Objective:To analyze the practical experiences and challenges faced by nurses in community-based elderly care institutions in the management of insulin therapy for elderly patients with diabetes.Methods:This qualitative study employed purpose sampling to recruit nurses from two community-based elderly care institutions in Beijing from June to October 2023. Semi-structured interviews were conducted focusing on their experiences and challenges in insulin use for elderly patients with type 2 diabetes. All interviews were audio-recorded and transcribed into text. Framework analysis was used to analyze the interview data.Results:A total of 15 nurses participated in the interviews, all of whom were female with work experience ranging from 4 to 12 years. The analysis revealed three main themes and 2-3 subthemes under each theme. Theme 1 patients′ experiences with insulin injection: concerns about adverse reactions such as hypoglycemia, obesity, and injection pain; attention to insulin dosage, blood glucose levels, dietary management, and weight control. Theme 2 nurses′ practices and challenges in insulin management: communication and emotional support; trust-building between nurses and elderly patients; impact of insufficient human resources. Theme 3 nurses′ experiences with diabetes knowledge education and training: motivation for training; adaptation of training content, format and frequency to local conditions; implementation and significance of health education.Conclusions:The management of elderly people with diabetes in community-based elderly care institutions presents significant challenges. It is essential to provide personalized insulin management support, emotional support, and psychological counseling for elderly diabetic patients. Additionally, nurses require access to relevant diabetes knowledge education and training to enhance their ability of effective care.

Objective To evaluate the role of distortion product otoacoustic emissions (DPOAE) testing in evaluating early hearing loss among noise-exposed workers. Methods A total of 174 noise-exposed workers in a metal shipbuilding enterprise were selected as the research subjects by the convenience sampling method. Pure tone audiometry (PTA), DPOAE and the level of noise exposure were conducted on the workers. The rank correlation analysis was used to analyze the correlation between DPOAE amplitude and PTA threshold. The multilevel model was used to analyze the effects of gender, age, noise exposure intensity, cumulative noise exposure (CNE), hearing loss classification and PTA threshold on DPOAE results. Results At the frequencies of 0.50, 1.00, 2.00, 3.00, 4.00, 6.00 and 8.00 kHz, the DPOAE amplitude was negatively correlated with the PTA threshold (rank correlation coefficients were -0.12, -0.48, -0.47, -0.18, -0.23, -0.44, -0.19, respectively, all P<0.01). At the most frequencies, DPOAE amplitude was negatively correlated with age and CNE (all P<0.05). The results of multilevel model analysis showed that there were significant differences in DPOAE amplitudes at certain frequencies across gender, age, noise intensity, CNE, and hearing loss classification (all P<0.05). Significant differences in DPOAE responses were found among different CNE and hearing loss groups (all P<0.01). Conclusion DPOAE testing can objectively reflect the hearing status of noise-exposed workers and could be considered for inclusion in routine hearing monitoring to facilitate early detection of noise-induced hearing loss.

Objective:To analyze the practical experiences and challenges faced by nurses in community-based elderly care institutions in the management of insulin therapy for elderly patients with diabetes.Methods:This qualitative study employed purpose sampling to recruit nurses from two community-based elderly care institutions in Beijing from June to October 2023. Semi-structured interviews were conducted focusing on their experiences and challenges in insulin use for elderly patients with type 2 diabetes. All interviews were audio-recorded and transcribed into text. Framework analysis was used to analyze the interview data.Results:A total of 15 nurses participated in the interviews, all of whom were female with work experience ranging from 4 to 12 years. The analysis revealed three main themes and 2-3 subthemes under each theme. Theme 1 patients′ experiences with insulin injection: concerns about adverse reactions such as hypoglycemia, obesity, and injection pain; attention to insulin dosage, blood glucose levels, dietary management, and weight control. Theme 2 nurses′ practices and challenges in insulin management: communication and emotional support; trust-building between nurses and elderly patients; impact of insufficient human resources. Theme 3 nurses′ experiences with diabetes knowledge education and training: motivation for training; adaptation of training content, format and frequency to local conditions; implementation and significance of health education.Conclusions:The management of elderly people with diabetes in community-based elderly care institutions presents significant challenges. It is essential to provide personalized insulin management support, emotional support, and psychological counseling for elderly diabetic patients. Additionally, nurses require access to relevant diabetes knowledge education and training to enhance their ability of effective care.

Mindfulness training has shown beneficial effects on cognitive functions in older adults.Howev-er,the studies on this topic have used different methods and populations,and their results were inconsistent.No sys-tematic review has synthesized and evaluated these findings.This review aims to address this gap by categorizing the studies based on the training methods and cohorts of older adults,and summarizing the effects of mindfulness training on cognitive function.The review finds that mindfulness training had different effects depending on the lev-el of cognitive decline and the training method.Both standardized and unstandardized training methods improved cognitive performance in older adults with normal or subjective cognitive decline.However,the effect of mindful-ness training diminished as cognitive decline worsened,being inconsistent in mild cognitive impairment and non-sig-nificant in dementia.The review also discusses the possible mechanisms and suggested directions for future re-search.