; Health Personnel; Educational Status; Social Support; Workplace; Delivery of Health Care
PubMed: 37086594
DOI: 10.1016/j.pec.2023.107765 -
Disability and Rehabilitation Aug 2020To develop and pretest a comprehensive occupation- and health condition-specific job matching tool for vocational rehabilitation of persons with spinal cord injury. The...
An interdisciplinary approach to job matching: developing an occupation-specific job matching tool for reintegrating persons with spinal cord injury into the labor market.
To develop and pretest a comprehensive occupation- and health condition-specific job matching tool for vocational rehabilitation of persons with spinal cord injury. The study design involved qualitative and quantitative steps. First, an interdisciplinary scoping review covering return-to-work, organizational and vocational psychology research was conducted to devise a conceptual job matching framework. Then, the occupation- and health condition-specific tool content was determined based on a database analysis of jobs performed by persons with spinal cord injury and focus groups with affected persons. Finally, a tool prototype was developed and pretested in a simulation exercise with vocational rehabilitation professionals. The study yielded a tool prototype with matching profiles that structure the demands and characteristics of 415 occupations as well as spinal cord injury-related needs and limitations into a stable, a modifiable, and a needs-supplies dimension of person-job match. Vocational rehabilitation professionals perceived the prototype as helpful for determining target jobs for vocational retraining and for goal-oriented intervention planning. By comprehensively assessing the person-job match of individuals with spinal cord injury, the tool facilitates determining suitable target jobs and interdisciplinary intervention planning in vocational rehabilitation and is thus likely to promote sustainable return to work.Implications for rehabilitationJob matching is crucial for a sustainable work reintegration of persons with disabilities. However, the majority of existing job matching tools lack applicability for return to work because they are (1) not occupation-specific or rely on outdated occupational information, (2) not health condition-specific, and (3) not comprehensive with regard to the relevant aspects for determining a person-job match.Persons with spinal cord injury are a case in point for the need of job matching tools that comprehensively address occupation- and health condition-specific information.The present study responded to the shortcomings of existing job matching tools and uses vocational rehabilitation of persons with spinal cord injury as a case in point for developing a job matching tool that is both occupation- and health condition-specific at the same time.The developed tool was perceived as promising for determining suitable target jobs for vocational retraining of persons with spinal cord injury and for goal-oriented intervention planning in an interdisciplinary vocational rehabilitation setting. The tool's underlying conceptual framework may also serve as a blueprint for developing job matching tools for other types of disabilities.
Topics: Disabled Persons; Humans; Occupations; Rehabilitation, Vocational; Return to Work; Spinal Cord Injuries; Vocational Education
PubMed: 30929524
DOI: 10.1080/09638288.2018.1561958 -
JBI Evidence Synthesis May 2024The objective of this review was to identify the literature and map the individual and environmental factors that influence registered nurses' and midwives' decision to... (Review)
Review
OBJECTIVE
The objective of this review was to identify the literature and map the individual and environmental factors that influence registered nurses' and midwives' decision to stay or leave their professions within the first 3 years of practice.
INTRODUCTION
Nursing and midwifery workforce sustainability is an international concern. One aspect is the retention of new registered nurses and midwives in their first years of practice. Several factors are thought to influence the decisions of new registered nurses and midwives to leave or stay in their professions. This review sought to identify and map those factors to enable further research for workforce sustainability development strategies.
INCLUSION CRITERIA
The study cohort included registered nurses and midwives in their first 3 years of practice, which we called newcomers . Nurses who were required to work under the supervision of registered nurses and midwives (ie, enrolled nurses, licensed practical nurses, and licensed vocational nurses) were excluded. Papers were included only if they explored individual or environmental factors influencing nurses' decision to stay in or leave the professions of nursing or midwifery. Studies could be from any country or care environment, and participants were newcomers providing direct clinical care. Newcomers employed in other health roles, such as education, research, administration, or non-nursing/midwifery roles, were excluded. All research designs and peer-reviewed papers were included; policy documents were excluded. The date of inclusion was from the earliest publication on this topic, which was 1974, to the date of the search.
METHODS
The JBI methodology for scoping reviews was followed, and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidance. The search strategy aimed to locate published and unpublished primary studies, reviews, and text and opinion papers. The initial search of relevant databases was conducted in January 2020 and updated in January 2022. Reference lists of included articles were also screened. Following data extraction, descriptive qualitative content analysis was undertaken.
RESULTS
Twelve articles from 11 studies were included in this review. They were published between 2005 and 2020, and originated from 5 countries. Two studies were observational, 3 were cross-sectional, 5 were longitudinal studies, 1 was a pre- and post-program evaluation, and 1 was a scoping review. All studies focused on registered nurses; no publications on registered midwives met the inclusion criteria. Individual factors we identified that impact newcomers' intention to stay in or leave the profession included physical and psychological health, professional identity, professional commitment, and development. Environmental factors included workplace culture, engagement, and management.
CONCLUSIONS
Professional self-image, identity, and a sense of pride in the profession are important components of newcomer retention. Strategies that positively support transition to practice and create realistic expectations were highlighted. Managers play an important role in registered nurse retention, as they can influence many of the newcomers' experiences. It is concerning that no studies about newcomer midwives were found. Many studies explored turnover or intention to leave the job/employer rather than the profession. These are important considerations for future research.
Topics: Humans; Midwifery; Nurses; Female; Personnel Turnover
PubMed: 37661721
DOI: 10.11124/JBIES-22-00367 -
Materials (Basel, Switzerland) Dec 2022In concrete structures, replacing conventional steel bars with high-strength steel reinforcement (HSSR) can effectively save the use of materials. However, the...
In concrete structures, replacing conventional steel bars with high-strength steel reinforcement (HSSR) can effectively save the use of materials. However, the deformation properties and strength dispersion of HSSR are different from those of conventional steel reinforcement, which restricts or conservatively uses them in practical applications. For example, the partial safety factor of HRB500 grade steel bars (the yield strength is 500 MPa) in guideline GB50010-2010 is larger than that of conventional steel bars, and there is no relevant guidance for HRB600 grade steel bars (the yield strength is 600 MPa). Based on this, this paper will propose the limit state design method of high-strength steel reinforced concrete beam (HSSRCB) based on reliability analysis, which is convenient for the popularization and use of HSSR. Firstly, the flexural performance test of HSSRCBs was introduced, and the flexural capacity of HSSRCB was analyzed based on the existing prediction model. Second, a sectional numerical analysis model was established, where the section was discretized into several points, and then the curvature was gradually increased to obtain the corresponding bending moment through integration. A large number of samples were calculated to obtain statistical characteristics of the error of prediction model. Then, the limit state functions were established for two kinds of format, including partial safety factor format (PSSF) and resistance reduction factor format (RRFF), respectively, and the reliability of HSSRCBs was analyzed based on Monte Carlo simulation. Finally, the recommended values of partial safety factor of material and reduction factor of bearing capacity were proposed, in which the design strength of HRB500 and HRB600 reinforcement was 454 MPa and 545 MPa for PSSF, respectively, and the resistance reduction factor for the flexural capacity of HSSRCB was 0.8 and 0.75 for RRFF, respectively.
PubMed: 36556805
DOI: 10.3390/ma15248999 -
Nurse Education Today Apr 2022The first Accelerated Bachelor of Science in Nursing (ABSN) program with a two-year educational period in Japan was developed in a nursing university in Tokyo in 2017...
BACKGROUND
The first Accelerated Bachelor of Science in Nursing (ABSN) program with a two-year educational period in Japan was developed in a nursing university in Tokyo in 2017 (i.e., 2017-ABSN two-year program or designated as program 1) for individuals aiming to pursue nursing as a second career. It replaced program 2, the second-year bachelor's degree transfer program which is a three-year program implemented from 1997 to 2016. The original and currently on-going four-year undergraduate Bachelor of Science in Nursing (BSN) is designated as program 3.
OBJECTIVE
To evaluate the 2017-ABSN two-year program from learners' perspective.
METHODS
We used a case-control study design. As cases, the subjects were third-year bachelor's degree transfer students of program 1 at the nursing university in Tokyo. As controls, second-year bachelor's degree transfer students of program 2 and four-year undergraduate students of program 3 in the same university were given a questionnaire when they graduated. The survey items were grouped into five scales: (1) The education you are receiving, (2) Studying nursing, (3) Stress level, (4) The highest score on the national nursing examination practice test, and (5) The vocational commitment. The mean score of each item was calculated and comparisons were conducted using the Mann Whitney test.
RESULTS
Responses from 77 students (program 1), 23 students (program 2), and 133 students (program 3) were analyzed. The program 1 students had a significantly lower mean score on (1) The education you are receiving item "There is time for preparation and review" (p = 0.01). The program 1 students had a significantly lower score on (2) The studying nursing item "I can get the job (role) I want" (p = 0.01). The program 1 students had a significantly higher score on (4) The best score in the national nursing examination practice test (p = 0.01).
CONCLUSION
Shortening the academic period to two years in program 1 had no effect on the knowledge base of the students. However, the program 1 students had a significantly lower score in their identity as a nurse. It is often difficult to acquire a new nursing culture in a short period from a previous culture that has already been mastered. Educators need to fully understand the characteristics of learners and provide them with individualized and professional guidance to further improve their skills.
Topics: Case-Control Studies; Education, Nursing, Baccalaureate; Humans; Japan; Students, Nursing; Surveys and Questionnaires
PubMed: 35144205
DOI: 10.1016/j.nedt.2022.105275