RESUMO
BACKGROUND: Although developmental supportive care is an effective approach to improve the long-term psychomotor and/or neurobehavioral function of preterm infants, very limited studies have focused on the impact of after-discharge developmental support. The underlying epigenetic changes are unclear. PURPOSE: This study aimed to explore the preliminary effect of an evidence-based Postdischarge Developmental Support Program (PDSP) on preterm infant neurodevelopment and underlying epigenetic changes, including brain-derived neurotrophic factor (BDNF) gene-related DNA methylation and expression. METHODS: In this randomized controlled pilot trial, the preterm infant-parent dyads were randomized into either the intervention group/PDSP group (n = 22) or the control group/usual care group (n = 22). The neurodevelopmental outcomes of preterm infants were measured by Ages & Stages Questionnaires. Urine BDNF concentration level was tested by the enzyme-linked immunosorbent assay. Infant saliva specimens were collected to analyze the methylation level of BDNF gene promoter I at pre- and postintervention test. RESULTS: After PDSP intervention, the total neurodevelopmental and the 5 domain scores of the PDSP group were all significantly higher than those of the control group ( P < .05). The BDNF levels decreased significantly only within control group ( P = .01). The difference in BDNF concentration and methylation levels between groups was not statistically significant. IMPLICATIONS FOR PRACTICE AND RESEARCH: Postdischarge Developmental Support Program may promote the neurodevelopment of preterm infants but has no effect on BDNF's expression and gene methylation level at 3 months of corrected age. The epigenetic mechanism of PDSP needs further study using a larger sample and longer follow-up.
Assuntos
Metilação de DNA , Recém-Nascido Prematuro , Lactente , Recém-Nascido , Humanos , Alta do Paciente , Assistência ao Convalescente , Fator Neurotrófico Derivado do Encéfalo/genéticaRESUMO
This study aims to understand the knowledge, attitudes and practices of COVID-19 in the Chinese context and to provide insights for developing targeted outbreak prevention and control measures among the general public. We conducted an online survey of urban and rural residents in Henan Province. A total of 517 valid questionnaires were collected via the online platform. The mean scores for knowledge and practice were 5.57/9 and 2.04/3, respectively. More than 90% of the participants believed COVID-19 was serious and preventable, were concerned about the disease process, and actively engaged in learning related knowledge. Our results showed that the COVID-19 knowledge level was significantly different among groups with different ages, genders, education levels and marital statuses; COVID-19 practice was significantly different among different regions. Multiple linear regression analysis showed that education level, female sex, unmarried status, and health care worker status had a significant impact on COVID-19 knowledge; urban area was associated with a higher practice score; COVID-19 knowledge was significantly associated with residents' attitude toward preventive measures that can prevent COVID-19 infection; urban area was significantly related to the willingness to go to a fever clinic to check for suspected infection. We found that Chinese urban and rural residents held a moderate level of COVID-19 knowledge and practice and showed a positive attitude toward the disease. It is necessary to develop relevant education programs targeting the general population in China to improve COVID-19-related knowledge, attitudes and practices, particularly for rural and undereducated residents.
Assuntos
COVID-19/psicologia , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , População Rural/estatística & dados numéricos , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , China , Estudos Transversais , Escolaridade , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto JovemRESUMO
AIMS: To review the studies on nursing research capacity and the managerial approaches that have been taken to promote nursing research capacity building in China. BACKGROUND: In the nursing profession, research has become increasingly important worldwide. Over the last two decades, continuous efforts have been devoted to improving nursing research capacity in China. However, the results of these efforts were rarely evaluated in a national scale. EVALUATION: A systematic literature review was conducted in accordance with the PRISMA checklist and guidelines. The literature was sourced from PubMed, CINAHL and two Chinese databases. In total, 19 articles were selected and their results were integrated, compared and analysed. KEY ISSUES: The development of nursing research has become a recent phenomenon in China. Chinese nurses' perceptions regarding research were mostly positive. However, their participation in research activity has traditionally been minimal. The factors associated with nursing research capacity in China were nurses' personal characteristics and organisational contexts. Several effective strategies (e.g. on-the-job research education) have been used to promote nursing research capacity. CONCLUSION: Currently, nursing research capacity in China is low despite hospital-promoting efforts. Systematic approaches need to be implemented to increase nursing research capacity in China in the near future. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing administrators need to seek innovative strategies to resolve issues (e.g. lack of research time and limited nursing research resources). They also need to strengthen their leadership skills in order to achieve the above objectives.
Assuntos
Pesquisa em Enfermagem/métodos , Pesquisa/tendências , China , Humanos , Liderança , Pesquisa em Enfermagem/tendênciasRESUMO
Adverse environmental stimulation in the neonatal intensive care unit (NICU) can affect neurodevelopment through epigenetic modification and thus has adverse effects on the long-term developmental outcome of preterm infants. Developmental care can reverse epigenetic changes in genes and promote neurodevelopment in preterm infants. This article reviews the influence of environmental stress in the NICU and developmental care on neurodevelopment in preterm infants, as well as related epigenetic effects, in order to provide a reference for epigenetic studies of preterm infants.