Effect of Bright Light Therapy on Perinatal Depression: A Systematic Review and Meta-Analysis: Effet de la luminothérapie sur la dépression périnatale: une revue systématique et une méta-analyse.

OBJECTIVE: This study represents the inaugural attempt to systematically review and analyse the efficacy of bright light therapy on depression among women experiencing major depressive disorder or depressive symptoms during the perinatal period, encompassing its efficacy on depression scores, remission rates, and response rates. METHODS: We searched 10 databases for randomized controlled trials examining bright light therapy's efficacy on perinatal depression up to January 2024. Data extraction was performed independently by 2 investigators. The Cochrane Handbook guidelines appraised the study quality, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach assessed evidence certainty. RESULTS: We incorporated 6 studies, encompassing 151 participants. When contrasted with dim light therapy, bright light therapy did not significantly alter depression scores (standard mean difference = -0.29, 95% confidence interval [CI], -0.62 to 0.04, P = 0.08, I² = 34%) or response rates (risk ratio [RR] = 1.56, 95% CI, 0.98 to 2.49, P = 0.06, I² = 0%) in women experiencing perinatal depression. Conversely, bright light therapy was associated with a substantial increase in remission rates (RR = 2.63, 95% CI, 1.29 to 5.38, P = 0.008, I² = 2%). CONCLUSION: Bright light therapy did not show efficacy in treating perinatal depression in terms of depression scores and response rates. However, regarding the remission rate, bright light did show efficacy compared to control conditions. Due to the limited sample size in the included studies, type II err or may occur. To obtain more conclusive evidence, future studies must employ larger sample sizes.

Development, validation and reliability testing of the hospice care environment scale.

BACKGROUND: WHO stated the environment is an important factor affecting the development of hospice care. The environment is the sum of factors affecting behavior besides the individual factors. Currently, a scale to comprehensively assess the hospice environment of nurse is still lacking. This study aimed to develop an instrument to investigate the environmental factors affecting hospice care of nurses. METHODS: Literature review and a semi-structured interview were conducted to form the items pool of the Hospice Care Environment Scale. Two rounds of Delphi expert consultation were conducted by 16 experts to revise the scale dimensions and entries to form the Hospice Care Environment Scale. A psychometric evaluation was then performed among 530 oncology nurses in a large tertiary oncology hospital in Hubei Province. The 500 valid questionnaires were randomly divided into two groups in a 1:1 ratio, sample 1 (n1 = 250) for item screening and sample 2 (n2 = 250) for quality evaluation of the resulting scale. Item analysis, reliability analysis, validity analysis and acceptability analysis were performed. RESULT: The Hospice Care Environment Scale consists of two dimensions and 13 entries. The Cronbach's α coefficient of the Hospice Care Environment Scale was 0.970, and the Cronbach's α coefficient of the two dimensions were 0.952 and 0.969, respectively, with the Item-content validity index and average Scale- content validity index of the scale was both 1.000. The validation factor analysis showed the standardized path coefficients of each item were basically above 0.5, and the factor structure model was stable and suitable. The average completion time of the scale was about 3 min, which had good feasibility. CONCLUSION: The Hospice Care Environment Scale to assess the environment of hospice care services, has good content and construct validity and reliability. This scale can provide guidance to evaluate the hospice care environment.

Current status of electronic health literacy among pregnant women with gestational diabetes mellitus and their perceptions of online health information: a mixed-methods study.

BACKGROUND: Women diagnosed with gestational diabetes mellitus often rely on internet-based health information for managing their condition. This study aims to investigate the present state of electronic health literacy among women with gestational diabetes mellitus, analyze the influencing factors, and explore their experiences regarding accessing, comprehending, evaluating, and applying online health information pertinent to gestational diabetes mellitus. METHODS: A sequential explanatory mixed methods research design was adopted in this study. Initially, 235 women with gestational diabetes mellitus participated in a cross-sectional survey. The research tools included general information and the Chinese version of the electronic Health Literacy Scale (eHEALS). Descriptive analyses were conducted to describe the characteristics of the sample, and multiple linear regression analyses were used to explore the factors influencing electronic health literacy among women with gestational diabetes mellitus. Secondly, 11 women with gestational diabetes mellitus joined semi-structured in-depth interviews to obtain their perceptions about online health information. The data were analyzed using inductive content analysis to develop themes. RESULTS: The median score of eHEALS in the Chinese version among 235 women diagnosed with gestational diabetes mellitus was 29 (interquartile range [IQR], 26 to 32). Factors influencing electronic health literacy among these women included accessing health information from medical professionals (ß = 0.137, p = 0.029) and utilizing health information from applications (ß = 0.159, p = 0.013). From the qualitative phase of the study, four thematic categories emerged: reasons and basis for accessing health information from the Internet; address barriers to accessing and applying online health information; desires for a higher level of online health information services; outcomes of accessing and applying online health information. CONCLUSION: The electronic health literacy of women diagnosed with gestational diabetes mellitus remains suboptimal and warrants improvement. The sources of access to health information affect electronic health literacy in women with gestational diabetes mellitus. Moreover, women facing gestational diabetes encounter numerous impediments when attempting to access health-related information online, underscoring the necessity for enhanced online health information services to meet their needs.

Pre- and postpartum fear of childbirth and its predictors among rural women in China.

BACKGROUND: Fear of childbirth (FOC) can influence both maternal and child health. Research on FOC in China is scarce, especially on rural women. This study aimed to assess pre- and postpartum FOC and its predictors among Chinese rural women. METHODS: This was a prospective correlation study. A total of 569 women completed the prenatal questionnaire in the third trimester, and 477 of them completed the postpartum questionnaire within three days after childbirth. Maternal socio-demographic information, clinical information, childbirth self-efficacy and prenatal and postpartum FOC were investigated. FOC was evaluated using the Wijma Childbirth Expectancy/ Experience Questionnaire (WDEQ). Descriptive, bivariate, multivariate linear regression analysis, univariate and multivariate logistic regression analyses were performed. RESULTS: The mean pre- and postpartum FOC scores were 64.5 (standard deviation: 25.1) and 64.3 (standard deviation: 23.9), respectively, with 20.8% of women reporting severe fear before childbirth and 18.2% after childbirth. Multivariate linear regression analysis revealed predictors for higher levels of prenatal FOC including higher education level, nullipara, higher monthly household income, lower family support, and lower childbirth self-efficacy (p < 0.05) and the predictors for higher levels of postpartum FOC included unemployed status, lower childbirth self-efficacy, and higher prenatal FOC (p < 0.05). Multivariate logistic regression showed that higher childbirth self-efficacy reduced the likelihood of severe prenatal FOC (OR: 0.99, p < 0.001), while severe prenatal FOC increased the likelihood of severe postpartum FOC (OR: 3.57, p < 0.001). CONCLUSION: The rural women have high levels of FOC before and after childbirth, with approximately 20% experiencing severe FOC during both periods. Higher education level, nullipara, higher monthly household income, lower family support, and lower childbirth self-efficacy are predictors of heightened prenatal FOC. Unemployed status, lower childbirth self-efficacy, and higher prenatal FOC are predictors of heightened postpartum FOC. Notably, enhancing childbirth self-efficacy emerges as crucial in mitigating severe prenatal FOC, while severe prenatal FOC significantly increases the likelihood of severe postpartum FOC. The development of targeted intervention strategies for the above factors can help reduce women's FOC level and improve their overall pregnancy and childbirth experience.

Behaviors and influencing factors of Chinese oncology nurses towards hospice care: a cross-sectional study based on social cognitive theory in 2022.

BACKGROUND: Although there is growing demand for hospice care in China due to its aging population and increasing cancer rates, the sector remains slow to expand. Oncology nurses are the primary providers of hospice care, but little is known about their behaviors towards hospice care and related factors. METHODS: This cross-sectional study conveniently sampled 933 oncology nurses from six grade A tertiary hospitals in Hubei Province between January to March 2022. The questionnaire was composed of seven parts: general information (including sociodemographic and work-related information), hospice care behaviors, hospice care knowledge, hospice care attitudes, hospice care self-efficacy, hospice care outcome expectancy, and hospice care environment. Data were analyzed using descriptive analysis, independent sample t-tests, one-way ANOVA, Pearson's correlation, multiple linear regression, random forest regression, and BP neural network model analysis. RESULTS: A total of 852 questionnaires were valid. The mean score of hospice care behaviors was 50.47 ± 10.56, with a mean item score of 3.61 ± 0.75. The three highest scoring behaviors were "pain assessment of patients (4.21 ± 0.91)", "satisfying the physical and mental needs of dying patients (4.04 ± 0.92)", and "creating good relationships between the medical staff and family members (4.02 ± 0.87)". The two lowest-scoring behaviors were "proactively recommending medical institutions for hospice care to terminally ill patients and their families (2.55 ± 1.10)" and "proactively talking to patients and families about death-related topics for patients who are critically ill and cannot be reversed (2.87 ± 1.03)." Multiple linear regression, random forest regression, and BP neural network models all showed that the frequency of sharing hospice care experiences with colleagues, hospice care attitudes, hospice care self-efficacy, and hospice care environments were positively associated with hospice care behaviors. CONCLUSIONS: The frequency of hospice care behaviors among Chinese oncology nurses is generally at a moderate to high level. The results provide a basis for promoting hospice care behaviors among oncology nurses in order to improve the quality of life for terminally ill cancer patients.

Longitudinal study of multidimensional factors influencing maternal and offspring health outcomes: a study protocol.

BACKGROUND: Reducing preventable adverse maternal and offspring outcomes is a global priority. The causes of adverse maternal and fetal outcomes are complex with multidimensional influencing factors. In addition, the Covid-19 epidemic has had a significant psychological and physical impact on people. China is now stepping into the post-epidemic era. We are curious about the psychological and physical situation of maternity in China at this stage. Therefore, we plan to initiate a prospective longitudinal study to investigate the multidimensional influences and mechanisms that affect maternal and offspring health. METHOD: We will recruit eligible pregnant women at Renmin Hospital of Hubei Province, China. The expected sample size is 1490. We will assess socio-demographics, Covid-19 related information, social capital, sleep, mental health and medical records, including clinical examination and biochemical tests. Eligible pregnant women will be enrolled in the study with less than 14 weeks of gestation. Participants will receive a total of nine follow-up visits between mid-pregnancy and one year postpartum. The offspring will be followed up at birth, 6 weeks, 3 months, 6 months and one year. In addition, a qualitative study will be conducted to understand the underlying causes that affect maternal and offspring health outcomes. DISCUSSION: This is the first longitudinal study of maternity in Wuhan, Hubei Province which integrates physical, psychological and social capital dimensions. Wuhan is the first city to be affected by Covid-19 in China. As China moves into the post-epidemic era, this study will provide us with a better understanding of the long-term impact of the epidemic on maternal and offspring health outcomes. We will implement a range of rigorous measures to enhance participants' retention rate and ensure the quality of data. The study will provide empirical results for maternal health in the post-epidemic era.

Paternal perinatal depression: A concept analysis.

AIM: Our aim is to clarify the concept of paternal perinatal depression including its definition, attributes, antecedents and consequences. DESIGN: A concept analysis. METHODS: To obtain relevant evidence, several databases were searched systematically including PubMed, EMBASE, Web of Science, CINAHL, PsycINFO and the Cochrane Library. Qualitative or quantitative articles published in English that focused on paternal perinatal depression were included. After the literature quality assessment, Walker and Avant's concept analysis strategy was used. RESULTS: Five defining attributes (i.e. symptoms occur during the partner's pregnancy or 1-year postpartum and last at least 2 weeks, emotional symptoms, somatic symptoms, negative parenting behaviours and 'masked' symptoms), four antecedents (i.e. personal issues, pregnancy-related issues, infant-related issues, social issues) and three consequences (i.e. offspring outcomes, marital relationship, maternal negative emotions) were identified.

Optimal gestational weight gain in Chinese pregnant women with gestational diabetes mellitus: A large retrospective cohort study.

AIM: To examine the optimal gestational weight gain (GWG) for Chinese pregnant women with gestational diabetes mellitus (GDM) based on the Chinese-specific body mass index (BMI) classification. METHODS: A retrospective cohort study was conducted using the 2017-2020 data from pregnant women with GDM in a tertiary hospital. A quadratic function model and the total predicted probability of adverse pregnancy outcomes were developed to obtain the optimal GWG. Differences in the incidence of adverse pregnancy outcomes between our optimal GWG recommendations and the Institute of Medicine (IOM) 2009 GWG guidelines were also analyzed. RESULTS: A total of 8103 pregnant women with GDM were analyzed. Based on the Chinese-specific BMI classification, the optimal GWG range was 11.0-17.5 kg for underweight women, 3.7-9.7 kg for normal-weight women, -0.6 to 4.8 kg for overweight women, and - 9.8 to 4.2 kg for obese women. Excessive GWG had a higher risk of large for gestational age (LGA) (OR: 2.99, 95% CI: 2.42-3.70), macrosomia (OR: 2.35, 95% CI: 1.77-3.12), pre-eclampsia (OR: 1.91, 95% CI: 1.37-2.65), gestational hypertension (OR: 1.65, 95% CI: 1.24-2.19), cesarean section (OR: 1.29, 95% CI: 1.15-1.44), postpartum hemorrhage (OR: 1.29, 95% CI: 1.02-1.64); insufficient GWG had a higher risk of small for gestational age (OR: 1.82, 95% CI: 1.20-2.75). Compared to the IOM 2009 GWG guidelines, the prevalence of macrosomia, LGA, and postpartum hemorrhage were significantly lower in pregnant women following the implementation of our recommended GWG range (p < 0.05). CONCLUSIONS: Compared to the IOM 2009 GWG recommendations, our optimal GWG recommendations for Chinese pregnant women were more sensitive.

Validating the use of the Wijma Delivery Expectancy/Experience Questionnaire in Mainland China: a descriptive, cross-sectional study.

BACKGROUND: Fear of childbirth (FOC) is a common psychological problem in Chinese pregnant women. FOC can influence both maternal health and infants' wellness. Special assessment tools for FOC in Mandarin Chinese are currently lacking. The aim of this study was to evaluate the psychometric properties of the Mandarin Chinese of the Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ-A). METHODS: We recruited 364 Chinese pregnant women from April 2021 to July 2021. Translation and cultural adaptation, as well as reliability and validity testing were conducted. Analyses included the content validity, structural validity, criterion-related validity, convergent validity and reliability. The content validity indices were used to assess the content validity of the tool. The structural validity was tested through exploratory factor analysis and confirmatory factor analysis. The Cronbach's alpha coefficient was used to evaluate the reliability of the W-DEQ-A Chinese version. RESULTS: The Chinese translation showed excellent similarities and equivalence to the original version, with the satisfactory content validity. Factor analysis indicated 5 factors, accounting for 57% of the total variance. Both criterion-related validity and convergent validity proved to be acceptable. The reliability was tested with a Cronbach's alpha coefficient of 0.911 for the total scale. CONCLUSION: The W-DEQ-A Chinese version is a reliable and valid tool to identify FOC in Mandarin Chinese-speaking populations.

Association between neonatal hyperbilirubinemia and hypoglycemia in Chinese women with diabetes in pregnancy and influence factors.

This retrospective study aimed to investigate the correlation between neonatal hyperbilirubinemia (NHB) and hypoglycemia (NH) in Chinese women with diabetes in pregnancy (DIP), and the influencing factors. All the data were collected July 1, 2017 and June 30, 2020, and 10,558 Chinese women with DIP and live births were included. Two separate multivariate binary stepwise forward logistic regression analysis calculated OR with 95% CI. The prevalence rates of NHB and NH was respectively 3.65% and 5.82% among women with DIP. The comorbidity of both diseases was 0.59%. NH were 1.81 times (OR 1.81, 1.19-2.76) more likely to have hyperbilirubinemia. NHB is positively correlated with NH (OR 1.93, 1.27-2.92). Increased gestational age has a protective effect on both NH (OR 0.76, 0.68-0.85) and NHB (OR 0.80, 0.69-0.92). Abnormal placental morphology is related to NH (OR 1.55, 1.16-2.08) and NHB (OR 1.64, 1.10-2.45). Regarding neonatal outcomes, congenital heart disease (CHD) (OR 2.16, 1.25-3.73; and OR 10.14, 6.47-15.90) was a risk factor for NH and NHB. NHB and NH were significantly correlated in women with DIP. The offspring of DIP with multiple risk factors have a significantly increased risk of neonatal hyperbilirubinemia.

Is the Gestational Weight Gain Recommended by the National Academy of Medicine Guidelines Suitable for Chinese Twin-Pregnant Women with Gestational Diabetes Mellitus?

OBJECTIVES: This study aimed to assess the applicability of the National Academy of Medicine (NAM) interim guidelines for twin pregnancies to the specific population of gestational diabetes mellitus by exploring the relationship between gestational weight gain and adverse pregnancy outcomes in Chinese twin-pregnant women with gestational diabetes mellitus. STUDY DESIGN: This was a retrospective cohort study of women diagnosed with diabetes in pregnancy between July 2017 and December 2020 at the Maternal and Child Health Hospital in Chongqing, China. The primary variable of interest was maternal total gestational weight gain. The primary outcomes were perinatal outcomes, which included: preeclampsia, small for gestational age, large for gestational age, low birth weight, neonatal pneumonia, neonatal respiratory distress syndrome, and neonatal intensive unit admission, etc. The association between inappropriate gestational weight gain and adverse pregnancy outcomes was estimated using multiple logistic regression analysis. RESULTS: A total of 455 twin-pregnant women who had gestational diabetes mellitus were analyzed. Women with low gestational weight gain had reduced risk of preeclampsia (adjusted odds ratio [aOR], 0.32; 95% CI or confidence interval, 0.17-0.63; p = 0.001) and their infants had higher risks of small for gestational age (aOR, 1.93; 95% CI, 1.04-3.58; p = 0.037), low birth weight (aOR, 2.27; 95% CI, 1.32-3.90; p = 0.003), neonatal intensive unit admission (aOR, 3.29; 95% CI, 1.10-5.78; p = 0.038), pneumonia (aOR, 2.41; 95% CI, 1.08-5.33; p = 0.031), and neonatal respiratory distress syndrome (aOR, 2.29; 95% CI, 1.10-4.78; p = 0.027); the infants of women with excessive gestational weight gain had a higher risk of large for gestational age (aOR, 3.76; 95% CI, 1.42-9.96; p = 0.008). CONCLUSION: Gestational weight gain controlled within the range recommended by the NAM could reduce the risk of perinatal adverse outcomes. The 2009 NAM gestational weight gain recommendations can be used for Chinese twin-pregnant women with gestational diabetes mellitus. KEY POINTS: · Inappropriate gestational weight gain can lead to adverse perinatal outcomes in twin pregnancies.. · Gestational weight gain controlled within recommended range could reduce the risk of poor perinatal outcomes.. · The National Academy of Medicine recommendations are suitable for Chinese twin-pregnant women with GDM..

Effect of Dietary Intervention Designed with Behavior Change Wheel on Compliance with Dietary Control in Women with Gestational Diabetes Mellitus: Study Protocol for a Randomized Controlled Trial.

BACKGROUND AND PURPOSE: Previous studies have shown that women with GDM can benefit from following dietary recommendations, which are based on food exchange serving (FES) and glycemic load (GL), but compliance with dietary recommendations in women with GDM is not ideal. Therefore, the aim of this paper is to design a dietary intervention program based on behavior change wheel (BCW) to affect GDM women's compliance with FES based on GL, and to compare the effects of this dietary intervention program versus general dietary management on compliance with dietary recommendations, improving maternal glucose metabolism, and reducing adverse pregnancy outcomes in women with GDM. METHODS: This paper is a methodological description of a two-arm randomized controlled trial. In this study, eligible women with GDM will be recruited and divided into the control group (n = 30) and the intervention group (n = 30). Women with GDM will respectively receive general dietary management (control group) and dietary intervention designed with BCW (intervention group) until after delivery. Information about pregnant women will be collected through questionnaires or prenatal and delivery records. CONCLUSION: This randomized controlled trial is designed specifically for women with GDM to achieve effective blood glucose control by strengthening GDM women's compliance with dietary recommendations. If this dietary intervention designed with BCW proves to be effective, then BCW may deserve to be applied to more areas of self-management in women with GDM.

A Snapback-Free and Low Turn-Off Loss 15 kV 4H-SiC IGBT with Multifunctional P-Floating Layer.

In this paper, a 4H-SiC IGBT with a multifunctional P-floating layer (MP-IGBT) is proposed and investigated by Silvaco TCAD simulations. Compared with the conventional 4H-SiC field stop IGBT (FS-IGBT), the MP-IGBT structure features a P-floating layer structure under the N-buffer layer. The P-floating layer increases the distributed path resistance below the buffer layer to eliminate the snapback phenomenon. In addition, the P-floating layer acts as an amplifying stage for the hole currents' injection. The snapback-free structure features a half-cell pitch of 10 µm. For the same forward voltage drop, the turn-off loss of the MP-IGBT structure is reduced by 42%.

Impact of hepatitis B virus infection on maternal and infant outcomes of women with gestational diabetes mellitus: A three-year retrospective study.

AIMS: To explore the impact of HBV infection on maternal and infant outcomes of GDM women. METHODS: We retrospectively identified 8126 women with GDM in China from July 2017 to June 2020, and divided them into GDM with HBV infection group (n = 483) and GDM with non-HBV infection group (n = 7643). Two sample t-test and Chi-square test were used to compare differences between groups. Logistic regression models were used to explore the association between HBV infection and maternal and infant outcomes. RESULTS: Placental abruption (PA), (2.3% vs. 1.0%, P = 0.008), placenta previa (4.3% vs. 2.8% p = 0.044), intrahepatic cholestasis of pregnancy (ICP), (6.4% vs. 3.0%, P < 0.001), cesarean section (52.0% vs. 46.0%, P = 0.011), fetal chromosomal abnormalities (1.2% vs. 0.4%, P = 0.021), and neonatal hyperglycemia (1.9% vs. 3.6%, P = 0.047) were more likely to occur in GDM with HBV infection group. After adjusting for the covariates, HBV infection was found to be associated with ICP (aOR, 2.35; 95% CI: [1.58-3.50]), PA (aOR, 2.34; 95% CI: 1.22-4.47), and fetal chromosomal abnormalities (aOR, 2.88; 95% CI: 1.18-7.03). CONCLUSIONS: HBV infection was associated with part of maternal and infant outcomes in the GDM population.

Relationship between the gut microbiota and temperament in children 1-2 years old in Chinese birth cohort.

BACKGROUND: Understanding the relationship between the gut microbiota and temperament can provide new insights for the regulation of behavioral intervention in children, which is still lacking research. This study aimed to examine the relationship between the gut microbiota and temperament in a cohort of children in 1 year and 2 years old. METHODS: This study included a total of 37 children with completed information, in which 51 samples at age 1 and 41 samples at age 2 were received respectively. We collected birth and demographic information. Parents reported their child's temperament characteristics using the Infant Behavior Questionnaire-revised (IBQ-R) and Early Childhood Behavior Questionnaire (ECBQ). Fecal samples were collected from each child at 1 and 2 years old and sequenced with MiSeq sequencer. Multiple linear regressions and linear mixed effect models were used to analyze the relationship between the temperament and their microbiota composition as well as the diversity and effect of gender or age on this relationship. RESULTS: At age of year 2, Faecalibacterium was negatively associated with high-intensity pleasure and surgency. Bifidobacterium was negatively correlated with Perceptual sensitivity. Results showed no difference about three domains between year 1 and year 2, while gut microbiota showed diversity difference and genera difference. There was no gender and age difference on the relationship between temperament and the gut microbiota. CONCLUSIONS: Temperament was associated with the gut microbiota over time. The temperament remained stable and the relationship between the gut microbiota and temperament wasn't associated with age and gender.

The effect of group-based Otago exercise program on fear of falling and physical function among older adults living in nursing homes: A pilot trial.

This pilot trial explored the feasibility of group-based Otago exercise program (OEP) and its impact on fear of falling (FOF) and physical function among Chinese older adults living in nursing homes. The intervention group received group-based OEP for 12 weeks, while the control group received routine care. The modified Survey of Activities and Fear of Falling in the Elderly (mSAFFE), timed Up and Go test (TUG), four-stage Balance test (FSBT), and 30 seconds sit-to-stand test (30s-SST) were used. After twelve weeks, we found that the intervention group had better outcomes than the control group in mSAFFE, TUG, FSBT and 30s-SST (p<0.05). Also, we compared the pretest-posttest results within the two groups, respectively. We found that, within the intervention group, the outcomes of mSAFFE, TUG, FSBT, and 30s-SST become significantly better after twelve weeks, but within the control group, the outcomes of TUG, FSBT, and 30s-SST become significantly worse. Our findings demonstrated that a group-based OEP was feasible and acceptability among Chinese older adults living in nursing homes and the group-based OEP could improve FOF and physical function among those older adults.

Impacts of Maternal Diet and Alcohol Consumption during Pregnancy on Maternal and Infant Gut Microbiota.

(1) Background: Maternal diet and alcohol consumption can influence both maternal and infant's gut microbiota. These relationships are still not examined in the Chinese population. The purpose of this study was to explore the effect of alcohol consumption and maternal diet during pregnancy on maternal and infant's gut microbiota. (2) Methods: Twenty-nine mother-child dyads were enrolled in central China. Fecal samples of mothers during late pregnancy and of newborns within 48 h were collected. The V3-V4 regions of 16S rRNA sequences were analyzed. A self-administrated questionnaire about simple diet frequency in the past week was completed by mothers before childbirth. The demographic information was finished by mothers at 24 h after childbirth. (3) Results: Among these 29 mothers, 10 mothers reported alcohol consumption during pregnancy. The PCoA (ß-diversity) showed significant difference in maternal gut microbiota between the alcohol consumption group vs. the non-alcohol consumption group (abund-Jaccard, r = 0.2, p = 0.006). The same phenomenon was observed in newborns (unweighted-UniFrac full tree, r = 0.174, p = 0.031). Maternal alcohol consumption frequency showed positive associations with maternal Phascolarctobacterium (p = 0.032) and Blautia (p = 0.019); maternal Faecalibacterium (p = 0.013) was negatively correlated with frequency of alcohol consumption. As for newborns, a positive relationship showed between Megamonas (p = 0.035) and newborns with maternal alcohol consumption. The diet was not associated with both maternal and infant's gut microbiota. (4) Conclusions: Maternal alcohol consumption during pregnancy influenced the gut microbiota on both mothers and the newborns. Future research is needed to explore these relationships in a lager birth cohort. Understanding the long-term effect of alcohol consumption on maternal and newborns' gut microbiota is needed.

Three learning modalities' impact on clinical judgment and perceptions in newly graduated registered nurses: A quasi-experimental study.

Newly graduated registered nurses face numerous challenges stemming from high patient workload, complicated interpersonal relationships, and a lack of nursing competence, which can lead to transitional shocks. Clinical judgment and confidence are well-known keys to successful role transitions for these nurses. Simulation training is proposed as a new modality for enhancing comprehensive clinical competence of nurses, but current evidence on the impact of different simulations on nurses' clinical judgment and confidence are still limited or inconsistent. This study compared the impact of three types of learning modalities on newly graduated registered nurses' clinical judgment, perceptions of self-confidence, and evaluations of the design features of the learning modalities. A quasi-experimental design was used. Fifty-nine participants were randomly assigned to three groups: (1) high-fidelity simulation, (2) virtual simulation, and (3) case study. Scales were used after the simulation. The virtual simulation group showed a higher level of clinical judgment. The high-fidelity simulation group felt more confident than the virtual simulation and case study groups. Both the high-fidelity simulation group and virtual simulation group reported higher scores in the domain of fidelity.

The effect of the group-based Otago exercise program on frailty among nursing home older adults with cognitive impairment.

This study investigated the effect of the group-based Otago exercise program (OEP) on frailty and physical function in older adults with cognitive impairment. We recruited eighteen older adults with cognitive impairment from a nursing-home to perform the OEP three times a week, for a period of three months in a nursing home. The intervention was feasible with attending an average of 21 out of 36 sessions. The frailty score decreased significantly (p<0.05). Physical function including Time Up and Go test (TUG), 30 seconds Sit-To-Stand Test (30 s-SST) and Four-Stage Balance Test was significantly positive after intervention (all p<0.001). The group-based OEP is a potentially effective strategy for reversing frailty and improving physical function among older adults with cognitive impairment.

Cultural adaptation and psychometric evaluation of the Chinese version of the nurse-specific end-of-life professional caregiver survey: a cross-sectional study.

BACKGROUND: Nurses' palliative and hospice care-specific education is associated with the quality of palliative and hospice care that influences health outcomes of patients with life-limiting illnesses and their caregivers. However, China lacks measures available to assess nurses' educational needs in palliative and hospice care. The End-of-Life Professional Caregiver Survey (EPCS) is a psychometrically reliable self-reporting scale to measure multidisciplinary professionals' palliative and hospice care educational needs. This study was performed to explore the psychometric properties of the Chinese version of the EPCS (EPCS-C) among Chinese nurses. METHODS: We translated and culturally adapted the EPCS into Chinese based on Beaton and colleagues' instrument adaptation process. A cross-sectional study design was used. We recruited 312 nurses from 1482 nurses in a tertiary hospital in central China using convenience sampling to complete the study. Participants completed the EPCS-C and a demographic questionnaire. Exploratory and confirmatory factor analysis was carried out to test and verify the construct validity of the nurse-specific EPCS-C. Cronbach's alpha coefficient was used to appraise the reliability of the nurse-specific EPCS-C. RESULTS: A three-factor structure of EPCS-C was determined, including cultural, ethical, and national values; patient- and family-centered communication; and effective care delivery. The exploratory factor analysis explained 70.82% of the total variances. The 3-factor solution of the nurse-specific EPCS-C had a satisfactory model fit: χ2 = 537.96, χ2/df = 2.96, CFI = 0.94, RMSEA = 0.079, IFI = 0.94, and GFI = 0.86. Cronbach's alpha coefficient of the overall questionnaire was 0.96. CONCLUSIONS: The nurse-specific EPCS-C showed satisfactory reliability and validity to assess nurses' palliative and hospice care educational need. Further research is required to verify the reliability and validity of the EPCS-C in a larger sample, especially the criterion-related validity.