Novel multidisciplinary cooperation model for obstetric medical quality control: A quasi-experimental study

OBJECTIVE

To explore the impact of a novel multidisciplinary cooperation model in obstetric medical quality control.

METHODS

This quasi-experimental study analyzed the quality indicators of full-term pregnant women who underwent vaginal trial labor in Zibo Maternal and Child Health Hospital between July 2021 and June 2022. The pregnant women were divided into two groups based on implementation of novel multidisciplinary cooperation: multidisciplinary and non-multidisciplinary. We compared the rate of labor analgesia, postpartum hemorrhage in vaginal delivery, transfer to cesarean section, and the 5-min Apgar score ≤7 in full-term neonates.

RESULTS

A total of 3751 pregnant women were enrolled into the study, of whom 2004 were included in the non-multidisciplinary group and 1747 in the multidisciplinary group. The analgesic rate of delivery of the multidisciplinary group was higher than that of the non-multidisciplinary group (P = 0.000). We established that the rate of postpartum bleeding (P = 0.040), transfer cesarean section (P = 0.003) and the incidence of Apgar score ≤7 in 5 min of full-term neonates (P = 0.038) of the multidisciplinary group was lower than that of the non-multidisciplinary group. There was no significant difference in the mean ages (29.40 ± 3.99 vs. 29.90 ± 4.27 years; P = 0.126), mean delivery gestational ages (39.65 ± 0.87 vs. 39.64 ± 1.06; P = 0.221), mean gravidity values (1.93 ± 1.09 vs. 2.00 ± 1.18; P = 0.586) and mean parity (1.40 ± 0.56 vs. 1.42 ± 0.59; P = 0.635) of the women in the two groups.

CONCLUSION

Multidisciplinary cooperation in delivery management can significantly improve some quality indicators. We established the analgesic rate of delivery can be increased and the rate of postpartum bleeding, transfer cesarean section and the incidence of Apgar score ≤7 in 5 min of full-term neonates can be decreased with the implementation of novel multidisciplinary cooperation.

Focusing on basic data and a model of healthcare security for rare diseases: The Multidisciplinary Expert Seminar on Healthcare Security for Rare Diseases in China was held in Beijing

On August 10, 2019, the Multidisciplinary Expert Seminar on Healthcare Security for Rare Diseases in China was held in Beijing. The seminar was organized by the Shanghai Foundation for Rare Disease and Shanghai Health Development Research Center and advised by the China Alliance of Rare Diseases. Participants in this seminar included government officials, experts in clinical medicine, pharmacy, epidemiology, health economics, and law as well as representatives from rare disease patient organizations. The participating experts cited three key elements of healthcare security, including its concept, data, and mechanism, to solve the problem of health care security for patients with rare diseases at the national level. Collection of basic data and creation of a model of healthcare security for rare diseases were discussed. Data collection should be actively promoted. Creation of a special zone to ensure medical care for patients with rare diseases should be considered. Healthcare security should be classified, which means that basic medical insurance provides better care for rare diseases that respond to treatment, and channels should be established for rare diseases that respond poorly to treatment.

Effect of a mentor-based, supportive-expressive program, Be Resilient to Breast Cancer, on survival in metastatic breast cancer: a randomised, controlled intervention trial

BACKGROUND

Because of medical advances, metastatic breast cancer (MBC) is now viewed as a chronic disease, rather than an imminent death sentence. Helping women live with this disease requires more than a medical approach to symptoms. Thus, a mentor-based and supportive-expressive program 'Be Resilient to Breast Cancer' (BRBC) was designed to help Chinese women with MBC enhance their resilience levels, biopsychosocial functions, and potentially extend their life span.

METHODS

A total of 226 women with MBC were randomly assigned, in a 1 : 1 ratio, to an intervention group (IG) that participated in BRBC or to a control group (CG) that received no intervention. Be Resilient to Breast Cancer was conducted for 120 min once a week. Primary outcomes were cancer-specific survival and secondary outcomes were resilience, Allostatic Load Index (ALI), anxiety, depression, and quality of life (QoL). The Cox proportional-hazards model was used for survival analysis and growth mixture models were performed for secondary outcomes.

RESULTS

Be Resilient to Breast Cancer did not significantly prolong 3- or 5-year survival (median survival, 36.7 months in IG and 31.5 months in CG). The hazard ratio for death was 0.736 (95% CI, 0.525-1.133, P=0.076; univariate Cox model) and 0.837 (95% CI, 0.578-1.211, P=0.345; multivariate Cox analysis). The IG improved in anxiety (ES=0.85, P<0.001), depression (ES=0.95, P<0.001), QoL (ES=0.55, P<0.001), resilience (ES=0.67, P<0.001), and ALI (ES=0.90, P<0.001) compared to CG.

CONCLUSIONS

BRBC does not improve survival of women with MBC in this study, though longer follow up is warranted. It positively impacts resilience, QoL, ALI, and emotional distress.

A journey to HIV prevention research: From social psychology to social health via multidisciplinarity

This is a personal account of my research in HIV prevention from 1984 to the present day. It demonstrates my disquiet with the individualism of psychology as a way of thinking about what was needed to prevent HIV transmission. HIV prevention requires social transformation which is produced via changes in social practices and norms of communities and networks rather than by changes in behaviours of individuals. My colleagues and I developed a 'social health' model of social transformation that involves enabling communities to modify their social practices by building on emergent community responses, responses that were identified by the use of a reflexive research methodology.

Smartphone Interventions for Weight Treatment and Behavioral Change in Pediatric Obesity: A Systematic Review

BACKGROUND

Traditional approaches for treating or managing children and adolescents with overweight or obesity have limited effectiveness. Current advances in smartphone technology may improve the attractiveness and accessibility of weight management support for children and adolescents with overweight or obesity. This systematic review aimed to provide a comparative evaluation of the effectiveness of using smartphones in the multidisciplinary treatment of child and adolescent overweight or obesity, with a specific interest in behavior change.

MATERIALS AND METHODS

The databases of Medline complete, OVID, CINAHL, EMBASE, and PubMed were searched for randomized controlled trial (RCT) studies addressing behavioral change using smartphone technology, plus nutrition and/or physical activity, to treat or manage child and adolescent obesity.

RESULTS

Only two RCTs have described the effectiveness of smartphone devices in pediatric overweight or obesity treatment. Within the limitation of the two studies, electronic contact (e-contact) appeared unsuccessful in achieving weight loss. However, smartphone usage was linked to improved engagement and reduced dropout rates during important sustainability phases of these long-term interventions.

CONCLUSIONS

Smartphone technologies allow users to accomplish tasks anywhere and anytime and, as such, provide researchers with additional and generationally appropriate capacities to deliver health promotion. E-contact should be used for its significant capacity to prolong engagement and decrease withdrawal during sustainability phases that follow intensive intervention for weight management in young populations. Despite increasing popularity in published protocols of weight management trials, the effectiveness of the impact of smartphone technology in pediatric programs remains equivocal.