Systematic and meta-based evaluation on job satisfaction of village doctors: An urgent need for solution issue

Impact of exercise type, duration, and intensity on depressive symptoms in older adults: a systematic review and meta-analysis

Objective

This systematic review and meta-analysis assessed the effects of three types of physical exercise (resistance exercise, aerobic exercise, and group exercise), different exercise intervention times (3 months, 6 months), and different exercise intensities (low, moderate, and high) on the improvement of depressive symptoms in older adults aged ≥60 years, as well as to explore the impact of the sustainability of these physical exercise intervention programs on depressive symptoms in older adults.

Methods

The randomized controlled trials (RCTs) on the effect of physical exercise on depressive symptoms in older adults were retrieved from Cochrane Library, Web of Science, PubMed, and Embase Data. The retrieval time limit is from establishing the database to January 7, 2024. We conducted a meta-analysis using a 95% confidence interval (95% CI) and the standardized mean differences (SMD). The I2 statistic was used to assess the heterogeneity of the outcomes of the studies. When I 2 < 50%, we used the fixed-effects model, and when I 2 > 50%, we used the random-effects model. Subgroup and sensitivity analyses investigated heterogeneity origins.

Results

There are 15 articles reported 20 studies, with a total of 1,346 patients, including 689 in the control group and 657 in the experimental group. The findings demonstrated a notable improvement in depression symptoms among older persons as an immediate result of engaging in physical exercise [SMD = -0.82, 95% CI (-1.19, -0.45)]. The subgroup analysis showed that moderate-intensity physical exercise [SMD = -0.25, 95% CI (-0.47, -0.03)], high-intensity physical exercise [SMD = -0.94, 95% CI (-1.37, -0.51)], resistance exercise [SMD = -0.70, 95% CI (-1.20, -0.20)], and group exercise [SMD = -0.97, 95% CI (-1.89, -0.05)], and the exercise intervention time was 3 months [SMD = -0.81, 95% CI (-1.38, -0.23)] or 6 months [SMD = -0.93, 95% CI (-1.46, -0.41)] were more effective in improving depressive symptoms in older adults.

Conclusion

The sustainable resistance and group exercise have a better effect on improving depressive symptoms in older adults. Appropriate exercise intervention time can also ensure the sustainable improvement effect of exercise.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/record_email.php, identifier CRD42023405525.

Decoding the past and future of distant metastasis from papillary thyroid carcinoma: a bibliometric analysis from 2004 to 2023

Background

Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy, and its distant metastasis (PTCDM), although uncommon, seriously affects the survival rate and quality of life of patients. With the rapid development of science and technology, research in the field of PTCDM has accumulated rapidly, presenting a complex knowledge structure and development trend.

Methods

In this study, bibliometric analysis was used to collect 479 PTCDM-related papers published between 2004 and 2023 through the Web of Science (WoS) Core Collection (WoSCC) database. Keyword clustering analysis was performed using VOSviewer and citespace, as well as dual-map overlay analysis, to explore knowledge flows and interconnections between different disciplines.

Results

The analysis indicated that China, the United States, and South Korea were the most active countries in conducting research activities. Italy's research was notable due to its higher average citation count. Keyword analysis revealed that "cancer," "papillary thyroid carcinoma," and "metastasis" were the most frequently used terms in these studies. The journal co-citation analysis underscored the dominant roles of molecular biology, immunology, and clinical medicine, as well as the growing importance of computer science in research.

Conclusion

This study identified the main trends and scientific structure of PTCDM research, highlighting the importance of interdisciplinary approaches and the crucial role of top academic journals in promoting high-quality research. The findings not only provide valuable information for basic and clinical research on thyroid cancer but also offer guidance for future research directions.

Construction and analysis of a lysosome-dependent cell death score-based prediction model for non-small cell lung cancer

BACKGROUND

Non-small cell lung cancer (NSCLC) is the most common type of tumor globally and the leading cause of cancer-related deaths. Although treatment strategies such as immune checkpoint inhibitors and chemotherapy have advanced, the heterogeneity among NSCLC patients results in significant variability in treatment outcomes. Studies have shown that certain patients respond poorly to immune checkpoint inhibitors, indicating that treatment response is closely related to multiple factors. Therefore, it is necessary to develop predictive models to stratify patients based on gene expression and clinical characteristics, aiming for precision therapy.

OBJECTIVE

This study aims to construct a stratified prognostic model for NSCLC patients based on lysosome-dependent cell death (LDCD) scoring by integrating single-cell RNA sequencing (scRNA-seq) and bulk RNA sequencing data. By analyzing the immune-related characteristics of high-risk and low-risk groups, we further explored the impact of cell death patterns on lung cancer and identified potential therapeutic targets.

METHODS

This study obtained single-cell RNA sequencing data and gene expression data of NSCLC patients and normal lung tissues from the GEO and TCGA databases. We used R packages such as Seurat and CellChat for data preprocessing and analysis, and performed dimensionality reduction and visualization through Principal Component Analysis (PCA) and UMAP algorithms. LASSO regression analysis was used to construct the predictive model, followed by cross-validation and ROC curve analysis. The model's effectiveness was validated through survival analysis and immune microenvironment analysis.

RESULTS

The study showed a significant increase in the proportion of monocytes in NSCLC tissues, suggesting their important role in cancer progression. Cell communication analysis indicated that macrophages, smooth muscle cells, and myeloid cells exhibit strong intercellular communication during cancer progression. Using the constructed prognostic model based on 12 LDCD-related genes, we found significant differences in overall survival and immune microenvironment between the high-risk and low-risk groups.

Associations between sugar-sweetened beverages consumption, duration of physical exercise, and depressive symptoms among Tibetan university students at high altitude

Background

Depressive symptoms have become a public health issue of common concern in countries all over the world, and have many negative impacts on university students' study and life. Depressive symptoms are influenced by many factors, including sugar-sweetened beverages (SSBs) consumption and duration of physical activity. However, no study has been conducted on the association between sugar-sweetened beverage consumption, duration of physical exercise, and depressive symptoms among Tibetan university students at high altitudes.

Methods

In this study, a self-assessment survey of SSBs consumption, duration of physical exercise, and depressive symptoms was conducted on 6,259 (2,745 boys, 43.86%) Tibetan university students aged 19-22 years in Lhasa and Ganzi areas, China, using stratified whole population sampling. The associations were also analyzed using one-way analysis of variance, binary logistic regression analysis, and ordered logistic regression analysis in the generalised linear model.

Results

The proportions of mild depression symptoms, moderate depression symptoms, and major depressive symptoms among Tibetan boys university students in high-altitude areas of China were 18.0, 22.9, and 1.5%, respectively; the proportions of girls students were 20.1, 21.9, and 1.5%, respectively, 1.5%, and the differences in the detection rates of depressive symptoms between sex were statistically significant (χ 2 value = 14.253, p < 0.01). Ordered logistic regression analyses showed that using duration of physical exercise >60 min/d and SSBs ≤1 times/week as the reference group, the duration of physical exercise <30 min/d and SSBs ≥5 times/week groups had the highest risk of developing depressive symptoms was the highest risk (OR = 6.98, 95% CI: 5.05-9.65; p < 0.001).

Conclusion

This study confirmed that there was a positive association between SSBs consumption and depressive symptoms and a negative association between the duration of physical exercise and depressive symptoms among Tibetan university students at high altitudes in China. In the future, SSBs consumption should be effectively controlled and the duration of physical exercise should be increased to reduce the occurrence of depressive symptoms and promote the physical and mental health of Tibetan university students in high-altitude areas.

Effective analysis of job satisfaction among medical staff in Chinese public hospitals: a random forest model

Objective

This study explored the factors and influence degree of job satisfaction among medical staff in Chinese public hospitals by constructing the optimal discriminant model.

Methods

The participant sample is based on the service volume of 12,405 officially appointed medical staff from different departments of 16 public hospitals for three consecutive years from 2017 to 2019. All medical staff (doctors, nurses, administrative personnel) invited to participate in the survey for the current year will no longer repeat their participation. The importance of all associated factors and the optimal evaluation model has been calculated.

Results

The overall job satisfaction of medical staff is 25.62%. The most important factors affecting medical staff satisfaction are: Value staff opinions (Q10), Get recognition for your work (Q11), Democracy (Q9), and Performance Evaluation Satisfaction (Q5). The random forest model is the best evaluation model for medical staff satisfaction, and its prediction accuracy is higher than other similar models.

Conclusion

The improvement of medical staff job satisfaction is significantly related to the improvement of democracy, recognition of work, and increased employee performance. It has shown that improving these five key variables can maximize the job satisfaction and motivation of medical staff. The random forest model can maximize the accuracy and effectiveness of similar research.

Global job satisfaction and fluctuation among community general practitioners: a systematic review and meta-analysis

INTRODUCTION

Community General Practitioners (CGPs) are crucial to primary healthcare worldwide. Their job satisfaction significantly impacts the quality and accessibility of healthcare. However, a comprehensive global perspective on this issue remains absent, necessitating this systematic review and meta-analysis.

METHODS

This systematic review and meta-analysis sourced literature from PubMed, Web of Science, CNKI, and Wanfang, up to June 14, 2023. Of the 2,742 identified studies, 100 articles were selected for meta-analysis to assess satisfaction levels, and 97 studies were chosen for comparative analysis of influential factors. We employed both meta-analytic and comparative analytic methodologies, focusing on varying geographical, economic, and temporal contexts.

RESULTS

The pooled rate and corresponding 95% confidence interval (CI) for job satisfaction among CGPs was 70.82% (95%CI: 66.62-75.02%) globally. Studies utilizing 5-point score scale obtained a random effect size of 3.52 (95%CI: 3.43-3.61). Diverse factors influenced satisfaction, with remuneration and working conditions being predominant. A noticeable decline in job satisfaction has been observed since the coronavirus disease 2019 outbreak, with satisfaction rates dropping from an average of 72.39% before 2009 to 63.09% in those published after 2020.

CONCLUSIONS

The downward trend in CGPs' job satisfaction is concerning and warrants urgent attention from policymakers, especially in regions with an acute shortage of CGPs. The findings from this comprehensive review and meta-analysis provide essential insights for informed healthcare policy-making. It highlights the urgency of implementing strategies to enhance CGP satisfaction, thereby improving the effectiveness of primary healthcare systems globally.

Dynamics of organizational climate and job satisfaction in healthcare service practice and research: a protocol for a systematic review

Organizational climate and job satisfaction have been established as fundamental pillars of research and practice in organizational behavior and organizational psychology, inspiring many explanations and operationalizations over time. In most sectors, global trends such as labor shortages, high rates of turnover and absenteeism, the need to increase productivity, and the interest in new work models concur to keep climate and job satisfaction on top of the research agenda. The situation is particularly acute in the healthcare sector, where related factors have the capacity to influence all aspects of care provision, including patient safety and the physical and mental health of care providers. Nevertheless, a gap in knowledge persists regarding climate, job satisfaction, and their relationships in healthcare services. This protocol describes a study that aims to examine the dynamics of climate and job satisfaction in healthcare organizations from the practice and research perspectives. The protocol complies with PRISMA-P. PRISMA will be used to report the results of the study. Databases will be searched for published studies in May 2023, and we expect to complete the study by December 2024. A framework based on a multi-dimensional concept of quality in research will be used to examine the quality of any studies before inclusion. The results will be disseminated in two systematic reviews. We will describe proposed models depicting the dynamics of climate and job satisfaction in healthcare organizations. We will systematize and discuss available evidence regarding the outcomes of climate and job satisfaction in healthcare work environments. We will synthesize information on research designs and methodological options of included studies. We will identify measures of climate and job satisfaction used in healthcare settings, assess their psychometric properties, and appraise the overall quality of underlying studies. Finally, we expect to identify areas in need of further research.

Village doctors' dilemma in China: A systematic evaluation of job burnout and turnover intention

Background

Village doctors (VDs) in China undertook arduous primary healthcare missions. However, they received little attention in comparison to doctors in urban public secondary and tertiary hospitals. There is an urgent need to explore the overall situation of turnover intention and job burnout among VDs to evaluate and adjust current health manpower policy.

Methods

In this study, seven databases like PubMed, EMBASE, Web of Science (WOS), WanFang, China Science and Technology Journal Database (VIP), Chinese BioMedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI) were systematically searched, relevant experts were consulted, and empirical research on job burnout and turnover intention among VDs in international publications was evaluated. Therefore, we evaluated the prevalence of job burnout among VDs in general, across all dimensions and different severity levels, as well as the scores of each category. For turnover intention, we assessed the prevalence of different groups and their overall situation and also identified significant contributors.

Results

In this study, we integrated 20 research evidences on job burnout and turnover intention among 23,284 VDs from almost all provinces in China, and the prevalence of turnover intention among VDs in China was as high as 44.1% [95% confidence interval (CI): 34.1-54.2], which was two to four times that of primary health workers in high-income countries, but not much different from some developing countries. Simultaneously, VDs with the highest risk of turnover intention were men [odds ratio (OR): 1.22 (1.05-1.43)], those with a monthly income below USD 163.4 [OR: 0.88 (0.78-0.98)], those with a high educational level [OR: 0.88 (0.78-0.98)], and those <40 years old [OR: 1.27 (1.16-1.40)]. Similarly, the detection rate of job burnout toward them was 59.8% (95% CI: 38.7-79.1) with the MBI-GS score being 44.44 (95% CI: 37.02-51.86) in a total of 90, while the detection rate of job burnout in moderate and above almost reached 20%. The most significant contributor that affects job burnout was low personal accomplishment (LPA), and the detection rate for moderate and higher severity was 65.2% (95% CI: 58.7-71.7).

Conclusion

Attention should be paid to the high turnover intention and severe job burnout of primary health workers in rural areas of developing countries, and targeted measures should be taken to improve the situation. Health policymakers should increase financial subsidies for VDs, set a reasonable workload, improve various health policies such as pension insurance for VDs, and encourage "targeted training" for medical students to enrich and expand their team.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021289139.

Association between pulmonary ventilatory function and mild cognitive impairment: A population-based study in rural China

Background

Mild cognitive impairment (MCI), a reversible intermediate state, plays an important role in the development and prevention of dementia. The relationship between pulmonary function and MCI risk has not yet been well-elucidated.

Methods

We included 2,947 rural Chinese residents aged ≥35 years who were free from a history of stroke, dementia, or other brain diseases and measured pulmonary ventilatory function using calibrated spirometry according to the recommended method. MCI was assessed with the Montreal Cognitive Assessment-Basic for Chinese scale. Logistic regression models and restricted cubic splines with covariate adjustment were performed to explore the association between pulmonary function and MCI risk.

Results

The prevalence of MCI increased with decreasing pulmonary function, from the lowest quartile to the highest quartile of pulmonary function: 63.9, 50.5, 43.8, and 43.6%, respectively. After adjustment for confounding factors, participants in the first quartile had a significantly increased risk of MCI (ORs, 1.691, 95% CI, 1.267-2.258), with the highest quartile as the reference. In the subgroup analysis, a significant association of pulmonary function and MCI was found in females and those with low physical activity. Meanwhile, we observed an L-shaped relationship between pulmonary function and MCI (P _non-linear = 0.032).

Conclusions

Poor pulmonary function was associated with an increased risk of MCI among rural Chinese adults, and presented a non-linear relationship. These findings remind us of the need for early cognitive assessment in local populations with lower pulmonary function.

Endocrine effects of three common gas signaling molecules in humans: A literature review

Gases such as hydrogen sulfide, nitric oxide and sulfur dioxide have important regulatory effects on the endocrine and physiological processes of the body and are collectively referred to as "gas signaling molecules". These gas signaling molecules are also closely related to Alzheimer's disease, the inflammatory response and depression. In this paper, we introduce the production and metabolic pathways of NO, H₂S and SO₂ in living organisms and review the regulatory functions of gas signaling molecules in the endocrine system and their mechanisms in relation to their clinical applications. This work will provide a basis for finding targets for intervention and establishing novel prevention and treatment strategies for related diseases.