Development and evaluation of a self care program on breastfeeding in Japan: A quasi-experimental study

金沢大学医薬保健研究域保健学系Background: Although the importance of breastfeeding is well known in Japan, in recent years less than 50% of mothers were fully breastfeeding at one month after birth. The purpose of this study was to develop a self-care program for breastfeeding aimed at increasing mothers\u27 breastfeeding confidence and to evaluate its effectiveness.Methods: A quasi-experimental pretest-posttest design was conducted in Japan. The intervention, a breastfeeding self-care program, was created to improve mothers\u27 self-efficacy for breastfeeding. This Breastfeeding Self-Care Program included: information on the advantages and basics of breastfeeding, a breastfeeding checklist to evaluate breastfeeding by mothers and midwives, and a pamphlet and audiovisual materials on breastfeeding. Mothers received this program during their postpartum hospital stay.A convenience sample of 117 primiparous women was recruited at two clinical sites from October 2007 to March 2008. The intervention group (n = 55), who gave birth in three odd-numbered months, received standard care and the Breastfeeding Self-Care Program while the control group (n = 62) gave birth in three even numbered months and received standard breastfeeding care.To evaluate the effectiveness of the Breastfeeding Self-Care Program, breastfeeding self-efficacy and breastfeeding rate were measured early postpartum, before the intervention, and after the intervention at one month postpartum. The study used the Japanese version of The Breastfeeding Self-Efficacy Scale Short Form (BSES-SF) to measure self-efficacy.Results: The BSES-SF score of the intervention group rose significantly from 34.8 at early postpartum to 49.9 at one month after birth (p < 0.01). For the control group, the score rose from 39.5 at early postpartum to 46.5 at one month after birth (p = 0.03). The early postpartum fully breastfeeding rate was 90% for the intervention group and 89% for the control group. At one month postpartum, the fully breastfeeding rate declined significantly to 65% for the control group compared to 90% for the intervention group (p = 0.02).Conclusion: Results indicate that the Breastfeeding Self-Care Program increased mothers\u27 self-efficacy for breastfeeding and had a positive effect on the continuation of breastfeeding. © 2010 Awano and Shimada; licensee BioMed Central Ltd

多様なニーズを抱える母子への切れ目ない支援

産前産後の母子にとって切れ目ない支援とは何かを明らかにすることを目的に、多様な困 難を抱えながら切れ目ない支援を受け続けることを可能とするケースについて検討した。質 的記述的研究デザイン。研究参加者は、研究参加同意が得られた出産１回経験者で、産後の 育児や生活による様々な困難感から出産した医院の助産師を中心とした支援を継続して受け 続けている30 歳台女性。インタビューを行い、育児の困難感や生活上での出来事とその時 に支援を求めた場面ごとに、助産師支援に対する女性の気持ちに焦点を当てて、支援を受け ることそれを継続して受けることの認識や動機などを抽出した。対象者は、妊娠前から精神 疾患既往歴や家族関係の難しさなど様々な困難を抱えていが、助産師による育児の行動の「モ デリング」、母乳栄養や子どもの成長を「相談」することと「支援」を受けることへの効果や、 「寄り添い」を受け「アドボケイト」されたと感じたこと、「傾聴」、「受容的態度」などを経 験したことで、専門職への「信頼」を感じたことが、支援を継続的に受け続けることを選択 の契機となっていた。早期産褥期のかかわりによる関係性の持ち方、アンカー的な態度によ る支援の方法が切れ目ない支援を展開するために必要であることが明らかになった

Do Infertile Women and Government Staff Differ in the Evaluation of Infertility-related Web Sites?

Objective: To investigate the evaluation of local government Web sites carrying information on infertility by infertile women and by government staff. In particular, the study investigated whether the women and staff differed with respect to the information they rate as important and their self-reported satisfaction with the Web sites. Design and Sample: Cross-sectional descriptive study. Sixty-two local government staff members, of whom 46 were public health nurses managing subsidy programs for infertility treatment in the Hokuriku region of Japan, and 84 infertile women attending local clinics. Measures: We measured the level of satisfaction with the local government Web sites and perceptions about the importance of each type of content. Data were descriptively analyzed, as well as by factor analysis and multiple regression analysis. Results: Local government Web sites were analyzed with respect to information about the treatment, details of the subsidy program, psychological support, and procedures for making a subsidy application. Conclusions: The women rated information on the treatment and details of the subsidy programs as important. There was no difference of satisfaction with the Web sites between the infertile women and the staff. Local government staff need to provide reliable data for women who are seeking information on infertility treatment. © 2011 Wiley Periodicals, Inc

Alterações anatomopatológicas do estômago, intestino delgado, fígado e rins de ratos (Rattus norvergicus) intoxicados experimentalmente com Melia azeradach L. (Cinamomo)

Orientador: Italo MinardiCo-orientador: João Maria Ferraz DinizDissertação (mestrado) - Universidade Federal do Parana, Setor de Ciencias AgrariasForam avaliados os efeitos clínicos e alterações anatomopatológicas do estômago, intestino delgado, fígado e rins de ratos albinos (Rattus norvergicus) Wistar, machos e adultos, intoxicados experimentalmente com suspensões aquosas de folhas, frutos maduros e frutos verdes de Melia azedarach L. , popularmente conhecida como "cinamomo", colhidos na região de Curitiba. Foram realizados três (3) experimentos, um para cada uma das partes da planta, seguindo-se a mesma metodologia. As suspensões aquosas obtidas de frutos verdes e maduros previamente desidratados e moídos e de folhas verdes e frescas trituradas com água destilada foram administradas aos ratos por via oral, uma vez ao dia durante 30 dias consecutivos. Os fragmentos dos órgãos de todos os ratos foram fixados em solução de formol a 10% e depois processados conforme técnicas histológicas. Macroscopicamente os ratos que receberam suspensão aquosa de frutos verdes apresentaram lesões ulcerativas na mucosa gástrica, congestão hepática e leve congestão no intestino delgado e no estudo histopatológico foram observados gastroenterite ulcerativa com intensa reação inflamatória e hiperplasia epitelial em 4 animais e gastroenterite catarral em todos os tratamentos, aumentanto proporcionalmente para os animais que receberam a suspensão concentrada. Um dos ratos mostrou lesão carcinomatosa na mucosa gástrica. Nos fígados dos animais nos três (3) experimentos observou-se megalocitose, necrose de hepatócitos isolados e centrolobular, hemorragias focais, fibrose nos espaços Porta e hiperplasia ductal. A rede reticular do fígado estava desarranjada. O quadro renal é de nefrose. As lesões foram proporcionais à concentração da suspensão da planta, sendo mais evidentes nos animais que receberam a suspensão aquosa de frutos verdes. De acordo com os resultados obtidos no presente estudo a Melia azedarach L., pode ser considerada como uma planta tóxicaClinical effects and anatomicopathological alterations were evaluated in the stomach, small intestine, liver and kidneys of albino rats (Rattus norvergicus), male adults, which were intoxicated experimentally with water suspensions of leaves, mellow fruits and unripe fruits of Melia azedarach L. , popularly knowm as "cinamomo", picked in the city of Curitiba. One (1) experiment was done for each part of the plant, total of three (3), following the same method. The water suspensions were obtained from mellow and unripe fruit, previously dehydrated and ground, and from fresh green leaves ground together with distillate water. They were administered to rats, orally, once a day for 30 consecutives days. The fragments of organs of these animals were fixed in a 10% formol solution and then processed in accordance to histologic techniques. In a macroscopic examination, the rats which received the water suspension of unripe fruit presented ulcerative lesions in the gastric mucosa, hepatic congestion, an a light congestion in the small intestine and in the histopahologic study they presented an ulcerative gastroenteritis with intense inflammatory reaction and epithelial hyperplasia in four (4) animals. One of the rats showed a carcinogenic lesion in the gastric mucosa. In the animals' livers, in all three (3) experiments, megalocitosis, necrosis of isolated and centrilobular hepatocytes, focuses hemorrhages, fibrosis in the Porta's spaces and ductal hyperplasia were observed. The liver's reticular net was changed. The nepfric state was of nephrosis. The lesions were proportional to the concentration of the plant's suspension, being more evidente in the animals which received the water suspension of green fruit. In accordance to the results obtained in the present study, the Melia azedarach L., can be considered a toxic plan

Support for infertility treatment in Japan: Differences in perceptions between female clients and staff

金沢大学医薬保健研究域保健学系The aim of this study was to clarify the perceptions of both infertile women accessing support services from local governments related to infertility treatment and the public servants providing that assistance. This cross-sectional descriptive study surveyed 62 local government staff members who managed medical expense subsidy programs for infertility treatment in the Hokuriku region of Japan and 84 infertile women attending the clinics. We measured the levels of satisfaction regarding the support services from local governments and the perceptions of the importance of each type of support. The data were analyzed descriptively and included factor analysis and multiple regression analysis. Local governments\u27 support services were analyzed by using four factors: providing information, education and consultation, improving existing services, and improving access. Both the women and the staff endorsed the importance of information provision, the easing of restrictions on subsidies for infertility treatment, reconsideration of the application procedures, and improvement of the publicizing of the available subsidies. © 2009 Blackwell Publishing Asia Pty Ltd

母子保健コーディネーターに関する地方自治体ホームページでの公開の現状と課題

近年、切れ目ない母子保健支援の必要性とそれによる施策が活発化されている状況の中、 母子保健コーディネーターの設置が検討されている。本研究は、全国自治体における母子保 健コーディネーターの設置状況を知るために、自治体が公開するホームペ―ジの内容を分析 した。国内の全1741 自治体（790 市745 町183 村と23 特別区合わせて）を対象に、ホームペー ジ（以下HP）を検索し、公開されている母子保健コーディネーターに関する掲載内容から（1） 設置の有無と人数、（2）担当者の業種、（3）役割に関する内容を調査した。対象とした1741 自治体すべてHP を開設しており、そのすべてを調査対象とした。母子保健コーディネーター の設置をHP 上で公表していたのは48 自治体（2.8％）であった。配置されている母子保健コー ディネーターの業種は、保健師は14 自治体、助産師は6 自治体、保健師と助産師は4 自治 体で、担当について明記していないのは24 自治体であった。役割に関しては、「相談役」「切 れ目ない子育てを支援する」といったものが多く、具体的な活動内容を示しているものは見 られなかった。また、母子保健コーディネーターについてのアイコンを設けていた自治体は 見られず、会議録や事業計画書の中にのみ掲載され、「母子保健コーディネーター」と入力 しなければその存在や活動について知ることができないものも多数見られた。これより、母 子保健コーディネーターの設置は進んでおらず、設置されている自治体においても母子保健 コーディネーターへのアクセスが難しいため認知・活用されにくいことが示唆された

Support for infertility treatment in Japan: Differences in perceptions between female clients and staffn hs_493 80..86

Abstract The aim of this study was to clarify the perceptions of both infertile women accessing support services from local governments related to infertility treatment and the public servants providing that assistance. This cross-sectional descriptive study surveyed 62 local government staff members who managed medical expense subsidy programs for infertility treatment in the Hokuriku region of Japan and 84 infertile women attending the clinics. We measured the levels of satisfaction regarding the support services from local governments and the perceptions of the importance of each type of support. The data were analyzed descriptively and included factor analysis and multiple regression analysis. Local governments&apos; support services were analyzed by using four factors: providing information, education and consultation, improving existing services, and improving access. Both the women and the staff endorsed the importance of information provision, the easing of restrictions on subsidies for infertility treatment, reconsideration of the application procedures, and improvement of the publicizing of the available subsidies

Hyperhomocysteinemia induced by excessive methionine intake promotes rupture of cerebral aneurysms in ovariectomized rats.

BackgroundHyperhomocysteinemia (HHcy) is associated with inflammation and a rise in the expression of matrix metalloproteinase-9 (MMP-9) in the vascular wall. However, the role of HHcy in the growth and rupture of cerebral aneurysms remains unclear.MethodsThirteen-week-old female Sprague-Dawley rats were subject to bilateral ovariectomy and ligation of the right common carotid artery and fed an 8 % high-salt diet to induce cerebral aneurysms. Two weeks later, they underwent ligation of the bilateral posterior renal arteries. They were divided into two groups and methionine (MET) was or was not added to their drinking water. In another set of experiments, the role of folic acid (FA) against cerebral aneurysms was assessed.ResultsDuring a 12-week observation period, subarachnoid hemorrhage due to aneurysm rupture was observed at the anterior communicating artery (AcomA) or the posterior half of the circle of Willis. HHcy induced by excessive MET intake significantly increased the incidence of ruptured aneurysms at 6-8 weeks. At the AcomA of rats treated with MET, we observed the promotion of aneurysmal growth and infiltration by M1 macrophages. Furthermore, the mRNA level of MMP-9, the ratio of MMP-9 to the tissue inhibitor of metalloproteinase-2, and the level of interleukin-6 were higher in these rats. Treatment with FA abolished the effect of MET, suggesting that the inflammatory response and vascular degradation at the AcomA is attributable to HHcy due to excessive MET intake.ConclusionsWe first demonstrate that in hypertensive ovariectomized rats, HHcy induced by excessive MET intake may be associated with the propensity of the aneurysm wall to rupture