ObjectiveTo investigate a suspected outbreak of healthcare-associated infection with carbapenem-resistant Klebsiella pneumoniae (CRKP) in a geriatric emergency ward, and to provide references for the prevention and control of multidrug-resistant bacteria in a hospital in Shanghai. MethodsOn-site epidemiological investigation, combined with environmental hygiene monitoring and pulsed field gel electrophoresis (PFGE) molecular typing method, were adopted to investigate a suspected outbreak of CRKP infection in the geriatric emergency ward of a hospital from October to November 2022, aiming at finding out factors caused the outbreak before taking corresponding control measures. ResultsA total of 3 cases of healthcare-associated CRKP infection were identified, of which 2 cases were homologous to a previous case of community-associated CRKP infection. What’s more, the 2 cases lived in the same ward with the latter and with adjacent beds, but the third case was non-homologous to the community-associated infection case. A total of 46 samples were collected from the environmental surfaces and the hands of healthcare workers, of which 7 samples tested positive for CRKP and were identical to the strains from the 2 healthcare-associated infection cases and the 1 community-associated infection case, originating from the bedrails, bedside tables, surface of non-invasive ventilator, bed curtains and panels of monitoring equipment, with a detection rate of 15.22%. But none of the 11 samples from the hands of healthcare workers tested positive for CRKP. The outbreak was effectively controlled after taking specific prevention and control measures such as strengthening personnel management, intensifying environmental cleaning and disinfection and strictly enforcing hand hygiene among healthcare workers. Subsequently, no similar new cases were reported during the 14-day follow-up period. ConclusionIncomplete environmental cleaning and disinfection, as well as inadequate enforcement of hand hygiene among heatheare workers may have contributed to the suspected outbreak of CRKP in the geriatric emergency ward. Early warning and timely investigation of suspected outbreaks of multidrug-resistant bacteria are crucial for preventing and controlling such outbreaks in hospitals.

Objective To construct a theoretical framework of multidimensional level of matemal labour satisfaction to provide a scientific basis for taking measures to improve matemal labour satisfaction,in order to promote the improvement of nursing care quality.Methods A purposive sampling method was used to select 30 mothers who underwent a 42 days postpartum review in the postpartum clinics of 3 tertiary A hospitals in Nantong City from July to September 2023 for semi-structured in-depth interviews,and programmatic grounded theory was used for data analysis.Results A theoretical framework for multidimensional matemal satisfaction in childbirth was established,comprising 4 dimensions of the basic level(knowledge dissemination,resource acquisition,psychological adjustment),the core level(professionalism,interaction and cooperation,information sharing),the spiritual level(respect for autonomy,emotional care,empowerment),and the practical level(comfort and safety,skill enhancement,comprehensive recovery).Conclusion This study constructs a multidimensional theoretical framework for assessing childbirth satisfaction among parturient women,providing innovative perspectives and methodological guidance to optimize nursing practices and elevate service quality.Nursing personnel should utilize this framework to ensure the ongoing improvement and enhancement of nursing services,meeting the evolving needs of parturient women and facilitating a smooth transition through the critical life event of childbirth.

Objective: To evaluate the effect of weight monitoring feedback intervention among primary school students, so as to provide the evidence for strengthening children's weight management. Methods: In October 2023, students from grades four to six in a primary school in Hangzhou City were selected and randomly assigned to a control group and an intervention group on a class-by-class basis. The included primary school students had their height and weight measured at a fixed time each week, and the results were fed back to their parents in the form of cards. The cards for the control group contained knowledge about healthy lifestyles, while those for the intervention group additionally included information on body mass index (BMI), BMI grouping, and BMI ranking. Overweight and obesity were determined according to the age- and gender-specific criteria in the Screening for Overweight and Obesity among School-aged Children and Adolescents. After a 9-month intervention period, the prevalence rates of overweight and obesity and lifestyle behavior data between the two groups before and after the intervention were compared by a generalized linear mixed model, in order to assess the effectiveness of the weight monitoring information feedback intervention. Results: The intervention group consisted of 368 students, including 208 boys (56.52%) and 160 girls (43.48%). The majority of students were 11 years, with 153 students accounting for 41.58%. The prevalence rate of overweight and obesity was 24.18%. The control group had 324 students, with 180 boys (55.56%) and 144 girls (44.44%). The predominant age was also 11 years, with 128 students accounting for 39.51%. The prevalence rate of overweight and obesity was 25.31%. Before the intervention, there were no statistically significant differences between the two groups in terms of gender, age, prevalence rate of overweight and obesity, eating habits, exercise situation, and sleep patterns (all P>0.05). After the intervention, there were significant interactions between group and time for the prevalence rate of overweight and obesity, the frequency of moderate-intensity exercise per week, and adequate sleep in the two groups (all P<0.05). The prevalence rate of overweight and obesity in the intervention group (OR=0.461, 95%CI: 0.252-0.845) was lower than that in the control group. The proportions of students in the intervention group who engaged in moderate-intensity exercise ≥4 times per week (OR=1.315, 95%CI: 1.033-1.675) and had adequate sleep (OR=1.402, 95%CI: 1.049-1.875) were higher than those in the control group. Conclusion Weight monitoring feedback can reduce the incidence of overweight and obesity among primary school students and has a certain improving effect on lifestyle behaviors such as exercise and sleep.

Objective:To explore and the relationships among the symptoms of postpartum depression and perceived social support,sleep quality and postpartum stress in elderly postpartum women.Methods:Totally 267 elderly pregnant women were selected[average age(37±2)years]from three hospitals.The Edinburgh Postnatal Depression Scale(EPDS),Perceived Social Support Scale(PSSS),Pittsburgh Sleep Quality Index(PSQI)and the Maternal Postpartum Stress Scale(MPSS)were used to conduct the questionnaire survey.Results:The elderly preg-nant women with lower perceived social support(β=-0.11),poorer the sleep quality(β=0.43),higher the post-partum stress(β=0.12),being primipara(β=-1.19),having mastitis(β=1.43),and having a male infant(β=-0.83)had more severe postpartum depression symptoms.Conclusion:Postpartum depression symptoms in elder-ly pregnant women may be related to perceived social support,sleep quality,postpartum stress,delivery history,mastitis,and infant gender.

Objective:To explore and the relationships among the symptoms of postpartum depression and perceived social support,sleep quality and postpartum stress in elderly postpartum women.Methods:Totally 267 elderly pregnant women were selected[average age(37±2)years]from three hospitals.The Edinburgh Postnatal Depression Scale(EPDS),Perceived Social Support Scale(PSSS),Pittsburgh Sleep Quality Index(PSQI)and the Maternal Postpartum Stress Scale(MPSS)were used to conduct the questionnaire survey.Results:The elderly preg-nant women with lower perceived social support(β=-0.11),poorer the sleep quality(β=0.43),higher the post-partum stress(β=0.12),being primipara(β=-1.19),having mastitis(β=1.43),and having a male infant(β=-0.83)had more severe postpartum depression symptoms.Conclusion:Postpartum depression symptoms in elder-ly pregnant women may be related to perceived social support,sleep quality,postpartum stress,delivery history,mastitis,and infant gender.

Objective To construct a theoretical framework of multidimensional level of matemal labour satisfaction to provide a scientific basis for taking measures to improve matemal labour satisfaction,in order to promote the improvement of nursing care quality.Methods A purposive sampling method was used to select 30 mothers who underwent a 42 days postpartum review in the postpartum clinics of 3 tertiary A hospitals in Nantong City from July to September 2023 for semi-structured in-depth interviews,and programmatic grounded theory was used for data analysis.Results A theoretical framework for multidimensional matemal satisfaction in childbirth was established,comprising 4 dimensions of the basic level(knowledge dissemination,resource acquisition,psychological adjustment),the core level(professionalism,interaction and cooperation,information sharing),the spiritual level(respect for autonomy,emotional care,empowerment),and the practical level(comfort and safety,skill enhancement,comprehensive recovery).Conclusion This study constructs a multidimensional theoretical framework for assessing childbirth satisfaction among parturient women,providing innovative perspectives and methodological guidance to optimize nursing practices and elevate service quality.Nursing personnel should utilize this framework to ensure the ongoing improvement and enhancement of nursing services,meeting the evolving needs of parturient women and facilitating a smooth transition through the critical life event of childbirth.

Objective:To explore the effect of "WeChat official account"+multidisciplinary team (MDT) cooperative nursing in discharged patients with cerebral infarction.Methods:From January 2019 to December 2020, 118 discharged patients with cerebral infarction were selected by convenience sampling from Qingdao Hospital affiliated to Shandong First Medical University as the research object. The patients admitted from January to December 2019 were taken as the control group, and the patients admitted from January to December 2020 were taken as the observation group, with 59 cases each. The control group was given routine intervention and follow-up after discharge. The observation group received "WeChat official account"+ MDT cooperative nursing on the basis of the control group. Both groups were intervened for three months. The Stroke Behavior Change Questionnaire, Fugl-Meyer Assessment (FMA) , Self-Rating Anxiety Scale (SAS) , Self-Rating Depression Scale (SDS) , compliance and adverse events of the two groups were compared before and after the intervention.Results:Before the intervention, there was no statistical difference between the two groups in the scores of Stroke Behavior Change Questionnaire, FMA, SDS and SAS ( P>0.05) . After the intervention, the scores of Stroke Behavior Change Questionnaire and FMA in the observation group were higher than those before the intervention and the control group, and the SDS and SAS scores were lower than those before the intervention and the control group, with statistical differences ( P<0.01) . The treatment compliance of the observation group was 94.92% (56/59) , higher than 81.36% (48/59) of the control group, with a statistical difference ( P<0.05) . Conclusions:"WeChat official account" + MDT cooperative nursing can effectively improve the exercise behavior of discharged cerebral infarction patients, increase compliance, promote neurological recovery, alleviate negative emotions, and reduce the incidence of adverse events after discharge, which is worthy of clinical practice.

Objective:To verify the reliability and validity of the Chinese Version of Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN-C) in patients with major depressive disorder(MDD).Methods:A total of 122 patients with MDD and 122 controls were recruited and measured with the BRIAN-C, 16-Item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16), 7-Item Generalized Anxiety Disorder Scale(GAD-7) and 6-Item Short Form Health Survey(SF-6). The index D and correlation analysis were conducted to evaluate the discrimination and homogeneity of the items, respectively. The Cronbach′s α coefficient, Spearman-Brown coefficient, intraclass correlation coefficient ( ICC) and retest correlation coefficient were conducted to evaluate the reliability.Confirmatory factor analysis, correlation analysis and the receiver operating characteristic (ROC) curve were conducted to evaluate the construct validity, criterion validity and prediction validity, respectively. Results:The item distinction and homogeneity analysis showed significant differences ( P<0.05). The Cronbach′s α coefficient and the Spearman-Brown coefficient were 0.911 and 0.807, while the ICC and the correlation coefficient r of test-retest reliability were 0.639 (95% confidence interval( CI):0.375-0.729) and 0.43 ( P=0.001), respectively. Confirmatory factor analysis showed that the fit indexes χ 2/dF=1.937, goodness-of-fit index(GFI)=0.822, comparative fit index (CFI)=0.877, Tucker-lewis index (TLI)=0.855, and root mean square error of approximation (RMSEA)=0.088. The score of BRIAN-C was significantly correlated with that of QIDS-SR16, GAD-7 or SF-6 ( r=0.74, 0.46, -0.69, all P<0.05).The ROC curve suggested that the area under curve (AUC) was 0.939 (95% CI: 0.909-0.970, P<0.05) for distinguishing MDD patients from controls. The optimal cut-off was 29, with 0.861 sensitivity and 0.926 specificity. Conclusions:The BRIAN-C scale has good reliability and validity, which is supposed to be used in Chinese cultural background to evaluate the biorhythms in patients with MDD.

Objective:To verify the reliability and validity of the Chinese Version of Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN-C) in patients with major depressive disorder(MDD).Methods:A total of 122 patients with MDD and 122 controls were recruited and measured with the BRIAN-C, 16-Item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16), 7-Item Generalized Anxiety Disorder Scale(GAD-7) and 6-Item Short Form Health Survey(SF-6). The index D and correlation analysis were conducted to evaluate the discrimination and homogeneity of the items, respectively. The Cronbach′s α coefficient, Spearman-Brown coefficient, intraclass correlation coefficient ( ICC) and retest correlation coefficient were conducted to evaluate the reliability.Confirmatory factor analysis, correlation analysis and the receiver operating characteristic (ROC) curve were conducted to evaluate the construct validity, criterion validity and prediction validity, respectively. Results:The item distinction and homogeneity analysis showed significant differences ( P<0.05). The Cronbach′s α coefficient and the Spearman-Brown coefficient were 0.911 and 0.807, while the ICC and the correlation coefficient r of test-retest reliability were 0.639 (95% confidence interval( CI):0.375-0.729) and 0.43 ( P=0.001), respectively. Confirmatory factor analysis showed that the fit indexes χ 2/dF=1.937, goodness-of-fit index(GFI)=0.822, comparative fit index (CFI)=0.877, Tucker-lewis index (TLI)=0.855, and root mean square error of approximation (RMSEA)=0.088. The score of BRIAN-C was significantly correlated with that of QIDS-SR16, GAD-7 or SF-6 ( r=0.74, 0.46, -0.69, all P<0.05).The ROC curve suggested that the area under curve (AUC) was 0.939 (95% CI: 0.909-0.970, P<0.05) for distinguishing MDD patients from controls. The optimal cut-off was 29, with 0.861 sensitivity and 0.926 specificity. Conclusions:The BRIAN-C scale has good reliability and validity, which is supposed to be used in Chinese cultural background to evaluate the biorhythms in patients with MDD.

Objective:To explore the effect of postpartum fatigue(PPF) on maternal behavior in rats and its mechanisms.Methods:Sprague-Dawley (SD) rats on the first day after delivery were randomized into the control group and the PPF group using the random number table method, with eight rats in each group.The rat model of PPF was established by forcing rats to stand in a cage with water and last for seven days.To maintain galactosis and lactation, rats and pups were caged for 90 min after every 3 h of separation.The control group was separated routinely without any stimulus.The length and body mass of the pups were recorded at birth and postnatal day 7.On the seven days after modeling, the following maternal behaviors were observed via video recordings: suckling, nesting, clicking and retrieval.The morphology of neurons in the paraventricular nucleus of hypothalamus (PVH) was observed by HE staining.The expression of oxytocin in the paraventricular hypothalamus (OxtPVH) was determined by immunofluorescence and immunohistochemistry.Western blot and qRT-PCR were performed to detect mRNA and protein expression of prolactin (PRL) in pituitary gland, respectively.Statistical analysis was performed by SPSS version 22.0, normally distributed continuous variables were compared between the two groups using an independent-sample t test, and nonnormally distributed continuous variables were compared between the two groups by Mann-Whitney U test. Results:On the seventh day after modeling, the length and weight gain of pups in the PPF group ((5.82±0.17) cm, (5.33±2.54) g)were significantly lower than those of the control group ((6.24±0.36) cm, (7.92±2.54) g, t=3.199, 2.227, both P<0.05). Compared with the control group, the rats in PPF group exhibited abnormal maternal behaviors, such as gnawing cage, biting tails, turning circles, repeatedly nesting and refusal to suckling.The results from the maternal behavioral test revealed that the latency of first pup retrieval and last pup retrieval ((39.25±3.50) s, (280.75±59.16) s) in the PPF group were significantly prolonged compared with those in the control group((19.25±7.68) s, (146.00±49.62) s, t=-4.742, -3.490, both P<0.05), the duration of nesting building ((19.50±12.69) s)and clicking ((95.50±70.55)s) in the PPF group were significantly shorter than those in the control group((68.00±37.59) s, (243.00±62.07) s; t=2.445, 3.139, both P<0.05). Compared with control group, the neurons cells of PVH in the PPF group were in disordered manner and the OxtPVH content in the PPF group decreased significantly.The mRNA (0.33(0.29, 0.38) vs 0.85(0.76, 1.76), Z=-3.576, P<0.05) and protein ((1.00±0.65) vs (4.17±0.49), t=-7.726, P<0.05) levels of PRL in PPF group were significantly decreased compared with those in the control group. Conclusion:The behaviors of holding back, nesting and licking offspring are decreased in postnatal fatigued rats.This may be related to the decreased expression of OxtPVH and PRL in hypothalamus of female rats.