The association of nighttime sleep duration and quality with chronic kidney disease in middle-aged and older Chinese: a cohort study

ObjectiveThis cohort study aimed to assess the associations between sleep duration and quality with the risk of incident chronic kidney disease (CKD) in middle-aged and older Chinese.MethodsWe used the 2011 and 2015 surveys of the China Health and Retirement Longitudinal Study (CHARLS). Nighttime sleep duration was categorized into five groups: ≤4, (4–6], (6–8], (8–10], and >10 h/night. Sleep quality was assessed by restless days in the past week (<1, 1–2, 3–4, and 5–7 days/week). Multivariate logistic regression was used to assess the association between sleep duration and quality with incident CKD.ResultsA total of 11,339 participants free of CKD at baseline were included in this study. After four years follow-up, the incidence of CKD was 7.8%. There was a “U-shaped” association between sleep duration and risk of CKD. Compared to 6–8 h of nighttime sleep duration, those who slept ≤4 h/night (RR: 1.639, 95% CI: 1.287–2.087) or >10 h/night (RR: 2.342, 95% CI: 1.007–5.451) had increased risk of developing CKD after adjustment for confounders. Participants with 5–7 restless days per week had significantly increased risk of CKD (adjusted RR: 1.686, 95% CI: 1.352–2.102), compared to those who rarely or never had a restless sleep.ConclusionsExtreme nighttime sleep duration and poor sleep quality were associated with increased risk of CKD in middle-aged and older Chinese. Obtaining an optimal nighttime sleep duration and better sleep quality might reduce the risk of CKD.     

Association of genetic variants at MYP10 and MYP15 with high myopia in a Han Chinese population

Background: Previous genome-wide association study (GWAS) has revealed the association between MYP10 at 8p23 and MYP15 at 10q21.1 and high myopia (HM) in a French population. This study is managed to discover the connection between some single nucleotide polymorphism (located at MYP10 and MYP15) and Han Chinese HM.

Methods and Results: This case-control association study contained 1673 samples, including 869 ophthalmic patients and 804 controls. Twelve tag SNPs have been selected from the MYP10 and MYP15 loci and genotyped by SNaPshot method. Among 12 SNPs, rs4840437 and rs6989782 in TNKS gene were found significant association with HM. Carriers of rs4840437G allele and rs4840437GG genotype created a low risk of high myopia (P = .036, OR = 0.81, 95%CI = 0.71–0.93; P = .016, OR = 0.73, 95%CI = 0.56–0.96; respectively). Carriers of rs6989782T allele and rs6989782TT+CT genotype also had a decreased risk of high myopia (P = .048, OR = 0.82, 95%CI = 0.71–0.94; P = .006, OR = 0.74, 95%CI = 0.59–0.92; respectively). Other 10 SNPs displaced nonsignificant association with HM. Additionally, the risk haplotype AC and the protective haplotype GT, generated by two SNPs in TNKS, were considerably more likely to be association with HM (for AC, P = .002 and OR = 1.26; for GT, P = .027 and OR = 0.84).

Conclusions: Our results demonstrated that some heritable variants in the TNKS gene are associated with HM in the Han population. The possible functions of TNKS in the development and pathogenesis of hereditary high myopia still require further researches to identify.     

Elevated maternal serum-free β-human chorionic gonadotropin (β-hCG) and reduced risk of spontaneous preterm delivery*

Objective: To evaluate the relationship between first and second trimester maternal serum-free β-hCG and the risk of spontaneous preterm delivery (PTD).

Study design: This was a case-control study of women evaluated and delivered at our institution from 2011 to 2015. Spontaneous PTD was defined as delivery before 37 weeks due to spontaneous preterm labor or premature rupture of membranes. Patient with multifetal gestation and those with medically indicated term or PTD were excluded.

Results: Of 877 women meeting the inclusion criteria, 173 delivered preterm and 704 delivered at term, and 8.1% had high free β-hCG in one or both trimesters. High maternal first and/or second trimester free β-hCG (≥95th percentile) was associated with lower rates of PTD. Thirty-two women with high free β-hCG in both first and second trimesters delivered at term. Gestational age at delivery and birth weights were lower in women who did not have high free β-hCG in any trimester. Low free β-hCG (≤5th percentile) in either trimester was not associated with an increased or decreased likelihood of PTD. Logistic regression demonstrated an independent association of high free β-hCG (≥95th percentile) with a reduced likelihood of PTD. Stratified analysis revealed a stronger impact of this association in women with no prior history of PTD.

Conclusions: High free β-hCG, in the absence of risk factors for medically indicated PTD, is associated with a reduced likelihood of spontaneous PTD and may represent a marker indicating lower risk.     

Narrative Study of the Significance of Infertility and Its Treatment for Maternal Identity

ObjectiveTo explore how women who experienced infertility and underwent fertility treatments constructed maternal identities after they successfully gave birth.DesignNarrative qualitative study.SettingFinland, Scandinavia.ParticipantsTwenty-six previously infertile Finnish women who later conceived were recruited via social media, health clinics, and relevant informal support organizations.MethodsNarrative analysis was used to process written accounts and individual episodic interviews with each of the 26 women.ResultsFour different identity stories emerged from the data: Fractured Maternity, Pursuing Maternity, Learning Maternity, and Discovering Maternity. Infertility, its treatment, and childbirth were narrated as turning points in the participants’ life courses, but the significance of these turning points for maternal identity varied across the four stories.ConclusionThese findings have important implications for nursing practice. Health care professionals should be aware of the effects of previous long-standing infertility on the subsequent experience of motherhood so they can provide women with understanding, sufficient support, and appropriate interventions throughout the transition to motherhood.     

La pleine conscience incarnée : un concept unificateur entre les traditions orientales et occidentales de la pleine conscience

ObjectiveThe interest in mindfulness as a concept continues to grow as shown in the increase in the number of publications pertaining to mindfulness in the last four decades. This increase is also a reflection of the fact that the term “mindfulness” is currently used as an umbrella for a variety of approaches that assign different meanings to the same word. Although differences among varying conceptualizations and definitions of “mindfulness” have been previously highlighted, few efforts have attempted to compare these varying conceptual approaches as a means to address commonalties between them. Therefore, the objective of this paper is to review different conceptualizations of mindfulness in order to understand their common and distinctive components.MethodIn order to investigate commonalities and distinctions among different mindfulness conceptualizations, we conducted a thorough qualitative review of theoretical and empirical papers belonging to three approaches in mindfulness: Eastern Buddhist traditions, Western modern mindfulness meditation programs, and Langerian mindfulness. Each of these approaches is presented first at a conceptual level (i.e., how it defines mindfulness) and then at a practical level (i.e., how to operationalize mindfulness). Empirical research pertaining to the effectiveness of each approach is presented and discussed. As Buddhism incorporates different schools of thoughts, this paper focuses primarily on the conceptualization of mindfulness outlined within Theravada Buddhism. It operationalizes mindfulness through an engagement in intensive and daily meditative practice, which includes both concentrative and open-monitoring meditation. In addition, Buddhism includes a set of ethical principles. Western modern mindfulness meditation programs are conceptualized according to Kabat-Zinn and other western scholars. Definitions varied to some extent according to different scholars, each including a different set of components (e.g., attention, awareness, acceptance, nonjudgement, observation). Western modern mindfulness meditation programs are operationalized though the development and implementation of structured psychosomatic interventions, such as Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy. Langerian mindfulness is conceptualized as a general style or mode of functioning through which individuals actively reconstruct their environment by creating new categories or distinctions, and seeking multiple perspectives. Langer operationalized mindfulness through a set of sociocognitive tasks. The role of the body in these three approaches and more specifically the mind-body connection is highlighted through the analysis of clinical, behavioral, and neuroscientific research findings.Results and DiscussionDefinitions from both eastern and western approaches share self-regulation of attention and awareness as central common elements. Both attention and awareness processes increase interoceptive and exteroceptive body awareness and mind-body connection, therefore suggesting a role of embodiment in conceptualizing and operationalizing mindfulness across different approaches. We therefore introduce the new concept of Embodied Mindfulness as an integration of top-down and bottom-up processes and argue for its utility in the empirical study of mindfulness across the three conceptual approaches.ConclusionsThe new notion of embodied mindfulness integrates different conceptualizations of mindfulness by allowing a common understanding of the mechanisms of change across these conceptualizations. This new notion has also both research and clinical implications. This new notion suggests further emphasizing the body and mind-body connection in both studying/measuring mindfulness and in developing/validating clinical interventions.     

记忆抱怨主诉人群记忆障碍感知的质性研究

目的了解记忆抱怨主诉人群记忆障碍感知状况,为临床开展针对性护理干预提供思路。方法采用现象学研究方法,对15例记忆抱怨主诉个案进行深度访谈。结果记忆抱怨主诉人群存在负性记忆障碍感知,并可归纳为4个主题:盲目接受现实(宿命论),忽略社会支持(认为得不到他人的帮助),知识缺乏(缺乏改善记忆力或延缓记忆问题恶化的方法,对记忆问题感到不理解和困惑),消极的个人认知(记忆力减退是老化的标志;记忆下降是痴傻的表现)。结论记忆抱怨主诉人群存在负性记忆障碍感知。医护人员应了解记忆抱怨主诉人群记忆障碍感知来源,及早干预,帮助患者树立正确的记忆障碍感知体验,从而促进其健康相关行为方式的选择。     

Longitudinal association of egg intake frequency with cardiovascular disease in Chinese adults

Background and aimsReducing dietary cholesterol is generally acceptable for the prevention of cardiovascular disease (CVD). Eggs are nutrient-dense and common food items across the world, while rich in cholesterol. The potential effects of egg intake on cardiovascular health remain uncertainty and have been under debate in past decades.Methods and resultsA nationwide cohort of 20,688 participants aged 16–110 years without CVD at baseline were derived from the China Family Panel Studies. Egg consumption was assessed by a semi-quantitative food frequency questionnaire. We adopted stratified Cox proportional hazards model with random intercepts for provinces to evaluate associations of egg intake with CVD incidence. During a median follow-up of 6.0 years, we identified 2395 total CVD incidence and mean egg consumption was 3 times/week. Egg intakes were associated lower risks of CVD incidence in the multivariate-adjusted model. Compared with the non-consumers, the corresponding HRs (95% confidence interval) for total CVD events were 0.84 (0.74–0.94) for 1–2 times per week, 0.78 (0.69–0.88) for 3–6/week, and 0.83 (0.72–0.95) for ≥7/week. Similar relationships were found in hypertension. Approximately non-linear relationships were observed between egg consumption with total CVD and hypertension incidence, identifying the lowest risk in 3–6 times/week. Subgroup analyses estimated lower risks of total CVD and hypertension in females only, with significant effect modification by sex (P for interaction = 0.008 and 0.020).ConclusionEgg consumption may be associated with lower risks of CVD incidence among Chinese adults. Our findings could have implications in CVD prevention and might be considered in the development of dietary guidelines.