Abstract There is growing evidence that the COVID-19 pandemic has had an impact on the mental health and professional identity of nursing students. This study aimed to explore the trajectories of psychological distress and professional identity and examine their causal relationship among graduate nursing students. A prospective longitudinal study was conducted with 556 graduate nursing students in China who were asked to complete the Questionnaires for Emergent Events of Public Health and the Professional Identity Questionnaire for Nursing Students at three timepoints during the pandemic (T1 = onset of the outbreak, T2 = state-wide isolation, T3 = school reopening). The results showed that psychological distress and psychological identity changed over time, with the lowest psychological distress and highest professional identity at T3. The cross-lagged analysis showed that professional identity at T1 and T2 negatively predicted psychological distress at T2 and T3. We concluded that nurse educators should develop programs and strategies to cultivate professional identity in graduate nursing education to improve mental health during public health crises.

Resumen: Cada vez hay más evidencia de que la reciente epidemia de que la COVID-19 puede afectar a la salud mental y la identidad profesional de los estudiantes de posgrado en enfermería. Es por ello que el propósito de este estudio fue explorar las trayectorias del estrés psicológico y la identidad ocupacional y examinar su relación causal de dichos estudiantes de posgrado durante la nueva epidemia. Se llevó a cabo un estudio prospectivo longitudinal con 556 estudiantes de posgrado en enfermería en China, a los que se les pidió que completaran los cuestionarios de emergencia de salud pública y el de identidad ocupacional para estudiantes de enfermería en tres etapas del brote (T1 = brote, T2 = aislamiento estatal, T3 = reapertura escolar). Los resultados mostraron que estrés psicológico y la identidad psicológica de los estudiantes universitarios habían cambiado con el tiempo. En T3, la perturbación emocional fue la más baja y la identidad ocupacional la más alta. El análisis de retraso cruzado mostró que la identidad ocupacional de T1 y T2 tenía un efecto predictivo negativo sobre la perturbación psicológica de T2 y T3. Conclusión: los educadores de enfermería deberían formular programas y estrategias que cultiven la identidad profesional de sus estudiantes a fin de mejorar la salud mental en emergencias públicas.

OBJECTIVES: Mesenchymal stem cells (MSCs) are potentially ideal for type 2 diabetes treatment, owing to their multidirectional differentiation ability and immunomodulatory properties. Here we investigated whether the stem cells from human exfoliated deciduous teeth (SHED) in combination with hyperbaric oxygen (HBO) could treat type 2 diabetic rats, and explored the underlying mechanism. METHODS: SD rats were used to generate a type 2 diabetes model, which received stem cell therapy, HBO therapy, or both together. Before and after treatment, body weight, blood glucose, and serum insulin, blood lipid, pro-inflammatory cytokines (tumor necrosis factor-alpha and interleukin-6), and urinary proteins were measured and compared. After 6 weeks, rats were sacrificed and their organs were subjected to hematoxylin and eosin staining and immunofluorescence staining for insulin and glucagon; apoptosis and proliferation were analyzed in islet cells. Structural changes in islets were observed under an electron microscope. Expression levels of Pdx1, Ngn3, and Pax4 mRNAs in the pancreas were assessed by real-time quantitative polymerase chain reaction (RT-qPCR). RESULTS: In comparison with diabetic mice, those treated with the combination or SHE therapy showed decreased blood glucose, insulin resistance, serum lipids, and pro-inflammatory cytokines and increased body weight and serum insulin. The morphology and structure of pancreatic islets improved, as evident from an increase in insulin-positive cells and a decrease in glucagon-positive cells. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining of islet cells revealed the decreased apoptosis index, while Ki67 and proliferating cell nuclear antigen staining showed increased proliferation index. Pancreatic expression of Pdx1, Ngn3, and Pax4 was upregulated. CONCLUSION: SHED combined with HBO therapy was effective for treating type 2 diabetic rats. The underlying mechanism may involve SHED-mediated increase in the proliferation and trans-differentiation of islet β-cells and decrease in pro-inflammatory cytokines and apoptosis of islets.