The Effect of a Perinatal Breastfeeding Support Program on Breastfeeding Outcomes in Primiparous Mothers.

The purpose of this study was to examine the effect of a self-efficacy intervention on primiparous mothers' breastfeeding behaviors. Participants were recruited from an antenatal clinic at a university-affiliated hospital. Seventy-five primiparous mothers were recruited from November 2013 to February 2014 for the control group, and 75 primiparous mothers were recruited from March to June 2014 for the intervention group. The intervention group participated in a 1-hr prenatal breastfeeding workshop and a 1-hr breastfeeding counseling session within 24 hr after delivery. The Breastfeeding Self-Efficacy Scale-Short Form and the infant feeding method were assessed at hospital discharge, as well as 4 and 8 weeks postpartum. The breastfeeding support program was found to be effective and beneficial to mothers. Nurses should incorporate breastfeeding self-efficacy interventions into their routine care to support new mothers and to increase their breastfeeding self-efficacy and the duration of their breastfeeding exclusivity.

An Investigation of Factors Influencing Nurses' Clinical Decision-Making Skills.

This study aims to investigate the influencing factors on nurses' clinical decision-making (CDM) skills. A cross-sectional nonexperimental research design was conducted in the medical, surgical, and emergency departments of two university hospitals, between May and June 2014. We used a quantile regression method to identify the influencing factors across different quantiles of the CDM skills distribution and compared the results with the corresponding ordinary least squares (OLS) estimates. Our findings revealed that nurses were best at the skills of managing oneself. Educational level, experience, and the total structural empowerment had significant positive impacts on nurses' CDM skills, while the nurse-patient relationship, patient care and interaction, formal empowerment, and information empowerment were negatively correlated with nurses' CDM skills. These variables explained no more than 30% of the variance in nurses' CDM skills and mainly explained the lower quantiles of nurses' CDM skills distribution.

Pain relief effect of breast feeding and music therapy during heel lance for healthy-term neonates in China: a randomized controlled trial.

OBJECTIVES: to test the effectiveness of breast feeding (BF), music therapy (MT), and combined breast feeding and music therapy (BF+MT) on pain relief in healthy-term neonates during heel lance. DESIGN: randomised controlled trial. SETTING: in the postpartum unit of one university-affiliated hospital in China from August 2013 to February 2014. PARTICIPANTS: among 288 healthy-term neonates recruited, 250 completed the trial. All neonates were undergoing heel lancing for metabolic screening, were breast fed, and had not been fed for the previous 30 minutes. INTERVENTIONS: all participants were randomly assigned into four groups - BF, MT, BF+MT, and no intervention - with 72 neonates in each group. Neonates in the control group received routine care. Neonates in the other three intervention groups received corresponding interventions five minutes before the heel lancing and throughout the whole procedure. MEASUREMENTS: Neonatal Infant Pain Scale (NIPS), latency to first cry, and duration of first crying. FINDINGS: mean changes in NIPS scores from baseline over time was dependent on the interventions given. Neonates in the BF and combined BF+MT groups had significantly longer latency to first cry, shorter duration of first crying, and lower pain mean score during and one minute after heel lance, compared to the other two groups. No significant difference in pain response was found between BF groups with or without music therapy. The MT group did not achieve a significantly reduced pain response in all outcome measures. CONCLUSIONS: BF could significantly reduce pain response in healthy-term neonates during heel lance. MT did not enhance the effect of pain relief of BF. IMPLICATIONS FOR PRACTICE: healthy-term neonates should be breast fed to alleviate pain during heel lance. There is no need for the additional input of classical music on breast feeding in clinic to relieve procedural pain. Nurses should encourage breast feeding to relieve pain during heel lance.

Predictors of breast feeding self-efficacy among Chinese mothers: a cross-sectional questionnaire survey.

OBJECTIVES: to examine breast feeding self-efficacy and identify its predictors among expectant Chinese mothers in the antenatal period. DESIGN AND SETTING: a cross-sectional descriptive questionnaire survey was conducted in the antenatal clinics of three university hospitals in China between September and December 2011. PARTICIPANTS: expectant mothers planning to breast feed, and who were at least 18 years of age, expecting a single, healthy, full-term baby, and competent in Mandarin (n=201). MEASUREMENTS: a socio-demographic data sheet, the Chinese version of the Breastfeeding Self-Efficacy Scale, and the Perceived Social Support Scale. FINDINGS: the expectant Chinese mothers reported moderate levels of breast feeding self-efficacy. Expectant mothers who had had previous experience in breast feeding, who had watched other mothers breast feed their infants, or who had made the decision to breast feed earlier reported higher breast feeding self-efficacy. Expectant mothers' perceived social support, perceived attitude of significant others, including husband, mothers, and friends, towards breast feeding are correlated with breast feeding self-efficacy. The best-fit regression analysis revealed five variables that explained 34% of the variance in breast feeding self-efficacy in the antenatal period: perceived social support, previous experience of breast feeding, previous experience of watching others breast feed, timing of maternal decision to breast feed, and perceived husband's attitude towards breast feeding. CONCLUSIONS: this study highlighted the importance of improving Chinese mothers' breast feeding self-efficacy by considering the main predictors found in this study. IMPLICATIONS FOR PRACTICE: health care professionals could develop strategies to promote breast feeding self-efficacy, such as providing opportunities for expectant mothers to learn from others' successful experience, adopt a family-centred approach in the provision of breast feeding education, provide breast feeding education at the beginning of pregnancy or even earlier, and rally comprehensive social support for expectant mothers.

Ablation of ALCAT1 mitigates hypertrophic cardiomyopathy through effects on oxidative stress and mitophagy.

Oxidative stress causes mitochondrial dysfunction and heart failure through unknown mechanisms. Cardiolipin (CL), a mitochondrial membrane phospholipid required for oxidative phosphorylation, plays a pivotal role in cardiac function. The onset of age-related heart diseases is characterized by aberrant CL acyl composition that is highly sensitive to oxidative damage, leading to CL peroxidation and mitochondrial dysfunction. Here we report a key role of ALCAT1, a lysocardiolipin acyltransferase that catalyzes the synthesis of CL with a high peroxidation index, in mitochondrial dysfunction associated with hypertrophic cardiomyopathy. We show that ALCAT1 expression was potently upregulated by the onset of hyperthyroid cardiomyopathy, leading to oxidative stress and mitochondrial dysfunction. Accordingly, overexpression of ALCAT1 in H9c2 cardiac cells caused severe oxidative stress, lipid peroxidation, and mitochondrial DNA (mtDNA) depletion. Conversely, ablation of ALCAT1 prevented the onset of T4-induced cardiomyopathy and cardiac dysfunction. ALCAT1 deficiency also mitigated oxidative stress, insulin resistance, and mitochondrial dysfunction by improving mitochondrial quality control through upregulation of PINK1, a mitochondrial GTPase required for mitochondrial autophagy. Together, these findings implicate a key role of ALCAT1 as the missing link between oxidative stress and mitochondrial dysfunction in the etiology of age-related heart diseases.

Ion transport through dimethyl sulfoxide (DMSO) induced transient water pores in cell membranes.

It is well known that dimethyl sulphoxide (DMSO) increases membrane permeability, which makes it widely used as a vehicle to facilitate drug delivery across biological membranes. However, the mechanism of how DMSO increases membrane permeability has not been well understood. Recently, molecular dynamics simulations have demonstrated that DMSO can induce water pores in biological membranes, but no direct experimental evidence is so far available to prove the simulation result. Using FluxOR Tl⁺ influx assay and intracellular Ca²âº imaging technique, we studied the effect of DMSO on Tl⁺ and Ca²âº permeation across cell membranes. Upon application of DMSO on CHO-K1 cell line, Tl⁺ influx was transiently increased in a dose-dependent manner. The increase in Tl⁺ permeability induced by DMSO was not changed in the presence of blockers for K⁺ channel and Na⁺-K⁺ ATPase, suggesting that Tl⁺ permeates through transient water pores induced by DMSO to enter into the cell. In addition, Ca²âº permeability was significantly increased upon application of DMSO, indicating that the transient water pores induced by DMSO were non-selective pores. Furthermore, similar results could be obtained from RAW264.7 macrophage cell line. Therefore, this study provided experimental evidence to support the prediction that DMSO can induce transient water pores in cell membranes, which in turn facilitates the transport of active substances across membranes.

[Reconstruction of urothelium tissue using issue-engineering technique].

OBJECTIVE: To evaluate the feasibility of reconstruction of urothelium tissue in vivo using tissue-engineering technique. METHODS: The urothelium cells were obtained from young rabbit, bladder by mechanical and enzyme digested methods. After expanded in vitro, the 4th to 5th generation urothelium cells were seeded onto the surface of 8 Polylatical/glycolic acid copolymer polymer, the polymer matrix without seeding cells served as control group. A total of 8 cell-polymer scaffolds and 4 simply scaffolds were separately implanted into subcutaneous pockets of athymic mice. The experiment groups included cell-polymer scaffolds 4 weeks and cell-polymer scaffolds 8 weeks. The control group included simply scaffold 4 weeks and simply scaffold 8 weeks. After 4 and 8 weeks, the specimens were obtained and examined by gross inspection, histologically and immunohistochemically. RESULTS: The results of HE and Masson staining showed that the polymer were covered by urothelium cells layers and cells layers increased markley in experimental group. Immunocytochemical studies revealed that the cells were stained positively for anti-cytokeratins (AE1/AE3) in experimental group. Fiber tissue deposition were found on the surface of polymers in control group by HE and Masson staining. Immunocytochemical staining of implants showed the negative result for cytokeratins in control group. CONCLUSION: It is feasibility that reconstruction of urothelium tissue using tissue-engineering technique,which provides basic understandings for further development of the bladder and ureteral tissue engineered research.