Background: Epidemiological studies assessing the association between sedentary time and cardiovascular diseases (CVD) risks have been published at a rapid pace in recent years, which makes the periodic review of knowledge essential. Furthermore, much of the early and ongoing work used screen time as a marker of total sedentary time, which may weaken the association between sedentary time and CVD risks. Objective: To update evidence on CVD risks associated with different types of sedentary time, especially total sedentary time and screen time, and to explore as a marker of total sedentary time, whether screen time had similar CVD risks with total sedentary time. Methods: PRISMA guideline was followed for the performing and reporting of this systematic review and meta-analysis. Three independent researchers searched eight electronic databases and two clinical trial registries for all studies published between January 2015 and December 2021 that assessed the association between sedentary time and CVD risks in adults. A standardized form was used for data extraction and collection. Wilmot and colleagues’ modified tool was used for quality assessment. The categorical association was assessed by comparing the pooled effect sizes for CVD risks associated with the highest and the lowest sedentary time categories across included studies. Stata 16.0 and Review Manager 5.3 were used for all statistical analyses, P ≤ 0.05 was considered as statistically significant. Results: Seventeen prospective cohort studies and two cross-sectional studies with 145,1730 participants and over 48,668 CVD cases and deaths were included. Two included studies measured sedentary time with the accelerometer, 16 studies with self-reported questions, and one study with both the accelerometer and self-reported questions. CVD outcomes were self-reported in two included studies and objectively adjudicated through medical records or death certifications in 17 studies. Compared with the lowest total sedentary time category (median duration, 2.75 h/d), participants in the highest category (median duration, 10.5 h/d) had an increased risk of CVD morbidity (pooled RR, 1.24; 95% CI, 1.21–1.27). Compared with the lowest total sedentary time category (median duration, 2.98 h/d), participants in the highest category (median duration, 10.2 h/d) had an increased risk of CVD mortality (pooled HR, 1.29; 95% CI, 1.13–1.47). The association between screen time and CVD risks was similar to total sedentary time with the cut-off point of 5–6 h/d. The associations between occupational sitting time, leisure sedentary time, and CVD risks stayed inconclusive. Conclusion: Total sedentary time and screen time are both associated with cardiovascular health. As a marker of total sedentary time, screen time over 5–6 h/d had similar CVD risks with total sedentary time over 10–11 h/d.

Background: A nature-based social prescription (NBSP) is an approach to improving mental health outcomes that involves prescribing nature-based interventions as complementary or alternative therapy to traditional ones. A variety of advantages are available from NBSP for people looking to enhance their mental well-being. The effect size of the nature-based social prescriptions (NBSPs) has not been thoroughly evaluated by systematic reviews and meta-analyses.Objectives: The current study aimed to analyze existing studies and conduct a meta-analysis to determine the overall effect size of the nature-based social prescriptions (NBSP’s) outcomes on mental health.Methods: By choosing the relevant papers from among those that were available, a meta-analysis was carried out in the current study. A systematic search of electronic databases (Pub Med, Web of Science, Scopus, Cochrane Library, Embase, CINAHL, and PsychINFO) was conducted to identify relevant studies. Studies were included if they evaluated the effects of NBSP on mental health outcomes. Effect sizes were calculated using the random effects model.Results: Meta-analysis of interventions statistics shows that CBT (SMD −0.0035; 95% CI: [−0.5090; 0.5020]; Tau^2: 0.1011; Tau: 0.318), digital intervention (SMD −0.3654; 95% CI: [−0.5258; 1.2566]; Tau^2: 0.2976, Tau: 0.5455), music intervention (SMD −2.1281; 95% CI: [−0.4659; 4.7221]; Tau^2: 3.4046; Tau:1.8452), and psychological interventions (SMD −0.8529; 95% CI: [0.3051; 1.4007]; Tau^2: 0.1224; Tau: 0.3499) do not significantly impact. The other interventions [social belongingness, communication training, blue intervention, nature-based education, cognitive behavior group therapy (CBGT), social prescribing coordinator, self-help intervention, participatory, organizational intervention, inpatient services, brief diet, internet-based intervention, prenatal intervention, yoga and meditation, ergonomics training program, yoga nidra intervention, and storytelling] highlighted above are significant.Conclusion: The conclusion of the meta-analysis supports the idea that incorporating nature-based social prescription interventions into mental healthcare plans can effectively complement traditional therapies and improve mental health outcomes.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023412458, CRD42023412458.

New nurses' clinical competency is a central concern across the world. The China Health and Planning Commission proposed an "Outline of transition programs for newly graduated nurses (try out)" to promote the new nurses' clinical competency within the first two years. Compared with the transition program in other countries, the one in China is longer. New nurses' experiences in their transition to practice were not fully explored in China. Their lived experience may inform the better transition program in China and other countries. To explore the experience of new nurses during the two-year transition period to clinical practice. A descriptive phenomenological study. Face-to-face, semi-structured in-depth interviews were conducted in two teaching hospitals in China to interview 14 nurses within three months after the completion of transition. Data were analyzed using Colaizzi's seven-step data analysis method，which includes familiarization, identifying significant statements, formulating meanings, clustering themes, developing an exhaustive description, producing the fundamental structure, and seeking verification (1978). Tape-recording and observational notes were taken and typed word by word. Two researchers verified the verbatim transcripts. Five categories and 15 theme clusters were identified: 1. early-stage stress and anxiety; perceived change of mentality and self-reflection; 2. self-encouragement; self-compulsion, tolerance, adaptation; peer support and affirmation; 3. Growth: overall clinical competency improvement; perceived harvesting; nursing skills improvement; knowledge enhancement; 4. self-inadequacy; rotation benefits; the merits of different departments; lack sense of belonging; and 5. Expectation: desire to be treated equally; hope to have more opportunities. The findings of our study suggested that support was most needed while the new nurses were facing challenges in the early stage to promote their sense of belonging. In addition, more systematic learning opportunities are needed to maximize learning for NGNs with different nursing degrees.

Transition education is a robust strategy to improve the core competency of newly graduated nurses and the quality of clinical nursing and ensure people's safety. Limited information about the learning objectives and educational content for newly graduated nurses in China was available. Construct the learning objectives and educational content for newly graduated nurses based on defined core competencies. We used a literature review and the e-Delphi method to conduct this study. Ten tertiary teaching hospitals and six nursing schools in Zhejiang Province, China, were selected. Experts (n = 21) were invited to the e-Delphi study. Based on seven competencies from the literature review and the research group discussions, we formed an initial set of objectives and specific educational content for newly graduated nurses. Subsequently, experts provided supportive and modification advice on the competencies, objectives, and specific content in the two Delphi rounds. The consensus percentage and the weight of each first-level, second-level, and third-level item were calculated. Consensus was achieved on seven core competencies, 44 learning objectives, and 60 components of educational content. The positive coefficient of the two Delphi rounds was 100 %, the authority coefficient was 0.83 and 0.87, the proportion of experts who made suggestions was 71.40 %, the coefficient of variation (CV) was <0.25 (P < 0.05) except for two items and the Kendall coefficient (W) was 0.15-0.48 (P < 0.01). The developed objectives and content framework provide a reference for implementing systematic and standardized education for newly graduated nurses.

Background: Observational studies have suggested associations between sedentary behaviors (SB), physical activity (PA), sleep duration (SD), and obesity, but the causal relationships remain unclear. Methods: We used Mendelian randomization (MR) with genetic variation as instrumental variables (IVs) to assess the causality between SB/PA/SD and obesity. Genetic variants associated with SB/PA/SD were obtained from Genome-wide association study (GWAS), and obesity data came from FinnGen. The primary MR analysis used the instrumental variable weighted (IVW) method, with sensitivity tests including Cochran Q, MR-Egger intercepts, and MR-Radial. Expression Quantitative Trait Loci (eQTL) analysis was applied to identify significant genetic associations and biological pathways in obesity-related tissues. Results: The MR analysis revealed causal relationships between four SB-related lifestyle patterns and obesity. Specifically, increased genetic liability to television watching (IVW MR Odds ratio [OR] = 1.55, [95% CI]:[1.27, 1.90], p = 1.67×10⁻⁵), computer use ([OR] = 1.52, [95% CI]:[1.08, 2.13], p = 1.61×10⁻²), leisure screen time (LST) ([OR] = 1.62, [95% CI] = [1.43, 1.84], p = 6.49×10⁻¹⁴, and driving (MR [OR] = 2.79, [95% CI]:[1.25, 6.21], p = 1.23×10⁻²) was found to increase the risk of obesity. Our findings indicate that no causal relationships were observed between SB at work, sedentary commuting, PA, SD, and obesity. The eQTL analysis revealed strong associations between specific genes (RPS26, TTC12, CCDC92, NICN1) and SNPs (rs10876864, rs2734849, rs4765541, rs7615206) in both subcutaneous and visceral adipose tissues, which are associated with these SBs. Enrichment analysis further revealed that these genes are involved in crucial biological pathways, including cortisol synthesis, thyroid hormone synthesis, and insulin secretion. Conclusions: Our findings support a causal relationship between four specific SBs (LST, television watching, computer use, driving) and obesity. These results provide valuable insights into potential interventions to address obesity effectively, supported by genetic associations in the eQTL and enrichment analysis. Further research and public health initiatives focusing on reducing specific SBs may be warranted.