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Ureña-Lorenzo A, Fernandez-Alvarez MDM, Cachero-Rodríguez J, Martin-Payo R. Content, Behaviour Change Techniques, and Quality of Postpartum Depression Apps to Be Recommended by Midwives: Systematic Search and Evaluation. NURSING REPORTS 2024; 14:2291-2301. [PMID: 39311178 PMCID: PMC11435284 DOI: 10.3390/nursrep14030170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/30/2024] [Accepted: 09/03/2024] [Indexed: 09/29/2024] Open
Abstract
BACKGROUND Postpartum depression is a public health problem that affects a considerable percentage of women. Despite the proliferation of related apps, there are limited data available on the best apps to prevent postpartum depression. We identified which apps available in Spanish could be recommended by midwives based on their content, quality, and behaviour change techniques, as a complementary tool for preventing postpartum depression in women. METHODS A systematic search was performed to identify apps available on iOS App Store and Google Play, which were used to replicate how patients' access "postpartum depression prevention" apps. Apps' quality, behaviour change potential, and contents were assessed. RESULTS A total of 1408 apps were identified, of which 7 were retrieved for assessment (0.5%). The mean objective and subject quality were 3.1 (SD = 1.01) and 2.7 (SD = 1.27), respectively. A total of 24 topics were identified. The mean ABACUS score was 6.6 (SD = 3.64), and the mean number of topics addressed by the apps was 9.9 (SD = 5.90). CONCLUSION The results of the present study suggest that a specific free app is not available in Spanish for the prevention of postpartum depression, and only a small percentage of free apps should be recommended based on their quality, BCTs, and contents. The systematic review protocol was not registered.
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Affiliation(s)
| | - Maria del Mar Fernandez-Alvarez
- Faculty of Medicine and Health Sciences, Universidad de Oviedo, 33006 Oviedo, Spain; (J.C.-R.); (R.M.-P.)
- PRECAM Research Group, Health Research Institute of Asturias (ISPA), 33011 Oviedo, Spain
| | - Judit Cachero-Rodríguez
- Faculty of Medicine and Health Sciences, Universidad de Oviedo, 33006 Oviedo, Spain; (J.C.-R.); (R.M.-P.)
- PRECAM Research Group, Health Research Institute of Asturias (ISPA), 33011 Oviedo, Spain
| | - Ruben Martin-Payo
- Faculty of Medicine and Health Sciences, Universidad de Oviedo, 33006 Oviedo, Spain; (J.C.-R.); (R.M.-P.)
- PRECAM Research Group, Health Research Institute of Asturias (ISPA), 33011 Oviedo, Spain
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Li Y, Zhou L, Xiao L, Wang H, Wang G. Wheel Running During Pregnancy Alleviates Anxiety-and Depression-Like Behaviors During the Postpartum Period in Mice: The Roles of NLRP3 Neuroinflammasome Activation, Prolactin, and the Prolactin Receptor in the Hippocampus. Neurochem Res 2024; 49:2615-2635. [PMID: 38904910 DOI: 10.1007/s11064-024-04180-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/05/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024]
Abstract
Despite the increase in the prevalence of postpartum depression among maternal disorder, its treatment outcomes remain suboptimal. Studies have shown that exercise can reduce postpartum depressive episodes in the mother, but the effects of exercise during pregnancy on maternal behavior and the potential mechanisms involved remain poorly understood. From the second day of pregnancy to the day of birth, dams exercised for 1 h a day by running on a controlled wheel. The maternal behaviors of the dams were assessed on postpartum day 2 to postpartum day 8. Chronic restraint stress was applied from postpartum day 2 to day 12. Blood was collected on postpartum days 3 and 8, then subjected to ELISA to determine the serum concentration of prolactin. The weight of each dam and the food intake were recorded. Anxiety- and depression-like behavioral tests were conducted, and hippocampal neuroinflammation and prolactin receptor levels were measured. The dams exhibited elevated levels of anxiety and depression, decreased serum prolactin levels, decreased prolactin receptor expression, and activation of NLRP3-mediated neuroinflammation in the hippocampus following the induction of postpartum chronic restraint stress, which were reversed with controlled wheel running during pregnancy. Overall, the findings of this study revealed that the preventive effects of exercise during pregnancy on postpartum anxiety-and depression-like behaviors were accompanied by increased serum prolactin levels, hippocampal prolactin receptor expression and hippocampal NLRP3-mediated neuroinflammation.
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Affiliation(s)
- Yixin Li
- Department of Psychiatry, Renmin Hospital of Wuhan University, Jiefang Road No. 238, Wuhan, 430060, China
| | - Lin Zhou
- Department of Psychiatry, Renmin Hospital of Wuhan University, Jiefang Road No. 238, Wuhan, 430060, China
| | - Ling Xiao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Jiefang Road No. 238, Wuhan, 430060, China
| | - Huiling Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Jiefang Road No. 238, Wuhan, 430060, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Jiefang Road No. 238, Wuhan, 430060, China.
- Institute of Neuropsychiatry, Renmin Hospital of Wuhan University, Jiefang Road No. 238, Wuhan, 430060, China.
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Weiss SJ, Xu L. Postpartum symptoms of anxiety, depression and stress: differential relationships to women's cortisol profiles. Arch Womens Ment Health 2024; 27:435-445. [PMID: 38214755 PMCID: PMC11116185 DOI: 10.1007/s00737-024-01421-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
PURPOSE Women are at high risk of stress, anxiety, and depression during the postpartum but the ways in which these different types of psychological distress are related to cortisol regulation is not clear. We examined the distinct association of each type of distress with women's average cortisol level, cortisol awakening response (CAR), cortisol decline across the day (diurnal slope), and overall amount of cortisol secretion across the day (AUCG). METHODS At 6 months postpartum, a diverse group of 58 women completed measures of depression, anxiety, perceived stress, and life stressors. Each woman provided 4 salivary samples for cortisol assay from waking to bedtime on each of 2 consecutive days. Linear regressions were used to examine associations of stress, anxiety and depression to each of the 4 cortisol measures, controlling for number of stressful life events. RESULTS Depressive symptoms were associated with less of a rise in the CAR (β = -.46, p = 0.01), steeper diurnal slope (β = .51, p = 0.006), and higher average cortisol level (β = .42, p = .01). Women who met the clinical cutoff for an anxiety disorder had lower overall cortisol output (β = -.29, p = 0.03). Stress was not related to any cortisol metric. CONCLUSIONS Findings suggest that stress is less associated with cortisol alterations in the postpartum than are more severe types of psychological distress. Anxiety and depression may have distinct and opposite profiles of cortisol dysregulation. Results indicate that mental health assessment is critical even in the later postpartum so that interventions can be initiated to reduce emotional suffering and the risk of impaired cortisol regulation.
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Affiliation(s)
- Sandra J Weiss
- Department of Community Health Systems, University of California, San Francisco, CA, USA.
| | - Ling Xu
- Department of Community Health Systems, University of California, San Francisco, CA, USA
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Uçakcı Asalıoğlu C, Yaman Sözbir Ş. Effect of online health training/counseling and progressive muscle relaxation exercise on postpartum depression and maternal attachment: A randomized controlled trial. Int J Gynaecol Obstet 2024; 165:1218-1228. [PMID: 38294240 DOI: 10.1002/ijgo.15359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/15/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVE To evaluate the effect of online health training/counseling and a progressive muscle relaxation exercise (PMRE) program on postpartum depression and maternal attachment. METHODS The present study was a randomized, controlled, experimental trial. Participants were asked to complete the Prenatal Attachment Inventory (PAI) and the Edinburgh Postpartum Depression Scale (EPDS) at 35 weeks of pregnancy. Group assignment was done by stratified block randomization according to EPDS score (0-9, 10-30) and parity. Women in the experimental group received training in progressive muscle relaxation, postpartum depression, and maternal attachment via online video calls twice a week starting at 36-37 weeks of pregnancy. They were asked to complete the PMRE program from 36 weeks of pregnancy until 6 months postpartum, and online counseling was provided throughout this period. Participants completed the Maternal Postpartum Attachment Scale (MPAS) and the EPDS at 6 weeks postpartum. RESULTS Mean PAI score was 64.24 ± 9.61 in the experimental group before the intervention and 62.14 ± 10.13 in the control group. The mean EPDS score of the experimental group was 9.12 ± 5.05 and the mean score of the control group was 9.77 ± 6.30 (P > 0.05). The mean MPAS score after the intervention was 13.92 ± 5.54 in the experimental group and 17.51 ± 6.12 in the control group. The mean EPDS score of the experimental group was 3.40 ± 3.00 and the mean score of the control group was 11.40 ± 5.91 (P < 0.05). CONCLUSION Online health training/counseling and PMRE reduce the risk of postpartum depression and increase maternal attachment.
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Affiliation(s)
| | - Şengül Yaman Sözbir
- Department of Nursing, Gazi University Faculty of Nursing, Çankaya, Ankara, Turkey
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Martínez Vázquez S, Perete AR, de la Torre-Luque A, Nakić Radoš S, Brekalo M, Amezcua-Prieto C, Caparros-Gonzalez RA. Assessment of Postpartum Stress Using the Maternal Postpartum Stress Scale (MPSS) in Spanish Women. Healthcare (Basel) 2024; 12:1032. [PMID: 38786442 PMCID: PMC11121621 DOI: 10.3390/healthcare12101032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/16/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Although scales that evaluate postpartum stress exist, they lack specificity in maternal postpartum stress. The MPSS was created because there was a need to assess maternal stress during the postpartum stage. The introduction of the MPSS has enriched the evaluation tools for postpartum stress and has helped understand maternal stress at various postpartum time points and identify women at high risk for postpartum stress during this period. The aim was to translate the MPSS into Spanish and study its psychometric properties. Postpartum women (N = 167) with a mean age of 34.26 (SD = 4.71) were involved in this study. In addition to the MPSS, a battery of instruments was administered: a demographic sheet, the Birth Satisfaction Scale-Revised (BSS-R) and the Edinburgh Postnatal Depression Scale (EPDS). The MPSS data were analyzed, checking item communality first. As a result, three items showed unsatisfactory communality values (h2 < 0.40). Confirmatory Factor Analysis was conducted, comparing factor models using the full pool of MPSS items or the version without items with unacceptable communality. As a result, the original three-factor structure was endorsed on the Spanish MPSS, with better fit indices when removing items with low communality (RMSEA = 0.067, CFI = 0.99, TLI = 0.99). The reliability of this version was satisfactory (ω = 0.93). Finally, group comparisons for some perinatal variables were performed, showing no significant differences between groups of interest (p = 0.05 and above). To conclude, the MPSS will contribute to the existing literature, having a wider capacity to assess perinatal mental health difficulties in Spanish-speaking populations.
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Affiliation(s)
| | - Adrián Ruíz Perete
- Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain; (A.R.P.); (A.d.l.T.-L.)
| | - Alejandro de la Torre-Luque
- Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain; (A.R.P.); (A.d.l.T.-L.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Sandra Nakić Radoš
- University Department of Psychology, Catholic University of Croatia, 10 000 Zagreb, Croatia; (S.N.R.); (M.B.)
| | - Maja Brekalo
- University Department of Psychology, Catholic University of Croatia, 10 000 Zagreb, Croatia; (S.N.R.); (M.B.)
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs GRANADA, 18071 Granada, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Rafael A. Caparros-Gonzalez
- Instituto de Investigación Biosanitaria ibs GRANADA, 18071 Granada, Spain;
- Department of Nursing, University of Granada, 18016 Granada, Spain
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N Fotso M, Gonzalez NA, Sanivarapu RR, Osman U, Latha Kumar A, Sadagopan A, Mahmoud A, Begg M, Tarhuni M, Khan S. Association of Physical Activity with the Prevention and Treatment of Depression During the Postpartum Period: A Narrative Review. Cureus 2023; 15:e44453. [PMID: 37791151 PMCID: PMC10544133 DOI: 10.7759/cureus.44453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
The benefits of physical activity during pregnancy or postpartum are auspicious, especially in preventing and treating postpartum depression. This review aimed to examine the relationship between exercise and postpartum depression in terms of prevention and treatment. The goals were to determine if exercise alone is sufficient for this purpose and to attract attention to the kind, intensity, and duration needed to achieve this purpose. A literature review was conducted in PubMed, PubMed Central, MEDLINE, and Cochrane libraries. The search terms were "physical activity," "postpartum depression," "postnatal depression," and "exercise." Physical activity can be a preventative measure and a treatment aid for pregnant or postpartum women with depressive disorders. However, the exercise protocol should include a support/wellness program to achieve better and more remarkable results.
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Affiliation(s)
- Monique N Fotso
- Obstetrics and Gynecology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Natalie A Gonzalez
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Raghavendra R Sanivarapu
- Pulmonary and Critical Care Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Usama Osman
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Abishek Latha Kumar
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Aishwarya Sadagopan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Anas Mahmoud
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Maha Begg
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mawada Tarhuni
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Turner J, Clanchy K, Vincze L. Telehealth interventions for physical activity and exercise participation in postpartum women: A quantitative systematic review. Prev Med 2023; 167:107413. [PMID: 36603606 DOI: 10.1016/j.ypmed.2022.107413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/14/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023]
Abstract
Postpartum women are one of the least physically active vulnerable populations globally and telehealth has been proposed as a potential method of delivering effective exercise interventions for this population. However, clinical practice guidelines are based upon the recommendations for the general population and therefore, the most efficacious exercise dose and the delivery method for this population is unclear. This quantitative systematic review will examine the implementation and outcomes of telehealth exercise interventions in the postpartum population to synthesise the degree to which these outcomes have been assessed and evaluated. Five databases were searched from January 2001 to March 2022. Studies implementing synchronous telehealth exercise interventions for postpartum women were included. Interventions were examined against the Template for Intervention Description and Replication (TIDieR) checklist that assesses intervention reporting completeness and replicability. Of the 1036 records identified, 16 studies progressed to data extraction. Six interventions provided individualised exercise prescription, and only four were delivered by university-level exercise practitioners. Physical activity participation was well reported, however health-related outcomes (i.e., muscular strength and aerobic capacity) were very minimally assessed. Only one intervention utilised modern video conferencing as the primary telehealth communication method. With the minimal assessment of health-related outcomes, there is limited scope to assess the effectiveness of these interventions for postpartum women. Future research interventions need to be reported according to a validated trial reporting system and focus on relevant health related outcomes including postpartum depressive symptoms, quality of life, cardiovascular fitness, muscular strength and body composition.
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Affiliation(s)
- Jemma Turner
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| | - Kelly Clanchy
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia.
| | - Lisa Vincze
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
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Wang R, Shan Y. Hot spots and frontiers of postpartum depression research in the past 5 years: A bibliometric analysis. Front Psychol 2022; 13:901668. [PMID: 36605266 PMCID: PMC9807912 DOI: 10.3389/fpsyg.2022.901668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
Objective This study applied the bibliometric method to analyze the hotspots and frontiers in the field of postpartum depression research from 2017 to 2021. Methods A computer-based search for studies related to postpartum depression (PPD) was conducted in the Web of Science Core Collection from 2017 to 2021. Using CiteSpace 5.8. R3 visualization software, this paper analyzed the hot spots and frontiers of postpartum depression research from countries, institutions, authors, cited references and keywords, and drew corresponding knowledge maps. Results A total of 3,789 articles were retrieved, and the annual publication volume showed a steady increase. The countries and institutions with the most publications were the United States and the University of Toronto, respectively. Cindylee Dennis was the most productive author. The most frequently cited and centrally cited articles were meta-analyses on risk factors associated with antenatal depression or anxiety and meta-analyses on the prevalence of antenatal or postnatal anxiety, respectively. The research hotspots in the field of postpartum depression in the past 5 years mainly focused on the risk factors for PPD, and the impact of the COVID-19 epidemic on PPD. Providing various aspects of social and family support to women with PPD may be a research trend in this field. Conclusion This study provides a trend and frontier in the field of postpartum depression, and valuable information for researchers to find potential partners and partner countries, and a reference for future research topics and development directions.
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Yu Q, Wong KK, Lei OK, Nie J, Shi Q, Zou L, Kong Z. Comparative Effectiveness of Multiple Exercise Interventions in the Treatment of Mental Health Disorders: A Systematic Review and Network Meta-Analysis. SPORTS MEDICINE - OPEN 2022; 8:135. [PMID: 36308622 PMCID: PMC9617247 DOI: 10.1186/s40798-022-00529-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/16/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The efficacy of exercise interventions in the treatment of mental health disorders is well known, but research is lacking on the most efficient exercise type for specific mental health disorders. OBJECTIVE The present study aimed to compare and rank the effectiveness of various exercise types in the treatment of mental health disorders. METHODS The PubMed, Web of Science, PsycINFO, SPORTDiscus, CINAHL databases, and the Cochrane Central Register of Controlled Trials as well as Google Scholar were searched up to December 2021. We performed pairwise and network meta-analyses as well as meta-regression analyses for mental health disorders in general and each type of mental health disorder, with alterations in symptom severity as the primary outcome. RESULTS A total of 6456 participants from 117 randomized controlled trials were surveyed. The multimodal exercise (71%) had the highest probability of being the most efficient exercise for relieving depressive symptoms. While resistance exercise (60%) was more likely to be the most effective treatment for anxiety disorder, patients with post-traumatic stress disorder (PTSD) benefited more from mind-body exercise (52%). Furthermore, resistance exercise (31%) and multimodal exercise (37%) had more beneficial effects in the treatment of the positive and negative symptoms of schizophrenia, respectively. The length of intervention and exercise frequency independently moderated the effects of mind-body exercise on depressive (coefficient = 0.14, p = .03) and negative schizophrenia (coefficient = 0.96, p = .04) symptoms. CONCLUSION Multimodal exercise ranked best for treating depressive and negative schizophrenic symptoms, while resistance exercise seemed to be more beneficial for those with anxiety-related and positive schizophrenic symptoms. Mind-body exercise was recommended as the most promising exercise type in the treatment of PTSD. However, the findings should be treated with caution due to potential risk of bias in at least one dimension of assessment and low-to-moderate certainty of evidence. Trial Registration This systematic review was registered in the PROSPERO international prospective register of systematic reviews (CRD42022310237).
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Affiliation(s)
- Qian Yu
- Faculty of Education, University of Macau, Macao, China
| | - Ka-Kit Wong
- Faculty of Education, University of Macau, Macao, China
| | - On-Kei Lei
- Faculty of Education, University of Macau, Macao, China
| | - Jinlei Nie
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Qingde Shi
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, China
| | - Liye Zou
- Body-Brain-Mind Laboratory, The Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, School of Psychology, Shenzhen University, Shenzhen, 518060 China
| | - Zhaowei Kong
- Faculty of Education, University of Macau, Macao, China
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