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

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

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

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

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

Post-Traumatic Stress Disorder Among Senior Victims of Tsunami-Affected Areas in Southern Sri Lanka

Background: On 26 December 2004, a large earthquake occurred off the coast of Sumatra, and a devastating tsunami struck surrounding countries. Sri Lanka was seriously affected, with more than 31,000 deaths and 4,000 people missing. Objective: To elucidate the relationship between factors of tsunami-related exposure and mental health conditions among the senior residents of tsunami-affected areas in southern Sri Lanka. Subjects: A total of 90 subjects (43 men, 47 women) aged 60 years or older who were living in the Matara district at the time of the tsunami attack. Methods: A survey by interview using a structured questionnaire was conducted in 2008. The collected information included demographic factors, tsunami-related exposure and mental health conditions. The Impact of Event Scale-Revised (IES-R) was used to assess their post-traumatic stress disorder symptoms. Results: The median of the IES-R score was significantly higher in those who were situated at home; those who saw anyone the dead or injured; those whose evacuations were delayed; those whose family member or friend was injured; those who were injured; those who lost their children, spouse or family members; those whose family member was missing; those who lost livelihood, compared with those who were not or those who did not. Multiple linear regression analysis showed that younger age and loss of or injury to family members due to the tsunami were significantly associated with an increase in IES-R score. Conclusion: The results indicate that tsunami-related exposures have affected elderly survivors\u27 mental health

The Mediating Role of Sleep Quality on Well-Being Among Japanese Working Family Caregivers

The purpose of this study was to investigate whether the well-being of caregivers is mediated by the association between behavioral and psychological symptoms in elderly relatives and the quality of sleep experienced by caregivers using a mediational model. The participants were 105 working family caregivers in Japan. We assessed well-being based on the Kessler Scale 10, self-rated health, and satisfaction in daily life. Our results showed that the well-being in working family caregivers was impacted by the severity of behavioral and psychological symptoms in elderly relatives. Well-being in working family caregivers was also affected by quality of sleep. Maintaining good quality of sleep in working family caregivers is important for reducing caregiver burden and psychological distress, and for improving the balance between work and family life

Associations between daily lifestyle characteristics and latent depressive symptoms in elementary school children: A cross-sectional survey

This study aimed to identify associations between daily lifestyle characteristics and latent depressive symptoms in young children by analyzing self-reported questionnaire data. In 2011, in Nagasaki Japan, a cross-sectional survey of 1961 children aged between 10 and 12 years was conducted. Children answered questionnaires that collected demographic information, along with daily lifestyle characteristics, and were administered the Birleson Depression Self-Rating Scale for Children (DSRSC-J). The mean age of the participants was 10.98 years (±0.83 standard deviation [SD]) with a mean DSRSC-J raw score of 11.61 (±6.34 SD). In total, 24.7% of participants reported depressive symptoms. A multiple logistic regression analysis revealed that depressive symptoms were associated with female gender (odds ratio [OR]:1.86; 95% CI: 1.48?2.33), experiencing growth (OR: 1.25; 1.07-1.44), a bedtime later than 11 pm (OR: 1.25; 1.01-1.66), skipping breakfast (OR: 1.55; 1.15-2.10), and not having a set dinner time (OR: 1.65; 1.32?2.07). Conversely, absence of depressive symptoms was associated with involvement in school-related athletic clubs (OR: 0.60, 95% Cl: 0.48?0.76) and at home studying for at least one hour per day (OR: 0.67, 95% Cl: 0.54?0.84). Depressive symptoms in young children were associated with social contact and their parent’s lifestyles. Non-experts in the field of mental health who interact with young children should carefully note the presence of factors associated with depressive symptoms as this would help children with latent depressive symptoms receive prompt and timely care

Modest Expansion of Vβ2+CD4+ T Cells and No Expansion of Vβ7+CD4+ T Cells in a Subgroup of Kawasaki Disease Patients with Erythematic BCG Inoculation Site Lesions

Background: The similarities between Kawasaki disease (KD) and superantigen (SA) diseases indicate that a microbial SA might cause KD. Viral diseases can trigger an endogenous SA.Methods: We evaluated expression of Vβ2 (responding to staphylococcal TSST-1) and Vβ7 (responding to the endogenous SA induced by type-1 interferon or Epstein-Barr virus infection) on T cells from 70 KD patients along with the following control subjects: 18 non-vasculitic patients (NVs), 7 patients with anaphylactoid purpura (AP), and two with neonatal TSS-like exanthematous disease (NTED), a typical SA disease. We examined the correlation of clinical features of KD with Vβ2+ or Vβ7+CD4+T cell populations.Results: The Vβ2+CD4+T cell rates were comparable between KD patients (9.9±2.9%) and NVs (9.0±1.8%), but were lower in AP patients (6.6±1.8%). However, the Vβ2+CD4+T cell rate was significantly higher in KD patients with erythematic BCG inoculation site lesions (10.8±3.2%) than in those without (8.8±2.1%) and NVs (9.0±1.8%), but much lower than in NTED patients (25.2%, 16.9%). Multivariate linear regression analysis with elevation of Vβ2 expression as a dependent variable revealed significant correlations with BCG. In contrast, Vβ7+CD4+T cell rates were not significantly different between KD patients and other study subjects.Conclusion: While we were unable to find evidence supporting the involvement of the endogenous SA in the pathogenesis of KD in this study, modest expansion of the Vβ2+CD4+T cell population in a subgroup of KD with erythematic BCG inoculation site lesions implies the involvement of a microbial agent(s) different from TSST-1 as well as immunopathological heterogeneity of KD. (249 words