RESUMEN
BACKGROUND: The exclusive breastfeeding rates is low in some countries. Low breastfeeding rates results in higher healthcare expenses and adverse health outcomes for individuals and society. Co-parenting is effective in promoting breastfeeding as it involves shared responsibility and collaboration between parents in raising children. However, the current breastfeeding co-parenting intervention programs exhibits significant variations in components, timing, and duration across studies. An evidence-based breastfeeding co-parenting intervention program is essential for enhancing breastfeeding-related outcomes. OBJECTIVE: To develop an evidence-based breastfeeding co-parenting intervention program for healthcare providers to guide parents with primiparas on breastfeeding. METHOD: To form an initial version of the intervention program, a systematic literature review was conducted to consolidate information on current intervention programs. Two rounds of Delphi method were followed to gather expert comments for the program modification to establish the formal version. RESULTS: Fourteen articles published between 1995 and 2022 were screened. Details of these researches, including starting and ending time, duration and specific contents, were integrated to developed the initial program. Then, six experts completed the two rounds consultation with a positive coefficient of 85.71%, coefficient judgment basis of 0.93, familiarity coefficient of 0.87, authority coefficient of 0.90 and the Kendall's W of 0.62. Finally, an evidence-based breastfeeding co-parenting intervention program was constructed in this study, consisting of breastfeeding co-parenting courses, individual counselling and a father's support group. CONCLUSION: This research developed a breastfeeding co-parenting intervention program for healthcare providers to guide primiparous parents to improve breastfeeding rates. Through a systematic literature review and Delphi method with good reliability, the program integrates breastfeeding courses, individual counseling, and a father's support group. Future research will focus on evaluating its impact and scalability to benefit maternal and infant health globally. TRIAL REGISTRATION: ChiCTR.org.cn (ChiCTR2300069648). Registration date: 2023-03-22.
Asunto(s)
Lactancia Materna , Responsabilidad Parental , Desarrollo de Programa , Humanos , Femenino , Embarazo , Técnica Delphi , Promoción de la Salud/métodos , Paridad , Masculino , AdultoRESUMEN
Astrocytes have countless links with neurons. Previously, astrocytes were only considered a scaffold of neurons; in fact, astrocytes perform a variety of functions, including providing support for neuronal structures and energy metabolism, offering isolation and protection and influencing the formation, function and elimination of synapses. Because of these functions, astrocytes play an critical role in central nervous system (CNS) diseases. The regulation of the secretiory factors, receptors, channels and pathways of astrocytes can effectively inhibit the occurrence and development of CNS diseases, such as neuromyelitis optica (NMO), multiple sclerosis, Alzheimer's disease (AD), Parkinson's disease (PD) and Huntington's disease. The expression of aquaporin 4 in AS is directly related to NMO and indirectly involved in the clearance of Aß and tau proteins in AD. Connexin 43 has a bidirectional effect on glutamate diffusion at different stages of stroke. Interestingly, astrocytes reduce the occurrence of PD through multiple effects such as secretion of related factors, mitochondrial autophagy and aquaporin 4. Therefore, this review is focused on the structure and function of astrocytes and the correlation between astrocytes and CNS diseases and drug treatment to explore the new functions of astrocytes with the astrocytes as the target. This, in turn, would provide a reference for the development of new drugs to protect neurons and promote the recovery of nerve function.
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Enfermedad de Alzheimer , Enfermedades del Sistema Nervioso Central , Esclerosis Múltiple , Neuromielitis Óptica , Enfermedad de Parkinson , Humanos , Acuaporina 4/metabolismo , Astrocitos/metabolismo , Neuromielitis Óptica/metabolismo , Esclerosis Múltiple/metabolismo , Enfermedad de Parkinson/metabolismo , Enfermedad de Alzheimer/metabolismoRESUMEN
Background: It's challenging for healthcare workers to detect neonatal hypoglycemia due to its rapid progression and lack of aura symptoms. This may lead to brain function impairment for the newborn, placing a significant care burden on the family and creating an economic burden for society. Tools for early diagnosis of neonatal hypoglycemia are lacking. This study aimed to identify newborns at high risk of developing neonatal hypoglycemia early by developing a risk prediction model. Methods: Using a retrospective design, pairs (470) of women and their newborns in a tertiary hospital from December 2021 to September 2022 were included in this study. Socio-demographic data and clinical data of mothers and newborns were collected. Univariate and multivariate logistic regression were used to screen optimized factors. A neonatal hypoglycemia risk nomogram was constructed using R software, and the calibration curve and receiver operator characteristic curve (ROC) was utilized to evaluate model performance. Results: Factors integrated into the prediction risk nomogram were maternal age (odds ratio [OR] =1.10, 95% CI: 1.04, 1.17), fasting period (OR=1.07, 95% CI: 1.03, 1.12), ritodrine use (OR=2.00, 95% CI: 1.05, 3.88), gestational diabetes mellitus (OR=2.13, 95% CI: 1.30, 3.50), gestational week (OR=0.80, 95% CI: 0.66, 0.96), fetal distress (OR=1.76, 95% CI: 1.11, 2.79) and neonatal body mass index (OR=1.50, 95% CI: 1.24, 1.84). The area under the curve (AUC) was 0.79 (95% confidence interval [CI]: 0.75, 0.82), specificity was 0.82, and sensitivity was 0.62. Conclusion: The prediction model of this study demonstrated good predictive performance. The development of the model identifies advancing maternal age, an extended fasting period before delivery, ritodrine use, gestational diabetes mellitus diagnosis, fetal distress diagnosis and an increase in neonatal body mass index increase the probability of developing neonatal hypoglycemia, while an extended gestational week reduces the probability of developing neonatal hypoglycemia.
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Diabetes Gestacional , Enfermedades Fetales , Hipoglucemia , Enfermedades del Recién Nacido , Ritodrina , Embarazo , Humanos , Recién Nacido , Femenino , Estudios Retrospectivos , Diabetes Gestacional/diagnóstico , Diabetes Gestacional/epidemiología , Hipoglucemia/diagnóstico , Hipoglucemia/epidemiología , Hipoglucemia/etiología , Edad Materna , Enfermedades del Recién Nacido/diagnóstico , Enfermedades del Recién Nacido/epidemiología , Enfermedades del Recién Nacido/etiologíaRESUMEN
Background: Although the beneficial effects of exclusive breastfeeding (EBF) on infants and mothers have been identified, EBF rates remain unsatisfactory. Co-parenting interventions for perinatal couples have not been systematically evaluated and analyzed for their effects on breastfeeding outcomes. Aims and Objectives: To systematically evaluate the effects of co-parenting interventions on the rate of EBF, breastfeeding knowledge, breastfeeding attitude, breastfeeding self-efficacy, parental relationship, and partner support. Methods: Randomized controlled trials and quasi-experimental studies were systematically screened in eight online databases from inception to November 2022. Trials included in this review were assessed using the Cochrane Risk of Bias Assessment Tool. Eligible trials were used to conduct a meta-analysis using Review Manager software. The I2 statistic was used to assess heterogeneity between studies. When it was not possible to conduct a meta-analysis, a descriptive analysis was used to present the findings due to insufficient data from the included studies. Results: Fifteen of the 1,869 articles reviewed met the inclusion criteria. Co-parenting interventions significantly improved the EBF rate at 16 weeks (odds ratio [OR] = 3.85, 95% confidence interval, CI [1.84 to 8.03], p < 0.001, I2 = 69%) and 6 months (OR = 2.82, 95% CI [1.47 to 5.41], p = 0.002, I2 = 85%). This study revealed that co-parenting interventions made statistically significant improvements in parental relationship (standardized mean difference [SMD] = 0.26, 95% CI [0.13 to 0.38], p < 0.001, I2 = 80%). There was no evidence of the effectiveness of interventions in terms of overall parental support (SMD = 0.75, 95% CI [-0.46 to 1.97], p < 0.001, I2 = 96%). Given the discrepant and limited research data, findings on breastfeeding knowledge, breastfeeding attitudes, and breastfeeding self-efficacy were presented descriptively. Conclusion: Co-parenting interventions effectively increase EBF rates at 16 weeks and 6 months postpartum, and improve breastfeeding knowledge, breastfeeding attitude, and parental relationships.
Asunto(s)
Lactancia Materna , Responsabilidad Parental , Lactante , Femenino , Embarazo , Humanos , Madres , Periodo Posparto , Factores de TiempoRESUMEN
Chalcones is a flavonoid wildly presented in many herbs. It has the effect to inhibit cells adipogenic differentiation. In order to study the effect of pinostrobin chalcone extracted and isolated from leaves of hickoryes on the adipogenic differentiation of murine embryonic mesenchymal stem cell (C3H10T1/2), MTS [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)- 2H-tetrazolium] method was used to detect the cell proliferation; adipogenic differentiation was characterized by oil red O staining and isopropanol extraction; the triglyceride content was detected by GAP-PAP enzyme method; and the C3H10T1/2 cell differentiation into adipocytes was also examined by the mRNA and protein expression of PPARγ, C/EBPα and FABP4 by RT-PCR and Western blot respectively. Results indicated that pinostrobin chalcone almost had no effect on cell proliferation activity when the concentration was less than or equal to 50 µmolâ¢L⻹; the oil red O staining, isopropanol extraction and GAP-PAP enzyme method showed that pinostrobin chalcone significantly decreased the C3H10T1/2 adipogenic differentiation and triglyceride content in the cytoplasm of adipocytes; the RT-PCR and Western blot analysis showed that pinostrobin chalcone can down-regulate the mRNA and protein levels of FABP4, PPARγ and C/EBPα in C3H10T1/2 cells(P<0.05 or P<0.01). The experiment results suggest that pinostrobin chalcone can inhibit C3H10T1/2 adipogenic differentiation.