Effects of emotional ambiguity and emotional intensity on true and false memory.

Whereas the effects of emotional intensity (the perceived strength of an item's valence or arousal) have long been studied in true- and false-memory research, emotional ambiguity (the uncertainty that attaches to perceived emotional intensity) has only been studied recently. Available evidence suggests that emotional ambiguity has reliable effects on true memory that are distinct from those of emotional intensity. However, those findings are mostly restricted to recall, and the effects of emotional ambiguity on false memory remain unexplored. The current study addressed both limitations by measuring the effects of emotional ambiguity and emotional intensity on true and false recognition. In two experiments, we manipulated valence ambiguity and valence intensity (Experiment 1) and arousal ambiguity and arousal intensity (Experiment 2) of Deese/Roediger/McDermott lists. Multiple linear regression analyses were conducted for Experiment 1, Experiment 2, and the combined data of the experiments to separate the effects of emotional ambiguity and emotional intensity. Our results showed that both valence ambiguity and arousal ambiguity improved true recognition, and the effects of valence ambiguity remained robust even when controlling for valence intensity, arousal intensity, and arousal ambiguity. More importantly, for both valence and arousal, there was an interaction between ambiguity and intensity in false memory. Specifically, we found that valence ambiguity increased false recognition with positive valence, while arousal ambiguity amplified the effect of arousal intensity on false recognition. Our results are discussed in the context of the emotional ambiguity hypothesis and fuzzy-trace theory.

Evaluation of the Impact of Remote Monitoring Using the Sharesource Connectivity Platform on Adherence to Automated Peritoneal Dialysis in 51 Patients.

BACKGROUND This study from a single center in Taiwan aimed to evaluate the impact of remote patient monitoring (RPM) using the Sharesource connectivity platform on adherence to automated peritoneal dialysis (APD) in 51 patients. MATERIAL AND METHODS We analyzed data on 51 patients with end-stage renal disease (ESRD) under APD. They were treated with a traditional APD machine HomeChoice (phase 1), changed to new APD machine HomeChoice Claria for 12 weeks (phase 2), then connected to the Sharesource platform for another 12 weeks (phase 3), and were followed up for 1 year. The non-adherence rate was compared between the 3 phases. The secondary outcomes included peritonitis rate, hospitalization rate, and hospitalization days, 1 year before and after receiving a new APD machine. Patients were subdivided into good and poor adherence (>1 episode of non-adherence in phase 1) groups for further analysis. RESULTS The average non-adherence rates were 10.5%, 5.1%, and 4.9% in phases 1, 2, and 3, respectively, although differences were not significant. Serum potassium (P<0.0001) and C-reactive protein (CRP) (P=0.026) levels significantly decreased in phase 3. The 1-year peritonitis rate, hospitalization rate, and number of days of hospitalization showed no significant changes. Subgroup analysis revealed that the non-adherence rate in the poor adherence group decreased from 48.4% in phase 1 to 14.2% and 12.4% in phases 2 and 3, respectively (P=0.007). CONCLUSIONS Remoting monitoring using the Sharesource connectivity platform increased dialysis adherence in APD treatment, especially in patients with poor adherence. Serum potassium level and inflammation status were also improved by this system.

The font size effect depends on inter-item relation.

The font size effect refers to the metacognitive illusion that larger fonts lead to higher judgments of learning (JOLs) but not better recall. Prior studies demonstrated robust JOL effects of font size under conditions of intra-item relation (i.e., cue-target relatedness within a word pair), even though intra-item relation is a more diagnostic cue than font size. However, it remains an open question whether the JOL effects of font size persist under conditions of inter-item relation (i.e., relations across items on a single-word list). In the current study, we examined the JOL and recall effects of font size when font size and inter-item relation were factorially manipulated in three JOL-recall experiments. Additionally, to manipulate the salience of inter-item relation, we presented related and unrelated lists in a blocked manner in Experiment 1 but in a mixed manner in Experiments 2 and 3. Our results showed that the JOL effects of font size are moderated or eliminated when inter-item relation is manipulated simultaneously with font size. Moreover, the smaller font led to better recall for related lists but not for unrelated lists across all three experiments. Therefore, our results demonstrate that individual cues may not be integrated with equal weight, and there can be a trade-off between item-specific and relational processing during the JOL process. Additionally, highlighting key information with larger fonts may not be optimal with related items.

Neuroprotective Effects of Lactobacillus plantarum PS128 in a Mouse Model of Parkinson's Disease: The Role of Gut Microbiota and MicroRNAs.

Parkinson's disease (PD) is a neurodegenerative disease characterized by motor deficits and marked neuroinflammation in various brain regions. The pathophysiology of PD is complex and mounting evidence has suggested an association with the dysregulation of microRNAs (miRNAs) and gut dysbiosis. Using a rotenone-induced PD mouse model, we observed that administration of Lactobacillus plantarum PS128 (PS128) significantly improved motor deficits in PD-like mice, accompanied by an increased level of dopamine, reduced dopaminergic neuron loss, reduced microglial activation, reduced levels of inflammatory factors, and enhanced expression of neurotrophic factor in the brain. Notably, the inflammation-related expression of miR-155-5p was significantly upregulated in the proximal colon, midbrain, and striatum of PD-like mice. PS128 reduced the level of miR-155-5p, whereas it increased the expression of suppressor of cytokine signaling 1 (SOCS1), a direct target of miR-155-5p and a critical inhibitor of the inflammatory response in the brain. Alteration of the fecal microbiota in PD-like mice was partially restored by PS128 administration. Among them, Bifidobacterium, Ruminiclostridium_6, Bacteroides, and Alistipes were statistically correlated with the improvement of rotenone-induced motor deficits and the expression of miR-155-5p and SOCS1. Our findings suggested that PS128 ameliorates motor deficits and exerts neuroprotective effects by regulating the gut microbiota and miR-155-5p/SOCS1 pathway in rotenone-induced PD-like mice.

Risk factors associated with periodontal disease and its impact on quality of life among pregnant women.

BACKGROUND: Periodontal disease during pregnancy affects maternal oral health and increases the risk of adverse pregnancy outcomes. However, studies on the risk factors for periodontal disease and its impact on oral health-related quality of life in pregnant women in Taiwan are lacking. This present study aimed to identify the risk factors associated with periodontal disease during pregnancy and examine the relationship of periodontal disease with oral health-related quality of life among pregnant women. METHODS: This study was conducted in a large medical centre in northern Taiwan. Eighty-four participants completed a periodontal examination by dentists as well as structured questionnaires, including the Oral Health Impact Profile-14, demographics, obstetric history, dietary habits, and oral hygiene behaviours. Multivariate logistic regression was used to determine the risk factors associated with periodontal disease and a t-test was used to compare the difference in oral health-related quality of life between pregnant women with and without periodontal disease. RESULTS: Fifty participants (59.5%) had periodontal diseases. Risk factors for periodontal disease included eating out for lunch, consuming beverages, brushing less than three times per day, and not receiving regular professional dental cleanings. The oral health-related quality of life was significantly poorer in pregnant women with periodontal disease than in those without. CONCLUSIONS: The risk factors for periodontal disease, including eating out for lunch, drinking beverages, brushing teeth less, and not regular dental cleaning, provide convincing evidence for pregnant women to maintain good oral hygiene to prevent periodontal disease and improve oral health-related quality of life.

Pregnancy can cause poor mouth health. Expectant mothers with gum disease might face problems such as low birth weight and premature birth. This study found that certain factors can worsen gum disease during pregnancy. These include eating out for lunch, drinking sugary or acidic drinks, brushing their teeth less than three daily, and skipping regular teeth cleaning by a dentist. Pregnant women with gum disease also reported a lower quality of life related to oral health compared to those without it. Healthcare providers should educate pregnant women about oral health maintenance. Emphasize the importance of professional dental cleanings every three months, frequent tooth brushing, avoiding sugary and acidic drinks, and reducing eating out for lunch. Future research should explore additional ways to support pregnant women in this regard.

Multidisciplinary care program in pre-end-stage kidney disease from 2010 to 2018 in Taiwan.

BACKGROUND: The Taiwanese government launched a universal pay-for-performance (P4P) program in 2006 to promote multidisciplinary care for patients with stage 3b-5 chronic kidney disease (CKD). This study aimed to understand the enrollments, care processes, and outcomes of the P4P program between 2010 and 2018. METHODS: We conducted a population-based study using the Taiwan National Health Insurance Research Data. We divided the incident dialysis population into joining and not joining P4P groups based on whether patients had joined the pre-ESRD program before dialysis or not. Trends in the medications prescribed, anemia correction, vascular access preparation before dialysis initiation, and cumulative survival rate were compared. RESULTS: The program included more than 100,000 patients with late-stage CKD. Enrollment increased by almost 100% from 2010 to 2018, with increases seen in those over 75 years old (127.5%), male (96.7%), and earlier CKD stages (≥35% stage 3b in 2018). Females were more likely to stay being enrolled. The joining P4P group was prescribed more appropriate medications, such as erythropoietin-stimulating agents and statins. However, a high number of patients were still prescribed metformin (≥40%) and non-steroidal anti-inflammatory drugs (≥20%). Compared to the not joining P4P group, the patients in the P4P group had better anemia management, dialysis preparation, and post-dialysis survival. CONCLUSION: The patients in the joining P4P program group were delivered more appropriate CKD care and were associated with better survival outcomes. Polices and action plans are needed to extend the coverage of and enrollment in the P4P program.

Care and management of stillborn babies from the parents' perspective: A phenomenological study.

AIM: To explore parents' perspective on hospital's care and management of the remains of stillborn babies. BACKGROUND: Each year, 2.6 million of pregnancies end as stillbirth. Recent literature began to understand parents' traumatic experience in stillbirth and its profound impact on parents' mental health and psychosocial effect. But there is limited understanding on the actual care and management of the stillborn baby, nor is there an agreement on how hospitals should care for the stillborn baby to mitigate parents' profound loss. DESIGN: A descriptive phenomenological approach was applied to conduct this study. METHODS: A purposive sample of twenty couples (40 individuals) who had encountered how to care for the remains of their stillborn babies participated in the study. The data were collected through in-depth interviews, which involved semi-structured and open-ended questions. The phenomenological methods of Giorgi were applied to analyse the data. The COREQ checklist was used preparing the manuscript. RESULTS: Parents felt unprepared and lack of support when they had to handle their stillborn babies' remains. The research results revealed two major themes: (1) Handling stillborn babies remain ignorantly; (2) Pacifying the disturbed soul on both sides. CONCLUSIONS: It was found in the study that reflection and identification were the emerging themes, which can enable healthcare professionals to understand parents' concerns in a meaningful way, as they deal with the remains of stillborn babies. Moreover, it is hoped that hospital administration and health care personnel should consider stillborn parents' concerns and incorporate their needs into nursing assessment and treatment practices. RELEVANCE TO CLINICAL PRACTICE: Given stillbirth's profound implication for parents' identity and psychosocial role, hospitals need to be more sensitive and proactive to parents' cultural and religious needs when they care for stillborn baby and handle its body.

Safety Evaluation and Anti-Inflammatory Efficacy of Lacticaseibacillus paracasei PS23.

Lacticaseibacillus paracasei strain PS23 (PS23) exhibits some probiotic properties. In this study, a genomic analysis of PS23 revealed no genes related to virulence or antibiotic resistance. Moreover, ornithine decarboxylase activity was not detected in vitro. In addition, PS23 was sensitive to the tested antibiotics. Genotoxicity tests for PS23 including the Ames test and chromosomal aberrations in vitro using Chinese hamster ovary cells and micronuclei in immature erythrocytes of ICR mice were all negative. Moreover, following a 28-day study involving repeated oral dose toxicity tests (40, 400, and 4000 mg/kg equal 1.28 × 1010, 1.28 × 1011, and 1.28 × 1012 CFU/kg body weight, respectively) using an ICR mouse model, no adverse effects were observed from any doses. In addition, supplementation with live or heat-killed PS23 ameliorates DSS-induced colonic inflammation in mice. Our findings suggest that PS23 is safe and has anti-inflammatory effects and may therefore have therapeutic implications.

The Association of Urinary Sclerostin and Renal Magnesium Handling in Type 2 Diabetic Patients with Chronic Kidney Disease.

INTRODUCTION: Sclerostin could enhance renal excretion of calcium (Ca) and phosphate (P). The association between sclerostin and magnesium (Mg) has not yet discovered. In patients with type 2 diabetes mellitus (T2DM) or chronic kidney disease (CKD), higher serum sclerostin and altered renal excretion of Ca, P, and Mg were detected. Therefore, we tried to evaluate if there was any association between sclerostin and fractional excretion of Ca, P, and Mg (FeCa, FeP, and FeMg) in T2DM with CKD. METHODS: In this prospective cohort study, 43 T2DM patients without CKD or with CKD stage 1-5 were enrolled. Values of parameters, including serum and urine sclerostin, were collected at baseline and 6 months later. For baseline data, the Mann-Whitney U test, χ2 test, or Spearman's correlation were used. For multivariate repeated measurement analysis, generalized estimating equation (GEE) model was utilized. RESULTS: Patients with lower estimated glomerular filtration rate had higher serum sclerostin, FeP, FeMg, and lower FeCa. By correlation analysis, serum sclerostin was negatively associated with FeCa (p = 0.02) and positively associated with FeP (p = 0.002). The urine sclerostin to creatinine ratio (Uscl/Ucre) was positively correlated with FeP (p = 0.007) and FeMg (p = 0.005). After multivariate analyses by GEE model, serum sclerostin was still inversely associated with FeCa, while Uscl/Ucre was significantly associated with FeMg. On the other hand, FeP lost its associations with serum sclerostin or Uscl/Ucre. CONCLUSION: In our study population of T2DM patients with or without CKD, the inverse correlation between serum sclerostin and FeCa could not be explained by the calciuric effect of sclerostin. In addition, a newly discovered positive association between urinary sclerostin and FeMg indicated a possible role of urinary sclerostin in regulating renal Mg handling especially over distal convoluted tubules.

Flexible Textile-Based Pressure Sensing System Applied in the Operating Room for Pressure Injury Monitoring of Cardiac Operation Patients.

Pressure injury is the most important issue facing paralysis patients and the elderly, especially in long-term care or nursing. A new interfacial pressure sensing system combined with a flexible textile-based pressure sensor array and a real-time readout system improved by the Kalman filter is proposed to monitor interfacial pressure progress in the cardiac operation. With the design of the Kalman filter and parameter optimization, noise immunity can be improved by approximately 72%. Additionally, cardiac operation patients were selected to test this developed system for the direct correlation between pressure injury and interfacial pressure for the first time. The pressure progress of the operation time was recorded and presented with the visible data by time- and 2-dimension-dependent characteristics. In the data for 47 cardiac operation patients, an extreme body mass index (BMI) and significantly increased pressure after 2 h are the top 2 factors associated with the occurrence of pressure injury. This methodology can be used to prevent high interfacial pressure in high-risk patients before and during operation. It can be suggested that this system, integrated with air mattresses, can improve the quality of care and reduce the burden of the workforce and medical cost, especially for pressure injury.

Cystatin C as a predictor for outcomes in patients with negligible renal function.

BACKGROUND: High serum cystatin C (CysC) has been associated with clinical risks independently of the glomerular filtration rate (GFR). This study aims to investigate the predictive power of CysC in patients with a negligible GFR. METHODS: Patients on chronic hemodialysis or peritoneal dialysis were enrolled for measurement of CysC levels and were followed up for one year. A daily urine amount <100 ml was considered negligible residual renal function (RRF). RESULTS: CysC results were available in 183 dialysis patients. Of these, 131 patients had a negligible RRF. The multivariate Cox proportional hazards model showed that CysC was an independent predictor of fatal and nonfatal cardiovascular and infection events in all dialysis patients and in dialysis patients with a negligible RRF. CONCLUSION: CysC maintained its predictive power for adverse outcomes in patients with no meaningful GFR, indicating that the prognostic value of CysC is independent of the GFR.

Haemolytic uremic syndrome following fire ant bites.

BACKGROUND: Haemolytic-uremic syndrome (HUS) is a severe, life-threatening disease with symptoms such as haemolytic anaemia, renal failure, and a low platelet count. Possible aetiology includes bacterial infections, medication, post-hematopoietic cell transplantation, pregnancy, autoimmune disease, and acquired immunodeficiency syndrome. CASE PRESENTATION: We report the case of a 21-year-old healthy man who developed acute renal failure caused by HUS. Typical symptoms of HUS combined with severe uraemia developed following a large local reaction after suspected Solenopsis invicta (fire ant) bites. He was successfully treated with plasma exchange and achieved complete recovery of renal function. CONCLUSION: This is the first case illustrating a serious systemic reaction of HUS to fire ant bites, and highlights this severe complication in patients who sustain fire ant bites.

Shorter daily dwelling time in peritoneal dialysis attenuates the epithelial-to-mesenchymal transition of mesothelial cells.

BACKGROUND: Peritoneal dialysis (PD) therapy is known to induce morphological and functional changes in the peritoneal membrane. Long-term exposure to conventional bio-incompatible dialysate and peritonitis is the main etiology of inflammation. Consequently, the peritoneal membrane undergoes structural changes, including angiogenesis, fibrosis, and hyalinizing vasculopathy, which ultimately results in technique failure. The epithelial-to-mesenchymal transition (EMT) of mesothelial cells (MCs) plays an important role during the above process; however, the clinical parameters associated with the EMT process of MCs remain to be explored. METHODS: To investigate the parameters impacting EMT during PD therapy, 53 clinical stable PD patients were enrolled. EMT assessments were conducted through human peritoneal MCs cultured from dialysate effluent with one consistent standard criterion (MC morphology and the expression of an epithelial marker, cytokeratin 18). The factors potentially associated with EMT were analyzed using logistic regression analysis. Primary MCs derived from the omentum were isolated for the in vitro study. RESULTS: Forty-seven percent of the patients presented with EMT, 28% with non-EMT, and 15% with a mixed presentation. Logistic regression analysis showed that patients who received persistent PD therapy (dwelling time of 24 h/day) had significantly higher EMT tendency. These results were consistent in vitro. CONCLUSIONS: Dwelling time had a significant effect on the occurrence of EMT on MCs.

Judgments of Learning Reactivity on Item-Specific and Relational Processing.

Judgments of learning (JOLs) reactivity refers to the finding that the mere solicitation of JOLs modifies subsequent memory performance. One theoretical explanation is the item-specific processing hypothesis, which posits that item-level JOLs redound to the benefit of later memory performance because they enhance item-specific processing. The current study was designed to test this account. We factorially manipulated the organization (blocked vs. randomized) of categorized lists and JOL condition (item-JOLs, list-JOLs, no-JOLs) between participants, and fit the dual-retrieval model to free recall data to pinpoint the underlying memory processes that were affected by JOL solicitation. Our results showed that item-level JOLs produced positive reactivity for randomized but not for blocked categorized lists. Moreover, we found that the positive JOL reactivity for randomized categorized lists was tied to a familiarity judgment process that is associated with gist processing, rather than to item-specific recollective processes. Thus, our results pose a challenge to the item-specific processing explanation of JOL reactivity. We argue that JOL reactivity is not restricted to item-specific processing; instead, whether JOLs predominantly engage participants with item-specific or relational processing depends on the interaction between learning stimuli and JOLs.

Deep distortions in everyday memory: Fact memory is illogical, too.

A distinction has recently been drawn between surface distortions and deep distortions in false memory, where the former are conventional errors of commission and the latter are illogical relations among multiple memories of items. The deep distortions that have been studied to date are violations of the logical rules that govern incompatibility relations, such as additivity and countable additivity. Because that work is confined to laboratory word-list tasks, it is subject to the ecological validity criticism that memory for everyday facts may not exhibit such phenomena. We report evidence that memory for everyday facts displays the same deep distortions as laboratory tasks. We developed a version of the conjoint-recognition paradigm that measures memory for incompatible general knowledge facts, similar to those found on the quiz program Jeopardy! In experiments with university participants, four deep distortions were detected (violations of the additivity, countable additivity, universal set, and compensation rules), with participants consistently remembering more than what is logically possible. The distortions were more robust than in laboratory experiments, and memories of incompatible facts (e.g., Jupiter and Saturn cannot both be the largest planet in the solar system) did not suppress each other. These patterns were replicated in subsequent experiments with older and more diverse participant samples. Consistent with the notion that deep distortions are by-products of gist memory, conjoint-recognition modeling analyses revealed that memory for everyday facts was even more reliant on gist than memory for word lists, and that verbatim memory was near-floor. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Renal protective effect of metformin in type 2 diabetes patients.

BACKGROUND: Inhibiting the development and progression of diabetic kidney disease (DKD) is an important issue, but the renoprotective effect of metformin is still controversial. AIMS: To assess the renoprotective effect of metformin in patients with type 2 diabetes. METHODS: This retrospective observational multicenter cohort study included 316,693 patients with type 2 diabetes from seven hospital. After age, gender, medical year, baseline estimated glomerular filtration rate (eGFR), urine protein (dipstick), glycated hemoglobin (HbA1C) and propensity score matching; a total of 13,096 metformin and 13,096 non-metformin patients were included. The main results were doubling of serum creatinine, eGFR ≤ 15 mL/min/1.73 m2 and end stage kidney disease (ESKD). RESULTS: After conducting a multivariable logistic regression analysis on the variables, the metformin group was revealed to have better renal outcomes than non-metformin group, including a lower incidence of doubling of serum creatinine (hazard ratio [HR], 0.71; 95% CI, 0.65-0.77), eGFR ≤ 15 mL/min/1.73 m2 (HR 0.61; 95% CI 0.53-0.71), and ESKD (HR 0.55; 95% CI 0.47-0.66). The subgroup analyses revealed a consistent renoprotective effect across patients with various renal functions. Furthermore, when considering factors such as age, sex, comorbidities, and medications in subgroup analyses, it consistently showed that the metformin group experienced a slower deterioration in renal function across nearly all patient subgroups. CONCLUSIONS: Metformin decreased the risk of renal function deterioration.

The recognition effects of attribute ambiguity.

When examining memory effects of semantic attributes, it is common practice to manipulate normed mean (M) ratings of the attributes (i.e., attribute intensity) in learning materials. Meanwhile, the standard deviations (SDs) of attribute ratings (i.e., attribute ambiguity) are usually treated as indexes of measurement error. However, some recent research found that recall accuracy varied as a function of both the intensity and ambiguity of semantic attributes such as valence, categorization, concreteness, and meaningfulness. These findings challenged the traditional interpretation of attribute rating SDs as noise indexes. In the current study, we examined the recognition effects of ambiguity, intensity, and Ambiguity × Intensity interactions for 21 attributes using mega study data for over 5,000 words. Our results showed that attribute ambiguity had reliable recognition effects beyond those of attribute intensity, and that it sometimes explained more unique variance in recognition than attribute intensity. Thus, we concluded that attribute ambiguity is a distinct psychological dimension of semantic attributes, which is processed separately from attribute intensity during encoding. Two theoretical hypotheses had been proposed for the memory effects of attribute ambiguity. We discuss the implications of our findings for the two theoretical hypotheses about how attribute ambiguity influences episodic memory.

Comparing word frequency, semantic diversity, and semantic distinctiveness in lexical organization.

Word frequency (WF) is a strong predictor of lexical behavior. However, much research has shown that measures of contextual and semantic diversity offer a better account of lexical behaviors than WF (Adelman et al., 2006; Jones et al., 2012). In contrast to these previous studies, Chapman and Martin (see record 2022-14138-001) recently demonstrated that WF seems to account for distinct and greater levels of variance than measures of contextual and semantic diversity across a variety of datatypes. However, there are two limitations to these findings. The first is that Chapman and Martin (2022) compared variables derived from different corpora, which makes any conclusion about the theoretical advantage of one metric over another confounded, as it could be the construction of one corpus that provides the advantage and not the underlying theoretical construct. Second, they did not consider recent developments in the semantic distinctiveness model (SDM; Johns, 2021a; Johns et al., 2020; Johns & Jones, 2022). The current paper addressed the second limitation. Consistent with Chapman and Martin (2022), our results showed that the earliest versions of the SDM were less predictive of lexical data relative to WF when derived from a different corpus. However, the later versions of the SDM accounted for substantially more unique variance than WF in lexical decision and naming data. The results suggest that context-based accounts provide a better explanation of lexical organization than repetition-based accounts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Self-management experience of first-time diagnosed gestational diabetes mellitus: A focus group interview.

AIM: Gestational diabetes mellitus (GDM) has become the most common complication in women during pregnancy in Taiwan. Since several clinical trials have demonstrated benefits of aggressive treatment, which rely heavily on self-management. The present study was conducted to explore the self-management experience of women with first-time diagnosed GDM. DESIGN: A qualitative descriptive approach was applied to conduct this study. METHODS: Purposive sampling was used to recruit patients with first-time diagnosed GDM from the maternity outpatient clinics of medical centre in Taiwan. A total of three focus groups interviews with 22 women were conducted to collect the data. Content analysis was applied to analyse the data. RESULTS: Four themes were identified: (1) unexpectedly having a high-risk pregnancy, (2) different perceptions for self-management, (3) implementation predicament of self-management and (4) maternal duty to ensure the safety of mother and child.

All-Cause Standardized Mortality Ratio in Hemodialysis and Peritoneal Dialysis Patients: A Nationwide Population-Based Cohort Study.

Patients with end-stage renal disease (ESRD) are at a higher mortality risk compared with the general population. Previous studies have described a relationship between mortality and patients with ESRD, but the data on standardized mortality ratio (SMR) corresponding to different causes of death in patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) are limited. This study was designed as a nationwide population-based retrospective cohort study. Incident dialysis patients between January 2000 and December 2015 in Taiwan were included. Using data acquired from the Taiwan Death Registry, SMR values were calculated and compared with the overall survival. The results showed there were a total of 128,966 patients enrolled, including 117,376 incident HD patients and 11,590 incident PD patients. It was found that 75,297 patients (58.4%) died during the period of 2000-2017. The overall SMR was 5.21. The neoplasms SMR was 2.11; the endocrine, nutritional, metabolic, and immunity disorders SMR was 13.53; the circulatory system SMR was 4.31; the respiratory system SMR was 2.59; the digestive system SMR was 6.1; and the genitourinary system SMR was 27.22. Therefore, more attention should be paid to these diseases in clinical care.