Initiation of breastfeeding within 120 minutes after birth is associated with breastfeeding at four months among Japanese women: A self-administered questionnaire survey

<p>Abstract</p> <p>Background</p> <p>The proportion of mothers in Japan who breastfeed exclusively has been low since the 1970s. The purpose of this study was to examine the association between the time of first breastfeed after birth and the proportion of mothers fully breastfeeding up to four months postpartum.</p> <p>Methods</p> <p>A survey was conducted using a self-administered questionnaire. The participants were 318 mothers who participated in a physical examination of their four month old infants in Nagasaki City, Japan in 2003.</p> <p>Results</p> <p>The time of first breastfeeding up to 120 minutes was significantly associated with the proportion of mothers fully breastfeeding during their stay in the clinic/hospital (p = 0.006), at one month (p = 0.004) and at four months after birth (p = 0.003). There was no significant difference in the proportion of full breastfeeding in mothers who first breastfed between the period of less 30 minutes after birth and that of between 31 and 120 minutes after birth. Logistic regression analysis indicated that the proportion of mothers who continued full breastfeeding at four months was significantly higher in those who breastfed their baby within 120 minutes compared with more than 120 minutes (OR 2.5, p = 0.01), but was not significantly different in those who breastfed within 30 minutes compared with more than 30 minutes (OR 1.8, p = 0.06). Early breastfeeding was affected by caesarean section, premature delivery and severe bleeding during delivery.</p> <p>Conclusion</p> <p>Commencement of early breastfeeding was associated with the proportion of mothers who fully breastfed their infants up to four months. Early breastfeeding, especially within two hours, is recommended for child and maternal health.</p

The thyroid function of Graves' disease patients is aggravated by depressive personality during antithyroid drug treatment

<p>Abstract</p> <p>Background</p> <p>We previously reported that depressive personality (the scores of hypochondriasis, depression and psychasthenia determined by the Minnesota Multiphasic Personality Inventory (MMPI)) and daily hassles of Graves' disease (GD) patients treated long trem with antithyroid drug (ATD) were significantly higher in a relapsed group than in a remitted group, even in the euthyroid state. The present study aims to examine the relationship among depressive personality, emotional stresses, thyroid function and the prognosis of hyperthyroidism in newly diagnosed GD patients.</p> <p>Methods</p> <p>Sixty-four untreated GD patients responded to the MMPI for personality traits, the Natsume's Stress Inventory for major life events, and the Hayashi's Daily Life Stress Inventory for daily life stresses before and during ATD treatment.</p> <p>Results</p> <p>In the untreated thyrotoxic state, depressive personality (T-scores of hypochondriasis, depression or psychasthenia greater than 60 points in MMPI) were found for 44 patients (69%). For 15 (23%) of these patients, the scores decreased to the normal range after treatment. However, depressive personality persisted after treatment in the remaining 29 patients (46%). Normal scores before treatment were found for 20 patients (31%), and the scores were persistently normal for 15 patients (23%). The remaining 5 patients (8%) had higher depressive personality after treatment. Such depressive personality was not associated with the severity of hyperthyroidism. Serum TSH receptor antibody activity at three years after treatment was significantly (p = 0.0351) greater in the depression group than in the non- depression group. The remission rate at four years after treatment was significantly (p = 0.0305) lower in the depression group than in the non- depression group (22% vs 52%).</p> <p>Conclusion</p> <p>The data indicate that in GD patients treated with ATD, depressive personality during treatment reflects the effect of emotional stress more than that of thyrotoxicosis and that it aggravates hyperthyroidism. Psychosomatic therapeutic approaches including antipsychiatric drugs and/or psychotherapy appears to be useful for improving the prognosis of hyperthyroidism.</p

Why is there no carbonic anhydrase activity available to fish plasma?

Carbonic anhydrase (CA) is absent from the plasma of vertebrates. In vitro, CA in fish plasma will short-circuit the effect of catecholamines, which is to increase red blood cell (RBC) pH and volume, both of which enhance the affinity of hemoglobin for O2. CA was infused into trout for a period of 6 h and injected after 48 h, during which the animal was submitted to deep hypoxia (PO2=30&shy;35 mmHg; 4.0&shy;4.7 kPa). O2 content, lactate content, catecholamine levels, hematocrit, hemoglobin concentration and pHi were similar to those in the saline-infused control group. In contrast, cell volume was significantly higher and pHe, total CO2 content and organic phosphate levels were significantly lower than in the control group. The concentration of CA was not high enough completely to short-circuit the increase in pHi and red blood cell volume caused by catecholamines. The lower pHe in the CA-infused animals could enhance the activity of the Na+/H+ pump, which would keep the nucleotide triphosphate levels low. pH is a balance between acid loading at the muscle and acid excretion at the gills or the kidneys; we cannot distinguish between which of these resulted in a decrease of plasma pH. In conclusion, CA in plasma did not cause the expected reduction in blood oxygen content but did have a marked effect on plasma total CO2 content

Adherence to behavior changes for COVID-19 prevention in communitydwelling older adults

Background: Preventing coronavirus disease 2019 (COVID-19) in older people is an important public health issue. The purpose of this study was to investigate the relationship between the level of fear regarding COVID-19 and adherence to COVID-19 prevention measures among community-dwelling older adults.Methods: This study was a cross-sectional survey conducted from July 15 to August 19, 2020, in 127 community-dwelling older adults ≥65 years old in Japan. A questionnaire including participants’ basic attributes (age, sex, body mass index, and family structure), levels of fear regarding COVID-19, increasing adherence to four behaviors (restrictions on going out, maintaining physical distancing, wearing masks, and washing hands) for COVID-19 prevention, and its stress levels was used. We calculated the relationship between the level of fear of COVID-19 and the level of each behavioral change using Spearman’s correlation coefficient (rs).Results: About 95% of older adults displayed fear of COVID-19. Rates of adherence to all four COVID-19 prevention measures increased to approximately 80–95%. However, about 40–55% of older adults were stressed by all behavior modifications except washing hands. The increasing level of fear regarding COVID-19 correlated positively with decreasing frequency of going out (rs=0.280, p=0.001) and increasing frequency of washing hands (rs=0.336, p<0.001).Conclusion: The behavioral changes of COVID-19 prevention measures in community-dwelling older people were excellent with increasing adherence rates. While such high adherence rates may increase the preventive effect in community-dwelling older people, the new lifestyle during the COVID-19 epidemic may cause frailty due to restrictions on going out and stress regarding behavior modifications

Health-related quality of life among women in rural Bangladesh after surgical repair of obstetric fistula

Objective To identify factors influencing health-related quality of life (QOL) among women in Bangladesh after successful surgical repair of obstetric fistula. Methods In 2012, a cross-sectional study was conducted of women who had undergone a successful surgical repair of an obstetric fistula at a hospital in northwest Bangladesh between June 2005 and May 2012. Sociodemographic, obstetric, and fistula-related information was collected by interview. Health-related QOL was assessed using the 36-item Short Form Health Survey (SF-36). Results A total of 113 women were included. Linear regression analysis showed that discrimination experiences negatively affected four of the eight scales of SF-36, as well as both the physical and mental component summaries (P < 0.05 for all). Married status had a positive effect on four scales and the mental component summary (P < 0.05 for all). Age inversely affected two scales and the physical component summary (P < 0.01 for all). Internalized stigma negatively influenced two scales (P < 0.05 for both). Not having living children and experiencing two or more previous stillbirths negatively influenced one scale (P < 0.05 for both). Conclusion Several factors influence health-related QOL after obstetric fistula repair; a comprehensive approach is needed to address these issues

Factors associated with overall satisfaction level of older people regarding medical-health and long-term care service within residential areas

Purpose: This study examined the factors related to the overall satisfaction level of older people treated at home, regarding medical and welfare services in their area of residence.Method: The survey targeted older people who reported using the services at a day rehabilitation center in Nagasaki Prefecture. The survey investigated the individuals’ backgrounds of, including their age, sex, period of long-term care insurance use, living environment, details and anxiety. It also indicated, through a self-rate system, the extent of information sharing among medical personnel and long-term care workers. The Japanese version of the Client Satisfaction Questionnaire 8-item version (CSQ-8J) was used to measure their level of satisfaction with medical and long-term care services. Results: Data from 205 people were analyzed, which included 73 men (35.6%) and 132 women (64.4%). The mean age was 81.2 ± 7.6(mean±standard deviation) years, the mean period of long-term care insurance was 38.1 ± 38.2 months, and the mean CSQ-8J score was 24.8 ± 5.7 points. The results of the multiple regression analysis (backward stepwise method) showed that only the item “information on illness and treatment is shared among medical personnel and long-term care workers” was significantly associated with the CSQ-8J score (p = 0.007). The results suggest the need to determine the details of the information regarding illness and treatment that should be shared among concerned parties

Human Papillomavirus and Cervical Cancer Knowledge, Perceptions, and Screening Behavior: A Cross-Sectional Community-Based Survey in Rural Philippines

BACKGROUND: Cervical cancer is the second most common cancer among women in the Philippines. Cervical cancer screening is an effective method to reduce incidence. However, screening utilization is limited. This study aims to assess human papillomavirus (HPV) and cervical cancer knowledge, perceptions, and screening utilization, and to investigate factors influencing screening utilization among rural women in the Philippines. METHODS: This cross-sectional community-based study was conducted among 338 rural women aged 20-50 years, with a child under 5 years old registered in one of four public rural health centers in Tacao Island,Masbate Province in October 2017. A questionnaire administered via face-to-face interviews elicited information about demographic characteristics, knowledge, perceived susceptibility and perceived severity of HPV and cervical cancer, and cervical cancer screening utilization. RESULTS: Mean age of participants was 32.5 years. Only 13.9% of participants had ever had cervical cancer screening. Although most women had heard of cervical cancer screening, their knowledge about the cause, risk factors, and preventive measures of HPV and cervical cancer was limited. Older age and higher education status were significantly associated with screening utilization. However, knowledge and perceived susceptibility and severity showed no association. The main reason for having screening was due to a health professional\u27s request or recommendation, and the reasons for not having screening were cost, not having symptoms, and fear of pain or discomfort and/or embarrassment during the procedure.Conclusions: Health education must increase knowledge about HPV and cervical cancer and screening among women, including the nature and progression of cervical cancer, benefits of screening, screening cost, and screening procedure.Health care providers have an important role in educating and motivating women to undergo screening

Caregiver burden mediates between caregiver\u27s mental health condition and elder\u27s behavioral problems among Japanese family caregivers

Objectives: In Japan, the prevalence of depression has been reported to occur among 1 in 4 family caregivers. The purpose of this study was to investigate the self-rated burden associated with mental health conditions among caregivers.Methods: We studied 95 caregivers aged 38-87 years in a cross-sectional study. The General Health Questionnaire (GHQ-12) score of 4 or more was defined as poor mental health.Results: The proportion of caregivers with poor mental health was 24%. Caregivers with a high GHQ-12 score had the number of caregiver burdens increased by 2.5-fold compared to those with a low GHQ-12 score (p = 0.001). The proportion of caregivers with a high GHQ-12 score was significantly higher with an increasing number of behavioral problems among care recipients (p = 0.003). A mediational model was used to identify the underlying mechanism of the relationship between the number of behavioral problems and poor mental health in caregivers. Consequently, we found that mental health conditions in caregivers were associated with both the number of caregiver burdens and behavioral problems among care recipients.Conclusions: It is vital to provide support not only to the caregivers but also to their elderly relatives, paying particular attention to early identification of poor mental health in caregivers so as to administer effective interventions, and to offer useful advice concerning how to deal with behavioral problems