AIMS AND OBJECTIVES:To compare and rank the effectiveness of various non-pharmacological interventions on depression for community-dwelling individuals with spinal cord injury (SCI). BACKGROUND:Depression is a significant and persistent mental health problem among community-dwelling individuals with SCI. There is increasing evidence that non-pharmacological interventions are safe and effective for alleviating depression. However, the efficacy and comparative effectiveness of various non-pharmacological interventions for community-dwelling individuals with SCI remain unclear. DESIGN:Systematic review and network meta-analysis (NMA) according to PRISMA-NMA guidance. METHODS:We included randomized controlled trials (RCTs) of community-dwelling individuals with SCI comparing non-pharmacological interventions versus usual care/waiting list and reporting depressive symptoms using validated scales. China National Knowledge Infrastructure, Wanfang Data, Chinese Biomedical Literature Database, China Science and Technology Journal Database, the Cochrane Library, PubMed, Web of Science, Embase, ProQuest and Scopus were systematically retrieved. Pairwise meta-analyses were performed using Review Manager 5.4.1, and the network meta-analysis was conducted using Stata 15.1. RESULTS:Thirty-two RCTs involving 2200 participants were identified from database inception to May 2026. Compared with the control group, combination therapy (SMD = -0.86, 95% CI: -1.46 to -0.27), exercise therapy (SMD = -0.66, 95% CI: -1.16 to -0.15), psychological interventions (SMD = -0.41, 95% CI: -0.70 to -0.13) and self-management education (SMD = -0.33, 95% CI: -0.61 to -0.05) showed statistically significant effects, whereas vocational rehabilitation was not (SMD = -0.03, 95% CI: -1.00 to 0.95). Combination therapy had the highest SUCRA (89.1%, mean rank = 1.5), followed by exercise therapy (76.9%, mean rank = 2.2), psychological interventions (55.5%, mean rank = 3.2), self-management education (44.0%, mean rank = 3.8) and vocational rehabilitation (24.7%, mean rank = 4.8). CONCLUSION:Combination therapy had the highest ranking probability. However, all comparisons were rated as very low certainty according to CINeMA. The findings should be interpreted with caution. RELEVANCE TO CLINICAL PRACTICE:Community nurses may consider integrating exercise, self-management education and brief psychological support into individualized depression management for individuals with SCI. Support should be tailored according to depressive symptom severity, functional status, secondary complications, patient preferences, safety considerations and available community resources. Nurse-led or nurse-coordinated care may include depressive symptom screening, exercise planning, self-management coaching, motivational interviewing, scheduled follow-up and referral to mental health professionals when indicated. TRIAL REGISTRATION:PROSPERO: CRD42022342155.

ObjectiveTo explore the barriers and facilitators to leisure-time physical activity among community-dwelling adults with spinal cord injury in China, using the Capability, Opportunity, Motivation-Behaviour model as a theoretical framework.DesignA qualitative study employing semi-structured interviews.SettingTwo rehabilitation centres in Guangzhou, China.ParticipantsTwenty community-dwelling adults with spinal cord injury, purposively sampled for diversity in gender, age, injury level and severity.ResultsThe analysis identified multifaceted factors across the Capability, Opportunity and Motivation-Behaviour domains. Within the Capability domain, barriers included limited physical function and a pessimistic mindset, whereas facilitators encompassed strong psychological resilience, high self-efficacy and positive beliefs in rehabilitation. Opportunity was constrained by limited social resources, inadequate rehabilitation facilities and financial constraints, but was enhanced by diverse social support. Within the Motivation domain, engagement in leisure-time physical activity was hindered by low self-discipline, fear of physical activity and motivational conflict, while motivation was strengthened by reflection on the benefits of physical activity, a desire for social reintegration and return to work.ConclusionsPromoting leisure-time physical activity among this population requires a theory-informed, multi-level intervention strategy. Interventions should simultaneously strengthen individual capability, expand opportunity and foster motivation. Crucially, such interventions must be contextually adapted to address China-specific socioeconomic constraints and cultural norms.

《国际功能、残疾与健康分类(international classifica-tion of functioning,disability and health,ICF)》由世界卫生组织(WHO)在2001年发布[1],二十多年来,WHO 一直致力于ICF在全世界的临床应用,并根据各国反馈推出了 ICF的不同版本,包括了通用版(ICF generic set,ICF-GS)[2]、核心组合版(ICF core set,ICF-CS)[3]及康复组合版(ICF re-habilitation set,ICF-RS)[4].

Aiming at the low efficiency of single-vehicle submarine search and high complexity of cluster submarine search of Unmanned Surface Vehicle (USV), a new model for distributed antisubmarine of non-cluster USV is proposed by making full use of the long-endurance and long-distance submarine search capabilities of USV. This model uses a small number of USV carrying sonar detection equipment and distributes them relatively according to the designated position to form a multistatic sonar detection system, based on which anti-submarine operations are carried out. Around this model, a multistatic sonar system detection performance evaluation model is established based on maximizing the coverage of submarine search to study the influence of the deployment of the system platform on the detection coverage ability. The swarm intelligent algorithm optimizes the array information of the multistatic sonar system to achieve better detection effect. The simulation results show that using the swarm intelligence algorithm to reasonably optimize the array deployment of the model can greatly improve its regional coverage.

Purpose To translate the Moorong Self-Efficacy Scale (MSES) into Chinese and to examine its reliability and validity in patients with spinal cord injury (SCI). Methods A cross-sectional study design was employed. The MSES was translated into Chinese by forward- and back-translation and its psychometric properties were examined among 176 patients with SCI recruited from four rehabilitation centers in China using convenience sampling. Results In this study, all 176 patients were aged from 18 to 90 years old with an average of 39.51 +/- 14.07. The content validity index of the scale was 0.99. Principal components analysis with varimax orthogonal rotation was used. Three factors were extracted accounting for 39.083%, 11.149%, and 8.391% of the total variance and labeled as general self-efficacy (eight items), social self-efficacy (five items), and self-management self-efficacy (three items). Confirmatory factor analysis showed acceptable fit compared with previous studies. Pearson's correlation coefficient between the total scores of the MSES and the General Self-Efficacy Scale was 0.660 (p < 0.001). Cronbach's alpha coefficient was 0.892 for total items and 0.862, 0.817, and 0.739 for the three factors. The interclass correlation coefficients between the pretest and retest were 0.859 (0.733-0.925) for the total score. Conclusions The Chinese version of the MSES is reliable and valid, suggesting that it is suitable for evaluating self-efficacy of Chinese patients with SCI.

BackgroundDementia caregivers suffer from mental health problems while caring for dementia patients. As a core value, familism has been linked to the mental health of dementia caregivers. This study aims to systematically review the familism of dementia caregivers and to examine the association between familism and mental health of anxiety, depression, and burden in empirical research studies.MethodsWe conducted a systematic search in various databases like Medline, PubMed, and Embase databases from inception till April 2021. Fisher's z was calculated with correlation coefficient or regression coefficient values for three familism dimensions and mental health of anxiety, depression, and burden. All statistical analyses were performed using Comprehensive Meta‐Analysis (CMA) version 2.0 software.ResultsA total of seven studies with 1178 participants were eligible for the meta‐analysis. For caregivers' anxiety, three of seven studies, with 358 participants, were examined in terms of the average corrected correlation coefficient across the studies. It was found that dementia caregivers' familism was significantly related to anxiety. The pooled z‐value was 0.148 (95% CI = 0.043‑0.253). In addition, caregivers' familism significantly affected depression (z = 0.080; 95% CI = 0.003‑0.156), as did familial obligation (z = 0.122; 95% CI = 0.034‑0.211), but perceived family support was not associated with this (z = 0.051, 95% CI = −0.038‑0.140). As for caregiver burden, there was no evidence that familism was significantly associated with it (z = −0.073; 95% CI = −0.297 to 0.151), including familial obligation and perceived family support (z = −0.087 and −0.089, respectively; 95% CI = −0.278 to 0.104 and −0.335 to 0.157, respectively).ConclusionsAn association between caregiver familism and anxiety/depression exists in dementia patients. More research is needed to explore the relationship between familism and burden.

目的 系统评价远程干预在居家脊髓损伤患者压力性损伤预防中的应用效果,为临床干预提供循证依据.方法 计算机检索中国生物医学文献数据库、中国知网、万方数据库、维普数据库、Cochrane Library、PubMed、Embase、Web of Science、Scopus、ProQuest和BMJ Best Practice从建库到2021年8月收录的相关文献.由2名研究人员进行质量评价后,采用RevMan 5.3软件进行Meta分析.结果 共纳入14篇文献,包括9项随机对照试验和5项类实验研究,共1582例患者.Meta分析结果显示,远程干预能降低居家脊髓损伤患者压力性损伤的发生率[RR=0.29,95％CI(0.20,0.43),P<0.001],提高患者的生活质量[SMD=0.94,95％CI(0.19,1.68),P=0.010]和满意度[SMD=0.86,95％CI(0.58,1.13),P<0.001];不良事件发生率比较,差异无统计学意义[RR=0.50,95％CI(0.20,1.27),P=0.140].结论 远程干预在居家脊髓损伤患者压力性损伤预防中是安全、可行的,能降低其压力性损伤的发生率,提高患者的生活质量和满意度.受纳入研究质量和数量的限制,上述结论尚需更多高质量的研究验证.

Background: Pressure injury is a common complication after a spinal cord injury. Long-term multidisciplinary follow-up is difficult after such patients have been discharged. Telemedicine promises to provide convenient and effective support for the prevention and treatment of pressure injury, but previous attempts to demonstrate that have produced inconsistent results. Objective: The aim of this study is to evaluate the effectiveness of telemedicine in preventing and treating pressure injury among community-dwelling patients with spinal cord injury, and determine which telemedicine form is more effective. Methods: This systematic review was performed according to the PRISMA-NMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Network Meta-Analysis) standards. Ten databases were searched to identify randomized controlled trials and quasi-experimental studies related to the effectiveness of telemedicine intervention in patients with spinal cord injury. Two researchers worked independently and blindly selected studies, extracted data, and assessed the risk of bias. The results were described as relative risk (RR) and weighted mean difference and 95% CI. Results: The 35 studies comprised 25 randomized controlled trials and 10 quasi-experimental studies involving 3131 patients. The results showed that telemedicine can significantly (P<.05) reduce the incidence of pressure injury (RR 0.24, 95% CI 0.14-0.41; P<.05; I-2=0%), promote faster healing (RR 0.73, 95% CI 0.62-0.85; P<.05; I-2=0%), and yield lower scores on the pressure ulcer scale of healing (weighted mean difference=-1.98, 95% CI -3.51 to -0.46; P<.05; I2=0%). Cumulative ranking estimates showed that combining telemedicine with conventional intervention (93.5%) was the most effective approach. Conclusions: Telemedicine is a feasible way to prevent pressure injury among patients with spinal cord injuries. It can decrease the incidence and severity of pressure injury and accelerate patients' healing without imposing economic burden. It is best used in tandem with other, more conventional interventions. Due to the limited quality and quantity of included studies, large-scale and well-designed randomized controlled trials are warranted.

ObjectiveTo examine the feasibility of the Body Function component in the International Classification of Functioning, Disability and Health Rehabilitation Set (ICF-RS) as a functional assessment instrument for orthopedic patients by using Rasch analysis.MethodsA total of 119 orthopedic inpatients hospitalized in Shenzhen Longcheng Hospital were recruited from July 2018 to November 2019 through convenient sampling method. The component of Body Function (9 categories) of the ICF-RS was used to assess the patients. Rasch analysis was performed using the RUMM 2030 software. The psychometric properties were reported including overall goodness of fit, goodness of fit for each item, person separation index, differential item functioning, and person-item threshold distribution map.ResultsThe first-round Rasch analysis found that the overall goodness of fit for the Body Function component of the ICF-RS was poor （χ2=39.01, P=0.002 8, the significance level after Bonferroni correction was 0.05/9=0.005 6), the item-fit and individual-fit residuals were (0.36±1.34) and (-0.24±0.62), respectively. The person separation index was 0.55. The residuals of the category b130 Energy and Drive Function was 3.642, more than 2.5, and it fit the Rasch model poorly. After deleting the category b130 Energy and Drive Function, the second-round Rasch analysis found that the overall goodness of fit for the Body Function component of the ICF-RS was satisfied (χ2=25.60, P=0.059 9, the significance level after Bonferroni correction was 0.05/8=0.006 3), the item-fit and individual-fit residuals were (0.40±0.90) and (-0.27±0.59), respectively. The person separation index was 0.58. The residuals of the remaining items were all within ±2.5 with a nonsignificant P value. The results showed no differential item functioning in terms of age, gender, course of disease, and marital status. The person-item threshold distribution map showed that the categories basically covered the patient coordinates. The patients performed the worst in the category b280 Pain Sensation and the best in the category b640 Sexual Function.ConclusionAfter deleting the category b130 Energy and Drive Function, the remaining 8 categories of Body Function component in the ICF-RS fit well with the Rasch model, and could be used as a functional assessment instrument for orthopedic patients.

Objective: To assess the effect of a self-management intervention delivered by mobile application (APP) for depression among community-dwell-ing individuals with spinal cord injury (SCI). Design: Randomized controlled trial.Settings: General communities in China.Participants: Community-dwelling individuals with SCI who were diagnosed within 2 years were recruited in this study (N=98). It was a conve-nience sample with an average age of 41.71, 82.7% participants were men.Interventions: Participants in the intervention group (n=49) received 5 sessions on self-management training provided by nurse-led multidisci-plinary team via APP at the second, fourth, sixth, eighth, and 12th weeks, respectively, after they discharge from hospitals. Participants in the con-trol group (n=49) received routine telephone counselling provided by follow-up nurses at the 12th week after they discharge.Outcome Measure: The outcome of this study is depression, which is not the primary outcomes in the registration of this program. Depression was measured by version 2 of Beck Depression Inventory at discharge (T0), the 12th week after discharge from hospitals (T1), and the 24th week after discharge from hospitals (T2).Results: There were 98 participants (49 in the intervention group and 49 in the control group) completing the intervention and data collection. Compared with the control group, the intervention group had lower level of depression at T2 (B=-5.76; 95% CI=-9.97,-1.54; P=.007). Small to moderate effect sizes on depression favoring the intervention were demonstrated at T1 (Cohen's d=-.178) and T2 (Cohen's d=-.535).Conclusions: APP-based self-management support can be a potential intervention to reduce depression among community-dwelling individuals with SCI.Archives of Physical Medicine and Rehabilitation 2023;104:195-202 (c) 2022 by the American Congress of Rehabilitation Medicine.

Background Spinal cord injury (SCI) severely impairs the physical and mental health of patients, decreasing their self-efficacy in coping with daily life and quality of life (QOL). In China, a large gap remains between the complex long-term health needs of SCI patients and the current community care system. With the prevalence of mobile terminals, the usage of mobile health apps has the potential to fill this gap by extending qualified medical resources to the families of SCI patients. Our team developed the app Together for the transitional care of home-dwelling SCI patients in China. Objective This study aimed to evaluate the effects of app-based transitional care on the self-efficacy and QOL of SCI patients. Methods Through a three-round Delphi process, an Android app was designed. Both medical staff and patients could access the app. Medical staff used it for providing remote transitional care to SCI patients. Patients used it to view transitional care time and send messages to medical staff. Thereafter, a multicenter and assessor-blinded randomized controlled trial was conducted. Participants (n=98) who had SCI and lived at home following discharge were recruited and randomly assigned to a study group (n=49) and control group (n=49) using a randomized number list in four research centers. Patients in both groups received systematic discharge education before discharge. The study group received five follow-ups conducted by trained nurses through the app, which had four core functions, namely remote assessment, health education, interdisciplinary referral, and patient interaction, at weeks 2, 4, 6, 8, and 12 following discharge. The control group received a routine telephone follow-up conducted by nurses at week 12 following discharge. The outcome measures were the Moorong Self-Efficacy Scale (MSES) and 36-item Short-Form Health Survey (SF-36) scores. Data were collected before discharge (T0) and at weeks 12 (T1) and 24 following discharge (T2). Differences between the groups were tested by repeated measures analysis of variance and simple effect analysis. Results After the follow-up, the total MSES scores in the study group improved over time (T0=67.80, T1=71.90, and T2=76.29) and were higher than those in the control group (T2=64.49) at 24 weeks following discharge (simple effect analysis: F1=8.506, P=.004). Regarding the total SF-36 score, although it was higher in patients from the study group (T2=65.36) than those from the control group (T2=58.77) at 24 weeks following discharge, only time effects were significant (F2,95=6.671, P=.002) and neither the group effects nor the interaction effects influenced the change in QOL (group effects: F1,96=0.082, P=.78; interaction effects: F2,95=3.059, P=.052). Conclusions This study confirmed that app-based transitional care improves the self-efficacy of SCI patients. Nevertheless, QOL improvement is not yet evident. Future investigations with larger sample sizes and longer observation periods are warranted to further verify the effects. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012317; http://www.chictr.org.cn/showproj.aspx?proj=19828

Owing to its compatibility with existing Si technology, epitaxial graphene on SiC is expected to replace III-V materials in future. This paper proposes an available approach to overcome the low quality and the high cost properties of traditional epitaxial growth access. The epitaxial graphene grows in low vacuum environment, using Ar as the filling gas. The epitaxial graphene was investigated with optical microscope, atomic force microscopy and Raman spectroscopy. It is found that large area graphene cover on SiC C-face conformally. The Raman results show that the materials obtained in lower vacuum environment are ordered and put free standing monolayer graphene.

AIMS AND OBJECTIVES:To determine the aspects of excretory dysfunction most influential in determining the quality of life of survivors of spinal cord injury.BACKGROUND:Excretory dysfunction is one of the most common and troublesome sequelae of spinal cord injury. Previous studies have shown that it can restrict social participation restriction, cause readmission and generally influence quality of life substantially.DESIGN:A cross-sectional survey of hospital inpatients following STOBE guidelines.METHODS:A convenience sample of 101 patients with traumatic or non-traumatic spinal cord injury were asked about their experiences of excretory dysfunction, and management and their self-perceived quality of life. Univariate analysis and multiple linear regression were performed to isolate the most important relationships.RESULTS:Only 2 of the 101 subjects professed to be unaffected by excretion dysfunction. Bladder-related dysfunction was the most frequently mentioned type of problem. Quality of life impairment was found to be most often associated with bladder accidents, bowel accidents and having more than one bladder complications.CONCLUSIONS:Excretory dysfunction substantially impacts quality of life after a spinal cord injury. Bladder accidents, bowel accidents and more than one bladder complication are factors independently influencing the quality of life of spinal cord injury survivors.RELEVANCE TO CLINICAL PRACTICE:To improve excretion-related QOL, patients' bladder and bowel self-management training should be strengthened seeking to prevent complications and reduce the risk of bladder and bowel accidents.

OBJECTIVE:To develop a team approach to applying the International Classification of Functioning, Disability and Health Rehabilitation Set (ICF-RS) in clinical evaluation.DESIGN:A Delphi study.SUBJECTS:Experts from rehabilitation institutions in China including physicians, nurses, physiotherapists and occupational therapists.METHODS:A 2-round Delphi survey and expert panel discussion were used to generate the team approach. Firstly, the candidate types of professionals for team rating were chosen through expert panel discussion. A carefully selected group of participants was then asked to score the suitability of physicians, nurses, or other candidate therapists for each category's rat-ing, applying the International Classification of Functioning, Disability and Health Rehabilitation Set in clinical evaluation. After initial assignment of cate-gory to types of professionals, a second round Delphi survey was conducted to quantify the professionals' agreement with the category assignments and generate a final team evaluation approach.RESULTS:Thirty of the category assignments achiev-ed consensus. The final team evaluation approach assigned 6 categories to physicians to evaluate, 7 categories to nurses, 9 categories to physiotherapists, and 8 to occupational therapists.CONCLUSION:Such a team evaluation approach could facilitate implementation of the ICF-RS in clinical settings and provide a more convenient assessment tool for professionals.

目的:以移动APP“脊髓损伤患者远程延续护理系统”中的《国际功能、残疾和健康分类》(ICF)相关随访指标为结局评定指标,纵向探讨脊髓损伤患者出院后功能状态的变化趋势.方法:2018年6月-2019年9月,选取广州市、十堰市和成都市4家医院的6个临床科室的符合纳入排除标准的91例脊髓损伤患者,随访护士以APP中的32个随访指标(31个ICF类目和1个不能被ICF涵盖的指标“照顾者的能力”)为测量工具,分别在患者出院时、出院后3个月和出院后6个月使用APP评定患者的功能状态.结果:75％(24个)ICF类目的适用率占90％以上,适用率最低的两个类目分别是性功能(29.67％)和生殖功能(14.29％);在32个随访指标中,21个ICF类目(5个身体功能领域的类目,全部10个活动和参与领域的类目,6个背景性因素领域的类目)和1个不能被ICF涵盖的指标“照顾者的能力”在3个时点的评定结果之间的差异均有显著性意义,表明居家SCI患者的这些功能状态随时间发展有所好转.未呈现明显好转趋势的10个类目涉及生理功能障碍和常见并发症,均属于身体功能和身体结构成份.结论:SCI患者出院后6个月内,大部分个体功能状态随着时间的推移逐渐好转.但部分生理功能障碍和并发症难以随着时间推移有明显改善,仍需要长期的康复和科学管理.

目的 对现有的神经源性膀胱功能障碍评估与管理相关指南进行整合,从而形成本土化证据资源.方法 以ADAPTE方法 为依据,形成神经源性膀胱功能障碍评估与管理的临床护理实践草案,通过神经源性膀胱功能障碍患者与相关专家的相继论证,对推荐意见进行评价并整合,最终修订形成正式版指南.结果 最终纳入5篇循证指南,整合形成的指南内容包括神经源性膀胱功能障碍的分类、病史采集、相关检查、导尿建议及辅助膀胱管理措施共5个主题,共20条推荐意见.结论 本研究整合形成了神经源性膀胱功能障碍评估与管理领域高质量的循证资源,为临床中的循证护理实践提供了参考和依据.

目的 了解社区脊髓损伤患者的心理状况和社会参与水平现状,并探讨二者的相关性.方法 采用便利抽样法,选取2016年9月至2017年9月在中山大学孙逸仙纪念医院和南方医科大学南方医院就诊后回归社区的脊髓损伤患者250例为研究对象,采用一般资料调查问卷、医院焦虑抑郁量表和中文版自主参与测评问卷对其进行调查.结果 被调查的250例社区脊髓损伤患者医院焦虑抑郁量表总得分为(16.25±6.85)分,其中焦虑亚量表得分为(7.12±3.76)分,抑郁亚量表得分为(9.13±3.77)分,焦虑、抑郁发生率分别为34.80％和57.60％;自主参与测评问卷总得分为(44.90±17.31)分,总均分为(1.80±0.69)分.患者医院焦虑抑郁量表总得分以及焦虑、抑郁亚量表得分均与自主参与测评问卷总得分及各维度得分呈正相关(P<0.001).结论 社区脊髓损伤患者焦虑、抑郁发生率高,社会参与处于中等水平.医护人员在为社区脊髓损伤患者提供延续性康复护理的过程中,要关注其心理状况和社会参与情况,采取有效措施缓解患者焦虑和抑郁情绪,提高其社会参与的积极性.

Background: The International Classification of Functioning, Disability, and Health (ICF) is a unified system of functioning terminology that has been used to develop electronic health records and assessment instruments. Its application has been limited, however, by its complex terminology, numerous categories, uncertain operationalization, and the training required to use it well. Together is a mobile health app designed to extend medical support to the families of spinal cord injury (SCI) patients in China. The app's core framework is a set of only 31 ICF categories. The app also provides rating guidelines and automatically transforms routine assessment results to the terms of the ICF qualifiers. Objective: The goal of the research is to examine the suitability of the ICF set used in the app Together for use as an instrument for assessing the functioning of SCI patients. Methods: A cross-sectional study was conducted including 112 SCI patients recruited before discharge from four rehabilitation centers in China between May 2018 and October 2019. Nurses used the app to assess patient functioning in face-to-face interviews. The resulting data were then subjected to Rasch analysis. Results: After deleting two categories (family relationships and socializing) and one personal factor (knowledge about spinal cord injury) that did not fit the Rasch model, the body functions and body structures, activities and participation, and contextual factors components of the ICF exhibited adequate fit to the Rasch model. All three demonstrated acceptable person separation indices. The 28 categories retained in the set were free of differential item functioning by gender, age, education level, or etiology. Conclusions: Together overcomes some of the obstacles to practical application of the ICF. The app is a reliable assessment tool for assessing functioning after spinal cord injury.