Objective: This study aimed to explore the turnover intention among male nurses and analyze the underlying mechanisms through the lens of the social cognitive theory to provide valuable insights for developing targeted intervention strategies to mitigate the turnover of male nurses. Methods: A cross‐sectional survey was conducted. Questionnaires were distributed to male nurses in Jiangsu Province, China, from September to December 2023, with the assistance of the nursing departments. The first part of the questionnaire collected the sociodemographic information. The second part included three instruments, i.e., the Turnover Intention Scale, the Chinese version of the Decent Work Perception Scale, and the Colleague Solidarity Scale for Nurses. Results: Of the 6630 male nurses who were solicited by email, 4227 provided a valid response, and the response rate was 63.76%. Their turnover intention score was 14.27 ± 4.34. According to path analysis, both head nurse support, colleague support, and decent work perception directly reduced turnover intention ( β = 0.19, 0.47, and −0.65, respectively, p < 0.001). However, head nurse support and colleague support indirectly increased turnover intention via decent work perception ( β = −0.27 and −0.09, respectively, p < 0.001). Conclusion: The male nurses in Jiangsu, China, had a high level of turnover intention, and decent work perception and colleague solidarity were key influencing factors. To effectively reduce the turnover intention of male nurses, nursing managers should focus on fostering career development opportunities and cultivating a supportive organizational environment.

Background: The use of ultrasound (US) makes it convenient to identify dysphagia or swallowing impairment. The aim of the study was to evaluate the validity and reliability of US measurements for swallowing function. Methods: We conducted a systematic review and meta‐analysis. Embase, Medline, Cochrane Library, Web of Science, CINAHL, and Scopus databases were systematically searched from inception to July 22, 2024. Published studies on the validity and reliability of US measurements for assessing dysphagia or swallowing impairment in individuals aged 18 years and older were included. The review followed PRISMA guidelines and was evaluated using the QUADAS‐2 tool for diagnostic studies. Two authors independently screened potentially eligible literature, evaluated the quality of the included studies, and then extracted the data. Data synthesis was conducted via random‐effects meta‐analysis using Stata software. Results: This review included 38 articles, assessing the value of using hyoid bone displacement, thyrohyoid approximation, and tongue muscle thickness change on US for identifying dysphagia. The pooled sensitivities were 0.64 (95% CI: 0.50–0.79), 0.89 (95% CI: 0.66–1.11), and 0.60 (95% CI: 0.44–0.76), respectively; with pooled specificities of 0.71 (95% CI: 0.64–0.78), 0.82 (95% CI: 0.76–0.88), and 0.69 (95% CI: 0.62–0.77), respectively. Additionally, the area under the summary receiver operating characteristic curve (SROC) for identifying dysphagia using masseter thickness was 0.74 (95% CI: 0.70–0.78). The correlation coefficient of 0.58 (95% CI: 0.20–0.81) was observed between displacement and swallowing function, whereas the correlation for swallowing muscle cross‐sectional area (CSA) was 0.26 (95% CI: 0.09–0.42). Meta‐analyses revealed intrarater reliability values of 0.88 (95% CI: 0.76–0.94) for displacement, 0.93 (95% CI: 0.87–0.96) for CSA, 0.77 (95% CI: 0.73–0.80) for swallowing muscle thickness, and 0.79 (95% CI: 0.74–0.84) for echo intensity. Interrater reliability values were 0.75 (95% CI: 0.55–0.87) for displacement, 0.89 (95% CI: 0.83–0.94) for CSA, and 0.68 (95% CI: 0.57–0.75) for swallowing muscle thickness. Conclusion: Data from this review suggested that US was a reliable and valid screening tool for assessing dysphagia and swallowing impairment. Future research could aim at proposing standardised and universal US protocols to promote comparability and reliability in clinical practice.

Objective: Although several studies have examined the association between estradiol and human aggression, a consistent understanding of their correlation has yet to be established. This study aimed to investigate this relationship comprehensively. Methods: We systematically searched five English databases (PubMed, Web of Science, EMBASE, Cochrane Library, and CINAHL) from their inception to June 5, 2023. Two authors independently screened publications and extracted data based on predefined inclusion and exclusion criteria. Statistical analyses were performed using Review Manager 5.4, and a random-effects model was used to pool the data. Results: We identified 14 eligible studies comprising data from 1820 participants that met the inclusion criteria. This meta-analysis indicated a positive correlation between estradiol and human aggression, albeit a weak one. The pooled Fisher z value was 0.16 (95% confidence interval = 0.05–0.26; I ² = 73%, p<.00001). Furthermore, we found that participants’ sex and age, the measures of aggression, and the literature quality might be sources of heterogeneity. Conclusions: Human aggression exhibited a weak positive correlation with estradiol concentration, whereas this relationship was influenced by participants’ sex and age, the measure of aggression used, and the quality assessment of the literature. Gaining a better understanding of the association between estradiol and aggression could aid in the identification of populations prone to aggression.

Objectives The current status of patient and visitor violence (PVV) reporting among nurses has proven insufficient. Therefore, we explored the barriers and facilitators in nurses’ reporting of PVV. Design Cross-sectional study. Setting General and specialised hospitals in Jiangsu Province, China. Participants A convenience sampling of 3363 nurses in Jiangsu Province was collected between January and July 2023. Main outcome measure The reporting rate of PVV was assessed by the hospital workplace violence questionnaire-revised version; multivariable logistic regression analyses were performed to determine factors associated with PVV reporting at the 5% significance level. Results Out of the 3363 surveyed nurses, 1813 (53.9%) reported experiencing PVV within the past year. Notably, only 16.1% of these nurses proactively reported PVV incidents after encountering them. Factors that facilitated reporting of PVV comprised being male (OR 1.832, 95% CI 1.083 to 3.101), working in specialised hospitals (OR 2.335, 95% CI 1.517 to 3.594), serving in emergency (OR 1.788, 95% CI 1.105 to 2.892), outpatient (OR 3.153, 95% CI 1.697 to 5.860), paediatrics (OR 3.808, 95% CI 1.976 to 7.338), possessing agreeableness personality (OR 2.112, 95% CI 1.140 to 3.911), prior hearing of PVV (OR 1.749, 95% CI 1.305 to 2.346) and having hospitals that actively encouraged reporting (OR 2.700, 95% CI 1.848 to 3.946) while safeguarding staff interests (OR 2.072, 95% CI 1.010 to 4.248) and emphasising nurses more (OR 2.109, 95% CI 1.123 to 3.958). Conversely, factors impeding nurses from reporting PVV included having night shifts 5–9 times per month (OR 0.481, 95% CI 0.282 to 0.819) and selectively reporting based on the severity of the violence (OR 0.550, 95% CI 0.344 to 0.878). Conclusion The reporting rate of PVV among nurses was notably low. Nursing managers should consider implementing comprehensive measures that address both the facilitating and blocking factors identified in the study. This strategic approach aims to enhance the reporting rate of PVV incidents among nurses, fostering a safer and more supportive environment within healthcare settings.

Objective: Serum free thyroxine (FT ₄ ) has been demonstrated to be associated with human aggression. Based on the theoretical and empirical research on hostile attribution bias and psychological resilience, this study developed a chain mediating model to investigate whether these factors mediate the relationship between serum FT ₄ and aggression among thyroid disease patients. Methods: A total of 418 thyroid disease patients who met the inclusion and exclusion criteria were recruited from a general hospital in Suzhou, Jiangsu Province, China, to participate in this study and completed the self-report versions of the Buss-Perry Aggression Questionnaire (BPAQ), the Word Sentence Association Paradigm for Hostility Scale (WSAP-Hostility), and the Connor-Davidson Resilience Scale (CD-RISC10). Blood samples were collected to measure serum FT ₄ levels by chemiluminescence immunoassay. SPSS 32.0 was used for descriptive and inferential statistical analyses. Amos 29.0 was applied to conduct structural equation modeling to examine the chain mediating roles of hostile attribution bias and psychological resilience in the association between serum FT ₄ and aggression. Results: Serum FT ₄ levels were directly associated with aggression among thyroid disease patients ( β = 0.244, 95% CI [0.148, 0.334]). Serum FT ₄ exhibited indirect statistical associations with aggression through two independent mediating pathways of hostile attribution bias ( β = 0.129, 95% CI [0.088, 0.178]) and psychological resilience ( β = 0.068, 95% CI [0.038, 0.107]), as well as the chain mediating pathway of these two variables ( β = 0.029, 95% CI [0.016, 0.048]). Multi-group structural equation modeling demonstrated measurement and structural invariance across sexes, with no significant differences in the path coefficients. Conclusion: Hostile attribution bias and psychological resilience served as mediators in the association between serum FT ₄ levels and aggression among thyroid disease patients. Causal inferences cannot be drawn from this cross-sectional design, and future longitudinal studies are required to extend these findings.

Post-extubation dysphagia (PED) is a prevalent and debilitating complication in intensive care unit (ICU) patients, yet the longitudinal heterogeneity of swallowing recovery remains poorly understood. This study was aimed to characterize distinct recovery trajectories of swallowing function in ICU patients with PED and to identify the clinical predictors associated with each pattern. This longitudinal observational study utilized convenience sampling to enroll ICU patients from a tertiary hospital. Swallowing function was evaluated using the Standard Swallowing Assessment (SSA) at seven time points post-extubation, at 4-6, 24, 48, and 72 h and 7, 14, and 28 days. Latent recovery trajectories were identified using growth mixture modeling (GMM), and independent predictors of group membership were determined by multivariate logistic regression. Of 495 intubated patients, 248 (54.98%) developed PED and were included; 209 completed all follow-up assessments. Three distinct trajectories emerged: Group HS (high level, slow improvement; 10.0%), Group HR (high level, rapid improvement; 22.5%), and Group LE (low level, early recovery; 67.5%). For both Group HR and Group HS, membership was predicted by older age, neurological diagnosis, higher peak inspiratory pressure, longer intubation duration, and early pharyngeal pain. In addition, membership in Group HR was uniquely associated with an APACHE II score of 10-14 and exposure to fiberoptic bronchoscopy. Post-extubation swallowing recovery follows distinct trajectories shaped by physiological, procedural, and disease-related factors. Early trajectory identification allows for personalized, stage-specific interventions to optimize functional outcomes and mitigate long-term morbidity.