Search

Background: Newborn anogenital distance (AGD) has been associated with prenatal exposure of phthalates. The association between prenatal phthalate exposure and sex steroid hormones in newborns is unclear. Object: This study aimed to examine whether cord-blood sex hormone levels were associated with prenatal phthalate exposure and newborn anogenital distance (AGD). Methods: In the Taiwan Maternal and Infant Cohort Study, we recruited 1,676 pregnant women in their third trimester in 2012–2015 in Taiwan. We determined 11 urinary phthalate metabolites in pregnant women, three maternal and five cord-blood steroid sex-hormone concentrations. Five hundred and sixty-five mother-infant pairs with sufficient data were included. Trained neonatologists measured 263 newborns' AGD. We examined the associations of prenatal phthalate metabolite levels with AGD and hormones using linear regression models and evaluated correlations between maternal and cord-blood sex hormone levels and AGD. Results: Compared with the male newborns exposed to maternal phthalate metabolites at the first tertile, AGD was -3.75, -3.43, and -3.53 mm shorter among those exposed at the median tertile of di-2-ethylhexyl phthalate (DEHP) metabolites, monobenzyl phthalate (MBzP), and monomethyl phthalate (MMP), respectively. Compared with those who had exposed at the first tertile, cord-blood follicle-stimulating hormone (FSH) decreased among male newborns exposed at higher levels of MMP, mono-n-butyl phthalate (MnBP), MBzP and DEHP, and among female newborns exposed at higher levels of MMP, MBzP and mono(2-ethyl-5-hydroxyhexyl) phthalate. However, we did not observe significant correlations of maternal or cord-blood sex steroid hormones with newborns' AGDs. Conclusions: Alterations in cord-blood sex steroid hormone levels were associated with prenatal phthalate exposures, particularly in male newborns. Women aspiring to be pregnant should be alerted of the need of reducing phthalate exposure. [ABSTRACT FROM AUTHOR]

Background: The optimum approach to enhance the understanding toward dementia is to experience how patients feel as they experience the manifestations of the disease. The application of virtual reality (VR) and relevant innovative technologies for developing caregiver training programs allows caregivers to better understand dementia and empathize with patients. Objectives: To develop a VR-based experiential training course on individualized care for the behavioral and psychological symptoms of dementia (BPSD). Methods: The participants were caregivers of patients with dementia. They assessed the usability of the VR product after the intervention and the VR experience as a preliminary measure of the effectiveness of the intervention using a usability scale and a self-reported appraisal scale, respectively. Results and Conclusion: Ten in-service and in-home caregivers completed the VR training course. The course yielded a usability score of 74.06 points, indicating excellent usability. The content validity index (CVI) of the self-reported VR experience appraisal scale ranged from 0.8–1, scale-level CVI was 0.81, and reliability (Cronbach's α) was 0.929. The mean score of the overall scale was 4.67 ± 0.33. These findings suggest that the VR-based experiential training course enabled the home caregivers to deepen their understanding of the BPSD shown by community-dwelling patients and, therefore, to provide better care services. The course developed in this study is the first VR course directed toward dementia care in Taiwan. Given its excellent usability, as well as the effectiveness of the VR experience appraisal scale for deepening the caregivers' skills in managing patients' BPSD symptoms, the course can be promoted and applied in caregiver training programs for dementia in the future. [ABSTRACT FROM AUTHOR]