Low-frequency repetitive transcranial magnetic stimulation over the right orbitofrontal cortex for patients with first-episode schizophrenia: A randomized, double-blind, sham-controlled trial.

Repetitive transcranial magnetic stimulation (rTMS) has been used in the treatment of patients with schizophrenia. The conventional targets of rTMS treatment are the dorsolateral prefrontal cortex (DLPFC) and temporoparietal cortex (TPC). However, the efficacy of these two treatment strategies was quite heterogeneous. Structural and functional abnormalities of the orbitofrontal cortex (OFC) in schizophrenia are closely related to negative symptoms. We sought to determine whether 1 Hz rTMS over the right OFC is effective in treating patients with first-episode schizophrenia. In this study, eighty-nine patients with drug-naïve, first-episode schizophrenia were randomly divided into the rTMS (n = 47) or sham stimulation (n = 42) groups, with both groups receiving twenty sessions of 1 Hz rTMS treatment. The PANSS was assessed at baseline, day 10, and day 20, and MATRICS Consensus Cognitive Battery (MCCB) was implemented to assess the cognitive impairment at baseline and day 20. Results showed that patients in the active rTMS group had more improvement in clinical symptoms and cognitive deficits than patients in sham group at day 20. In conclusion, 1 Hz rTMS over OFC can improve psychotic symptoms and cognitive functions in schizophrenic patients. Our study provides a new alternative for the treatment of negative symptoms and cognitive deficits in schizophrenia.

Employability, organizational commitment and person-organization fit among nurses in China: A correctional cross-sectional research.

AIM: This study aimed to explore the effect of training on organizational commitment, the mediating effect of employability and the moderating role of person-organization fit. DESIGN: A correctional cross-sectional research design was adopted for this study. METHODS: A questionnaire-based survey of 859 nurses in a public hospital in Western China was conducted to identify their perceptions of training, employability, organizational commitment and person-organization fit. Hierarchical linear regression and conditional process analysis on moderated mediation were performed. RESULTS: Training had a positive effect on organizational commitment (p < .01). Internal and external employability mediated the relationship between training and organizational commitment (p < .01). Person-organization fit enhanced the indirect effect of training on organizational commitment through external employability (p < .05).

Emotional exhaustion and unhealthy eating among COVID-19 front-line healthcare workers during recuperation: A cross-sectional study.

Objective: Thousands of healthcare workers on the frontlines who have been battling the COVID-19 pandemic could face emotional and mental health risks even after their critical pandemic work. This study examined the impact of affective rumination on emotional exhaustion and the spillover effect of affective rumination on unhealthy food consumption among healthcare workers during recuperation. Methods: A total of 418 frontline healthcare workers from 10 Chinese medical institutions were recruited through random cluster sampling. A linear mixed model in SPSS25.0 was performed for hierarchical regression to analyze the effect of affective rumination on unhealthy food consumption via emotional exhaustion. A conditional process analysis was employed to investigate the moderating role of family support in the mediating effect of emotional exhaustion. Results: Front-line healthcare workers scored at a medium level on an emotional exhaustion scale (2.45 ± 0.88). Affective rumination mediated by emotional exhaustion had a significant positive predictive effect on unhealthy food consumption. The indirect effect accounted for ~43.9% of the total effect. Family support amplified the effect of emotional exhaustion on unhealthy food consumption (ß = 0.092, p < 0.05). Conclusion: Affective rumination could be a cause of emotional exhaustion and unhealthy food consumption. First-line healthcare workers could be screened for possible emotional exhaustion through the evaluation of affective rumination in order to provide them with targeted interventions. Family support did not prove to be beneficial in all cases as it enhanced the positive effect of emotional exhaustion on unhealthy eating in the current study. Therefore, family support should be carefully integrated in future interventions.

The effect of hindrance stressors on the emotional exhaustion among front-line healthcare workers in the recuperation period during the COVID-19 epidemic in China: a prospective cross-sectional study.

OBJECTIVES: This study aimed to examine the influence and conditioning process of hindrance stressors on the emotional exhaustion of the front-line healthcare workers during recuperation, examine the potential mediating process of rumination, and explore the moderating role of organisational and family factors. SETTING: This cross-sectional study was conducted during 12-20 July 2020. Total 418 questionnaires were collected from front-line healthcare workers by random cluster sampling. Hierarchical regression was performed to analyse the mediating effect of affective rumination using SPSS25.0, while PROCESS was used to further investigate the moderating role of servant leadership and family support. PARTICIPANTS: 418 healthcare workers were investigated randomly from front-line medical teams. Inclusion criteria included worked as front-line health workers and participated in the fight against COVID-19 in Hubei; age ≥18 years; normal cognitive and comprehension abilities under physical and mental health; volunteer to participate in this study. Exclusion criteria included recently affected by major events other than COVID-19 or those with a history of neurasthenia and trauma. RESULTS: Using descriptive analysis of average value and SD measured by a five-item scale (MBI-GS), we found that front-line healthcare workers' emotional exhaustion score (2.45±0.88) was at the medium level. Hindrance stressors, mediated by affective rumination, had a significant positive predictive effect on emotional exhaustion. Servant leadership negatively moderated the direct effect of hindrance stressors on emotional exhaustion (ß=-0.106, p<0.01). Family support positively moderated the impact of hindrance stressors on emotional exhaustion (ß=0.082, p<0.05). CONCLUSIONS: During the recuperation period, after successfully controlling COVID-19 at the front line, the first-line healthcare workers should be screened through affective rumination evaluation to gain insight for targeted interventions. We find that servant leadership is beneficial in alleviating emotional exhaustion while family support worsens emotional exhaustion. We suggest that servant leadership should be further promoted in medical organisations, and family support should be applied correctly and cautiously.

Emotional exhaustion in front-line healthcare workers during the COVID-19 pandemic in Wuhan, China: the effects of time pressure, social sharing and cognitive appraisal.

BACKGROUND: With the increasing spread of COVID-19, healthcare workers, especially front-line medical staff, have become more vulnerable to emotional exhaustion. OBJECTIVES: This study aimed to determine the influence of time pressure on the emotional exhaustion of front-line healthcare workers, and explore the effects of social sharing and cognitive reappraisal on this. METHODS: This cross-sectional study was conducted in March 2020. A total of 232 questionnaires were completed by front-line healthcare workers in Wuhan city, Hubei province, China. Hierarchical linear regression and conditional process analysis were performed to explore the relationships among time pressure, social sharing, cognitive reappraisal, and emotional exhaustion. RESULTS: Time pressure was positively associated with social sharing and emotional exhaustion. Social sharing presented the dark side, a negative effect that was always kept concealed, in terms of the impact on emotional exhaustion. Cognitive reappraisal negatively moderated the relationship between time pressure and social sharing, and it further indirectly influenced the relationship between time pressure and emotional exhaustion through social sharing. CONCLUSIONS: Our findings shed light on how time pressure influences the emotional exhaustion of healthcare workers during the COVID-19 period. Although social sharing is commonly regarded as a positive behavior, we identified a dark side in terms of its impact. We also identified that improving cognitive reappraisal may present a positive strategy toward alleviating emotional exhaustion.

Practical Experience of Establishing German Standard Level 1 Perinatal Center in Chongqing Health Care for Women and Children.

Germany, as a western developed country, has an advanced medical level, especially in the health care of very immature premature infants. We trace the medical history of perinatology to understand the development of perinatal centers in Germany. After analyzing the classification and function, hierarchical management and quality control systems of German perinatal centers, we established a German standard level 1 perinatal center in the Chongqing Health Center for Women and Children (CHCWC). During more than two years of practice, we changed concepts, continuously updated clinical knowledge and skills, developed a series of high-quality work processes and supervision systems and introduced advanced medical equipment. We believe that the experience of establishing a German standard level 1 perinatal center and perinatal center network in Chongqing is worthy of being promoted to the Chinese maternal and child health care system.

Burnout among obstetricians and paediatricians: a cross-sectional study from China.

OBJECTIVES: Hospitals devoted to maternal and child health represent unique healthcare institutions in China. Healthcare professionals in these hospitals attend to health services for women and children, and also provide technical services and support for district maternal and children's healthcare as well as family planning. However, few studies have examined occupational burnout among doctors employed in these hospitals. This research addresses the gap in the literature. METHODS: A cross-sectional survey of obstetricians and paediatricians from 11 maternal and child health hospitals across China was conducted May through June 2017. A total of 678 people completed a self-administered questionnaire. The survey included questions about demographics, doctor-patient relationships and networks of support as well as characteristics designed to capture the occurrence of burnout, such as emotional exhaustion, cynicism and professional efficacy. T-test, variance and multiple regression analyses were used to examine the data. RESULTS: The research revealed that 56.6% of obstetricians and paediatricians exhibited signs of occupational burnout. Poor doctor-patient relationships and high average number of weekly hours worked contributed to burnout. Additionally, low family support corresponded to physicians' low sense of professional efficacy. CONCLUSIONS: Several factors have contributed to occupational burnout among paediatricians and obstetricians at maternal and child health hospitals in China, including lack of family support, poor doctor-patient relationships and heavy workloads.