An Integrative Review of Fear of Childbirth

This study aimed to provide knowledge for midwives to deepen their understanding of their clients when working closely with women during the perinatal period through an integrative review of ‘fear of childbirth’, and to clarify the research topics to be addressed in the future. Methods: This study used an integrative review (IR) method in addition to bibliometric analysis methods to classify and analyse the studies. Review questions (RQ) included 1. ‘what is the status of research efforts (number of papers, location, etc.) on “fear of childbirth”?’, 2. ‘what are the screening methods and prevalence of “fear of childbirth”?’, and 3. ‘what can be learned from the findings of these studies?’ Findings: RQ1: The number of papers published gradually increased after 1981 and has been increasing since 2000. Studies conducted in Scandinavia accounted for more than half of the total studies. Conversely, only five studies were conducted in Japan. RQ2: The Wijma Delivery Experience Questionnaire is a screening scale for fear of childbirth developed in Sweden, which has been translated and utilised in multiple languages. In meta-analyses worldwide, the prevalence of fear of childbirth has been reported to range from 3.7% to 43%. RQ3: Fear of childbirth leaves a negative impression of past childbirth experiences on women’s psychological well-being and subsequently leads to post-traumatic stress disorder. Intervention studies have shown that prenatal education can help couples overcome their fear of childbirth. However, the effectiveness of intervention studies that have examined these psychological aspects has not yet been clarified. Conclusion: The prevalence of fear of childbirth varies considerably, possibly owing to cultural differences. Research on fear of childbirth has reported negative effects on the postpartum period and on subsequent pregnancy and childbirth. Practising women-centred care may help prevent this fear

Enzymes and inhibitors in airway that regulate infection of influenza virus

It has been proposed that the pathogenicity of the influenza and Sendai virus is primarily determined by host cellular proteases that activate viral infectivity. We isolated trypsin-type serin proteases from rat lungs, candidates for the processing proteases of viral envelope glycoproteins, such as tryptase Clara localized in the Clara cells of the bronchial epithelium and mini-plasmin. These enzymes specifically cleave the precursor of fusion glycoprotein HA of influenza virus at Arg325, and the Fo of Sendai virus at Arg116 in the consensus cleavage motif, Gln(Glu)-X-Arg, resulting in the induction of infectivity of these viruses. Proteolytic activation of viruses by these enzymes occurs extracellularly, probably on the surface and/or in the lumen of the respiratory tract. On the other hand, we isolated two compounds from human bronchial lavage, which inhibitor the activity of tryptase Clara. One was a mucus protease inhibitor and the other was a pulmonary surfactant. These compounds inhibited multiple cycles of virus replication in vitro and in vivo, but did not themselves affect the hemagglutination and the infectivity of the virus. Administration of these compounds in the airway may be useful for preventing and treating infection with influenza virus and Sendai virus

Novel SPEF2 Variant in a Japanese Patient with Primary Ciliary Dyskinesia: A Case Report and Literature Review

Primary ciliary dyskinesia (PCD) is a genetic and congenital disease associated with an abnormal ciliary ultrastructure and function and is estimated to affect 1 in 15,000–20,000 individuals. A PCD diagnosis can be achieved by genotyping. Here, we performed whole-exome analysis for the diagnosis of PCD and described the detailed clinical characteristics of the case. A 39-year-old Japanese woman with sinusitis and bronchiectasis without situs inversus had had upper and lower respiratory symptoms since childhood and had received long-term macrolide therapy without an accurate diagnosis. A moderate deterioration of cilia function was observed by high-speed video microscopy analysis; additionally, the number of cells with moving cilia was fewer than that in patients without PCD. Electron microscopy revealed no apparent structural abnormalities. We performedwhole-exome analysis and identified novel biallelic variants of SPEF2 in the homozygous state (c.1860_1861insCT).We confirmed the absence of SPEF2 protein expression in the cilia of the nasal mucosa using fluorescent immunostaining. Accordingly, she was diagnosed as having PCD with the SPEF2 variant. The present case suggests that the deterioration of cilia function is moderate, the number of respiratory cells with moving cilia might be reduced, and the respiratory condition could be severe in patients with PCD with the SPEF2 variant

Early aggressive intervention for infantile atopic dermatitis to prevent development of food allergy : a multicenter, investigator‑blinded, randomized, parallel group controlled trial (PACI Study) : protocol for a randomized controlled trial

Background: Atopic dermatitis is the first clinical manifestation of the atopic march, with the highest incidence in the first year of life. Those affected often go on to develop other allergic diseases including food allergy, asthma, and allergic rhinitis. Recent evidence suggests that sensitization to foods may occur through a defective skin barrier which is common in atopic dermatitis in early life. We hypothesize that therapeutic aggressive intervention to treat new onset atopic dermatitis may prevent the development of later allergen sensitization, and associated food allergy, asthma, and allergic rhinitis. Methods: This study is a multi-center, pragmatic, two-parallel group, assessor-blind, superiority, individually randomized controlled trial. Atopic dermatitis infants (N = 650) 7–13 weeks old who develop an itchy rash within the previous 28 days are randomly assigned to the aggressive treatment or the conventional treatment in a 1:1 ratio. The primary outcome is oral food challenge-proven IgE-mediated hen’s egg allergy at the age of 28 weeks. Discussion: This is a novel pragmatic RCT study to examine the efficacy of early aggressive treatment for atopic dermatitis to prevent later food allergy. If our hypothesis is correct, we hope that such a strategy might impact on disease prevention in countries where food allergy is common, and that our results might reduce the frequency and associated costs of all food allergies as well as hens egg food allergy. Long-term follow and other similar studies will help to determine whether such a strategy will reduce the burden of other allergic diseases such as asthma and allergic rhinitis

Correlation between Child Behavior and Depression in Mother with Autism Spectrum Disorders Child

Background: The behavioural characteris­tics of an autistic child can lead to challenging relationships with the mother. For mothers who serve as the key person in the care of their children with ASD, maintaining good mental health, which may be directly related to the growth and development of their children, is an important issue for professionals engaged in parenting support. The aim of this study was to determine the interaction between the behavioural problems of children with ASD (from toddlers to adolescents) and their mothers’ depression.Subjects and Method: This was a cross-sectional study carried out in Yamaguchi Prefecture, Japan. The recruitment of subjects was through a paediatric out-patient unit. Eighty-six mothers with ASD participated in this observational study. The Center for Epidemiological Studies-Depression (CES-D) scalewas used as a measure of depression in mothers, and the Child Behaviour Checklist (CBCL) was used as an assessment of the children’s behavioral characteristics. The prevalence of depression among mothers of children with ASD was estimated and related factors were also examined.Results: There were 66 boys (76.7%), 12 girls (14.0%) and 8 (9.3%) non-responders. Comparing the pre- adolescent and adolescent groups, there were significant differences in the ages of mothers and children (P <0.001). In this study, the prevalence rate of depression in mothers of children with ASD was 47.7% (95% CI= 36.8 to 58.7), and the prevalence rate of depression in mothers of adolescent children group was 48.6% (95% CI= 31.4 to 6.0). The predictive factors of maternal depression were others’ problems (toileting problems, and masturbation) in CBCL and children’s age group.Conclusion: These children’s behavioural characteristics were recognised as serious problems by their mothers, which in turn can negatively affect their mental health, particularly the depression of mothers in the adolescent group was probably due to concerns about their children’s unsocial behaviour.Keywords: Mental health, behavioural problems, pre-adolescent, adolescentCorrespondence: Kumiko Kido, Department of Nursing, Faculty of Health Sciences, Kagawa Prefectural Univer­sity of Health Sciences, Murechohara 281-1 Taka­matsu, Kagawa, Japan. Email: kkumiko0­[email protected]. Mobile:+819013360452Journal of Maternal and Child Health (2021), 06(04): 475-485https://doi.org/10.26911/thejmch.2021.06.04.0

Tender Loving Care: A Conceptual Analysis

Background: Studies have shown that combining tender loving care (TLC) with the treatment of patients with recurrent miscarriages can improve pregnancy outcomes. The importance of TLC has long been recognised in studies on psychiatric, gerontological, and end-of-life nursing in Western countries. Recently, randomised controlled trials (RCTs) have been used to examine the improvement in outcomes with the addition of TLC to the treatment of patients with recurrent miscarriages; however, no conclusions have been reached. TLC is a highly beneficial and harmless intervention that is not necessary for conducting RCTs. Therefore, healthcare professionals need to be aware of exercising TLC when treating patients with recurrent miscarriages. However, the concept of TLC is ambiguous and its definition is unclear. Purpose: This study aimed to conduct a conceptual analysis of TLC and clarify its constructs. Clarifying the definition of TLC will provide professionals with basic information that will be helpful when exercising TLC with patients who experienced repeated miscarriages despite of hopes of having a baby. Methods: This study was conducted using Walker and Avant’s concept analysis approach. Research published between the first edition of the journal till January 2022 were searched, and the titles and abstracts of the studies were reviewed to determine their suitability. Consequently, 28 articles, all of which were in English, were selected for conceptual analysis. The were CINAHL Plus with Full Text and MEDLINE databases were examined. The search term used was ‘tender loving care’. Results: The results of the conceptual analysis of TLC revealed the following antecedents, defining attributes, and consequences. The antecedents involve patients with the following diseases or disabilities: (1) suffering from mental or physical distress, (2) facing significant barriers in life (illness, disability, etc.), and (3) being unable to manage their mental health and well-being through self-care. Conclusion: In this study, a conceptual analysis of TLC was conducted using Walker and Avant's (2000) method. As a result of the conceptual analysis, ‘tender loving care’ was defined as ‘the care for mentally or physically distressed or impaired subjects by health professionals, parents, and teachers based on compassion and empathy, who perceive the condition of the subject and respond appropriately, thereby reducing tension, distress, and anxiety and achieving a state of mental and physical well-being’

Menstruation, Hygiene Practice and Menstrual Distress in Female Undergraduate Students

Background: Currently, there is no up-to-date survey on actual menstruation, including recent changes in the amount of menstrual blood loss in women as the age of the first menstruation decreases in Japan. Also, few study has examined whether temperature in clothing reflecting with basal body temperature and other factors are related to menstruation-associated symptoms. Purpose: The study aimed to determine the actual menstruation, the change in the number of sanitary napkins and menstrual distress during one menstrual cycle, and the predictive factors of menstrual distress. Methods: The samples were eight university students over the age of 20. This study was conducted from the end of June to the end of September 2020. They were asked to undertake the following: menstrual cycle, length of menstruation; the amount of menstrual blood loss; changing sanitary napkins; the Japanese version of the Menstrual Distress Questionnaire (J-MDQ). The J-MDQ consists of 47 questions answered on a scale of 0 to 3, with a higher score indicating more severe menstruation-related symptoms, within a week before, during and a week after menstruation. Multiple liner regression and Friedman test were conducted as statistical analysis. Results: The volume of menstrual blood loss increased drastically on the second day of the menstruation, and rapidly decreased from the third day. Napkin changing was also most frequent on the second day, however there is no correlation between the volume of menstrual blood and the number of times changing sanitary napkins after the second day of menstruation. The total J-MDQ during menstruation was significantly higher than pre and after menstruation (P<0.05). The duration of blood flow were associated with J-MDQ. Conclusions: Appropriate changing sanitary napkins needs to be recommended to improve for vulvar hygiene. The menstrual distress was highest during menstruation