To explore the associations of depression and anxiety with cognitive function in older adults, and the potential mediating role of mental health. Data were collected from a cross-sectional survey of community-dwelling older adults in Guangxi, China, conducted between July 2022 and July 2023. Valid data from 10,370 participants aged 60 years and older were analyzed. Cognitive function was assessed using the Memory Impairment Screen (AD8), while depression and anxiety symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Scale-7 (GAD-7), respectively. Linear regression, correlation analysis, and chain mediation analysis were employed to investigate the relationships among age, mental health, and cognitive function. Among the 10,370 participants (4,590 males and 5,780 females, aged 65–103 years, mean age: 73.41 ± 6.67 years), 23.95

Background and objectiveWork-related musculoskeletal disorders (WMSDs) are highly prevalent among nurses and threaten workforce stability. Although sleep disturbance is known to be associated with WMSDs, the psychosocial pathways underlying this relationship remain poorly understood. This study aims to examine whether sense of agency and perceived social support mediate the relationship between sleep quality and WMSDs among hospital nurses, using a structural equation modeling approach.MethodsA convenience sample of staff nurses was recruited from six tertiary hospitals in three Chinese cities. Participants self-reported sociodemographics, the Pittsburgh Sleep Quality Index (PSQI), sense of personal control, perceived social support, and the 12-month prevalence/number of WMSDs. Structural equation modeling with maximum likelihood estimation was constructed to examine the hypothesized pathways, and bias-corrected bootstrap analysis was conducted to analyze the mediating effect of the sense of agency and perceived social support between sleep quality and the number of WMSDs.ResultsOur study included information from 1,388 nurses working in clinical settings. After controlling the factors of gender, length of service, night shift, frequent trunk flexion, frequent heavy lifting, and perceived work fatigue, the PSQI of nurses showed a direct negative association with the sense of agency and perceived social support. Perceived social support had a direct positive impact on the sense of agency, and perceived social support and agency had a direct negative impact on the number of WMSDs in nurses (p < 0.001), χ2/df = 7.466, CFI = 0.906, RMSEA = 0.070, and the model demonstrated acceptable fit indices. The direct effect accounted for 81.8% of the total effect, while the indirect effects through three significant mediation paths accounted for 18.2% of the total effect (indirect effect = 0.035, total effect = 0.192).ConclusionEven after accounting for established ergonomic and occupational covariates, poor sleep quality was not only directly associated with a higher number of WMSD sites among nurses but also showed an indirect association with WMSDs through lower sense of agency and perceived social support. Interventions that protect and bolster these psychosocial resources should be embedded within integrated musculoskeletal-health frameworks addressing biological, psychological, and social determinants.

Abstract Background and objective Nurses are essential for safeguarding public health, and their physical condition directly affects care quality and patient safety. Work-related musculoskeletal disorders (WMSDs) are highly prevalent in this workforce and may be amplified by circadian disruption. We therefore integrated individual and environmental risk factors, with special attention to night-shift characteristics, to identify and rank determinants of WMSDs among shift-working nurses. Seven machine-learning algorithms were compared to generate a comprehensive, validated prediction tool that enables managers and nurses to implement targeted, proactive interventions and reduce occupational injury. Methods This study is a cross-sectional study. The general information, lifestyle, psychosocial data, working environment and shift characteristics of shift nurses were collected, and the influencing factors of WMSDs were analyzed. The mean square error increase and residual sum of squares are calculated, and the importance of influencing factors is sorted respectively. The independent influencing factors of WMSDs in shift nurses were included. After screening variables again by Lasso regression, seven prediction models of LDA, PLS, RDA, GLM, RF, SVM-Radial and SVM-Linear were established by machine learning. The AUC, accuracy and specificity median were used to evaluate the prediction efficiency, and the best prediction model was obtained and the accuracy of the prediction factors was verified. Results Among 1 080 shift-working nurses, the WMSD prevalence at any body site was 85.19%. The top-ranked determinants were perceived control, perceived social support, Pittsburgh Sleep Quality Index (PSQI) score, chronotype, frequent bending over, night-shift nap duration, friend support, work support, family support, prolonged neck flexion and years in nursing. The LASSO-selected predictor set comprised dairy intake frequency, shift pattern, monthly night shifts, number of nurses on night duty, post-night-shift recovery days, post-night-shift catch-up sleep, frequent trunk flexion, prolonged neck flexion, PSQI, chronotype and perceived control. Random forest achieved the highest predictive performance (median AUC = 0.919). Conclusions Individual characteristics, lifestyle, physical condition, occupational features, shift schedule, biomechanical load and psychosocial factors collectively influence WMSD occurrence in nurses. Random forest outperformed the other algorithms and should be carried out in conjunction with various factors in the model.

This study aimed to analyze latent profiles and characteristics of nurses’ knowledge, attitudes, and practices (KAP) regarding pressure injury (PI) prevention, as well as influencing factors across distinct profiles. A convenience sampling method was employed to recruit nurses from hospitals at various tiers in Guangxi Zhuang Autonomous Region between July and August 2024. Data were collected using a General Information Questionnaire and a Nurse PI-KAP Questionnaire. Latent profile analysis (LPA) identified distinct PI-KAP profiles, while univariate analysis and multinomial logistic regression determined profile-specific influencing factors. Among 17,253 enrolled nurses, the total PI-KAP score was 63.44 ± 7.69. Three latent profiles emerged: low-level PI-KAP (12.82

BackgroundThis study aimed to investigate and analyze the current status of oral disease treatment among the older adult in Guangxi Zhuang Autonomous Region, while also assessing the continuing medical education (CME) needs of dental institution personnel regarding oral diseases in this population.MethodsConvenience sampling was used to investigate the oral disease treatment among older adults and to assess CME needs of dental institution personnel regarding oral diseases in this population across various oral medical and health institutions in Guangxi.ResultsA total of 754 valid questionnaires were collected, of which 70.3% were from non-public oral health institutions. Out-of-pocket costs for older adults were as high as 91.3%. The per capita cost of older adult patients was beyond 500 yuan in 51.6% of the oral health institutions. In terms of CME training, 32.8% of dental institution medical personnel have participated in CME courses specifically on oral diseases in the older adult. Meanwhile, 69.9% of institutions have expressed a need for CME training on oral diseases in the older adult.ConclusionNon-public oral health institutions account for a significant proportion, and the older adult primarily pay out-of-pocket for oral disease treatment in these facilities. The high cost of treatment may pose a significant barrier to the older adult seeking oral healthcare. Increasing CME programs targeted at geriatric oral diseases can help enhance the treatment capabilities of dental healthcare workers and improve oral health outcomes for the older adult population.

PurposeDespite the wealth of data on the role of chronic disease comorbidity in shaping cognitive dysfunction in older adults, a comprehensive view of this dynamic interplay remains a frontier. This study will reveal the intricate interactions between the number of chronic diseases and cognitive function in the elderly, based on the perspective of cognitive function in patients with multiple chronic diseases.MethodsOur study was based on the data from the 2023 China Psychological Care for the Elderly Action Survey, and the SPSS 26.0 (IBM Corp., Armonk, NY, United States) software package was used for mediation model analysis. The approach encompassed descriptive analysis of variables, Spearman’s correlation analyses to explore associations between variables, and a moderated mediation analysis.ResultsThe study found that the number of chronic diseases (r = 0.183, p < 0.001) was positively correlated with cognitive function. Anxiety and depression partially mediated the relationship between the number of chronic diseases and cognitive function (β = 0.227, 0.235, both p < 0.001). Age moderated the association between the number of chronic diseases and depression (β = 0.010, p < 0.001).ConclusionThis study provides a comprehensive mediation model that establishes a new association between the number of chronic diseases and cognitive function in older adults. It suggests that we should pay attention to the negative impact of multiple chronic diseases on cognitive function of the elderly and improve their psychological coping ability, so as to ensure the stable development of healthy aging.

Given the discrepancy between the low utilization rate of hospice care services and the high willingness to choose hospice care, this study aims to identify the factors influencing the utilization among older adults. The findings will provide a foundation for interventions designed to enhance the growth of this service. A mixed-methods study of convergent parallel designs. In the quantitative research phase, in January 2024, a convenience sampling method was used to recruit 350 terminally ill older individuals from three hospitals and three communities in Guangxi, China. Face-to-face surveys were conducted using a general information questionnaire, a Home Hospice Care Service Needs Questionnaire, and a Home Hospice Care Service Knowledge, Attitude, and Practice Scale. In the qualitative research phase, semi-structured interviews were conducted with 16 terminally ill older individuals to explore the barriers and facilitators to the utilization of home hospice care services. A total of 332 (94.86%) older individuals completed the survey, and 45 (13.55%) accepted home hospice care. The identified barriers to utilization included high physiological, psychological, and spiritual needs, as well as families' feelings of guilt. The facilitators included being of advanced age (≥80 years), having chronic diseases, not needing a caregiver, having high social needs and knowledge scores, and perceiving a significant economic burden. The utilization of home hospice care services by older adults is lower, which is influenced by both subjective and objective factors. The novel identification of 'families' guilty' as a barrier underscores the need for targeted interventions that address emotional and psychological barriers within families. Policymakers should consider these factors when developing strategies to promote the development of home hospice care for older adults, ensuring that interventions are culturally sensitive and economically feasible.

ObjectiveThe purpose of this study was to understand the relationship between the multiple chronic conditions (MCC), mental health and cognitive function of older adults in the community, and to propose a hypothesis that depressive symptom mediate the number of chronic diseases and cognitive impairment in older adults.MethodParticipants aged 65 years and older from 35 communities in 14 cities in Guangxi, China were recruited. The residents’ depressive symptom (PHQ-9) and cognitive status (AD-8) were evaluated, Chi-square test was used to explore the effects of different socio-demographic characteristics on depressive symptom and cognitive impairment. Pearson correlation analysis and the process model 4 were used to explore the relationship between the number of chronic diseases, depressive symptom and cognitive impairment.ResultA total of 11,582 older adults were included in our analysis. The rate of MCC reaching 26.53%. Hypertension combined with diabetes accounts for the highest proportion of two chronic diseases (13.2%). Among the combination of three chronic diseases, the highest incidence of coexisting hypertension combined with cervical/lumbar spondylosis, and rheumatoid arthritis (7.1%). In this study, depression symptoms accounted for 12.9% of older adults aged 65 and above, and cognitive impairment accounted for 27.4%. Female, older age, reside in urban areas, lower educational levels, no spouse, live alone, and MCC were risk factors for depressive symptom and cognitive impairment in older adults (P<0.05). Depressive symptom had a mediating effect in the number of chronic diseases and cognitive impairment, and the mediating effect (1.109) accounted for 44.13% of the total effect (0.247).ConclusionThe mental health of the older adult needs to be taken seriously, and improving depressive symptom can reduce the occurrence of cognitive impairment in older patients with MCC to a certain extent.

Purpose: Practitioners in China who implement hospice care services include doctors, nurses, and care workers. These individuals play an important role in the holistic care of patients at the end of life and their families. This study aimed to provide baseline data to develop hospice care services and improve relevant policies by investigating the knowledge and attitudes of hospice care practitioners (HCPs) and analyzing influencing factors. Methods: This cross-sectional descriptive study used stratified sampling and quota sampling. The HCPs were from nursing homes, medical institutions, integrated medical and nursing institutions, and community health service centers in Guangxi Zhuang Autonomous Region. We examined HCPs' demographic characteristics and scores on a self-designed Chinese scale to measure their knowledge and attitudes(K&A scale). A total of 1821 HCPs completed surveys from May 2022 to July 2022. The data were analyzed using descriptive statistics, univariate analysis and multiple linear regression. Results: The standard score of the K&A scale of 1821 HCPs was 61.62 (SD=9.78), and the individual mean scores of knowledge and attitudes were 76.42 (SD=28.13) and 58.69 (SD=11.31), respectively. The final multiple linear regression analysis indicated that the main factors that influenced the K&A score were monthly income, job satisfaction, and the hospice care-related system (HCS). Conclusion: The HCPs in this study displayed moderate mean scores for knowledge and a less favorable attitude toward hospice care. Monthly income, job satisfaction and the HCS were the common factors that influenced HCPs' K&A. The results suggest the need to strengthen targeted and professional training for HCPs, increase their welfare and benefits, and improve indigenous policies of hospice care.

Background To delve deeply into the impact of depression and anxiety on cognitive function in the elderly, as well as the mediating mechanisms involved. Methods Data were derived from the baseline survey of a cross-sectional study on the health status of community-dwelling elderly individuals in Guangxi, China, conducted from July 2022 to July 2023. Valid data from 10,370 elderly individuals aged 60 years and older were analyzed. Cognitive function of the elderly was assessed using the Memory Impairment Screen (AD8), while depression symptoms and anxiety symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Scale-7 (GAD-7), respectively. Univariate and multiple linear regression analyses were conducted to explore the influencing factors of cognitive function in the elderly. Pearson correlation analysis was used to investigate the correlations among depression symptoms, anxiety symptoms, cognitive function, and related factors. Chain mediation analysis was performed using AMOS 26.0 software to explore the mechanisms of the effects of age and mental health on cognitive function among community-dwelling elderly individuals. Results A total of 10,370 elderly individuals were surveyed in this study, including 4,590 males and 5,780 females, aged 65–103 years (mean age: 73.41 ± 6.67 years). The mean score on the AD8 scale was 1.05 ± 1.71, with 2,484 (23.95%) individuals identified as having mild cognitive impairment and 1,705 (16.44%) individuals with cognitive dysfunction. The mean score on the PHQ9 scale was 1.22 ± 2.30, with 580 individuals (5.59%) classified as having mild depression, 121 (1.17%) with moderate depression, 33 (0.32%) with moderately severe depression, and 7 (0.07%) with severe depression. The mean score on the GAD7 scale was 0.70 ± 1.89, with 368 individuals (3.55%) identified as having mild anxiety, 78 (0.75%) with moderate anxiety, and 22 (0.21%) with severe anxiety.Multivariate linear regression analysis showed statistically significant differences in the effects of gender, age, category, years of education, marital status, PHQ9, and GAD7 on cognitive function among the elderly (P < 0.05). There was a positive correlation between PHQ9 scores and AD8 scores (r = 0.361, P < 0.001) in the elderly, as well as a positive correlation between GAD7 scores and AD8 scores (r = 0.287, P < 0.001). Additionally, a strong positive correlation was observed between PHQ9 scores and GAD7 scores (r = 0.690, P < 0.001). Age was also positively correlated with AD8 scores (r = 0.213, P < 0.001).The study further revealed a chained mediating effect of age, mental health, and cognitive function among the elderly. The total effect estimate was 0.055, which was statistically significant (P < 0.001). The direct effect estimate was 0.04, indicating a significant positive and direct impact of age on AD8 scores (P < 0.001). Conclusions The finding that mental health plays a partial mediating role between age and cognitive function provides a new perspective for understanding the decline in cognitive function. This discovery holds significant theoretical and practical implications for improving the mental health and cognitive function of the elderly, which can contribute to the development of more effective intervention measures and enhance the quality of life for the elderly.

Objective:To investigate the current status of elderly health services in medical institutions at all levels within Guangxi Province, China. Methods:Using a purposeful sampling method, a questionnaire survey was conducted from July 24, 2023 to October 24, 2023 on the general situation, human resources, rehabilitation medicine, nursing services, and the development of hospice care at 1305 medical institutions in Guangxi. Results:Among the surveyed 1305 medical institutions in Guangxi, 172 (13.18%) had established departments of geriatrics, while 293 (22.45%) boasted departments of rehabilitation medicine. Furthermore, 909 (69.66%) of these institutions offered annual free physical examination services to individuals aged 65 and above. Notably, a total of 362 medical institutions, encompassing both comprehensive hospitals and grassroots hospitals, were recognized as elderly-friendly institutions, accounting for 31.4% of the surveyed sample.The highest demand for talents in medical institutions at all levels included specialized physicians/general practitioners (74.6%), traditional Chinese medicine practitioners (63.1%), rehabilitation therapists (56.1%), and specialized nurses for the elderly (41.7%). A total of 1038 medical institutions conducted popular science activities on elderly health, accounting for 79.5% of the total, focusing mainly on disease prevention (89.21%), nutritional diets (84.68%), rational medication use (79.77%), physical exercise (68.21%), and mental health (60.79%). Only 88 medical institutions provided hospice care services, accounting for 6.7% of the total. Conclusion:Guangxi medical institutions' elderly services are inadequate. Geriatrics and rehab departments are scarce, talent is lacking, and hospice care is underdeveloped. As aging accelerates, the country and society must support elderly care. Governments should introduce talent incentives, and medical institutions should enhance services, foster a positive work environment, and advance Guangxi's elderly health agenda.

Abstract Background Social isolation is a state of active or passive detachment from society that accelerates the decline of physical and mental functions of the elderly and leads to various adverse consequences. However, the relationship between social isolation and oral health as well as cognitive function has not yet been established.Methods This was a cross-sectional survey conducted on an older population, where we collected data from 530 older adults using the General Information Questionnaire, LSNS-6, OHAT, and MoCA-B. The purpose of the survey was to investigate the current status of social isolation and its influencing factors, as well as to explore the relationship between oral health, cognitive function, and social isolation among the elderly.Results In Guangxi, the incidence of social isolation among the elderly was 10.38%, with the high risk of social isolation accounting for 53.77%. Marital status, place of residence (urban or rural), cognitive function, and oral health status were identified as factors influencing social isolation among the elderly. The study found a negative correlation between the oral health score and social isolation score (r = -0.373, P < 0.001), with unhealthy oral status showing the strongest correlation with social isolation (r = -0.448, P < 0.001). Additionally, cognitive function scores were positively correlated with social isolation scores (r = 0.377, P < 0.001), with dementia showing the strongest association with social isolation (r = 0.324, P < 0.001). Furthermore, oral health demonstrated a high screening capacity for social isolation (AUC 95% CI = 0.823 (0.757, 0.890)), with an optimal cut-off value of 9.5, sensitivity of 67.3%, specificity of 90.1%, and Yoden index of 0.574.Conclusion The social isolation status of the elderly is influenced by various factors, including marital status, residence (urban or rural), cognitive function, and oral health status. Moreover, the Oral Health Assessment Tool (OHAT) can be utilized as an effective objective tool for screening social isolation among the elderly.

哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin, mTOR)是细胞功能的中心调节因子,通过mTOR复合物 1(mTOR complex 1, mTORC1)和mTORC2在细胞运动、增殖与存活、基因转录、蛋白质合成、自噬等不同的细胞基本过程中发挥重要作用[1-2].

目的:了解广西壮族自治区养老机构老年人养老服务需求现状,并分析其影响因素,为养老机构提升养老服务质量提供参考依据.方法:2021年9月-11月采用便利抽样方法选取广西壮族自治区养老机构124名老年人,对其养老需求进行问卷调查.结果:老年人养老需求总分为(170.97±25.40)分,处于较高水平.疾病护理需求为(4.47±0.47)分、基础护理需求为(4.09±0.88)分、生活护理需求为(4.12±0.84)分、心理护理需求为(4.37±0.63)分、临终护理需求为(4.29±0.64)分.多元线性回归分析结果显示,年龄、民族、入住养老院前的居住情况、医疗付费方式及入住养老院原因是养老机构老年人养老需求的影响因素(P＜0.05).结论:养老机构老年人在疾病护理、心理护理、临终护理方面的服务需求较高,养老机构应强化医疗、护理服务供给,加强人文及临终关怀服务,提高机构老年人养老生活质量.

目的 评估人体测量学指标对老年人轻度认知障碍的筛查能力,确定最佳筛查指标.方法 采用多阶段分层抽样的方法,对广西3个市6个社区/乡镇的60岁以上常住老年人502名进行蒙特利尔认知评估量表-北京版(MoCA-B)测评和人体指标测量,以认知评估结果为金标准,将老年人分为认知正常组和轻度认知障碍组,比较两组人体测量学指标的差异,绘制受试者工作特征曲线,评价人体测量学指标对轻度认知障碍的筛查能力.结果 认知正常组244名,轻度认知障碍组258名.两组身高、腰围、小腿围、BMI、腰高比、腰小腿围比、身体圆度指数、腹部体积指数和体脂肪指数比较,差异有统计学意义(均P＜0.05);腰小腿围比对总样本轻度认知障碍具有较高的筛查能力(AUC=0.681);联合指标腰小腿围比+腰高比在60～＜65岁老年人中筛查能力最高(AUC=0.708);腰小腿围比+体脂肪指数在65～＜75岁老年人中筛查能力最高(AUC=0.735).结论 腰小腿围比、体脂肪指数和腰高比对老年人轻度认知障碍具有一定筛查价值.腰小腿围比+腰高比是60～＜65岁老年人的最佳联合筛查指标;腰小腿围比+体脂肪指数是65～＜75岁老年人的最佳联合筛查指标.

目的:调查广西壮族自治区医学生对老年群体的态度及从事老年服务工作的意愿,并分析其影响因素.方法:便利抽取广西壮族自治区6所医学院校1064名医学生作为研究对象,采用一般资料调查问卷、医学生从事老年服务工作意向、老年人态度问卷调查医学生对老年群体态度及从事老年服务工作意愿,并分析其影响因素.结果:17.95％医学生对老年群体态度趋于积极;40.04％的医学生表示将来愿意从事老年服务相关工作;多元线性回归分析显示,专业、性别、文化程度、户口所在地是医学生对老年群体态度的影响因素;Logistic回归分析显示,职业生涯规划培训、宗教信仰、与老年人生活的经历、照顾老年人的经历、自己与老年人的关系、专业为第一志愿是影响医学生从事老年服务工作的影响因素.结论:广西壮族自治区医学生对老年群体的总体态度不积极,从事老年服务工作意愿较低.政府应注重对养老产业的帮扶,出台相应人才激励政策,医学院校应加强宣教,养老机构应构建良好的工作环境,呼吁更多医学生志愿投身健康养老服务.

选择适合的工具对老年人口腔健康进行评估,以及时了解老年人口腔健康,有助于护理人员、照护者针对老年人口腔健康情况制订及实施个性化的口腔护理方案,降低老年人因口腔健康问题导致的肺炎、认知障碍等不良结局的发生率.本文对国内外用于评估老年人口腔健康的工具进行总结,包括评估工具的主要内容、特点、应用现状及局限性,以期为老年人口腔健康评估工具的开发及合理化选用提供参考,为完善老年人口腔护理方案提供依据.

We have reviewed a large number of relevant literature to determine the deficiencies of orthopedics in the diagnosis and prevention of venous thromboembolism（VTE）events during the perioperative period, and found that the TEG technology has been widely used after liver transplantation, which may make up for the deficiencies. This review expounds the detection principle and latest thromboelastography (TEG) development, and highlights the advantages of TEG over previous screening methods in diagnosing hypercoagulability. By analyzing the correlation and consistency between TEG and conventional coagulation test, reliable indexes for diagnosing hypercoagulability and important parameters for guiding perioperative anticoagulation treatment were summarized. Furthermore, our work contributes to further studies of TEG in orthopedics. Based on the research results, we believe that TEG may help orthopedists to identify and predict VTE events, use anticoagulants, eventually reduce the occurrence of VTE events.

探讨系列化微课程联合案例教学在ECMO临床护理教学实践中的应用效果.将广西某三级甲等综合医院2021年7月至2022年1月在ICU实习的30名护理本科生作为对照组,2022年2月-2022年8月在ICU实习的30名护理本科生作为观察组,对照组采用常规带教模式,观察组在对照组的基础上,采用系列化微课程联合案例教学法开展教学活动.比较两组的自我导向学习能力、临床思维能力、理论和技能操作得分.观察组的自我导向学习能力得分、临床思维能力得分、理论和技能操作得分均高于对照组(P＜0.05).由此可以得出,将系列化微课程联合案例教学法应用在ECMO临床护理教学实践中,可有助于提升护理实习生的自主学习能力、批判性思维能力,提高ICU临床护理教学效果.