The implementation of evidence-based practice (EBP) in nursing is essential for improving patient care outcomes, yet systemic barriers, leadership challenges, and resource limitations continue to hinder its integration into clinical practice. Nurse managers (NMs) play a crucial role in bridging the gap between policy directives and frontline implementation, yet the dynamic interplay between leadership strategies, knowledge utilisation, and organisational barriers remains underexplored, particularly in resource-constrained settings. This study examines how NMs navigate these challenges to sustain EBP adoption in acute care environments. This collective case study employed a longitudinal qualitative design across two acute care settings in the UK. Data were collected over eight months through semi-structured interviews with NMs, nonparticipant observations, and document analysis of clinical guidelines and internal reports. A thematic analysis approach was used to synthesise findings and provide a nuanced understanding of leadership strategies and systemic factors influencing EBP adoption. Six interconnected themes emerged: (1) Adaptive leadership strategies, where NMs employ a hybrid of directive and collaborative leadership approaches to drive EBP; (2) Overcoming organisational and resource barriers, including staff shortages, financial constraints, and competing priorities; (3) Knowledge utilisation and learning networks, highlighting the role of informal mentorship, structured CPD, and peer learning in sustaining EBP; (4) Digital transformation and EBP, examining the benefits and challenges of integrating digital tools and addressing IT literacy gaps; (5) Patient-centred adaptations, exploring how NMs balance evidence-based interventions with patient preferences and cultural considerations; and (6) Emotional and psychological support, underscoring the importance of managing staff resistance and mitigating change fatigue. Findings of this study emphasise the pivotal role of NMs in driving EBP implementation through adaptive leadership, strategic resource management, and fostering learning networks. Addressing organisational barriers requires multi-level interventions that integrate leadership actions with systemic enablers to promote sustainable, evidence-informed nursing practice. Findings provide critical insights for healthcare policymakers, hospital administrators, and educators in enhancing EBP uptake within resource-limited settings.
OBJECTIVES:LGBTQ+ community involvement is typically considered protective for sexual minoritized men (SMM). However, LGBTQ+ community involvement may expose SMM to body-image specific pressures (i.e., intraminority body stigma) that may reinforce idealized body ideals and disordered eating in SMM. We examined intraminority body stigma and body dissatisfaction as mediators of the longitudinal association between LGBTQ+ community involvement and disordered eating in SMM. METHODS:Two-hundred and twenty-five cisgender SMM between (18 and 30 years) were recruited via Prolific. Participants completed surveys at baseline and 3- and 6-month follow-ups. Prospective serial mediation models examined 3-month intraminority body stigma and body dissatisfaction as mechanisms of the links between baseline LGBTQ+ community involvement and six-month disordered eating. RESULTS:Greater baseline LGBTQ+ community involvement predicted increased three-month intraminority body stigma, which was associated with greater 3-month thinness-oriented body dissatisfaction, which, in turn, predicted increased 6-month thinness-oriented disordered eating. Simple significant mediation pathways indicated that greater baseline LGBTQ+ community involvement predicted increased three-month intraminority body stigma, which, in turn, predicted increased 6-month thinness-oriented disordered eating in SMM. Prospective models did not describe significant mediation pathways in relation to muscularity-oriented disordered eating. Thinness and muscularity models suggested that, after accounting for covariates and serial mediators, baseline LGBTQ+ community involvement predicted less disordered eating six months later. DISCUSSION:Intraminority body stigma may be a key mechanism clarifying the link between LGBTQ+ community involvement and thinness-oriented disordered eating in SMM. Future research should further contextualize body image and eating concerns among LGBTQ+ individuals in the service of reducing eating disorder disparities affecting this community.
This paper investigates changes in the parental role in family formation in contemporary China. Existing studies often focus narrowly on spouse search or are limited to specific historical periods or locations. Expanding the intergenerational contract framework, we adopt a multidimensional approach that examines both parental influence over spouse choice and monetary support after marriage. Using data from the 2006 and 2017 Chinese General Social Survey, we construct marriage cohorts reflecting China's major social, political, and economic transitions to chart parental involvement in family formation over seven decades. We find a temporary decline in parental influence during the reform era of rapid modernization. Rather than a linear progression toward youth autonomy and independence, we observe lingering parental influence over spouse choice and deepening parental monetary support after marriage, particularly among those married in the 2010s. In addition, gender, hukou status, only child status, and father's education are significant predictors of parental monetary support. In the newly negotiated intergenerational contract, parents selectively retreat from or advance in different aspects of family formation, in response to modernization forces, China's familist culture, and the necessity of intergenerational interdependence in an increasingly neoliberal economy. The continued and divergent roles of parents in family formation have important implications for understanding generational dynamics within families and the reproduction of social inequality.
Background:Arterial stiffness is a strong predictor of cardiovascular morbidity and mortality, especially in older adults. Despite exercise being shown to positively influence arterial health, the relative effectiveness of various exercise modalities remains unclear. Objectives:This systematic review aimed to examine the effects of resistance training (RT), aerobic training (AER), and concurrent aerobic plus resistance training (CON) on arterial stiffness in older adults, a recognised modifiable and independent cardiovascular risk factor. Methods:A comprehensive search of Medline (EBSCO), EMBASE, the Cochrane Database of Systematic Reviews, and clinicaltrials.gov was conducted. The robust search strategy, which also included systematic reviews being hand-searched for relevant articles and a forward and backwards citation search on the included articles, was employed to reduce the risk of selection and publication biases. Studies included in the review assessed arterial stiffness using pulse wave velocity (PWV) and focused on individuals aged 60 years and above who participated in a chronic (≥ 8 weeks) structured exercise intervention (RT, AER, or CON). Only randomised controlled trials were included. Sixteen studies met the inclusion criteria, and their methodological quality was evaluated using the PEDro scale. Results:The findings indicated that resistance training generally had a neutral effect (mean difference, MD: 0.06 m/s. SD: ±0.45) on arterial stiffness, whilst aerobic training produced modest improvements (MD: -0.62 m/s, SD: ±0.51). Notably, concurrent training consistently reduced arterial stiffness across diverse older adult(s) populations (MD: -0.85 m/s, SD: ±0.63). Conclusion:Combined aerobic and resistance training is the most effective non-pharmacological strategy for reducing arterial stiffness in older adults. This approach may offer essential benefits for cardiovascular health and healthy ageing. Further long-term studies are needed to explore the mechanisms involved and to inform tailored exercise interventions in geriatric populations.
Chemosensory hedonic capacity, the ability to derive pleasure from smells and tastes, is closely related to eating behaviors and overall well-being. However, research on chemosensory hedonic capacity has rarely focused on older adults and is largely limited to cross-sectional designs. Given the importance of sensory functions, eating behaviors, and satisfaction with food-related life (SWFL) for the well-being of older adults, it is important to investigate chemosensory hedonic capacity and its associations with eating behaviors and SWFL in this population. Thus, the present, one-year longitudinal study examined the prospective associations between chemosensory hedonic capacity, appetitive traits (as comprehensive indicators of eating behaviors), and SWFL among Chinese older adults. A total of 551 participants (46.6% men; Mage = 59.06 years) completed online surveys at baseline (T1), with 202 of these participants completing the surveys one year later (T2). Multivariate regression and mediation analyses were conducted. Results revealed that higher chemosensory hedonic capacity at T1 was associated with higher enjoyment of food at T2, lower food fussiness at T2, and higher SWFL at T2, after adjusting for covariates and the autoregressive effects. Mediation analyses showed that higher chemosensory hedonic capacity at T1 was related to lower food fussiness at T2, which, in turn, was related to greater SWFL at T2, supporting the mediating role of food fussiness at T2. These findings extend the literature by highlighting the longitudinal associations of chemosensory hedonic capacity with appetitive traits and SWFL in older adults, which have important implications for developing strategies to improve eating behaviors and food-related wellbeing in this population.
