Gerontechnology has great potential in promoting older adults’ well-being. With the accelerated aging process, gerontechnology has a promising market prospect. However, most technological developers and healthcare professionals attached importance to products’ effectiveness, and ignored older adults’ demands and user experience, which reduced older adults' adoption intention of gerontechnology use. The inclusion of older adults in the design process of technologies is essential to maximize the effect. This study explored older adults’ demands for a self-developed intelligent medication administration system and proposed optimization schemes, thus providing reference to developing geriatric-friendly technologies and products. A cross-sectional survey was conducted to explore older adults’ technological demands for the self-developed intelligent medication administration system, and data were analyzed based on the Kano model. A self-made questionnaire was administered from July 2020 to October 2020 after participants used this system for two weeks. The study was registered with the Chinese Clinical Trial Registry (ChiCTR2000040644). A total of 354 older adults participated in the survey. Four items, namely larger font size, simpler operation process, scheduled medication reminders and reliable hardware, were classified as must-be attributes; three items, namely searching drug instructions through WeChat, more sensitive system and longer battery life, as attractive attributes; one item, viewing disease-related information through WeChat, as the one-dimensional attribute; and the rest were indifferent attributes, including simple and beautiful displays, blocking advertisements automatically, providing user privacy protection protocol, viewing personal medical information only by logged-in users, recording all the medications, ordering medications through WeChat. The satisfaction values were between 0.24 and 0.69, and dissatisfaction values were between 0.06 and 0.94. This study suggested that older adults had personalized technology demands. Including their technological demands and desire may assist in decreasing the digital divide and promoting the satisfaction of e-health and/or m-health. Based on older adults’ demands, our study proposed optimization schemes of the intelligent medication administration system, which may help developers design geriatric-friendly intelligent products and nurses to perform older adults-centered and efficient medication management.

Among many risk factors for preeclampsia (PE), prepregnancy body mass index (BMI) is one of few controllable factors. However, there is a lack of stratified analysis based on the prepregnancy BMI. This study aimed to determine the influencing factors for PE and assess the impact of PE on obstetric outcomes in twin pregnancies by prepregnancy BMI. This was a retrospective cohort study between January 1, 2017, and December 31, 2022, in Southwest China. Impact factors and associations between PE and obstetric outcomes were analyzed separately for twin pregnancies with prepregnancy BMI < 24kg/m² (non-overweight group) and BMI ≥ 24kg/m² (overweight group). In total, 3602 twin pregnancies were included, of which, 672 women were allocated into the overweight group and 11.8% of them reported with PE; 2930 women were allocated into the non-overweight group, with a PE incidence of 5.6%. PE had a negative effect on birthweight and increased the incidence of neonatal intensive care unit admission in both the overweight and non-overweight groups (43.0% vs. 28.0%, p = .008; 45.7% vs. 29.1%, p < .001). Among overweight women, PE increased the proportion of postpartum hemorrhage (15.2% vs. 4.4%, p < .001). After adjustments, multivariate regression analysis showed that excessive gestational weight gain (aOR = 1.103, 95% CI: 1.056-1.152; aOR = 1.094, 95% CI: 1.064-1.126) and hypoproteinemia (aOR = 2.828, 95% CI: 1.501-5.330; aOR = 6.932, 95% CI: 4.819-9.971) were the shared risk factors for PE in both overweight and non-overweight groups. In overweight group, in vitro fertilization was the other risk factor (aOR = 2.713, 95% CI: 1.183-6.878), whereas dichorionic fertilization (aOR = 0.435, 95% CI: 0.193-0.976) and aspirin use during pregnancy (aOR = 0.456, 95% CI: 0.246-0.844) were protective factors. Additionally, anemia during pregnancy (aOR = 1.542, 95% CI: 1.090-2.180) and growth discordance in twins (aOR = 2.451, 95% CI: 1.215-4.205) were connected with an increased risk of PE only in non-overweight twin pregnancies. Both discrepancy and similarity of impact factors on developing PE were found between overweight and non-overweight twin pregnancies in this study. However, the dosage and initiation time of aspirin, as well as twin chorionicity on the occurrence of PE in two subgroups, are still debated.

Practical Guidelines for Safe Childbirth Checklist has not been widely used in medical institutions at all levels in China. This study aims to understand the current status of knowledge, attitude and practice of obstetric medical staff toward the Safe Childbirth Checklist and analyze its influencing factors to provide a reference for establishing the promotion of the checklist. Convenience sampling was used in a cross-sectional survey of 685 obstetric medical staff in Chongqing using a self-designed questionnaire to analyze their knowledge, attitude and practice of the checklist. The scores of knowledge, attitude and practice of obstetric medical staff on the checklist were 29.96 ± 5.44, 62.87 ± 9.11, and 37.74 ± 6.82, respectively. Occupation and hospital level were influencing factors of the knowledge and practice scores, while length of service was the only influencing factor of the knowledge score. Education was the influencing factor of attitude score. The total effects of the knowledge, facilitation and inhibition dimensions on practice were 0.671, 0.263 and -0.135, respectively. Mediating effects presented in the facilitation and inhibition of attitude in safe childbirth. Obstetrics medical staff know the checklist well, however, their attitudes and practices need to be improved. Managers should take targeted measures to strengthen the attitudes and practices of obstetric medical staff toward safe childbirth and promote the use of the checklist, thus providing a powerful safeguard for higher delivery quality and safer delivery.