To examine longitudinal associations between adverse childhood experiences (ACEs) and cardiometabolic multimorbidity (CMM) and to assess whether unhealthy lifestyles modify these associations. This study utilized data from 5 waves of the China Health and Retirement Longitudinal Study (CHARLS). The study population comprised 11 200 participants aged 45 years or older, with available data on CMM and all 12 ACE indicators. The longitudinal associations between ACEs and CMM were assessed by generalized estimating equation (GEE) regression models. A mediation analysis examined the potential causal chain in which unhealthy lifestyle scores mediate the relationship between ACEs and CMM. A total of 11 200 participants were eligible for our analysis (mean (SD) age, 58.1 (8.8) years; 5839 (52.1%) were females), and 949 (8.47%) reported four or more ACEs. Compared with those without ACE exposure, participants who experienced four or more ACEs had an increased risk of CMM (odds ratio (OR), 1.40; 95% confidence interval (CI), 1.08-1.83). Drinking status significantly modified the associations between ACE groups and CMM (P for interaction = 0.034). Mediation analyses showed that unhealthy lifestyles partially explained 8.59% (95% CI, 0.56%-16.62%) of the relationship between ACEs and CMM. Childhood adverse events contribute to the development of CMM, and this effect is more significant in people who drink alcohol. Unhealthy lifestyles can aggravate the health inequity of ACEs on CMM.

OBJECTIVE:Perioperative pressure injuries (PIs) are a common complication of surgical hospitalization that can lead to serious health problems, compromise wound healing, and cause infections. This study aimed to predict the early risk of PI in perioperative patients by developing an interpretable machine-learning model. METHODS:Clinical data of perioperative surgical inpatients in a tertiary hospital in Shanghai from 2017 to 2023 were retrospectively analyzed, covering a total of 14,416 patients for screening. Feature variables were selected using the XGBoost model. Seven machine-learning (ML) models were employed to predict these variables. To evaluate the performance of these prediction models, various metrics such as accuracy, recall, and area under the curve were employed. In addition, a 10-fold cross-validation method was implemented to ensure the generalizability of the models. Furthermore, this study incorporated SHapley Additive exPlanations (SHAP) values to visualize and elucidate the significance of each factor involved. This study was reported using the TRIPOD checklist. RESULTS:In the 7 ML models developed, both the Random Forest model and the XGBoost model exhibited exceptional performance. In addition, the study incorporated the SHAP framework to enhance the interpretability of these models. The importance of SHAP variables in the model from high to low were operation duration, age, serum albumin, body mass index, body temperature, and anesthesia grade. CONCLUSIONS:The ML model developed in this study demonstrated strong performance in predicting perioperative PIs. Furthermore, the SHAP method offered valuable insights for interpreting the ML model.

Background: Online information (OI) has become a major source of caregiving knowledge and support for mothers of preterm infants (MPIs). However, despite its widespread use, the relationship between OI use and maternal mental health (MMH), including anxiety, stress, and depression (ASD), remains poorly understood, particularly in real-world contexts where information quality and emotional interpretation may vary. Objectives: To characterize patterns of OI use among MPIs, examine its associations with MMH, and identify unmet support needs.Methods: A cross-sectional survey was conducted in a neonatal intensive care unit between March and June 2025. A total of 110 MPIs were recruited. Data were collected using a structured questionnaire assessing OI use, perceived impact, social support, and MMH symptoms. MMH was defined as self-reported ASD. Multivariable logistic regression and interaction analyses were performed. Findings: High-frequency OI use and stronger emotional responses to OI were more common among ASD-positive than ASD-negative MPIs (91.3% vs 72.2%, P < 0.05). ASD-positive mothers also reported greater engagement with healthcare professionals within their online networks (P < 0.05). However, no OI-related variables were independently associated with MMH in multivariable analyses. Significant interaction effects were observed between OI use and parity, suggesting that associations varied according to caregiving experience. Interpretation: The psychological implications of OI use among MPIs appear to be driven more by behavioural engagement and emotional processing than by access alone. Interventions should prioritise supporting information appraisal and integrating psychological support within OI environments, particularly for first-time mothers.

Aim This qualitative study, guided by the Effort-Recovery Theory (ERT), examines how compassion fatigue (CF) develops in elderly healthcare aides (HCAs) in China. The study focuses on the developmental mechanisms and dynamic trajectory of CF. Background With global population aging, especially in China, where adults aged over 60 reached 310 million (22% of the population) by the end of 2024, HCAs face increasing physical and emotional burdens. Their physical labor includes daily care and emergency response, while their emotional labor involves managing empathy and nonverbal communication with residents who have cognitive impairments. However, existing research on CF has primarily focused on hospital nurses, with limited attention to HCAs’ unique experiences, particularly the dynamic process of CF under China’s sociocultural context. Methods A qualitative descriptive design was adopted, with 13 HCAs recruited from a large long-term care facility in Shanghai through purposive sampling. Data were collected via semi-participant observation and in-depth interviews, and analyzed using directed content analysis. The study adhered to the COREQ checklist to ensure methodological rigor. Results The analysis revealed a four-stage development process of CF. Stage one is Work Demand Overload. This stage involves physical burden, such as intensive labor and fragmented sleep. It also involves psychological burden, such as high cognitive demands and emotional entanglement. Stage two is Compensatory Effort Strategies. These strategies include emotional detachment through surface acting. They also include physiological compensation, for example, caffeine dependence. Another strategy is culturally specific cognitive reframing, such as believing in "karmic merit". Stage three is Insufficient Recovery. Stage three is Insufficient Recovery. Divergent recovery awareness influences this stage, which encompasses active micro-recovery, passive adaptation, and awareness-action disconnection. Structural barriers also contribute, which include institutional resource exclusion and cultural stigma. Stage four is Negative Effects, where CF emerges, which manifests as occupational burnout, secondary traumatization, and declining empathy satisfaction. Conclusion This study confirms that ERT effectively explains CF in HCAs. An imbalance between resource consumption and recovery drives the development of CF. Cultural norms, like the expectation of "family-like care", and institutional constraints make this imbalance worse. The findings address a gap in CF research about HCAs. They also provide a theory base for interventions. These could include optimizing workloads and improving recovery resources. Such steps could support the well-being of HCAs and enhance the quality of care.

This study investigates the use of machine learning (ML) models combined with a Synthetic Minority Over-sampling Technique (SMOTE) and its variants to predict perioperative pressure injuries (PIs) in an imbalanced dataset. PIs are a significant healthcare problem, often leading to prolonged hospitalization and increased medical costs. Conventional risk assessment scales are limited in their ability to predict PIs accurately, prompting the exploration of ML techniques to address this challenge.We utilized data from 7,292 patients admitted to a tertiary care hospital in Shanghai between May 2017 and July 2023, with a final dataset of 2,972 patients, including 158 with PIs. Seven ML algorithms-Support Vector Machine (SVM), Logistic Regression (LR), Random Forest (RF), Extreme Gradient Boosting (XGBoost), Extra Trees (ET), K-Nearest Neighbors (KNN), and Decision Trees (DT)-were used in conjunction with SMOTE, SMOTE+ENN, Borderline-SMOTE, ADASYN, and GAN to balance the dataset and improve model performance.Results revealed significant improvements in model performance when SMOTE and its variants were used. For instance, the XGBoost model hadan AUC of 0.996 with SMOTE, compared to 0.800 on raw data. SMOTE+ENN and Borderline-SMOTE further enhanced the models' ability to identify minority classes. External validation indicatedthat XGBoost, RF, and ET exhibited the highest stability and accuracy, with XGBoost having an AUC of 0.977. SHAP analysis revealed that factors such as anesthesia grade, age, and serum albumin levels significantly influenced model predictions.In conclusion, integrating SMOTE with ML algorithms effectively addressed a data imbalance and improved the prediction of perioperative PIs. Future work should focus on refining SMOTE techniques and exploring their application to larger, multi-center datasets to enhance the generalizability of these findings, and especially for diseaseswith a lowincidence.

BACKGROUND AND OBJECTIVE:With an aging population worldwide, pressure injury (PI) is becoming a critical challenge for healthcare professionals. We aimed to investigate the difference in PI trend globally across age groups from 1990 to 2021. METHODS:This study utilized data from the Global Burden of Diseases (GBD) 2021 to determine the age-standardized incidence rate (ASR) of PI stratified by age groups from 1990 to 2021. Estimated annual percentage changes (EAPCs) were calculated to measure corresponding temporal trends. RESULTS:Over three decades, the incident cases of PI have doubled from 1.1 million to 2.5 million worldwide. The incidence of PI showed an exponential rise with increasing age groups in 2021. The significant increasing trends were observed in the population aged 20-54 years (EAPC = 0.11) and 55+ years (EAPC = 0.55) from 1990 to 2021. The ASR among males has increased from 32.53 to 33.34 per 100,000 population, with an EAPC of 0.27, while the ASR among females decreased. The ASR was increased with higher income levels and the highest ASR was observed in the high-income region (49.95 per 100,000 population). Among six regions, the Americas had the highest ASR in 2021 (90.20 per 100,000 population), while South-East Asia showed the fastest increase (EAPC = 1.22). CONCLUSIONS:The global burden of PI is a growing global health problem among the elderly population, particularly in the Americas. A greater incidence burden in males and high-income level regions was found. This study advocates for urgent attention to coping strategies for aging populations and older people with PI. CLINICAL RELEVANCE:This study advocates for urgent attention to coping strategies for aging populations.

This study aimed to explore the brain network characteristics in elderly patients with Parkinson's disease (PD) with depressive symptoms. Thirty elderly PD patients with depressive symptoms (PD-D) and 26 matched PD patients without depressive symptoms (PD-NOD) were recruited based on HAMD-24 with a cut-off of 7. The resting-state functional connectivity (RSFC) was conducted by 53-channel functional near-infrared spectroscopy (fNIRS). There were no statistically significant differences in MMSE scores, disease duration, Hoehn-Yahr stage, daily levodopa equivalent dose, and MDS-UPDRS III between the two groups. However, compared to the PD-NOD group, the PD-D group showed significantly higher MDS-UPDRS II, HAMA-14, and HAMD-24. The interhemispheric FC strength and the FC strength between the left dorsolateral prefrontal cortex (DLPFC-L) and the left frontal polar area (FPA-L) was significantly lower in the PD-D group (FDRp < 0.05). As for graph theoretic metrics, the PD-D group had significantly lower degree centrality (aDc) and node efficiency (aNe) in the DLPFC-L and the FPA-L (FDR, p < 0.05), as well as decreased global efficiency (aEg). Pearson correlation analysis indicated moderate negative correlations between HAMD-24 scores and the interhemispheric FC strength, FC between DLPFC-L and FPA-L, aEg, aDc in FPA-L, aNe in DLPFC-L and FPA-L. In conclusion, PD-D patients show decreased integration and efficiency in their brain networks. Furthermore, RSFC between DLPFC-L and FPA-L regions is negatively correlated with depressive symptoms. These findings propose that targeting DLPFC-L and FPA-L regions via non-invasive brain stimulation may be a potential intervention for alleviating depressive symptoms in elderly PD patients.

OBJECTIVE: To comprehensively assess the association between operative positioning with intraoperative-acquired pressure injury (IAPI) development. METHODS: This retrospective cohort study included 455 patients who underwent surgery between October 2020 and January 2021. The authors grouped patients by operative positioning into the prone position and nonprone position groups. They used propensity-score matching at a 1:2 ratio to control for preoperative confounders, applied multiple logistic regression models to analyze the effects between positioning and IAPI, and assessed interactions of positioning and intraoperative factors on IAPI. RESULTS: The final enrollment was 92 cases in the prone position group and 181 in the nonprone position group. Multivariable logistic analysis suggested that the prone position had a 2.92 times higher risk of IAPI than the nonprone position (odds ratio, 2.92; 95% CI, 1.13-7.57; P = .026). Subgroup analysis showed a significant multiplicative interaction between positioning and foam dressing on IAPI (P < .05), which was not observed in other intraoperative factors (P > .05). CONCLUSIONS: This study provides evidence that prone operative positioning can increase IAPI risk. Patients in the prone position may particularly benefit from using dressings in Chinese populations. Further large-sample longitudinal studies are required to confirm these findings.

OBJECTIVES:This study aimed to explore the potential risk factors associated with toileting-related falls in community-dwelling older adults who presented to the emergency department and were subsequently hospitalised.DESIGN:This was a cross-sectional study.SETTING AND PARTICIPANTS:This study was conducted in two teaching hospitals in Shanghai, China between October 2019 and December 2021 among community-dwelling adults aged ≥60 years.METHODS:In-person interviews, physical assessment and medical record review were performed to collect data on the characteristics and risk factors of falls. Associations of toileting-related falls with demographic characteristics and geriatric syndromes were examined using logistic regression models.MAIN OUTCOME MEASURES:Potential risk factors for toileting-related falls.RESULTS:This study included 419 older patients with a mean age of 73.8±9.7 years. Among 60 (14.3%) patients with toileting-related falls (mean age: 78.8±9.2 years), 63.3% of toileting-related falls, mainly occurred between 00:00 and 05:59 hours, compared with 17.3% of non-toileting-related falls, which primarily occurred during the daytime. The rate of recurrent falls (35%) was significantly higher in the toileting-related falls group than in the non-toileting-related falls group (21.2%) (p=0.02). Logistic regression showed that visual impairment (OR 2.7, 95% CI 1.1 to 7.1), cognitive impairment (OR 3.3, 95% CI 1.3 to 8.4), gait instability (OR 3.1, 95% CI 1.1 to 8.8) and urinary incontinence (OR 3.4, 95% CI 1.2 to 9.9) were strongly associated with toileting-related falls. Twenty-three (38.3%) patients in the toileting-related falls group had moderate and severe injuries, compared with 71.7% in the non-toileting-related falls group (p<0.05).CONCLUSIONS:This study revealed that patients who reported toileting-related falls were more likely to have cognitive impairment, urinary incontinence, gait instability, visual impairment than patients who fell during other activities. Social and healthcare professionals should prioritise the management of toileting activities in older patients and provide targeted interventions to those in the high-risk group.

This study aims to investigate the coping competence of 12 community health centers through nursing workforce, emergency preparation, emergency response training, and emergency support in a district of Shanghai during the coronavirus disease 2019 (COVID-19) pandemic in 2022 to propose coping strategies and implication for Future Public Health Emergency Events for community health centers. A cross-sectional survey was conducted on June 2022, and 12 community health centers (servicing a population of 104,472.67 ± 41,421.18, with 125 ± 36 health care providers per center) were then divided into group A (n = 5, medical care ratio ≥ 1:1) and group B (n = 7, medical care ratio < 1:1) according to collected data, and the nursing human resources management and coping competence of the centers with COVID-19 of both groups were retrospectively analyzed. Nursing shortages were obvious across all 12 centers. Certain deficiencies in the coping competence of community health centers with emergencies must be addressed (possession rate < 70% in both groups, p > 0.05). Community health centers need to enhance hospital-to-hospital collaboration and the ability to transport emergency staff to the post promptly during outbreaks. Emergency coping assessments, emergency drills at different levels, and mental health support need to be implemented regularly among community health centers, and effective donation management should be pursued as well. We expect that this study could support efforts by leaders of community health centers to conclude coping strategies including increasing nursing workforce, optimizing human recourse management, and identifying areas of improvement of centers for emergency coping during public health events.

To construct and validate an intraoperative hypothermia risk prediction model for elderly patients undergoing total hip arthroplasty (THA). We collected data from 718 patients undergoing THA in a tertiary hospital from January 2021 to December 2022. Of these patients, 512 were assigned to the modeling group from January 2021 to April 2022, and 206 participants were assigned to the validation group from May 2022 to December 2022. A logistic regression analysis was performed to construct the model. The area under the curve (AUC) was used to test the model’s predictive ability. The incidence rate of intraoperative hypothermia was 51.67

Aim: The purpose of this study was to construct a core competencies evaluation index system for critical care blood purification nurses in China. Background: While nursing is an integral part of critical care blood purification treatment, there are no established indicators to evaluate the core competencies of critical care blood purification nurses. Design: A Delphi study. Methods: An initial draft of the competencies evaluation index system for critical care blood purification nurses was developed through a literature review and semi-structured interviews. From February 2023 to March 2023, a two-round Delphi survey was conducted to consult with 18 experts in the field of critical care blood purification from eight provinces in China to rate the importance of each item and propose modifications to the evaluation index system. Results: The effective questionnaire recovery rates in two rounds of expert consultation were 94.4 % and 94.1 % and the average expert authority coefficients were 0.88 in both rounds. The core competencies evaluation index system of critical care blood purification nurses consisted of 39 items in five domains, namely theoretical knowledge, practical skills, professional development capability, critical thinking ability and personal qualities and attributes. The Kendall's W coefficients for the first- and second-level indicators were.21 and.20 in the first round and.23 and.25, respectively, in the second round of consultations (p <.01). Conclusion: The core competencies evaluation index system of critical care blood purification nurses is scientific and reliable and can provide references for the recruitment, training and management of critical care blood purification nurses.

目的 分析滇东南地区新生儿院前延迟就医状况并探讨其影响因素.方法 纳入 2018 年 10 月—2020年 9 月期间滇东南地区某二甲医院新生儿科收治的患儿 252 例,采用病例回顾性分析方法,通过描述性分析、多元Logistic回归等方法分析新生儿院前延迟的特征及其影响因素.结果 新生儿发生院前延迟就医共 187 例(74.2%),1 天内就诊率为 25.8%,3 天内就诊率为 62.3%,7 天内就诊率为 88.5%,平均延迟就医天数为(4.01±3.78)天.母孕期产检不规律(OR=3.725,95%CI:1.278～10.861)、新生儿住院日龄不同(新生儿日龄>7 天OR= 4.050,95%CI:1.767～9.283)、识别症状的类型不同(喂养OR=6.709,95%CI:1.637～27.499;新生儿特有症状OR=19.038,95%CI:5.540～65.418;感染迹象OR=12.244,95%CI:3.487～42.996)、就医前是否自行采取措施(未自行采取措施OR=0.282,95%CI:0.126～0.631)是影响新生儿院前延迟就医的因素.结论 滇东南地区新生儿存在院前就医延迟现象.应加强欠发达地区母孕期保健意识、提高家长对新生儿异常症状的认知、改善家长的求医行为,以降低新生儿院前延迟就医的发生.

ObjectivesDeep tissue injury is a common form of pressure ulcers in muscle tissues under bony prominences caused by sustained pressure or shear, which has a great impact on patients with restricted mobility such as spinal cord injury. Frequent spasms in spinal cord injury patients featured by muscle stiffening may be one of the factors leading to deep tissue injury. The purpose of this study was to investigate the relationship between the gluteal muscle shear modulus and intramuscular compressive/shear stress/strain.MethodsA semi-3D finite element model of the human buttock was established using COMSOL software and the acquired biomechanical data were analyzed through Pearson correlation and Spearman correlation.ResultsResults showed that the compressive stress, strain energy density, and average von Mises stress increased with the increase of the gluteal muscle shear modulus.ConclusionThese results may indicate muscle stiffening caused by muscle spasms could lead to higher deep tissue injury development risk as well as shed light on effective treatments for relieving muscular sclerosis mechanically.

OBJECTIVE: To determine the key factors influencing intraoperative-acquired pressure injury (IAPI). METHODS: Researchers assessed 413 surgical patients in a Shanghai tertiary hospital using an information collection form and an IAPI occurrence record form. Analysis took place using the classification and regression tree algorithm and multiple logistic regression. RESULTS: A total of 43 surgical patients (10.4%) had IAPI, including 32 stage 1 cases (74.4%), and 11 stage 2 cases (25.6%). The multiple logistic regression analysis indicated that operation duration, surgical position, preoperative hypertension, and preoperative Braden Scale risk score were independently associated with IAPI development. The decision tree showed that preoperative Braden Scale score, surgical position, operation grade, operation duration, age, prealbumin level, and body mass index were important factors and that preoperative Braden Scale score was the most critical decision variable. The cross-validation method was used to indicate a model accuracy of 91.8%. CONCLUSIONS: The decision tree effectively identified key factors for IAPI, complementing the logistic regression analysis and providing a scientific basis for the further development of structural risk assessment, prevention, and treatment strategies for IAPI.

PURPOSE:This study aimed to elucidate the experiences and growth trajectories of mothers who have infants with esophageal atresia, which would contribute to our understanding of their unique nursing care requirements and support the development of personalized nursing care strategies and interventions for these critically ill infants. DESIGN AND METHODS:This study used a qualitative descriptive approach including face to face interviews with semi-structured questions. The interviews were audio-recorded and transcribed verbatim. RESULTS:Eight mothers were interviewed between November 2021 to January 2022. The mothers described two categories of care experiences: "grief" and "post-traumatic growth". Subcategories included "beginning of chaos", "facing reality", "forced mother-infant separation", "deprived life", "deepened self-knowledge", "enhanced perception of social support", and "shift in life priorities". CONCLUSIONS:The findings of this study indicated mother of infants with esophageal atresia experienced grief, and also reported growth. A better understanding of mothers' experience and positive changes may facilitate peditric nursing practice and promote mothers to attain good psychological adaptation to enable them to take good care of their children. APPLICATION TO PRACTICE:Pediatric nurses' insight into the experience of mothers caring for infants with esophageal atresia could facilitate increased physical intimacy and optimized interaction time to understand the unique personality of these infants. Collaborating with mothers could enhance nurses' comprehension of their perspectives, concerns, and needs, and could guide intervention strategies.

Background A smooth transition from the neonatal intensive care unit (NICU) to home is critical for establishing parents' competence as primary caregivers and ensuring infant health. In the clinical context with a restrictive visiting policy, family-centred care is challenging to implement, prohibiting a smooth transition of care for the families. According to Meleis' Transition Theory, parents might experience emotional change initiated by critical events during this transition. Objectives The aim of this study was to understand parents' emotional experience of their preterm infant's birth to discharge home from the NICU to facilitate the care transition better. Methods This qualitative descriptive study using semistructured interviews was conducted between June and August 2020. Purposive sampling was used to recruit 17 parents (6 fathers and 11 mothers) from the NICU of a tertiary hospital in eastern China. Data were analysed using content analysis. Results The following three situational themes characterised by three-phase emotions related to 16 critical events were obtained from the data and were used to describe parents' experiences during the transition: Theme 1, Life falling apart; Theme 2, Feeling anxious and struggling with uncertainty; and Theme 3, Feeling both hopeful and inadequate at discharge. Conclusions Parents of preterm infants have distinctive emotional experiences in each phase during their infants' transition from the NICU to home. Awareness of parents' critical events and emotional experiences in each phase could help NICU staff anticipate and provide timely and targeted support for parents. The next step is to develop a family-centred intervention for healthcare providers to better prepare parents for the transition from the NICU to home.

Abstract Aim The primary objective of this study was to assess the patient safety culture in a general hospital in Shanghai, China, through a modified Manchester Patient Safety Framework (MaPSaF). Design This study has a qualitative interview design. Data were collected through group interviews and analyses performed through content analysis. Methods The MaPSaF was translated into Chinese and used to assess the patient safety culture in a large general hospital in Shanghai, China. Group interviews using the MaPSaF were conducted with 15 nurses in the obstetric ward. Participants rated their safety practice individually on each of the nine MaPSaF safety culture dimensions. The dimensions and scores were then collectively discussed and a practice‐wide consensus score for each dimension was agreed. Discussions were recorded, transcribed and analysed to assess patient safety in the obstetric ward. Results It took about 2 hr to complete the discussion focusing on patients' safety employing the MaPSaF. Most participants recognized the process as acceptable and useful. The MaPSaF directed team discussion about patient safety issues and facilitated communication, prompting some practice changes. All participants responded positively to the discussion and perceived MaPSaF as a good safety culture assessment tool, with clear, comprehensive and understandable entries. The process demonstrated that the department of obstetrics in the hospital already had a positive patient safety culture, but certain areas were highlighted as still needing improvement. Based on participants' positive experience and perception of the MaPSaF, it can be concluded that there is potential benefit in its adaptation and use in obstetrics wards of Chinese hospitals. The MaPSaF has the potential to strengthen existing safety cultures and improve general safety through collaborative measures.

Abstract Background To explore the safety and economics of two materials of peripheral intravenous catheters based on propensity score matching. Methods A multi-center prospective survey on inpatients in 5 hospitals in Shanghai, Sichuan, and Shandong. Propensity score matching (PSM) was used to analyze the complications, indwelling time, comfort, and economic comparison. Results The data of 3,245 patients were matched by PSM. There were 1812 patients with two different materials, 906 cases in each group. The complication rate in the Vialon group (22.4% vs 29.5%) was lower than that in the Teflon group, and its average indwelling time was significantly longer than that of the Teflon material group (0.13 days) (p < 0.05). The comfort evaluation of patients in the Vialon group was 5.5% higher than that in the Teflon group. The additional cost of unplanned extubation of Vialon material was lower than that of Teflon material. Conclusions The peripheral intravenous catheters made of Vialon material can reduce complications and the total cost.

ObjectiveDuring the COVID-19 pandemic, face-to-face intervention services for families of children with autism spectrum disorder (ASD) were limited. This study aimed to evaluate the effectiveness of an 8-week, online-delivered Project ImPACT program for children with ASD and their parents in China during the COVID-19 pandemic. MethodsA pilot non-randomized study with a waitlist control group was conducted in 68 children with ASD and their parents in the Department of Developmental and Behavioral Pediatrics between April 15, 2020 and March 19, 2021. Participants were allocated to either the intervention (IG) or the waitlist group (WLG) according to their order of recruitment. Parents in the IG immediately received 8 weeks of the online-delivered Project ImPACT program, and the WLG received the same program with a delay when the IG had completed all sessions. Participants in both groups received treatment as usual during the research period. ResultsThe online-delivered Project ImPACT program significantly improved the parent-reported social communication skills of children with ASD. Furthermore, parent's involvement in the training program produced a collateral reduction in parenting stress and an increase in perceived competence in the parental role. Parents rated the program acceptable in terms of curriculum schedule, session content, homework assignments, and therapist feedback. ConclusionsThe 8-week, online-delivered Project ImPACT program is a feasible and effective social skill training program for families of children with ASD in China during the COVID-19 pandemic. Due to the methodological limitations, randomized controlled studies with larger sample sizes are suggested to provide more solid evidence.