Applicability of care quality indicators for women with low-risk pregnancies planning hospital birth: a retrospective study of medical records

Practices for planned birth among women with low-risk pregnancies vary by birth setting, medical professional, and organizational system. Appropriate monitoring is essential for quality improvement. Although sets of quality indicators have been developed, their applicability has not been tested. To improve the quality of childbirth care for low-risk mothers and infants in Japanese hospitals, we developed 35 quality indicators using existing clinical guidelines and quality indicators. We retrospectively analysed data for 347 women in Japan diagnosed with low-risk pregnancy in the second trimester, admitted between April 2015 and March 2016. We obtained scores for 35 quality indicators and evaluated their applicability, i.e., feasibility, improvement potential, and reliability (intra- and inter-rater reliability: kappa score, positive and negative agreement). The range of adherence to each indicator was 0–95.7%. We identified feasibility concerns for six indicators with over 25% missing data. Two indicators with over 90% adherence showed limited potential for improvement. Three indicators had poor kappa scores for intra-rater reliability, with positive/negative agreement scores 0.94/0.33, 0.33/0.95, and 0.00/0.97, respectively. Two indicators had poor kappa scores for inter-rater reliability, with positive/negative agreement scores 0.25/0.92 and 0.68/0.61, respectively. The findings indicated that these 35 care quality indicators for low-risk pregnant women may be applicable to real-world practice, with some caveats

A case of tetanus treated with Kampo medicines such as Kakkonto and Shakuyakukanzoto

CaseA 74-year-old man developed tetanus 3 days after working with cow and poultry manure. Kakkonto and shakuyakukanzoto, traditional Japanese herbal medicines that are effective for the relief of pain primarily related to muscle contraction, were given to control the trismus and painful contracture of the neck. Generalized convulsions were controlled without the use of muscle relaxants.OutcomeAfter 30 days, the patient was discharged from the hospital without any sequelae.ConclusionKakkonto and shakuyakukanzoto may be useful for the control of muscle spasms resulting from generalized tetanus

Comparison of quality of human serum albumin preparations in two pharmaceutical products

AimHuman serum albumin (HSA) is known for its multiple functions, such as maintenance of colloid osmotic pressure, transport of endogenous and exogenous substances, and antioxidation. The aim of this study was to measure the redox state and concentrations of β-d-glucan and endotoxin to compare the quality of 5% HSA preparations from two different manufacturers.MethodsThe quality of 5% HSA preparations in two different pharmaceutical products (groups A and B) was compared in terms of the percentage of reduced and oxidized albumin and the contaminant level of β-d-glucan and endotoxin.ResultsThe percentage of human mercaptoalbumin in group A was significantly higher than that in group B (P < 0.01), whereas that of human non-mercaptoalbumin-2 in group A was significantly lower (P < 0.01). The concentration of β-d-glucan in group A was significantly lower than in group B (P < 0.01).ConclusionsThe present findings indicate the need for quality control of HSA preparations in applications involving the use of large volumes

EFFECTS OF AROMATHERAPY FOR SELF-CARE DURING PREGNANCY

Stress reduction care is important for pregnant women to decrease obstetric complications and children's health problems after birth. We investigated the long-term effects during pregnancy of daily self-care with aromatherapy using essential oils containing linalyl acetate and linalool. We randomly assigned 16 healthy pregnant women into an aromatherapy group and a control group. Nine participants were assigned to the aromatherapy group and seven participants to the control group. Intervention was started at 28 weeks of pregnancy and the results were assessed at 32 and 36 weeks of pregnancy as well as during childbirth. We conducted a comprehensive assessment using State-Trait Anxiety Inventory (STAI) and Visual Analogue Scale (VAS) as subjective questionnaire surveys and autonomic nervoqs activity from heart-rate variability as objective physiological indicators as well as the results of childbirth. The STAI traits showed significant aromatherapy effects (p＜0.05) for reducing anxiety. Moreover, a dose- response relationship was observed which demonstrated a significant difference (p＜0.016) within the aromatherapy group for the relaxing effects by VAS. This study revealed that it is effective to reconrmend self-care using aromatherapy with essential oils containing linalyl acetate and linalool for the purpose of reducing anxiety and providing relaxation over the long term during pregnancy. However, it is necessary to conduct further studies with an increased number of participants to investigate the effects on the autonomic nervous system and the effects on childbirth

Comparative data on emotional (psychotic) aggressive biting behavior in mice of ddY strain measured by using two devices; Aggressive response meter and powerlab-compatible type aggressive response meter

The Aggressive Response Meter (ARM) has been validated for measuring emotional (psychotic) aggression triggered by mental irritation in mice. In the present article, we newly developed a device, pARM (PowerLab-compatible type ARM). We collected on the aggressive biting behavior (ABB) intensity and ABB frequency of 20 male and female mice of ddY strain studied over a period of 6 days by using pARM and the former ARM. We calculated Pearson's correlation between the values of pARM and those of ARM. The accumulated data can be referred as a basis for demonstrating the consistence of pARM and the former ARM, and used in future research to augment the understanding of stress-induced emotional aggression in mice

Efficient isolation of Swine influenza viruses by age-targeted specimen collection

The control of swine influenza virus (SIV) infection is paramount for increasing the productivity of pig farming and minimizing the threat of pandemic outbreaks. Thus, SIV surveillance should be conducted by region and on a regular basis. Here, we established a microneutralization assay specific for SIV seroprevalence surveillance by using reporter gene-expressing recombinant influenza viruses. Growth-based SIV seroprevalence revealed that most sows and piglets were positive for neutralizing antibodies against influenza viruses. In contrast, the 90-day-old growing pigs exhibited limited neutralizing activity in their sera, suggesting that this particular age of population is most susceptible to SIV infection and thus is an ideal age group for SIV isolation. From nasal swab specimens of healthy pigs in this age population, we were able to isolate SIVs at a higher incidence (5.3%) than those of previous reports. Nucleotide sequencing and phylogenetic analysis of the hemagglutinin (HA) genes revealed that the isolated SIVs have circulated and evolved in pigs but not have been recently introduced from humans, implying that a large number of SIV lineages may remain “undiscovered” in the global porcine populations. We propose that the 90-day-old growing pig-targeted nasal swab collection presented in this study facilitates global SIV surveillance and contributes to the detection and control of SIV infection