BackgroundThe transition to parenthood, which is influenced a lot by local parenting culture, is a dramatic stress for both men and women. Chinese social and cultural contexts form specific parental culture, shaping the unique experience of transition to parenthood. However, the understanding of the transition to parenthood in mainland China is limited. Additionally, few qualitative studies explored the transition to parenthood from both dyadic perspectives.AimTo explore the first-time transition to parenthood experience among mothers and fathers in mainland China during pregnancy, and compare the similarities and differences between their experiences in this transition period.MethodsA descriptive qualitative study was conducted with 36 parents, including 18 primiparous women and their husbands. Data were analyzed by directed content analysis guided by the Transition Shock Model. The interview texts were first analyzed at individual levels and subsequently at the couple level to identify dyadic themes.ResultsFive themes and thirteen sub-themes emerged from the data analysis, including role integration, health risk, dilemma of preparation, protective isolation, and multi-dimensional expectation. Unexpectedly, the experiences and perspectives of mothers and fathers regarding the transition to parenthood were found to be similar, with the exception of the sub-theme extra-care requirement.ConclusionThe findings shed light on the complex emotional journey and expectations of parents, as well as the challenges they face in terms of physical well-being, limited coping resources, and restricted social connections. Notably, fathers in China often shared the stress of the whole process during the transition period alongside mothers but often lacked accessible avenues for seeking and receiving support. These findings underscore the importance of actively involving fathers as a key support population in perinatal care, as well as the need for comprehensive support systems and tailored interventions to enhance the well-being and adaptation of parents.

Background Gestational diabetes mellitus (GDM) threatens GDM mothers and their offspring’s health and breastfeeding is one of the most effective ways to decrease the risk. However, the prevalence of breastfeeding among GDM mothers is far from optimal and how GDM mothers develop their feeding behavior is still unclear. Thus, this study aimed to explore the formation of GDM mothers’ breastfeeding behaviors based on the health belief model (HBM). Methods A questionnaire survey was conducted on 324 GDM mothers who have given birth within 6 months from January 1 to February 6, 2022. According to HBM, GDM mothers’ knowledge, the perceived threat from GDM, the perceived value of breastfeeding, self-efficacy, social support and GDM mothers’ breastfeeding behavior were measured. Exclusive breastfeeding (EBF) was defined as an infant who received only breast milk in the past 24 h before the survey. Structural equation modeling (SEM) was applied to explore how GDM mothers form their breastfeeding behaviors based on HBM. Results The prevalence of EBF among GDM mothers was 33.95%. GDM mothers had limited knowledge of GDM (average 63.14% correct answer to 7 questions), especially poor on the long-term effect of GDM (39.81%) and protective effect of breastfeeding (34.57%-45.99%). Although GDM mothers showed high perceived benefits (Mean: 3.35, SD: 0.46), high self-efficacy (Mean: 3.43, SD: 0.97) and high level of social support for breastfeeding (Mean: 3.74, SD: 0.74), the various barriers (Mean: 2.20, SD: 0.47) hindered their success in EBF. The SEM results showed that a higher level of social support and more self-efficacy of breastfeeding resulted in a higher likelihood of EBF, while the higher level of knowledge of GDM, perceived higher barriers and benefits of breastfeeding and higher susceptibility to GDM consequences led to less EBF. Conclusion To promote EBF, physicians’ education, emphasizing the protective effect of breastfeeding and how to correct breastfeeding, is highly recommended. In addition, social support for GDM mothers is also important to reduce their barriers to breastfeeding and help enhance self-efficacy in breastfeeding.

Objective To explore behavior patterns of rational antibiotics use and their impact factors among community residents for providing evidence to implement targeted-promotion of rational antibiotics use in China.Methods Using convenient sampling and a questionnaire self-designed according to capacity-opportunity-motivation-behaviors（COM-B）model,we conducted an online survey among 481 adults（≥ 18 years） from three urban communities in Hubei,Hebei and Jiangsu province during 5–19 of September,2020.Latent class analysis was used to identify the public antibiotic use behavior patterns and multi-nominal logistic regression model was adopted in analyses on influencing factors of different behavior patterns.Results Among the 413 participants with valid responses,three behavioral patterns of antibiotic use were identified,namely “irrational antibiotics use”,“antibiotic self-medication”,“relatively rational antibiotics use”,and the proportion of the participants for the three groups was 27.12% 27.12% and 45.76%,respectively.The results of logistic regression analysis showed that in comparison with the participants assessed as having “relatively rational antibiotics use ”,higher scores of medication-related skills（odds ratio [OR] = 0.663,P = 0.037）,social influence（OR = 0.475,P = 0.002）,resource and environment（OR = 0.643,P = 0.042）,self-capability beliefs（OR = 0.589,P = 0.034）,and intentions（OR = 0.504,P = 0.004） were protective factors against irrational antibiotics use but with a family member suffering from chronic diseases（OR = 1.895,P = 0.039） was a promoting factor for irrational antibiotics use for the participants assessed as having “irrational antibiotics use”;for the participants having “antibiotic self-medication”,higher scores of social influence（OR = 0.565,P = 0.004）,behavioral reinforcement（OR = 0.486,P = 0.013） and knowledge（OR = 0.379,P = 0.019） were significant protective factors against irrational antibiotics use.Conclusion In this survey,three different antibiotic use behavior patterns were identified among community adults in China;lack of relevant skills,adverse social influence,inadequate environment resources,insufficient belief in ability,strong intention to use antibiotics,and with family member suffering from chronic diseases are risk factors for irrational antibiotics use in the adults.

Background Anxiety and depression are among the most significant disorders to affect parents of newborn babies. Research shows that anxiety and depression have comorbidity with parenting confidence and the postnatal sense of security. Little is known, however, about the dynamic interactions between mothers’ and fathers’ parenting confidence, postnatal sense of security, and anxiety and depression. This study aimed to identify the actor and partner effects of parenting confidence and postpartum anxiety and depression via postnatal sense of security within one week after birth of mother-father dyad in China. Methods A cross-sectional design was used. A total of 204 mother-father dyads in Wuhan, China completed measures of parenting confidence, postnatal sense of security, anxiety and depression. The actor-partner interdependence mediation model was used to examine the dyadic relationships among the variables. Results Both fathers’ and mothers’ parenting confidence was negatively associated with their anxiety and depression through their own postnatal sense of security. Moreover, individuals’ parenting stress was indirectly related to their spouse’s anxiety and depression through their spouse’s postnatal sense of security. Conclusions The findings highlight the important roles of individuals’ parenting confidence in affecting their own and their spouse’s postnatal sense of security, contributing to the symptoms of anxiety and/or depression within Chinese parents of newborn babies. Thus, support plans and training programs are encouraged to be developed in couple-involved ways to facilitate fathers’ engagement and further promote positive experience for both fathers and mothers.

Background:Gestational diabetes mellitus (GDM) is a condition in which women develop hyperglycemia during pregnancy, and is associated with long-term health burden on both mother and their offspring, such as future type 2 diabetes mellitus (T2DM). Although breastfeeding was expected to mitigate metabolic sequelae for both mothers and their newborns, the prevalence of breastfeeding in GDM mothers are sub-optimal worldwide.Objective:To explore the experience of disease among mothers with GDM and how they develop feeding behaviors.Methods:This study was conducted in three branches of an integrated tertiary hospital in the central area of China. Mothers who were diagnosed with GDM, had no other complications, and gave birth before no more than 6 months were approached based on a purposive sampling. GDM mothers' experience of the disease and breastfeeding were collected via in-depth interviews. A theory-driven thematic analysis based on Health Belief Model (HBM) was applied for data analysis. Inductive reasoning was used to identify emerging themes which were not included in HBM.Results:16 GDM mothers were included in the current study, with nine using breastfeeding, six mixed feeding and one artificial feeding, respectively. Nine themes were identified, including: 1) GDM diagnosis and severity; 2) information searching and GDM knowledge;3) GDM management; 4) perceived susceptibility of future diabetes;5) perceived severity of future diabetes;6) perceived benefits of breastfeeding;7) perceived barriers of breastfeeding;8) decision making process of feeding and social support. Generally, mothers with GDM lack reliable sources of information, considered the disease as a minor and transient illness during pregnancy, and failed to realize the long-term risk of GDM and the protective effect of breastfeeding to themselves and their babies. They rarely considered GDM in their feeding decision. Instead, the formation of feeding behaviors depends on the balance between the benefits and barriers of breastfeeding as well as the level of social support.Conclusion:To promote breastfeeding, a multi-facet intervention targeted on healthcare providers (HCPs), GDM mothers and their networks was important to help GDM mothers better and correctly understand the disease and breastfeeding, and increase their capacity of breastfeeding.

BackgroundThe public's irrational use of antibiotics for upper respiratory tract infections (URTIs) is prevalent worldwide. This study aims to synthesize evidence on how people use antibiotics to treat URTIs, its prevalence and determinants.MethodsA mixed methods systematic review was conducted using a convergent segregated approach. Relevant studies were searched from PubMed, Cochrane Library, Embase, and Web of Science. A qualitative analysis was initiated, exploring the public's antibiotic use experience for URTIS based on the Consumer Behavior Model (CBM). This was followed by a quantitative synthesis, tapping into the prevalence and predictors of public behavior in antibiotic usage for URTIs. The segregated syntheses complemented each other and were further integrated.ResultsA total of 86 studies were included: 48 quantitative, 30 qualitative, eight mixed methods studies. The included studies were conducted in Europe (n = 29), Asia (n = 27) and North America (n = 21), assessing the behaviors of patients (n = 46), their parents or caregivers (n = 31), or both (n = 9). Eleven themes emerged covering the six CBM stages: need recognition, information searching, alternative evaluation, antibiotic obtaining, antibiotic consumption, and post-consumption evaluation. The six stages reinforce each other, forming a vicious cycle. The high prevalence of the public's irrational use of antibiotics for URTIs is evident despite the high heterogeneity of the studies (ranging from 0.0 to 92.7%). The perceived seriousness of illness and misbelief in antibiotics were identified consistently across the studies as the major motivation driving the public's irrational use of antibiotics for URTIs. However, individual capacity (e.g., knowledge) and opportunity (e.g., contextual restriction) in reducing antibiotic use have mixed effect.ConclusionSystemic interventions concerning both supply and demand sides are warranted. The public needs to be educated about the appropriate management of URTIs and health care providers need to re-shape public attitudes toward antibiotic use for URTIs through communication and prescribing practices.Systematic review registrationhttps://www.crd.york.ac.uk/prospero, identifier: CRD42021266407.

Background: Few studies have focused on the influence of indoor air pollution on depression and cognitive impairment; besides, the underlying mechanism is not well-established.Objective: This study aimed to fill the above gaps by exploring the underlying influence mechanism of solid fuel use, the major cause of indoor air pollution, with the risk of depression and cognitive impairment. Methods: This data came from China Health and Retirement Longitudinal Study (CHARLS) 2015 dataset. Self -reported household cooking fuels were collected and categorized as clean fuels and solid fuels. High -sensitivity C-reactive protein (CRP) and white blood cells (WBC) were used to measure inflammation. Depres-sion and cognitive function were assessed by using standardized questionnaires.Results: Respondents had an average Center for Epidemiologic Studies Depression Scale (CESD-10) scores of 7.68 (SD = 6.14) and cognitive function scores of 15.97 (SD = 4.84). In the whole sample, 36.4 % of respondents used solid fuels use, but this proportion was much greater among those living in rural areas (78.38 %). Compared with clean fuel users, solid fuel users had more depression and worse cognitive function. After adjusting for con-founders, indoor air pollution was significantly associated with depression and cognitive function respectively (beta = -0.444, p < 0.001; beta = 0.656, p < 0.001). Indoor air pollution was significantly related to the WBC (beta = 0.170, p < 0.01), but not for the CRP. The WBC mediated the association between indoor air pollution and depression (beta = 0.026, p < 0.01).Conclusion: In conclusion, solid fuel use was significantly associated with a higher risk of depression and cognitive impairment. Furthermore, we found that solid fuel use influences depression partly via the inflam-matory profile.