The breastfeeding experience of women with multiple pregnancies: a meta-synthesis of qualitative studies.

BACKGROUND: The experiences and challenges associated with breastfeeding multiple births can be considerably more complex than those of singletons. Multiple births refer to the delivery of more than one offspring in a single birth event. Emphasizing the needs and experiences of mothers with multiple births during breastfeeding can enable healthcare providers to design targeted interventions that enhance breastfeeding rates. However, existing breastfeeding and health education resources and practices do not fully meet the needs of women who breastfeed multiples. This review aimed to review and synthesize qualitative studies on the breastfeeding experiences of women with multiple births. METHODS: A systematic search was conducted in 10 electronic databases for papers published from the inception of the database to March 2024. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was utilized to evaluate the methodological quality of the studies included. The thematic synthesis method of Thomas and Harden was employed to integrate and analyze the included literature to derive new categories and conclusions. FINDINGS: Eight studies met the inclusion criteria and quality assessment criteria for this study. Through the integration of their results, four themes were identified: the choice and willingness to breastfeed multiple births; the challenges of breastfeeding multiple births; stage management and individualised adaptation of breastfeeding; and the experience of support. CONCLUSION: Throughout the feeding process from pregnancy to the postpartum period, mothers with multiple births often have predominantly negative experiences with breastfeeding. Consequently, hospitals should create a multidisciplinary follow-up team comprising obstetrics, neonatology, psychology, and community services to offer specialized and personalized support to these women at various stages. SYSTEMATIC REVIEW REGISTRATION: [ https://www.crd.york.ac.uk/PROSPERO/ ], identifier [PROSPERO 2024 CRD42024520348].

Research Competence in Clinical Nursing Insights From Chinese Nurses: A Cross-Sectional Survey.

AIM: To assess the research capacity of 3014 clinical nurses in northeastern China, examining their participation in research and self-assessed competencies to advance nursing practice. BACKGROUND: Nursing research is essential for the development of the nursing discipline, yet significant progress in enhancing the research capabilities of nursing staff has been limited over the past decades. Clinical nurses, central to the execution of research activities, need improved research skills to identify relevant topics and synthesise clinical experiences with the literature. DESIGN: A cross-sectional survey. METHODS: In 2023, using a convenience sampling method, a cross-sectional questionnaire survey was conducted on 3014 nurses in a Grade A tertiary hospital. The questionnaire included questions on basic information and scientific research, as well as a self-evaluation scale assessing the nurses' capability for conducting scientific research. RESULTS: Among the nurses participating in the survey, 29.66% (894) had published academic papers in Chinese, 2.06% (62) had published papers in Science Citation Index journals, 2.39% (72) had hosted nursing research projects, 5.87% (177) had participated in nursing research projects and 71% (2140) expressed their willingness to participate in nursing research activities. The average score on the self-evaluation of research capability was 54.08 ± 24.55, with scores ranging from 0 to 120. CONCLUSION: The clinical nurses' research capacity scores are at the midpoint of the scale (0-120), indicating basic research capabilities with room for improvement. There is a high willingness to engage in research. Nursing managers should consider these factors in training programmes and promote research activities to improve the team's scientific capability. RELEVANCE TO CLINICAL PRACTICE: This study reveals a critical gap between nurses' willingness and actual involvement in research, emphasising the need for enhanced research skills to improve nursing practice. PATIENT OR PUBLIC CONTRIBUTION: This study did not require patient or public involvement in its design, outcome measures or execution. The contribution of patients/members of the public was limited solely to data collection.

Pregnancy and parenting experiences of women with twin-to-twin transfusion syndrome: a qualitative study.

BACKGROUND: Qualitative research can reflect the actual thoughts and experience of research subjects and can be used to explore the experiences of women presenting with twin-to-twin transfusion syndrome (TTTS) to facilitate the provision of targeted psychological support. METHODS: A semi-structured interview method was used to assess the pregnancy and parenting experiences of women with TTTS. Colaizzi method was used for data analysis. RESULTS: Eighteen women participated in the study. We found that women with TTTS during pregnancy experienced persistent worry about their children's health from the disease diagnosis to the subsequent parenting processes, even in case of minor changes in their children's health. The lack of an efficient referral process and health information increased their uncertainty about their children's health. CONCLUSION: In addition to the children's health, other difficulties encountered during pregnancy and parenting may aggravate the pressure. Clinicians in the first-visit hospital and foetal medicine centre should improve the referral process and establish a follow-up system to provide women with health information and psychological support.

Association between night shift and sleep quality and health among Chinese nurses: A cross-sectional study.

AIM: To explore the sleep quality among Chinese nurses and identify the association between night shift and sleep quality and health. BACKGROUND: Chinese nurses have many night shifts; the effect of it regarding nurses' sleep quality and health is still not being explored. METHODS: This was a cross-sectional study. There were 3,206 nurse participants. The participants self-completed a sociodemographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI) and the Cornell Medical Index (CMI). RESULTS: Night shift nurses demonstrated relatively worse sleep quality (55.1%) and more health problems (20.7%). Night shift work was significantly associated with poor sleep quality (ß = 0.96, confidence interval [CI] = 0.67-1.26) and poor health (ß = 2.01, CI = 0.15-3.88). Except for sleep medication (ß = 0.02, CI = -0.01, 0.05) and psychological health (ß = 0.38, CI = -0.27, 1.03), night shift work was significantly associated with other PSQI domains and physical health. CONCLUSION: Night shift work was a risk factor for nurses' sleep quality and health. Night shift nurses have more sleep disorders and physical health problems. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should pay attention to the impact of shift work on nurses' sleep quality and health and reform the rotating shift work system to improve nurses' occupational health.

[Acupuncture treatment of male infertility: a systematic review].

OBJECTIVE: To systematically evaluate acupuncture as a treatment for male infertility. METHODS: We searched Chi na Biology Medical Database (CBM), Wan Fang Medical Information System, China National Knowledge Infrastructure (CNKI), VIP Information Resource System (VIP), and PubMed for published literature on acupuncture as a treatment for male infertility on May 1 2014. Based on the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA), we evaluated the quality of the reports, conducted meta-analysis on the identified studies via RevMan5.2, and assessed the quality of the evidence in the literature by Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS: A total of 12 studies involving 2,177 patients were included, the quality of which was evaluated as mediocre. With regard to the cure rate, acupuncture was comparable to traditional Chinese medicine (TCM) (P > 0.05) but better than Western medicine (RR = 4.00, 95% CI 1.63 to 9.82, P < 0.01) while acupuncture + TCM was better than either TCM (RR = 1.77, 95% CI 1.20 to 2.60, P < 0.01) or Western medicine used alone (RR = 2.73, 95% CI 1.51 to 4.93, P < 0.01), and acupuncture + Western medicine was better than Western medicine alone (RR = 1.88, 95% CI 1.17 to 3.02, P = 0.01). The combined use of acupuncture, ear pressure, TCM, and Western medicine showed a higher cure rate than the combination of TCM and Western medicine (RR = 3.45, 95% CI 2.90 to 4.11, P < 0.01). In therapeutic effectiveness, acupuncture was comparable to TCM (P > 0.05) but superior to Western medicine (RR = 1.41, 95% CI 1.12 to 1.71, P < 0.01), acupuncture + TCM was superior to either TCM (RR = 1.14, 95% CI 1.05 to 1.23, P < 0.01) or Western medicine alone (RR = 1.43, 95% CI 1.22 to 1.67, P < 0.01), and acupuncture + Western medicine was superior to Western medicine alone (RR = 1.25, 95% CI 1.05 to 1.49, P = 0.01). In improving sperm concentration, acupuncture was as effective as TCM (P > 0.05) and sham acupuncture (P > 0.05) but outdid Western medicine (RR = 27.00, 95% CI 24.27 to 29.73, P < 0.01) and acupuncture + TCM outdid either TCM (RR = 14.65, 95% CI 7.58 to 21.72, P < 0.01) or Western medicine alone (RR = 1.04, 95% CI--1.43 to 3.51, P > 0.05). In improving grade a sperm, acupuncture exhibited a similar effect to TCM (P > 0.05) and sham acupuncture (P > 0.05), and acupuncture + TCM was more effective than TCM alone (RR = 7.78, 95% CI 3.51 to 12.23, P < 0.01) but equally effective as Western medicine (P > 0.05). In elevating the level of grade a + b sperm, acupuncture + TCM excelled either TCM (RR = 11.00, 95%, CI 3.17 to 18.82, P < 0.01) or Western medicine alone (RR = 12.22, 95% CI 6.87 to 17.57, P < 0. 01), while acupuncture produced a comparable effect with sham acupuncture (P > 0.05). As for the quality of the included studies, only 3 conclusions of the 23 meta-analyses were assessed to be of average quality, while the others of poor or extremely poor quality. Therefore, the recommendation grade of the conclusions was low. CONCLUSION: For the treatment of male infertility, acupuncture is reported to be equally effective as TMC and more effective than Western medicine, and its effectiveness is enhanced when applied in combination with either TCM or Western medicine. Acupuncture is distinctively efficacious in improving sperm quality. Nevertheless, the overall quality of the included studies is low.

Association Between Passive Smoking and Menstrual Discomfort: A Cross-Sectional Study of 2,571 Non-smoking Chinese Nurses.

Introduction: Menstrual discomfort affects women's quality of life, which is an important public health issue. Evidence confirming the link between passive smoking and menstrual discomfort is limited. Therefore, the aim of this study is to investigate the aforementioned topic on the basis of a cross-sectional study of 2,571 non-smoking Chinese nurses. Methods: Demographic information and passive smoking were assessed using a self-administered questionnaire. Menstrual discomfort was characterized as dysmenorrhea, illness or weakness, bed rest, and restlessness during menstruation, which was assessed using a modified version of the Cornell Medical Index-Health Questionnaire. Multivariate-adjusted odds ratio (OR) and 95% confidence intervals (CIs) were estimated using the logistic regression model. Results: A total of 1:195 nurses (46.48%) were exposed to passive smoking. Compared with non-passive smoking nurses, passive smoking nurses were more likely to have menstrual discomfort symptoms (72.38 vs. 64.39%), especially symptoms of dysmenorrhea (49.54 vs. 42.08%), illnesses or weakness (48.28 vs. 42.08%), and restlessness during menstruation (53.05 vs. 46.22%). Exposure to passive smoking was significantly associated with menstrual discomfort (OR = 1.41, 95%CI: 1.19-1.67), especially symptoms of dysmenorrhea (OR = 1.32, 95%CI: 1.13-1.56), illness or weakness (OR = 1.24, 95%CI: 1.06-1.46), and restlessness (OR = 1.26, 95%CI: 1.08-1.48) during menstruation. The subgroup analyses, stratified by age, children, and marital status, agreed with the main findings. Conclusions: Exposure to passive smoking was related to symptoms of dysmenorrhea and menstrual discomfort.

Radiological and histopathological features of short rib­polydactyly syndrome type III and identification of two novel DYNC2H1 variants.

Short rib­polydactyly syndrome type III (SRPS3) is a lethal perinatal skeletal disorder consisting of polydactyly and multi­system organ abnormalities. To further assess the pathogenicity of two pairs of compound heterozygotes and to search for novel molecular etiology, X­rays and hematoxylin and eosin staining were conducted in three cases: Two retrospective samples and a newly identified patient with SRPS3. In addition, next­generation sequencing was used to evaluate a fetus with SRPS3. Typical radiological features of the three cases included a long, narrow thorax with short ribs, shortened long bones, spurs at the metaphysis of the long bones and congenital bowing of the femurs. The present study also observed atypical histopathological changes, together with the absence of proliferation and abundance of retaining cartilage in the primary spongiosum. In addition, two novel compound heterozygous variants were identified in the dynein cytoplasmic 2 heavy chain 1 (DYNC2H1) gene of the fetus: NM_001080463.1, c.6591_6593delTGG (chr11:103055738­103055740); NM_001080463.1, c.7883T>C (chr11:103070000). The findings of the present study provided further confirmation of the pathogenicity of two compound heterozygous variants in two retrospective samples and identified novel compound heterozygous variants. These findings may improve our knowledge of the histopathological and radiological changes in patients with SRPS3 and the relative effects of DYNC2H1 variants. The findings of the present study may facilitate the clinical and molecular diagnosis of SRPS3.

Association Between Passive Smoking and Health Among Chinese Nurses: A Cross-Sectional Study.

This study aimed to investigate the association between passive smoking and physical and psychological health in Chinese nurses. Participants of this cross-sectional study comprised 2,484 non-smoking nurses. Passive smoking and demographic information were assessed using a self-administered questionnaire. Physical, psychological, and overall health status of nurses were measured using the Cornell Medical Index (CMI) health questionnaire. Multivariate-adjusted odds ratio (OR) and 95% confidence interval (CI) for nurses' health were estimated by exposure to passive smoking using unconditional logistic regression models. A total of 1,219 nurses (49.07%) were exposed to passive smoking. Of these, 609 (24.52%), 160 (6.44%), and 587 (23.63%) nurses had poorer physical, mental, and overall health, respectively. After adjusting for other confounding factors, compared with the non-passive smoking group, passive smoking was associated with poor physical (OR = 1.51, 95% CI: 1.25-1.83), mental (OR = 1.48, 95% CI: 1.07-2.07), and overall (OR = 1.58, 95% CI: 1.30-1.93) health of nurses, respectively. We also carried out subgroup analyses stratified by age, department, and professional title, which showed that most findings supported the main results. This study demonstrated that exposure to passive smoking was a risk factor for overall decreased physical and mental health status among Chinese nurses.

Rare De Novo IGF2 Variant on the Paternal Allele in a Patient With Silver-Russell Syndrome.

Silver-Russell syndrome (SRS) is a rare, well-recognized disorder characterized by growth restriction, including intrauterine and postnatal growth. Most SRS cases are caused by hypomethylation of the paternal imprinting center 1 (IC1) in chromosome 11p15.5 and maternal uniparental disomy in chromosome 7 (UPD7). Here, we report on a Chinese family with a 4 year old male proband presenting with low birth weight, growth retardation, short stature, a narrow chin, delayed bone age, and speech delays, as a result of a rare molecular etiology. Whole-exome sequencing was conducted, and a novel de novo IGF2 splicing variant, NM_000612.4: c.157+5G > A, was identified on the paternal allele. In vitro functional analysis by RT-PCR and Sanger sequencing revealed that the variant leads to an aberrant RNA transcript lacking exon 2. Our results further confirm the IGF2 variant mediates SRS and expand the pathogenic variant and phenotypic spectrum of IGF2-mediated SRS. The results indicate that, beyond DNA methylation and UPD7 and CDKN1C variant tests, IGF2 gene screening should also be considered for SRS molecular diagnoses.