Psychological health of women who have conceived using assisted reproductive technology in Taiwan: findings from a longitudinal study

Background: Despite the increasing use of Assisted Reproductive Technology (ART) and the significant physical and emotional commitments that these treatments and procedures involve, only limited evidence exists regarding the psychological health of women who undergo ART. This study investigated the changes over time in the psychological health of women who have conceived using ART during the first, second, and third trimesters of pregnancy and during the postpartum period in Taiwan. Methods: A quantitative longitudinal study was conducted at a fertility centre in Taiwan. 158 pregnant women who had conceived using ART completed a web-based questionnaire that included the following instruments: State Anxiety Inventory, Edinburgh Postnatal Depression Scale, Modified Maternal Foetal Attachment Scale, Pregnancy Stress Rating Scale, Maternity Social Support Scale, Intimate Bond Measure, and Parenting Stress Index. The data were collected the first (9–12 weeks), second (19–22 weeks), third (28–31 weeks) trimesters of pregnancy and at 7–10 weeks postpartum. Results: Levels of anxiety and depression, which are both key indicators of psychological health, were highest during the first trimester, with scores of 42.30 ± 11.11 and 8.43 ± 4.44, respectively. After the first trimester, anxiety scores decreased and remained stable through the remainder of pregnancy, with scores of 38.03 ± 10.58 in the second and 38.39 ± 10.36 in the third trimester, but increased at two-months postpartum, attaining a score of 41.18 ± 11.68. Further, depression scores showed a similar pattern, declining to a mean of 7.21 ± 4.23 in the second and 6.99 ± 4.11 in the third trimester and then increasing to 8.39 ± 5.25 at two-months postpartum. Pregnancy stress and social support were found to be the most important predictors of change in psychological health during pregnancy and the postpartum period. Conclusion: Psychological health was found to be poorest during the first trimester and at two-months postpartum. Moreover, pregnancy stress and social support were identified as key predictors of change in psychological health. The findings indicate a need for increased sensitivity among healthcare professionals to the psychological vulnerability of women who have conceived using ART as well as a need to introduce tailored interventions to provide appropriate psychological support to these women

First-time mothers\u2019 experiences of pregnancy and birth following assisted reproductive technology treatment in Taiwan

Background: Assisted reproductive technology (ART) treatment tends to involve significant physical and emotional commitments that can impact maternal, infant, and family health and well-being. An in-depth understanding of experiences is necessary to provide adequate support for women and their families during pregnancy and transition to parenthood following ART treatment. The aim of this study was to explore first-time mothers\u2019 experiences of pregnancy and transition to parenthood following successful ART treatment in Taiwan. Method: Twelve first-time mothers who conceived and gave live birth using ART treatment were purposively selected from a fertility centre in Taipei, Taiwan. Women\u2019s experiences in pregnancy and in their transition to motherhood were explored using semi-structured in-depth interviews. All interviews were recorded, transcribed, and analysed using the Colaizzi strategy. Results: The mothers\u2019 accounts reflected three main themes: \u2018being different from mothers who became pregnant naturally\u2019, \u2018ensuring health and safety of the foetus\u2019, and \u2018welcoming new lives with excitement\u2019. The difference mothers felt about themselves was evident in four subthemes: becoming pregnant after a long wait, feeling vulnerable during pregnancy, relying on family\u2019s assistance and support, and worrying about the impact of ART on health. The theme on \u2018ensuring health and safety of the foetus\u2019 encompassed three subthemes: activities to protect the unborn baby, monitoring foetal movement constantly to maintain peace of mind, and receiving foetal reduction for the sake of the pregnancy. Narratives around \u2018welcoming new lives with excitement\u2019 reflected four subthemes: overcoming hardship for worthwhile results, realising one\u2019s life and dreams, proving to be fertile enough to give birth, and return to normal life track. Conclusion: Findings indicate the need for educational and psychosocial interventions to support women and their families physically and psychologically during ART treatment. The stigma related to infertility and the psychosocial support from family are aspects to consider while planning intervention programmes

A Chinese Herbal Decoction, Modified Yi Guan Jian, Induces Apoptosis in Hepatic Stellate Cells through an ROS-Mediated Mitochondrial/Caspase Pathway

The Chinese herb modified Yi Guan Jian (mYGJ) is an effective regimen that is usually used in outpatients with chronic liver diseases such as fibrosis and cirrhosis. However, the mechanism for the action of mYGJ on liver fibrosis is not yet clear. In this study, we found that mYGJ induced hepatic stellate cells (HSCs) apoptosis concomitant with the downregulation of Bcl-2 expression and slight elevation of Bax level. Moreover, the reactive oxygen species (ROS) were generated in the early stages of mYGJ-induced HSCs apoptosis to facilitate calcium and cytochrome c release from the mitochondria to cytosol. Subsequently, caspase 9 and caspase 3 were activated. Furthermore, the activation of ER stress-associated caspase 12 in HSCs was also evaluated. Together, we report the first evidence-based study to demonstrate that mYGJ decoction induces HSCs apoptosis through ROS accumulation and the intrinsic apoptosis pathway. These findings provide rationale for further clinical investigation of traditional Chinese medicine recipes against liver fibrosis

Apoptosis in Hepatic Stellate Cells through an ROS-Mediated Mitochondrial/Caspase Pathway

The Chinese herb modified Yi Guan Jian (mYGJ) is an effective regimen that is usually used in outpatients with chronic liver diseases such as fibrosis and cirrhosis. However, the mechanism for the action of mYGJ on liver fibrosis is not yet clear. In this study, we found that mYGJ induced hepatic stellate cells (HSCs) apoptosis concomitant with the downregulation of Bcl-2 expression and slight elevation of Bax level. Moreover, the reactive oxygen species (ROS) were generated in the early stages of mYGJ-induced HSCs apoptosis to facilitate calcium and cytochrome c release from the mitochondria to cytosol. Subsequently, caspase 9 and caspase 3 were activated. Furthermore, the activation of ER stress-associated caspase 12 in HSCs was also evaluated. Together, we report the first evidence-based study to demonstrate that mYGJ decoction induces HSCs apoptosis through ROS accumulation and the intrinsic apoptosis pathway. These findings provide rationale for further clinical investigation of traditional Chinese medicine recipes against liver fibrosis

Emerged HA and NA Mutants of the Pandemic Influenza H1N1 Viruses with Increasing Epidemiological Significance in Taipei and Kaohsiung, Taiwan, 2009–10

The 2009 influenza pandemic provided an opportunity to observe dynamic changes of the hemagglutinin (HA) and neuraminidase (NA) of pH1N1 strains that spread in two metropolitan areas -Taipei and Kaohsiung. We observed cumulative increases of amino acid substitutions of both HA and NA that were higher in the post–peak than in the pre-peak period of the epidemic. About 14.94% and 3.44% of 174 isolates had one and two amino acids changes, respective, in the four antigenic sites. One unique adaptive mutation of HA2 (E374K) was first detected three weeks before the epidemic peak. This mutation evolved through the epidemic, and finally emerged as the major circulated strain, with significantly higher frequency in the post-peak period than in the pre-peak (64.65% vs 9.28%, p<0.0001). E374K persisted until ten months post-nationwide vaccination without further antigenic changes (e.g. prior to the highest selective pressure). In public health measures, the epidemic peaked at seven weeks after oseltamivir treatment was initiated. The emerging E374K mutants spread before the first peak of school class suspension, extended their survival in high-density population areas before vaccination, dominated in the second wave of class suspension, and were fixed as herd immunity developed. The tempo-spatial spreading of E374K mutants was more concentrated during the post–peak (p = 0.000004) in seven districts with higher spatial clusters (p<0.001). This is the first study examining viral changes during the naïve phase of a pandemic of influenza through integrated virological/serological/clinical surveillance, tempo-spatial analysis, and intervention policies. The vaccination increased the percentage of E374K mutants (22.86% vs 72.34%, p<0.001) and significantly elevated the frequency of mutations in Sa antigenic site (2.36% vs 23.40%, p<0.001). Future pre-vaccination public health efforts should monitor amino acids of HA and NA of pandemic influenza viruses isolated at exponential and peak phases in areas with high cluster cases

First-time mothers’ experiences of pregnancy and birth following assisted reproductive technology treatment in Taiwan

Background Assisted Reproductive Technology (ART) treatment tends to involve significant physical and emotional commitments that can impact maternal, infant and family health and well-being. An in-depth understanding of experiences is necessary to provide adequate support for women and their families during pregnancy and transition to parenthood following ART treatment. The aim of this study was to explore first-time mothers’ experiences of pregnancy and transition to parenthood following successful ART treatment in Taiwan. Method Twelve first-time mothers who conceived and gave live birth using ART treatment were purposively selected from a fertility centre in Taipei, Taiwan. Women’s experiences in pregnancy and in their transition to motherhood were explored using semi-structured in-depth interviews. All interviews were recorded, transcribed, and analysed using the Colaizzi strategy. Results The mothers’ accounts reflected three main themes: ‘being different from mothers who became pregnant naturally’; ‘ensuring health and safety of the foetus’; and ‘welcoming new lives with excitement’. The difference mothers felt about themselves was evident in four subthemes: becoming pregnant after a long wait, feeling vulnerable during pregnancy, relying on family’s assistance and support, and worrying about the impact of ART on health. The theme on ‘ensuring health and safety of the foetus’ encompassed three subthemes: activities to protect the unborn baby, monitoring foetal movement constantly to maintain peace of mind, and receiving foetal reduction for the sake of the pregnancy. Narratives around ‘welcoming new lives with excitement’ reflected four subthemes: overcoming hardship for worthwhile results, realising one’s life and dreams, proving to be fertile enough to give birth, and return to normal life track. Conclusion Findings indicate the need for educational and psychosocial interventions to support women and their families physically and psychologically during ART treatment. The stigma related to infertility and the psychosocial support from family are aspects to consider while planning intervention programmes

Genetic associations at 53 loci highlight cell types and biological pathways relevant for kidney function.

Reduced glomerular filtration rate defines chronic kidney disease and is associated with cardiovascular and all-cause mortality. We conducted a meta-analysis of genome-wide association studies for estimated glomerular filtration rate (eGFR), combining data across 133,413 individuals with replication in up to 42,166 individuals. We identify 24 new and confirm 29 previously identified loci. Of these 53 loci, 19 associate with eGFR among individuals with diabetes. Using bioinformatics, we show that identified genes at eGFR loci are enriched for expression in kidney tissues and in pathways relevant for kidney development and transmembrane transporter activity, kidney structure, and regulation of glucose metabolism. Chromatin state mapping and DNase I hypersensitivity analyses across adult tissues demonstrate preferential mapping of associated variants to regulatory regions in kidney but not extra-renal tissues. These findings suggest that genetic determinants of eGFR are mediated largely through direct effects within the kidney and highlight important cell types and biological pathways

First time Taiwanese fathers' lived experiences during the third trimester of their wives' pregnancy, labour and delivery and the initial postnatal period : a phenomenological study

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

[[alternative]]台灣第一胎準父親於其配偶第三孕期時生活經驗之探討

[[abstract]]此篇文章是應用描述性研究的方法來探討十四位第一胎準父親的生活經驗。研究過程中，研究者於準父親的配偶懷孕第三孕期時，與每一位準父親進行一次無結構式的訪談，並應用Colaiaai 的方法來執行資料內容的分析。此外，研究者應用Lincoln和Cuba 的方法來檢定及確定本研究的嚴謹度。研究結果發現，在準父親的配偶第三孕期時，準父親有八種生活經驗，分別是：喜上眉梢、不確定感、調適、準備要當父親、與胎兒建立關係、關心胎兒的性別、對胎動的雀躍與人生視野的擴展。此研究結果可清楚了解準父親的實際之生活經驗與需求，因此對於護理臨床實務、護理教育與研究都具有重要的貢獻。如果護理與助產的工作目標是要提供高品質的服務，此份研究結果可驗證，護理人員所提供之服務就必須是真正符合婦女及其家人所需要的服務。也就是說在家庭的孕育過程中，護理人員為了要達成以家庭為中心的護理理念，不僅要滿足婦女的利益，也要考慮到婦女先生的需要及照護，這樣才能真正的提供高品質的服務。[[abstract]]This descriptive phenomenological study was designed to explore the life experiences of 14 Taiwanese first-time expectant fathers while their wives were in the third trimester of pregnancy. The authors used unstructured interviews to obtain the data from each participant. Data were analyzed by Colaizzi’s (1978) method as a qualitative content analysis. In addition, the researcher used the work of Lincoln and Guba (1985) to enhance the rigorousness of this study. The findings demonstrated that during the third trimester of their wives’ pregnancy eight key themes emerged among the first-time expectant fathers, as follows: (1) Jubilation; (2) Feelings of uuncertainty (3) Adjustment; (4) Preparation for fatherhood; (5) Engagement; (6) Gender concerns; (7) The wonder of fetal movement, and (8) Expanded vision. The findings from this study have an important contribution to make to an advancement of practice, education and research concerning first-time fathers’ needs and aspirations. In addition, the findings showed that there is a need to reaffirm the place of caring in nursing and midwifery if our goal is to provide a high quality service which meets the needs of the woman and her family. It is essential for nurses to champion the advancement of family-centred care which involves their partners in pregnancy