Status and influencing factors of undergraduate midwifery students' core competencies: A cross sectional study.

INTRODUCTION: Midwifery undergraduate students' core competencies directly affect the quality of midwifery services and overall quality of midwifery teams. However, limited research has explored the core competencies of undergraduate midwifery students in China. OBJECTIVES: This study aimed to describe the level of core competencies among undergraduate midwifery students in China and investigated possible associated factors. DESIGN: This was a cross-sectional descriptive study. SETTINGS AND PARTICIPANTS: The study population comprised third- and fourth-year undergraduate midwifery students at Zunyi Medical University in Guizhou Province in southwest China (n = 207, response rate 94.1 %). METHODS: Data were collected using an online survey that included a general information questionnaire, a general self-efficacy scale, and a core competencies self-assessment questionnaire for midwifery undergraduates. Data were statistically analyzed using SPSS 18.0. Pearson's correlation analysis was used to explore the relationship between self-efficacy and the core competencies. Stepwise multiple linear regression was used to explore influencing factors. RESULTS: The total score for the core competencies among midwifery undergraduates was 118.46 (8.97). The highest mean score was for professional attitude, 4.21 (0.43), and the lowest was for professional skills, 3.70 (0.30). We found a positive association between self-efficacy and core competencies (r = 0.251, P < 0.01). Grade (ß = 0.261, P < 0.01), scholarship (ß = -0.231, P < 0.01), work intention (ß = -0.135, P < 0.05), and self-efficacy (ß = 0.207, P < 0.01) significantly influenced undergraduate midwifery students' core competencies (R2 = 0.189, adjusted R2 = 0.173, F = 11.775, P < 0.001). CONCLUSIONS: Undergraduate midwifery students showed moderate core competencies, indicating room for improvement. Fourth-grade midwifery students had higher core competencies than third-grade students. Additionally, scholarship, work intention, and self-efficacy were significant influencing factors. Midwifery educators should examine students' core competencies and explore targeted interventions, particularly for those with low self-efficacy and core competencies.

Effect of levothyroxine on pregnancy outcomes in women with thyroid autoimmunity: a systematic review with meta-analysis of randomized controlled trials.

OBJECTIVE: To investigate whether levothyroxine is associated with improved live birth and other benefits in women with thyroid autoimmunity. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Women positive for thyroid peroxidase antibody. INTERVENTION(S): MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched without any language restrictions. Pooled effect sizes were calculated using random-effects models. MAIN OUTCOME MEASURE(S): The primary outcome was the incidence of live birth, miscarriage, preterm birth, clinical pregnancy, ectopic pregnancy, neonatal admission, and birth weight. The summary measures were reported as relative risk (RR) with 95% confidence interval. RESULT(S): Levothyroxine supplementation was not associated with an increased rate of live birth or a decreased risk of miscarriage. Results were similar in subgroup analyses of live birth by age, baseline thyrotropin, baseline thyroid peroxidase antibody, body mass index, and use of assisted conception. For live birth, the effect estimate lay within the futility boundary for RR of 20% and 15%, but at a 10% RR, the effect estimate lay between the futility boundary and the inferior boundary. CONCLUSION(S): High- to moderate-quality evidence demonstrated that the use of levothyroxine was not associated with improvements in clinical pregnancy outcomes among women positive for thyroid peroxidase antibody. REGISTRATION NUMBER: PROSPERO CRD42019132976.

Effects of Vitamin D Supplementation on Prevention of Type 2 Diabetes in Patients With Prediabetes: A Systematic Review and Meta-analysis.

BACKGROUND: While observational studies have shown an association between vitamin D insufficiency and diabetes, it is unclear whether intervention with vitamin D supplements can lower the risk of type 2 diabetes mellitus (T2DM). PURPOSE: To assess whether vitamin D supplementation reduces the risk of T2DM in people with prediabetes. DATA SOURCES: We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) from inception to 5 July 2019. STUDY SELECTION: We included randomized controlled trials assessing vitamin D supplementation versus placebo in relation to new-onset T2DM in people with prediabetes. DATA EXTRACTION: We screened studies and extracted data from published trials independently. DATA SYNTHESIS: We identified eight eligible trials with a total of 4,896 subjects. Vitamin D supplementation significantly reduced the risk of T2DM (risk ratio [RR] 0.89 [95% CI 0.80-0.99]; I 2 = 0%). Benefit was found in nonobese subjects (RR 0.73 [95% CI 0.57-0.92]) but not in obese subjects (RR 0.95 [95% CI 0.84-1.08]) (P interaction = 0.048). The reversion of prediabetes to normoglycemia occurred in 116 of 548 (21.2%) participants in the vitamin D group and 75 of 532 (14.1%) in the control group. Vitamin D supplementation increased reversion rate of prediabetes to normoglycemia (RR 1.48 [95% CI 1.14-1.92]; I 2 = 0%.) LIMITATIONS: Definitions of prediabetes and new-onset diabetes in eligible studies were different, and long-term data on outcomes of T2DM prevention were lacking. CONCLUSIONS: In persons with prediabetes, vitamin D supplementation reduces the risk of T2DM and increases the reversion rate of prediabetes to normoglycemia. The benefit of the prevention of T2DM could be limited to nonobese subjects. Individual participant data meta-analyses are needed to confirm these findings.

Therapeutic effect of tripterine on adjuvant arthritis in rats.

AIMS OF THE STUDY: Tripterygium wilfordii Hoog f., a perennial vine, is used in traditional Chinese medicine for treatment of rheumatoid arthritis. This study was to determine whether tripterine, isolated from Tripterygium wilfordii Hoog f., had therapeutic effects on adjuvant arthritis. MATERIALS AND METHODS: Adjuvant arthritis (AA) was induced in rats on day 0. Tripterine 5, 10 and 20 mg kg(-1)day(-1), or prednisone 10 mg kg(-1)day(-1) was given to rats intragastrically from day 19 to day 24. RESULTS: Tripterine significantly inhibited paw swelling and bone destruction in AA rats. Serum level of IgG anti-Mycobacterium tuberculosis antibodies and delayed-type hypersensitivity (DTH) induced by Mycobacterium tuberculosis were also decreased by tripterine. The effects of tripterine were associated with decreased interleukin-1beta (IL-1beta) mRNA expression in ankle joint synovial membrane and tumor necrosis factor-alpha (TNF-alpha) mRNA expression in homogenized paws from adjuvant-induced arthritic rats. CONCLUSIONS: These findings suggested that tripterine had a therapeutic effect on adjuvant arthritis.