Length of maternity leave and health of mother and child - a review

Summary: Objectives:: Assessment of the literature on the length of maternity leaves and health of mothers and children; evaluation of the Swiss situation in view of the maternity leave policy implemented in 2005. Methods:: Review of thirteen original studies identified by PubMed using topic-related terms. Results:: A positive association was shown between the length of maternity leave and mother's mental health and duration of breastfeeding. Extended maternity leaves were also associated with lower perinatal, neonatal and post-neonatal mortality rates as well as lower child mortality; however, results are obtained in ecological studies. There is less evidence regarding other health outcomes. The new policy in Switzerland extends maternity leave for a considerable number of women to 14 weeks. With this prolongation, fewer depressive symptoms and longer breastfeeding duration can be expected, while benefits regarding other health outcomes would warrant longer leaves. Conclusions:: Longer maternity leaves are likely to produce health benefits. The new policy in Switzerland will probably improve the situation of those women, who previously were granted only minimal leave and/or mothers with additional social risk factor

Crying babies, tired mothers - challenges of the postnatal hospital stay: an interpretive phenomenological study

ABSTRACT: BACKGROUND: According to an old Swiss proverb, 'a new mother lazing in childbed is a blessing to her family'. Today mothers rarely enjoy restful days after birth, but enter directly into the challenge of combining baby- and self-care. They often face a combination of infant crying and personal tiredness. Yet, routine postnatal care often lacks effective strategies to alleviate these challenges which can adversely affect family health. We explored how new mothers experience and handle postnatal infant crying and their own tiredness in the context of changing hospital care practices in Switzerland. METHODS: Purposeful sampling was used to enroll 15 mothers of diverse parity and educational backgrounds, all of who had given birth to a full term healthy neonate. Using interpretive phenomenology, we analyzed interview and participant observation data collected during the postnatal hospital stay and at 6 and 12 weeks post birth. This paper reports on the postnatal hospital experience. RESULTS: Women's personal beliefs about beneficial childcare practices shaped how they cared for their newborn's and their own needs during the early postnatal period in the hospital. These beliefs ranged from an infant-centered approach focused on the infant's development of a basic sense of trust to an approach that balanced the infants' demands with the mother's personal needs. Getting adequate rest was particularly difficult for mothers striving to provide infant-centered care for an unsettled neonate. These mothers suffered from sleep deprivation and severe tiredness unless they were able to leave the baby with health professionals for several hours during the night. CONCLUSION: New mothers often need permission to attend to their own needs, as well as practical support with childcare to recover from birth especially when neonates are fussy. To strengthen family health from the earliest stage, postnatal care should establish conditions which enable new mothers to balanc the care of their infant with their own need

Female gender is associated with dental care and dental hygiene, but not with complete dentition in the Swiss adult population

Aim: Little is known about the impact of gender on oral health, besides the influence of reproductive factors on female dentition. The aim of this study was to analyse gender differences with regard to oral health and oral health behaviour in the Swiss adult population, using data from the Swiss Health Survey of 2002. Subjects and methods: The Swiss Health Survey regularly collects detailed information on health and health determinants of a random sample of the Swiss population aged 15years and older. A written questionnaire including items on oral health was filled in by 7,115 men and 9,026 women in 2002. Weighted prevalence rates were calculated, and multivariate logistic regression analyses used to evaluate the role of gender for complete and functional dentition and for oral health behaviour. Finally, the multivariate model was stratified for men and women and run for the outcome "complete dentition”. Results: Women had a higher prevalence of visits to the dentist in the last 12 months (64% versus 60% men), of visits to dental hygienists (39% versus 34%), and of frequent tooth brushing (several times a day) (82% versus 66%). Adjusting for preventive behaviour, socio-demographic and socio-economic variables in multivariate analyses, female gender was positively associated with the prevalence of visits to the dentist (OR 1.33, 95% CI 1.24-1.43) and of frequent tooth brushing several times a day (OR 2.57, 95% CI 2.36-2.79), but not with complete dentition (OR 1.01, 95% CI 0.93-1.09). In the stratified analysis, associations of complete dentition with socio-economic status, oral hygiene and preventive behaviour were stronger in men than in women. Conclusion: Gender plays an important role in oral health. Adult women report a more pronounced preventive oral health behaviour than men; their dentition, however, is not more often complete. Mechanisms involved in women's oral health are probably more complex than those underlying men's oral health. An in-depth gender analysis is needed to shed more light upon this issu

Aging Images as a Motivational Trigger for Smoking Cessation in Young Women

Recruiting adolescents into smoking cessation programs has been challenging, and there is a lack of effective smoking cessation interventions for this age group. We aimed to assess whether the approach of using aging images can be used to recruit young, female smokers for a smoking cessation course. In this study, 853 14- to 18-year-old subjects were photographed (2006–2007). After software-aided aging, the images evoked strong emotions, especially in subjects with an advanced motivational stage to quit. Twenty-four percent of current smokers reported that the aging images increased their motivation to quit smoking (pre-contemplation: 8%; contemplation: 32%; and preparation: 71%). In multivariate analyses, the aged images had a high motivational impact to quit smoking that was associated with an increased readiness to stop smoking and the individual’s assessment of the aging images as shocking, but not with the number of previous attempts to quit and the assessment of the pictures as realistic. However, it was not possible to recruit the study population for a smoking cessation course. We concluded that aging images are a promising intervention for reaching young women and increasing their motivation to stop smoking. However, smoking cessation courses may not be appropriate for this age group: none of the recruits agreed to take a cessation course

Evaluation der Wirksamkeit des Gleichstellungsgesetzes: Synthesebericht

"Der vorliegende Synthesebericht ist eine zusammenfassende Darstellung der Resultate der im Rahmen der Evaluation der Wirksamkeit des Gleichstellungsgesetzes (GlG) im Auftrag des Bundesamtes für Justiz realisierten Erhebungen und Analysen. Der Evaluationsauftrag geht auf eine Motion von NR Vreni Hubmann (02.3142) zurück, welche verlangte, dass Rachekündigungen in privatrechtlichen Arbeitsverhältnissen nichtig statt anfechtbar sein sollen und die Dauer des Kündigungsschutzes angemessen zu verlängern sei. Da das Thema der Rachekündigung nicht für sich allein untersucht werden kann, wurde die Evaluation ausgedehnt auf die Frage, inwiefern das GlG seinem Anspruch gerecht wird. Mögliche Schwachstellen sollen aufgezeigt und ein allfälliger Reformbedarf ermittelt werden. Die Evaluationsarbeiten begannen im Dezember 2003 und wurden im April 2005 abgeschlossen. Der Synthesebericht präsentiert die Gesamtanlage der Evaluation, fasst die Teilberichte zu den einzelnen Erhebungen bzw. Analysen zusammen und präsentiert anschliessend die wichtigsten Ergebnisse zu den einzelnen Fragestellungen der Evaluation. Am Ende stehen die Schlussfolgerungen aus den Resultaten." (Autorenreferat

Relationship between gender role, anger expression, thermal discomfort and sleep onset latency in women

ABSTRACT: BACKGROUND: Women with thermal discomfort from cold extremities (hands and feet; TDCE) often suffer from prolonged sleep onset latency (SOL). Suppressed anger could contribute to the genesis of both TDCE and prolonged SOL. The aim of the study was to test the hypothesis whether stereotypic feminine gender socialization (SFGS) is related to anger suppression (experienced anger inwards, Anger-In), which in turn could affect TDCE and SOL. METHODS: 148 women, a sub-sample of a larger survey carried out in the Canton Basel-Stadt (Switzerland), sent back detailed postal questionnaires about SOL, TDCE, anger expression (STAXI, state -trait -anger -expression -inventory) and SFGS using a gender power inventory, estimating the degree of gender specific power expression explicitly within women by stereotypic feminine or male attribution. Statistics was performed by path analysis. RESULTS: A significant direct path was found from stereotypic feminine attribution to Anger-In and prolonged SOL. Additionally, a further indirect path from Anger-In via TDCE to SOL was found. In contrast, stereotypic male attribution was not related to Anger-In but was significantly associated with outwardly expressed anger. LIMITATIONS: Self-reported data, retrospective cross-sectional survey, prospective studies are required including physiological measurements. CONCLUSION: Stereotypic feminine gender socialization may play an important determinant for anger suppression, which subsequently can lead to thermal discomfort from cold extremities and prolonged sleep onset latency

Bedside Measurement of Volatile Organic Compounds in the Atmosphere of Neonatal Incubators Using Ion Mobility Spectrometry

Background: Early and non-invasive diagnosis of common diseases is of great importance in the care of preterm infants. We hypothesized that volatile organic compounds (VOC) can be successfully measured in the neonatal incubator atmosphere. Methods: This is a feasibility study to investigate whether the discrimination of occupied and unoccupied neonatal incubators is possible by bedside measurement of volatile organic compounds (VOCs) on the neonatal intensive care unit. VOC profiles were measured in the incubator air using ion mobility spectrometry coupled to multi-capillary columns (BreathDiscovery B&S Analytik GmbH, Dortmund, Germany). Results: Seventeen incubators occupied by preterm infants (50 measurements) and nine unoccupied neonatal incubators were sampled, using 37 room air measurements as controls. Three VOC signals that allow the discrimination between occupied and unoccupied incubators were identified. The best discrimination was reached by peak P20 exhibiting a sensitivity, specificity, positive predictive value and negative predictive value of 94.0, 88.9, 97.3, and 72.3%, respectively. Use of a decision tree improved these values to 100.0, 88.9, 98.0, and 100.0%, respectively. Discussion: A bedside method that allows the characterization of VOC profiles in the neonatal incubator atmosphere using ion mobility spectrometry was established. Occupied and unoccupied incubators could be discriminated by characterizing VOC profiles. This technique has the potential to yield results within minutes. Thus, future studies are recommended to test the hypothesis that VOCs within neonatal incubators are useful biomarkers for non-invasive diagnostics in preterm neonates

Patterns of volatile organic compounds in excrements of preterm neonates

Background: As neonates are susceptible for many diseases, establishing noninvasive diagnostic methods is desirable. We hypothesized that volatile organic compounds (VOCs) could be successfully measured in diaper samples. Methods: We performed a feasibility study to investigate whether ambient airindependent headspace measurements of the VOC profiles of diapers from premature infants can be conducted using ion mobility spectrometer coupled with multi-capillary columns (B & S Analytik GmbH). Results: We analysed 39 diapers filled with stool (n = 10) or urine (n = 20) respectively, using empty diapers as a control (n = 9). A total of 158 different VOCs were identified, and we classified the content of the diapers (urine or stool) according to their VOC profiles with a significance level of p<0.05. Conclusions: We have developed a novel method to study headspace VOC profiles of biosamples using ion mobility spectrometry coupled with multi-capillary columns. Using this method, we have characterized the VOC profiles of stool and urine of preterm neonates. Future studies are warranted to characterize specific VOC profiles in infections and other diseases of the preterm neonate, thus establishing quick and noninvasive diagnostics in the routine care of the highly vulnerable preterm and term neonates

Attenuated asthma phenotype in mice with a fetal-like antigen receptor repertoire

We hypothesized that the scarcity of N-nucleotides might contribute to the inability of the neonate to mount a robust allergic immune response. To test this, we used terminal deoxyribunucleotidyl Transferase defcient (TdT−/−) mice, which express “fetal-like” T cell receptor and immunoglobulin repertoires with largely germline-encoded CDR3 regions. Intraperitoneal sensitization was followed by aerosol provocation with either PBS or the allergen OVA in both TdT−/− mice and wild-type mice to develop allergic respiratory infammation. The efects of this procedure were investigated by lung function test, immunological analysis of serum and brochoalveolar lavage. The local TH2 cytokine milieu was signifcantly attenuated in TdT−/− mice. Within this group, the induction of total IgE levels was also signifcantly reduced after sensitization. TdT−/− mice showed a tendency toward reduced eosinophilic infow into the bronchial tubes, which was associated with the elimination of respiratory hyperreactivity. In conclusion, in a murine model of allergic airway infammation, the expression of fetal-like antigen receptors was associated with potent indications of a reduced ability to mount an asthma phenotype. This underlines the importance of somatically-generated antigen-receptor repertoire diversity in type one allergic immune responses and suggests that the fetus may be protected from allergic responses, at least in part, by controlling N addition

Prevalence of renal impairment and its association with cardiovascular risk factors in a general population: results of the Swiss SAPALDIA study

Background. Impaired renal function is evolving as an independent marker of the risk of cardiovascular morbidity and mortality. Little is known about the prevalence of impaired renal function and its relationship to cardiovascular risk factors in the Swiss general population. Methods. SAPALDIA comprises a random sample of the Swiss population established in 1991, originally to investigate the health effects of long-term exposure to air pollution. Participants were reassessed in 2002/3 and blood measurements were obtained (n = 6317). Renal function was estimated using the Cockcroft-Gault equation and the modified MDRD (four-component) equation incorporating age, race, gender and serum creatinine level. Results. The estimated prevalence of impaired renal function [estimated glomerular filtration rate <60 ml/min/1.73 m2] differed substantially between men and women, particularly at higher ages, and amounted to 13% [95% confidence interval (CI) 10-16%] and 36% (95% CI 32-40%) in men and women, respectively, of 65 years or older. Smoking, obesity, blood lipid levels, high systolic blood pressure and hyperuricaemia were all more common in men when compared with women. These cardiovascular risk factors were also associated independently with creatinine in both women and men. Women were less likely to receive cardiovascular drugs, in particular angiotensin-converting enzyme inhibitors and β-blockers, when compared with men of the same age. Conclusion. Moderate renal impairment seems to be prevalent in the general population, with an apparent excess in females which is not explained by conventional cardiovascular risk factors. The unexpected finding questions the validity of the prediction equations, in particular in female