Aims and objectives This study aimed to obtain the incidence of diastasis recti abdominis (DRA) and analyse possible risk factors in adult females. Moreover, the relationships between DRA and lower back pain, pelvic floor function and quality of life were also analysed. Background Diastasis recti abdominis is a separation of the abdominal muscles at the linea alba. Currently, studies on the prevalence rates, risk factors and consequences of DRA are varied. In particular, reports on DRA among adult women are lacking. Design A one‐sample questionnaire study design is used following the STROBE checklist. Methods The inter‐rectus distance was measured by computed tomography in 644 women. Custom questionnaires, the Oswestry Disability Index, The International Consultation on Incontinence Questionnaire‐Urinary Incontinence Short Form and the Medical Outcomes Study 36‐Item Short Form Health Survey (SF‐36) were used to investigate personal information, the subjects’ back pain, pelvic floor function and quality of life, respectively. Results The incidence of DRA was 28.4%. Age, the number of pregnancies, BMI and diabetes were influencing factors for DRA. After age stratification, pregnancy and diabetes were found to be risk factors for DRA in young women, and obesity and diabetes were risk factors for DRA in older women. This study showed that the association between DRA and low back pain was highly significant. Conclusions Diastasis recti abdominis is common in adult women. Avoiding multiple pregnancies, preventing diabetes and controlling weight may prevent DRA, which may be beneficial for decreasing low back pain in women. Relevance to clinical practice The findings have important implications for the health of adult women which can provide the basis for appropriate nursing implementation for DRA patients. The application of specific prevention and intervention measures for the risk factors may reduce the severity of low back pain.

IntroductionAging brings with an increased risk of chronic diseases among older adults, which could affect health outcomes. Evidence has showed that health literacy is associated with health outcomes. However, limited studies explore the underlying mechanism between health literacy and health outcomes. Hence, this study aimed to determine whether self-efficacy for managing chronic disease mediates the relationship between health literacy and health outcomes among older patients with chronic diseases, and to explore whether disease duration moderates the relationship between health literacy, self-efficacy for managing chronic disease, and health outcomes.MethodsParticipants were recruited from tertiary hospitals in Zhejiang Province, China from May 2019 to June 2020 using a convenience sampling method. A total of 471 older patients with chronic diseases completed questionnaires measuring demographics, disease-related information, health literacy, self-efficacy for managing chronic disease, and health outcomes. The mediation effect was examined using the structural equation model method, based on the bias-corrected bootstrapping method. The moderation effect was tested by the multiple-group analysis.ResultsA good fit model suggested that self-efficacy for managing chronic disease partially mediated the relationships between health literacy and health outcomes. In addition, disease duration moderated the relationships between health literacy, self-efficacy for managing chronic disease, and health outcomes.DiscussionThe findings highlight that adequate health literacy improved health outcomes among older patients with chronic diseases, which was further promoted by self-efficacy for managing chronic diseases. Moreover, a long disease duration could enhance the effect.

BackgroundRestraint is widely used in nursing homes to address safety concerns. However, many studies have shown that improper restraint can lead to many adverse outcomes. Nursing staff are the main practitioners of physical restraint in nursing homes and play an important role in restraint decision-making and management. In China, there is still a lack of large-scale surveys on the current situation regarding the use of restraint. This study aimed to identify this situation and the influencing factors of the knowledge, attitude, and practice of nursing staff regarding physical restraint in elderly care institutions.MethodsA cross-sectional multicenter descriptive study was conducted. A total of 311 staff in 25 elderly care institutions in Zhejiang Province were recruited using a quota sampling method. A homemade questionnaire was administered to collect general information and information on knowledge, attitude and practice regarding physical restraint.ResultsThe average scoring rates of the knowledge and attitude dimensions of the 311 staff were 48.7 and 75.6%, respectively. The average scoring rate of the practice dimension of 140 staff who implemented restraint was 80.1%. Educational background and training experience were the influencing factors of restraint knowledge. Training experience, educational background and professional title were the influencing factors of restraint attitude. Restraint knowledge and length of service were the influencing factors of restraint practice.ConclusionsKnowledge of physical restraint among nursing staff is not promising. Their attitude toward restraint was inappropriate or irresponsible in some aspects. Restraint practice is not sufficiently standardized. It is necessary to strengthen restraint training for nursing staff to improve their overall level of restraint knowledge, attitude and practice.

For the digestive system, there exists one common malignant tumor, known as gastric cancer. It is the third most prevalent type of tumor among different tumors worldwide. It has been reported that long noncoding RNAs (lncRNAs), participate in various biological processes of gastric cancer. However, there are still many lncRNAs with unknown functions, and we discovered a novel lncRNA designated as FBXO18-AS. Whether lncRNAFBXO18-AS participates in gastric cancer progression is still unknown. Bioinformatic analysis, immunohistochemistry, Western blotting, and qPCR were carried out to explore FBXO18-AS and TGF-β1 expression. In addition, EdU, MTS, migration and transwell assays were performed to investigate the invasion, proliferation and migration of gastric cancer in vitro. We first discovered that FBXO18-AS expression was upregulated in gastric cancer and linked to poorer outcomes among patients with gastric cancer. Then, we confirmed that FBXO18-AS promoted the proliferation, invasion, migration, and an EMT-like process in gastric cancer in vivo and in vitro. Mechanistically, FBXO18-AS was found to be involved in the progression of gastric cancer by modulating TGF-β1/Smad signaling. Therefore, it might offer a possible biomarker for gastric cancer diagnosis and an effective strategy for clinical treatment.

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