Background/purpose

Workplace stress among nurses providing care for people living with human immunodeficiency virus is a serious problem in China that may increase rates of job burnout and affect quality of care. Mindfulness-based intervention has been shown to be effective in relieving stress and burnout in nurses. Therefore, we designed a mixed-method pilot study to evaluate a mindfulness-based intervention for nurses providing care for people living with human immunodeficiency virus.

Methods

Twenty nurses caring for people living with human immunodeficiency virus in the First Hospital of Changsha, China participated in a mindfulness-based intervention for 2 hr sessions weekly for 6 weeks. The Perceived Stress Scale, Maslach Burnout Inventory, Five Facets Mindfulness Questionnaire, State-Trait Anxiety Inventory, and the Beck Depression Inventory were used to collect data before and after the mindfulness-based intervention. Participants were invited to attend an in-depth interview 1 week after the end of the mindfulness-based intervention to give feedback.

Results

The quantitative analyses revealed a significant change in Five Facets Mindfulness Questionnaire scores. There were no significant differences between pre- and post-intervention measures of any other variables. Qualitative results showed nurses experienced a decrease in work and daily life pressures; improvements in communications with patients, colleagues and families, with better regulation of negative emotions, and acceptance of other people and attention.

Conclusion

This study supports the acceptability and potential benefits of the mindfulness-based intervention in helping nurses caring for people living with human immunodeficiency virus to manage stress and emotions, and improve their acceptance of others and attention. A larger study with a randomized controlled trial design is warranted to confirm the effectiveness of this mindfulness-based intervention.

Background

The American Diabetes Association recently included glycated hemoglobin in the diagnostic criteria for diabetes, but research on the utility of this biomarker in Southeast Asians is scant. The aim of this study was to evaluate the association between percent HbA1c and incident diabetes in an Asian population of adult men and women without reported diabetes.

Methods

Data analysis of 5,770 men and women enrolled in the Singapore Chinese Health Study who provided a blood sample at the follow-up I visit (1999-2004) and had no cancer and no reported history of diabetes or cardiovascular disease events. Diabetes was defined as self-report of physician diagnosis, identified at the follow-up II visit (2006-2010).

Results

Hazard ratios (and 95% confidence intervals) for incident diabetes by 5 categories of HbA1c were estimated with Cox regression models and continuous HbA1c with cubic spline analysis. Compared to individuals with an HbA1c ≤ 5.7% (≤39 mmol/mol), individuals with HbA1c 5.8-5.9% (40-41 mmol/mol), 6.0-6.1% (42-43 mmol/mol), 6.2-6.4% (44-47 mmol/mol), and ≥ 6.5% (≥48 mmol/mol) had significantly increased risk for incident diabetes during follow-up. In cubic spline analysis, levels below 5.7% HbA1c were not significantly associated with incident diabetes.

Conclusions

Our study found a strong and graded association with HbA1c 5.8% and above with incident diabetes in Chinese men and women.

Background/purpose

Nurses engaged in the care of people living with HIV (PLWH) are commonly exposed to workplace stress. This study aimed to explore the stress experiences and coping strategies among nurses taking care of PLWH in China.

Methods

Nurses were recruited from the AIDS department of a public, general, third-grade class-A hospital, which has the largest HIV care department in the Hunan Province of China. Thirty-three nurses working in the AIDS Department were recruited in this qualitative study. Eight nurses participated in a focus group and 25 nurses underwent in-depth individual interviews aimed at characterizing the nurse's feelings and struggles with stress during caregiving for PLWH. The interviews were audio-recorded, transcribed verbatim, anonymized, and imported into NVivo 8.0 software. The data were coded and subjected to thematic analysis.

Results

Concerns about occupational exposure, heavy workload, mental health problems and risk behaviors of patients, and discrimination towards nurses caring for PLWH were the four main sources of stress. The negative impact of stress included problems with emotion regulation, somatic health and sleep, and work performance. Some participants also reported a positive impact of work stress on their mental health. Using personality strengths, problem-solving, help-seeking, concealing and avoiding/suppression were common coping strategies employed by nurses caring for PLWH.

Conclusion

Our findings help characterize the stress experienced by nurses caring for PLWH in the Chinese cultural context, and may inform specific interventions to help manage stress and promote mental health of nurses.

Fructus Gardenia (FG), containing the major active constituent Geniposide, is widely used in China for medicinal purposes. Currently, clinical reports of FG toxicity have not been published, however, animal studies have shown FG or Geniposide can cause hepatotoxicity in rats. We investigated Geniposide-induced hepatic injury in male Sprague-Dawley rats after 3-day intragastric administration of 100 mg/kg or 300 mg/kg Geniposide. Changes in hepatic histomorphology, serum liver enzyme, serum and hepatic bile acid profiles, and hepatic bile acid synthesis and transportation gene expression were measured. The 300 mg/kg Geniposide caused liver injury evidenced by pathological changes and increases in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and γ-glutamytransferase (γ-GT). While liver, but not sera, total bile acids (TBAs) were increased 75% by this dose, dominated by increases in taurine-conjugated bile acids (t-CBAs). The 300 mg/kg Geniposide also down-regulated expression of Farnesoid X receptor (FXR), small heterodimer partner (SHP) and bile salt export pump (BSEP). In conclusion, 300 mg/kg Geniposide can induce liver injury with associated changes in bile acid regulating genes, leading to an accumulation of taurine conjugates in the rat liver. Taurocholic acid (TCA), taurochenodeoxycholic acid (TCDCA) as well as tauro-α-muricholic acid (T-α-MCA) are potential markers for Geniposide-induced hepatic damage.