Cigarette smoking knowledge, attitudes, and practices of patients and staff at a perinatal substance abuse treatment center.

PubMed

Chisolm, Margaret S; Brigham, Emily P; Lookatch, Samantha J; Tuten, Michelle; Strain, Eric C; Jones, Hendrée E

2010-10-01

This study compares cigarette smoking knowledge, attitudes, and practices (S-KAP) of opioid- and other substance-dependent patients and their multidisciplinary staff at an outpatient perinatal substance abuse treatment center. Consenting patients (n = 95) and staff (n = 41) concurrently completed a modified form of the S-KAP survey instrument. Ninety-five percent of patients reported currently smoking, and half endorsed wanting "to quit smoking now." This patient desire to quit smoking was significantly underrated by staff compared to the patients themselves (p = .028). Both patients and staff demonstrated suboptimal knowledge of smoking health risks, but 73% of patients reported trying to quit with past pregnancies to avoid harm to the fetus/baby. Although results show that patients could benefit from smoking cessation strategies centered on smoking's fetal/neonatal health risks, organizational interventions that focus on changing staff attitudes about patient desire to quit smoking may first need to be implemented. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Improvement of perinatal outcome in diabetic pregnant women.

PubMed

Szilagyi, A; Szabo, I

2001-01-01

Obstetrical and perinatal outcomes in newborns of diabetic pregnant women depend on metabolic control and fetal surveillance during pregnancy. The effects of fetal surveillance on perinatal mortality and morbidity was analyzed in diabetic pregnant women with appropriate glucose control in our regional center for diabetes and pregnancy. 480 deliveries complicated by frank or gestational diabetes occurred in our Department in the period of 1988-1999. Perinatal mortality and morbidity, prevalence of premature deliveries, methods of fetal surveillance, options for respiratory distress syndrome (RDS) profilaxis, cesarean section rate, timing of delivery and its indications and occurrence of malformations have been analyzed. It was found that malformation rate and perinatal mortality may be reduced to even lower level than that of in healthy pregnant women by appropriate glucose control and by using the latest methods of intrauterine fetal surveillance including cardiotocography (non stress test and oxytocin challenge test), doppler fetal artery velocimetry and fetal pulse oximetry. Timing of delivery was needed in 35% of the cases with IDDM and 15% of gestational diabetes due to chronic placental insufficiency. If labour induction was needed before the 38 weeks, amniocentesis was performed to test fetal lung maturity. Direct fetal glucocorticoid administration was used to enhance fetal lung maturation in 14 cases. C-section rate was slightly higher than that of in non diabetic pregnant women. Our perinatal morbidity data (macrosomia, hyperbilirubinemia, hypoglycemia, injuries, infections) are comparable with the data from the literature. Although perinatal mortality with the help of thorough fetal surveillance is even better in diabetic pregnant women than in non diabetic patients, future eye should be focused on factors affecting perinatal morbidity, because it is still higher than in newborns of healthy mothers.

Japan Link Center (JaLC): link management and DOI assignment for Japanese electronic scholarly contents

NASA Astrophysics Data System (ADS)

Kato, Takafumi; Tsuchiya, Eri; Kubota, Soichi; Miyagawa, Yoshiyuki

JST, cooperated with several national institutes, is currently developing “Japan Link Center”, which manages Japanese electronic scholarly contents (journal articles, books, dissertations etc.) in an integrated fashion using Digital Object Identifier (DOI). Japan Link Center will manage metadata and whereabouts information of the contents in the digital environment and provide domestic and international linking information, cite/cited information to activate dissemination of S&T information, furthermore, to strengthen transmission of S&T information from Japan. Japan Link Center is expected to be appointed as the 9th DOI registration agency (RA) in the world by the International DOI Foundation (IDF) this spring.

[Risk adjusted assessment of quality of perinatal centers - results of perinatal/neonatal quality surveillance in Saxonia].

PubMed

Koch, R; Gmyrek, D; Vogtmann, Ch

2005-12-01

The weak point of the country-wide perinatal/neonatal quality surveillance as a tool for evaluation of achievements of a distinct clinic, is the ignorance of interhospital differences in the case-mix of patients. Therefore, that approach can not result in a reliable bench marking. To adjust the results of quality assessment of different hospitals according to their risk profile of patients by multivariate analysis. The perinatal/neonatal data base of 12.783 newborns of the saxonian quality surveillance from 1998 to 2000 was analyzed. 4 relevant quality indicators of newborn outcome -- a) severe intraventricular hemorrhage in preterm infants < 1500 g, b) death in hospital of preterm infants < 1500 g, c) death in newborns with birth weight > 2500 g and d) hypoxic-ischemic encephalopathy -- were targeted to find out specific risk predictors by considering 26 risk factors. A logistic regression model was used to develop the risk predictors. Risk predictors for the 4 quality indicators could be described by 3 - 9 out of 26 analyzed risk factors. The AUC (ROC)-values for these quality indicators were 82, 89, 89 and 89 %, what signifies their reliability. Using the new specific predictors for calculation the risk adjusted incidence rates of quality indicator yielded in some remarkable changes. The apparent differences in the outcome criteria of analyzed hospitals were found to be much less pronounced. The application of the proposed method for risk adjustment of quality indicators makes it possible to perform a more objective comparison of neonatal outcome criteria between different hospitals or regions.

[Assessment of three-level selective perinatal care based on the analysis of early perinatal death rates and cesarean sections in Poland in 2008].

PubMed

Troszyński, Michał; Niemiec, Tomasz; Wilczyńska, Anna

2009-09-01

The aim of the following work was to assess three-level selective perinatal care in Polish voivodeships in 2008 on the basis of the following parameters: birth rates as well as perinatal death rates, divided into three classes of neonatal weights, in hospitals on each of the three levels. The goal of selective perinatal care is, among other things, to diagnose threats to the mother and/or fetus and direct women with high-risk pregnancies to higher level obstetrics and neonatology clinics and units. The structure of a regional three-level perinatal care, as well as the rules and procedures governing the process of redirecting patients to different levels of perinatal care have been defined in great detail. Perinatal death rates analysis has been carried out on the basis of data received from Voivodeship Public Health Centers in sixteen voivodeships in Poland in 2008. The main document constituted MZ-29 form section X, modified by the authors and subdivided into levels of perinatal care. All data contained in the form have been verified: the numbers concerning birth and death rates as well as perinatal deaths and birth weight subgroups from given voivodeship hospitals. Statistic analysis was limited to the presentation of result tables and graphs within voivodeships. Birth rates and perinatal death rates revealed that in the course of ten years the level of perinatal care, introduced gradually in Poland between the years 1997-1999, resulted in its improvement. Perinatal death rates decreased in the course of ten years from 9.5% in 1999 to 6.45% in 2008, i.e. by 0.3% annually. On the first level, the rate of neonates with very low birth weight, 500-999g, decreased by 5.5% and was 21.1% in 2008 and 36.6% in 1999, whereas on the third level, the birth rate in the same group (500-999g) increased by 12.7% and was 47.7% in 2008 and 35.5% in 1999. There is a growing and alarming tendency to perform cesarean sections. The increase amounted up to 1.2% annually (18.2% in 19999

Perinatal grief online.

PubMed

Capitulo, Kathleen Leask

2004-01-01

To describe and interpret the culture of an online perinatal loss group. This qualitative study used ethnography, the study of culture. Methods included participant-observation, review of 447 e-mails, and participants' feedback about the findings. The setting was online in a perinatal loss listserv consisting of mothers and one grandmother who had experienced a perinatal loss through miscarriage, stillbirth, or neonatal death. In this changing group, there were between 82 to 87 participants from North America, Europe, Asia, and Australia. The essence of the culture was Shared Metamorphosis. The Internet connected grieving women who otherwise would likely not have met. Participants shared virtual identities, created a community, and brought meaning to their perpetual losses. Their grief was a process of remembrance and memories, and they used symbols to represent the deceased babies; angels were a commonly discussed symbol. For bereaved mothers "life would never be the same," but joining the community of the perinatal loss listserv meant they would never be alone. The culture of online support can link individuals who are geographically distant but share common issues, in this case a perinatal loss. Professionals can use this study to better understand what women experience after a perinatal loss, and what their role can be in validating and supporting these new "mothers of angels."

Integrated perinatal mental health care: a national model of perinatal primary care in vulnerable populations.

PubMed

Lomonaco-Haycraft, Kimberly C; Hyer, Jennifer; Tibbits, Britney; Grote, Jennifer; Stainback-Tracy, Kelly; Ulrickson, Claire; Lieberman, Alison; van Bekkum, Lies; Hoffman, M Camille

2018-06-18

IntroductionPerinatal mood and anxiety disorders (PMADs) are the most common complication of pregnancy and have been found to have long-term implications for both mother and child. In vulnerable patient populations such as those served at Denver Health, a federally qualified health center the prevalence of PMADs is nearly double the nationally reported rate of 15-20%. Nearly 17% of women will be diagnosed with major depression at some point in their lives and those numbers are twice as high in women who live in poverty. Women also appear to be at higher risk for depression in the child-bearing years. In order to better address these issues, an Integrated Perinatal Mental Health program was created to screen, assess, and treat PMADs in alignment with national recommendations to improve maternal-child health and wellness. This program was built upon a national model of Integrated Behavioral Health already in place at Denver Health. A multidisciplinary team of physicians, behavioral health providers, public health, and administrators was assembled at Denver Health, an integrated hospital and community health care system that serves as the safety net hospital to the city and county of Denver, CO. This team was brought together to create a universal screen-to-treat process for PMAD's in perinatal clinics and to adapt the existing Integrated Behavioral Health (IBH) model into a program better suited to the health system's obstetric population. Universal prenatal and postnatal depression screening was implemented at the obstetric intake visit, a third trimester prenatal care visit, and at the postpartum visit across the clinical system. At the same time, IBH services were implemented across our health system's perinatal care system in a stepwise fashion. This included our women's care clinics as well as the family medicine and pediatric clinics. These efforts occurred in tandem to support all patients and staff enabling a specially trained behavioral health provider

Activities of the Japanese space weather forecast center at Communications Research Laboratory.

PubMed

Watari, Shinichi; Tomita, Fumihiko

2002-12-01

The International Space Environment Service (ISES) is an international organization for space weather forecasts and belongs to the International Union of Radio Science (URSI). There are eleven ISES forecast centers in the world, and Communications Research Laboratory (CRL) runs the Japanese one. We make forecasts on the space environment and deliver them over the phones and through the Internet. Our forecasts could be useful for human activities in space. Currently solar activity is near maximum phase of the solar cycle 23. We report the several large disturbances of space environment occurred in 2001, during which low-latitude auroras were observed several times in Japan.

Impact of egg donation deliveries from domestic and overseas sources on maternal care: a questionnaire survey of Japanese perinatal physicians.

PubMed

Hibino, Yuri; Shimazono, Yosuke

2014-07-01

Recent demographic changes, such as marriage at later ages and delayed childbearing, have contributed to the increased demand for ovum donation. The purpose of the present study was to evaluate the frequency and impact of egg donation deliveries on maternal care using a questionnaire survey of Japanese perinatal care providers. A quantitative survey was conducted from October to November 2012 using self-administered anonymous questionnaires. We asked 2,693 obstetrics clinics/hospitals throughout Japan to complete the survey: 679 questionnaires were returned (response rate, 25.2 %). Of the respondents, 15.8 % answered that they had handled egg donation deliveries in the past. With regards to the country in which patients received egg donation services, the most frequent was the United States, including Hawaii. Asian countries, such as Thailand, Korea, and Singapore, were also reported; only two cases in Japan were reported. "Advanced age/menopause" was the most frequent reason for egg donation, and the mean age at egg donation delivery, because of advanced age/menopause, was 48.3 years. Our findings will increase public awareness of the legal issues related to assisted reproductive technology and cross-border reproductive care, as well as care of the mother and child in pregnancies resulting from reproductive technologies such as egg donation overseas. People should be aware of the issues involved in egg donation abroad and the resulting deliveries, and should implement specific care for women bearing children at later ages.

Mother-infant antidepressant concentrations, maternal depression, and perinatal events.

PubMed

Sit, Dorothy; Perel, James M; Wisniewski, Stephen R; Helsel, Joseph C; Luther, James F; Wisner, Katherine L

2011-07-01

The authors explored the relationship of cord-maternal antidepressant concentration ratios and maternal depression with perinatal events and preterm birth. The investigators examined 21 mother-infant pairs that had antidepressant exposure during pregnancy. The antidepressants included serotonin reuptake inhibitors (SRIs) and nortriptyline (a norepinephrine inhibitor and mild SRI). The mothers were evaluated with the Structured Clinical Interview for DSM-IV. Depression ratings were repeated at 20, 30, and 36 weeks' pregnancy. At delivery, investigators assessed cord and maternal antidepressant concentrations, neonatal outcomes on the Peripartum Events Scale (PES), and gestational weeks at birth. The investigators performed this study at the Women's Behavioral HealthCARE Program, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pennsylvania, from April 2003 until September 2006. Mean ± SD cord-to-maternal concentration ratios were 0.52 ± 0.35 (range, 0.00-1.64) for the parent drug and 0.54 ± 0.17 (range, 0.28-0.79) for the metabolite. Nine of 21 mothers (43%) had a major depressive episode. From examining the maximum depression ratings, the mean ± SD Structured Interview Guide for the Hamilton Depression Rating Scale, Atypical Depression Symptoms Version score was 16.0 ± 7.6. One third (7/21) of infants had at least 1 perinatal event (PES ≥ 1). The frequency of deliveries complicated by any perinatal event was similar in depressed and nondepressed mothers. There was no significant association between perinatal events and cord-to-maternal antidepressant concentration ratios or maternal depression levels. Exposure to short half-life antidepressants compared to fluoxetine resulted in more perinatal events (7/16 = 44% vs 0/5 = 0%; P = .06). Fourteen percent (3/21) of infants were preterm. Preterm birth was not associated with cord-to-maternal metabolite concentration ratios, depression levels, or exposure to fluoxetine

Integrated Approach to Reduce Perinatal Adverse Events: Standardized Processes, Interdisciplinary Teamwork Training, and Performance Feedback.

PubMed

Riley, William; Begun, James W; Meredith, Les; Miller, Kristi K; Connolly, Kathy; Price, Rebecca; Muri, Janet H; McCullough, Mac; Davis, Stanley

2016-12-01

To improve safety practices and reduce adverse events in perinatal units of acute care hospitals. Primary data collected from perinatal units of 14 hospitals participating in the intervention between 2008 and 2012. Baseline secondary data collected from the same hospitals between 2006 and 2007. A prospective study involving 342,754 deliveries was conducted using a quality improvement collaborative that supported three primary interventions. Primary measures include adoption of three standardized care processes and four measures of outcomes. Chart audits were conducted to measure the implementation of standardized care processes. Outcome measures were collected and validated by the National Perinatal Information Center. The hospital perinatal units increased use of all three care processes, raising consolidated overall use from 38 to 81 percent between 2008 and 2012. The harms measured by the Adverse Outcome Index decreased 14 percent, and a run chart analysis revealed two special causes associated with the interventions. This study demonstrates the ability of hospital perinatal staff to implement efforts to reduce perinatal harm using a quality improvement collaborative. Findings help inform the relationship between the use of standardized care processes, teamwork training, and improved perinatal outcomes, and suggest that a multiplicity of integrated strategies, rather than a single intervention, may be essential to achieve high reliability. © Health Research and Educational Trust.

Perinatal Brain Injury: Mechanisms, Prevention, and Outcomes.

PubMed

Novak, Christopher M; Ozen, Maide; Burd, Irina

2018-06-01

Perinatal brain injury may lead to long-term morbidity and neurodevelopmental impairment. Improvements in perinatal care have resulted in the survival of more infants with perinatal brain injury. The effects of hypoxia-ischemia, inflammation, and infection during critical periods of development can lead to a common pathway of perinatal brain injury marked by neuronal excitotoxicity, cellular apoptosis, and microglial activation. Various interventions can prevent or improve the outcomes of different types of perinatal brain injury. The objective of this article is to review the mechanisms of perinatal brain injury, approaches to prevention, and outcomes among children with perinatal brain injury. Copyright © 2018 Elsevier Inc. All rights reserved.

[Perinatal tuberculosis].

PubMed

Sáenz-Gómez, Jessica; Karam Bechara, José; Jamaica Balderas, Lourdes

Perinatal tuberculosis is acquired during birth or during the early neonatal period. Although its incidence is unknown, a search was conducted in Medline and 28 cases were found of perinatal tuberculosis reported from 1983 to 2011. Diagnosis of this disease is important due to having nonspecific symptoms that are mistaken for other infectious diseases. The disease has a high mortality rate (60%); therefore, it requires prompt diagnostic suspicion by the medical staff to prevent a fatal outcome. We describe the case of a 3-month-old male whose 29-year-old mother died of septic shock at 15 days of delivery. The infant's condition began within 30 days of age with cough and difficulty breathing with a diagnosis of multiple foci pneumonia. The infant presented respiratory impairment, meriting change of antibiotics twice, without improvement. The autopsy report of the mother revealed peritoneal tuberculosis. PCR was carried out using tracheal aspirate and pleural fluid of the patient, which were positive for Mycobacterium tuberculosis. Perinatal diagnosis of tuberculosis was established. No hepatic granuloma was found. Perinatal infection should be suspected in children with sepsis and/or pneumonia unresponsive to antibiotics. In this care, the history of tuberculosis in the mother should have oriented the diagnosis. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

Can Japanese students embrace learner-centered methods for teaching medical interviewing skills? Focus groups.

PubMed

Saiki, Takuya; Mukohara, Kei; Otani, Takashi; Ban, Nobutaro

2011-01-01

Students' perceptions of learner-centered methods for teaching medical interviewing skills have not been fully explored. To explore Japanese students' perceptions of learner-centered methods for teaching medical interviewing skills such as role play with student-created scenarios, peer-assisted video reviews, and student-led small group debriefing. We conducted three focus groups with a total of 15 students who participated in the learner-centered seminars on medical interviewing skills at the Nagoya University School of Medicine. The transcripts were analyzed by two authors independently. Keywords and concepts were identified and a thematic framework was developed. Overall, students valued the experience of writing their own scenarios for role play, but some questioned their realism. Many students commented that peer-assisted video reviews provided them with more objective perspectives on their performance. However, some students expressed concerns about competitiveness during the video reviews. While students appreciated teachers' minimum involvement in the group debriefing, some criticized that teachers did not explain the objectives of the seminar clearly. Many students had difficulties in exchanging constructive feedback. We were able to gain new insights into positive and negative perceptions of students about learner-centered methods for teaching medical interviewing skills at one medical school in Japan.

Promoting antenatal steroid use for fetal maturation: results from the California Perinatal Quality Care Collaborative.

PubMed

Wirtschafter, David D; Danielsen, Beate H; Main, Elliott K; Korst, Lisa M; Gregory, Kimberly D; Wertz, Andrew; Stevenson, David K; Gould, Jeffrey B

2006-05-01

The California Perinatal Quality Care Collaborative (CPQCC) was formed to seek perinatal care improvements by creating a confidential multi-institutional database to identify topics for quality improvement (QI). We aimed to evaluate this approach by assessing antenatal steroid administration before preterm (24 to 33 weeks of gestation) delivery. We hypothesized that mean performance would improve and the number of centers performing below the lowest quartile of the baseline year would decrease. In 1998, a statewide QI cycle targeting antenatal steroid use was announced, calling for the evaluation of the 1998 baseline data, dissemination of recommended interventions using member-developed educational materials, and presentations to California neonatologists in 1999-2000. Postintervention data were assessed for the year 2001 and publicly released in 2003. A total of 25 centers voluntarily participated in the intervention. Antenatal steroid administration rate increased from 76% of 1524 infants in 1998 to 86% of 1475 infants in 2001 (P < .001). In 2001, 23 of 25 hospitals exceeded the 1998 lower-quartile cutoff point of 69.3%. Regional collaborations represent an effective strategy for improving the quality of perinatal care.

Countrywide analysis of perinatal outcome.

PubMed

Stembera, Z; Kravka, A; Mandys, F

1988-01-01

The computer laboratory of the Research Institute for the Care of Mother and Child in Prague performs annually a countrywide analysis of perinatal outcome in order to obtain a background for the preparation of the optimal strategy for improving perinatal care in CSR in the future. The total as well as weight specific perinatal mortality rate further sub-divided into early neonatal death rate and late fetal death rate and differentiated according to the birthweight, was correlated with the incidence of different factors influencing the perinatal mortality rate both countrywide and for each of the eight provinces of CSR. This way a correlation was found between some of the mentioned perinatal outcomes and e.g. instrumental equipment of obstetrical departments and neonatal intensive care units, frequency of caesarean sections, or transport of LBW newborns in incubators or "in utero" etc. The results of this analysis have proved that there still remain in some provinces opportunity for further decrease in perinatal mortality due to the incomplete observance of the two intervention strategies "Risk approach" and "New technology" which were introduced in the whole country during the last 10 years.

[Can implementation of intensified perinatal survey be effective in improving the quality of perinatal care?].

PubMed

Troszyński, Michał

2010-01-01

Intensive scientific research and rapid technical progress have influenced the rapid fall in term newborn mortality. At the same time new problems have arisen such as saving the lives of infants with low and very low birth weight. Solving these problems needs reorganization of perinatal care, better equipment, especially in reference units and in outpatient clinics, as well as more intensive staff training. to obtain information whether implementation of intensified perinatal survey of fetus and newborn mortality can improve the quality of perinatal care in Poland. Implementation of the survey based on Central Statistics Office (GUS) data, Ministry of Health MZ-29 section X Document and the author's own studies. In the year 2008 newborn with birth weight less than 2500 g, constituted 6,06% liveborn infants, newborn weighing from 1000 to 2499 g - 5%, those with weight from 500 to 999 g - 0.51% of all live born infants. These figures differ according to voivodeship. The intensive survey concerning birth weight and perinatal mortality indeces in voivodeshipPoland, as well as in individual voivodeships, showed differences between data from the Central Statistics Office and data from the Ministry of Health MZ-29 document. This may be due to different methods of registrating newborn deaths eg. newborns transfered in the first weekoflife from the maternity ward to intensive care neonatal ward or to other specialistic departaments. Another reason for the difference may be discharge of the newborn data according to the place of birth or the mother's place of permanent domicile registration. This causes disturbances in flow of infomation resulting in ineffective analysis of perinatal mortality and of perinatal care evaluation. In the ongoing analysis it was found that in Poland stillbirths occur twice as often as perinatal deaths (4.3 per thousands) stillbirths and 2.15 per thousands perinatal deaths), with significant differences between voivodeships. This makes it

The influence of the war on perinatal and maternal mortality in Bosnia and Herzegovina.

PubMed

Fatusić, Z; Kurjak, A; Grgić, G; Tulumović, A

2005-10-01

To investigate the influence of the war on perinatal and maternal mortality during the war conflict in Bosnia and Herzegovina. In a retrospective study we analysed perinatal and maternal mortality in the pre-war period (1988-1991), the war period (1992-1995) and the post-war period (1996-2003). We also analysed the number of deliveries, the perinatal and maternal mortality rates and their causes. During the analysed period we had a range of 3337-6912 deliveries per year, with a decreased number in the war period. During the war period and immediately after the war, the perinatal mortality rate increased to 20.9-26.3% (average 24.28%). After the war the rate decreased to 8.01% in 2003 (p < 0.05). Maternal mortality before the war was 39/100,000 deliveries, during the war it increased to 65/100,000 and after the war it decreased to 12/100,000 deliveries (p < 0.05). The increase in maternal mortality during the war was because of an increased number of uterine ruptures, sepsis and bleeding due to shell injury of pregnant women. During the war we could expect a decreased number of deliveries, and an increased rate of perinatal and maternal mortality and preterm deliveries due to: inadequate nutrition, stress factors (life in refugee's centers, bombing, deaths of relatives, uncertain future...), and break down of the perinatal care system (lack of medical staff, impossibility of collecting valid health records, particularly perinatal information, and the destruction of medical buildings).

[Impact of perinatal mortality in multiple pregnancies over total perinatal mortality in a hospital in Monterrey, Nuevo León].

PubMed

Hernández-Herrera, Ricardo Jorge; Ramírez-Sánchez, Luis Fernando

2010-07-01

The incidence of multiple pregnancies has increased on the last decade resulting in a rise of premature and underweight newborns infants, with increase of the perinatal morbidity and mortality. To determine the impact of perinatal mortality of multiple pregnancies in the total perinatal mortality. perinatal mortality rate of multiple pregnancies treated in the Unidad Médica de Alta Especialidad No. 23, Monterrey, Nuevo León (Mexico) were analized, from 2002 to 2008. The prevalence of multiple pregnancies, the rate of premature births, the incidence of low-birth weight products and perinatal mortality was estimated. The difference between overall mortality and multiple pregnancy rate was measured by chi2. Of the 144,114 births, there were 1076 (0.8%) fetal deaths and 1,617 (1.10%) neonatal deaths. There were 110 high-order fetal pregnancies (more than three fetuses): 92 triplets, 14 quadruplets, 3 quintuplets and 1 sextuplet, producing a total of 353 newborns. Multiple pregnancies represent 2.8% (59/2093) of the total perinatal mortality (p = 0.3). 79.9% (1674/2093) of the total perinatal mortality were newborns weighing less than 2500 g. In the group of multiple pregnancies, all perinatal deaths occurred in products weighing less than 2500 g. The perinatal mortality of multiple pregnancies does not impact significantly overall perinatal mortality.

[Childbirth pain, perinatal dissociation and perinatal distress as predictors of posttraumatic stress symptoms].

PubMed

Boudou, M; Séjourné, N; Chabrol, H

2007-11-01

This prospective, longitudinal study investigated the contributive role of childbirth pain, perinatal distress and perinatal dissociation to the development of PTSD symptoms following childbirth. One hundred and seventeen women participated at the study. The first day after delivery they completed a questionnaire to evaluate pain, the peritraumatic distress inventory (PDI) and the peritraumatic dissociative experience questionnaire (PDEQ). Six weeks after birth, they completed the impact of event scale-revised (IES-R) to measure posttraumatic stress symptoms and the Edinburgh Postnatal Depression Scale (EPDS) to assess maternal depression. A multiple regression analysis revealed that only both components of perinatal distress, life-threat perception and dysphoric emotions were significant predictors of posttraumatic stress symptoms. In another multiple regression analysis predicting dysphoric emotions, affective dimension of pain was the only significant predictor. Perinatal distress was the best predictor of posttraumatic stress symptoms. Dysphoric emotions were associated with affective dimension of pain, suggesting that women distressed by the childbirth pain would have higher risk to develop posttraumatic stress symptoms.

Perinatal Bereavement: A Principle-based Concept Analysis

PubMed Central

FENSTERMACHER, Kimberly; HUPCEY, Judith E.

2013-01-01

Aim This paper is a report of an analysis of the concept of perinatal bereavement. Background The concept of perinatal bereavement emerged in the scientific literature during the 1970s. Perinatal bereavement is a practice based concept, although it is not well defined in the scientific literature and is often intermingled with the concepts of mourning and grief. Design Concept Analysis. Data Sources Using the term ‘perinatal bereavement’ and limits of only English and human, Pub Med and CINAHL were searched to yield 278 available references dating from 1974 – 2011. Articles specific to the experience of perinatal bereavement were reviewed. The final data set was 143 articles. Review Methods The methods of principle-based concept analysis were used. Results reveal conceptual components (antecedents, attributes and outcomes) which are delineated to create a theoretical definition of perinatal bereavement. Results The concept is epistemologically immature, with few explicit definitions to describe the phenomenon. Inconsistency in conceptual meaning threatens the construct validity of measurement tools for perinatal bereavement and contributes to incongruent theoretical definitions. This has implications for both nursing science (how the concept is studied and theoretically integrated) and clinical practice (timing and delivery of support interventions). Conclusions Perinatal bereavement is a multifaceted global phenomenon that follows perinatal loss. Lack of conceptual clarity and lack of a clearly articulated conceptual definition impede the synthesis and translation of research findings into practice. A theoretical definition of perinatal bereavement is offered as a platform for researchers to advance the concept through research and theory development. PMID:23458030

Cross-National Differences in Psychosocial Factors of Perinatal Depression: A Systematic Review of India and Japan.

PubMed

Takegata, Mizuki; Ohashi, Yukiko; Lazarus, Anisha; Kitamura, Toshinori

2017-12-04

Perinatal depression is prevalent worldwide. However, there are few available studies that discuss the different cultural factors affecting perinatal depression within Asian countries. This study aims to compare the literature regarding related factors relating to perinatal depression in India and Japan, and to synthesize the evidence common to both countries in addition to the country-specific evidence. We conducted a systematic review using several databases (CINAHL, MEDLINE, Pubmed, Ovid, SCOPUS, IndMED, and ICHUSI). Keywords were "antenatal depression" or "postpartum depression", and "India" or "Japan". Both Japanese and English language papers were reviewed. The identified evidence was compared between the two countries, as well as with non-Asian countries based on previous reports. In total, 15 articles on India and 35 on Japan were reviewed. Although several factors were shared between the two countries as well as with other non-Asian countries (vulnerable personality, being abused, age, marital conflict, and lower socio-demographic status), some differing factors were identified between India and Japan and non-Asian countries; India: poor socioeconomic status, living only with the husband, pregnancy not welcomed by the husband, a female baby, and poor relationship with in-laws; Japan: infertility treatment, conflict with work-life balance, poor relationships with biological mother or in-laws, and concerns about social relations with the other mother's friends. To conclude, involving the family and community may be important for implementing both global standardized and culture-specific interventions. In India, treatment involving the in-laws may be effective because large family structure is a significant predictor of perinatal depression. In Japan, a family/community approach involving not only the mother's family of origin but also the working environment is essential.

Anthropometric differences in preschool children of Japanese ancestry in Lima, Peru.

PubMed

Shimabuku, Roberto; Teruya, Alberto; Nakachi, Graciela

2009-08-01

Ethnic differences in the pattern and trend of growth and weight have been described in studies of migrant populations. Our objective was to compare anthropometric parameters and overweight prevalence in third and fourth generation Japanese descendant preschoolers within the Peruvian preschool population. A total of 337 measurements of height and weight from 284 children, three to five years of age, were taken over three years in one Japanese-Peruvian preschool center in Lima, Peru. The data of each parameter were classified into three ethnic groups according to their parents' surnames: Japanese descendant children (n = 104), with both parents with Japanese surnames; Japanese-Peruvian descendant (n = 93), one parent with a Japanese surname and one with a non-Japanese surname; and Peruvian descendant (n = 140), both parents with non-Japanese surnames. We used the National Center for Health Statistics (NCHS) 2000 growth charts as reference values to obtain centiles, Z scores, and body mass index (BMI). In boys, the three groups differed significantly in height, weight, BMI, Z scores, and overweight prevalence. Peruvian descendant boys were taller and heavier than Japanese-Peruvian and Japanese descendants. Moreover, Japanese-Peruvian descendant boys were taller and heavier than Japanese descendant boys. In girls, there were no significant differences in height and weight and in overweight prevalence among the three ethnic groups. Japanese descendants in Peru have height, weight and BMI values similar to those of Japanese children in Japan but lesser than Peruvian children. These findings may be related to differences in ethnic background.

Perinatal Mortality in the United States, 1950-81.

ERIC Educational Resources Information Center

Powell-Griner, Eve

1986-01-01

This report describes long-term trends in perinatal mortality in the United States in three basic parts: development of perinatal mortality measures, components of fetal and infant mortality, and trends and differentials in perinatal mortality. Perinatal deaths refer to the sum of spontaneous fetal deaths occurring after 20 weeks gestation plus…

Comparison of cigarette smoking knowledge, attitudes, and practices among staff in perinatal and other substance abuse treatment settings.

PubMed

Miller-Thomas, Tonya; Leoutsakos, Jeannie-Marie S; Terplan, Mishka; Brigham, Emily P; Chisolm, Margaret S

2014-01-01

Despite the high prevalence and known morbidity and mortality caused by cigarette smoking, 60% to 70% of substance abuse treatment programs lack smoking cessation counseling or fail to offer pharmacotherapy for smoking cessation, including those programs designed to meet the needs of drug-dependent pregnant patients. Previous studies of staff knowledge, attitudes, and practices (S-KAP) at general substance abuse/HIV treatment programs have suggested that staff may contribute to the deficiency in smoking cessation treatment in these settings. It is not known whether similar deficiencies exist at perinatal substance abuse treatment programs. This study compared cigarette S-KAP in perinatal substance abuse (n = 41) and general substance abuse/HIV treatment (Veterans Affairs [VA] medical center, hospital-, and community-based) workforce samples (n = 335). Significant differences were seen between the 2 groups on all measures, but perinatal staff compared favorably to general staff only on measures of barriers to smoking cessation services. Perinatal staff compared unfavorably on all other measures: knowledge, beliefs/attitudes, self-efficacy, and smoking cessation practices. Pair-wise comparisons of knowledge and beliefs/attitudes revealed a significant difference between perinatal and VA staff; of self-efficacy, between perinatal and staff at all other settings; and of smoking cessation practices, between perinatal and VA and community-based staff. These results-showing deficiencies of perinatal staff on most S-KAP measures-are concerning and suggest that identifying gaps in and improving S-KAP in perinatal substance abuse programs is urgently needed, for which the VA may provide an efficacious model.

The implementation of unit-based perinatal mortality audit in perinatal cooperation units in the northern region of the Netherlands.

PubMed

van Diem, Mariet Th; Timmer, Albertus; Bergman, Klasien A; Bouman, Katelijne; van Egmond, Nico; Stant, Dennis A; Ulkeman, Lida H M; Veen, Wenda B; Erwich, Jan Jaap H M

2012-07-09

Perinatal (mortality) audit can be considered to be a way to improve the careprocess for all pregnant women and their newborns by creating an opportunity to learn from unwanted events in the care process. In unit-based perinatal audit, the caregivers involved in cases that result in mortality are usually part of the audit group. This makes such an audit a delicate matter. The purpose of this study was to implement unit-based perinatal mortality audit in all 15 perinatal cooperation units in the northern region of the Netherlands between September 2007 and March 2010. These units consist of hospital-based and independent community-based perinatal caregivers. The implementation strategy encompassed an information plan, an organization plan, and a training plan. The main outcomes are the number of participating perinatal cooperation units at the end of the project, the identified substandard factors (SSF), the actions to improve care, and the opinions of the participants. The perinatal mortality audit was implemented in all 15 perinatal cooperation units. 677 different caregivers analyzed 112 cases of perinatal mortality and identified 163 substandard factors. In 31% of cases the guidelines were not followed and in 23% care was not according to normal practice. In 28% of cases, the documentation was not in order, while in 13% of cases the communication between caregivers was insufficient. 442 actions to improve care were reported for 'external cooperation' (15%), 'internal cooperation' (17%), 'practice organization' (26%), 'training and education' (10%), and 'medical performance' (27%). Valued aspects of the audit meetings were: the multidisciplinary character (13%), the collective and non-judgmental search for substandard factors (21%), the perception of safety (13%), the motivation to reflect on one's own professional performance (5%), and the inherent postgraduate education (10%). Following our implementation strategy, the perinatal mortality audit has been

Perinatal Complications and Aging Indicators by Midlife

PubMed Central

Caspi, Avshalom; Ambler, Antony; Belsky, Daniel W.; Chapple, Simon; Cohen, Harvey Jay; Israel, Salomon; Poulton, Richie; Ramrakha, Sandhya; Rivera, Christine D.; Sugden, Karen; Williams, Benjamin; Wolke, Dieter; Moffitt, Terrie E.

2014-01-01

BACKGROUND: Perinatal complications predict increased risk for morbidity and early mortality. Evidence of perinatal programming of adult mortality raises the question of what mechanisms embed this long-term effect. We tested a hypothesis related to the theory of developmental origins of health and disease: that perinatal complications assessed at birth predict indicators of accelerated aging by midlife. METHODS: Perinatal complications, including both maternal and neonatal complications, were assessed in the Dunedin Multidisciplinary Health and Development Study cohort (N = 1037), a 38-year, prospective longitudinal study of a representative birth cohort. Two aging indicators were assessed at age 38 years, objectively by leukocyte telomere length (TL) and subjectively by perceived facial age. RESULTS: Perinatal complications predicted both leukocyte TL (β = −0.101; 95% confidence interval, −0.169 to −0.033; P = .004) and perceived age (β = 0.097; 95% confidence interval, 0.029 to 0.165; P = .005) by midlife. We repeated analyses with controls for measures of family history and social risk that could predispose to perinatal complications and accelerated aging, and for measures of poor health taken in between birth and the age-38 follow-up. These covariates attenuated, but did not fully explain the associations observed between perinatal complications and aging indicators. CONCLUSIONS: Our findings provide support for early-life developmental programming by linking newborns’ perinatal complications to accelerated aging at midlife. We observed indications of accelerated aging “inside,” as measured by leukocyte TL, an indicator of cellular aging, and “outside,” as measured by perceived age, an indicator of declining tissue integrity. A better understanding of mechanisms underlying perinatal programming of adult aging is needed. PMID:25349321

Cultural processes in psychotherapy for perinatal loss: Breaking the cultural taboo against perinatal grief.

PubMed

Markin, Rayna D; Zilcha-Mano, Sigal

2018-03-01

This paper argues that there is a cultural taboo against the public recognition and expression of perinatal grief that hinders parents' ability to mourn and their psychological adjustment following a loss. It is proposed that this cultural taboo is recreated within the therapy relationship, as feelings of grief over a perinatal loss are minimized or avoided by the therapist and parent or patient. Importantly, it is suggested that if these cultural dynamics are recognized within the therapy relationship, then psychotherapy has the immense opportunity to break the taboo by validating the parent's loss as real and helping the parent to mourn within an empathic and affect-regulating relationship. Specifically, it is suggested that therapists break the cultural taboo against perinatal grief and help parents to mourn through: acknowledging and not pathologizing perinatal grief reactions, considering intrapsychic and cultural factors that impact a parent's response to loss, exploring cultural reenactments within the therapy relationship, empathizing with the parent's experience of loss and of having to grieve within a society that does not recognize perinatal loss, coregulating the parent's feelings of grief and loss, and helping patients to create personally meaningful mourning rituals. Lastly, the impact of within and between cultural differences and therapist attitudes on the therapy process is discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Officials welcome the arrival of the Japanese Experiment Module

NASA Image and Video Library

2007-04-17

In the Space Station Processing Facility, NASA and Japanese Aerospace and Exploration Agency (JAXA) officials welcome the arrival of the Experiment Logistics Module Pressurized Section for the Japanese Experiment Module, or JEM, to the Kennedy Space Center. Seen here at right are JAXA representatives, including Japanese astronaut Takao Doi (center of front row), who is a crew member for mission STS-123 that will deliver the module to the space station. The new International Space Station component arrived at Kennedy March 12 to begin preparations for its future launch on mission STS-123. It will serve as an on-orbit storage area for materials, tools and supplies. It can hold up to eight experiment racks and will attach to the top of another larger pressurized module.

Neurometabolite Alterations Associated With Cognitive Performance in Perinatally HIV-Infected Children.

PubMed

Van Dalen, Yvonne W; Blokhuis, Charlotte; Cohen, Sophie; Ter Stege, Jacqueline A; Teunissen, Charlotte E; Kuhle, Jens; Kootstra, Neeltje A; Scherpbier, Henriette J; Kuijpers, Taco W; Reiss, Peter; Majoie, Charles B L M; Caan, Matthan W A; Pajkrt, Dasja

2016-03-01

Despite treatment with combination antiretroviral therapy (cART), cognitive impairment is still observed in perinatally HIV-infected children. We aimed to evaluate potential underlying cerebral injury by comparing neurometabolite levels between perinatally HIV-infected children and healthy controls. This cross-sectional study evaluated neurometabolites, as measured by Magnetic Resonance Spectroscopy (MRS), in perinatally HIV-infected children stable on cART (n = 26) and healthy controls (n = 36).Participants were included from a cohort of perinatally HIV-infected children and healthy controls, matched group-wise for age, gender, ethnicity, and socio-economic status. N-acetylaspartate (NAA), glutamate (Glu), myo-inositol (mI), and choline (Cho) levels were studied as ratios over creatine (Cre). Group differences and associations with HIV-related parameters, cognitive functioning, and neuronal damage markers (neurofilament and total Tau proteins) were determined using age-adjusted linear regression analyses.HIV-infected children had increased Cho:Cre in white matter (HIV-infected = 0.29 ± 0.03; controls = 0.27 ± 0.03; P value = 0.045). Lower nadir CD4+ T-cell Z-scores were associated with reduced neuronal integrity markers NAA:Cre and Glu:Cre. A Centers for Disease Control and Prevention (CDC) stage C diagnosis was associated with higher glial markers Cho:Cre and mI:Cre. Poorer cognitive performance was mainly associated with higher Cho:Cre in HIV-infected children, and with lower NAA:Cre and Glu:Cre in healthy controls. There were no associations between neurometabolites and neuronal damage markers in blood or CSF.Compared to controls, perinatally HIV-infected children had increased Cho:Cre in white matter, suggestive of ongoing glial proliferation. Levels of several neurometabolites were associated with cognitive performance, suggesting that MRS may be a useful method to assess cerebral changes potentially linked to cognitive outcomes.

A literature review on integrated perinatal care

PubMed Central

Rodríguez, Charo; des Rivières-Pigeon, Catherine

2007-01-01

Context The perinatal period is one during which health care services are in high demand. Like other health care sub-sectors, perinatal health care delivery has undergone significant changes in recent years, such as the integrative wave that has swept through the health care industry since the early 1990s. Purpose The present study aims at reviewing scholarly work on integrated perinatal care to provide support for policy decision-making. Results Researchers interested in integrated perinatal care have, by assessing the effectiveness of individual clinical practices and intervention programs, mainly addressed issues of continuity of care and clinical and professional integration. Conclusions Improvements in perinatal health care delivery appear related not to structurally integrated health care delivery systems, but to organizing modalities that aim to support woman-centred care and cooperative clinical practice. PMID:17786177

Case review of perinatal deaths at hospitals in Kigali, Rwanda: perinatal audit with application of a three-delays analysis.

PubMed

Musafili, Aimable; Persson, Lars-Åke; Baribwira, Cyprien; Påfs, Jessica; Mulindwa, Patrick Adam; Essén, Birgitta

2017-03-11

Perinatal audit and the three-delays model are increasingly being employed to analyse barriers to perinatal health, at both community and facility level. Using these approaches, our aim was to assess factors that could contribute to perinatal mortality and potentially avoidable deaths at Rwandan hospitals. Perinatal audits were carried out at two main urban hospitals, one at district level and the other at tertiary level, in Kigali, Rwanda, from July 2012 to May 2013. Stillbirths and early neonatal deaths occurring after 22 completed weeks of gestation or more, or weighing at least 500 g, were included in the study. Factors contributing to mortality and potentially avoidable deaths, considering the local resources and feasibility, were identified using a three-delays model. Out of 8424 births, there were 269 perinatal deaths (106 macerated stillbirths, 63 fresh stillbirths, 100 early neonatal deaths) corresponding to a stillbirth rate of 20/1000 births and a perinatal mortality rate of 32/1000 births. In total, 250 perinatal deaths were available for audit. Factors contributing to mortality were ascertained for 79% of deaths. Delay in care-seeking was identified in 39% of deaths, delay in arriving at the health facility in 10%, and provision of suboptimal care at the health facility in 37%. Delay in seeking adequate care was commonly characterized by difficulties in recognising or reporting pregnancy-related danger signs. Lack of money was the major cause of delay in reaching a health facility. Delay in referrals, diagnosis and management of emergency obstetric cases were the most prominent contributors affecting the provision of appropriate and timely care by healthcare providers. Half of the perinatal deaths were judged to be potentially avoidable and 70% of these were fresh stillbirths and early neonatal deaths. Factors contributing to delays underlying perinatal mortality were identified in more than three-quarters of deaths. Half of the perinatal deaths were

The implementation of unit-based perinatal mortality audit in perinatal cooperation units in the northern region of the Netherlands

PubMed Central

2012-01-01

Background Perinatal (mortality) audit can be considered to be a way to improve the careprocess for all pregnant women and their newborns by creating an opportunity to learn from unwanted events in the care process. In unit-based perinatal audit, the caregivers involved in cases that result in mortality are usually part of the audit group. This makes such an audit a delicate matter. Methods The purpose of this study was to implement unit-based perinatal mortality audit in all 15 perinatal cooperation units in the northern region of the Netherlands between September 2007 and March 2010. These units consist of hospital-based and independent community-based perinatal caregivers. The implementation strategy encompassed an information plan, an organization plan, and a training plan. The main outcomes are the number of participating perinatal cooperation units at the end of the project, the identified substandard factors (SSF), the actions to improve care, and the opinions of the participants. Results The perinatal mortality audit was implemented in all 15 perinatal cooperation units. 677 different caregivers analyzed 112 cases of perinatal mortality and identified 163 substandard factors. In 31% of cases the guidelines were not followed and in 23% care was not according to normal practice. In 28% of cases, the documentation was not in order, while in 13% of cases the communication between caregivers was insufficient. 442 actions to improve care were reported for ‘external cooperation’ (15%), ‘internal cooperation’ (17%), ‘practice organization’ (26%), ‘training and education’ (10%), and ‘medical performance’ (27%). Valued aspects of the audit meetings were: the multidisciplinary character (13%), the collective and non-judgmental search for substandard factors (21%), the perception of safety (13%), the motivation to reflect on one’s own professional performance (5%), and the inherent postgraduate education (10%). Conclusion Following our

Cross-National Differences in Psychosocial Factors of Perinatal Depression: A Systematic Review of India and Japan

PubMed Central

Ohashi, Yukiko; Lazarus, Anisha; Kitamura, Toshinori

2017-01-01

Perinatal depression is prevalent worldwide. However, there are few available studies that discuss the different cultural factors affecting perinatal depression within Asian countries. This study aims to compare the literature regarding related factors relating to perinatal depression in India and Japan, and to synthesize the evidence common to both countries in addition to the country-specific evidence. We conducted a systematic review using several databases (CINAHL, MEDLINE, Pubmed, Ovid, SCOPUS, IndMED, and ICHUSI). Keywords were “antenatal depression” or “postpartum depression”, and “India” or “Japan”. Both Japanese and English language papers were reviewed. The identified evidence was compared between the two countries, as well as with non-Asian countries based on previous reports. In total, 15 articles on India and 35 on Japan were reviewed. Although several factors were shared between the two countries as well as with other non-Asian countries (vulnerable personality, being abused, age, marital conflict, and lower socio-demographic status), some differing factors were identified between India and Japan and non-Asian countries; India: poor socioeconomic status, living only with the husband, pregnancy not welcomed by the husband, a female baby, and poor relationship with in-laws; Japan: infertility treatment, conflict with work–life balance, poor relationships with biological mother or in-laws, and concerns about social relations with the other mother’s friends. To conclude, involving the family and community may be important for implementing both global standardized and culture-specific interventions. In India, treatment involving the in-laws may be effective because large family structure is a significant predictor of perinatal depression. In Japan, a family/community approach involving not only the mother’s family of origin but also the working environment is essential. PMID:29207561

[Introduction of British guidelines in perinatal mental healthcare--towards enhancing the function of perinatal mental healthcare in Japan].

PubMed

Suzuki, Toshihito

2014-01-01

Professionals in many different occupations, from psychiatrists, obstetricians, and pediatricians to nurses, midwives, pharmacists, clinical psychologists, public health nurses, and psychiatric social workers, are involved in perinatal mental healthcare. In order to enhance the function of such healthcare, it is necessary both to provide specialized training in each occupation and form a system and to smoothly conduct medical collaboration between different occupations. A deficiency in the medical function of perinatal mental healthcare greatly influences the mother and child's health, mental hygiene, and social life later in life. Therefore, a demand is seen for specialized staff and system formation capable of the following: 1) responding with appropriate perinatal management of female patients taking psychotropic drugs; 2) providing support and pregnancy consultation to female patients who wish to have children; and 3) properly handling postpartum mental disorder management, possibility of breastfeeding, and various issues that arise in mother-child relationships during upbringing. In the UK, the clinical guideline (NICE Clinical Guideline 45) for perinatal mental healthcare, which was created by the National Institute for Clinical Excellence (NICE), provides important guidelines on how to handle perinatal mental health. Aside from the NICE guideline, the Maudsley Prescribing Guidelines in Psychiatry indicates basic guidelines on prescribing perinatal drug therapy. In Japan, however, the current situation of perinatal mental healthcare is such that it has yet to be systemically developed. In this paper, we introduce the basic content in these British guidelines that should be noted. In addition, we consider the current status and future disposition of Japan's perinatal mental healthcare, with consideration for the differences in healthcare circumstances between Japan and the UK.

Perinatal Safety: From Concept to Nursing Practice

PubMed Central

Kennedy, Holly Powell

2010-01-01

Communication and teamwork problems are leading causes of documented preventable adverse outcomes in perinatal care. An essential component of perinatal safety is the organizational culture in which clinicians work. Clinicians’ individual and collective authority to question the plan of care and take action to change the direction of a clinical situation in the patient’s best interest can be viewed as their “agency for safety.” However, collective agency for safety and commitment to support nurses in their advocacy role is missing in many perinatal care settings. This paper draws from Organizational Accident Theory, High Reliability Theory, and Symbolic Interactionism to describe the nurse’s role in maintaining safety during labor and birth in acute care settings, and suggests actions for supporting the perinatal nurse at individual, group, and systems levels to achieve maximum safety in perinatal care. PMID:20147827

Perinatal safety: from concept to nursing practice.

PubMed

Lyndon, Audrey; Kennedy, Holly Powell

2010-01-01

Communication and teamwork problems are leading causes of documented preventable adverse outcomes in perinatal care. An essential component of perinatal safety is the organizational culture in which clinicians work. Clinicians' individual and collective authority to question the plan of care and take action to change the direction of a clinical situation in the patient's best interest can be viewed as their "agency for safety." However, collective agency for safety and commitment to support nurses in their role of advocacy is missing in many perinatal care settings. This article draws from Organizational Accident Theory, High Reliability Theory, and Symbolic Interactionism to describe the nurse's role in maintaining safety during labor and birth in acute care settings and suggests actions for supporting the perinatal nurse at individual, group, and systems levels to achieve maximum safety in perinatal care.

[Perinatal Information System. Incorporation latency and impact on perinatal clinical registry].

PubMed

Simini, F; Fernández, A; Sosa, C; Díaz Rossello, J L

2001-10-01

The Perinatal Information System (SIP) is a clinical record, local management and quality assurance software standard in Latin America and the Caribbean. The time to implement SIP in a Maternity Hospital is evaluated as well as the effect of statistics on perinatal health indicators in subsequent years. In the sample of 20 Maternity Hospitals (5 Countries, 40% Private and 60% Public) 85% had a reliable information system by the third year of use of SIP. 15% of hospitals still had problems at that time that were already clear during the second year, a time corrective measures can still be taken. The evaluation of the impact of yearly reports shows that 58% of recommendations were fulfilled, specially those regarding the complete filling-in of clinical records (62%) and to a lesser extent variables that reflect clinical practices and organization of services (52%). The conclusion is that Maternity Hospitals in Latin America and the Caribbean have the capacity to adopt a complex tool of computerized clinical records for quality assurance of perinatal care and monitoring of health indicators.

JETC (Japanese Technology Evaluation Center) Panel Report on High Temperature Superconductivity in Japan

NASA Technical Reports Server (NTRS)

Shelton, Duane; Gamota, George

1989-01-01

The Japanese regard success in R and D in high temperature superconductivity as an important national objective. The results of a detailed evaluation of the current state of Japanese high temperature superconductivity development are provided. The analysis was performed by a panel of technical experts drawn from U.S. industry and academia, and is based on reviews of the relevant literature and visits to Japanese government, academic and industrial laboratories. Detailed appraisals are presented on the following: Basic research; superconducting materials; large scale applications; processing of superconducting materials; superconducting electronics and thin films. In all cases, comparisons are made with the corresponding state-of-the-art in the United States.

Current Situation of Treatment for Anaphylaxis in a Japanese Pediatric Emergency Center.

PubMed

Ninchoji, Takeshi; Iwatani, Sota; Nishiyama, Masahiro; Kamiyoshi, Naohiro; Taniguchi-Ikeda, Mariko; Morisada, Naoya; Ishibashi, Kazuto; Iijima, Kazumoto; Ishida, Akihito; Morioka, Ichiro

2018-04-01

Anaphylaxis is a systemic allergic reaction that sometimes requires prompt treatment with intramuscular adrenaline. The aim of the study was to investigate the current situation regarding anaphylaxis treatment in a representative pediatric primary emergency facility in Japan. We retrospectively examined the medical records dating from April 2011 through March 2014 from Kobe Children's Primary Emergency Medical Center, where general pediatricians work on a part-time basis. Clinical characteristics and current treatments for patients with anaphylaxis who presented to the facility were investigated. Furthermore, we compared the clinical characteristics between anaphylaxis patients given intramuscular adrenaline and those not given it. During the study period, 217 patients were diagnosed with anaphylaxis. The median Sampson grade at the time of visit was 2, and 90 patients (41%) were grade 4 or higher. No patients received self-intramuscular injected adrenaline before arrival at our emergency medical center because none of the patients had been prescribed it. Further treatment during the visit was provided to 128 patients (59%), with only 17 (8%) receiving intramuscular adrenaline. Patients given intramuscular adrenaline had significantly lower peripheral saturation of oxygen at the visit (P = 0.025) and more frequent transfer to a referral hospital (P < 0.001) than those not given intramuscular adrenaline. Education for Japanese pediatric practitioners and patients is warranted, because no patients used self-intramuscular injected adrenaline as a prehospital treatment for anaphylaxis, and only severely affected patients who needed oxygen therapy or hospitalization received intramuscular adrenaline in a pediatric primary emergency setting.

Gestational age-specific perinatal mortality rates for assisted reproductive technology (ART) and other births.

PubMed

Chughtai, Abrar A; Wang, Alex Y; Hilder, Lisa; Li, Zhuoyang; Lui, Kei; Farquhar, Cindy; Sullivan, Elizabeth A

2018-02-01

definition of perinatal period commences at 20 completed weeks (140 days) of gestation and ends 27 completed days after birth which is different from the definition by World Health Organisation (commences at 22 completed weeks (154 days) of gestation and ends seven completed days after birth) and by Centers for Disease Control and Prevention (includes infant deaths under age 7 days and fetal deaths at 28 weeks of gestation or more). Preterm birth is the single most important contributing factor to increased risk of perinatal mortality among ART singletons compared to non-ART singletons. Further research on reducing early preterm delivery, with the aim of reducing the perinatal mortality among ART births is needed. Couples who access ART treatment should be fully informed regarding the risk of preterm birth and subsequent risk of perinatal death. There was no funding associated with this study. No conflict of interest was declared. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Rethinking the birthing body: Cartesian dualism and perinatal nursing.

PubMed

Goldberg, Lisa

2002-03-01

This paper highlights the pervasive influence of a Cartesian metaphysics on the medical paradigm and its profound impact on the practice of perinatal nursing in North America. Modern perinatal health care practices are founded on a Cartesian metaphysics that reduce birthing women to the status of object. Such practices deny the holistic aims of perinatal nursing. A philosophical inquiry informs the tenets of this metaphysical discussion regarding the foundations of perinatal nursing practices. Although perinatal health care is founded on a Cartesian metaphysics, an alternative paradigm of embodied practice is suggested as a way of viewing birthing women as embodied subjects. If the foundations of health care, which have been built on a Cartesian metaphysics, are not re-examined, perinatal nurses will be providing care that further reduce women to the status of object.

Perinatal outcomes of singleton term breech deliveries in Basra.

PubMed

Alshaheen, H; Abd Al-Karim, A

2010-01-01

This study aimed to assess the perinatal morbidity and mortality in breech deliveries, to study the correlation of parity and birth weight with perinatal mortality by mode of delivery. Of 210 women in labour in Basra maternity and child hospital, 97 underwent vaginal breech deliveries and 113 delivered by caesarean section. Birth trauma was restricted to vaginal deliveries. The perinatal mortality was significantly higher in vaginal deliveries (8.2%) compared with caesarean deliveries (0.9%). A higher perinatal mortality was recorded among infants > 3500-4000 g birth weight in vaginal deliveries. Caesarean section reduced the perinatal mortality in both nulliparous and parous women in term breech infants.

Is there an association between female circumcision and perinatal death?

PubMed Central

Essen, Birgitta; Bodker, Birgit; Sjoberg, N-O; Gudmundsson, Saemundur; Ostergren, P-O; Langhoff-Roos, Jens

2002-01-01

OBJECTIVE: In Sweden, a country with high standards of obstetric care, the high rate of perinatal mortality among children of immigrant women from the Horn of Africa raises the question of whether there is an association between female circumcision and perinatal death. METHOD: To investigate this, we examined a cohort of 63 perinatal deaths of infants born in Sweden over the period 1990-96 to circumcised women. FINDINGS: We found no evidence that female circumcision was related to perinatal death. Obstructed or prolonged labour, caused by scar tissue from circumcision, was not found to have any impact on the number of perinatal deaths. CONCLUSION: The results do not support previous conclusions that genital circumcision is related to perinatal death, regardless of other circumstances, and suggest that other, suboptimal factors contribute to perinatal death among circumcised migrant women. PMID:12219153

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Executive Director of NASDA Koji Yamamoto (center) joins others for a tour. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of the newest Space Station module, the Japanese Experiment Module/pressurized module.

NASA Image and Video Library

2003-06-12

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Executive Director of NASDA Koji Yamamoto (center) joins others for a tour. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of the newest Space Station module, the Japanese Experiment Module/pressurized module.

Perinatal inflammation and adult psychopathology: From preclinical models to humans.

PubMed

Depino, Amaicha Mara

2018-05-01

Perinatal environment plays a crucial role in brain development and determines its function through life. Epidemiological studies and clinical reports link perinatal exposure to infection and/or immune activation to various psychiatric disorders. In addition, accumulating evidence from animal models shows that perinatal inflammation can affect various behaviors relevant to psychiatric disorders such as schizophrenia, autism, anxiety and depression. Remarkably, the effects on behavior and brain function do not always depend on the type of inflammatory stimulus or the perinatal age targeted, so diverse inflammatory events can have similar consequences on the brain. Moreover, other perinatal environmental factors that affect behavior (e.g. diet and stress) also elicit inflammatory responses. Understanding the interplay between perinatal environment and inflammation on brain development is required to identify the mechanisms through which perinatal inflammation affect brain function in the adult animal. Evidence for the role of the peripheral immune system and glia on perinatal programming of behavior is discussed in this review, along with recent evidence for the role of epigenetic mechanisms affecting gene expression in the brain. Copyright © 2017 Elsevier Ltd. All rights reserved.

Spatial Analysis of China Province-level Perinatal Mortality

PubMed Central

XIANG, Kun; SONG, Deyong

2016-01-01

Background: Using spatial analysis tools to determine the spatial patterns of China province-level perinatal mortality and using spatial econometric model to examine the impacts of health care resources and different socio-economic factors on perinatal mortality. Methods: The Global Moran’s I index is used to examine whether the spatial autocorrelation exists in selected regions and Moran’s I scatter plot to examine the spatial clustering among regions. Spatial econometric models are used to investigate the spatial relationships between perinatal mortality and contributing factors. Results: The overall Moran’s I index indicates that perinatal mortality displays positive spatial autocorrelation. Moran’s I scatter plot analysis implies that there is a significant clustering of mortality in both high-rate regions and low-rate regions. The spatial econometric models analyses confirm the existence of a direct link between perinatal mortality and health care resources, socio-economic factors. Conclusions: Since a positive spatial autocorrelation has been detected in China province-level perinatal mortality, the upgrading of regional economic development and medical service level will affect the mortality not only in region itself but also its adjacent regions. PMID:27398334

Acknowledged Dependence and the Virtues of Perinatal Hospice

PubMed Central

Cobb, Aaron D.

2016-01-01

Prenatal screening can lead to the detection and diagnosis of significantly life-limiting conditions affecting the unborn child. Recognizing the difficulties facing parents who decide to continue the pregnancy, some have proposed perinatal hospice as a new modality of care. Although the medical literature has begun to devote significant attention to these practices, systematic philosophical reflection on perinatal hospice has been relatively limited. Drawing on Alasdair MacIntyre’s account of the virtues of acknowledged dependence, I contend that perinatal hospice manifests and facilitates virtues essential to living well with human dependency and vulnerability. For this reason, perinatal hospice deserves broad support within society. PMID:26661051

Japanese Competitiveness and Japanese Management.

ERIC Educational Resources Information Center

Minabe, Shigeo

1986-01-01

Analyzes and compares Japanese and American industrial policy and labor practices. Proposes that certain aspects of the Japanese system be adapted by American businesses for purpose of increasing international competitiveness. Proposes specific actions and plans for both the Japanese and American systems. (ML)

[Tobacco control policies and perinatal health].

PubMed

Peelen, M J; Sheikh, A; Kok, M; Hajenius, P; Zimmermann, L J; Kramer, B W; Hukkelhoven, C W; Reiss, I K; Mol, B W; Been, J V

2017-01-01

Study the association between the introduction of tobacco control policies in the Netherlands and changes in perinatal outcomes. National quasi-experimental study. We used Netherlands Perinatal Registry data (now called Perined) for the period 2000-2011. We studied whether the introduction of smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign in January 2004, and extension of the smoke-free law to the hospitality industry accompanied by another tax increase and media campaign in July 2008, was associated with changes in perinatal outcomes. We studied all singleton births (gestational age: 24+0 to 42+6 weeks). Our primary outcome measures were: perinatal mortality, preterm birth and being small-for-gestational-age (SGA). Interrupted time series logistic regression analyses were performed to investigate changes in these outcomes occurred after the introduction of the aforementioned tobacco control policies (ClinicalTrials.gov: NCT02189265). Among 2,069,695 singleton births, 13,027 (0.6%) perinatal deaths, 116,043 (5.6%) preterm live-births and 187,966 (9.1%) SGA live-births were observed. The policies introduced in January 2004 were not associated with significant changes in any of the primary outcome measures. A -4.4% (95% CI: -6.4 to -2.4; p < 0.001) decrease in odds of a SGA birth was observed after the policy extension in July 2008 to include a smoke-free hospitality industry, a further tax increase and another media campaign. This translates to an estimated over 500 cases of SGA being averted per year. A reduction in SGA births, but not preterm birth or perinatal mortality, was observed in the Netherlands after extension of the smoke-free workplace law to include bars and restaurants, in conjunction with a tax increase and media campaign in 2008.

Perinatal mortality attributable to complications of childbirth in Matlab, Bangladesh.

PubMed Central

Kusiako, T.; Ronsmans, C.; Van der Paal, L.

2000-01-01

Very few population-based studies of perinatal mortality in developing countries have examined the role of intrapartum risk factors. In the present study, the proportion of perinatal deaths that are attributable to complications during childbirth in Matlab, Bangladesh, was assessed using community-based data from a home-based programme led by professional midwives between 1987 and 1993. Complications during labour and delivery--such as prolonged or obstructed labour, abnormal fetal position, and hypertensive diseases of pregnancy--increased the risk of perinatal mortality fivefold and accounted for 30% of perinatal deaths. Premature labour, which occurred in 20% of pregnancies, accounted for 27% of perinatal mortality. Better care by qualified staff during delivery and improved care of newborns should substantially reduce perinatal mortality in this study population. PMID:10859856

Perinatal legislative policies and health outcomes.

PubMed

Lorch, Scott A

2017-10-01

Perinatal epidemiology examines the variation and determinants of pregnancy outcomes from a maternal and neonatal perspective. However, improving public and population health also requires the translation of this evidence base into substantive public policies. Assessing the impact of such public policies requires sufficient data to include potential confounding factors in the analysis, such as coexisting medical conditions and socioeconomic status, and appropriate statistical and epidemiological techniques. This review will explore policies addressing three areas of perinatal medicine-elective deliveries prior to 39 weeks' gestation; perinatal regionalization; and mandatory paid maternity leave policies-to illustrate the challenges when assessing the impact of specific policies at the patient and population level. Data support the use of these policies to improve perinatal health, but with weaker and less certain effect sizes when compared to the initial patient-level studies. Improved data collection and epidemiological techniques will allow for improved assessment of these policies and the identification of potential areas of improvement when translating patient-level studies into public policies. Copyright © 2017 Elsevier Inc. All rights reserved.

eHealth as the Next-Generation Perinatal Care: An Overview of the Literature.

PubMed

van den Heuvel, Josephus Fm; Groenhof, T Katrien; Veerbeek, Jan Hw; van Solinge, Wouter W; Lely, A Titia; Franx, Arie; Bekker, Mireille N

2018-06-05

the shift from hospital-centered to patient-centered care. This review showed that eHealth interventions have a very broad, multilevel field of application focused on perinatal care in all its aspects. Most of the reviewed 71 articles were published after 2013, suggesting this novel type of care is an important topic of clinical and scientific relevance. Despite the promising preliminary results as presented, we accentuate the need for evidence for health outcomes, patient satisfaction, and the impact on costs of the possibilities of eHealth interventions in perinatal care. In general, the combination of increased patient empowerment and home pregnancy care could lead to more satisfaction and efficiency. Despite the challenges of privacy, liability, and costs, eHealth is very likely to disperse globally in the next decade, and it has the potential to deliver a revolution in perinatal care. ©Josephus FM van den Heuvel, T Katrien Groenhof, Jan HW Veerbeek, Wouter W van Solinge, A Titia Lely, Arie Franx, Mireille N Bekker. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.06.2018.

Pre- and Postnatal Smoking Exposure and Risk of Atopic Eczema in Young Japanese Children: A Prospective Prebirth Cohort Study.

PubMed

Tanaka, Keiko; Miyake, Yoshihiro; Furukawa, Shinya; Arakawa, Masashi

2017-07-01

Epidemiological evidence regarding the effect of perinatal smoking exposure on atopic eczema in children continues to be inconclusive. The aim of this prospective prebirth cohort study was to investigate the association between prenatal smoking exposure and postnatal living with household smokers and the risk of atopic eczema in Japanese children aged 23 to 29 months. Study subjects were 1354 Japanese mother-child pairs. Information on the variables under study was obtained through questionnaires which were completed by mothers, first prior to delivery, then shortly after birth and subsequently around 4, 12, and 24 months after delivery. Eczema in the last 12 months was defined according to the criteria of the International Study of Asthma and Allergies in Childhood. Physician-diagnosed atopic eczema was considered present if reported by mothers. Compared with no perinatal smoking exposure, prenatal smoking exposure only was associated with an increased risk of physician-diagnosed atopic eczema (adjusted odds ratio = 7.11, 95% confidence interval: 1.43 to 27.8). Postnatal living with at least one household smoker only was not associated with the risk of physician-diagnosed atopic eczema; neither was the combination of both prenatal smoking exposure and postnatal living with at least one household smoker. No association was observed between perinatal smoking exposure status and the risk of eczema as defined according to the International Study of Asthma and Allergies in Childhood criteria. Our findings suggest that maternal smoking during pregnancy may increase the risk of atopic eczema in young children. In the present prebirth cohort study, we assessed the independent and additive effects of pre- and postnatal exposure to tobacco smoking on atopic eczema in children. Compared with no perinatal smoking exposure, prenatal smoking exposure only was significantly associated with an increased risk of atopic eczema. Postnatal smoking exposure only was not associated

Placenta accreta is an independent risk factor for late pre-term birth and perinatal mortality.

PubMed

Vinograd, Adi; Wainstock, Tamar; Mazor, Moshe; Beer-Weisel, Ruthy; Klaitman, Vered; Dukler, Doron; Hamou, Batel; Novack, Lena; Ben-Shalom Tirosh, Neta; Vinograd, Ofir; Erez, Offer

2015-08-01

This study is aimed to identify the risk factors for the development of placenta accreta (PA) and characterize its effect on maternal and perinatal outcomes. This population-based retrospective cohort study included all deliveries at our medical center during the study period. Those with placenta accreta (n = 551) comprised the study group, while the rest of the deliveries (n = 239 089) served as a comparison group. The prevalence of placenta accerta is 0.2%. Women with this complication had higher rates of ≥2 previous CS (p < 0.001), recurrent abortions (p = 0.03), and previous placenta accreta [p < 0.001]. The rates of placenta previa and peripartum hemorrhage necessitating blood transfusion were higher in women with placenta accreta than in the comparison group. PTB before 34 and 37 weeks of gestation was more common among women with placenta accreta (p < 0.01), as was the rate of perinatal mortality (p < 0.001). Placenta accreta was an independent risk factor for perinatal mortality (adj. OR 8.2; 95% CI 6.4-10.4, p < 0.001) and late PTB (adj. OR 1.4; 95% CI 1.1-1.7, p = 0.002). Placenta accreta is an independent risk factor for late PTB and perinatal mortality.

Perinatal suicide in Ontario, Canada: a 15-year population-based study.

PubMed

Grigoriadis, Sophie; Wilton, Andrew S; Kurdyak, Paul A; Rhodes, Anne E; VonderPorten, Emily H; Levitt, Anthony; Cheung, Amy; Vigod, Simone N

2017-08-28

Death by suicide during the perinatal period has been understudied in Canada. We examined the epidemiology of and health service use related to suicides during pregnancy and the first postpartum year. In this retrospective, population-based cohort study, we linked health administrative databases with coroner death records (1994-2008) for Ontario, Canada. We compared sociodemographic characteristics, clinical features and health service use in the 30 days and 1 year before death between women who died by suicide perinatally, women who died by suicide outside of the perinatal period and living perinatal women. The perinatal suicide rate was 2.58 per 100 000 live births, with suicide accounting for 51 (5.3%) of 966 perinatal deaths. Most suicides occurred during the final quarter of the first postpartum year, with highest rates in rural and remote regions. Perinatal women were more likely to die from hanging (33.3% [17/51]) or jumping or falling (19.6% [10/51]) than women who died by suicide non-perinatally ( p = 0.04). Only 39.2% (20/51) had mental health contact within the 30 days before death, similar to the rate among those who died by suicide non-perinatally (47.7% [762/1597]; odds ratio [OR] 0.71, 95% confidence interval [CI] 0.40-1.25). Compared with living perinatal women matched by pregnancy or postpartum status at date of suicide, perinatal women who died by suicide had similar likelihood of non-mental health primary care and obstetric care before the index date but had a lower likelihood of pediatric contact (64.5% [20/31] v. 88.4% [137/155] at 30 days; OR 0.24, 95% CI 0.10-0.58). The perinatal suicide rate for Ontario during the period 1994-2008 was comparable to international estimates and represents a substantial component of Canadian perinatal mortality. Given that deaths by suicide occur throughout the perinatal period, all health care providers must be collectively vigilant in assessing risk. © 2017 Canadian Medical Association or its licensors.

Maternal and perinatal outcomes during expectant management of 239 severe preeclamptic women between 24 and 33 weeks' gestation.

PubMed

Haddad, Bassam; Deis, Stéphanie; Goffinet, François; Paniel, Bernard J; Cabrol, Dominique; Siba, Baha M

2004-06-01

This study was undertaken to determine maternal and perinatal outcomes after expectant management of severe preeclampsia between 24 and 33 weeks' gestation. A prospective observational study of 239 women with severe preeclamptic and undelivered after antenatal steroid prophylaxis was performed. Pregnancy prolongation and maternal and perinatal morbidities were analyzed according to the gestational age at time of expectant management: 24 to 28, 29 to 31, and 32 to 33 weeks. Statistical analysis was performed by Student t test and chi(2) test. The days of pregnancy prolongation were significantly higher among those managed at less than 29 weeks (6) compared with the other groups (4). There were 13 perinatal deaths: 12 in those managed at less than 29 weeks and 1 in those managed at 29 to 31 weeks. Neonatal morbidities were significantly higher among those managed at less than 29 weeks compared with the other groups. There were no instances of maternal death or eclampsia. Maternal morbidities were similar among the groups. Expectant management of severe preeclampsia at 24 to 33 weeks in a tertiary care center is associated with good perinatal outcome with a minimal risk for the mother.

Substance use in the perinatal period

PubMed Central

Forray, Ariadna; Foster, Dawn

2015-01-01

Perinatal substance use remains a major public health problem and is associated with a number of deleterious maternal and fetal effects. Polysubstance use in pregnancy is common, and can potentiate adverse maternal and fetal outcomes. Tobacco is the most commonly used substance in pregnancy, followed by alcohol and illicit substances. The treatments for perinatal substance use are limited and consist mostly of behavioral and psychosocial interventions. Of these contingency management has shown the most efficacy. More recently, novel interventions such as progesterone for postpartum cocaine use have shown promise. The purpose of this review is to examine the recent literature on the use of tobacco, alcohol, cannabis, stimulants, and opioids in the perinatal period, their effects on maternal and fetal health and current treatments. PMID:26386836

A concept analysis of optimality in perinatal health.

PubMed

Kennedy, Holly Powell

2006-01-01

This analysis was conducted to describe the concept of optimality and its appropriateness for perinatal health care. The concept was identified in 24 scientific disciplines. Across all disciplines, the universal definition of optimality is the robust, efficient, and cost-effective achievement of best possible outcomes within a rule-governed framework. Optimality, specifically defined for perinatal health care, is the maximal perinatal outcome with minimal intervention placed against the context of the woman's social, medical, and obstetric history.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, workers (in protective clothing) brief STS-117 Mission Specialist James Reilly (center) and STS-115 Mission Specialist Joseph Tanner (right) about the Japanese Experiment Module (JEM). Equipment familiarization is a routine part of astronaut training and launch preparations.

NASA Image and Video Library

2003-10-21

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, workers (in protective clothing) brief STS-117 Mission Specialist James Reilly (center) and STS-115 Mission Specialist Joseph Tanner (right) about the Japanese Experiment Module (JEM). Equipment familiarization is a routine part of astronaut training and launch preparations.

Registry of the Japanese society of lung and heart-lung transplantation: the official Japanese lung transplantation report 2012.

PubMed

Oto, Takahiro; Okada, Yoshinori; Bando, Toru; Minami, Masato; Shiraishi, Takeshi; Nagayasu, Takeshi; Chida, Masayuki; Okumura, Meinoshin; Date, Hiroshi; Miyoshi, Shinichiro; Kondo, Takashi

2013-04-01

The Japanese Organ Transplant Law was amended, and the revised law took effect in July 2010 to overcome extreme donor shortage and to increase the availability of donor organs from brain-dead donors. It is now possible to procure organs from children. The year 2011 was the first year that it was possible to examine the results of this first extensive revision of the Japanese Organ Transplant Law, which took effect in 1997. Currently, seven transplant centers, including Tohoku, Dokkyo, Kyoto, Osaka, Okayama, Fukuoka and Nagasaki Universities, are authorized to perform lung transplantation in Japan, and by the end of 2011, a total of 239 lung transplants had been performed. The number of transplants per year and the ratio of brain-dead donor transplants increased dramatically after the revision of the Japanese Organ Transplant Law. The survival rates for lung transplant recipients registered with the Japanese Society for Lung and Heart-lung Transplantation were 93.3 % at 1 month, 91.5 % at 3 months, 86.3 % at 1 year, 79.0 % at 3 years, and 73.1 % at 5 years. The survival curves for brain-dead donor and living-donor lung transplantation were similar. The survival outcomes for both brain-dead and living-donor lung transplants were better than those reported by the International Society for Heart and Lung Transplantation. However, donor shortage remains a limitation of lung transplantation in Japan. The lung transplant centers in Japan should continue to make a special effort to save critically ill patients waiting for lung transplantation.

Minimal Brain Dysfunction: Associations with Perinatal Complications.

ERIC Educational Resources Information Center

Nichols, Paul L.

Examined with over 28,000 7-year-old children whose mothers registered for prenatal care was the relationship between perinatal complications and such characteristics as poor school achievement, hyperactivity, and neurological soft signs associated with the diagnosis of minimal brain dysfunction (MBD). Ten perinatal antecedents were studied:…

Trends in perinatal HIV prevention in New York City, 1994-2003.

PubMed

Peters, Vicki B; Liu, Kai-Lih; Robinson, Lisa-Gaye; Dominguez, Kenneth L; Abrams, Elaine J; Gill, Balwant S; Thomas, Pauline A

2008-10-01

We examined trends in perinatal HIV prevention interventions in New York City implemented during 1994 to 2003 to ascertain the success of the interventions in reducing perinatal transmission. We used data obtained from infant records at 22 hospitals. We used multiple logistic regression to analyze factors associated with prenatal care and perinatal HIV transmission. We analyzed data for 4729 perinatally HIV-exposed singleton births. Of mothers with prenatal care data, 92% had prenatal care. The overall proportion who received prenatal care and were diagnosed with HIV before delivery was 86% in 1994 to 1996 and 90% in 1997 to 2003. Use of prenatal antiretrovirals among mothers who received prenatal care was 63% in 1994 to 1996 and 82% in 1997 to 2003. From 1994 to 2003, cesarean births among the entire sample increased from 15% to 55%. During 1997 to 2003, the perinatal HIV transmission rate among the entire sample was 7%; 45% of mothers of infected infants had missed opportunities for perinatal HIV prevention. During 1997 to 2003, maternal illicit drug use was significantly associated with lack of prenatal care. Lack of prenatal, intrapartum, and neonatal antiretrovirals; maternal illicit drug use; and low birthweight were significantly associated with perinatal HIV transmission. Interventions for perinatal HIV prevention can successfully decrease HIV transmission rates. Ongoing perinatal HIV surveillance allows for monitoring the implementation of guidelines to prevent mother-to-child transmission of HIV and determining factors that may contribute to perinatal HIV transmission.

Perinatal depression: a review of US legislation and law.

PubMed

Rhodes, Ann M; Segre, Lisa S

2013-08-01

Accumulating research documenting the prevalence and negative effects of perinatal depression, together with highly publicized tragic critical incidents of suicide and filicide by mothers with postpartum psychosis, have fueled a continuum of legislation. Specialists in perinatal mental health should recognize how their work influences legislative initiatives and penal codes, and take this into consideration when developing perinatal services and research. Yet, without legal expertise, the status of legislative initiatives can be confusing. To address this shortfall, we assembled an interdisciplinary team of academics specializing in law, as well as perinatal mental health, to summarize these issues. This review presents the relevant federal and state legislation and summarizes the criminal codes that governed the court decisions on cases in which a mother committed filicide because of postpartum psychosis. Moreover, the review aims to help researchers and providers who specialize in perinatal depression understand their role in this legal landscape.

Perinatal Practices & Traditions Among Asian Indian Women.

PubMed

Goyal, Deepika

2016-01-01

As the population in the United States grows more diverse, nurses caring for childbearing women must be aware of the many cultural traditions and customs unique to their patients. This knowledge and insight supports women and their families with the appropriate care, information, and resources. A supportive relationship builds trust, offers guidance, and allows for the new family to integrate information from nurses and other healthcare providers with the practice of certain perinatal cultural traditions. The Asian Indian culture is rich in tradition, specifically during the perinatal period. To support the cultural beliefs and practices of Asian Indian women during this time, nurses need to be aware of and consider multiple factors. Many women are navigating the new role of motherhood while making sense of and incorporating important cultural rituals. The purpose of this article is to provide an overview of perinatal cultural practices and traditions specific to the Asian Indian culture that perinatal nurses may observe in the clinical setting. Cultural traditions and practices specific to the pregnancy and postpartum period are described together with symbolism and implications for nursing practice. It is important to note that information regarding perinatal customs is provided in an effort to promote culturally sensitive nursing care and may not pertain to all Asian Indian women living in the United States.

Unfolding Possibilities through a Decolonizing Project: Indigenous Knowledges and Rural Japanese Women

ERIC Educational Resources Information Center

Mayuzumi, Kimine

2009-01-01

Rural Japanese women have been overlooked or misrepresented in the academic and nationalist discourses on Japanese women. Using an anti-colonial feminist framework, I advocate that centering discussions on Indigenous knowledges will help fill this gap based on the belief that Indigenous-knowledge framework is a tool to show the agency of the…

Birth outcomes for women using free-standing birth centers in South Auckland, New Zealand.

PubMed

Bailey, David John

2017-09-01

This study investigates maternal and perinatal outcomes for women with low-risk pregnancies laboring in free-standing birth centers compared with laboring in a hospital maternity unit in a large New Zealand health district. The study used observational data from 47 381 births to women with low-risk pregnancies in South Auckland maternity facilities 2003-2010. Adjusted odds ratios with 95% confidence intervals were calculated for instrumental delivery, cesarean section, blood transfusion, neonatal unit admission, and perinatal mortality. Labor in birth centers was associated with significantly lower rates of instrumental delivery, cesarean section and blood transfusion compared with labor in hospital. Neonatal unit admission rates were lower for infants of nulliparous women laboring in birth centers. Intrapartum and neonatal mortality rates for birth centers were low and were not significantly different from the hospital population. Transfers to hospital for labor and postnatal complications occurred in 39% of nulliparous and 9% of multiparous labors. Risk factors identified for transfer were nulliparity, advanced maternal age, and prolonged pregnancy ≥41 weeks' gestation. Labor in South Auckland free-standing birth centers was associated with significantly lower maternal intervention and complication rates than labor in the hospital maternity unit and was not associated with increased perinatal morbidity. © 2017 Wiley Periodicals, Inc.

An evaluation of perinatal mental health interventions: An integrative literature review.

PubMed

Lavender, Theressa J; Ebert, Lyn; Jones, Donovan

2016-10-01

National statistics related specifically to the mental health of women in the perinatal period is poorly acknowledged in Australia. Maternal deaths related to mental health in the perinatal period can be attributed to a lack of appropriate treatment and/or support. A barrier to women's help-seeking behaviors is the lack of discrete, perinatal specific interventions where women can self-assess and access support. This review examines original research evaluating perinatal mental health interventions used by women to improve mental health. An integrative literature review was undertaken. A comprehensive search strategy using 5 electronic databases resulted in the retrieval of 1898 articles. Use of an inclusion and exclusion criteria and Critical Appraisal Skills Program tools resulted in 4 original research papers. Thematic analysis identified universal themes. Cognitive Behavioral Therapy, Behavioral Activation and Mindfulness-based interventions, specifically adapted to meet the needs of women in the perinatal period, demonstrate an overall improvement in mental health. Women involved in the interventions experienced both improvements in symptoms of anxiety and depression as well as secondary benefits from participating in the research. To improve perinatal mental health outcomes, innovative modes of providing effective perinatal mental health interventions that address the unique needs of women in the perinatal period are needed. Future development of perinatal mental health interventions require adaptions of Cognitive Behavioral Therapy, Behavioral Activation and/or Mindfulness-based methods to address mental health outcomes for women in the perinatal period. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Perinatal pathology: practice suggestions for limited-resource settings.

PubMed

Roberts, Drucilla J

2013-06-01

The practice of perinatal pathology in much of the world suffers, as do all subspecialties of anatomic pathology, from inadequate resources (equipment, consumables, and both professional and technical personnel), from lack of education (not only of the pathologist but also of the clinicians responsible for sending the specimens, and the technicians processing the specimens), and from lack of appropriate government sector support. Perinatal pathology has significant public health-related utility and should be championing its service by providing maternal and fetal/infant mortality and morbidity data to governmental health ministries. It is with this pathologic data that informed decisions can be made on health-related courses of action and allocation of resources. These perinatal pathology data are needed to develop appropriate public health initiatives, specifically toward achieving the Millennium Developmental Goals as the best way to effectively decrease infant and maternal deaths and to determine causes of perinatal mortality and morbidity. The following overview will focus on the utility of perinatal pathology specifically as related to its public health function and will suggest methods to improve its service in resource-poor settings. This article is offered not as a critique of the current practice that most pathologists find themselves working in globally, but to provide suggestions for improving perinatal pathology services, which could be implemented with the limited available resources and manpower most pathology departments currently have. In addition, we offer suggestions for graded improvements ("ramping up") over time.

Impact of perinatal asphyxia on the GABAergic and locomotor system.

PubMed

Van de Berg, W D J; Kwaijtaal, M; de Louw, A J A; Lissone, N P A; Schmitz, C; Faull, R L M; Blokland, A; Blanco, C E; Steinbusch, H W M

2003-01-01

Perinatal asphyxia can cause neuronal loss and depletion of neurotransmitters within the striatum. The striatum plays an important role in motor control, sensorimotor integration and learning. In the present study we investigated whether perinatal asphyxia leads to motor deficits related to striatal damage, and in particular to the loss of GABAergic neurons. Perinatal asphyxia was induced in time-pregnant Wistar rats on the day of delivery by placing the uterus horns, containing the pups, in a 37 degrees C water bath for 20 min. Three motor performance tasks (open field, grip test and walking pattern) were performed at 3 and 6 weeks of age. Antibodies against calbindin and parvalbumin were used to stain GABAergic striatal projection neurons and interneurons, respectively. The motor tests revealed subtle effects of perinatal asphyxia, i.e. small decrease in motor activity. Analysis of the walking pattern revealed an increase in stride width at 6 weeks of age after perinatal asphyxia. Furthermore, a substantial loss of calbindin-immunoreactive (-22%) and parvalbumin-immunoreactive (-43%) cells was found in the striatum following perinatal asphyxia at two months of age. GABA(A) receptor autoradiography revealed no changes in GABA binding activity within the striatum, globus pallidus or substantia nigra. We conclude that perinatal asphyxia resulted in a loss of GABAergic projection neurons and interneurons in the striatum without alteration of GABA(A) receptor affinity. Despite a considerable loss of striatal neurons, only minor deficits in motor performance were found after perinatal asphyxia.

Information Architecture for Perinatal Registration in the Netherlands.

PubMed

Goossen, William T F; Arns-Schiere, Anne Marieke

In the Netherlands, the perinatal registry has undergone significant changes in the past decades. The purpose of this article is to describe the current health care information architecture for the national perinatal registry, including how the national data set is arranged and how electronic messages are used to submit data. We provide implications for women's health care providers based on the creation and implementation of the Dutch perinatal registry system. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

KENNEDY SPACE CENTER, FLA. - Executive Director of NASDA Koji Yamamoto (left) and Center Director Roy Bridges Jr. (right) exchange mementos during Mr. Yamamoto’s visit to KSC. Mr. Bridges also holds the logo of the new Japan Aerospace Exploration Agency, a merger of three Japanese aeronautical and space agencies effective Oct.1, 2003. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of the newest Space Station module, the Japanese Experiment Module/pressurized module. His visit includes a tour of the Columbia Debris Hangar.

NASA Image and Video Library

2003-06-12

KENNEDY SPACE CENTER, FLA. - Executive Director of NASDA Koji Yamamoto (left) and Center Director Roy Bridges Jr. (right) exchange mementos during Mr. Yamamoto’s visit to KSC. Mr. Bridges also holds the logo of the new Japan Aerospace Exploration Agency, a merger of three Japanese aeronautical and space agencies effective Oct.1, 2003. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of the newest Space Station module, the Japanese Experiment Module/pressurized module. His visit includes a tour of the Columbia Debris Hangar.

KENNEDY SPACE CENTER, FLA. - Executive Director of NASDA Koji Yamamoto (left) is welcomed to KSC by Center Director Roy Bridges Jr. (right). On the table between them is the logo of the new Japan Aerospace Exploration Agency, a merger of three Japanese aeronautical and space agencies effective Oct.1, 2003. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of the newest Space Station module, the Japanese Experiment Module/pressurized module. His visit includes a tour of the Columbia Debris Hangar.

NASA Image and Video Library

2003-06-12

KENNEDY SPACE CENTER, FLA. - Executive Director of NASDA Koji Yamamoto (left) is welcomed to KSC by Center Director Roy Bridges Jr. (right). On the table between them is the logo of the new Japan Aerospace Exploration Agency, a merger of three Japanese aeronautical and space agencies effective Oct.1, 2003. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of the newest Space Station module, the Japanese Experiment Module/pressurized module. His visit includes a tour of the Columbia Debris Hangar.

Disasters and Perinatal Health: A Systematic Review

PubMed Central

Harville, EW; Xiong, X; Buekens, P

2012-01-01

Background The empirical literature on the effects of disaster on pregnancy and the postpartum period is limited. The objective of this review was to examine the existing evidence on the effect of disasters on perinatal health. Methods A systematic review was conducted by searching electronic databases (MEDLINE, EMBASE, Cinahl, PsycInfo), including literature on disasters and pregnancy outcomes (e.g., preterm birth, low birthweight, congenital anomalies), mental health, and child development. 110 articles were identified, but many published reports were anecdotes or recommendations rather than systematic studies. The final review included 49 peer-reviewed studies that met inclusion criteria. Results Studies addressing the World Trade Center disaster of September 11th and other terrorist attacks, environmental/chemical disasters, and natural disasters such as hurricanes and earthquakes were identified. Disasters of various types may reduce fetal growth in some women, though there does not appear to be an effect on gestational age at birth. Severity of exposure is the major predictor of mental health issues among pregnant and postpartum women. The mother's mental health after a disaster may more strongly influence on child development than any direct effect of disaster-related prenatal stress. Conclusions There is evidence that disaster impacts maternal mental health and some perinatal health outcomes, particular among highly-exposed women. Future research should focus on under-studied outcomes such as spontaneous abortion. Relief workers and clinicians should concentrate on the most exposed women, particularly with respect to mental health. PMID:21375788

Support after perinatal death: a study of support and counselling after perinatal bereavement.

PubMed Central

Forrest, G C; Standish, E; Baum, J D

1982-01-01

After an earlier study into the practical aspects of the management of perinatal death, a counselling service was introduced for parents whose baby had died in the perinatal period. The service was monitored, and the parents who received the service were compared with a group that did not. Fifty families were allocated randomly either to the counselling (supported) group or to the contrast group, who received routine hospital care. Assessment was carried out at six and 14 months after the death, using a semi-structured interview and two self-rating scales (the general health questionnaire and the Leeds scales). Two of 16 mothers in the supported group showed psychiatric disorder at six months, compared with 10 of 19 in the contrast group (p less than 0.01, Fisher's exact test). There was no significant difference between the two groups at 14 months, when 80% of all the women studied had recovered psychiatric symptoms. Socially isolated women and those who marital relations lacked intimacy had a higher incidence of psychiatric symptoms at six months. Early pregnancy (within six months) was associated with a higher incidence of psychiatric symptoms in the unsupported group. The duration of bereavement reaction after perinatal death was appreciably shortened by support and counselling. PMID:6814610

[Chorionicity and adverse perinatal outcome].

PubMed

Ferreira, Isabel; Laureano, Carla; Branco, Miguel; Nordeste, Ana; Fonseca, Margarida; Pinheiro, Adelaide; Silva, Maria Isabel; Almeida, Maria Céu

2005-01-01

Considering the highest rate of morbidity and mortality in diamniotic monochorionic twins, the authors evaluated and compared the adverse obstetric and perinatal outcome in twin pregnancies according to chorionicity. A retrospective study was conducted in all twin deliveries that occurred in the Obstetric Unit of Maternidade Bissaya-Barreto, for a period of tree years (from the 1st of January 1999 until the 31st of December 2001). From de 140 diamniotic twin pregnancies studied, we considered two groups according to the chorionicity: monochorionic and dichorionic. We compared multiple parameters as, epidemiologic data, adverse obstetric outcome, gestacional delivery age, type of delivery and the morbidity, the mortality and the follow-up of the newborn. The statistic tests used were the X2 and the t student. From the 140 twin pregnancies included in the study, 66% (92 cases) presented dichorionic placentation and 34% (48 cases) were monochorionic. In the group of monochorionic pregnancies, we observed highly difference related to pathology of amniotic fluid (14.5% vs 2.2%), discordant fetal growth (41.6% vs 22.8%) and rate of preterm delivery (66.6% vs 32.6%). Related to the newborn we verified that they had a lower average birth weight (1988g vs 2295g), a highly rate of weight discordancy (23% vs 15.3%), intraventricular haemorrhage (2.2% vs 0%) and IUGR (6.6% vs 1.6%), statistically significant in the monochorionic group. Also the perinatal mortality rate was significantly higher in the monochorionic pregnancies (93.7 per thousand vs 21.7 per thousand). The high rate of morbidity and mortality related to the monochorionic twin pregnancies, implies the need of a correct identification of the type of chorionicity and also a high standard of prenatal surveillance in prenatal specialised health centers.

Could Perinatal Asphyxia Induce a Synaptopathy? New Highlights from an Experimental Model

PubMed Central

Herrera, María Inés; Udovin, Lucas Daniel; Kusnier, Carlos; Kölliker-Frers, Rodolfo; de Souza, Wanderley

2017-01-01

Birth asphyxia also termed perinatal asphyxia is an obstetric complication that strongly affects brain structure and function. Central nervous system is highly susceptible to oxidative damage caused by perinatal asphyxia while activation and maturity of the proper pathways are relevant to avoiding abnormal neural development. Perinatal asphyxia is associated with high morbimortality in term and preterm neonates. Although several studies have demonstrated a variety of biochemical and molecular pathways involved in perinatal asphyxia physiopathology, little is known about the synaptic alterations induced by perinatal asphyxia. Nearly 25% of the newborns who survive perinatal asphyxia develop neurological disorders such as cerebral palsy and certain neurodevelopmental and learning disabilities where synaptic connectivity disturbances may be involved. Accordingly, here we review and discuss the association of possible synaptic dysfunction with perinatal asphyxia on the basis of updated evidence from an experimental model. PMID:28326198

Officials welcome the arrival of the Japanese Experiment Module

NASA Image and Video Library

2007-04-17

In the Space Station Processing Facility, NASA and Japanese Aerospace and Exploration Agency (JAXA) officials welcome the arrival of the Experiment Logistics Module Pressurized Section for the Japanese Experiment Module, or JEM, to the Kennedy Space Center. At the podium is Russ Romanella, director of International Space Station and Spacecraft Processing. Seated at right are Bill Parsons, director of Kennedy Space Center; Dr. Kichiro Imagawa, project manager of the JEM Development Project Team for JAXA; Melanie Saunders, associate manager of the International Space Station Program at Johnson Space Center; and Dominic Gorie, commander on mission STS-123 that will deliver the module to the space station. The new International Space Station component arrived at Kennedy March 12 to begin preparations for its future launch on mission STS-123. It will serve as an on-orbit storage area for materials, tools and supplies. It can hold up to eight experiment racks and will attach to the top of another larger pressurized module.

Officials welcome the arrival of the Japanese Experiment Module

NASA Image and Video Library

2007-04-17

In the Space Station Processing Facility, NASA and Japanese Aerospace and Exploration Agency (JAXA) officials welcome the arrival of the Experiment Logistics Module Pressurized Section for the Japanese Experiment Module, or JEM, to the Kennedy Space Center. At the podium is Bill Parsons, director of Kennedy Space Center. Seated at right are Russ Romanella, director of International Space Station and Spacecraft Processing; Dr. Kichiro Imagawa, project manager of the JEM Development Project Team for JAXA; Melanie Saunders, associate manager of the International Space Station Program at Johnson Space Center; and Dominic Gorie, commander on mission STS-123 that will deliver the module to the space station. The new International Space Station component arrived at Kennedy March 12 to begin preparations for its future launch on mission STS-123. It will serve as an on-orbit storage area for materials, tools and supplies. It can hold up to eight experiment racks and will attach to the top of another larger pressurized module.

The perinatal effects of delayed childbearing.

PubMed

Joseph, K S; Allen, Alexander C; Dodds, Linda; Turner, Linda Ann; Scott, Heather; Liston, Robert

2005-06-01

To determine if the rates of pregnancy complications, preterm birth, small for gestational age, perinatal mortality, and serious neonatal morbidity are higher among mothers aged 35-39 years or 40 years or older, compared with mothers 20-24 years. We performed a population-based study of all women in Nova Scotia, Canada, who delivered a singleton fetus between 1988 and 2002 (N = 157,445). Family income of women who delivered between 1988 and 1995 was obtained through a confidential linkage with tax records (n = 76,300). The primary outcome was perinatal death (excluding congenital anomalies) or serious neonatal morbidity. Analysis was based on logistic models. Older women were more likely to be married, affluent, weigh 70 kg or more, attend prenatal classes, and have a bad obstetric history but less likely to be nulliparous and to smoke. They were more likely to have hypertension, diabetes mellitus, placental abruption, or placenta previa. Preterm birth and small-for-gestational age rates were also higher; compared with women aged 20-24 years, adjusted rate ratios for preterm birth among women aged 35-39 years and 40 years or older were 1.61 (95% confidence interval [CI] 1.42-1.82; P < .001) and 1.80 (95% CI 1.37-2.36; P < .001), respectively. Adjusted rate ratios for perinatal mortality/morbidity were 1.46 (95% CI 1.11-1.92; P = .007) among women 35-39 years and 1.95 (95% CI 1.13-3.35; P = .02) among women 40 years or older. Perinatal mortality rates were low at all ages, especially in recent years. Older maternal age is associated with relatively higher risks of perinatal mortality/morbidity, although the absolute rate of such outcomes is low.

Functional vision in children with perinatal brain damage.

PubMed

Alimović, Sonja; Jurić, Nikolina; Bošnjak, Vlatka Mejaški

2014-09-01

Many authors have discussed the effects of visual stimulations on visual functions, but there is no research about the effects on using vision in everyday activities (i.e. functional vision). Children with perinatal brain damage can develop cerebral visual impairment with preserved visual functions (e.g. visual acuity, contrast sensitivity) but poor functional vision. Our aim was to discuss the importance of assessing and stimulating functional vision in children with perinatal brain damage. We assessed visual functions (grating visual acuity, contrast sensitivity) and functional vision (the ability of maintaining visual attention and using vision in communication) in 99 children with perinatal brain damage and visual impairment. All children were assessed before and after the visual stimulation program. Our first assessment results showed that children with perinatal brain damage had significantly more problems in functional vision than in basic visual functions. During the visual stimulation program both variables of functional vision and contrast sensitivity improved significantly, while grating acuity improved only in 2.7% of children. We also found that improvement of visual attention significantly correlated to improvement on all other functions describing vision. Therefore, functional vision assessment, especially assessment of visual attention is indispensable in early monitoring of child with perinatal brain damage.

Partner relationship, social support and perinatal distress among pregnant Icelandic women.

PubMed

Jonsdottir, Sigridur Sia; Thome, Marga; Steingrimsdottir, Thora; Lydsdottir, Linda Bara; Sigurdsson, Jon Fridrik; Olafsdottir, Halldora; Swahnberg, Katarina

2017-02-01

It is inferred that perinatal distress has adverse effects on the prospective mother and the health of the foetus/infant. More knowledge is needed to identify which symptoms of perinatal distress should be assessed during pregnancy and to shed light on the impact of women's satisfaction with their partner relationship on perinatal distress. The current study aimed to generate knowledge about the association of the partner relationship and social support when women are dealing with perinatal distress expressed by symptoms of depression, anxiety and stress. A structured interview was conducted with 562 Icelandic women who were screened three times during pregnancy with the Edinburgh Depression Scale and the Depression, Anxiety, Stress Scale. Of these, 360 had symptoms of distress and 202 belonged to a non-distress group. The women answered the Multidimensional Scale of Perceived Social Support and the Dyadic Adjustment Scale. The study had a multicentre prospective design allowing for exploration of association with perinatal distress. Women who were dissatisfied in their partner relationship were four times more likely to experience perinatal distress. Women with perinatal distress scored highest on the DASS Stress Subscale and the second highest scores were found on the Anxiety Subscale. Satisfaction in partner relationship is related to perinatal distress and needs to be assessed when health care professionals take care of distressed pregnant women, her partner and her family. Assessment of stress and anxiety should be included in the evaluation of perinatal distress, along with symptoms of depression. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

A qualitative study about the gendered experiences of motherhood and perinatal mortality in mountain villages of Nepal: implications for improving perinatal survival.

PubMed

Paudel, Mohan; Javanparast, Sara; Dasvarma, Gouranga; Newman, Lareen

2018-05-15

We aim to examine the gendered contexts of poor perinatal survival in the remote mountain villages of Nepal. The study setting comprised two remote mountain villages from a mid-western mountain district of Nepal that ranks lowest on the Human Development Index (0.304), and is reported as having the lowest child survival rates in the country. The findings are taken from a larger study of perinatal survival in remote mountain villages of Nepal, conducted through a qualitative methodological approach within a framework of social constructionist and critical theoretical perspectives. Data were collected through in-depth interviews with 42 women and their families, plus a range of healthcare providers (nurses/auxiliary nurses, female health volunteers, support staff, Auxiliary Health Worker and a traditional healer) and other stakeholders from February to June, 2015. Data were analysed with a comprehensive coding process utilising the thematic analysis technique. The social construction of gender is one of the key factors influencing poor perinatal survival in the villages in this study. The key emerging themes from the qualitative data are: (1) Gendered social construct and vulnerability for poor perinatal survival: child marriages, son preference and repeated child bearing; (2) Pregnancy and childbirth in intra-familial dynamics of relationships and power; and (3) Perception of birth as a polluted event: birth in Gotha (cowshed) and giving birth alone. Motherhood among women of a low social position is central to women and their babies experiencing vulnerabilities related to perinatal survival in the mountain villages. Gendered constructions along the continuum from pre-pregnancy to postnatal (girl settlement, a daughter-in-law, ritual pollution about mother and child) create challenges to ensuring perinatal survival in these villages. It is imperative that policies and programmes consider such a context to develop effective working strategies for sustained reduction

Anxiety measures validated in perinatal populations: a systematic review.

PubMed

Meades, Rose; Ayers, Susan

2011-09-01

Research and screening of anxiety in the perinatal period is hampered by a lack of psychometric data on self-report anxiety measures used in perinatal populations. This paper aimed to review self-report measures that have been validated with perinatal women. A systematic search was carried out of four electronic databases. Additional papers were obtained through searching identified articles. Thirty studies were identified that reported validation of an anxiety measure with perinatal women. Most commonly validated self-report measures were the General Health Questionnaire (GHQ), State-Trait Anxiety Inventory (STAI), and Hospital Anxiety and Depression Scales (HADS). Of the 30 studies included, 11 used a clinical interview to provide criterion validity. Remaining studies reported one or more other forms of validity (factorial, discriminant, concurrent and predictive) or reliability. The STAI shows criterion, discriminant and predictive validity and may be most useful for research purposes as a specific measure of anxiety. The Kessler 10 (K-10) may be the best short screening measure due to its ability to differentiate anxiety disorders. The Depression Anxiety Stress Scales 21 (DASS-21) measures multiple types of distress, shows appropriate content, and remains to be validated against clinical interview in perinatal populations. Nineteen studies did not report sensitivity or specificity data. The early stages of research into perinatal anxiety, the multitude of measures in use, and methodological differences restrict comparison of measures across studies. There is a need for further validation of self-report measures of anxiety in the perinatal period to enable accurate screening and detection of anxiety symptoms and disorders. Copyright © 2010 Elsevier B.V. All rights reserved.

Ethical issues in perinatal mental health research.

PubMed

Brandon, Anna R; Shivakumar, Geetha; Lee, Simon Craddock; Inrig, Stephen J; Sadler, John Z

2009-11-01

To review the background of current ethical standards for the conduct of perinatal mental health research and describe the ethical challenges in this research domain. Current literature reflects a growing sentiment in the scientific community that having no information regarding the impact of psychiatric treatment on the mother and developing fetus/infant poses dangers that may exceed the risks involved in research. However, without sufficient consensus across the scientific community, both regulatory bodies and perinatal researchers find themselves without a framework for decision making that satisfactorily limits the risks and facilitates the benefits of participation of pregnant and lactating women in clinical research. Psychiatric research in perinatal mental health is critically important as it enables clinicians and patients to participate in informed decision-making concerning treatment for psychiatric disorders. Specific areas of concern include fetal safety, maternal risk, the therapeutic misconception, commercial interests, forensic/legal issues, the informed consent process, and study design. Developing guidelines that address ethical challenges and include the views and concerns of multiple stakeholders could improve the access of perinatal women to the benefits of participation in mental health research in addition to providing evidence-based mental healthcare for this subpopulation.

Perinatal maternal stress and serotonin signaling: effects on pain sensitivity in offspring.

PubMed

Knaepen, Liesbeth; Pawluski, Jodi L; Patijn, Jacob; van Kleef, Maarten; Tibboel, Dick; Joosten, Elbert A

2014-07-01

It has been estimated that 20% of pregnant women are facing perinatal stress and depression. Perinatal maternal stress has been shown to increase pain sensitivity in offspring. For the treatment of their depressive symptoms, pregnant women are frequently prescribed selective serotonin reuptake inhibitors (SSRIs). Since the descending pain inhibitory circuit matures perinatally, perinatal SSRI exposure has been shown to affect pain sensitivity in offspring. In the present review, we summarize experimental and clinical evidence for the effect of perinatal maternal stress and SSRI exposure on pain sensitivity in offspring. Both experimental and clinical studies show the effect of perinatal maternal stress on regulation of the hypothalamic-pituitary-adrenal (HPA) system and the serotonin pain inhibitory system. Alterations in these two systems likely underlie long-term alterations in the development of pain sensitivity. This review sheds light on the effect of perinatal maternal stress and treatment with SSRIs on offspring pain sensitivity, in relation to the developing HPA system and 5-HT signaling. © 2013 Wiley Periodicals, Inc.

Perinatal Anxiety: Approach to Diagnosis & Management in the Obstetric Setting.

PubMed

Thorsness, Katie R; Watson, Corey; Larusso, Elizabeth M

2018-05-24

Anxiety is common in women during the perinatal period, manifests with various symptomatology and severity, and is associated with significant maternal morbidity and adverse obstetrical and neonatal outcomes. Given the intimate relationship and frequency of contact, the obstetric provider is optimally positioned to create a therapeutic alliance and manage perinatal anxiety. Time constraints, absence of randomized controlled trials, mixed quality of data, and concern for potential adverse reproductive outcomes all limit clinicians' ability to initiate informed risk-benefit discussions. Clear understanding of the role of the obstetric provider in the identification, stabilization, and initiation of medication and/or referral to psychotherapy for women with perinatal anxiety disorders is critical to maternal and neonatal wellbeing. Informed by our clinical practice as perinatal psychiatric providers, we have provided a concise summary of current research on the approach to treatment of perinatal anxiety disorders in the obstetric setting, including psychotherapy and supportive interventions, primary and adjuvant psychiatric medication, and general prescribing pearls. Medications examined include antidepressants, benzodiazepines, sedative-hypnotics, antihistamines, quetiapine, buspirone, propranolol, and melatonin. Further research into management of perinatal anxiety, particularly psychopharmacological management, is warranted. Copyright © 2018 Elsevier Inc. All rights reserved.

Dual role of astrocytes in perinatal asphyxia injury and neuroprotection.

PubMed

Romero, J; Muñiz, J; Logica Tornatore, T; Holubiec, M; González, J; Barreto, G E; Guelman, L; Lillig, C H; Blanco, E; Capani, F

2014-04-17

Perinatal asphyxia represents an important cause of severe neurological deficits including delayed mental and motor development, epilepsy, major cognitive deficits and blindness. However, at the moment, most of the therapeutic strategies were not well targeted toward the processes that induced the brain injury during perinatal asphyxia. Traditionally, experimental research focused on neurons, whereas astrocytes have been more related with the damage mechanisms of perinatal asphyxia. In this work, we propose to review possible protective as well as deleterious roles of astrocytes in the asphyctic brain with the aim to stimulate further research in this area of perinatal asphyxia still not well studied. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Epilepsy after perinatal stroke with different vascular subtypes.

PubMed

Laugesaar, Rael; Vaher, Ulvi; Lõo, Silva; Kolk, Anneli; Männamaa, Mairi; Talvik, Inga; Õiglane-Shlik, Eve; Loorits, Dagmar; Talvik, Tiina; Ilves, Pilvi

2018-06-01

With an incidence up to 63 per 100,000 live births, perinatal stroke is an important cause of childhood epilepsy. The aim of the study was to find the prevalence of and predictive factors for epilepsy, and to describe the course of epilepsy in children with perinatal stroke with different vascular subtypes. Patients were retrieved from the Estonian Paediatric Stroke Database with follow-up time at least 24 months. Patients were divided into 5 perinatal stroke syndromes: neonatal arterial ischemic stroke (AIS), neonatal hemorrhagic stroke, neonatal cerebral sinovenous thrombosis, presumed AIS, and presumed periventricular venous infarction. The final study group included 73 children with perinatal stroke (39 boys). With a median follow-up time of 8.6 years, epilepsy was diagnosed in 21/73 (29%) children, most of whom had AIS (17/21, 81%). The 18-year cumulative poststroke epilepsy risk according to the Kaplan-Meier estimator was 40.8% (95% confidence interval [CI] 20.7-55.9%). The median age at epilepsy diagnosis was 50 months (range 1 month to 18.4 years). Children with neonatal AIS had the highest risk of epilepsy, but children with presumed AIS more often had severe epilepsy syndromes. Cortical lesions (odds ratio [OR] 19.7, 95% CI 2.9-133), and involvement of thalamus (OR 9.8, 95% CI 1.8-53.5) and temporal lobe (OR 8.3, 95% CI 1.8-39.6) were independently associated with poststroke epilepsy. The risk for poststroke epilepsy after perinatal stroke depends on the vascular subtype. Patients with perinatal AIS need close follow-up to detect epilepsy and start with antiepileptic treatment on time.

Perinatal Origins of Adult Disease.

PubMed

Simeoni, Umberto; Armengaud, Jean-Baptiste; Siddeek, Benazir; Tolsa, Jean-François

2018-01-01

Epidemiological and experimental studies have shown that the peri-conception period, pregnancy, and infancy are windows of particular sensibility to environmental clues which influence lifelong trajectories across health and disease. Nutrition, stress, and toxins induce epigenetic marks that control long-term gene expression patterns and can be transmitted transgenerationally. Chronic diseases of adulthood such as hypertension, diabetes, and obesity thus have early, developmental origins in the perinatal period. The early epigenome, in interaction with other actors such as the microbiome, add powerful layers of diversity to the biological predisposition generated by the genome. Such "programming" is a normal, adaptive component of development, including in normal pregnancies and births. However, perinatal disease, either maternal (such as pre-eclampsia, ges-tational diabetes, or inflammatory disease) or fetal, and neonatal diseases (such as intrauterine growth restriction and preterm birth) are major conditions of altered programming, translated into an increased risk for chronic disease in these patients when they reach adulthood. Early prevention, optimal perinatal nutrition, and specific follow-up measures are key factors in the early preservation of long-term health. © 2018 S. Karger AG, Basel.

Trends in Perinatal HIV Prevention in New York City, 1994–2003

PubMed Central

Liu, Kai-Lih; Robinson, Lisa-Gaye; Dominguez, Kenneth L.; Abrams, Elaine J.; Gill, Balwant S.; Thomas, Pauline A.

2008-01-01

Objectives. We examined trends in perinatal HIV prevention interventions in New York City implemented during 1994 to 2003 to ascertain the success of the interventions in reducing perinatal transmission. Methods. We used data obtained from infant records at 22 hospitals. We used multiple logistic regression to analyze factors associated with prenatal care and perinatal HIV transmission. Results. We analyzed data for 4729 perinatally HIV-exposed singleton births. Of mothers with prenatal care data, 92% had prenatal care. The overall proportion who received prenatal care and were diagnosed with HIV before delivery was 86% in 1994 to 1996 and 90% in 1997 to 2003. Use of prenatal antiretrovirals among mothers who received prenatal care was 63% in 1994 to 1996 and 82% in 1997 to 2003. From 1994 to 2003, cesarean births among the entire sample increased from 15% to 55%. During 1997 to 2003, the perinatal HIV transmission rate among the entire sample was 7%; 45% of mothers of infected infants had missed opportunities for perinatal HIV prevention. During 1997 to 2003, maternal illicit drug use was significantly associated with lack of prenatal care. Lack of prenatal, intrapartum, and neonatal antiretrovirals; maternal illicit drug use; and low birthweight were significantly associated with perinatal HIV transmission. Conclusions. Interventions for perinatal HIV prevention can successfully decrease HIV transmission rates. Ongoing perinatal HIV surveillance allows for monitoring the implementation of guidelines to prevent mother-to-child transmission of HIV and determining factors that may contribute to perinatal HIV transmission. PMID:18309139

Testing of the Japanese Experimental Module in NBS

NASA Technical Reports Server (NTRS)

1993-01-01

This photograph was taken in the Marshall Space Flight Center (MSFC) Neutral Buoyancy Simulator (NBS) during the testing of the Japanese Experimental Module. The NBS provided the weightless environment encountered in space needed for testing and the practices of extra-vehicular activities.

[Perinatal mortality in foreign workers (author's transl)].

PubMed

Höfling, H J; Jonas, R; Brusis, E; Lochmüller, H; Selbmann, H K; Holzmann, K; Zander, J

1975-03-01

From 1970 to 1972, there were 216 perinatal deaths among 5595 newborns at the I. Frauenklinik der Universität München. 54 of these deaths were children of foreign workers (so-called "Gastarbeiter"). The data have been processed on punch cards and analysed by a computer. The differences noted underwent significance testing by the CHI-Quadrat test. Only statistical significant results are published. The perinatal mortality in the above period shows no difference between foreign and German ward patients. There is, however, a significant lower perinatal mortality in private patients. We feel that this difference is due to a significant lower rate of prematures in the private patient group. The cocial status as well as higher interest and motivation in health resulting in better prenatal care are discussed as causal reasons for this fact.

Handling Japanese without a Japanese Operating System.

ERIC Educational Resources Information Center

Hatasa, Kazumi; And Others

1992-01-01

The Macintosh HyperCard environment has become a popular platform for Japanese language courseware because of its flexibility and ease of programing. This project created Japanese bitmap font files for the JIS Levels 1 and 2, and writing XFCNs for font manipulation, Japanese kana input, and answer correction. (12 references) (Author/LB)

Detecting the severity of perinatal anxiety with the Perinatal Anxiety Screening Scale (PASS).

PubMed

Somerville, Susanne; Byrne, Shannon L; Dedman, Kellie; Hagan, Rosemary; Coo, Soledad; Oxnam, Elizabeth; Doherty, Dorota; Cunningham, Nadia; Page, Andrew C

2015-11-01

The Perinatal Anxiety Screening Scale (PASS; Somerville et al., 2014) reliably identifies perinatal women at risk of problematic anxiety when a clinical cut-off score of 26 is used. This study aimed to identify a severity continuum of anxiety symptoms with the PASS to enhance screening, treatment and research for perinatal anxiety. Antenatal and postnatal women (n=410) recruited from the antenatal clinics and mental health services at an obstetric hospital completed the Edinburgh Postnatal Depression Scale (EPDS), the Depression, Anxiety and Stress Scale (DASS-21), the Spielberg State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory II (BDI), and the PASS. The women referred to mental health services were assessed to determine anxiety diagnoses via a diagnostic interview conducted by an experienced mental health professional from the Department of Psychological Medicine - King Edward Memorial Hospital. Three normative groups for the PASS, namely minimal anxiety, mild-moderate anxiety, and severe anxiety, were identified based on the severity of anxiety indicated on the standardised scales and anxiety diagnoses. Two cut-off points for the normative groups were calculated using the Jacobson-Truax method (Jacobson and Truax, 1991) resulting in three severity ranges: 'minimal anxiety'; 'mild-moderate anxiety'; and 'severe anxiety'. The most frequent diagnoses in the study sample were adjustment disorder, mixed anxiety and depression, generalised anxiety, and post-traumatic stress disorder. This may limit the generalisability of the severity range results to other anxiety diagnoses including obsessive compulsive disorder and specific phobia. Severity ranges for the PASS add value to having a clinically validated cut-off score in the detection and monitoring of problematic perinatal anxiety. The PASS can now be used to identify risk of an anxiety disorder and the severity ranges can indicate developing risk for early referrals for further assessments

Decreasing Malpractice Claims by Reducing Preventable Perinatal Harm.

PubMed

Riley, William; Meredith, Les W; Price, Rebecca; Miller, Kristi K; Begun, James W; McCullough, Mac; Davis, Stanley

2016-12-01

To evaluate the association of improved patient safety practices with medical malpractice claims and costs in the perinatal units of acute care hospitals. Malpractice and harm data from participating hospitals; litigation records and medical malpractice claims data from American Excess Insurance Exchange, RRG, whose data are managed by Premier Insurance Management Services, Inc. (owned by Premier Inc., a health care improvement company). A quasi-experimental prospective design to compare baseline and postintervention data. Statistical significance tests for differences were performed using chi-square, Wilcoxon signed-rank test, and t-test. Claims data were collected and evaluated by experienced senior claims managers through on-site claim audits to evaluate claim frequency, severity, and financial information. Data were provided to the analyzing institution through confidentiality contracts. There is a significant reduction in the number of perinatal malpractice claims paid, losses paid, and indemnity payments (43.9 percent, 77.6 percent, and 84.6 percent, respectively) following interventions to improve perinatal patient safety and reduce perinatal harm. This compares with no significant reductions in the nonperinatal claims in the same hospitals during the same time period. The number of perinatal malpractice claims and dollar amount of claims payments decreased significantly in the participating hospitals, while there was no significant decrease in nonperinatal malpractice claims activity in the same hospitals. © Health Research and Educational Trust.

Perinatal mental health: Fathers - the (mostly) forgotten parent.

PubMed

Wong, Olivia; Nguyen, Tram; Thomas, Naomi; Thomson-Salo, Frances; Handrinos, Dennis; Judd, Fiona

2016-12-01

The importance of parental mental health as a determinant of infant and child outcomes is increasingly acknowledged. Yet, there is limited information regarding paternal mental health during the perinatal period. The aim of this review is to summarize existing clinical research regarding paternal mental health in the perinatal period in various contexts, and its possible impact on infant development. An electronic literature search was conducted using MEDLINE and PubMed databases. Key texts were used to cross-check for any further articles of interest. Men are at increased risk of mental health problems during the transition to fatherhood, as well as during the perinatal period. Paternal mental health during the perinatal period has been shown to impact on their child's emotional and behavioral development. However, research addressing the needs of fathers with mental illness and the impact of their illness on their infant and family has been limited. A paradigm shift is required, from a focus on women following childbirth and women with pre-existing psychiatric disorders, to a broader family perspective with the focus firmly on parent-infant relationships. This paradigm shift needs to involve greater research into the fathering role and paternal mental illness during the perinatal period, including further studies into risk factors, impact on the family system, and the most appropriate form of intervention and service provision. © 2015 Wiley Publishing Asia Pty Ltd.

Teaching for Tolerance and Understanding during the Japanese Internment: Lessons for Educators Today

ERIC Educational Resources Information Center

Banks, Cherry A. McGee

2007-01-01

Following the Japanese attack on the US naval base at Pearl Harbor on December 7, 1941, the nation was thrown into a state of fear and hysteria. On February 19, 1942, President Roosevelt issued Executive Order No. 9066 which resulted in more than 120,000 persons of Japanese ancestry being either interned in relocation centers, drafted, or…

Evaluating the quality of perinatal anxiety information available online.

PubMed

Kirby, Paige L; Reynolds, Kristin A; Walker, John R; Furer, Patricia; Pryor, Teaghan A M

2018-06-22

The Internet is an easily accessible source of information for women experiencing anxiety in pregnancy and/or postpartum to use when seeking health information. However, the Internet has several drawbacks, including inaccurate content that may be perceived as being accurate, non-biased, and evidence-based. Prior research indicates that anxiety and postpartum mental health websites have poor quality in terms of describing treatment options. There is a lack of research and knowledge in the area of perinatal anxiety, and an absence of research evaluating perinatal anxiety websites. The purpose of this study was to evaluate the quality of information regarding perinatal anxiety available on the Internet. Websites concerning perinatal anxiety were selected using the Google search engine. Each website was evaluated based on quality of health information, website usability, and readability. The 20 websites included in this study had low to moderate quality scores based on the DISCERN tool. There were no associations found between website order and website quality, or between website readability and website quality. Many websites had high PEMAT scores for the understandability section, which included content, style, and layout of information; however, most did not use visual aids to enhance comprehension. Most websites had low actionability scores, suggesting that information may not be useful in describing what actions may be taken to manage perinatal anxiety. This study highlights the need for high-quality websites concerning perinatal anxiety that are easy to navigate and provide the public with evidence-based information.

Magnitude of income-related disparities in adverse perinatal outcomes.

PubMed

Shankardass, Ketan; O'Campo, Patricia; Dodds, Linda; Fahey, John; Joseph, Ks; Morinis, Julia; Allen, Victoria M

2014-03-04

To assess and compare multiple measurements of socioeconomic position (SEP) in order to determine the relationship with adverse perinatal outcomes across various contexts. A birth registry, the Nova Scotia Atlee Perinatal Database, was confidentially linked to income tax and related information for the year in which delivery occurred. Multiple logistic regression was used to examine odds ratios between multiple indicators of SEP and multiple adverse perinatal outcomes in 117734 singleton births between 1988 and 2003. Models for after tax family income were also adjusted for neighborhood deprivation to gauge the relative magnitude of effects related to SEP at both levels. Effects of SEP were stratified by single- versus multiple-parent family composition, and by urban versus rural location of residence. The risk of small for gestational age and spontaneous preterm birth was higher across all the indicators of lower SEP, while risk for large for gestational age was lower across indicators of lower SEP. Higher risk of postneonatal death was demonstrated for several measures of lower SEP. Higher material deprivation in the neighborhood of residence was associated with increased risk for perinatal death, small for gestational age birth, and iatrogenic and spontaneous preterm birth. Family composition and urbanicity were shown to modify the association between income and some perinatal outcomes. This study highlights the importance of understanding the definitions of SEP and the mechanisms that lead to the association between income and poor perinatal outcomes, and broadening the types of SEP measures used in some cases.

The distribution of apolipoprotein E alleles in Scottish perinatal deaths

PubMed Central

Becher, J‐C; Keeling, J W; McIntosh, N; Wyatt, B; Bell, J

2006-01-01

Background The apolipoprotein E (ApoE) polymorphism has been well studied in the adult human population, in part because the e4 allele is a known risk factor for Alzheimer's disease. Little is known of the distribution of ApoE alleles in newborns, and their association with perinatal brain damage has not been investigated. Methods ApoE genotyping was undertaken in a Scottish cohort of perinatal deaths (n = 261), some of whom had prenatal brain damage. The distribution of ApoE alleles in perinatal deaths was compared with that in healthy liveborn infants and in adults in Scotland. Results ApoE e2 was over‐represented in 251 perinatal deaths (13% v 8% in healthy newborns, odds ratio (OR) = 1.63, 95% confidence interval (CI) 1.13 to 2.36 and 13% v 8% in adults, OR = 1.67, 95% CI 1.16 to 2.41), both in liveborn and stillborn perinatal deaths. In contrast, the prevalence of ApoE e4 was raised in healthy liveborn infants (19%) compared with stillbirths (13%, OR = 1.59, 95% CI 1.11 to 2.26) and with adults (15%, OR = 1.35, 95% CI 1.04 to 1.76). However, no correlation was found between ApoE genotype and the presence or absence of perinatal brain damage. Conclusions This study shows a shift in ApoE allelic distribution in early life compared with adults. The raised prevalence of ApoE e2 associated with perinatal death suggests that this allele is detrimental to pregnancy outcome, whereas ApoE e4 may be less so. However, ApoE genotype did not appear to influence the vulnerability for perinatal hypoxic/ischaemic brain damage, in agreement with findings in adult brains and in animal models. PMID:16183800

Community Conversations with Parents to Improve Perinatal Care

ERIC Educational Resources Information Center

Martin, Joanne

2007-01-01

The state of Indiana took a unique approach to developing a statewide plan to improve perinatal health outcomes by engaging parents in a series of focus groups, called Community Conversations in Perinatal Care (CCPC), to hear directly from consumers about their health care experiences and needs. Recognizing that disparities exist among different…

Mapping Perinatal Nursing Process Measurement Concepts to Standard Terminologies.

PubMed

Ivory, Catherine H

2016-07-01

The use of standard terminologies is an essential component for using data to inform practice and conduct research; perinatal nursing data standardization is needed. This study explored whether 76 distinct process elements important for perinatal nursing were present in four American Nurses Association-recognized standard terminologies. The 76 process elements were taken from a valid paper-based perinatal nursing process measurement tool. Using terminology-supported browsers, the elements were manually mapped to the selected terminologies by the researcher. A five-member expert panel validated 100% of the mapping findings. The majority of the process elements (n = 63, 83%) were present in SNOMED-CT, 28% (n = 21) in LOINC, 34% (n = 26) in ICNP, and 15% (n = 11) in CCC. SNOMED-CT and LOINC are terminologies currently recommended for use to facilitate interoperability in the capture of assessment and problem data in certified electronic medical records. Study results suggest that SNOMED-CT and LOINC contain perinatal nursing process elements and are useful standard terminologies to support perinatal nursing practice in electronic health records. Terminology mapping is the first step toward incorporating traditional paper-based tools into electronic systems.

Post-traumatic stress disorder in the perinatal period: A concept analysis.

PubMed

Vignato, Julie; Georges, Jane M; Bush, Ruth A; Connelly, Cynthia D

2017-12-01

To report an analysis of the concept of perinatal post-traumatic stress disorder. Prevalence of perinatal post-traumatic stress disorder is rising in the USA, with 9% of the U.S. perinatal population diagnosed with the disorder and an additional 18% being at risk for the condition. Left untreated, adverse maternal-child outcomes result in increased morbidity, mortality and healthcare costs. Concept analysis via Walker and Avant's approach. The databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Academic Search Premier and PsychINFO were searched for articles, written in English, published between 2006-2015, containing the terms perinatal and post-traumatic stress disorder. Perinatal post-traumatic stress disorder owns unique attributes, antecedents and outcomes when compared to post-traumatic stress disorder in other contexts, and may be defined as a disorder arising after a traumatic experience, diagnosed any time from conception to 6 months postpartum, lasting longer than 1 month, leading to specific negative maternal symptoms and poor maternal-infant outcomes. Attributes include a diagnostic time frame (conception to 6 months postpartum), harmful prior or current trauma and specific diagnostic symptomatology defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Antecedents were identified as trauma (perinatal complications and abuse), postpartum depression and previous psychiatric history. Consequences comprised adverse maternal-infant outcomes. Further research on perinatal post-traumatic stress disorder antecedents, attributes and outcomes in ethnically diverse populations may provide clinicians a more comprehensive framework for identifying and treating perinatal post-traumatic stress disorder. Nurses are encouraged to increase their awareness of perinatal post-traumatic stress disorder for early assessment and intervention, and prevention of adverse maternal-infant outcomes. © 2017 John Wiley

Perinatal thrombosis: implications for mothers and neonates.

PubMed

O'Brien, Sarah H

2015-01-01

Stroke is more likely to occur in the perinatal period than any other time in childhood, and these events can lead to a lifetime of intellectual and motor disabilities, epilepsy, and behavioral challenges. This review describes the epidemiology and natural history of perinatal arterial ischemic stroke (PAIS) and cerebral sinovenous thrombosis (CSVT), risk factors for these complications, recent evidence regarding treatment strategies, and current gaps in knowledge. Existing evidence demonstrates the multifactorial etiology of symptomatic ischemic stroke in neonates, which includes a combination of maternal, delivery, and neonatal factors. The importance of inherited thrombophilia in the pathophysiology and long-term outcomes of perinatal stroke requires additional study. At this time, there is no evidence to support routine extensive thrombophilia screening outside of a research setting. Despite the frequency of perinatal stroke and its association with substantial morbidity, treatment strategies are currently limited, and prevention strategies are nonexistent. Anticoagulation is rarely indicated in PAIS, and more work needs to focus on neuroprotective prevention and alternate treatment strategies. Anticoagulation does appear to be safe in CSVT and may prevent thrombus progression but clinical equipoise remains, and clinical trials are needed to obtain evidence regarding short- and long-term efficacy outcomes. © 2015 by The American Society of Hematology. All rights reserved.

[Studies on flomoxef in the perinatal period].

PubMed

Cho, N; Fukunaga, K; Kunii, K; Kobayashi, I

1991-06-01

Pharmacokinetic, bacteriological and clinical studies on flomoxef (FMOX) in the perinatal period were carried out with the following summary of the results. Antibacterial effects of FMOX on the growth of methicillin-resistant Staphylococcus aureus (MRSA, MIC 400 micrograms/ml), methicillin-sensitive S. aureus (MSSA, MIC 0.78 microgram/ml), Escherichia coli (MIC 3.13 micrograms/ml and MIC 0.20 microgram/ml) in amniotic fluid were determined and it was found that the activity of FMOX was enhanced in the amniotic fluid. FMOX rapidly penetrated into tissues and sera of pregnant women upon intravenous injection and its maternal serum concentrations reached their peak levels shortly after administration. Placental penetration of FMOX to the fetus was good and, after single intravenous injection of 1 g, the concentrations of FMOX in the umbilical cord serum and amniotic fluid exceeded MICs against major causative organisms of perinatal infections. These results indicate that single intravenous injection of FMOX 1 g twice a day is effective for the treatment and prophylaxis of perinatal infections. Injection of FMOX for the treatment of 14 cases of puerperal infections showed excellent clinical effectiveness with 100% clinical effect and 81.8% bacteriological response. No side-effect was observed in any case. All of these results suggested clinical usefulness of FMOX in the perinatal period.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Executive Director of NASDA Koji Yamamoto (center) gets information about the facility while on a tour of KSC. Behind the group is the Japanese Experiment Module (JEM)/pressurized module. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of JEM.

NASA Image and Video Library

2003-06-12

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Executive Director of NASDA Koji Yamamoto (center) gets information about the facility while on a tour of KSC. Behind the group is the Japanese Experiment Module (JEM)/pressurized module. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of JEM.

Executive Functioning in Children and Adolescents With Perinatal HIV Infection and Perinatal HIV Exposure.

PubMed

Nichols, Sharon L; Chernoff, Miriam C; Malee, Kathleen M; Sirois, Patricia A; Woods, Steven P; Williams, Paige L; Yildirim, Cenk; Delis, Dean; Kammerer, Betsy

2016-12-01

Executive functions (EFs) are critical for management of life activities, but few studies have evaluated EFs in children and adolescents with perinatally acquired HIV (PHIV), who are at risk for problems in academics, behavior, and medication adherence. We compared EFs in youth with PHIV and in perinatally HIV-exposed but uninfected (PHEU) youth. Four Delis-Kaplan Executive Function System (D-KEFS) subtests were administered to 173 youth with PHIV and 85 PHEU youth, aged 9 to <19 years, who were enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS) Memory and Executive Functioning Study. Youth with PHIV, with or without history of a Centers for Disease Control and Prevention Class C (AIDS-defining) condition (PHIV/C [n = 45] and PHIV/non-C [n = 128], respectively), were compared with each other and with PHEU youth. Among youth with PHIV, associations with measures of current and past disease severity were evaluated using adjusted linear regression models. The PHIV/C group (mean age, 15.5 years), compared with the PHIV/non-C and PHEU groups (mean ages, 14.5 and 12.9 years, respectively), were significantly slower on the Inhibition and Color Naming/Reading Combined conditions of the Color-Word Interference subtest and made more errors on Inhibition; differences between the PHIV/C and PHEU groups persisted in adjusted models. No differences in adjusted means for fluency or problem-solving were found. The PHIV/non-C and PHEU groups did not differ on any measure. Associations of specific EF measures with HIV RNA viral load, CD4-positive T-lymphocyte percentage, and age at greatest disease severity were observed. Youth with PHIV and previous AIDS-defining conditions performed more poorly on some EF measures. Relationships of EF development with the degree and timing of disease severity require further study. Implications for long-term outcomes and interventions are important avenues for follow-up. © The Author 2016. Published by Oxford University Press on behalf of

The National Network of State Perinatal Quality Collaboratives: A Growing Movement to Improve Maternal and Infant Health.

PubMed

Henderson, Zsakeba T; Ernst, Kelly; Simpson, Kathleen Rice; Berns, Scott; Suchdev, Danielle B; Main, Elliott; McCaffrey, Martin; Lee, Karyn; Rouse, Tara Bristol; Olson, Christine K

2018-03-01

State Perinatal Quality Collaboratives (PQCs) are networks of multidisciplinary teams working to improve maternal and infant health outcomes. To address the shared needs across state PQCs and enable collaboration, Centers for Disease Control and Prevention (CDC), in partnership with March of Dimes and perinatal quality improvement experts from across the country, supported the development and launch of the National Network of Perinatal Quality Collaboratives (NNPQC). This process included assessing the status of PQCs in this country and identifying the needs and resources that would be most useful to support PQC development. National representatives from 48 states gathered for the first meeting of the NNPQC to share best practices for making measurable improvements in maternal and infant health. The number of state PQCs has grown considerably over the past decade, with an active PQC or a PQC in development in almost every state. However, PQCs have some common challenges that need to be addressed. After its successful launch, the NNPQC is positioned to ensure that every state PQC has access to key tools and resources that build capacity to actively improve maternal and infant health outcomes and healthcare quality.

The National Network of State Perinatal Quality Collaboratives: A Growing Movement to Improve Maternal and Infant Health.

PubMed

Henderson, Zsakeba T; Ernst, Kelly; Simpson, Kathleen Rice; Berns, Scott D; Suchdev, Danielle B; Main, Elliott; McCaffrey, Martin; Lee, Karyn; Rouse, Tara Bristol; Olson, Christine K

2018-02-01

State Perinatal Quality Collaboratives (PQCs) are networks of multidisciplinary teams working to improve maternal and infant health outcomes. To address the shared needs across state PQCs and enable collaboration, Centers for Disease Control and Prevention, in partnership with March of Dimes and perinatal quality improvement experts from across the country, supported the development and launch of the National Network of PQCs National Network of Perinatal Quality Collaboratives (NNPQC). This process included assessing the status of PQCs in this country and identifying the needs and resources that would be most useful to support PQC development. National representatives from 48 states gathered for the first meeting of the NNPQC to share best practices for making measurable improvements in maternal and infant health. The number of state PQCs has grown considerably over the past decade, with an active PQC or a PQC in development in almost every state. However, PQCs have some common challenges that need to be addressed. After its successful launch, the NNPQC is positioned to ensure that every state PQC has access to key tools and resources that build capacity to actively improve maternal and infant health outcomes and healthcare quality.

The effect of fertility treatment on adverse perinatal outcomes in women aged at least 40 years.

PubMed

Harlev, Avi; Walfisch, Asnat; Oran, Eynan; Har-Vardi, Iris; Friger, Michael; Lunenfeld, Eitan; Levitas, Eliahu

2018-01-01

To compare perinatal outcomes between spontaneous conception and assisted reproductive technologies (ART) among patients of advanced maternal age. The present retrospective study included data from singleton pregnancies of women aged at least 40 years who delivered between January 1, 1991, and December 31, 2013, at Soroka University Medical Center, Beer Sheva, Israel. Demographic, obstetric, and perinatal data were compared between pregnancies conceived with ART (in vitro fertilization [IVF] or ovulation induction) and those conceived spontaneously. Multiple regression models were used to define independent predictors of adverse outcomes. A total of 8244 singleton pregnancies were included; 229 (2.8%) following IVF, 86 (1.0%) following ovulation induction, and 7929 (96.2%) were spontaneous. Preterm delivery (P<0.001), fetal growth restriction (FGR) (P<0.001), and cesarean delivery (P<0.001) demonstrated linear associations with the conception mode; the highest rates for each were observed for IVF, with decreased rates for ovulation induction and spontaneous conception. The incidence of gestational diabetes and hypertensive disorders were highest among pregnancies following ART. No association was observed between conception mode and perinatal mortality. Multivariate logistic regression demonstrated that IVF was independently associated with increased odds of preterm delivery (P<0.001) and FGR (P=0.027) compared with spontaneous conception. Among patients of advanced maternal age, ART were independently associated with increased FGR and preterm delivery rates compared with spontaneous pregnancies; perinatal mortality was comparable. © 2017 International Federation of Gynecology and Obstetrics.

Assessment of Japanese stimulant control law offenders using the Addiction Severity Index--Japanese version: comparison with patients in treatment settings.

PubMed

Watanabe, Takashi; Ogai, Yasukazu; Koga, Takehiro; Senoo, Eiichi; Nakamura, Kazuhiko; Mori, Norio; Ikeda, Kazutaka

2009-12-01

The present study assessed problems in Japanese prisoners (inmates) who abused methamphetamine. Fifty-two male inmates were assessed in 2005-2007 using the Addiction Severity Index-Japanese version and compared with 55 male methamphetamine abusers in hospitals and recovery centers. The chi(2) and Mann-Whitney-Wilcoxon tests showed that the inmates had a significantly lower education level, more frequently had full-time jobs, had more experience living with a sexual partner, and more frequently had a history of juvenile delinquency and criminal records than patients. Although psychiatric symptoms, such as depression, anxiety, and hallucinations, were not common among inmates, suicidal behavior and trouble controlling violence were common in both groups.

Family Violence and Maltreatment of Women During the Perinatal Period: Associations with Infant Morbidity in Indian Slum Communities.

PubMed

Silverman, Jay G; Balaiah, Donta; Decker, Michele R; Boyce, Sabrina C; Ritter, Julie; Naik, D D; Nair, Saritha; Saggurti, Niranjan; Raj, Anita

2016-01-01

To determine the prevalence of non-violent, gender-based forms of maltreatment of women by husbands and in-laws [i.e., gender-based household maltreatment (GBHM)] during pregnancy and postpartum; to clarify the role of GBHM in compromising infant health, and whether this role extends beyond that previously observed for intimate partner violence (IPV). Cross-sectional, quantitative data were collected from women (ages 15-35) seeking immunizations for their infants <6 months of age (N = 1061) in urban health centers in Mumbai, India. Logistic regression models were constructed to assess associations between maternal abuse (perinatal IPV, in-law violence and GBHM) and recent infant morbidity (diarrhea, respiratory distress, fever, colic and vomiting). More than one in four women (28.4%) reported IPV during their recent pregnancy and/or during the postpartum period, 2.6% reported perinatal violence from in-laws, and 49.0% reported one or more forms of perinatal GBHM. In adjusted regression models that included all forms of family violence and maltreatment, perinatal GBHM remained significantly associated with infant morbidity (AORs 1.4-1.9); perinatal IPV and in-law violence ceased to predict infant morbidity in models including GBHM. Findings indicate that non-violent expressions of gender inequity (e.g., nutritional deprivation, deprivation of sleep, blocking access to health care during pregnancy) are more strongly associated with poor infant health than physical or sexual violence from husbands or in-laws in urban India. These results strongly suggest the need to expand the conception of gender inequities beyond IPV to include non-violent forms of gendered mistreatment in considering their impact on infant health.

Magnitude of income-related disparities in adverse perinatal outcomes

PubMed Central

2014-01-01

Background To assess and compare multiple measurements of socioeconomic position (SEP) in order to determine the relationship with adverse perinatal outcomes across various contexts. Methods A birth registry, the Nova Scotia Atlee Perinatal Database, was confidentially linked to income tax and related information for the year in which delivery occurred. Multiple logistic regression was used to examine odds ratios between multiple indicators of SEP and multiple adverse perinatal outcomes in 117734 singleton births between 1988 and 2003. Models for after tax family income were also adjusted for neighborhood deprivation to gauge the relative magnitude of effects related to SEP at both levels. Effects of SEP were stratified by single- versus multiple-parent family composition, and by urban versus rural location of residence. Results The risk of small for gestational age and spontaneous preterm birth was higher across all the indicators of lower SEP, while risk for large for gestational age was lower across indicators of lower SEP. Higher risk of postneonatal death was demonstrated for several measures of lower SEP. Higher material deprivation in the neighborhood of residence was associated with increased risk for perinatal death, small for gestational age birth, and iatrogenic and spontaneous preterm birth. Family composition and urbanicity were shown to modify the association between income and some perinatal outcomes. Conclusions This study highlights the importance of understanding the definitions of SEP and the mechanisms that lead to the association between income and poor perinatal outcomes, and broadening the types of SEP measures used in some cases. PMID:24589212

Consensus Bundle on Maternal Mental Health: Perinatal Depression and Anxiety.

PubMed

Kendig, Susan; Keats, John P; Hoffman, M Camille; Kay, Lisa B; Miller, Emily S; Moore Simas, Tiffany A; Frieder, Ariela; Hackley, Barbara; Indman, Pec; Raines, Christena; Semenuk, Kisha; Wisner, Katherine L; Lemieux, Lauren A

2017-03-01

Perinatal mood and anxiety disorders are among the most common mental health conditions encountered by women of reproductive age. When left untreated, perinatal mood and anxiety disorders can have profound adverse effects on women and their children, ranging from increased risk of poor adherence to medical care, exacerbation of medical conditions, loss of interpersonal and financial resources, smoking and substance use, suicide, and infanticide. Perinatal mood and anxiety disorders are associated with increased risks of maternal and infant mortality and morbidity and are recognized as a significant patient safety issue. In 2015, the Council on Patient Safety in Women's Health Care convened an interdisciplinary workgroup to develop an evidence-based patient safety bundle to address maternal mental health. The focus of this bundle is perinatal mood and anxiety disorders. The bundle is modeled after other bundles released by the Council on Patient Safety in Women's Health Care and provides broad direction for incorporating perinatal mood and anxiety disorder screening, intervention, referral, and follow-up into maternity care practice across health care settings. This commentary provides information to assist with bundle implementation.

Introduction of a qualitative perinatal audit at Muhimbili National Hospital, Dar es Salaam, Tanzania

PubMed Central

Kidanto, Hussein L; Mogren, Ingrid; van Roosmalen, Jos; Thomas, Angela N; Massawe, Siriel N; Nystrom, Lennarth; Lindmark, Gunilla

2009-01-01

Background Perinatal death is a devastating experience for the mother and of concern in clinical practice. Regular perinatal audit may identify suboptimal care related to perinatal deaths and thus appropriate measures for its reduction. The aim of this study was to perform a qualitative perinatal audit of intrapartum and early neonatal deaths and propose means of reducing the perinatal mortality rate (PMR). Methods From 1st August, 2007 to 31st December, 2007 we conducted an audit of perinatal deaths (n = 133) with birth weight 1500 g or more at Muhimbili National Hospital (MNH). The audit was done by three obstetricians, two external and one internal auditors. Each auditor independently evaluated the cases narratives. Suboptimal factors were identified in the antepartum, intrapartum and early neonatal period and classified into three levels of delay (community, infrastructure and health care). The contribution of each suboptimal factor to adverse perinatal outcome was identified and the case graded according to possible avoidability. Degree of agreement between auditors was assessed by the kappa coefficient. Results The PMR was 92 per 1000 total births. Suboptimal factors were identified in 80% of audited cases and half of suboptimal factors were found to be the likely cause of adverse perinatal outcome and were preventable. Poor foetal heart monitoring during labour was indirectly associated with over 40% of perinatal death. There was a poor to fair agreement between external and internal auditors. Conclusion There are significant areas of care that need improvement. Poor monitoring during labour was a major cause of avoidable perinatal mortality. This type of audit was a good starting point for quality assurance at MNH. Regular perinatal audits to identify avoidable causes of perinatal deaths with feed back to the staff may be a useful strategy to reduce perinatal mortality. PMID:19765312

Hippocampal volume and memory performance in children with perinatal stroke.

PubMed

Gold, Jeffrey J; Trauner, Doris A

2014-01-01

Pediatric neurologists and neonatologists often are asked to predict cognitive outcome after perinatal brain injury (including likely memory and learning outcomes). However, relatively few data exist on how accurate predictions can be made. Furthermore, although the consequences of brain injury on hippocampal volume and memory performance have been studied extensively in adults, little work has been done in children. We measured the volume of the hippocampus in 27 children with perinatal stroke and 19 controls, and measured their performance on standardized verbal and non-verbal memory tests. We discovered the following: (1) As a group, children with perinatal stroke had smaller left and right hippocampi compared with control children. (2) Individually, children with perinatal stroke demonstrated 1 of 3 findings: no hippocampal loss, unilateral hippocampal loss, or bilateral hippocampal volume loss compared with control children. (3) Hippocampal volume inversely correlated with memory test performance in the perinatal stroke group, with smaller left and right hippocampal volumes related to poorer verbal and non-verbal memory test performance, respectively. (4) Seizures played a significant role in determining memory deficit and extent of hippocampal volume reduction in patients with perinatal stroke. These findings support the view that, in the developing brain, the left and right hippocampi preferentially support verbal and nonverbal memory respectively, a consistent finding in the adult literature but a subject of debate in the pediatric literature. This is the first work to report that children with focal brain injury incurred from perinatal stroke have volume reduction in the hippocampus and impairments in certain aspects of declarative memory. Copyright © 2014 Elsevier Inc. All rights reserved.

Recurrence of perinatal death in Northern Tanzania: a registry based cohort study.

PubMed

Mahande, Michael J; Daltveit, Anne K; Mmbaga, Blandina T; Obure, Joseph; Masenga, Gileard; Manongi, Rachel; Lie, Rolv T

2013-08-29

Perinatal mortality is known to be high in Sub-Saharan Africa. Some women may carry a particularly high risk which would be reflected in a high recurrence risk. We aim to estimate the recurrence risk of perinatal death using data from a hospital in Northern Tanzania. We constructed a cohort study using data from the hospital based KCMC Medical Birth Registry. Women who delivered a singleton for the first time at the hospital between 2000 and 2008 were followed in the registry for subsequent deliveries up to 2010 and 3,909 women were identified with at least one more delivery within the follow-up period. Recurrence risk of perinatal death was estimated in multivariate models analysis while adjusting for confounders and accounting for correlation between births from the same mother. The recurrence risk of perinatal death for women who had lost a previous baby was 9.1%. This amounted to a relative risk of 3.2 (95% CI: 2.2 - 4.7) compared to the much lower risk of 2.8% for women who had had a surviving baby. Recurrence contributed 21.2% (31/146) of perinatal deaths in subsequent pregnancies. Preeclampsia, placental abruption, placenta previa, induced labor, preterm delivery and low birth weight in a previous delivery with a surviving baby were also associated with increased perinatal mortality in the next pregnancy. Some women in Tanzanian who suffer a perinatal loss in one pregnancy are at a particularly high risk of also losing the baby of a subsequent pregnancy. Strategies of perinatal death prevention that target pregnant women who are particularly vulnerable or already have experienced a perinatal loss should be considered in future research.

Learn Japanese: Secondary School Text, Volume VI.

ERIC Educational Resources Information Center

Hasegawa, Nobuko; And Others

This is the sixth in a series of ten texts designed for teaching Japanese at the secondary level. Also available are supplementary instructional materials and teacher's guides. Throughout the two units of four lessons each, the theme centers around life in Japan as seen through the eyes of an American student. Each unit contains conversations,…

Learn Japanese: Secondary School Text, Volume 5.

ERIC Educational Resources Information Center

Hirai, Bernice; And Others

This is the fifth in a series of ten texts designed for teaching Japanese at the secondary level. Also available are supplementary instructional materials and teacher's guides. Throughout the two units of four lessons each, the theme centers around life in Japan as seen through the eyes of an American student. Each unit contains conversations,…

Perinatal asphyxia: a review from a metabolomics perspective.

PubMed

Fattuoni, Claudia; Palmas, Francesco; Noto, Antonio; Fanos, Vassilios; Barberini, Luigi

2015-04-17

Perinatal asphyxia is defined as an oxygen deprivation that occurs around the time of birth, and may be caused by several perinatal events. This medical condition affects some four million neonates worldwide per year, causing the death of one million subjects. In most cases, infants successfully recover from hypoxia episodes; however, some patients may develop HIE, leading to permanent neurological conditions or impairment of different organs and systems. Given its multifactor dependency, the timing, severity and outcome of this disease, mainly assessed through Sarnat staging, are of difficult evaluation. Moreover, although the latest newborn resuscitation guideline suggests the use of a 21% oxygen concentration or room air, such an approach is still under debate. Therefore, the pathological mechanism is still not clear and a golden standard treatment has yet to be defined. In this context, metabolomics, a new discipline that has described important perinatal issues over the last years, proved to be a useful tool for the monitoring, the assessment, and the identification of potential biomarkers associated with asphyxia events. This review covers metabolomics research on perinatal asphyxia condition, examining in detail the studies reported both on animal and human models.

The long-term psychiatric and medical prognosis of perinatal mental illness.

PubMed

Meltzer-Brody, Samantha; Stuebe, Alison

2014-01-01

The perinatal period provides an important window into a woman's long-term health. Perinatal mental illness is a common condition conferring potential serious long-term psychiatric and medical consequences for the mother and family. It is known that childbirth acts as a powerful trigger for depressive episodes in some women, and that women with histories of a mood disorder are particularly vulnerable. Some evidence links perinatal mental illness with obstetrical complications and reduced lactation initiation and duration. Therefore, perinatal mental illness may be a marker for long-term risk, and may contribute directly to subsequent cardiometabolic disease through both neuroendocrine mechanisms and the effects of mental illness on health behaviours. In clinical practice, these associations underscore the importance of screening and treating women with perinatal mental illness to ensure best possible long-term outcomes. Early screening and treatment may both mitigate the primary disease process and reduce the risk of comorbid medical conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Perinatal Depression – the Fourth Inflammatory Morbidity of Pregnancy? Theory and Literature Review

PubMed Central

Osborne, Lauren M.; Monk, Catherine

2015-01-01

Perinatal depression is one of the leading causes of maternal morbidity and mortality. The biological etiology of this disorder remains in question, despite considerable research into the contributions of hormonal imbalance, the role of monoamines, and dysregulation of the HPA axis. Because inflammation is known to be associated with major depression in men and non-perinatal women as well as with other important morbidities of pregnancy (such as preeclampsia, preterm birth, and gestational diabetes), and because these morbidities may correlate with perinatal depression, inflammation may be a common physiological pathway that can also help explain perinatal depression. In this paper, we review the theoretical background of inflammation in perinatal depression and then review the literature concerning immune and inflammatory factors in the etiology and course of perinatal depression. We close with recommendations for future studies in this still relatively unexplored area. Identification and understanding of a common pathophysiology between other pregnancy morbidities and perinatal depression would link physical and mental well-being, likely leading to better treatment and prevention. PMID:23608136

[Group B streptococcal perinatal infection: A Global, Latin American and Mexican Overview].

PubMed

Palacios-Saucedo, Gerardo C; Hernández-Hernández, Talyha Itzel; Rivera-Morales, Lydia Guadalupe; Briones-Lara, Evangelina; Caballero-Trejo, Amílcar; Vázquez-Guillén, José M; Amador-Patiño, Gustavo I; García-Cabello, Ricardo; Solórzano-Santos, Fortino; Rodríguez-Padillacs, Cristina

2017-01-01

Group B streptococci (Streptococcus agalactiae) cause a number of infections in women during pregnancy and postpartum, such as urinary tract infection, chorioamnionitis and endometritis, consequently may affect the newborn. Group B streptococci is the most common cause of severe infections in newborns in developed countries. Studies on the epidemiology of group B streptococci infections in Latin America are still limited. This information is also unknown in Mexico, but studies carried out in the center of the country have found high rates of vaginal colonization in pregnant women and there are case series and case reports of newborns. Microbiological and molecular epidemiology studies in Mexico have shown that populations of group B streptococci have a clonal distribution and that there are clones with genetic and phenotypic characteristics of high virulence that appear to be responsible for most of perinatal pathology. However, the actual role of group B streptococci in perinatal pathology in Mexico is unknown. Consequently, whether to perform or not the screening for determining the group B streptococci colonization status in pregnant women, and the indication or not for intrapartum antibiotic prophylaxis to prevent neonatal group B streptococci infection in Mexico, are still controversial.

The 2016 American Orthopaedic Association-Japanese Orthopaedic Association Traveling Fellowship.

PubMed

Nandi, Sumon; Cho, Samuel K; Freedman, Brett A; Firoozabadi, Reza

2017-06-07

The American Orthopaedic Association-Japanese Orthopaedic Association (AOA-JOA) Traveling Fellowship, which began in 1992 as a collaborative effort between the 2 orthopaedic communities, is aimed at fostering leadership among early-career surgeons through clinical, academic, and cultural exchange. Over 3 weeks, we experienced an extraordinary journey that led us across nearly 800 miles of the picturesque Japanese countryside, with stops at 6 distinguished academic centers. The opportunity to become personally acquainted with orthopaedic leaders in Japan, learn from their experiences, and immerse ourselves in the ancient and storied culture of a beautiful country was one that we will not soon forget. Along the way, we accumulated a wealth of information while enjoying the legendary hospitality of the Japanese people. There is a ubiquitous challenge in delivering cost-effective, accessible health care while maintaining a commitment to education and research. The U.S. orthopaedic community may take solace in the fact that our Japanese colleagues stand with us as partners in this pursuit, and our relationship with them continues to grow stronger through endeavors such as the AOA-JOA Traveling Fellowship. We look forward to honoring our Japanese colleagues in 2017 when we host them in the United States.

A current landscape of provincial perinatal data collection in Canada.

PubMed

Massey, Kiran A; Magee, Laura A; Dale, Sheryll; Claydon, Jennifer; Morris, Tara J; von Dadelszen, Peter; Liston, Robert M; Ansermino, J Mark

2009-03-01

The Canadian Perinatal Network (CPN) was launched in 2005 as a national perinatal database project designed to identify best practices in maternity care. The inaugural project of CPN is focused on interventions that optimize maternal and perinatal outcomes in women with threatened preterm birth at 22+0 to 28+6 weeks' gestation. To examine existing data collection by perinatal health programs (PHPs) to inform decisions about shared data collection and CPN database construction. We reviewed the database manuals and websites of all Canadian PHPs and compiled a list of data fields and their definitions. We compared these fields and definitions with those of CPN and the Canadian Minimal Dataset, proposed as a common dataset by the Canadian Perinatal Programs Coalition of Canadian PHPs. PHPs collect information on 2/3 of deliveries in Canada. PHPs consistently collect information on maternal demographics (including both maternal and neonatal personal identifiers), past obstetrical history, maternal lifestyle, aspects of labour and delivery, and basic neonatal outcomes. However, most PHPs collect insufficient data to enable identification of obstetric (and neonatal) practices associated with improved maternal and perinatal outcomes. In addition, there is between-PHP variability in defining many data fields. Construction of a separate CPN database was needed although harmonization of data field definitions with those of the proposed Canadian Minimal Dataset was done to plan for future shared data collection. This convergence should be the goal of researchers and clinicians alike as we construct a common language for electronic health records.

Assessment of Japanese Stimulant Control Law Offenders Using the Addiction Severity Index—Japanese Version: Comparison with Patients in Treatment Settings

PubMed Central

Watanabe, Takashi; Ogai, Yasukazu; Koga, Takehiro; Senoo, Eiichi; Nakamura, Kazuhiko; Mori, Norio; Ikeda, Kazutaka

2009-01-01

The present study assessed problems in Japanese prisoners (inmates) who abused methamphetamine. Fifty-two male inmates were assessed in 2005–2007 using the Addiction Severity Index-Japanese version and compared with 55 male methamphetamine abusers in hospitals and recovery centers. The χ2 and Mann-Whitney-Wilcoxon tests showed that the inmates had a significantly lower education level, more frequently had full-time jobs, had more experience living with a sexual partner, and more frequently had a history of juvenile delinquency and criminal records than patients. Although psychiatric symptoms, such as depression, anxiety, and hallucinations, were not common among inmates, suicidal behavior and trouble controlling violence were common in both groups. PMID:20049245

Consensus Bundle on Maternal Mental Health: Perinatal Depression and Anxiety.

PubMed

Kendig, Susan; Keats, John P; Hoffman, M Camille; Kay, Lisa B; Miller, Emily S; Simas, Tiffany A Moore; Frieder, Ariela; Hackley, Barbara; Indman, Pec; Raines, Christena; Semenuk, Kisha; Wisner, Katherine L; Lemieux, Lauren A

2017-03-01

Perinatal mood and anxiety disorders are among the most common mental health conditions encountered by women of reproductive age. When left untreated, perinatal mood and anxiety disorders can have profound adverse effects on women and their children, ranging from increased risk of poor adherence to medical care, exacerbation of medical conditions, loss of interpersonal and financial resources, smoking and substance use, suicide, and infanticide. Perinatal mood and anxiety disorders are associated with increased risks of maternal and infant mortality and morbidity and are recognized as a significant patient safety issue. In 2015, the Council on Patient Safety in Women's Health Care convened an interdisciplinary work group to develop an evidence-based patient safety bundle to address maternal mental health. The focus of this bundle is perinatal mood and anxiety disorders. The bundle is modeled after other bundles released by the Council on Patient Safety in Women's Health Care and provides broad direction for incorporating perinatal mood and anxiety disorder screening, intervention, referral, and follow-up into maternity care practice across health care settings. This commentary provides information to assist with bundle implementation. © 2017 by the American College of Nurse-Midwives.

Modifying CBT for Perinatal Depression: What Do Women Want?

ERIC Educational Resources Information Center

O'Mahen, Heather; Fedock, Gina; Henshaw, Erin; Himle, Joseph A.; Forman, Jane; Flynn, Heather A.

2012-01-01

The evidence for the efficacy of CBT for depression during the perinatal period is mixed. This was a qualitative study that aimed to understand the perinatal-specific needs of depressed women in an effort to inform treatment modifications that may increase the relevance and acceptability of CBT during this period. Stratified purposeful sampling…

Perinatal mental health service provision in Switzerland and in the UK.

PubMed

Amiel Castro, Rita T; Schroeder, Katrin; Pinard, Claudia; Blöchlinger, Patricia; Künzli, Hansjörg; Riecher-Rössler, Anita; Kammerer, Martin

2015-01-01

The epidemiology of maternal perinatal-psychiatric disorders as well as their effect on the baby is well recognised. Increasingly well researched specialised treatment methods can reduce maternal morbidity, positively affect mother-baby bonding and empower women's confidence as a mother. Here, we aimed to compare guidelines and the structure of perinatal-psychiatric service delivery in the United Kingdom and in Switzerland from the government's perspective. Swiss cantons provided information regarding guidelines and structure of service delivery in 2000. A subsequent survey using the same questionnaire was carried out in 2007. In the UK, similar information was accessed through published reports from 2000-2012. Guidelines for perinatal psychiatry exist in the UK, whereas in Switzerland in 2000 none of the 26 cantons had guidelines, and in 2007 only one canton did. Joint mother-baby admissions on general psychiatric wards were offered by 92% of the Swiss cantons. In the UK, pregnant women and joint mother-baby admissions are only advised onto specialised perinatal-psychiatric units. In Switzerland, in 2007, three specialised units (max. 24 beds) were in place corresponding to 1 unit per 2.5 million people, while in the UK there were 22 mother-baby units (168 beds) in 2012 (1 unit per 2.8 million). In the UK, less than 50% of trusts provided specialised perinatal-psychiatric health care. The main difference between the UK and Switzerland was the absence of guidelines, regular assessment and plans for future development of perinatal psychiatry in Switzerland. There are still geographical differences in the provision of perinatal-psychiatric services in the UK.

Pregnancy outcomes in perinatally HIV-infected young women in Madrid, Spain: 2000-2015.

PubMed

Prieto, Luis M; Fernández McPhee, Carolina; Rojas, Patricia; Mazariegos, Diana; Muñoz, Eloy; Mellado, Maria José; Holguín, África; Navarro, María Luisa; González-Tomé, María Isabel; Ramos, José Tomás

2017-01-01

An increasing number of perinatally HIV-infected women (PHIV) are reaching adulthood and becoming pregnant. Most PHIV women have been exposed to a high number of antiretroviral regimens, and they may have difficulties to achieve viral suppression. Psychosocial problems are not uncommon and could be an important barrier for treatment adherence. The effects of chronic HIV infection and long-term exposure to antiretroviral treatment of PHIV women cause concerns on the developing fetus. The aims of this study were to describe the prevention of mother-to-child transmission strategies in PHIV women and the infant outcomes in the Madrid Cohort of HIV-infected mother-infant pairs. All PHIV pregnant women registered in the Cohort that gave birth from 2000 to 2015 were included in the study. Twenty-eight pregnancies in twenty-two perinatally infected women were registered. Most women were Caucasian and heavily treatment-experienced. Nine cases (32.1%) were at high risk of HIV mother-to-child transmission. Maternal HIV-1 viral load was detectable close to delivery in four women (14.3%). The management of these cases was described, and the treatment strategies were discussed. None of the newborns acquired HIV infection. Eight infants (28.6%) were small for gestational age. This study included a large series of pregnancies among PHIV women attended according to a youth-centered care model. The challenges in the management of this population by health-care providers were described. Specific strategies to minimize perinatal transmission risks should be addressed in future collaborative studies.

Prenatal and perinatal risk factors and the clinical implications on autism spectrum disorder.

PubMed

Chien, Yi-Ling; Chou, Miao-Chun; Chou, Wen-Jiun; Wu, Yu-Yu; Tsai, Wen-Che; Chiu, Yen-Nan; Gau, Susan Shur-Fen

2018-06-01

Prenatal and perinatal factors may increase the risk of autism spectrum disorder. However, little is known about whether unaffected siblings of probands with autism spectrum disorder also share the phenomenon and whether the prenatal/perinatal factors are related to the clinical severity of autistic symptoms. We compared the frequency of prenatal and perinatal factors among 323 probands with autism spectrum disorder (mean age ± standard deviation, 10.7 ± 3.5 years; males, 91.0%), 257 unaffected siblings (11.7 ± 4.5; 42.8%), and 1504 typically developing controls (8.9 ± 1.6 years; 53.1%); and investigated their effects on the severity of autistic symptoms. We found that probands with autism spectrum disorder and their unaffected siblings had more prenatal/perinatal events than typically developing controls with higher numbers of prenatal/perinatal factors in probands than in unaffected siblings. The prenatal/perinatal events were associated with greater stereotyped behaviors, social-emotional problems, socio-communication deficits, and overall severity. We also found that six prenatal/perinatal factors (i.e. preeclampsia, polyhydramnios, oligoamnios, placenta previa, umbilical cord knot, and gestational diabetes) were associated with the severity of autistic symptoms, particularly stereotyped behaviors and socio-communication deficits. Our findings suggest that prenatal and perinatal factors may potentially moderate the clinical expression of autism spectrum disorder. The underlying mechanism warrants further research.

Pregnancy before recurrent pregnancy loss more often complicated by post-term birth and perinatal death.

PubMed

Wagner, Marise M; Visser, Jantien; Verburg, Harjo; Hukkelhoven, Chantal W P M; Van Lith, Jan M M; Bloemenkamp, Kitty W M

2018-01-01

The cause of recurrent pregnancy loss often remains unknown. Possibly, pathophysiological pathways are shared with other pregnancy complications. All women with secondary recurrent pregnancy loss (SRPL) visiting Leiden University Medical Center (January 2000-2015) were included in this retrospective cohort to assess whether women with SRPL have a more complicated first pregnancy compared with control women. SRPL was defined as three or more consecutive pregnancy losses before 22 weeks of gestation, with a previous birth. The control group consisted of all Dutch nullipara delivering a singleton (January 2000-2015). Information was obtained from the Dutch Perinatal Registry. Outcomes were preeclampsia, preterm birth, post-term birth, intrauterine growth restriction, breach position, induction of labor, cesarean section, congenital abnormalities, perinatal death and severe hemorrhage in the first ongoing pregnancy. Subgroup analyses were performed for women with idiopathic SRPL and for women ≤35 years. In all, 172 women with SRPL and 1 196 178 control women were included. Women with SRPL were older and had a higher body mass index; 29.7 years vs. 28.8 years and 25.1 kg/m 2 vs. 24.1 kg/m 2 , respectively. Women with SRPL more often had a post-term birth (OR 1.86, 95% CI 1.10-3.17) and more perinatal deaths occurred in women with SRPL compared with the control group (OR 5.03, 95% CI 2.48-10.2). Similar results were found in both subgroup analyses. The first ongoing pregnancy of women with (idiopathic) SRPL is more often complicated by post-term birth and perinatal death. Revealing possible links between SRPL and these pregnancy complications might lead to a better understanding of underlying pathophysiology. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Impacts of online and group perinatal education: a mixed methods study protocol for the optimization of perinatal health services.

PubMed

Roch, Geneviève; Borgès Da Silva, Roxane; de Montigny, Francine; Witteman, Holly O; Pierce, Tamarha; Semenic, Sonia; Poissant, Julie; Parent, André-Anne; White, Deena; Chaillet, Nils; Dubois, Carl-Ardy; Ouimet, Mathieu; Lapointe, Geneviève; Turcotte, Stéphane; Prud'homme, Alexandre; Painchaud Guérard, Geneviève; Gagnon, Marie-Pierre

2018-05-29

Prenatal education is a core component of perinatal care and services provided by health institutions. Whereas group prenatal education is the most common educational model, some health institutions have opted to implement online prenatal education to address accessibility issues as well as the evolving needs of future parents. Various studies have shown that prenatal education can be effective in acquisition of knowledge on labour and delivery, reducing psychological distress and maximising father's involvement. However, these results may depend on educational material, organization, format and content. Furthermore, the effectiveness of online prenatal education compared to group prenatal education remains unclear in the literature. This project aims to evaluate the impacts of group prenatal education and online prenatal education on health determinants and users' health status, as well as on networks of perinatal educational services maintained with community-based partners. This multipronged mixed methods study uses a collaborative research approach to integrate and mobilize knowledge throughout the process. It consists of: 1) a prospective cohort study with quantitative data collection and qualitative interviews with future and new parents; and 2) a multiple case study integrating documentary sources and interviews with stakeholders involved in the implementation of perinatal information service networks and collaborations with community partners. Perinatal health indicators and determinants will be compared between prenatal education groups (group prenatal education and online prenatal education) and standard care without these prenatal education services (control group). This study will provide knowledge about the impact of online prenatal education as a new technological service delivery model compared to traditional group prenatal education. Indicators related to the complementarity of these interventions and those available in community settings will

Optimizing the treatment of mood disorders in the perinatal period

PubMed Central

Meltzer-Brody, Samantha; Jones, Ian

2015-01-01

The perinatal period is a time of high risk for women with unipolar and bipolar mood disorders. We discuss treatment considerations for perinatal mood disorders, including unipolar and bipolar depression as well as postpartum psychosis. We further explore the unique issues faced by women and their families across the full trajectory of the perinatal period from preconception planning through pregnancy and following childbirth. Treatment of perinatal mood disorders requires a collaborative care approach between obstetrics practitioners and mental health providers, to ensure that a thoughtful risk : benefit analysis is conducted. It is vital to consider the risks of the underlying illness versus risks of medication exposure during pregnancy or lactation. When considering medication treatment, attention must be paid to prior medication trials that were most efficacious and best tolerated. Lastly, it is important to assess the impact of individual psychosocial stressors and lifestyle factors on treatment response. PMID:26246794

Depression in perinatally HIV-infected pregnant women compared to non-perinatally HIV-infected and HIV-uninfected pregnant women.

PubMed

Angrand, Ruth C; Sperling, Rhoda; Roccobono, Kinga; Osborne, Lauren M; Jao, Jennifer

2018-05-18

"Depression (as noted in chart by a physician)" was compared between HIV infected pregnant women and controls. Perinatally HIV-infected (PHIV), non-perinatally HIV-infected (NPHIV), and HIV-uninfected (HIV-U) pregnant women were all compared using a logistic regression model. Overall, HIV-infected women had higher rates of depression than HIV-U, with PHIV women demonstrating a clinically and statistically significant increased risk compared to HIV-U women [adjusted OR: 15.9, 95% CI = 1.8-143.8]. Future studies in larger populations are warranted to confirm these findings and further elucidate mental health outcomes of PHIV and NPHIV pregnant women.

Consensus Bundle on Maternal Mental Health: Perinatal Depression and Anxiety.

PubMed

Kendig, Susan; Keats, John P; Hoffman, M Camille; Kay, Lisa B; Miller, Emily S; Moore Simas, Tiffany A; Frieder, Ariela; Hackley, Barbara; Indman, Pec; Raines, Christena; Semenuk, Kisha; Wisner, Katherine L; Lemieux, Lauren A

Perinatal mood and anxiety disorders are among the most common mental health conditions encountered by women of reproductive age. When left untreated, perinatal mood and anxiety disorders can have profound adverse effects on women and their children, ranging from increased risk of poor adherence to medical care, exacerbation of medical conditions, loss of interpersonal and financial resources, smoking and substance use, suicide, and infanticide. Perinatal mood and anxiety disorders are associated with increased risks of maternal and infant mortality and morbidity and are recognized as a significant patient safety issue. In 2015, the Council on Patient Safety in Women's Health Care convened an interdisciplinary workgroup to develop an evidence-based patient safety bundle to address maternal mental health. The focus of this bundle is perinatal mood and anxiety disorders. The bundle is modeled after other bundles released by the Council on Patient Safety in Women's Health Care and provides broad direction for incorporating perinatal mood and anxiety disorder screening, intervention, referral, and follow-up into maternity care practice across health care settings. This commentary provides information to assist with bundle implementation. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

MATERNAL GRIEVING AND THE PERCEPTION OF AND ATTACHMENT TO CHILDREN BORN SUBSEQUENT TO A PERINATAL LOSS.

PubMed

Al-Maharma, Dua' Yousef; Abujaradeh, Hiba; Mahmoud, Khadejah Fahmi; Jarrad, Reem Ahmad

2016-07-01

The purpose of this study was to examine the relationship between maternal grieving for perinatal loss (PL) and the perception of and attachment to children born subsequent to a recent PL among mothers in Jordan. A cross-sectional, descriptive correlational design was used. A convenience sample of 190 mothers of full-term, healthy newborns born subsequent to a recent PL was recruited from seven Maternal and Child Health Care Centers in Jordan. These mothers were assessed using the Perinatal Grief Scale (L.J. Toedter, J.N. Lasker, & J.M. Alhadeff), 1988, the Maternal Postnatal Attachment Scale (J.T. Condon & C.J. Corkindale, 1998), and the Neonatal Perception Inventory II (E. Broussard, 1979). Results showed a significant negative relationship between grief intensity and the attachment level, r = -.37, p = .000, and a significant positive relationship between the attachment level and neonatal perception, r = .28, p = .000. Mothers' grief intensity was significantly affected by their demographic characteristics; however, there was no significant relationship between grief intensity and neonatal perception, r = .23, p = .23. Perinatal grief was negatively related to maternal attachment to the subsequent child. Nurses should address bereaved mothers and their children who might be at risk for developing attachment disturbances to facilitate positive adaptation to the subsequent pregnancy and parenthood. © 2016 Michigan Association for Infant Mental Health.

Neuroprotective actions of perinatal choline nutrition

PubMed Central

Blusztajn, Jan Krzysztof; Mellott, Tiffany J.

2017-01-01

Choline is an essential nutrient for humans. Studies in rats and mice have shown that high choline intake during gestation or the perinatal period improves cognitive function in adulthood, prevents memory decline of old age, and protects the brain from damage and cognitive and neurological deterioration associated with epilepsy and hereditary conditions such as Down’s and Rett syndromes. These behavioral changes are accompanied by modified patterns of expression of hundreds of cortical and hippocampal genes including those encoding proteins central for learning and memory processing. The effects of choline correlate with cerebral cortical changes in DNA and histone methylation, thus suggesting an epigenomic mechanism of action of perinatal choline. PMID:23314544

Do American born Japanese children still grow faster than native Japanese?

PubMed

Kano, K; Chung, C S

1975-09-01

Growth patterns of Japanese schoolchildren in Hawaii, composed of 2,954 boys and 3,213 girls aged between 11 and 17, were compared with those comparable groups of Japanese schoolchildren in Japan based on the data published by the Japanese Ministry of Education. Growth characteristics studied were height, weight, and relative weight index, weight/(height). The Hawaii-Japanese boys were taller at early ages but the difference disappeared by age 16. Native Japanese girls were shorter than Hawaii-Japanese until age 13, but they overtook the latter by age 14, exceeding them in height after age 15. A similar pattern was found in weights of girls but the Hawaii-Japanese boys remained consistently heavier by 5.0 to 9.0 kg than native Japanese. The relative weight measure indicated that the Hawaii boys were more "obese" than native Japanese boys for the growth period studied; whereas the same tendency was maintained until age 15 in girls. These observations indicate a marked degree of convergence of the patterns of physical growth of the two populations, whose differences were unmistakably in favor of American born children in earlier studies. It is concluded that the convergence is due largely to the improved environmental conditions in Japan in recent years.

[Perinatal clomiphene citrate treatment changes sexual orientations of male mice].

PubMed

He, Feng-Qin; Zhang, Heng-Rui

2013-10-01

Perinatal period and adolescence are critical for brain development, which is the biological basis of an individual's sexual orientation and sexual behavior. In this study, animals were divided into two groups and their sexual orientations were observed: one group experienced drug treatments during the perinatal period, and the other group was castrated at puberty. The results showed that estradiol treatment had no effect on mature male offspring's sexual orientations, but 9 days and 14 days of clomiphene citrate treatment significantly increased the chance of homosexuality and effeminized behavior. In addition, the sexual orientation of mature normal male offspring, which were castrated when they were 21 days old,was not significant different from the control animals. These findings suggest that the inhibition of perinatal estrogen activities could suppress individual male-typical responses, enhance female-typical responses and induce homosexual orientations. Moreover, the masculinizing effects of estrogen were more obvious during perinatal period than adolescence.

ProvenCare perinatal: a model for delivering evidence/ guideline-based care for perinatal populations.

PubMed

Berry, Scott A; Laam, Leslie A; Wary, Andrea A; Mateer, Harry O; Cassagnol, Hans P; McKinley, Karen E; Nolan, Ruth A

2011-05-01

Geisinger Health System (GHS) has applied its ProvenCare model to demonstrate that a large integrated health care delivery system, enabled by an electronic health record (EHR), could reengineer a complicated clinical process, reduce unwarranted variation, and provide evidence-based care for patients with a specified clinical condition. In 2007 GHS began to apply the model to a more complicated, longer-term condition of "wellness"--perinatal care. ADAPTING PROVENCARE TO PERINATAL CARE: The ProvenCare Perinatal initiative was more complex than the five previous ProvenCare endeavors in terms of breadth, scope, and duration. Each of the 22 sites created a process flow map to depict the current, real-time process at each location. The local practice site providers-physicians and mid-level practitioners-reached consensus on 103 unique best practice measures (BPMs), which would be tracked for every patient. These maps were then used to create a single standardized pathway that included the BPMs but also preserved some unique care offerings that reflected the needs of the local context. A nine-phase methodology, expanded from the previous six-phase model, was implemented on schedule. Pre- to postimplementation improvement occurred for all seven BPMs or BPM bundles that were considered the most clinically relevant, with five statistically significant. In addition, the rate of primary cesarean sections decreased by 32%, and birth trauma remained unchanged as the number of vaginal births increased. Preliminary experience suggests that integrating evidence/guideline-based best practices into work flows in inpatient and outpatient settings can achieve improvements in daily patient care processes and outcomes.

Social Support Following Perinatal Loss

PubMed Central

Kavanaugh, Karen; Trier, Darcie; Korzec, Michelle

2005-01-01

The purpose of this project was to examine parents' descriptions of the ways family and friends supported them after they had experienced a perinatal loss. For this project, a secondary analysis of data from two phenomenological studies on perinatal loss was performed. A combined total of 62 interview transcripts from 22 mothers and 9 fathers were examined. Data analysis included identifying all statements in the interview transcripts that pertained to the ways that family and friends supported parents. The modes of supportive behavior (emotional, advice/feedback, practical, financial, and socializing) in Vaux's theory of social support served as a useful framework for presenting the findings. Parents received emotional support most frequently. Findings from the current study provide data for health care professionals to use to provide guidance to family and friends of bereaved parents. PMID:17426820

A study of the standard brain in Japanese children: morphological comparison with the MNI template.

PubMed

Uchiyama, Hitoshi T; Seki, Ayumi; Tanaka, Daisuke; Koeda, Tatsuya; Jcs Group

2013-03-01

Functional magnetic resonance imaging (MRI) studies involve normalization so that the brains of different subjects can be described using the same coordinate system. However, standard brain templates, including the Montreal Neurological Institute (MNI) template that is most frequently used at present, were created based on the brains of Western adults. Because morphological characteristics of the brain differ by race and ethnicity and between adults and children, errors are likely to occur when data from the brains of non-Western individuals are processed using these templates. Therefore, this study was conducted to collect basic data for the creation of a Japanese pediatric standard brain. Participants in this study were 45 healthy children (contributing 65 brain images) between the ages of 6 and 9 years, who had nothing notable in their perinatal and other histories and neurological findings, had normal physical findings and cognitive function, exhibited no behavioral abnormalities, and provided analyzable MR images. 3D-T1-weighted images were obtained using a 1.5-T MRI device, and images from each child were adjusted to the reference image by affine transformation using SPM8. The lengths were measured and compared with those of the MNI template. The Western adult standard brain and the Japanese pediatric standard brain obtained in this study differed greatly in size, particularly along the anteroposterior diameter and in height, suggesting that the correction rates are high, and that errors are likely to occur in the normalization of pediatric brain images. We propose that the use of the Japanese pediatric standard brain created in this study will improve the accuracy of identification of brain regions in functional brain imaging studies involving children. Copyright © 2012 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Missed Opportunities for Preventing Perinatal Transmission of Human Immunodeficiency Virus, Florida, 2007–2014

PubMed Central

Trepka, Mary Jo; Mukherjee, Soumyadeep; Beck-Sagué, Consuelo; Maddox, Lorene M.; Fennie, Kristopher P.; Sheehan, Diana M.; Prabhakar, Maithri; Thompson, Dan; Lieb, Spencer

2016-01-01

Objectives Despite declining numbers of perinatally exposed infants, an increase in perinatal human immunodeficiency virus (HIV) infections from 2011 to 2013 prompted this study to identify missed perinatal HIV prevention opportunities. Methods Deidentified records of children born from 2007 through 2014, exposed to HIV perinatally, and reported to the Florida Department of Health were obtained. Crude relative risks (RRs) and 95% confidence intervals (CIs) for factors associated with perinatal transmission, nondiagnosis of maternal HIV infection, and nonreceipt of antiretroviral medication were calculated. Results Of the 4337 known singleton births exposed to maternal HIV infection, 70 (1.6%) were perinatally infected. Among perinatal transmission cases, more than one-third of mothers used illegal drugs or acquired a sexually transmitted infection during pregnancy. Perinatal transmission was most strongly associated with maternal HIV diagnosis during labor and delivery (RR 5.66; 95% CI 2.31–13.91) or after birth (RR 26.50; 95% CI 15.44–45.49) compared with antenatally or prenatally. Among the 29 women whose infection was not known before pregnancy and whose child was perinatally infected, 18 were not diagnosed during pregnancy; 12 had evidence of an acute HIV infection, and 6 had no prenatal care. Conclusions Late diagnosis of maternal HIV infection appeared to be primarily the result of acute maternal infections and inadequate prenatal care. In Florida, effective programs to improve utilization of prenatal care and detection and primary prevention of prenatal acute infection are needed. PMID:28158882

Perinatal Programming of Asthma: The Role of Gut Microbiota

PubMed Central

Azad, Meghan B.; Kozyrskyj, Anita L.

2012-01-01

Perinatal programming, a dominant theory for the origins of cardiovascular disease, proposes that environmental stimuli influence developmental pathways during critical periods of prenatal and postnatal development, inducing permanent changes in metabolism. In this paper, we present evidence for the perinatal programming of asthma via the intestinal microbiome. While epigenetic mechanisms continue to provide new explanations for the programming hypothesis of asthma development, it is increasingly apparent that the intestinal microbiota plays an independent and potentially interactive role. Commensal gut bacteria are essential to immune system development, and exposures disrupting the infant gut microbiota have been linked to asthma. This paper summarizes the recent findings that implicate caesarean delivery, breastfeeding, perinatal stress, probiotics, and antibiotics as modifiers of infant gut microbiota in the development of asthma. PMID:22110540

Action plan to reduce perinatal mortality.

PubMed

Bhakoo, O N; Kumar, R

1990-01-01

The government of India has set a goal of reducing perinatal mortality from its current rate of 48/1000 to 30-35/1000 by the year 2000. Perinatal deaths result from maternal malnutrition, inadequate prenatal care, complications of delivery, and infections in the postpartum period. Since reductions in perinatal mortality require attention to social, economic, and behavioral factors, as well as improvements in the health care delivery system, a comprehensive strategy is required. Social measures, such as raising the age at marriage to 18 years for females, improving the nutritional status of adolescent girls, reducing the strenuousness of work during pregnancy, improving female literacy, raising women's status in the society and thus in the family, and poverty alleviation programs, would all help eliminate the extent of complications of pregnancy. Measures required to enhance infant survival include improved prenatal care, prenatal tetanus toxoid immunization, use of sterile disposable cord care kits, the provision of mucus extractors and resuscitation materials to birth attendants, the creation of neonatal care units in health facilities, and more efficient referral of high-risk newborns and mothers. Since 90% of births in rural India take place at home priority must be given to training traditional birth attendants in the identification of high risk factors during pregnancy, delivery, and the newborn period.

Associations of maternal pre-pregnancy underweight with small-for-gestational-age and spontaneous preterm birth, and optimal gestational weight gain in Japanese women.

PubMed

Fujiwara, Kana; Aoki, Shigeru; Kurasawa, Kentaro; Okuda, Mika; Takahashi, Tsuneo; Hirahara, Fumiki

2014-04-01

To determine associations of maternal pre-pregnancy underweight with poor outcomes and evaluate how gestational weight gain affects risks for such outcomes in pre-pregnancy underweight Japanese women. By analyzing the January 2001-December 2012 hospital database, we retrospectively identified 6954 women with pre-pregnancy normal weights (body mass index, 18.5-24.9 kg/m²) and 1057 pre-pregnancy underweight women (body mass index, <18.5 kg/m²) who delivered at the Perinatal Maternity and Neonatal Center of Yokohama City University. These women were stratified by weekly weight gain during the second/third trimesters to investigate associations of gestational weight gain with spontaneous preterm birth and small for gestational age (SGA). Spontaneous preterm birth and SGA incidences were compared with those of women meeting Institute of Medicine (IO M) guidelines to determine optimal weight gain in Japanese women. Preterm birth and SGA incidences were significantly higher in pre-pregnancy underweight than in pre-pregnancy normal weight women (4.6% vs 2.4% [P=0.005] and 13.9% vs 9.7% [P = 0.003], respectively). For pre-pregnancy normal weight women, preterm birth incidence was significantly higher in those with weight gain of less than 0.2 kg/week than in those IOM guidelines. For pre-pregnancy underweight women, preterm birth and SGA incidences were significantly higher in those with weight gain of less than 0.3 kg/week than in those meeting IOM guidelines. Preterm birth and SGA incidences did not differ significantly between pre-pregnancy normal weight women with weight gain of 0.2 kg/week or more and pre-pregnancy underweight women with weight gain of 0.3 kg/week or more, as compared to women meeting IOM guidelines. These results suggest that IOM guidelines for gestational weight gain may lack external validity in Japanese women. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

Psychosocial impact of perinatal loss among Muslim women.

PubMed

Sutan, Rosnah; Miskam, Hazlina Mohd

2012-06-18

Women of reproductive age are vulnerable to psychosocial problems, but these have remained largely unexplored in Muslim women in developing countries. The aim of this study was to explore and describe psychosocial impact and social support following perinatal loss among Muslim women. A qualitative study was conducted in a specialist centre among Muslim mothers who had experienced perinatal loss. Purposive sampling to achieve maximum variation among Muslims in relation to age, parity and previous perinatal death was used. Data was collected by focus group discussion and in-depth unstructured interview until the saturation point met. Sixteen mothers who had recent perinatal loss of wanted pregnancy, had received antenatal follow up from public or private health clinics, and had delivery in our centre participated for the study. All of them had experienced psychological difficulties including feelings of confusion, emptiness and anxiety over facing another pregnancy. Two out of sixteen showed anger and one felt guilt. They reported experiencing a lack of communication and privacy in the hospital during the period of grief. Family members and friends play an important role in providing support. The majority agreed that the decision makers were husbands and families instead of themselves. The respondents felt that repetitive reminder of whatever happened was a test from God improved their sense of self-worth. They appreciated this reminder especially when it came from husband, family or friends closed to them. Muslim mothers who had experienced perinatal loss showed some level of adverse psychosocial impact which affected their feelings. Husbands and family members were the main decision makers for Muslim women. Health care providers should provide psychosocial support during antenatal, delivery and postnatal care. On-going support involving husband should be available where needed.

Psychosocial impact of perinatal loss among Muslim women

PubMed Central

2012-01-01

Background Women of reproductive age are vulnerable to psychosocial problems, but these have remained largely unexplored in Muslim women in developing countries. The aim of this study was to explore and describe psychosocial impact and social support following perinatal loss among Muslim women. Methods A qualitative study was conducted in a specialist centre among Muslim mothers who had experienced perinatal loss. Purposive sampling to achieve maximum variation among Muslims in relation to age, parity and previous perinatal death was used. Data was collected by focus group discussion and in-depth unstructured interview until the saturation point met. Sixteen mothers who had recent perinatal loss of wanted pregnancy, had received antenatal follow up from public or private health clinics, and had delivery in our centre participated for the study. All of them had experienced psychological difficulties including feelings of confusion, emptiness and anxiety over facing another pregnancy. Results Two out of sixteen showed anger and one felt guilt. They reported experiencing a lack of communication and privacy in the hospital during the period of grief. Family members and friends play an important role in providing support. The majority agreed that the decision makers were husbands and families instead of themselves. The respondents felt that repetitive reminder of whatever happened was a test from God improved their sense of self-worth. They appreciated this reminder especially when it came from husband, family or friends closed to them. Conclusion Muslim mothers who had experienced perinatal loss showed some level of adverse psychosocial impact which affected their feelings. Husbands and family members were the main decision makers for Muslim women. Health care providers should provide psychosocial support during antenatal, delivery and postnatal care. On-going support involving husband should be available where needed. PMID:22708998

Perinatal asphyxia in monochorionic versus dichorionic twins: incidence, risk factors and outcome.

PubMed

van Steenis, A; Kromhout, H E; Steggerda, S J; Sueters, M; Rijken, M; Oepkes, D; Lopriore, E

2014-01-01

To estimate the incidence, risk factors, severity and outcome after perinatal asphyxia in monochorionic (MC) versus dichorionic (DC) twins. We included all consecutive near-term MC and DC twins with perinatal asphyxia admitted to our neonatal ward between 2004 and 2013 and compared the perinatal characteristics and neonatal outcome between both groups. The incidence of perinatal asphyxia in MC and DC twin infants was 4.0 (11/272) and 4.0% (8/200; p = 1.00). In contrast to DC twins, asphyxia in MC twins was strongly associated with acute exsanguination and anemia at birth; 64% (7/11) in MC twins and 0% (0/8) in DC twins (p < 0.01). Median hemoglobin level at birth in the MC and DC groups was 11.5 and 18.6 g/dl, respectively (p < 0.01). Perinatal asphyxia in MC twins is often associated with severe anemia at birth due to acute hemorrhage through the placental vascular anastomoses. © 2014 S. Karger AG, Basel.

KENNEDY SPACE CENTER, FLA. - Shuttle Launch Director Mike Leinbach (right) explains recovery and reconstruction efforts of Columbia to the Executive Director of NASDA Koji Yamamoto (center, foreground) and others visiting the Columbia Debris Hangar. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of the newest Space Station module, the Japanese Experiment Module/pressurized module.

NASA Image and Video Library

2003-06-12

KENNEDY SPACE CENTER, FLA. - Shuttle Launch Director Mike Leinbach (right) explains recovery and reconstruction efforts of Columbia to the Executive Director of NASDA Koji Yamamoto (center, foreground) and others visiting the Columbia Debris Hangar. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of the newest Space Station module, the Japanese Experiment Module/pressurized module.

KENNEDY SPACE CENTER, FLA. - Executive Director of NASDA Koji Yamamoto (left) is welcomed to KSC by Center Director Roy Bridges Jr. (right). Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of the newest Space Station module, the Japanese Experiment Module/pressurized module. His visit includes a tour of the Columbia Debris Hangar.

NASA Image and Video Library

2003-06-12

KENNEDY SPACE CENTER, FLA. - Executive Director of NASDA Koji Yamamoto (left) is welcomed to KSC by Center Director Roy Bridges Jr. (right). Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of the newest Space Station module, the Japanese Experiment Module/pressurized module. His visit includes a tour of the Columbia Debris Hangar.

Japaneseplex: A forensic SNP assay for identification of Japanese people using Japanese-specific alleles.

PubMed

Yuasa, Isao; Akane, Atsushi; Yamamoto, Toshimichi; Matsusue, Aya; Endoh, Minoru; Nakagawa, Mayumi; Umetsu, Kazuo; Ishikawa, Takaki; Iino, Morio

2018-04-24

It is sometimes necessary to determine whether a forensic biological sample came from a Japanese person. In this study, we developed a 60-locus SNP assay designed for the differentiation of Japanese people from other East Asians using entirely and nearly Japanese-specific alleles. This multiplex assay consisted of 6 independent PCR reactions followed by single nucleotide extension. The average number and standard deviation of Japanese-specific alleles possessed by an individual were 0.81 ± 0.93 in 108 Koreans from Seoul, 8.87 ± 2.89 in 103 Japanese from Tottori, 17.20 ± 3.80 in 88 Japanese from Okinawa, and 0 in 220 Han Chinese from Wuxi and Changsha. The Koreans had 0-4 Japanese-specific alleles per individual, whereas the Japanese had 4-26 Japanese-specific alleles. Almost all Japanese were distinguished from the Koreans and other people by the factorial correspondence and principal component analyses. The Snipper program was also useful to estimate the degree of Japaneseness. The method described here was successfully applied to the differentiation of Japanese from non-Japanese people in forensic cases. This Japanese-specific SNP assay was named Japaneseplex. Copyright © 2018 Elsevier B.V. All rights reserved.

Cortical Reorganization of Language Functioning Following Perinatal Left MCA Stroke

ERIC Educational Resources Information Center

Tillema, Jan-Mendelt; Byars, Anna W.; Jacola, Lisa M.; Schapiro, Mark B.; Schmithorst, Vince J.; Szaflarski, Jerzy P.; Holland, Scott K.

2008-01-01

Objective: Functional MRI was used to determine differences in patterns of cortical activation between children who suffered perinatal left middle cerebral artery (MCA) stroke and healthy children performing a silent verb generation task. Methods: Ten children with prior perinatal left MCA stroke (age 6-16 years) and ten healthy age matched…

Term perinatal mortality audit in the Netherlands 2010-2012: a population-based cohort study.

PubMed

Eskes, Martine; Waelput, Adja J M; Erwich, Jan Jaap H M; Brouwers, Hens A A; Ravelli, Anita C J; Achterberg, Peter W; Merkus, Hans J M W M; Bruinse, Hein W

2014-10-14

To assess the implementation and first results of a term perinatal internal audit by a standardised method. Population-based cohort study. All 90 Dutch hospitals with obstetric/paediatric departments linked to community practices of midwives, general practitioners in their attachment areas, organised in perinatal cooperation groups (PCG). The population consisted of 943 registered term perinatal deaths occurring in 2010-2012 with detailed information, including 707 cases with completed audit results. Participation in the audit, perinatal death classification, identification of substandard factors (SSF), SSF in relation to death, conclusive recommendations for quality improvement in perinatal care and antepartum risk selection at the start of labour. After the introduction of the perinatal audit in 2010, all PCGs participated. They organised 645 audit sessions, with an average of 31 healthcare professionals per session. Of all 1102 term perinatal deaths (2.3/1000) data were registered for 86% (943) and standardised anonymised audit results for 64% (707). In 53% of the cases at least one SSF was identified. Non-compliance to guidelines (35%) and deviation from usual professional care (41%) were the most frequent SSF. There was a (very) probable relation between the SSF and perinatal death for 8% of all cases. This declined over the years: from 10% (n=23) in 2010 to 5% (n=10) in 2012 (p=0.060). Simultaneously term perinatal mortality decreased from 2.3 to 2.0/1000 births (p<0.00001). Possibilities for improvement were identified in the organisation of care (35%), guidelines or usual care (19%) and in documentation (15%). More pregnancies were antepartum selected as high risk, 70% in 2010 and 84% in 2012 (p=0.0001). The perinatal audit is implemented nationwide in all obstetrical units in the Netherlands in a short time period. It is possible that the audit contributed to the decrease in term perinatal mortality. Published by the BMJ Publishing Group Limited. For

The effectiveness of regionalization of perinatal care services--a systematic review.

PubMed

Rashidian, A; Omidvari, A H; Vali, Y; Mortaz, S; Yousefi-Nooraie, R; Jafari, M; Bhutta, Z A

2014-10-01

Several reports recommend the implementation of perinatal regionalization for improvements in maternal and neonatal outcomes, while research evidence on the effectiveness of perinatal regionalization has been limited. The interventional studies have been assessed for robust evidence on the effectiveness of perinatal regionalization on improving maternal and neonatal health outcomes. Bibliographic databases of Medline, EMbase, EconLit, HMIC have been searched using sensitive search terms for interventional studies that reported important patient or process outcomes. At least two authors assessed eligibility for inclusion and the risk of biases and extracted data from the included studies. As meta-analysis was not possible, a narrative analysis as well as a 'vote-counting' analysis has been conducted for important outcomes. After initial screenings 53 full text papers were retrieved. Eight studies were included in the review from the USA, Canada and France. Studies varied in their designs, and in the specifications of the intervention and setting. Only three interrupted time series studies had a low risk of bias, of which only one study reported significant reductions in neonatal and infant mortality. Studies of higher risk of bias were more likely to report improvements in outcomes. Implementing perinatal regionalization programs is correlated with improvements in perinatal outcomes, but it is not possible to establish a causal link. Despite several high profile policy statements, evidence of effect is weak. It is necessary to assess the effectiveness of perinatal regionalization using robust research designs in a more diverse range of countries.

Participant Characteristics in the Kumamoto University Regional Center of Japan Environment and Children's Study (JECS): Association of Pregnancy Outcomes with Pregestational Maternal Body Mass Index and Maternal Weight Gain during Pregnancy.

PubMed

Kaimura, Michiko; Oda, Masako; Mitsubuchi, Hiroshi; Ohba, Takashi; Katoh, Takahiko

2017-01-01

The purpose of this study was to identify participant characteristics in the Kumamoto University Regional Center of the Japan Environment and Children's Study (K-JECS) and to investigate the association of pregnancy outcomes with pregestational maternal body mass index (BMI) and maternal weight gain during pregnancy (MWG). The subjects were women with singleton birth, who had been recruited by the K-JECS, and were registered in the data systems for the first and second questionnaires and transcripts of medical records. The subjects were categorized by BMI with further classification by MWG. The chi-squared test and one-way analysis of variance were performed to determine the correlations of BMI and MWG with perinatal outcomes. Logistic regression analysis was performed to examine perinatal outcome risks. The subject characteristics were similar to the trends observed in the Japanese general population. The odds ratio for natural delivery was low in the overweight groups (OW) and normal weight groups (NW) with excessive weight gain. On the other hand, the risk of cesarean section was high in the OW, and risk of induced or accelerated delivery was high in the NW with excessive weight gain. The risks of preterm birth and LBW were high in the insufficient weight gain groups regardless of BMI. The risks of pregnancy-induced hypertension and gestational diabetes were high in the OW.

Preferred prenatal counselling at the limits of viability: a survey among Dutch perinatal professionals.

PubMed

Geurtzen, R; Van Heijst, Arno; Hermens, Rosella; Scheepers, Hubertina; Woiski, Mallory; Draaisma, Jos; Hogeveen, Marije

2018-01-03

Since 2010, intensive care can be offered in the Netherlands at 24 +0  weeks gestation (with parental consent) but the Dutch guideline lacks recommendations on organization, content and preferred decision-making of the counselling. Our aim is to explore preferred prenatal counselling at the limits of viability by Dutch perinatal professionals and compare this to current care. Online nationwide survey as part of the PreCo study (2013) amongst obstetricians and neonatologists in all Dutch level III perinatal care centers (n = 205).The survey regarded prenatal counselling at the limits of viability and focused on the domains of organization, content and decision-making in both current and preferred practice. One hundred twenty-two surveys were returned out of 205 eligible professionals (response rate 60%). Organization-wise: more than 80% of all professionals preferred (but currently missed) having protocols for several aspects of counselling, joint counselling by both neonatologist and obstetrician, and the use of supportive materials. Most professionals preferred using national or local data (70%) on outcome statistics for the counselling content, in contrast to the international statistics currently used (74%). Current decisions on initiation care were mostly made together (in 99% parents and doctor). This shared decision model was preferred by 95% of the professionals. Dutch perinatal professionals would prefer more protocolized counselling, joint counselling, supportive material and local outcome statistics. Further studies on both barriers to perform adequate counselling, as well as on Dutch outcome statistics and parents' opinions are needed in order to develop a national framework. Clinicaltrials.gov, NCT02782650 , retrospectively registered May 2016.

The model of palliative care in the perinatal setting: a review of the literature

PubMed Central

2012-01-01

Background The notion of Palliative Care (PC) in neonatal and perinatal medicine has largely developed in recent decades. Our aim was to systematically review the literature on this topic, summarise the evolution of care and, based on the available data, suggest a current standard for this type of care. Methods Data sources included Medline, the Cochrane Library, CINAHL, and the bibliographies of the papers retrieved. Articles focusing on neonatal/perinatal hospices or PC were included. A qualitative analysis of the content was performed, and data on the lead author, country, year, type of article or design, and direct and indirect subjects were obtained. Results Among the 1558 articles retrieved, we did not find a single quantitative empirical study. To study the evolution of the model of care, we ultimately included 101 studies, most of which were from the USA. Fifty of these were comments/reflections, and only 30 were classifiable as clinical studies (half of these were case reports). The analysis revealed a gradual conceptual evolution of the model, which includes the notions of family-centered care, comprehensive care (including bereavement) and early and integrative care (also including the antenatal period). A subset of 27 articles that made special mention of antenatal aspects showed a similar distribution. In this subset, the results of the four descriptive clinical studies showed that, in the context of specific programmes, a significant number of couples (between 37 and 87%) opted for PC and to continue with the pregnancy when the foetus has been diagnosed with a lethal illness. Conclusions Despite the interest that PC has aroused in perinatal medicine, there are no evidence-based empirical studies to indicate the best model of care for this clinical setting. The very notion of PC has evolved to encompass perinatal PC, which includes, among other things, the idea of comprehensive care, and early and integrative care initiated antenatally. PMID:22409881

Kinesthetic deficits after perinatal stroke: robotic measurement in hemiparetic children.

PubMed

Kuczynski, Andrea M; Semrau, Jennifer A; Kirton, Adam; Dukelow, Sean P

2017-02-15

While sensory dysfunction is common in children with hemiparetic cerebral palsy (CP) secondary to perinatal stroke, it is an understudied contributor to disability with limited objective measurement tools. Robotic technology offers the potential to objectively measure complex sensorimotor function but has been understudied in perinatal stroke. The present study aimed to quantify kinesthetic deficits in hemiparetic children with perinatal stroke and determine their association with clinical function. Case-control study. Participants were 6-19 years of age. Stroke participants had MRI confirmed unilateral perinatal arterial ischemic stroke or periventricular venous infarction, and symptomatic hemiparetic cerebral palsy. Participants completed a robotic assessment of upper extremity kinesthesia using a robotic exoskeleton (KINARM). Four kinesthetic parameters (response latency, initial direction error, peak speed ratio, and path length ratio) and their variabilities were measured with and without vision. Robotic outcomes were compared across stroke groups and controls and to clinical measures of sensorimotor function. Forty-three stroke participants (23 arterial, 20 venous, median age 12 years, 42% female) were compared to 106 healthy controls. Stroke cases displayed significantly impaired kinesthesia that remained when vision was restored. Kinesthesia was more impaired in arterial versus venous lesions and correlated with clinical measures. Robotic assessment of kinesthesia is feasible in children with perinatal stroke. Kinesthetic impairment is common and associated with stroke type. Failure to correct with vision suggests sensory network dysfunction.

Cigarette smoking in pregnancy: relationship to perinatal outcomes in six Italian centres.

PubMed

De Scrilli, A; Boracchi, P; Pardi, G; Bevilacqua, G; Pezzani, F M; Marconi, A; Davanzo, R; Paludetto, R; Selvaggi, L; Zuppa, A A

1986-01-01

In this study the relationship of maternal smoking in pregnancy to low birth weight, fetal growth retardation, preterm delivery, and perinatal deaths has been investigated in a sample of 36,544 women with their single newborns, from 6 Italian centers (Triese, Milan, Parma, Rome, Naples, Bari), where a multicenter survey of perinatal preventive medicine (MPPI) was carried out, between 1973 and 1979, with the financial support of the Consiglio Nazionale dell Ricerche. The proportions of babies weighing 2500 g or less, and of babies with birth weight, head circumference or crown-heel length below the 10th centile were similar among nonsmokers and "stopped" smoker mothers, while they increased with increasing smoking levels. As regards head circumference and crown-heel length below the 10th centile, odds ratios are essentially the same before and after adjustment for age, parity, and socioeconomic class (about 1.5 for "1-10CGT" and up to 2.5 for "11+CGT"). Only slight increases have been observed in the odds ratios concerning low birthweight below the 10th centile (about 1.5 for "1-10CGT" and up to 3.5 for "11+CGT") after adjusting for the socioeconomic demographic variables (i.e. mainly removing the favourable effect of high socioeconomic class or low parity, which more frequently characterize smoker mothers). Owing to the lower smokers' frequencies, cigarette smoking estimated attributable risks concerning low birth weight and "small for dates" babies in the MPPI centres (between 4% and 19%) are considerably lower than those estimated in studies carried out in the US or Canada. Data analyzed in the present study do not indicate any relationship between maternal smoking and preterm delivery or perinatal deaths.

The diagnosis of fetal esophageal atresia and its implications on perinatal outcome.

PubMed

Kunisaki, Shaun M; Bruch, Steven W; Hirschl, Ronald B; Mychaliska, George B; Treadwell, Marjorie C; Coran, Arnold G

2014-10-01

The current diagnostic accuracy and perinatal outcome of fetuses with esophageal atresia (EA) continues to be debated. In this review, we report on our experience at a tertiary care fetal center with the prenatal ultrasound diagnosis of EA. Enrollment criteria included a small/absent stomach bubble with a normal or elevated amniotic fluid index between 2005 and 2013. Perinatal outcomes were analyzed and compared to postnatally diagnosed EA cases. Of the 22 fetuses evaluated, polyhydramnios occurred in 73%. Three (14%) died in utero or shortly after birth, but none had EA. In the presence of an absent/small stomach and polyhydramnios, the positive predictive value for EA was 67%. In fetal EA cases confirmed postnatally (group 1, n = 11), there were no differences in gestational age, birthweight, or mortality when compared to postnatally diagnosed infants (group 2, n = 59). Group 1 was associated with long-gap EA, need for esophageal replacement, and increased hospital length of stay. When taken in context with the current literature, we conclude that ultrasound findings suggestive of EA continue to be associated with a relatively high rate of false positives. However, among postnatally confirmed cases, there is an increased risk for long-gap EA and prolonged hospitalization.

Adverse obstetric and perinatal outcomes in subfertile women conceiving without assisted reproductive technologies.

PubMed

Jaques, Alice M; Amor, David J; Baker, H W Gordon; Healy, David L; Ukoumunne, Obioha C; Breheny, Sue; Garrett, Claire; Halliday, Jane L

2010-12-01

To determine whether adverse perinatal outcomes are increased in subfertile women. Cohort study. Two tertiary assisted reproductive technologies (ART) centers; Victorian births register. Records of women who registered with the clinics (1991-2000), but did not have an infant using ART, were linked to the birth register (1991-2004) to identify singleton non-ART births within 5 years of registration (N = 2171). Controls, matched by maternal age and year of infant's birth, were selected randomly from birth records (N = 4363). None. Adverse obstetric and perinatal outcomes. After adjusting for confounders, compared with controls, subfertile women had increased odds of hypertension or preeclampsia (adjusted odds ratio [OR] 1.29, 1.02-1.61), antepartum hemorrhage (adjusted OR 1.41, 1.05-1.89), perinatal death (adjusted OR 2.19, 1.10-4.36), low birth weight (adjusted OR 1.44, 1.11-1.85), preterm birth <37 weeks (adjusted OR 1.32, 1.05-1.67) or <31 weeks (adjusted OR 2.37, 1.35-4.13), and cesarean delivery (adjusted OR 1.56, 1.37-1.77). There was weak evidence for increased birth defects (adjusted OR 1.30, 0.98-1.72) and gestational diabetes (adjusted OR 1.25, 0.96-1.63). No increased risk was found for prelabor rupture of membranes, small for gestational age, or postpartum hemorrhage. Subfertile women with singleton births are at increased risk of several adverse outcomes. These risks should be considered during their antenatal care and when analyzing adverse effects of ART. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

[Perinatal audit in the North of the Netherlands: the first 2 years].

PubMed

van Diem, Mariet Th; Bergman, Klasien A; Bouman, Katelijne; van Egmond, Nico; Stant, Dennis A; Timmer, Albertus; Ulkeman, Lida H M; Veen, Wenda B; Erwich, Jan Jaap H M

2011-01-01

Description of the implementation of local audit meetings and the identified substandard factors, points of special interest, actions for improvement and the opinion of the participating health care providers. Descriptive study. A new organisation and methodology for perinatal mortality audit meetings was introduced in 15 collaborative structures in the northern part of the Netherlands in the period September 2007 to March 2010. During these multidisciplinary audit meetings, cases of perinatal mortality selected by the obstetric collaborative group were discussed in a structured way under the direction of an independent chairman. In total 64 audit meetings were held, in which 677 perinatal health care providers took part at least once, and 112 cases of perinatal death were evaluated. 163 substandard factors were identified. These included : not following the protocol, guideline, standard (31%) or usual care (23%) and insufficient documentation (28%) and communication between health care providers (13%). 442 actions to improve care were reported divided over: 'external collaboration' (15%), 'internal collaboration' (17%), 'practice management' (26%) and 'training and education' (10%). The most valued aspects of the audit meetings were: their multidisciplinary character, the collaborative search for substandard factors, their security, the learning effect and the positive effect on collaboration. Cases of perinatal mortality were discussed in all 15 perinatal collaborative structures in the northern part of the Netherlands. Substandard factors were identified, but further analysis of these factors merits attention. The participants concluded that the multidisciplinary approach and the collaboration during the audit meetings improved the cooperation between perinatal health care providers.

Perinatal dioxin exposure and psychosocial and behavioral development in school-aged children.

PubMed

Kono, Yumi; Oka, Akira; Tada, Hiroshi; Itabashi, Kazuo; Matsui, Eiko; Nakamura, Yosikazu

2015-09-01

The aim of this study was to elucidate the association between psychosocial and behavioral problems in children at school age and dioxin level in breast milk or estimated dioxin exposure (EDE) through breastfeeding in the general Japanese population. Dioxin level of breast milk at 1month of age and breastfeeding ratio through the first year of life were used to calculate the EDE of infants born in 1998-2005 in Japan. The Japanese Social Difficulties Questionnaire (SDQ) for the assessment of children's behavior was sent by mail to mothers whose breast milk underwent the dioxin survey, at the time when their infants were aged 6-13 years. The study subjects were 175 pairs of mothers and their first infants (79 boys, 96 girls). The mean total dioxin levels of breast milk were 18.3 and 19.8 (pgTEQ/g fat) and EDEs were 16.4 and 19.6 (ngTEQ/kg/year) in boys and girls, respectively. In linear multiple regression analyses after adjusting for age at SDQ, maternal age, birth weight and maternal smoking habit, dioxin level in breast milk was not significantly related to the total difficulties score (TDS) of SDQ in boys, B=2.29 (95% CI -7.60-12.18), or in girls, B=-1.04 (95% CI -9.24-7.15). EDE correlated to the TDS in neither boys, B=-0.99 (95% CI -4.14-2.15), nor girls, B=1.08 (95% CI -2.69-4.85). No evidence was found of a correlation between perinatal dioxin exposure and behavioral and psychosocial problems of children measured by SDQ. These results support the benefits of recommending breastfeeding. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Perinatal statistics of a 15-year period in the Central Region of Saudi Arabia.

PubMed

Sobaih, Badr H; Al-Shebly, Mashael M

2013-01-01

Perinatal statistics are one of the most essential outcome indicators used by many developed countries in order to evaluate perinatal services provided to newborns. In this retrospective study, we collected 15 years of perinatal data at King Khalid University Hospital in Riyadh, Saudi Arabia in order to determine stillbirth and other mortality rates in our institute and compare them with international figures. A total of 58,073 babies were evaluated. Data were collected from maternal and neonatal registry books and from perinatal mortality and morbidity meeting reports between 1994 and 2008. Data were entered and analyzed using Microsoft Office Excel 2007. The stillbirth rate was 11.7/1000, early neonatal death rate was 3.4/1000, perinatal mortality rate (PMR) was 14.9/1000, and corrected PMR was 11.9/1000. Our rates were not significantly different from those of North American and European ones. We noticed a dramatic reduction in the corrected PMR in the last 3 years of the study because of greater advancement in perinatal and neonatal care. Our mortality rates were comparable to the North American and European rates which may reflect the quality of perinatal care provided in our institute.

A multilayered approach for the analysis of perinatal mortality using different classification systems.

PubMed

Gordijn, Sanne J; Korteweg, Fleurisca J; Erwich, Jan Jaap H M; Holm, Jozien P; van Diem, Mariet Th; Bergman, Klasien A; Timmer, Albertus

2009-06-01

Many classification systems for perinatal mortality are available, all with their own strengths and weaknesses: none of them has been universally accepted. We present a systematic multilayered approach for the analysis of perinatal mortality based on information related to the moment of death, the conditions associated with death and the underlying cause of death, using a combination of representatives of existing classification systems. We compared the existing classification systems regarding their definition of the perinatal period, level of complexity, inclusion of maternal, foetal and/or placental factors and whether they focus at a clinical or pathological viewpoint. Furthermore, we allocated the classification systems to one of three categories: 'when', 'what' or 'why', dependent on whether the allocation of the individual cases of perinatal mortality is based on the moment of death ('when'), the clinical conditions associated with death ('what'), or the underlying cause of death ('why'). A multilayered approach for the analysis and classification of perinatal mortality is possible by using combinations of existing systems; for example the Wigglesworth or Nordic Baltic ('when'), ReCoDe ('what') and Tulip ('why') classification systems. This approach is useful not only for in depth analysis of perinatal mortality in the developed world but also for analysis of perinatal mortality in the developing countries, where resources to investigate death are often limited.

The BirthPlace collaborative practice model: results from the San Diego Birth Center Study.

PubMed

Swartz; Jackson; Lang; Ecker; Ganiats; Dickinson; Nguyen

1998-07-01

Objective: The search for quality, cost-effective health care programs in the United States is now a major focus in the era of health care reform. New programs need to be evaluated as alternatives are developed in the health care system. The BirthPlace program provides comprehensive perinatal services with certified nurse-midwives and obstetricians working together in an integrated collaborative practice serving a primarily low-income population. Low-risk women are delivered by nurse-midwives in a freestanding birth center (The BirthPlace), which is one component of a larger integrated health network. All others are delivered by team obstetricians at the affiliated tertiary hospital. Wellness, preventive measures, early intervention, and family involvement are emphasized. The San Diego Birth Center Study is a 4-year research project funded by the U.S. Federal Agency for Health Care Policy and Research (#R01-HS07161) to evaluate this program. The National Birth Center Study (NEJM, 1989; 321(26): 1801-11) described the advantages and safety of freestanding birth centers. However, a prospective cohort study with a concurrent comparison group of comparable risk had not been conducted on a collaborative practice-freestanding birth center model to address questions of safety, cost, and patient satisfaction.Methods: The specific aims of this study are to compare this collaborative practice model to the traditional model of perinatal health care (physician providers and hospital delivery). A prospective cohort study comparing these two health care models was conducted with a final expected sample size of approximately 2,000 birth center and 1,350 traditional care subjects. Women were recruited from both the birth center and traditional care programs (private physicians offices and hospital based clinics) at the beginning of prenatal care and followed through the end of the perinatal period. Prenatal, intrapartum, postpartum and infant morbidity and mortality are being

Prenatal and early postnatal depression and child maltreatment among Japanese fathers.

PubMed

Takehara, Kenji; Suto, Maiko; Kakee, Naoko; Tachibana, Yoshiyuki; Mori, Rintaro

2017-08-01

We investigated the association of paternal depression in the prenatal and early postnatal period with child maltreatment tendency at two months postpartum among Japanese fathers. This population-based longitudinal study recruited Japanese perinatal women and their partners living in Nishio City, Aichi, Japan. Of the 270 fathers who participated, 196 were included in the analysis. All data were collected via self-administrated questionnaires at four time points: 20 weeks' gestation and in the first few days, one month, and two months postpartum. Paternal depression was assessed using the Edinburgh Postnatal Depression Scale. Three definitions of paternal depression were coded based on participants' scores on this measure: prenatal, prior, and current. Child maltreatment tendency was evaluated using the Child Maltreatment Scale at two months postpartum. The associations of the three definitions of paternal depression and child maltreatment tendency were separately analyzed using logistic regression analysis. The prevalence of prenatal, prior, and current paternal depression was 9.7%, 10.2%, and 8.8%, respectively. According to the multivariate analysis, current paternal depression was significantly associated with child maltreatment tendency at two months postpartum (adjusted odds ratio: 7.77, 95% CI: 1.83-33.02). The other two types of depression, however, were not related to child maltreatment tendency. Thus, current paternal depression increased the risk of child maltreatment tendency in the postnatal period, suggesting that early detection and treatment of paternal depression might be useful for the prevention of child maltreatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Is Gestational Hypertension Protective against Perinatal Mortality in Twin Pregnancies?

PubMed Central

Luo, Qi-Guang; Zhang, Ji-Yan; Cheng, Wei-Wei; Audibert, Francois; Luo, Zhong-Cheng

2014-01-01

Background Pregnancy-induced or gestational hypertension is a common pregnancy complication. Paradoxically, gestational hypertension has been associated with a protective effect against perinatal mortality in twin pregnancies in analytic models (logistic regression) without accounting for survival time. Whether this effect is real remains uncertain. This study aimed to validate the impact of gestational hypertension on perinatal mortality in twin pregnancies using a survival analysis approach. Methods This was a retrospective cohort study of 278,821 twin pregnancies, using the U.S. 1995–2000 matched multiple birth dataset (the largest dataset available for multiple births). Cox proportional hazard models were applied to estimate the adjusted hazard ratios (aHR) of perinatal death (stillbirth and neonatal death) comparing gestational hypertensive vs. non-hypertensive pregnancies controlling for maternal characteristics and twin cluster-level dependence. Results Comparing births in gestational hypertensive vs. non-hypertensive twin pregnancies, perinatal mortality rates were significantly lower (1.20% vs. 3.38%), so were neonatal mortality (0.72% vs. 2.30%) and stillbirth (0.48% vs. 1.10%) rates. The aHRs (95% confidence intervals) were 0.34 (0.31–0.38) for perinatal death, 0.31 (0.27–0.34) for neonatal death, and 0.45 (0.38–0.53) for stillbirth, respectively. The protective effect of gestational hypertension against perinatal death became weaker over advancing gestational age; the aHRs in very preterm (<32 weeks), mild preterm (32–36 weeks) and term (37+ weeks) births were 0.29, 0.48 and 0.76, respectively. The largest risk reductions in neonatal mortality were observed for infections and immaturity-related conditions. Conclusions Gestational hypertension appears to be beneficial for fetal survival in twin pregnancies, especially in those ending more prematurely or for deaths due to infections and immaturity-related conditions. Prospective studies are

Is gestational hypertension protective against perinatal mortality in twin pregnancies?

PubMed

Luo, Qi-Guang; Zhang, Ji-Yan; Cheng, Wei-Wei; Audibert, Francois; Luo, Zhong-Cheng

2014-01-01

Pregnancy-induced or gestational hypertension is a common pregnancy complication. Paradoxically, gestational hypertension has been associated with a protective effect against perinatal mortality in twin pregnancies in analytic models (logistic regression) without accounting for survival time. Whether this effect is real remains uncertain. This study aimed to validate the impact of gestational hypertension on perinatal mortality in twin pregnancies using a survival analysis approach. This was a retrospective cohort study of 278,821 twin pregnancies, using the U.S. 1995-2000 matched multiple birth dataset (the largest dataset available for multiple births). Cox proportional hazard models were applied to estimate the adjusted hazard ratios (aHR) of perinatal death (stillbirth and neonatal death) comparing gestational hypertensive vs. non-hypertensive pregnancies controlling for maternal characteristics and twin cluster-level dependence. Comparing births in gestational hypertensive vs. non-hypertensive twin pregnancies, perinatal mortality rates were significantly lower (1.20% vs. 3.38%), so were neonatal mortality (0.72% vs. 2.30%) and stillbirth (0.48% vs. 1.10%) rates. The aHRs (95% confidence intervals) were 0.34 (0.31-0.38) for perinatal death, 0.31 (0.27-0.34) for neonatal death, and 0.45 (0.38-0.53) for stillbirth, respectively. The protective effect of gestational hypertension against perinatal death became weaker over advancing gestational age; the aHRs in very preterm (<32 weeks), mild preterm (32-36 weeks) and term (37+ weeks) births were 0.29, 0.48 and 0.76, respectively. The largest risk reductions in neonatal mortality were observed for infections and immaturity-related conditions. Gestational hypertension appears to be beneficial for fetal survival in twin pregnancies, especially in those ending more prematurely or for deaths due to infections and immaturity-related conditions. Prospective studies are required to rule out the possibility of unmeasured

Eating disorders and trauma history in women with perinatal depression.

PubMed

Meltzer-Brody, Samantha; Zerwas, Stephanie; Leserman, Jane; Holle, Ann Von; Regis, Taylor; Bulik, Cynthia

2011-06-01

Although the prevalence of perinatal depression (depression occurring during pregnancy and postpartum) is 10%, little is known about psychiatric comorbidity in these women. We examined the prevalence of comorbid eating disorders (ED) and trauma history in women with perinatal depression. A research questionnaire was administered to 158 consecutive patients seen in a perinatal psychiatry clinic during pregnancy (n=99) or postpartum (n=59). Measures included Structured Clinical Interview for DSM (SCID) IV-based questions for lifetime eating psychopathology and assessments of comorbid psychiatric illness including the State/Trait Anxiety Inventory (STAI), Patient Health Questionnaire (PHQ-9), Edinburgh Postnatal Depression Scale (EPDS), and Trauma Inventory. In this cohort, 37.1% reported a putative lifetime ED history; 10.1% reported anorexia nervosa (AN), 10.1% reported bulimia nervosa (BN), 10.1% reported ED not otherwise specified-purging subtype (EDNOS-P), and 7.0% reported binge eating disorder (BED). Women with BN reported more severe depression (EPDS score, 19.1, standard deviation [SD 4.3], p=0.02; PHQ-severity 14.5, SD 7.4, p=0.02) than the referent group of women with perinatal depression and no ED history (EPDS 13.3, SD=6.1; PHQ 9.0, SD=6.2). Women with AN were more likely to report sexual trauma history than the referent group (62.5% vs. 29.3%, p<0.05), and those with BN were more likely report physical (50.0%, p<0.05) and sexual (66.7%, p<0.05) trauma histories. ED histories were present in over one third of admissions to a perinatal psychiatry clinic. Women with BN reported more severe depression and histories of physical and sexual trauma. Screening for histories of eating psychopathology is important in women with perinatal depression.

Parent and family impact of raising a child with perinatal stroke

PubMed Central

2014-01-01

Background Perinatal stroke is a leading cause of early brain injury, cerebral palsy, and lifelong neurological morbidity. No study to date has examined the impact of raising a child with perinatal stroke on parents and families. However, a large breadth of research suggests that parents, especially mothers, may be at increased risk for psychological concerns. The primary aim of this study was to examine the impact of raising a child with perinatal stroke on mothers’ wellbeing. A secondary aim was to examine how caring for a child with perinatal stroke differentially affects mothers and fathers. Methods In Study I, a matched case-control design was used to compare the wellbeing of mothers of children with perinatal stroke and mothers of children with typical development. In Study II, a matched case-control design was used to compare mother-father dyads. Participants completed validated measures of anxiety and depression, stress, quality of life and family functioning, marital satisfaction, and marital distress. Parents of children with perinatal stroke also completed a recently validated measure of the psychosocial impact of perinatal stroke including guilt and blame outcomes. Disease severity was categorized by parents, validated by the Pediatric Stroke Outcome Measure (PSOM), and compared across the above outcomes in Study I. Results A total of 112 mothers participated in Study I (n = 56 per group; mean child age = 7.42 years), and 56 parents participated in Study II (n = 28 per group; mean child age = 8.25 years). In Study I, parent assessment of disease severity was correlated with PSOM scores (γ = 0.75, p < .001) and associated with parent outcomes. Mothers of children with mild conditions were indistinguishable from controls on the outcome measures. However, mothers of children with moderate/severe conditions had poorer outcomes on measures of depression, marital satisfaction, quality of life, and family functioning. In Study II

Parent and family impact of raising a child with perinatal stroke.

PubMed

Bemister, Taryn B; Brooks, Brian L; Dyck, Richard H; Kirton, Adam

2014-07-14

Perinatal stroke is a leading cause of early brain injury, cerebral palsy, and lifelong neurological morbidity. No study to date has examined the impact of raising a child with perinatal stroke on parents and families. However, a large breadth of research suggests that parents, especially mothers, may be at increased risk for psychological concerns. The primary aim of this study was to examine the impact of raising a child with perinatal stroke on mothers' wellbeing. A secondary aim was to examine how caring for a child with perinatal stroke differentially affects mothers and fathers. In Study I, a matched case-control design was used to compare the wellbeing of mothers of children with perinatal stroke and mothers of children with typical development. In Study II, a matched case-control design was used to compare mother-father dyads. Participants completed validated measures of anxiety and depression, stress, quality of life and family functioning, marital satisfaction, and marital distress. Parents of children with perinatal stroke also completed a recently validated measure of the psychosocial impact of perinatal stroke including guilt and blame outcomes. Disease severity was categorized by parents, validated by the Pediatric Stroke Outcome Measure (PSOM), and compared across the above outcomes in Study I. A total of 112 mothers participated in Study I (n = 56 per group; mean child age = 7.42 years), and 56 parents participated in Study II (n = 28 per group; mean child age = 8.25 years). In Study I, parent assessment of disease severity was correlated with PSOM scores (γ = 0.75, p < .001) and associated with parent outcomes. Mothers of children with mild conditions were indistinguishable from controls on the outcome measures. However, mothers of children with moderate/severe conditions had poorer outcomes on measures of depression, marital satisfaction, quality of life, and family functioning. In Study II, mothers and fathers had similar

[Understanding the symbolic values of Japanese onomatopoeia: comparison of Japanese and Chinese speakers].

PubMed

Haryu, Etsuko; Zhao, Lihua

2007-10-01

Do non-native speakers of the Japanese language understand the symbolic values of Japanese onomatopoeia matching a voiced/unvoiced consonant with a big/small sound made by a big/small object? In three experiments, participants who were native speakers of Japanese, Japanese-learning Chinese, or Chinese without knowledge of the Japanese language were shown two pictures. One picture was of a small object making a small sound, such as a small vase being broken, and the other was of a big object making a big sound, such as a big vase being broken. Participants were presented with two novel onomatopoetic words with voicing contrasts, e.g.,/dachan/vs./tachan/, and were told that each word corresponded to one of the two pictures. They were then asked to match the words to the corresponding pictures. Chinese without knowledge of Japanese performed only at chance level, whereas Japanese and Japanese-learning Chinese successfully matched a voiced/unvoiced consonant with a big/small object respectively. The results suggest that the key to understanding the symbolic values of voicing contrasts in Japanese onomatopoeia is some basic knowledge that is intrinsic to the Japanese language.

Maternal Malaria and Perinatal HIV Transmission, Western Kenya1,2

PubMed Central

Ayisi, John G.; van Eijk, Anna M.; ter Kuile, Feiko O.; Shi, Ya Ping; Yang, Chunfu; Kolczak, Margarette S.; Otieno, Juliana A.; Misore, Ambrose O.; Kager, Piet A.; Lal, Renu B.; Steketee, Richard W.; Nahlen, Bernard L.

2004-01-01

To determine whether maternal placental malaria is associated with an increased risk for perinatal mother-to-child HIV transmission (MTCT), we studied HIV-positive women in western Kenya. We enrolled 512 mother-infant pairs; 128 (25.0%) women had malaria, and 102 (19.9%) infants acquired HIV perinatally. Log10 HIV viral load and episiotomy or perineal tear were associated with increased perinatal HIV transmission, whereas low-density malaria (<10,000 parasites/μL) was associated with reduced risk (adjusted relative risk [ARR] 0.4). Among women dually infected with malaria and HIV, high-density malaria (>10,000 parasites/μL) was associated with increased risk for perinatal MTCT (ARR 2.0), compared to low-density malaria. The interaction between placental malaria and MTCT appears to be variable and complex: placental malaria that is controlled at low density may cause an increase in broad-based immune responses that protect against MTCT; uncontrolled, high-density malaria may simultaneously disrupt placental architecture and generate substantial antigen stimulus to HIV replication and increase risk for MTCT. PMID:15200854

Predicting grief intensity after recent perinatal loss.

PubMed

Hutti, Marianne H; Myers, John; Hall, Lynne A; Polivka, Barbara J; White, Susan; Hill, Janice; Kloenne, Elizabeth; Hayden, Jaclyn; Grisanti, Meredith McGrew

2017-10-01

The Perinatal Grief Intensity Scale (PGIS) was developed for clinical use to identify and predict intense grief and need for follow-up after perinatal loss. This study evaluates the validity of the PGIS via its ability to predict future intense grief based on a PGIS score obtained early after a loss. A prospective observational study was conducted with 103 international, English-speaking women recruited at hospital discharge or via the internet who experienced a miscarriage, stillbirth, or neonatal death within the previous 8weeks. Survey data were collected at baseline using the PGIS and the Perinatal Grief Scale (PGS). Follow-up data on the PGS were obtained 3months later. Data analysis included descriptive statistics, Cronbach's alpha, receiver operating characteristic curve analysis, and confirmatory factor analysis. Cronbach's alphas were ≥0.70 for both instruments. PGIS factor analysis yielded three factors as predicted, explaining 57.7% of the variance. The optimal cutoff identified for the PGIS was 3.535. No difference was found when the ability of the PGIS to identify intense grief was compared to the PGS (p=0.754). The PGIS was not inferior to the PGS (AUC=0.78, 95% CI 0.68-0.88, p<0.001) in predicting intense grief at the follow-up. A PGIS score≥3.53 at baseline was associated with increased grief intensity at Time 2 (PGS: OR=1.97, 95% CI 1.59-2.34, p<0.001). The PGIS is comparable to the PGS, has a lower response burden, and can reliably and validly predict women who may experience future intense grief associated with perinatal loss. Copyright © 2017 Elsevier Inc. All rights reserved.

Nursing diagnosis of grieving: content validity in perinatal loss situations.

PubMed

Paloma-Castro, Olga; Romero-Sánchez, José Manuel; Paramio-Cuevas, Juan Carlos; Pastor-Montero, Sonia María; Castro-Yuste, Cristina; Frandsen, Anna J; Albar-Marín, María Jesús; Bas-Sarmiento, Pilar; Moreno-Corral, Luis Javier

2014-06-01

To validate the content of the NANDA-I nursing diagnosis of grieving in situations of perinatal loss. Using the Fehring's model, 208 Spanish experts were asked to assess the adequacy of the defining characteristics and other manifestations identified in the literature for cases of perinatal loss. The content validity index was 0.867. Twelve of the 18 defining characteristics were validated, seven as major and five as minor. From the manifestations proposed, "empty inside" was considered as major. The nursing diagnosis of grieving fits in content to the cases of perinatal loss according to experts. The results have provided evidence to support the use of the diagnosis in care plans for said clinical situation. © 2013 NANDA International.

Perinatal programming prevention measures.

PubMed

Larguía, A Miguel; González, María Aurelia; Dinerstein, Néstor Alejandro; Soto Conti, Constanza

2015-01-01

Over the past 10 years, there has been outstanding scientific progress related to perinatal programming and its epigenetic effects in health, and we can anticipate this trend will continue in the near future. We need to make use and apply these achievements to human neurodevelopment via prevention interventions. Based on the concept of the interaction between genome and ambiome, this chapter proposes low-cost easy-implementation preventive strategies for maternal and infant health institutions.Breastfeeding and human milk administration are the first preventive measures, as has been reviewed in the policy statement of the American Academy of Pediatrics. Another strategy is the Safe and Family-Centered Maternity Hospitals initiative that promotes and empowers the inclusion of the families and the respect for their rights, especially during pregnancy and birth. (This change of paradigm was approved and is recommended by both United Nations Children's Fund, UNICEF, and Pan American Health Organization, PAHO.) Then, there is also an important emphasis given to the sacred hour-which highlights the impact of bonding, attachment, and breastfeeding during the first hour of life-the pain prevention and treatment in newborns, the control of the "new morbidity" represented by late preterm infants, and finally, the importance of avoiding intrauterine and extrauterine growth restriction. (However, there are not yet clear recommendations about nutritional interventions in order to diminish the potential metabolic syndrome consequence in the adult.).

Perinatal DDT Exposure Induces Hypertension and Cardiac Hypertrophy in Adult Mice.

PubMed

La Merrill, Michele A; Sethi, Sunjay; Benard, Ludovic; Moshier, Erin; Haraldsson, Borje; Buettner, Christoph

2016-11-01

Dichlorodiphenyltrichloroethane (DDT) was used extensively to control malaria, typhus, body lice, and bubonic plague worldwide, until countries began restricting its use in the 1970s. However, the use of DDT to control vector-borne diseases continues in developing countries. Prenatal DDT exposure is associated with elevated blood pressure in humans. We hypothesized that perinatal DDT exposure causes hypertension in adult mice. DDT was administered to C57BL/6J dams from gestational day 11.5 to postnatal day 5. Blood pressure (BP) and myocardial wall thickness were measured in male and female adult offspring. Adult mice were treated with an angiotensin converting enzyme (ACE) inhibitor, captopril, to evaluate sensitivity to amelioration of DDT-associated hypertension by ACE inhibition. We further assessed the influence of DDT exposure on the expression of mRNAs that regulate BP through renal ion transport. Adult mice perinatally exposed to DDT exhibited chronically increased systolic BP, increased myocardial wall thickness, and elevated expression of mRNAs of several renal ion transporters. Captopril completely reversed hypertension in mice perinatally exposed to DDT. These data demonstrate that perinatal exposure to DDT causes hypertension and cardiac hypertrophy in adult offspring. A key mechanism underpinning this hypertension is an overactivated renin angiotensin system because ACE inhibition reverses the hypertension induced by perinatal DDT exposure. Citation: La Merrill M, Sethi S, Benard L, Moshier E, Haraldsson B, Buettner C. 2016. Perinatal DDT exposure induces hypertension and cardiac hypertrophy in adult mice. Environ Health Perspect 124:1722-1727; http://dx.doi.org/10.1289/EHP164.

The Japanese Mind: Understanding Contemporary Japanese Culture.

ERIC Educational Resources Information Center

Davies, Roger J., Ed.; Ikeno, Osamu, Ed.

This collection of essays offers an overview of contemporary Japanese culture, and can serve as a resource for classes studying Japan. The 28 essays offer an informative, accessible look at the values, attitudes, behavior patterns, and communication styles of modern Japan from the unique perspective of the Japanese people. Filled with examples…

The evolution of the Japanese medical education system: a historical perspective.

PubMed

Kuwabara, Norimitsu; Yamashita, Miu; Yee, Keolamau; Kurahara, David

2015-03-01

The Japanese Medical Education system has been influenced by political events throughout the country's history. From long periods of isolation from the western world to the effect of world wars, Japan's training system for physicians has had to adapt in many ways and will continue to change. The Japanese medical education system was recently compared to the "Galapagos Islands" for its unusual and singular evolution, in a speech by visiting professor Dr. Gordon L. Noel at the University of Tokyo International Research center.1 Japanese medical schools are currently working to increase their students' clinical hours or else these students may not be able to train in the United States for residencies. Knowing the history of the Japanese Medical education system is paramount to understanding the current system in place today. Studying the historical foundation of this system will also provide insight on how the system must change in order to produce better clinicians. This article provides a glimpse into the medical system of another nation that may encourage needed reflection on the state of current healthcare training in the United States.

Perinatal biomarkers in prematurity: Early identification of neurologic injury

PubMed Central

Andrikopoulou, Maria; Almalki, Ahmad; Farzin, Azadeh; Cordeiro, Christina N.; Johnston, Michael V.; Burd, Irina

2014-01-01

Over the past few decades, biomarkers have become increasingly utilized as non-invasive tools in the early diagnosis and management of various clinical conditions. In perinatal medicine, the improved survival of extremely premature infants who are at high risk for adverse neurologic outcomes has increased the demand for the discovery of biomarkers in detecting and predicting the prognosis of infants with neonatal brain injury. By enabling the clinician to recognize potential brain damage early, biomarkers could allow clinicians to intervene at the early stages of disease, and to monitor the efficacy of those interventions. This review will first examine the potential perinatal biomarkers for neurologic complications of prematurity, specifically, intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL) and posthemorrhagic hydrocephalus (PHH). It will also evaluate knowledge gained from animal models regarding the pathogenesis of perinatal brain injury in prematurity. PMID:24768951

Social and cultural factors associated with perinatal grief in Chhattisgarh, India.

PubMed

Roberts, Lisa R; Montgomery, Susanne; Lee, Jerry W; Anderson, Barbara A

2012-06-01

Stillbirth is a globally significant public health problem with many medical causes. There are also indirect causal pathways including social and cultural factors which are particularly salient in India's traditional society. The purpose of this study was to explore women's perceptions of stillbirth and to determine how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India. Structured interviews were done face-to-face in 21 randomly selected villages among women of reproductive age (N=355) who had experienced stillbirth (n=178) and compared to those who had not (n=177), in the Christian Hospital, Mungeli catchment area. Perinatal grief was significantly higher among women with a history of stillbirth. Greater perinatal grief was associated with lack of support, maternal agreement with social norms, and younger maternal age. These predictors must be understood in light of an additional finding-distorted sex ratios, which reflect gender discrimination in the context of Indian society. The findings of this study will allow the development of a culturally appropriate health education program which should be designed to increase social support and address social norms, thereby reducing psychological distress to prevent complicated perinatal grief. Perinatal grief is a significant social burden which impacts the health women.

Characteristics of a global classification system for perinatal deaths: a Delphi consensus study.

PubMed

Wojcieszek, Aleena M; Reinebrant, Hanna E; Leisher, Susannah Hopkins; Allanson, Emma; Coory, Michael; Erwich, Jan Jaap; Frøen, J Frederik; Gardosi, Jason; Gordijn, Sanne; Gulmezoglu, Metin; Heazell, Alexander E P; Korteweg, Fleurisca J; McClure, Elizabeth; Pattinson, Robert; Silver, Robert M; Smith, Gordon; Teoh, Zheyi; Tunçalp, Özge; Flenady, Vicki

2016-08-15

Despite the global burden of perinatal deaths, there is currently no single, globally-acceptable classification system for perinatal deaths. Instead, multiple, disparate systems are in use world-wide. This inconsistency hinders accurate estimates of causes of death and impedes effective prevention strategies. The World Health Organisation (WHO) is developing a globally-acceptable classification approach for perinatal deaths. To inform this work, we sought to establish a consensus on the important characteristics of such a system. A group of international experts in the classification of perinatal deaths were identified and invited to join an expert panel to develop a list of important characteristics of a quality global classification system for perinatal death. A Delphi consensus methodology was used to reach agreement. Three rounds of consultation were undertaken using a purpose built on-line survey. Round one sought suggested characteristics for subsequent scoring and selection in rounds two and three. The panel of experts agreed on a total of 17 important characteristics for a globally-acceptable perinatal death classification system. Of these, 10 relate to the structural design of the system and 7 relate to the functional aspects and use of the system. This study serves as formative work towards the development of a globally-acceptable approach for the classification of the causes of perinatal deaths. The list of functional and structural characteristics identified should be taken into consideration when designing and developing such a system.

Episode-Based Payment for Perinatal Care in Medicaid: Implications for Practice and Policy.

PubMed

Jarlenski, Marian; Borrero, Sonya; La Charité, Trey; Zite, Nikki B

2016-06-01

Medicaid is an important source of health insurance coverage for low-income pregnant women and covers nearly half of all deliveries in the United States. In the face of budgetary pressures, several state Medicaid programs have implemented or are considering implementing episode-based payments for perinatal care. Under the episode-based payment model, Medicaid programs make a single payment for all pregnancy-related medical services provided to women with low- and medium-risk pregnancies from 40 weeks before delivery through 60 days postpartum. The health care provider who delivers a live birth is assigned responsibility for all care and must meet certain quality metrics and stay within delineated cost-per-episode parameters. Implementation of cost- and quality-dependent episode-based payments for perinatal care is notable because there is no published evidence about the effects of such initiatives on pregnancy or birth outcomes. In this article, we highlight challenges and potential adverse consequences related to defining the perinatal episode and assigning a responsible health care provider. We also describe concerns that perinatal care quality metrics may not address the most pressing health care issues that are likely to improve health outcomes and reduce costs. In their current incarnations, Medicaid programs' episode-based payments for perinatal care may not improve perinatal care delivery and subsequent health outcomes. Rigorous evaluation of the new episode-based payment initiatives is critically needed to inform policymakers about the intended and unintended consequences of implementing episode-based payments for perinatal care.

A quantitative analysis of optimal treatment capacity for perinatal asphyxia.

PubMed

Geva, Alon; Gray, James

2012-01-01

In centers electing to offer therapeutic hypothermia for treating hypoxic-ischemic encephalopathy (HIE), determining the optimal number of cooling devices is not straightforward. The authors used computer-based modeling to determine the level of service as a function of local HIE caseload and number of cooling devices available. The authors used discrete event simulation to create a model that varied the number of HIE cases and number of cooling devices available. Outcomes of interest were percentage of HIE-affected infants not cooled, number of infants not cooled, and percentage of time that all cooling devices were in use. With 1 cooling device, even the smallest perinatal center did not achieve a cooling rate of 99% of eligible infants. In contrast, 2 devices ensured 99% service in centers treating as many as 20 infants annually. In centers averaging no more than 1 HIE infant monthly, the addition of a third cooling device did not result in a substantial reduction in the number of infants who would not be cooled. Centers electing to offer therapeutic hypothermia with only a single cooling device are at significant risk of being unable to provide treatment to eligible infants, whereas 2 devices appear to suffice for most institutions treating as many as 20 annual HIE cases. Three devices would rarely be needed given current caseloads seen at individual institutions. The quantitative nature of this analysis allows decision makers to determine the number of devices necessary to ensure adequate availability of therapeutic hypothermia given the HIE caseload of a particular institution.

A Pilot Study of Heart Rate Variability Biofeedback Therapy in the Treatment of Perinatal Depression on a Specialized Perinatal Psychiatry Inpatient Unit

PubMed Central

Beckham, Jenna; Greene, Tammy B.; Meltzer-Brody, Samantha

2012-01-01

Purpose Heart rate variability biofeedback (HRVB) therapy may be useful in treating the prominent anxiety features of perinatal depression. We investigated the use of this non-pharmacologic therapy among women hospitalized with severe perinatal depression. Methods Three questionnaires, the State Trait Anxiety Inventory (STAI), Warwick Edinburgh Mental Well-Being Scale (WEMWBS), and Linear Analog Self Assessment (LASA), were administered to fifteen women in a specialized inpatient perinatal psychiatry unit. Participants were also contacted by telephone after discharge to assess continued use of HRVB techniques. Results The use of HRVB was associated with an improvement in all three scales. The greatest improvement (−13.867, p<0.001 and −11.533, p<0.001) was among STAI scores. A majority (81.9%, n=9) of women surveyed by telephone also reported continued frequent use at least once per week, and over half (54.6%, n=6) described the use of HRVB techniques as very or extremely beneficial. Conclusions The use of HRVB was associated with statistically significant improvement on all instrument scores, the greatest of which was STAI scores, and most women reported frequent continued use of HRVB techniques after discharge. These results suggest that HRVB may be particularly beneficial in the treatment of the prominent anxiety features of perinatal depression, both in inpatient and outpatient settings. PMID:23179141

Generation and validation of a universal perinatal database and biospecimen repository: PeriBank.

PubMed

Antony, K M; Hemarajata, P; Chen, J; Morris, J; Cook, C; Masalas, D; Gedminas, M; Brown, A; Versalovic, J; Aagaard, K

2016-11-01

There is a dearth of biospecimen repositories available to perinatal researchers. In order to address this need, here we describe the methodology used to establish such a resource. With the collaboration of MedSci.net, we generated an online perinatal database with 847 fields of clinical information. Simultaneously, we established a biospecimen repository of the same clinical participants. The demographic and clinical outcomes data are described for the first 10 000 participants enrolled. The demographic characteristics are consistent with the demographics of the delivery hospitals. Quality analysis of the biospecimens reveals variation in very few analytes. Furthermore, since the creation of PeriBank, we have demonstrated validity of the database and tissue integrity of the biospecimen repository. Here we establish that the creation of a universal perinatal database and biospecimen collection is not only possible, but allows for the performance of state-of-the-science translational perinatal research and is a potentially valuable resource to academic perinatal researchers.

Term perinatal mortality audit in the Netherlands 2010–2012: a population-based cohort study

PubMed Central

Eskes, Martine; Waelput, Adja J M; Erwich, Jan Jaap H M; Brouwers, Hens A A; Ravelli, Anita C J; Achterberg, Peter W; Merkus, Hans (J) M W M; Bruinse, Hein W

2014-01-01

Objective To assess the implementation and first results of a term perinatal internal audit by a standardised method. Design Population-based cohort study. Setting All 90 Dutch hospitals with obstetric/paediatric departments linked to community practices of midwives, general practitioners in their attachment areas, organised in perinatal cooperation groups (PCG). Population The population consisted of 943 registered term perinatal deaths occurring in 2010–2012 with detailed information, including 707 cases with completed audit results. Main outcome measures Participation in the audit, perinatal death classification, identification of substandard factors (SSF), SSF in relation to death, conclusive recommendations for quality improvement in perinatal care and antepartum risk selection at the start of labour. Results After the introduction of the perinatal audit in 2010, all PCGs participated. They organised 645 audit sessions, with an average of 31 healthcare professionals per session. Of all 1102 term perinatal deaths (2.3/1000) data were registered for 86% (943) and standardised anonymised audit results for 64% (707). In 53% of the cases at least one SSF was identified. Non-compliance to guidelines (35%) and deviation from usual professional care (41%) were the most frequent SSF. There was a (very) probable relation between the SSF and perinatal death for 8% of all cases. This declined over the years: from 10% (n=23) in 2010 to 5% (n=10) in 2012 (p=0.060). Simultaneously term perinatal mortality decreased from 2.3 to 2.0/1000 births (p<0.00001). Possibilities for improvement were identified in the organisation of care (35%), guidelines or usual care (19%) and in documentation (15%). More pregnancies were antepartum selected as high risk, 70% in 2010 and 84% in 2012 (p=0.0001). Conclusions The perinatal audit is implemented nationwide in all obstetrical units in the Netherlands in a short time period. It is possible that the audit contributed to the decrease in

What Is Business Japanese? Designing a Japanese Course for Business Communication.

ERIC Educational Resources Information Center

Koike, Shohei

Experiences in developing "Business Japanese" courses for the undergraduate major in Language and International Trade at Eastern Michigan University are described. In 1987, six new courses in Japanese were proposed so that Japanese could be offered as a language specialty in the program. Issues considered in defining business Japanese…

A Confirmatory Model for Substance Use Among Japanese American and Part-Japanese American Adolescents

PubMed Central

Williams, John Kino Yamaguchi; Else, 'Iwalani R. N.; Goebert, Deborah A.; Nishimura, Stephanie T.; Hishinuma, Earl S.; Andrade, Naleen N.

2013-01-01

Few studies have examined the effect of ethnicity and cultural identity on substance use among Asian and Pacific Islander adolescents. A cross-sequential study conducted in Hawai'i with 144 Japanese American and part-Japanese American adolescents assessed a model integrating Japanese ethnicity, cultural identity, substance use, major life events, and social support. Japanese American adolescents scored higher on the Japanese Culture Scale and on the Peers’ Social Support than the part-Japanese American adolescents. Significant associations for substance use and impairment included culturally intensified events and Japanese cultural identity- behavior subset. Models had good overall fits and suggested that conflict surrounding cultural identity may contribute to substance use. PMID:23480213

Node 2 and Japanese Experimental Module (JEM) In Space Station Processing Facility

NASA Technical Reports Server (NTRS)

2003-01-01

Lining the walls of the Space Station Processing Facility at the Kennedy Space Center (KSC) are the launch awaiting U.S. Node 2 (lower left). and the first pressurized module of the Japanese Experimental Module (JEM) (upper right), named 'Kibo' (Hope). Node 2, the 'utility hub' and second of three connectors between International Space Station (ISS) modules, was built in the Torino, Italy facility of Alenia Spazio, an International contractor based in Rome. Japan's major contribution to the station, the JEM, was built by the Space Development Agency of Japan (NASDA) at the Tsukuba Space Center near Tokyo and will expand research capabilities aboard the station. Both were part of an agreement between NASA and the European Space Agency (ESA). The Node 2 will be the next pressurized module installed on the Station. Once the Japanese and European laboratories are attached to it, the resulting roomier Station will expand from the equivalent space of a 3-bedroom house to a 5-bedroom house. The Marshall Space Center in Huntsville, Alabama manages the Node program for NASA.

Michigan Health & Hospital Association Keystone Obstetrics: a statewide collaborative for perinatal patient safety in Michigan.

PubMed

Simpson, Kathleen Rice; Knox, G Eric; Martin, Morgan; George, Chris; Watson, Sam R

2011-12-01

Preventable harm to mothers and infants during labor and birth is a significant patient safety and professional liability issue. A Michigan Health & Hospital Association Keystone Center for Patient Safety & Quality Obstetric Collaborative Project involved perinatal teams from 15 Michigan hospitals during an 11-month period in 2009. The purpose of the project was to promote safe care practices during labor and birth using the Comprehensive Unit-based Safety Program (CUSP). Consistent with the CUSP model, this project's components included assessing and promoting a culture of safety; interdisciplinary team building; case review; learning from defects through multiple methods of education; team and individual coaching and peer encouragement; administrative support for the establishment of a fundamental safety infrastructure; and ongoing evaluation of care processes and outcomes. Study measures included 32 components of a perinatal patient infrastructure, 6 care processes during labor and birth, and 4 neonatal outcomes. Significant improvements were found in the safety culture (Safety Attitudes Questionnaire), the perinatal patient safety infrastructure components, and all care processes. Although the project was successful, getting buy-in from all members of the clinical team in each hospital for all of the measures was challenging at times. There was initial resistance to some of the measures and their various expected aspects of care. For example, some of the clinicians were initially reluctant to adopt the recommended standardized oxytocin protocol. Peer encouragement and unit-based feedback on progress in minimizing early elective births proved useful in many hospitals. A CUSP in obstetrics can be beneficial in improving the care of mothers and infants during labor and birth.

Preconceptional and perinatal exposure to traffic-related air pollution and eczema in preschool children.

PubMed

Lu, Chan; Deng, Linjing; Ou, Cuiyun; Yuan, Hong; Chen, Xiang; Deng, Qihong

2017-02-01

indoor environmental factors. Our findings support the hypothesis that early childhood eczema is associated with exposure to traffic-related air pollutant during both preconceptional and perinatal period, especially at a high level of exposure. Copyright © 2016 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.

Perinatal DDT Exposure Induces Hypertension and Cardiac Hypertrophy in Adult Mice

PubMed Central

La Merrill, Michele A.; Sethi, Sunjay; Benard, Ludovic; Moshier, Erin; Haraldsson, Borje; Buettner, Christoph

2016-01-01

Background: Dichlorodiphenyltrichloroethane (DDT) was used extensively to control malaria, typhus, body lice, and bubonic plague worldwide, until countries began restricting its use in the 1970s. However, the use of DDT to control vector-borne diseases continues in developing countries. Prenatal DDT exposure is associated with elevated blood pressure in humans. Objective: We hypothesized that perinatal DDT exposure causes hypertension in adult mice. Methods: DDT was administered to C57BL/6J dams from gestational day 11.5 to postnatal day 5. Blood pressure (BP) and myocardial wall thickness were measured in male and female adult offspring. Adult mice were treated with an angiotensin converting enzyme (ACE) inhibitor, captopril, to evaluate sensitivity to amelioration of DDT-associated hypertension by ACE inhibition. We further assessed the influence of DDT exposure on the expression of mRNAs that regulate BP through renal ion transport. Results: Adult mice perinatally exposed to DDT exhibited chronically increased systolic BP, increased myocardial wall thickness, and elevated expression of mRNAs of several renal ion transporters. Captopril completely reversed hypertension in mice perinatally exposed to DDT. Conclusions: These data demonstrate that perinatal exposure to DDT causes hypertension and cardiac hypertrophy in adult offspring. A key mechanism underpinning this hypertension is an overactivated renin angiotensin system because ACE inhibition reverses the hypertension induced by perinatal DDT exposure. Citation: La Merrill M, Sethi S, Benard L, Moshier E, Haraldsson B, Buettner C. 2016. Perinatal DDT exposure induces hypertension and cardiac hypertrophy in adult mice. Environ Health Perspect 124:1722–1727; http://dx.doi.org/10.1289/EHP164 PMID:27325568

Effects of tobacco exposure on perinatal suicidal ideation, depression, and anxiety.

PubMed

Weng, Shu-Chuan; Huang, Jian-Pei; Huang, Ya-Li; Lee, Tony Szu-Hsien; Chen, Yi-Hua

2016-07-22

Previous studies have stressed the importance of tobacco exposure for the mood disorders of depression and anxiety. Although a few studies have focused on perinatal women, none have specifically considered the effects of smoking and secondhand smoke exposure on perinatal suicidal ideation. Thus, this study aimed to investigate the relationships of smoking/secondhand smoke exposure status with suicidal ideation, depression, and anxiety from the first trimester to the first month post partum. This cross-sectional study based on self-reported data was conducted at five hospitals in Taipei, Taiwan from July 2011 to June 2014. The questionnaire inquired about women's pregnancy history, sociodemographic information, and pre-pregnancy smoking and secondhand smoke exposure status, and assessed their suicidal ideation, depression, and anxiety symptoms. Logistic regression models were used for analysis. In the 3867 women in the study, secondhand smoke exposure was positively associated with perinatal depression and suicidal ideation. Compared with women without perinatal secondhand smoke exposure, women exposed to secondhand smoke independently exhibited higher risks for suicidal ideation during the second trimester (odds ratio (OR) = 7.63; 95 % confidence interval (CI) = 3.25-17.93) and third trimester (OR = 4.03; 95 % CI = 1.76-9.23). Women exposed to secondhand smoke had an increased risk of depression, especially those aged 26-35 years (OR = 1.71; 95 % CI = 1.27-2.29). Secondhand smoke exposure also considerably contributes to adverse mental health for women in perinatal periods, especially for the severe outcome of suicidal ideation. Our results strongly support the importance of propagating smoke-free environments to protect the health of perinatal women.

The Social Nature of Perceived Illness Representations of Perinatal Depression in Rural Uganda.

PubMed

Sarkar, Nandini D P; Bardaji, Azucena; Peeters Grietens, Koen; Bunders-Aelen, Joske; Baingana, Florence; Criel, Bart

2018-06-07

While the global health community advocates for greater integration of mental health into maternal health agendas, a more robust understanding of perinatal mental health, and its role in providing integrated maternal health care and service delivery, is required. The present study uses the Illness Representation Model, a theoretical cognitive framework for understanding illness conceptualisations, to qualitatively explore multiple stakeholder perspectives on perinatal depression in rural Uganda. A total of 70 in-depth interviews and 9 focus group discussions were conducted with various local health system stakeholders, followed by an emergent thematic analysis using NVivo 11. Local communities perceived perinatal depression as being both the fault of women, and not. It was perceived as having socio-economic and cultural causal factors, in particular, as being partner-related. In these communities, perinatal depression was thought to be a common occurrence, and its negative consequences for women, infants and the community at large were recognised. Coping and help-seeking behaviours prescribed by the participants were also primarily socio-cultural in nature. Placing the dynamics and mechanisms of these local conceptualisations of perinatal depression alongside existing gaps in social and health care systems highlights both the need of, and the opportunities for, growth and prioritisation of integrated perinatal biomedical, mental, and social health programs in resource-constrained settings.

Perinatal hypothyroidism modulates antioxidant defence status in the developing rat liver and heart.

PubMed

Zhang, Hongmei; Dong, Yan; Su, Qing

2017-02-01

In the present study, we investigated oxidative stress parameters and antioxidant defence status in perinatal hypothyroid rat liver and heart. We found that the proteincarbonyl content did not differ significantly between the three groups both in the pup liver and in the heart. The OH˙ level was significantly decreased in the hypothyroid heart but not in the liver compared with controls. A slight but not significant decrease in SOD activity was observed in both perinatal hypothyroid liver and heart. A significantly increased activity of CAT was observed in the liver but not in the heart of hypothyroid pups. The GPx activity was considerably increased compared with controls in the perinatal hypothyroid heart and was unaltered in the liver of hypothyroid pups. We also found that vitamin E levels in the liver decreased significantly in hypothyroidism and were unaltered in the heart of perinatal hypothyroid rats. The GSH content was elevated significantly in both hypothyroid liver and heart. The total antioxidant capacity was higher in the liver of the hypothyroid group but not in the hypothyroid heart. Thyroxine replacement could not repair the above changes to normal. In conclusion, perinatal hypothyroidism modulates the oxidative stress status of the perinatal liver and heart.

Demographic survey of the level and determinants of perinatal mortality in Karachi, Pakistan.

PubMed

Fikree, F F; Gray, R H

1996-01-01

A demographic survey was used to estimate the level and determinants of perinatal mortality in eight lower socio-economic squatter settlements of Karachi, Pakistan. The perinatal mortality rate was 54.1 per 1000 births, with a stillbirth to early neonatal mortality ratio of 1:1. About 65% of neonatal deaths occurred in the early neonatal period, and early neonatal mortality contributed 32% of all infant deaths. Risk factor assessment was conducted on 375 perinatal deaths and 6070 current survivors. Poorer socio-economic status variables such as maternal and paternal illiteracy, maternal work outside the home and fewer household assets were significantly associated with perinatal mortality as were biological factors of higher parental age, short birth intervals and poor obstetric history. Multivariable logistic analysis indicated that some socio-economic factors retained their significance after adjusting for the more proximate biological factors. Population attributable risk estimates suggest that public health measures for screening of high-risk women and use of family planning to space births will not improve perinatal mortality substantially without improvement of socio-economic conditions, particularly maternal education. The results of this study indicate that an evaluation of perinatal mortality can be conducted using pregnancy histories derived from demographic surveys.

Healthcare justice and human rights in perinatal medicine.

PubMed

Chervenak, Frank A; McCullough, Laurence B

2016-06-01

This article describes an approach to ethics of perinatal medicine in which "women and children first" plays a central role, based on the concept of healthcare justice. Healthcare justice requires that all patients receive clinical management based on their clinical needs, which are defined by deliberative (evidence-based, rigorous, transparent, and accountable) clinical judgment. All patients in perinatal medicine includes pregnant, fetal, and neonatal patients. Healthcare justice also protects the informed consent process, which is intended to empower the exercise of patient autonomy in the decision-making process about patient care. In the context of healthcare justice, the informed consent process should not be influenced by ethically irrelevant factors. Healthcare justice should be understood as a basis for the human rights to healthcare and to participate in decisions about one's healthcare. Healthcare justice in perinatal medicine creates an essential role for the perinatologist to be an effective advocate for pregnant, fetal, and neonatal patients, i.e., for "women and children first." Copyright © 2016 Elsevier Inc. All rights reserved.

Taurine and taurine-deficiency in the perinatal period.

PubMed

Aerts, Leona; Van Assche, Frans André

2002-01-01

Taurine, a non-protein sulfur amino-acid, is the most abundant free amino-acid in the body and plays an important role in several essential biological processes. Apart from its role in cholesterol degradation, it acts as neurotransmitter, and has a function as osmoregulator and antioxidant in most body tissues. During pregnancy, taurine accumulates in the maternal tissues, to be released in the perinatal period to the fetus via the placenta and to the newborn via the maternal milk. It is accumulated especially in the fetal and neonatal brain. Low maternal taurine levels result in low fetal taurine levels. Taurine-deficiency in the mother leads to growth retardation of the offspring, and to impaired perinatal development of the central nervous system and of the endocrine pancreas. The adult offspring of taurine-deficient mothers display signs of impaired neurological function, impaired glucose tolerance and vascular dysfunction; they may develop gestational diabetes and transmit the effects to the next generation. This transgeneration effect of taurine-deficiency in the perinatal period fits into the concept of fetal origin of adult disease.

Infertility and Perinatal Loss: When the Bough Breaks

PubMed Central

Byatt, Nancy

2016-01-01

Infertility and perinatal loss are common, and associated with lower quality of life, marital discord, complicated grief, major depressive disorder, anxiety disorders, and posttraumatic stress disorder. Young women, who lack social supports, have experienced recurrent pregnancy loss or a history of trauma and / or preexisting psychiatric illness are at a higher risk of experiencing psychiatric illnesses or symptoms after a perinatal loss or during infertility. It is especially important to detect, assess, and treat depression, anxiety, or other psychiatric symptoms because infertility or perinatal loss may be caused or perpetuated by such symptoms. Screening, psychoeducation, provision of resources and referrals, and an opportunity to discuss their loss and plan for future pregnancies can facilitate addressing mental health concerns that arise. Women at risk of or who are currently experiencing psychiatric symptoms should receive a comprehensive treatment plan that includes the following: (1) proactive clinical monitoring, (2) evidence-based approaches to psychotherapy, and (3) discussion of risks, benefits, and alternatives of medication treatment during preconception and pregnancy. PMID:26847216

Mozambican midwives' views on barriers to quality perinatal care.

PubMed

Pettersson, Karen Odberg; Johansson, Eva; Pelembe, Maria de Fatima M; Dgedge, Clemencia; Christensson, Kyllike

2006-02-01

Our purpose in this study was to explore the midwives' perception of factors obstructing or facilitating their ability to provide quality perinatal care at a central labor ward in Maputo. In-depth interviews were undertaken with 16 midwives and were analyzed according to grounded theory technique. Barriers to provision of quality perinatal care were identified as follows: (i) the unsupportive environment, (ii) nonempowering and limited interaction with women in labor, (iii) a sense of professional inadequacy and inferiority, and (iv) nonappliance of best caring practices. A model based on the midwives' reflections on barriers to quality perinatal care and responses to these were developed. Actions aimed at overcoming the barriers were improvising and identifying areas in need of change. Identified evading actions were holding others accountable and yielding to dysfunction and structural control. In order to improve perinatal care, the midwives need to see themselves as change agents and not as victims of external and internal causal relationships over which they have no influence. It is moreover essential that the midwives chose actions aiming at overcoming barriers to quality perinatal care instead of choosing evading actions, which might jeopardize the health of the unborn and newborn infant. We suggest that local as well as national education programs need to correspond with existing reality, even if they provide knowledge that surpasses the present possibilities in practice. Quality of intrapartum and the immediate newborn care requires a supportive environment, however, which in the context of this study presented such serious obstacles that they need to be addressed on the national level. Structural and administrative changes are difficult to target as these depend on national organization of maternal health care (MHC) services and national health expenditures.

A prototype system for perinatal knowledge engineering using an artificial intelligence tool.

PubMed

Sokol, R J; Chik, L

1988-01-01

Though several perinatal expert systems are extant, the use of artificial intelligence has, as yet, had minimal impact in medical computing. In this evaluation of the potential of AI techniques in the development of a computer based "Perinatal Consultant," a "top down" approach to the development of a perinatal knowledge base was taken, using as a source for such a knowledge base a 30-page manuscript of a chapter concerning high risk pregnancy. The UNIX utility "style" was used to parse sentences and obtain key words and phrases, both as part of a natural language interface and to identify key perinatal concepts. Compared with the "gold standard" of sentences containing key facts as chosen by the experts, a semiautomated method using a nonmedical speller to identify key words and phrases in context functioned with a sensitivity of 79%, i.e., approximately 8 in 10 key sentences were detected as the basis for PROLOG, rules and facts for the knowledge base. These encouraging results suggest that functional perinatal expert systems may well be expedited by using programming utilities in conjunction with AI tools and published literature.

Perinatal transmission of HIV-2 infection in malnourished children in Guinea Bissau.

PubMed

Ferro, A; Gomez, P; Andrian, C; Perra, A; Frongia, O; Sechi, M A; Sabbatani, S; Lillo, F; Varnier, O E

1994-01-01

Since there have been a few reports of pediatric HIV-2 infection. We therefore investigated the perinatal transmission of HIV-2 in 147 malnourished and 164 well-nourished children attending a health center in the northern part of Guinea Bissau. Specific HIV-2 antibodies were detected in 17 mothers and in 2 malnourished children, one of them with pediatric AIDS. This study demonstrates that mother to child transmission of HIV-2 infection occurs in Guinea Bissau and suggests that there is an increased likelihood of detecting HIV-2 infection in malnourished children. The high seroprevalence of HIV-2 in a rural population without known risk factors may represent a hidden threat to mother/child health.

PREGNANCY AND PERINATAL HEALTH, INNER MONGOLIA, CHINA, DECEMBER 1996-DECEMBER 1999

EPA Science Inventory

Pregnancy and Perinatal Health, Inner Mongolia, China, December 1996- December 1999
Subtitle: Pregnancy and Perinatal Health, Inner Mongolia, China
Authors: Z. Liu1, D.T. Lobdell2, L. He1, M. Yang1, R. Kwok2, J. Mumford2
Affiliations:
1 Ba Men Anti-Epidemic Station, ...

Mindfulness and perinatal mental health: A systematic review.

PubMed

Hall, Helen G; Beattie, Jill; Lau, Rosalind; East, Christine; Anne Biro, Mary

2016-02-01

Perinatal stress is associated with adverse maternal and infant outcomes. Mindfulness training may offer a safe and acceptable strategy to support perinatal mental health. To critically appraise and synthesise the best available evidence regarding the effectiveness of mindfulness training during pregnancy to support perinatal mental health. The search for relevant studies was conducted in six electronic databases and in the grey literature. Eligible studies were assessed for methodological quality according to standardised critical appraisal instruments. Data were extracted and recorded on a pre-designed form and then entered into Review Manager. Nine studies were included in the data synthesis. It was not appropriate to combine the study results because of the variation in methodologies and the interventions tested. Statistically significant improvements were found in small studies of women undertaking mindfulness awareness training in one study for stress (mean difference (MD) -5.28, 95% confidence intervals (CI) -10.4 to -0.42, n=22), two for depression (for example MD -5.48, 95% CI -8.96 to -2.0, n=46) and four for anxiety (for example, MD -6.50, 95% CI -10.95 to -2.05, n=32). However the findings of this review are limited by significant methodological issues within the current research studies. There is insufficient evidence from high quality research on which to base recommendations about the effectiveness of mindfulness to promote perinatal mental health. The limited positive findings support the design and conduct of adequately powered, longitudinal randomised controlled trials, with active controls. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Perinatal factors and the risk of bipolar disorder in Finland.

PubMed

Chudal, Roshan; Sourander, Andre; Polo-Kantola, Päivi; Hinkka-Yli-Salomäki, Susanna; Lehti, Venla; Sucksdorff, Dan; Gissler, Mika; Brown, Alan S

2014-02-01

Complications during the perinatal period have been associated with neurodevelopmental disorders like schizophrenia and autism. However, similar studies on bipolar disorder (BPD) have been limited and the findings are inconsistent. The aim of this study was to examine the association between perinatal risk factors and BPD. This nested case-control study, based on the Finnish Prenatal Study of Bipolar Disorders (FIPS-B), identified 724 cases and 1419 matched controls from population based registers. Conditional logistic regression was used to examine the associations between perinatal factors and BPD adjusting for potential confounding due to maternal age, psychiatric history and educational level, place of birth, number of previous births and maternal smoking during pregnancy. Children delivered by planned cesarean section had a 2.5-fold increased risk of BPD (95% CI: 1.32-4.78, P<0.01). No association was seen between other examined perinatal risk factors and BPD. The limitations of this study include: the restriction in the sample to treated cases of BPD in the population, and usage of hospital based clinical diagnosis for case ascertainment. In addition, in spite of the large sample size, there was low power to detect associations for certain exposures including the lowest birth weight category and pre-term birth. Birth by planned cesarean section was associated with risk of BPD, but most other perinatal risk factors examined in this study were not associated with BPD. Larger studies with greater statistical power to detect less common exposures and studies utilizing prospective biomarker-based exposures are necessary in the future. © 2013 Published by Elsevier B.V.

Cognitive-behavioral group treatment for perinatal anxiety: a pilot study.

PubMed

Green, Sheryl M; Haber, Erika; Frey, Benicio N; McCabe, Randi E

2015-08-01

Along with physical and biological changes, a tremendous amount of upheaval and adjustment accompany the pregnancy and postpartum period of a woman's life that together can often result in what is commonly known as postpartum depression. However, anxiety disorders have been found to be more frequent than depression during pregnancy and at least as common, if not more so, during the postpartum period, e.g., Brockington et al., (Archieves Women's Ment Health 9:253-263, 2006; Wenzel et al. (J Anxiety Disord, 19:295-311, 2005). Cognitive-behavioral therapy (CBT) is a well-established psychological treatment of choice for anxiety; however, few studies have specifically examined a cognitive-behavioral intervention targeting perinatal anxiety. This pilot study examined the effectiveness of a cognitive-behavioral group treatment (CBGT) program specifically tailored to address perinatal anxiety in 10 women who were either pregnant or within 12 months postpartum. Participants were recruited from a women's clinic at an academic hospital setting, with anxiety identified as their principal focus of distress. Following a diagnostic interview confirming a primary anxiety disorder and completion of assessment measures, participants completed a 6-week CBGT program. There was a statistically significant reduction in anxiety and depressive symptoms following the CBGT program (all p < 0.05). Participants also reported high acceptability and satisfaction with this treatment for addressing their perinatal anxiety. These findings suggest that CBGT for perinatal anxiety is a promising treatment for both anxiety and depressive symptoms experienced during the perinatal period. Further studies are needed to evaluate the treatment efficacy through larger controlled trials.

Social and Cultural Factors Associated with Perinatal Grief in Chhattisgarh, India

PubMed Central

Roberts, Lisa R.; Montgomery, Susanne; Lee, Jerry W.; Anderson, Barbara A.

2017-01-01

Stillbirth is a globally significant public health problem with many medical causes. There are also indirect causal pathways including social and cultural factors which are particularly salient in India's traditional society. The purpose of this study was to explore women's perceptions of stillbirth and to determine how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India. Structured interviews were done face-to-face in 21 randomly selected villages among women of reproductive age (N = 355) who had experienced stillbirth (n = 178) and compared to those who had not (n = 177), in the Christian Hospital, Mungeli catchment area. Perinatal grief was significantly higher among women with a history of stillbirth. Greater perinatal grief was associated with lack of support, maternal agreement with social norms, and younger maternal age. These predictors must be understood in light of an additional finding—distorted sex ratios, which reflect gender discrimination in the context of Indian society. The findings of this study will allow the development of a culturally appropriate health education program which should be designed to increase social support and address social norms, thereby reducing psychological distress to prevent complicated perinatal grief. Perinatal grief is a significant social burden which impacts the health women. PMID:21956647

Tobacco control policies and perinatal health: a national quasi-experimental study.

PubMed

Peelen, Myrthe J; Sheikh, Aziz; Kok, Marjolein; Hajenius, Petra; Zimmermann, Luc J; Kramer, Boris W; Hukkelhoven, Chantal W; Reiss, Irwin K; Mol, Ben W; Been, Jasper V

2016-04-22

We investigated whether changes in perinatal outcomes occurred following introduction of key tobacco control policies in the Netherlands: smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign (January-February 2004); and extension of the smoke-free law to the hospitality industry, accompanied by another tax increase and mass media campaign (July 2008). This was a national quasi-experimental study using Netherlands Perinatal Registry data (2000-2011; registration: ClinicalTrials.gov NCT02189265). Primary outcome measures were: perinatal mortality, preterm birth, and being small-for-gestational age (SGA). The association with timing of the tobacco control policies was investigated using interrupted time series logistic regression analyses with adjustment for confounders. Among 2,069,695 singleton births, there were 13,027 (0.6%) perinatal deaths, 116,043 (5.6%) preterm live-births and 187,966 (9.1%) SGA live-births. The 2004 policies were not associated with significant changes in the odds of developing any of the primary outcomes. After the 2008 policy change, a -4.4% (95% CI -2.4; -6.4, p < 0.001) decrease in odds of being SGA was observed. A reduction in SGA births, but not preterm birth or perinatal mortality, was observed in the Netherlands after extension of the smoke-free workplace law to bars and restaurants in conjunction with a tax increase and mass media campaign.

Tobacco control policies and perinatal health: a national quasi-experimental study

PubMed Central

Peelen, Myrthe J.; Sheikh, Aziz; Kok, Marjolein; Hajenius, Petra; Zimmermann, Luc J.; Kramer, Boris W.; Hukkelhoven, Chantal W.; Reiss, Irwin K.; Mol, Ben W.; Been, Jasper V.

2016-01-01

We investigated whether changes in perinatal outcomes occurred following introduction of key tobacco control policies in the Netherlands: smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign (January-February 2004); and extension of the smoke-free law to the hospitality industry, accompanied by another tax increase and mass media campaign (July 2008). This was a national quasi-experimental study using Netherlands Perinatal Registry data (2000–2011; registration: ClinicalTrials.gov NCT02189265). Primary outcome measures were: perinatal mortality, preterm birth, and being small-for-gestational age (SGA). The association with timing of the tobacco control policies was investigated using interrupted time series logistic regression analyses with adjustment for confounders. Among 2,069,695 singleton births, there were 13,027 (0.6%) perinatal deaths, 116,043 (5.6%) preterm live-births and 187,966 (9.1%) SGA live-births. The 2004 policies were not associated with significant changes in the odds of developing any of the primary outcomes. After the 2008 policy change, a -4.4% (95% CI -2.4; -6.4, p < 0.001) decrease in odds of being SGA was observed. A reduction in SGA births, but not preterm birth or perinatal mortality, was observed in the Netherlands after extension of the smoke-free workplace law to bars and restaurants in conjunction with a tax increase and mass media campaign. PMID:27103591

Mediators of the effects of rice intake on health in individuals consuming a traditional Japanese diet centered on rice

PubMed Central

Toyomaki, Atsuhito; Miyazaki, Akane; Nakai, Yukiei; Yamaguchi, Atsuko; Kubo, Chizuru; Suzuki, Junko; Ohkubo, Iwao; Shimizu, Mari; Musashi, Manabu; Kiso, Yoshinobu; Kusumi, Ichiro

2017-01-01

Although the Japanese diet is believed to be balanced and healthy, its benefits have been poorly investigated, especially in terms of effects on mental health. We investigated dietary patterns and physical and mental health in the Japanese population using an epidemiological survey to determine the health benefits of the traditional Japanese diet. Questionnaires to assess dietary habits, quality of life, sleep quality, impulsivity, and depression severity were distributed to 550 randomly selected middle-aged and elderly individuals. Participants with any physical or mental disease were excluded. Two-hundred and seventy-eight participants were selected for the final statistical analysis. We determined rice to be one of the most traditional foods in Japanese cuisine. Scores for each questionnaire were computed, and the correlations between rice intake and health indices were assessed. When analyzing the direct correlations between rice intake and health indices, we found only two correlations, namely those with quality of life (vitality) and sleep quality. Path analysis using structural equation modeling was performed to investigate the association between rice intake and health, with indirect effects included in the model. Additional associations between rice intake and health were explained using this model when compared to those using direct correlation analysis. Path analysis was used to identify mediators of the rice-health association. These mediators were miso (soybean paste) soup, green tea, and natto (fermented soybean) intake. Interestingly, these mediators have been major components of the Japanese diet since 1975, which has been considered one of the healthiest diets since the 1960s. Our results indicate that the combination of rice with other healthy foods, which is representative of the traditional Japanese diet, may contribute to improvements in physical and mental health. PMID:28968452

Mental health trajectories and related factors among perinatal women.

PubMed

Lin, Pei-Chao; Hung, Chich-Hsiu

2015-06-01

To investigate Taiwanese women's mental health trajectories from the third trimester of pregnancy to four weeks postpartum and the correlations of these trajectories with perceived social support and demographic characteristics. Previous studies have reported differences between prenatal and postpartum mental health status. A repeated design study was conducted in a medical hospital in Southern Taiwan. One-hundred and ninety-four Taiwanese women completed the Chinese Health Questionnaire and Social Support Scale at the 36th prenatal week and first and fourth week postpartum. Three linear mental health trajectories for perinatal women were identified. Consistently poor perinatal mental health was reported by 16·0% of the participants. Less social support was associated with lower prenatal mental health scores. Younger age was a risk factor for consistently poor perinatal health. Vaginal delivery was associated with improved mental health after childbirth. Mental health was worse in the third trimester of pregnancy than postpartum. Less social support was associated with lower prenatal mental health scores, and this association was similarly distributed between women with consistently poor and improved mental health after birth. Health care providers should assess women's mental health status and provide timely interventions during the perinatal period. Social support should be provided for pregnant women, especially younger women or those with lower perceived social support. © 2015 John Wiley & Sons Ltd.

Perinatal stroke and the risk of developing childhood epilepsy

PubMed Central

Golomb, Meredith R.; Garg, Bhuwan P.; Carvalho, Karen S.; Johnson, Cynthia S.; Williams, Linda S.

2008-01-01

Objectives To describe the prevalence of epilepsy after 6 months-of-age in children with perinatal stroke and examine whether perinatal data predict epilepsy onset and resolution. Study design A retrospective review of 64 children with perinatal stroke. In children with at least 6 months of follow-up data, Kaplan-Meier curves, univariate log-rank tests, and Cox proportional hazards models were used to examine predictors of time to development of seizures, and time to resolution of seizures in children with epilepsy. The association of risk factors with the presence of epilepsy at any time after 6 months-of-age was examined using Fisher’s exact test. Results Forty-one of the 61 children with at least 6 months of follow-up data (67%) had epilepsy between 6 months-of-age and last follow-up, but in 13 of 41 seizures eventually resolved and anticonvulsants were discontinued. Infarct on prenatal ultrasound (p=0.0065) and family history of epilepsy (p=0.0093) were significantly associated with time to development of seizures after 6 months-of-age in the univariate analysis. No assessed variables were associated with time to resolution of epilepsy or with the presence of epilepsy after 6 months-of-age. Conclusions Childhood epilepsy is frequent after perinatal stroke. Evidence of infarction on prenatal ultrasound and a family history of epilepsy predict earlier onset of active seizures. PMID:17889079

Nippon Nyumon: An Idea Book for Teaching Japanese Economic Topics.

ERIC Educational Resources Information Center

National Council for the Social Studies, Washington, DC.

This sourcebook contains lessons and materials developed by the Keizai Koho Center (Japan Institute for Social and Economic Affairs). The ideas and activities in the sourcebook focus on the Japanese economy and are useful in social studies classrooms and courses including, economics, geography, and world cultures. Essays in the sourcebook are: (1)…

Perinatal Care of Infants with Congenital Birth Defects.

PubMed

Sewell, Elizabeth K; Keene, Sarah

2018-06-01

Prenatal diagnosis has changed perinatal medicine dramatically, allowing for additional fetal monitoring, referral and counseling, delivery planning, the option of fetal intervention, and targeted postnatal management. Teams participating in the delivery room care of infants with known anomalies should be knowledgeable about specific needs and expectations but also ready for unexpected complications. A small number of neonates will need rapid access to postnatal interventions, such as surgery, but most can be stabilized with appropriate neonatal care. These targeted perinatal interventions have been shown to improve outcome in selected diagnoses. Copyright © 2018 Elsevier Inc. All rights reserved.

Hospital-based perinatal nurses identify the need to improve nursing care of adolescent mothers.

PubMed

Peterson, Wendy E; Davies, Barbara; Rashotte, Judy; Salvador, Anne; Trépanier, Marie-Josée

2012-01-01

To determine whether hospital-based perinatal nurses with expertise in adolescent mother-friendly care identify a need to improve inpatient nursing care of adolescent mothers and how well perinatal units support nurses' capacity to provide adolescent mother-friendly care. A key informant survey of nurses from eight perinatal units at three hospitals (four separate sites) in a Canadian city. Perinatal nurses expert in the care of adolescent mothers were identified by their managers and colleagues. These nurses and all perinatal clinical educators were invited to participate. Twenty-seven of 34 potential key informants completed the survey. Key informants rated their own skill in caring for adolescent mothers higher (median 8.0) than they rated the skill of other nurses (median 6.0) on their units. They attributed their expertise working with adolescent mothers to their clinical and life experiences and their ability to develop rapport with adolescents. A common reason for the assigned lower peer-group ratings was the judgmental manner in which some nurses care for adolescent mothers. Key informants also identified that hospital-based perinatal nurses lack adequate knowledge of community-based resources for adolescent mothers, educational programs related to adolescent mother-friendly care were insufficient, and policies to inform the nursing care of adolescent mothers were not available or known to them. A minority of perinatal nurses have expertise in adolescent mother-friendly care. There is a need for perinatal unit-level interventions to support the development of nurses' skills in caring for adolescent mothers and their knowledge of community-based resources. Peer mentoring and self-reflective practice are promising strategies. © 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Homogamy and Intermarriage of Japanese and Japanese Americans with Whites Surrounding World War II

ERIC Educational Resources Information Center

Ono, Hiromi; Berg, Justin

2010-01-01

Although some sociologists have suggested that Japanese Americans quickly assimilated into mainstream America, scholars of Japanese America have highlighted the heightened exclusion that the group experienced. This study tracked historical shifts in the exclusion level of Japanese and Japanese Americans in the United States surrounding World War…

Utility of local health registers in measuring perinatal mortality: A case study in rural Indonesia

PubMed Central

2011-01-01

Background Perinatal mortality is an important indicator of obstetric and newborn care services. Although the vast majority of global perinatal mortality is estimated to occur in developing countries, there is a critical paucity of reliable data at the local level to inform health policy, plan health care services, and monitor their impact. This paper explores the utility of information from village health registers to measure perinatal mortality at the sub district level in a rural area of Indonesia. Methods A retrospective pregnancy cohort for 2007 was constructed by triangulating data from antenatal care, birth, and newborn care registers in a sample of villages in three rural sub districts in Central Java, Indonesia. For each pregnancy, birth outcome and first week survival were traced and recorded from the different registers, as available. Additional local death records were consulted to verify perinatal mortality, or identify deaths not recorded in the health registers. Analyses were performed to assess data quality from registers, and measure perinatal mortality rates. Qualitative research was conducted to explore knowledge and practices of village midwives in register maintenance and reporting of perinatal mortality. Results Field activities were conducted in 23 villages, covering a total of 1759 deliveries that occurred in 2007. Perinatal mortality outcomes were 23 stillbirths and 15 early neonatal deaths, resulting in a perinatal mortality rate of 21.6 per 1000 live births in 2007. Stillbirth rates for the study population were about four times the rates reported in the routine Maternal and Child Health program information system. Inadequate awareness and supervision, and alternate workload were cited by local midwives as factors resulting in inconsistent data reporting. Conclusions Local maternal and child health registers are a useful source of information on perinatal mortality in rural Indonesia. Suitable training, supervision, and quality control

Utility of local health registers in measuring perinatal mortality: a case study in rural Indonesia.

PubMed

Burke, Leona; Suswardany, Dwi Linna; Michener, Keryl; Mazurki, Setiawaty; Adair, Timothy; Elmiyati, Catur; Rao, Chalapati

2011-03-17

Perinatal mortality is an important indicator of obstetric and newborn care services. Although the vast majority of global perinatal mortality is estimated to occur in developing countries, there is a critical paucity of reliable data at the local level to inform health policy, plan health care services, and monitor their impact. This paper explores the utility of information from village health registers to measure perinatal mortality at the sub district level in a rural area of Indonesia. A retrospective pregnancy cohort for 2007 was constructed by triangulating data from antenatal care, birth, and newborn care registers in a sample of villages in three rural sub districts in Central Java, Indonesia. For each pregnancy, birth outcome and first week survival were traced and recorded from the different registers, as available. Additional local death records were consulted to verify perinatal mortality, or identify deaths not recorded in the health registers. Analyses were performed to assess data quality from registers, and measure perinatal mortality rates. Qualitative research was conducted to explore knowledge and practices of village midwives in register maintenance and reporting of perinatal mortality. Field activities were conducted in 23 villages, covering a total of 1759 deliveries that occurred in 2007. Perinatal mortality outcomes were 23 stillbirths and 15 early neonatal deaths, resulting in a perinatal mortality rate of 21.6 per 1000 live births in 2007. Stillbirth rates for the study population were about four times the rates reported in the routine Maternal and Child Health program information system. Inadequate awareness and supervision, and alternate workload were cited by local midwives as factors resulting in inconsistent data reporting. Local maternal and child health registers are a useful source of information on perinatal mortality in rural Indonesia. Suitable training, supervision, and quality control, in conjunction with computerisation to

[Marital status and the severity of perinatal depression among pregnant women].

PubMed

Podolska, Magdalena; Sipak-Szmigiel, Olimpia

2010-01-01

Cohabitation existing for ages in all human cultures is becoming more common since the 1960s due to complex changes in postmodern societies. These societies have made the phenomenon of cohabitation the object of adequate theoretical reflection. The aim of this work was to determine whether the marital status of pregnant women affects the severity of perinatal depression. We enrolled 117 gravida hospitalized in 2006 and 2007 at the Department of Maternal-Fetal Medicine, Pomeranian Medical University. The gestational age ranged from week 32 to 40. The clinical condition of each gravida was assessed during routine obstetric history taking. The Edinburgh Postnatal Depression Scale by Cox, Holden, and Sagovski was used as the screening test for perinatal depression. 1. The marital status of the gravida with emphasis on cohabitation is a significant correlate of perinatal depression and its risk. 2. Clinical examination should concentrate not only on the physical and medical condition but also on the psychosocial status of the patient as the predictor of perinatal depression. 3. All pregnant women living in informal partnerships should be offered psychological support.

Seeking help for perinatal psychological distress: a meta-synthesis of women's experiences.

PubMed

Button, Susan; Thornton, Alexandra; Lee, Suzanne; Shakespeare, Judy; Ayers, Susan

2017-10-01

Women may not seek help for perinatal psychological distress, despite regular contact with primary care services. Barriers include ignorance of symptoms, inability to disclose distress, others' attitudes, and cultural expectations. Much of the evidence has been obtained from North American populations and may not, therefore, extrapolate to the UK. To understand the factors affecting women's decision to seek help for perinatal distress. Meta-synthesis of the available published qualitative evidence on UK women's experiences of seeking help for perinatal distress. Systematic searches were conducted in accordance with PRISMA guidelines. Databases searched were PubMed, Scopus, PsycINFO, PsycARTICLES, CINAHL, and Academic Search Complete. Searches of grey literature and references were also conducted. Studies were eligible for inclusion if they reported qualitative data on UK women's experiences of perinatal distress and contact with healthcare professionals. The synthesis was conducted using meta-ethnography. In all, 24 studies were eligible for inclusion. Metasynthesis identified three main themes: identifying a problem, the influence of healthcare professionals, and stigma. These themes build on current understanding of help seeking by identifying the need for women to be able to frame their experience, for healthcare professionals to educate women about their roles, the need for continuity of care, and the way that being seen as a 'bad mother' causes women to self-silence. Perinatal care provision needs to allow for continuity of care and for staff training that facilitates awareness of factors that influence women's help seeking. Further research is required, particularly in relation to effective means of identifying perinatal psychological distress. © British Journal of General Practice 2017.

Perinatal outcome in singleton pregnancies complicated with preeclampsia and eclampsia in Ecuador.

PubMed

Phoa, K Y N; Chedraui, P; Pérez-López, F R; Wendte, J F; Ghiabi, S; Vrijkotte, T; Pinto, P

2016-07-01

Preeclampsia in Ecuador is an understudied subject since available epidemiological data are scarce. The aim of this study was to describe perinatal outcomes among singleton pregnancies complicated with preeclampsia and eclampsia in a sample of low-income Ecuadorian women. Pregnant women complicated with preeclampsia (mild and severe) and eclampsia (defined according to criteria of the ACOG) delivering at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador were surveyed with a structured questionnaire containing maternal (socio-demographic) and neonatal data. Perinatal outcomes were compared according to severity of clinical presentation. A total of 163 women with preeclampsia [mild (23.9%), severe (68.7%) and eclampsia (7.4%)] were surveyed. Perinatal mortality and stillbirth rate was similar among studied groups (mild vs. severe preeclampsia/eclampsia cases). However, severe cases displayed higher rates of adverse perinatal outcomes: lower birth Apgar scores, more preterm births, and more low birth weight and small for gestational age infants. Caesarean-section rate and the number of admissions to intensive or intermediate neonatal care were higher in severe cases. A similar trend was found when analysis excluded preterm gestations. In conclusion, in this specific low-income Ecuadorian population perinatal outcome was adverse in pregnancies complicated with severe preeclampsia/eclampsia.

Prenatal, perinatal and postnatal factors associated with autism spectrum disorder.

PubMed

Hadjkacem, Imen; Ayadi, Héla; Turki, Mariem; Yaich, Sourour; Khemekhem, Khaoula; Walha, Adel; Cherif, Leila; Moalla, Yousr; Ghribi, Farhat

To identify prenatal, perinatal and postnatal risk factors in children with autism spectrum disorder (ASD) by comparing them to their siblings without autistic disorders. The present study is cross sectional and comparative. It was conducted over a period of three months (July-September 2014). It included 101 children: 50 ASD's children diagnosed according to DSM-5 criteria and 51 unaffected siblings. The severity of ASD was assessed by the CARS. Our study revealed a higher prevalence of prenatal, perinatal and postnatal factors in children with ASD in comparison with unaffected siblings. It showed also a significant association between perinatal and postnatal factors and ASD (respectively p=0.03 and p=0.042). In this group, perinatal factors were mainly as type of suffering acute fetal (26% of cases), long duration of delivery and prematurity (18% of cases for each factor), while postnatal factors were represented principally by respiratory infections (24%). As for parental factors, no correlation was found between advanced age of parents at the moment of the conception and ASD. Likewise, no correlation was observed between the severity of ASD and different factors. After logistic regression, the risk factors retained for autism in the final model were: male gender, prenatal urinary tract infection, acute fetal distress, difficult labor and respiratory infection. The present survey confirms the high prevalence of prenatal, perinatal and postnatal factors in children with ASD and suggests the intervention of some of these factors (acute fetal distress and difficult labor, among others), as determinant variables for the genesis of ASD. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

DRINKING WATER ARSENIC AND PERINATAL OUTCOMES

EPA Science Inventory

Drinking Water Arsenic and Perinatal Outcomes
DT Lobdell, Z Ning, RK Kwok, JL Mumford, ZY Liu, P Mendola

Many studies have documented an association between drinking water arsenic (DWA) and cancer, vascular diseases, and dermatological outcomes, but few have investigate...

New Fathers' Perinatal Depression and Anxiety-Treatment Options: An Integrative Review.

PubMed

O'Brien, Anthony P; McNeil, Karen A; Fletcher, Richard; Conrad, Agatha; Wilson, Amanda J; Jones, Donovan; Chan, Sally W

2017-07-01

More than 10% of fathers experience depression and anxiety during the perinatal period, but paternal perinatal depression (PPND) and anxiety have received less attention than maternal perinatal mental health problems. Few mainstream treatment options are available for men with PPND and anxiety. The aim of this literature review was to summarize the current understanding of PPND and the treatment programs specifically designed for fathers with perinatal depression. Eight electronic databases were searched using a predefined strategy, and reference lists were also hand searched. PPND and anxiety were identified to have a negative impact on family relationships, as well as the health of mothers and children. Evidence suggests a lack of support and tailored treatment options for men having trouble adjusting to the transition to fatherhood. Of the limited options available, cognitive behavioral therapy, group work, and blended delivery programs, including e-support approaches appear to be most effective in helping fathers with perinatal depression and anxiety. The review findings have important implications for the understanding of PPND and anxiety. Future research is needed to address the adoption of father-inclusive and father-specific models of care to encourage fathers' help-seeking behavior. Inclusion of male-specific requirements into support and treatment options can improve the ability of services to engage new fathers. Psychotherapeutic intervention could assist to address the cognitive differences and dissonance for men adjusting to the role of father, including male identity and role expectations.

New Fathers’ Perinatal Depression and Anxiety—Treatment Options: An Integrative Review

PubMed Central

O’Brien, Anthony P.; McNeil, Karen A.; Fletcher, Richard; Conrad, Agatha; Wilson, Amanda J.; Jones, Donovan; Chan, Sally W.

2016-01-01

More than 10% of fathers experience depression and anxiety during the perinatal period, but paternal perinatal depression (PPND) and anxiety have received less attention than maternal perinatal mental health problems. Few mainstream treatment options are available for men with PPND and anxiety. The aim of this literature review was to summarize the current understanding of PPND and the treatment programs specifically designed for fathers with perinatal depression. Eight electronic databases were searched using a predefined strategy, and reference lists were also hand searched. PPND and anxiety were identified to have a negative impact on family relationships, as well as the health of mothers and children. Evidence suggests a lack of support and tailored treatment options for men having trouble adjusting to the transition to fatherhood. Of the limited options available, cognitive behavioral therapy, group work, and blended delivery programs, including e-support approaches appear to be most effective in helping fathers with perinatal depression and anxiety. The review findings have important implications for the understanding of PPND and anxiety. Future research is needed to address the adoption of father-inclusive and father-specific models of care to encourage fathers’ help-seeking behavior. Inclusion of male-specific requirements into support and treatment options can improve the ability of services to engage new fathers. Psychotherapeutic intervention could assist to address the cognitive differences and dissonance for men adjusting to the role of father, including male identity and role expectations. PMID:27694550

The Anglo-Japanese Alliance and Japanese Expansionism 1902-1923.

DTIC Science & Technology

1992-06-05

Alienation 1919-1952. London: Cambridge University Press. 1982. • The Oriains of the Russo-Japanese War. London: Longman Group Limited. 1985. Nitobe ... Inazo . Bushido - The Soul of Japan. Tokyo: Tuttle. 1981. Okamoto, Shumpei. The Japan Oliaarchv and the Russo-Japanese War. New York: Columbia

Obstetric and perinatal outcomes in IVF versus ICSI-conceived pregnancies at a tertiary care center--a pilot study.

PubMed

Nouri, Kazem; Ott, Johannes; Stoegbauer, Lucia; Pietrowski, Detlef; Frantal, Sophie; Walch, Katharina

2013-08-31

Although most pregnancies after IVF result in normal healthy outcomes, an increased risk for a number of obstetric and neonatal complications, compared to naturally conceived pregnancies, has been reported. While there are many studies that compare pregnancies after assisted reproductive techniques with spontaneously conceived pregnancies, fewer data are available that evaluate the differences between IVF and ICSI-conceived pregnancies. The aim of our present study was, therefore, to compare obstetric and perinatal outcomes in pregnancies conceived after in vitro fertilization (IVF) versus intracytoplasmatic sperm injection (ICSI). Three-hundred thirty four women who had become pregnant after an IVF or ICSI procedure resulted in a total of 530 children referred between 2003 und 2009 to the Department of Obstetrics and Gynecology of the Medical University of Vienna, a tertiary care center, and were included in this retrospective cohort study. We assessed maternal and fetal parameters in both groups (IVF and ICSI). The main study outcomes were preterm delivery, the need for neonatal intensive care, and congenital malformations. Moreover, we compared the course of pregnancy between both groups and the occurrence of complications that led to maternal hospitalization during pregnancy. There were 80 children conceived via ICSI and 450 children conceived via IVF.Mean gestational age was significantly lower in the ICSI group (p = 0.001). After ICSI, the birth weight (p = 0.008) and the mean APGAR values after 1 minute and after 10 minutes were lower compared to that of the IVF group (p = 0.016 and p = 0.047, respectively). Moreover, ICSI-conceived children had to be hospitalized more often at a neonatal intensive care unit (p = 0.004). There was no difference in pH of the umbilical artery or in major congenital malformations between the two groups. Pregnancy complications (i.e., premature rupture of membranes, cervical insufficiency, and premature

Obstetric and perinatal outcomes in IVF versus ICSI-conceived pregnancies at a tertiary care center - a pilot study

PubMed Central

2013-01-01

Background Although most pregnancies after IVF result in normal healthy outcomes, an increased risk for a number of obstetric and neonatal complications, compared to naturally conceived pregnancies, has been reported. While there are many studies that compare pregnancies after assisted reproductive techniques with spontaneously conceived pregnancies, fewer data are available that evaluate the differences between IVF and ICSI-conceived pregnancies. The aim of our present study was, therefore, to compare obstetric and perinatal outcomes in pregnancies conceived after in vitro fertilization (IVF) versus intracytoplasmatic sperm injection (ICSI). Methods Three-hundred thirty four women who had become pregnant after an IVF or ICSI procedure resulted in a total of 530 children referred between 2003 und 2009 to the Department of Obstetrics and Gynecology of the Medical University of Vienna, a tertiary care center, and were included in this retrospective cohort study. We assessed maternal and fetal parameters in both groups (IVF and ICSI). The main study outcomes were preterm delivery, the need for neonatal intensive care, and congenital malformations. Moreover, we compared the course of pregnancy between both groups and the occurrence of complications that led to maternal hospitalization during pregnancy. Results There were 80 children conceived via ICSI and 450 children conceived via IVF. Mean gestational age was significantly lower in the ICSI group (p = 0.001). After ICSI, the birth weight (p = 0.008) and the mean APGAR values after 1 minute and after 10 minutes were lower compared to that of the IVF group (p = 0.016 and p = 0.047, respectively). Moreover, ICSI-conceived children had to be hospitalized more often at a neonatal intensive care unit (p = 0.004). There was no difference in pH of the umbilical artery or in major congenital malformations between the two groups. Pregnancy complications (i.e., premature rupture of membranes, cervical

Association of maternal fractures with adverse perinatal outcomes.

PubMed

El Kady, Dina; Gilbert, William M; Xing, Guibo; Smith, Lloyd H

2006-09-01

We sought to assess the effects of fracture injuries on maternal and fetal/neonatal outcomes in a large obstetric population. We performed a retrospective cohort study using a database in which maternal and neonatal hospital discharge summaries were linked with birth and death certificates to identify any relation between maternal fractures and maternal and perinatal morbidity. Fracture injuries and perinatal outcomes were identified with the use of the International Classification of Diseases, 9th revision, Clinical Modification codes. Outcomes were further subdivided on the basis of anatomic site of fracture. A total of 3292 women with > or = 1 fractures were identified. Maternal mortality (odds ratio, 169 [95% CI, 83.2,346.4]) and morbidity (abruption and blood transfusion) rates were increased significantly in women who were delivered during hospitalization for their injury. Women who were discharged undelivered continued to have delayed morbidity, which included a 46% increased risk of low birth weight infants (odds ratio, 1.5 [95% CI, 1.3,1.7]) and a 9-fold increased risk of thrombotic events (odds ratio, 9.2 [95% CI, 1.3,65.7]) Pelvic fractures had the worst outcomes. Fractures during pregnancy are an important marker for poor perinatal outcomes.

The role of inflammation in perinatal brain injury.

PubMed

Hagberg, Henrik; Mallard, Carina; Ferriero, Donna M; Vannucci, Susan J; Levison, Steven W; Vexler, Zinaida S; Gressens, Pierre

2015-04-01

Inflammation is increasingly recognized as being a critical contributor to both normal development and injury outcome in the immature brain. The focus of this Review is to highlight important differences in innate and adaptive immunity in immature versus adult brain, which support the notion that the consequences of inflammation will be entirely different depending on context and stage of CNS development. Perinatal brain injury can result from neonatal encephalopathy and perinatal arterial ischaemic stroke, usually at term, but also in preterm infants. Inflammation occurs before, during and after brain injury at term, and modulates vulnerability to and development of brain injury. Preterm birth, on the other hand, is often a result of exposure to inflammation at a very early developmental phase, which affects the brain not only during fetal life, but also over a protracted period of postnatal life in a neonatal intensive care setting, influencing critical phases of myelination and cortical plasticity. Neuroinflammation during the perinatal period can increase the risk of neurological and neuropsychiatric disease throughout childhood and adulthood, and is, therefore, of concern to the broader group of physicians who care for these individuals.

The role of inflammation in perinatal brain injury

PubMed Central

Hagberg, Henrik; Mallard, Carina; Ferriero, Donna M.; Vannucci, Susan J.; Levison, Steven W.; Vexler, Zinaida S.; Gressens, Pierre

2015-01-01

Inflammation is increasingly recognized as being a critical contributor to both normal development and injury outcome in the immature brain. The focus of this Review is to highlight important differences in innate and adaptive immunity in immature versus adult brain, which support the notion that the consequences of inflammation will be entirely different depending on context and stage of CNS development. Perinatal brain injury can result from neonatal encephalopathy and perinatal arterial ischaemic stroke, usually at term, but also in preterm infants. Inflammation occurs before, during and after brain injury at term, and modulates vulnerability to and development of brain injury. Preterm birth, on the other hand, is often a result of exposure to inflammation at a very early developmental phase, which affects the brain not only during fetal life, but also over a protracted period of postnatal life in a neonatal intensive care setting, influencing critical phases of myelination and cortical plasticity. Neuroinflammation during the perinatal period can increase the risk of neurological and neuropsychiatric disease throughout childhood and adulthood, and is, therefore, of concern to the broader group of physicians who care for these individuals. PMID:25686754

Introduction of the non-technical skills for surgeons (NOTSS) system in a Japanese cancer center.

PubMed

Tsuburaya, Akira; Soma, Takahiro; Yoshikawa, Takaki; Cho, Haruhiko; Miki, Tamotsu; Uramatsu, Masashi; Fujisawa, Yoshikazu; Youngson, George; Yule, Steven

2016-12-01

Non-technical skills rating systems, which are designed to support surgical performance, have been introduced worldwide, but not officially in Japan. We performed a pilot study to evaluate the "non-technical skills for surgeons" (NOTSS) rating system in a major Japanese cancer center. Upper gastrointestinal surgeons were selected as trainers or trainees. The trainers attended a master-class on NOTSS, which included simulated demo-videos, to promote consistency across the assessments. The trainers thereafter commenced observing the trainees and whole teams, utilizing the NOTSS and "observational teamwork assessment for surgery" (OTAS) rating systems, before and after their education. Four trainers and six trainees were involved in this study. Test scores for understanding human factors and the NOTSS system were 5.89 ± 1.69 and 8.00 ± 1.32 before and after the e-learning, respectively (mean ± SD, p = 0.010). The OTAS scores for the whole team improved significantly after the trainees' education in five out of nine stages (p < 0.05). There were no differences in the NOTSS scores before and after education, with a small improvement in the total scores for the "teamwork and communication" and "leadership" categories. These findings demonstrate that implementing the NOTSS system is feasible in Japan. Education of both surgical trainers and trainees would contribute to better team performance.

Intimate partner violence among women with eating disorders during the perinatal period

PubMed Central

Easter, Abigail; Lewis, Rebecca; Howard, Louise M.; Micali, Nadia

2015-01-01

ABSTRACT Objective  Prevalence of intimate partner violence (IPV) during pregnancy is estimated to be 4%–8%. Women with mental health difficulties are at increased risk for IPV during the perinatal period. Prevalence of IPV is high among women with eating disorders (ED); however, prevalence of IPV during the perinatal period among women with ED is unknown. Method  We studied women from a population‐based cohort, the Avon Longitudinal Study of Parents and Children. Prevalence and odds of physical and emotional IPV during and after the perinatal period was investigated among women with lifetime ED, with (n = 174) or without pregnancy shape and weight concern and/or purging behaviors (n = 189), and women with no ED (n = 8723). Results  Women with lifetime ED showed higher prevalence of IPV during and after the perinatal period (physical = 9.6%–14.3% and emotional = 24.1%–28.1%). Lifetime ED was associated with higher odds of physical IPV during the perinatal period (odds ratio: 2.34, 95% confidence interval: 1.11–4.93, p = .03). Lifetime ED with and without pregnancy shape and weight concerns and/or purging was associated with higher odds of IPV after the perinatal period, and higher odds of reporting emotional IPV at all time points. Associations were moderated by partner's response to pregnancy and maternal experience of childhood sexual abuse. Discussion  Mothers with ED and their children may be vulnerable to negative effects due to maternal ED and IPV combined, both of which have been associated with severe and long‐lasting harmful consequences. Partner's response to pregnancy and maternal experience of childhood sexual abuse might contribute to the association between ED and IPV perinatally. © 2015 The Authors. International Journal of Eating Disorders published by Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:727–735) PMID:26032597

Sexual Health Knowledge in a Sample of Perinatally HIV-infected and Perinatally-exposed Uninfected Youth

PubMed Central

Gromadzka, Olga; Santamaria, E. Karina; Benavides, Jessica M.; Dolezal, Curtis; Elkington, Katherine S.; Leu, Cheng-Shiun; McKay, Mary; Abrams, Elaine J.; Wiznia, Andrew; Bamji, Mahrukh; Ann Mellins, Claude

2015-01-01

This study describes sexual health knowledge in perinatally HIV-infected (PHIV+) and perinatally-exposed uninfected (PHIV-) ethnic-minority youth, ages 9–16 years, residing in NYC (n=316). Data on youth sexual health knowledge (e.g., pregnancy, STDs, birth control) and caregiver-adolescent communication about sexual health were examined. Participants in both groups answered only 35% of the sexual health knowledge questions correctly (mean=6.6/19). Higher scores were found among youth who reported more communication about sex with caregivers (vs. those who did not report talking about sex with caregivers; 8.54 vs. 5.84, p<.001) and among PHIV+ youth who were aware of their status (vs. PHIV+ youth who were not; 7.27 vs. 4.70, p<.001). Age was positively correlated with sexual health knowledge (beta=.489, p<.001). Both PHIV+ and PHIV− youth had poor sexual health knowledge, suggesting a need for sexual health education for both groups. Data suggest that interventions focused on caregiver-child risk communication may be important for prevention. PMID:26855617

A Conceptual Model of Cultural Predictors of Anxiety among Japanese American and Part-Japanese American Adolescents.

ERIC Educational Resources Information Center

Williams, John Kino Yamaguchi; Goebert, Deborah; Hishinuma, Earl; Miyamoto, Robin; Anzai, Neal; Izutsu, Satoru; Yanagida, Evelyn; Nishimura, Stephanie; Andrade, Naleen; Baker, F. M.

2002-01-01

Develops and assesses a model integrating Japanese ethnicity, cultural identity, and anxiety in Japanese American and part-Japanese American high school seniors. Japanese American adolescents scored higher on the scale and reported fewer anxiety symptoms than part-Japanese American adolescents. The model had a good overall fit, suggesting that…

The City MISS: development of a scale to measure stigma of perinatal mental illness.

PubMed

Moore, Donna; Ayers, Susan; Drey, Nicholas

2017-07-01

This study aimed to develop and validate a scale to measure perceived stigma for perinatal mental illness in women. Stigma is one of the most frequently cited barriers to seeking treatment and many women with perinatal mental illness fail to get the treatment they need. However, there is no psychometric scale that measures how women may experience the unique aspects of perinatal mental illness stigma. A draft scale of 30 items was developed from a literature review. Women with perinatal mental illness (n = 279) were recruited to complete the City Mental Illness Stigma Scale. Concurrent validity was measured using the Internalised Stigma of Mental Illness Scale. Factor analysis was used to create the final scale. The final 15-item City Mental Illness Stigma Scale has a three-factor structure: perceived external stigma, internal stigma and disclosure stigma. The scale accounted for 54% of the variance and had good internal reliability and concurrent validity. The City Mental Illness Stigma Scale appears to be a valid measure which provides a potentially useful tool for clinical practice and research in stigma and perinatal mental illness, including assessing the prevalence and characteristics of stigma. This research can be used to inform interventions to reduce or address the stigma experienced by some women with perinatal mental illness.

Untreated perinatal paternal depression: Effects on offspring.

PubMed

Gentile, Salvatore; Fusco, Maria Luigia

2017-06-01

Transition to parenthood represents an important life event which increases vulnerability to psychological disorders. Aim of this article is to analyze all studies which investigated the effects of untreated perinatal paternal depression in offspring. We searched pertinent, peer-reviewed articles published in English (January 1980 to April 2016) on MEDLINE, PsycINFO, and Science.gov. Twenty-three studies met the inclusion criteria. Most of the reviewed studies suffer from methodological limitations, including the small sample, the lack of a structured psychiatric diagnosis, and inclusion bias. Despite such limitations, paternal depression seems to be associated with an increased risk of developmental and behavioural problems and even psychiatric disorders in offspring. In particular, in infants and toddlers such problems vary from increased crying to hyperactivity and conduct problems to psychological and developmental impairment, and poor social outcomes. School-age children of depressed fathers have a doubled risk for suffering from specific psychiatric disorders. Hence, facilitating access to vigorous and evidence based treatments is a public health opportunity for improving the quality of life of depressed parents and their children. Evidences emerging from this review actually suggest that the traditional gender-focused approach to perinatal mood disorders should be completed by a family-centred approach, in order to improve the effectiveness of perinatal mental health programs. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Macrosomia, Perinatal and Infant Mortality in Cree Communities in Quebec, 1996-2010

PubMed Central

Xiao, Lin; Zhang, Dan-Li; Torrie, Jill; Auger, Nathalie; McHugh, Nancy Gros-Louis; Luo, Zhong-Cheng

2016-01-01

Background Cree births in Quebec are characterized by the highest reported prevalence of macrosomia (~35%) in the world. It is unclear whether Cree births are at greater elevated risk of perinatal and infant mortality than other First Nations relative to non-Aboriginal births in Quebec, and if macrosomia may be related. Methods This was a population-based retrospective birth cohort study using the linked birth-infant death database for singleton births to mothers from Cree (n = 5,340), other First Nations (n = 10,810) and non-Aboriginal (n = 229,960) communities in Quebec, 1996–2010. Community type was ascertained by residential postal code and municipality name. The primary outcomes were perinatal and infant mortality. Results Macrosomia (birth weight for gestational age >90th percentile) was substantially more frequent in Cree (38.0%) and other First Nations (21.9%) vs non-Aboriginal (9.4%) communities. Comparing Cree and other First Nations vs non-Aboriginal communities, perinatal mortality rates were 1.52 (95% confidence intervals 1.17, 1.98) and 1.34 (1.10, 1.64) times higher, and infant mortality rates 2.27 (1.71, 3.02) and 1.49 (1.16, 1.91) times higher, respectively. The risk elevations in perinatal and infant death in Cree communities attenuated after adjusting for maternal characteristics (age, education, marital status, parity), but became greater after further adjustment for birth weight (small, appropriate, or large for gestational age). Conclusions Cree communities had greater risk elevations in perinatal and infant mortality than other First Nations relative to non-Aboriginal communities in Quebec. High prevalence of macrosomia did not explain the elevated risk of perinatal and infant mortality in Cree communities. PMID:27517613

[Effect of perinatal recurrent infection on the brain development in immature mice].

PubMed

Song, Li-Li; Huang, Zhi-Heng; Pei, Yi-Ling; Chen, Chao

2014-12-01

To study the effects of perinatal recurrent infection on the brain development in immature mice. Six pregnant C57BL6 mice were randomly assigned to three groups: intrauterine infection, perinatal recurrent infection and control. The intrauterine infection group was intraperitoneally injected with LPS (0.5 mg/kg) on the 18th day of pregnancy. The perinatal recurrent infection group was injected with LPS (0.5 mg/kg) on the 18th day of pregnancy and their offsprings were intraperitoneally injected with the same dose of LPS daily from postnatal day 3 to 12. The control group was administered with normal saline at the same time points as the recurrent infection group. The short-time neurobehaviors were assessed on postnatal day 13. The mice were then sacrificed to measure brain weights and neuropathological changes using cresyl violet staining. Western blot was used to evaluate the expression of TNF-α, Caspase-3 and myelin basic protein (MBP). The brain weights of the recurrent infection group were significantly lower than the control and intrauterine infection groups (P<0.05) and the recurrent infection group displayed significant neuropathological changes. Perinatal recurrent infection resulted in increased expression levels of TNF-α and Caspase-3, and decreased expression level of MBP compared with the intrauterine infection and control groups (P<0.01). The neurobehavior test showed that the recurrent infection group used longer time in gait reflex, right reflex and geotaxis reflex compared with the control and intrauterine infection groups on postnatal day 13 (P<0.05). Perinatal recurrent infection may exacerbate inflammatory response and cell death in the immature brain, which may be one of the important factors for perinatal brain injury.

A SYSTEMATIC REVIEW OF INTERVENTIONS TARGETING PATERNAL MENTAL HEALTH IN THE PERINATAL PERIOD.

PubMed

Rominov, Holly; Pilkington, Pamela D; Giallo, Rebecca; Whelan, Thomas A

2016-05-01

Interventions targeting parents' mental health in the perinatal period are critical due to potential consequences of perinatal mental illness for the parent, the infant, and their family. To date, most programs have targeted mothers. This systematic review explores the current status and evidence for intervention programs aiming to prevent or treat paternal mental illness in the perinatal period. Electronic databases were systematically searched to identify peer-reviewed studies that described an intervention targeting fathers' mental health in the perinatal period. Mental health outcomes included depression, anxiety, and stress as well as more general measures of psychological functioning. Eleven studies were identified. Three of five psychosocial interventions and three massage-technique interventions reported significant effects. None of the couple-based interventions reported significant effects. A number of methodological limitations were identified, including inadequate reporting of study designs, and issues with the timing of interventions. The variability in outcomes measures across the studies made it difficult to evaluate the overall effectiveness of the interventions. Father-focused interventions aimed at preventing perinatal mood problems will be improved if future studies utilize more rigorous research strategies. © 2016 Michigan Association for Infant Mental Health.

Recommendations for palliative and bereavement care in the NICU: a family-centered integrative approach.

PubMed

Kenner, C; Press, J; Ryan, D

2015-12-01

Technological advances have increased our ability to detect a life-threatening, life-limiting or lethal problem early in pregnancy, leaving parents months to anticipate a death or a prematurely born infant. Babies can also be born with unanticipated problems that could lead to death. In either scenario, perinatal palliative care should be offered as a strategy for family support. Since the preponderance of professional training focuses on saving lives, many health professionals are uncomfortable with palliative care. This article's purpose is to define best practices for the provision of family-centered perinatal and neonatal palliative care and provision of support to bereaved families experiencing anticipated and unanticipated life-limiting conditions or death of their infant. An overview of core concepts and values is presented, followed by intervention strategies to promote an integrated family-centered approach to palliative and bereavement care. The concluding section presents evidence-based recommendations.

KENNEDY SPACE CENTER, FLA. - STS-114 Mission Specialist Soichi Noguchi, who is with the Japanese Aerospace and Exploration Agency, looks at the inside of the Japanese Experiment Module (JEM) in the Space Station Processing Facility. He and other crew members are at KSC becoming familiar with Shuttle and mission equipment. The mission is Logistics Flight 1, which is scheduled to deliver supplies and equipment plus the external stowage platform to the International Space Station.

NASA Image and Video Library

2004-03-05

KENNEDY SPACE CENTER, FLA. - STS-114 Mission Specialist Soichi Noguchi, who is with the Japanese Aerospace and Exploration Agency, looks at the inside of the Japanese Experiment Module (JEM) in the Space Station Processing Facility. He and other crew members are at KSC becoming familiar with Shuttle and mission equipment. The mission is Logistics Flight 1, which is scheduled to deliver supplies and equipment plus the external stowage platform to the International Space Station.

Statistical Machine Translation of Japanese

DTIC Science & Technology

2007-03-01

hiragana and katakana) syllabaries…………………….. 20 3.2 Sample Japanese sentence showing kanji and kana……………………... 21 3.5 Japanese formality example...syllabary. 19 Figure 3.1. Japanese kana syllabaries, hiragana for native Japanese words, word endings, and particles, and katakana for foreign...Figure 3.2. Simple Japanese sentence showing the use of kanji, hiragana , and katakana. Kanji is used for nouns and verb, adjective, and

Komatsudani Then and Now: Continuity and Change in a Japanese Preschool

ERIC Educational Resources Information Center

Tobin, Joseph; Karasawa, Mayumi; Hsueh, Yeh

2004-01-01

In this article the reflections of the teachers and directors of Komatsudani Hoikuen ("day-care center") on a video the authors recently made at their preschool are used to explore processes of continuity and change in Japanese preschool education over the course of a generation. The social changes that are associated with changing…

Childhood Maltreatment and Perinatal Mood and Anxiety Disorders: A Systematic Review.

PubMed

Choi, Karmel W; Sikkema, Kathleen J

2016-12-01

Perinatal mood and anxiety disorders (PMADs) compromise maternal and child well-being and may be influenced by traumatic experiences across the life course. A potent and common form of trauma is childhood maltreatment, but its specific impact on PMADs is not well understood. A systematic review was undertaken to synthesize empirical literature on the relationship between maternal histories of childhood maltreatment and PMADs. Of the 876 citations retrieved, 35 reports from a total of 26,239 participants met inclusion criteria, documenting substantial rates of childhood maltreatment and PMADs. Robust trends of association were observed between childhood maltreatment and perinatal depression, as well as post-traumatic stress disorder, but findings for anxiety were less consistent. Examining multivariate results suggested that childhood maltreatment predicts PMADs above and beyond sociodemographic, psychiatric, perinatal, and psychosocial factors, but may also be partially mediated by variables such as later victimization and moderated by protective early relationships. Future research should test mediating and moderating pathways using prospective cohorts, expanding to cross-cultural settings and other disorder outcomes. Treatment and prevention of childhood maltreatment and its sequelae may help mitigate risk for perinatal psychopathology and its impact on maternal and child outcomes. © The Author(s) 2015.

Acculturation of Personality: A Three-Culture Study of Japanese, Japanese Americans, and European Americans.

PubMed

Güngör, Derya; Bornstein, Marc H; De Leersnyder, Jozefien; Cote, Linda; Ceulemans, Eva; Mesquita, Batja

2013-07-01

The present study tests the hypothesis that involvement with a new culture instigates changes in personality of immigrants that result in (a) better fit with the norms of the culture of destination and (b) reduced fit with the norms of the culture of origin. Participants were 40 Japanese first-generation immigrants to the United States, 57 Japanese monoculturals, and 60 U.S. monoculturals. All participants completed the Jackson Personality Inventory (JPI) as a measure of the Big Five; immigrants completed the Japanese American Acculturation Scale. Immigrants' fits with the cultures of destination and origin were calculated by correlating Japanese American mothers' patterns of ratings on the Big Five with the average patterns of ratings of European Americans and Japanese on the same personality dimensions. Japanese Americans became more "American" and less "Japanese" in their personality as they reported higher participation in the U.S. culture. The results support the view that personality can be subject to cultural influence.

Adverse perinatal conditions and the inner ear.

PubMed

Newton, V

2001-12-01

Epidemiological studies in a number of Western countries have attributed 6-14% of sensorineural hearing impairment from birth or early childhood to problems relating to the birth process [1-4]. In spite of this association it is not always clear in individual instances whether adverse perinatal conditions identified subsequently have been causative of a hearing loss or not. It is possible that the hearing impairment was the consequence of an earlier intrauterine insult or is a coincidental finding. Infants carrying genetic mutations for hearing loss may coincidentally experience perinatal stress. It is therefore important to investigate the cause of a hearing loss discovered in infancy irrespective of the history of the infant having experienced adverse conditions surrounding the time of birth. Copyright 2002 Published by Elsevier Science Ltd.

Perinatal depression and screening among Aboriginal Australians in the Kimberley.

PubMed

Kotz, Jayne; Munns, Ailsa; Marriott, Rhonda; Marley, Julia V

2016-02-01

Adhoc culturally questionable perinatal mental-health screening among Aboriginal women in the Kimberley. Mental-health issues, substance abuse and suicide attempts are high among young Aboriginal women in Australia. There is no evidence that the Edinburgh Postnatal Depression Scale (EPDS) is effective or culturally safe. Screening practices are complicated by limited understanding of the complex cultural interface between Western and Aboriginal beliefs and notions about health and mental-health. What is the current context of perinatal mental-health screening practices among Aboriginal women in the Kimberley and what might be considered a culturally safe approach? A review of the literature and exploration of current screening practices preceded community participatory action research (CPAR) of perinatal mental-health screening. More than 100 Kimberley women and 72 health practitioners contributed to this joint strategic body of work. Recommendations for practice include one single culturally appropriate Kimberley version of the EPDS.

Perinatal Factors Affecting Expression of Obsessive Compulsive Disorder in Children and Adolescents

PubMed Central

Wieland, Natalie; Carey, Kathleen; Vivas, Fé; Petty, Carter R.; Johnson, Jessica; Reichert, Elizabeth; Pauls, David; Biederman, Joseph

2008-01-01

Abstract Objective To examine whether adverse perinatal experiences of children are associated with obsessive compulsive disorder (OCD) in youth. Methods Subjects were 130 children and adolescents with OCD recruited from a family genetic study of pediatric OCD and 49 matched controls from a contemporaneous family case-control study of attention-deficit/hyperactivity disorder (ADHD). Subjects were comprehensively assessed in multiple domains of function. A systematic history of pregnancy, delivery, and infancy complications was obtained. Results Compared to normal controls, children with OCD had mothers with significantly higher rates of illness during pregnancy requiring medical care (χ2 = 8.61, p = 0.003) and more birth difficulties (induced labor, forceps delivery, nuchal cord, or prolonged labor) (χ2 = 7.51, p = 0.006). Among the OCD-affected children, we found several significant associations between adverse perinatal experiences and earlier age at onset, increased OCD severity, and increased risk for comorbid ADHD, chronic tic disorder, anxiety disorder, and major depressive disorder. Conclusion Although exploratory, our analyses found that children with OCD had higher rates of several adverse perinatal experiences compared with controls. Among OCD-affected children, comorbid psychopathology was predicted by specific perinatal risk factors. Prospective studies of perinatal adverse events that minimize potential recall bias and type I errors are needed. PMID:18759647

The Relationship of Assisted Reproductive Technology on Perinatal Outcomes in Triplet Gestations.

PubMed

Shah, Jaimin S; Roman, Tania; Viteri, Oscar A; Haidar, Ziad A; Ontiveros, Alejandra; Sibai, Baha M

2018-06-08

 To assess whether assisted reproductive technology (ART) is associated with increased risk of adverse perinatal outcomes in triplet gestations compared with spontaneous conception.  Secondary analysis of a multicenter randomized trial for the prevention of preterm birth in multiple gestations. Triplets delivered at ≥ 24 weeks were studied. The primary outcome was the rate of composite neonatal morbidity (CNM) that included one or more of the following: bronchopulmonary dysplasia, respiratory distress syndrome, necrotizing enterocolitis, culture proven sepsis, pneumonia, retinopathy of prematurity, intraventricular hemorrhage, periventricular leukomalacia, or perinatal death.  There were 381 triplets (127 women) of which 89 patients conceived via ART and 38 patients spontaneously. Women with ART were more likely to be older, Caucasian, married, nulliparous, have higher level of education, and develop pre-eclampsia. Spontaneously conceived triplets were more likely to delivery at an earlier gestation (31.2 ± 3.5 vs 32.8 ± 2.7 weeks) ( p  = 0.009) with a lower birth weight ( p  < 0.001). After adjusting for confounders, no differences were noted in culture proven sepsis, perinatal death, CNM, respiratory distress syndrome, or Apgar score < 7 at 5 minutes. All remaining perinatal outcomes were similar.  Triplets conceived by ART had similar perinatal outcomes compared with spontaneously conceived triplets. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Prognostic models for renal cell carcinoma recurrence: external validation in a Japanese population.

PubMed

Utsumi, Takanobu; Ueda, Takeshi; Fukasawa, Satoshi; Komaru, Atsushi; Sazuka, Tomokazu; Kawamura, Koji; Imamoto, Takashi; Nihei, Naoki; Suzuki, Hiroyoshi; Ichikawa, Tomohiko

2011-09-01

The aim of the present study was to compare the accuracy of three prognostic models in predicting recurrence-free survival among Japanese patients who underwent nephrectomy for non-metastatic renal cell carcinoma (RCC). Patients originated from two centers: Chiba University Hospital (n = 152) and Chiba Cancer Center (n = 65). The following data were collected: age, sex, clinical presentation, Eastern Cooperative Oncology Group performance status, surgical technique, 1997 tumor-node-metastasis stage, clinical and pathological tumor size, histological subtype, disease recurrence, and progression. Three western models, including Yaycioglu's model, Cindolo's model and Kattan's nomogram, were used to predict recurrence-free survival. Predictive accuracy of these models were validated by using Harrell's concordance-index. Concordance-indexes were 0.795 and 0.745 for Kattan's nomogram, 0.700 and 0.634 for Yaycioglu's model, and 0.700 and 0.634 for Cindolo's model, respectively. Furthermore, the constructed calibration plots of Kattan's nomogram overestimated the predicted probability of recurrence-free survival after 5 years compared with the actual probability. Our findings suggest that despite working better than other predictive tools, Kattan's nomogram needs be used with caution when applied to Japanese patients who have undergone nephrectomy for non-metastatic RCC. © 2011 The Japanese Urological Association.

US and territory telemedicine policies: identifying gaps in perinatal care

PubMed Central

Okoroh, Ekwutosi M.; Kroelinger, Charlan D.; Smith, Alexander M.; Goodman, David A.; Barfield, Wanda D.

2016-01-01

BACKGROUND Perinatal regionalization is a system of maternal and neonatal risk-appropriate health care delivery in which resources are ideally allocated for mothers and newborns during pregnancy, labor and delivery, and postpartum, in order to deliver appropriate care. Typically, perinatal risk-appropriate care is provided in-person, but with the advancement of technologies, the opportunity to provide care remotely has emerged. Telemedicine provides distance-based care to patients by consultation, diagnosis, and treatment in rural or remote US jurisdictions (states and territories). OBJECTIVE We sought to summarize the telemedicine policies of states and territories and assess if maternal and neonatal risk-appropriate care is specified. STUDY DESIGN We conducted a 2014 systematic World Wide Web–based review of publicly available rules, statutes, regulations, laws, planning documents, and program descriptions among US jurisdictions (N=59) on telemedicine care. Policies including language on the topics of consultation, diagnosis, or treatment, and those specific to maternal and neonatal risk-appropriate care were categorized for analysis. RESULTS Overall, 36 jurisdictions (32 states; 3 territories; and District of Columbia) (61%) had telemedicine policies with language referencing consultation, diagnosis, or treatment; 29 (49%) referenced consultation, 30 (51%) referenced diagnosis, and 35 (59%) referenced treatment. In all, 26 jurisdictions (22 states; 3 territories; and District of Columbia) (44%), referenced all topics. Only 3 jurisdictions (3 states; 0 territories) (5%), had policy language specifically addressing perinatal care. CONCLUSION The majority of states have published telemedicine policies, but few specify policy language for perinatal risk-appropriate care. By ensuring that language specific to the perinatal population is included in telemedicine policies, access to maternal and neonatal care can be increased in rural, remote, and resource

Eye movement control in reading unspaced text: the case of the Japanese script.

PubMed

Kajii, N; Nazir, T A; Osaka, N

2001-09-01

The present study examines the landing-site distributions of the eyes during natural reading of Japanese script: a script that mixes three different writing systems (Kanji, Hiragana, and Katakana) and that misses regular spacing between words. The results show a clear preference of the eyes to land at the beginning rather than the center of the word. In addition, it was found that the eyes land on Kanji characters more frequently than on Hiragana or Katakana characters. Further analysis for two- and three-character words indicated that the eye's landing-site distribution differs depending on type of the characters in the word: the eyes prefer to land at the word beginning only when the initial character of the word is a Kanji character. For pure Hiragana words, the proportion of initial fixations did not differ between character positions. Thus, as already indicated by Kambe (National Institute of Japanese Language Report 85 (1986) 29), the visual distinctiveness of the three Japanese scripts plays a role in guiding eye movements in reading Japanese.

Effects of 2 G hypergravity exposure on Bobwhite (Colinus virginianus) and Japanese quail (Coturnix coturnix japonica)

NASA Technical Reports Server (NTRS)

Ronca, April E.; Baer, Lisa A.; Everett, Erin M.; Shaughnessey, Rebecca; Foushee, Rebecca E.

2004-01-01

We compared reproductive fitness and early postnatal growth of Bobwhite (Colinus virginianus) and Japanese (Coturnix coturnix japonica) quail incubated and hatched during 2 G centrifugation. Fertilized Bobwhite and Japanese quail eggs were placed in portable incubators on the 8-ft International Space Station Test Bed (ISSTB) Centrifuge at NASA Ames Research Center. The quail eggs were incubated throughout hatching and reared until Postnatal day (P)4 at either 1.0, 1.2 or 2.0 G. Two days before hatching, candling revealed significantly greater numbers of viable Bobwhite than Japanese quail eggs at all g-loads. Bobwhite quail exhibited significantly better hatching success at all g-loads than did Japanese quail. Bobwhite hatchlings were sensitive to gravitational loading as evidenced by reduced postnatal body mass and length of 2 G hatchlings relative to 1 G control hatchlings. In contrast, mass and length of Japanese quail hatchlings were unaffected by 1.2 or 2 G exposure. Together, our findings provide evidence for superior viability and hatching success in Bobwhite quail relative to Japanese quail, coupled with greater sensitivity of postnatal body growth and development to 2 G loading. Bobwhite quail may be better suited than Japanese quail for scientific studies on space biology platforms.

Maternal and perinatal outcomes in pregnancies with multiple sclerosis: a case-control study.

PubMed

Yalcin, Serenat Eris; Yalcin, Yakup; Yavuz, And; Akkurt, Mehmet Ozgur; Sezik, Mekin

2017-05-24

To assess whether maternal multiple sclerosis (MS) is associated with adverse pregnancy outcomes by determining the clinical course of disease during pregnancy and postpartum throughout a 10-year-period in a single tertiary center. We conducted a case-control study that included pregnancies with a definitive diagnosis of MS (n=43), matched with 100 healthy pregnant women with similar characteristics. Maternal and perinatal data were retrieved from hospital files. Groups were compared with the Mann-Whitney and χ2 tests. Logistic regression models were constructed to determine independent effects. Maternal demographic and baseline laboratory data were similar across the groups. Rates of preterm delivery, fetal growth restriction, preeclampsia, gestational diabetes, stillbirth, cesarean delivery, congenital malformation, and 5-min Apgar score were comparable (P>0.05 for all). General anesthesia during cesarean delivery (96% vs. 39%, P=0.002), urinary tract infection (UTI) (12% vs. 3%, P=0.04), low 1-min Apgar score (21% vs. 9%, P=0.04), and nonbreastfeeding (33% vs. 2%, P=0.001) were more frequent in women with MS. The low 1-min Apgar score and breastfeeding rates were independent of general anesthesia and UTI in regression models. MS during pregnancy was not associated with adverse maternal and perinatal outcomes except UTI, low 1-min Apgar scores, and decreased breastfeeding rates.

The Perinatal Risk Index: Early Risks Experienced by Domestic Adoptees in the United States.

PubMed

Marceau, Kristine; De Araujo-Greecher, Marielena; Miller, Emily S; Massey, Suena H; Mayes, Linda C; Ganiban, Jody M; Reiss, David; Shaw, Daniel S; Leve, Leslie D; Neiderhiser, Jenae M

2016-01-01

We aimed to assess comprehensively the prevalence of perinatal risks experienced by a potentially high-risk yet understudied population of children domestically adopted in the United States. Data are from participant report and medical records from mothers (n = 580) who completed a domestic adoption placement with nonrelatives at or near birth (Mean placement age = 7 days). We describe a comprehensive measure of perinatal risks, including divergences from previous assessment tools and the incorporation of multiple reporters, and report the prevalence of various types of perinatal risks. The prevalence of each specific risk factor was generally low, although several risks were more prevalent in this sample than estimates from nationally representative publicly available data. Nearly the entire sample (99%) experienced some type of risk exposure. Birth mothers who placed their children for adoption domestically in the US experience higher levels of perinatal risks than the national average, but not for all specific types of risk. Thus, the developmental trajectories of children adopted domestically may systematically differ from the general population to the extent that these specific perinatal risks impact development.

Association between Hypoxia and Perinatal Arterial Ischemic Stroke: A Meta-Analysis

PubMed Central

Qu, Yi; Wu, Jinlin; Li, Xihong; Mu, Dezhi

2014-01-01

Background Perinatal arterial ischemic stroke (AIS) occurs in an estimated 17 to 93 per 100000 live births, yet the etiology is poorly understood. Although investigators have implicated hypoxia as a potential cause of AIS, the role of hypoxia in AIS remains controversial. The aim of this study was to estimate the association between perinatal hypoxia factors and perinatal arterial ischemic stroke through a meta-analysis of published observational studies. Patients and methods A systematic search of electronically available studies published through July 2013 was conducted. Publication bias and heterogeneity across studies were evaluated and summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with fixed-effects or random-effects models. Results A total of 8 studies describing the association between perinatal hypoxia factors and neonatal arterial ischemic stroke (AIS) met inclusion criteria, and 550 newborns with AIS were enrolled. The associations were found for AIS: preeclampsia (OR 2.14; 95% CI, 1.25 to 3.66), ventouse delivery (OR 2.23; 95% CI, 1.26 to 3.97), fetal heart rate abnormalities (OR 6.30; 95% CI, 3.84 to 10.34), reduced fetal movement (OR 5.35; 95% CI, 2.17 to 13.23), meconium-stained liquor (OR 3.05; 95% CI, 2.02 to 4.60), low Apgar score (OR 5.77; 95% CI, 1.66 to 20.04) and resuscitation at birth (OR 4.59; 95% CI, 3.23 to 6.52). Our data did not show any significant change of the mean risk estimate for oxytocin induction (OR 1.33; 95% CI, 0.84 to 2.11) and low arterial umbilical cord ph (OR 4.63; 95% CI 2.14 to 9.98). Conclusions There is a significant association between perinatal hypoxia factors and AIS. The result indicates that perinatal hypoxia maybe one of causes of AIS. Large scale prospective clinical studies are still warranted. PMID:24587227

Anti-Tuberculosis Policy of the Government General of Korea during Japanese-Colonial Period (1910-1945): From Simple Restriction to Active Enlightenment.

PubMed

Choi, Eun Kyung

2013-12-01

In this paper, I tried to examine the characteristic of anti-tuberculosis policy in colonial Korea and find out internal constraint of hygienic administration by Japanese government during Japanese-Colonial Period. Despite of high prevalence of tuberculosis among Japanese in Korea, the Japanese Government General of Korea had done almost nothing until 1936. Japan's hygienic administration was highly dependent upon hygienic police, and mainly with compulsory isolation and disinfection. It was inefficient in tuberculosis problem. In 1918, Japanese Government General enacted 'Ordinance of Prevention of Tuberculosis', solely based upon naive tuberculosis etiology in sputum; consisted of simple crackdown and isolation and had no effect due to the limit of anti-tuberculosis and health budget. Also the ordinance actually set limitation upon the tuberculosis facilities, only a few health care facilities could be affordable for tuberculosis patients. Since 1936, the Japanese Government General of Korea began tuberculosis prevention measures in earnest. Due to the Second Sino- Japanese War and World War II, there was urgent need to make Korean society and population as "safe, and healthy rear area". The Government organized 'Chosen Anti-tuberculosis Association' and highly pursued enlightment campaign. It was almost temporary measures of enlightenment and publicity. Also various types of health screening and tuberculosis prevalence research were introduced to Korean people. But it was not so effective to identify tuberculosis problem in Korea. Mass tuberculin test and X-ray test was introduced, but it was not well organized and scientifically designed. Besides, tuberculosis treatment facility was extremely rare because of strict isolation and high standard policy. Japanese Governemtn set numerous tuberculosis-counseling centers and mobilized public doctor for consulting tuberculosis, but the accessibility of centers was very low. Moreover, there was no source to establish

Register based monitoring shows decreasing socioeconomic differences in Finnish perinatal health

PubMed Central

Gissler, M; Merilainen, J; Vuori, E; Hemminki, E

2003-01-01

Study objective: Several studies on differences in infant outcome by socioeconomic position have been done, but these have usually been based on ad hoc data linkages. The aim of this paper was to investigate whether socioeconomic differences in perinatal health in Finland could be regularly monitored using routinely collected data from one single register. Design and setting: Since October 1990, the Finnish Medical Birth Register (MBR) has included data on maternal occupation. A special computer program that converted the occupation name into an occupational code and into a socioeconomic position was prepared. Perinatal health was measured with five different indicators. The Finnish MBR data for years 1991 to 1999 (n=565 863 newborns) were used in the study. The study period was divided into three, three year periods to study time trends. Results: An occupational code was derived for 95% of women, but it was not possible to define a socioeconomic position for 22% of women, including, for example, students and housewives (the group "Others"). For the rest, the data showed socioeconomic differences in all perinatal health indicators. Maternal smoking explained up to half of the excess risk for adverse perinatal outcome in the lowest socioeconomic group. The socioeconomic differences narrowed during the 1990s: infant outcome improved in the lowest socioeconomic group, but remained at the same level or even deteriorated in other groups. When comparing the lowest group with the highest group, the odds ratios (OR) adjusted for maternal background characteristics at least halved for prematurity (from 1.32 (95% confidence intervals 1.24 to 1.43) in 1991–1993 to 1.16 (1.08 to 1.25) in 1997–1999), for low birth weight (from 1.49 (1.36 to 1.63) to 1.25 (1.17 to 1.40)), and for perinatal mortality (from 1.79 (1.44 to 2.21) to 1.33 (1.07 to 1.66)). Conclusions: Social inequality in perinatal health outcomes exists in Finland, but seems to have diminished in the 1990s. These

Recurrence of preterm birth and perinatal mortality in northern Tanzania: registry-based cohort study.

PubMed

Mahande, Michael J; Daltveit, Anne K; Obure, Joseph; Mmbaga, Blandina T; Masenga, Gileard; Manongi, Rachel; Lie, Rolv T

2013-08-01

To estimate the recurrence risk of preterm delivery and estimate the perinatal mortality in repeated preterm deliveries. Prospective study in Tanzania of 18 176 women who delivered a singleton between 2000 and 2008 at KCMC hospital. The women were followed up to 2010 for consecutive births. A total of 3359 women were identified with a total of 3867 subsequent deliveries in the follow-up period. Recurrence risk of preterm birth and perinatal mortality was estimated using log-binomial regression and adjusted for potential confounders. For women with a previous preterm birth, the risk of preterm birth in a subsequent pregnancy was 17%. This recurrence risk was estimated to be 2.7-fold (95% CI: 2.1-3.4) of the risk of women with a previous term birth. The perinatal mortality of babies in a second preterm birth of the same woman was 15%. Babies born at term who had an older sibling that was born preterm had a perinatal mortality of 10%. Babies born at term who had an older sibling who was also born at term had a perinatal mortality of 1.7%. Previous delivery of a preterm infant is a strong predictor of future preterm births in Tanzania. Previous or repeated preterm births increase the risk of perinatal death substantially in the subsequent pregnancy. © 2013 Blackwell Publishing Ltd.

Americans and Japanese Nonverbal Communication. Linguistic Communications 15 (Papers in Japanese Linguistics 3).

ERIC Educational Resources Information Center

Taylor, Harvey M.

Each culture has its own nonverbal as well as its verbal language. Movements, gestures and sounds have distinct and often conflicting interpretations in different countries. For Americans communicating with Japanese, misunderstandings are of two types: Japanese behavior which is completely new to the American, and Japanese behavior which is…

Perinatal Problems and Psychiatric Comorbidity Among Children with ADHD

PubMed Central

Owens, Elizabeth B.; Hinshaw, Stephen P.

2013-01-01

Objective Among two large, independent samples of girls with attention-deficit/hyperactivity disorder (ADHD), we examined associations between specific (maternal gestational smoking and drug use, early labor, low birth weight, and infant breathing problems at birth) and cumulative prenatal and perinatal risk factors and psychiatric comorbidity during childhood. Method Data from the (a) Multimodal Treatment Study of Children with ADHD, a randomized clinical trial with 579 children aged 7 to 9.9 years with combined-type ADHD, and the (b) Berkeley Girls ADHD Longitudinal Sample, a naturalistic study of 140 girls with ADHD (93 combined-type and 47 inattentive-type) who were first seen when they were 6 to 12 years old, were analyzed separately. In each sample, perinatal risk factors were assessed retrospectively by maternal report, and current childhood psychiatric comorbidity was assessed using maternal report on the Diagnostic Interview Schedule for Children. Results Consistent findings across these two studies show that infant breathing problems, early labor, and total perinatal problems predicted childhood comorbid depression but not comorbid anxiety or externalizing disorders. These associations remained significant, in both samples, with control of family SES and maternal symptoms of ADHD and depression. Results attenuated slightly with control of the number of child comorbidities plus SES and maternal symptoms. Conclusion Accumulating evidence suggests that perinatal risk factors are important precursors of childhood psychiatric comorbidity and that the association between these risk factors and detrimental psychiatric outcomes cannot be explained by maternal psychiatric symptoms or SES during childhood. PMID:23581554

Japanese H-IIA rocket

NASA Image and Video Library

2013-11-14

The Japanese H-IIA rocket will be launching the GPM Core Observatory into orbit in 2014. Credit: JAXA The Global Precipitation Measurement (GPM) mission is an international partnership co-led by NASA and the Japan Aerospace Exploration Agency (JAXA) that will provide next-generation global observations of precipitation from space. GPM will study global rain, snow and ice to better understand our climate, weather, and hydrometeorological processes. As of Novermber 2013 the GPM Core Observatory is in the final stages of testing at NASA Goddard Space Flight Center. The satellite will be flown to Japan in the fall of 2013 and launched into orbit on an HII-A rocket in early 2014. For more on the GPM mission, visit gpm.gsfc.nasa.gov/. NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

Building Perinatal Case Manager Capacity Using Quality Improvement.

PubMed

Fitzgerald, Elaine

2015-01-01

Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote and support breastfeeding. A positive change was observed in infant feeding knowledge and case manager self-efficacy to promote breastfeeding. Among the 24 mothers participating in this QI initiative, 100% initiated and continued breastfeeding at 1 week postpartum, and 92% were breastfeeding at 2 weeks postpartum.

Neonatal Outcomes in the Birth Center Setting: A Systematic Review.

PubMed

Phillippi, Julia C; Danhausen, Kathleen; Alliman, Jill; Phillippi, R David

2018-01-01

This systematic review investigates the effect of the birth center setting on neonatal mortality in economically developed countries to aid women and clinicians in decision making. We searched the Google Scholar, CINAHL, and PubMed databases using key terms birth/birthing center or out of hospital with perinatal/neonatal outcomes. Ancestry searches identified additional studies, and an alert was set for new publications. We included primary source studies in English, published after 1980, conducted in a developed country, and researching planned birth in centers with guidelines similar to American Association of Birth Centers standards. After initial review, we conducted a preliminary analysis, assessing which measures of neonatal health, morbidity, and mortality were included across studies. Neonatal mortality was selected as the sole summary measure as other measures were sporadically reported or inconsistently defined. Seventeen studies were included, representing at least 84,500 women admitted to a birth center in labor. There were substantial differences of study design, sampling techniques, and definitions of neonatal outcomes across studies, limiting conclusive statements of the effect of intrapartum care in a birth center. No reviewed study found a statistically increased rate of neonatal mortality in birth centers compared to low-risk women giving birth in hospitals, nor did data suggest a trend toward higher neonatal mortality in birth centers. As in all birth settings, nulliparous women, women aged greater than 35 years, and women with pregnancies of more than 42 weeks' gestation may have an increased risk of neonatal mortality. There are substantial flaws in the literature concerning the effect of birth center care on neonatal outcomes. More research is needed on subgroups at risk of poor outcomes in the birth center environment. To expedite research, consistent use of national and international definitions of perinatal and neonatal mortality within

Detraditionalisation: Japanese Students in the USA.

ERIC Educational Resources Information Center

Ueno, Junko

2001-01-01

Focuses on the identity formation of Japanese students temporarily living in the United States. The students were enrolled in Japanese Saturday school and in American public schools. Student interviews reveal a mixture of Japanese and American characteristics. Suggests Japanese students do not reject either culture--Japanese or American--but that…

Japanese-English language equivalence of the Cognitive Abilities Screening Instrument among Japanese-Americans.

PubMed

Gibbons, Laura E; McCurry, Susan; Rhoads, Kristoffer; Masaki, Kamal; White, Lon; Borenstein, Amy R; Larson, Eric B; Crane, Paul K

2009-02-01

The Cognitive Abilities Screening Instrument (CASI) was designed for use in cross-cultural studies of Japanese and Japanese-American elderly in Japan and the U.S.A. The measurement equivalence in Japanese and English had not been confirmed in prior studies. We analyzed the 40 CASI items for differential item functioning (DIF) related to test language, as well as self-reported proficiency with written Japanese, age, and educational attainment in two large epidemiologic studies of Japanese-American elderly: the Kame Project (n=1708) and the Honolulu-Asia Aging Study (HAAS; n = 3148). DIF was present if the demographic groups differed in the probability of success on an item, after controlling for their underlying cognitive functioning ability. While seven CASI items had DIF related to language of testing in Kame (registration of one item; recall of one item; similes; judgment; repeating a phrase; reading and performing a command; and following a three-step instruction), the impact of DIF on participants' scores was minimal. Mean scores for Japanese and English speakers in Kame changed by <0.1 SD after accounting for DIF related to test language. In HAAS, insufficient numbers of participants were tested in Japanese to assess DIF related to test language. In both studies, DIF related to written Japanese proficiency, age, and educational attainment had minimal impact. To the extent that DIF could be assessed, the CASI appeared to meet the goal of measuring cognitive function equivalently in Japanese and English. Stratified data collection would be needed to confirm this conclusion. DIF assessment should be used in other studies with multiple language groups to confirm that measures function equivalently or, if not, form scores that account for DIF.

Representations of rituals and care in perinatal death in British midwifery textbooks 1937-2004.

PubMed

Cameron, Joan; Taylor, Julie; Greene, Alexandra

2008-09-01

to assess the evolution of attitudes and practices relating to perinatal loss through an analysis of British midwifery textbooks. a literature review of midwifery textbooks, written or edited by midwives, published in the UK after 1902, and a critical analysis of textbooks to determine the ideological and professional standpoints presented to readers. the rhetoric and ritual relating to perinatal loss as portrayed in British midwifery textbooks has changed, with the most dramatic changes taking place in the past 30 years. Evidence to support the changes is largely anecdotal, and little reference is made to research relating to perinatal death. The 'dirty' elements of perinatal death relating to the decay that takes place in the baby's body after death are not addressed. The critique of psychological theory relating to loss is absent, as are alternatives to the model proposed by Kübler Ross. Cultural aspects of loss and bereavement are rarely addressed. the review of midwifery textbooks suggests that an ideological shift has taken place in relation to perinatal loss. The changing demographic trends, and the shift of birth and death from home to hospital, have altered the expectations and experiences of parents and professionals. Midwifery textbooks provide readers with a prescribed and formulaic approach to perinatal loss. the absence of information relating to the appearance of the dead baby, together with the lack of clinical exposure, may mean that midwives are unable to provide parents with appropriate information. The lack of reference to an evidence base that may conflict with the ideology presented in the midwifery textbooks leaves readers with an incomplete understanding of the professional issues relating to perinatal loss.

Marketing and Quality of Life: A Model for Improving Perinatal Health Status

ERIC Educational Resources Information Center

Dever, G. E. Alan; Smith, Leah T.; Stamps, Bunnie V.

2005-01-01

Introduction: A marketing/business model using non-traditional Quality of Life measures was developed to assess perinatal health status on a micro-geographic level. This perinatal health status needs assessment study for Georgia South Central Region was conducted for the years 1994-1999. The model may be applied to any geographic unit in the…

Vitamin-caused faulty perinatal hormonal imprinting and its consequences in adult age.

PubMed

Csaba, G

2017-09-01

Lipid-soluble vitamins (vitamins A, D, E, and K) are actually hormones (exohormones), as they can be directly bound by hormone receptors or are in connection with molecules, which influence hormone receptors. Vitamin D is a transition between endo- and exohormones and the possibility of similar situation in case of other lipid-soluble hormones is discussed. The perinatal exposition with these "vitamins" can cause faulty perinatal hormonal imprinting with similar consequences as the faulty imprinting by the synthetic endohormones, members of the same hormone family or industrial, communal, or medical endocrine disruptors. The faulty imprinting leads to late (lifelong) consequences with altered hormone binding by receptors, altered sexuality, brain function, immunity, bone development, and fractures, etc. In addition, as hormonal imprinting is an epigenetic process, the effect of a single exposure by fat-soluble vitamins is inherited to the progeny generations. As vitamins are handled differently from hormones; however, perinatal treatments take place frequently and sometimes it is forced, the negative late effect of faulty perinatal vitamin-caused hormonal imprinting must be considered.

Single-dose pharmacokinetic study comparing the pharmacokinetics of recombinant human chorionic gonadotropin in healthy Japanese and Caucasian women and recombinant human chorionic gonadotropin and urinary human chorionic gonadotropin in healthy Japanese women.

PubMed

Bagchus, Wilhelmina; Wolna, Peter; Uhl, Wolfgang

2018-01-01

Recombinant hCG (r-hCG) was approved in Japan in 2016. As a prerequisite for a Phase III study in Japan related to this approval, the pharmacokinetic (PK) profile of r-hCG was investigated. An open-label, partly randomized, single-center, single-dose, group-comparison, Phase I PK-bridging study was done that compared a single 250 μg dose of r-hCG with a single 5000 IU dose of urinary hCG (u-hCG) in healthy Japanese women, as well as comparing a single 250 μg dose of r-hCG in Japanese and Caucasian women. The Japanese participants were randomized 1:1 to receive either r-hCG or u-hCG, while the Caucasian participants were weight-matched to the Japanese participants who were receiving r-hCG in a 1:1 fashion. The primary PK parameters were the area under the serum concentration-time curve from time 0 extrapolated to infinity (AUC 0-∞ ) and the maximum serum concentration (C max ). The mean serum hCG concentration-time profiles of r-hCG in the Japanese and Caucasian participants were a similar shape, but the level of overall exposure was ~20% lower in the Japanese participants. For the Japanese participants, r-hCG resulted in an 11% lower C max but a 19% higher AUC 0-∞ compared with u-hCG. No new safety signal was identified. This study cannot exclude a potential difference in the PK profile of r-hCG between Japanese and Caucasian participants. However, this study does not indicate that there are clinically relevant differences in the serum PK of r-hCG and u-hCG in the Japanese participants.

Self-efficacy and postpartum depression teaching behaviors of hospital-based perinatal nurses.

PubMed

Logsdon, M Cynthia; Foltz, Melissa Pinto; Scheetz, James; Myers, John A

2010-01-01

Based upon the Self-Efficacy Theory, this study examined the relationship between self-efficacy, self-efficacy-related variables, and postpartum depression teaching behaviors of hospital-based perinatal nurses. Findings revealed that teaching new mothers about postpartum depression is related to a perinatal nurse's self-efficacy in postpartum-depression teaching, self-esteem, and the following self-efficacy-related variables: social persuasion (supervisor's expectations for teaching); mastery (postpartum depression continuing education and teaching experience); and vicarious experience (observing other nurses teach new mothers about postpartum depression). Teaching new mothers about postpartum depression can assist mothers in overcoming barriers to depression treatment. Nurse educators and managers play an important role in encouraging postpartum depression education for perinatal nurses.

Identifying the educational needs of nursing staff: the role of the clinical nurse specialist in perinatal nursing.

PubMed

Millhaem, Toni Brown; Timm, Kathleen

2007-01-01

One of the priorities of the perinatal clinical nurse specialist is the identification of educational needs. This article describes the experience of 2 perinatal clinical nurse specialists and presents various methods for identifying the educational needs of perinatal nursing staff in the hospital setting.

Midwives and the Computerization of Perinatal Data Entry: The Theory of Beneficial Engagement.

PubMed

Craswell, Alison; Moxham, Lorna; Broadbent, Marc

2016-10-01

Theory building in nursing and midwifery both to explain and inform practice is important to advance these professions via provision of a theoretical foundation. This research explored the process of perinatal data entry undertaken by midwives to explore the impact of the movement from paper to computer collection of data. Use of grounded theory methodology enabled theory building, leading to a theoretical understanding of the phenomenon and development of the Theory of Beneficial Engagement grounded in the data. Methods involved in-depth semistructured interviews with 15 users of perinatal data systems. Participants were recruited from 12 different healthcare locations and were utilizing three different electronic systems for data entry. The research question that guided the study focused on examining the influences of using the computer for perinatal data entry. Findings indicated that qualities particular to some midwives denoted engagement with perinatal data entry, suggesting a strong desire to enter complete, timely, and accurate data. The Theory of Beneficial Engagement provides a model of user engagement with systems for perinatal data entry consistent with other theories of engagement. The theory developed describes this phenomenon in a simple, elegant manner that can be applied to other areas where mandatory data entry is undertaken.

A cross-sectional survey of policies guiding second stage labor in urban Japanese hospitals, clinics and midwifery birth centers.

PubMed

Baba, Kaori; Kataoka, Yaeko; Nakayama, Kaori; Yaju, Yukari; Horiuchi, Shigeko; Eto, Hiromi

2016-02-24

The Japan Academy of Midwifery developed and disseminated the '2012 Evidence-based Guidelines for Midwifery Care (Guidelines for Midwives)' for low-risk births to achieve a more uniform standard of care during childbirth in Japan. The objective of this study was to cross-sectional survey policy implementation regarding care during the second stage of labor at Japanese hospitals, clinics, and midwifery birth centers, and to compare those policies with the recommendations in Guidelines for Midwives. This study was conducted in the four major urbanized areas (e.g. Tokyo) of the Kanto region of Japan. Respondents were chiefs of the institutions (obstetricians/midwives), nurse administrators (including midwives) of the obstetrical departments, or other nurse/midwives who were well versed in the routine care of the targeted institutions. The Guidelines implementation questionnaire comprised 12 items. Data was collected from October 2010 to July 2011. The overall response was 255 of the 684 institutions (37%). Of the total responses 46% were hospitals, 26% were clinics and 28% were midwifery birth centers. Few institutions reported perineal massage education for 'almost all cases'. Using 'active birth' were all midwifery birth centers, 56% hospitals and 32% clinics. Few institutions used water births. The majority of hospitals (73%) and clinics (80%) but a minority (39%) of midwifery birth centers reported 'not implemented' about applying warm compress to the perineum. Few midwifery birth centers (10%) and more hospitals (38%) and clinics (50%) had a policy for valsalva as routine care. Many hospitals (90%) and clinics (88%) and fewer midwifery birth centers (54%) offered hands-on technique to provide perineal support during birth. A majority of institutions used antiseptic solution for perineal disinfection. Few institutions routinely used episiotomies for multiparas, however routine use for primiparas was slightly more in hospitals (21%) and clinics (25%). All

Using action research to develop midwives' skills to support women with perinatal mental health needs.

PubMed

Madden, Deirdre; Sliney, Annmarie; O'Friel, Aoife; McMackin, Barbara; O'Callaghan, Bernie; Casey, Kate; Courtney, Lisa; Fleming, Valerie; Brady, Vivienne

2018-02-01

The aim of the research was to identify and develop midwives' skills to support women with mental health needs during pregnancy, using an action research approach. A review of perinatal mental health services in a large Dublin maternity unit revealed a high number of referred women who 'did not attend' the perinatal mental health service with few guidelines in place to support midwives in identifying and referring women for specialist help. Action research using cooperative inquiry involved a mental health nurse specialist and a team of midwives, who were drawn to each other in mutual concern about an area of practice. Data were gathered from three Cooperative Inquiry meetings, which incorporated one main Action Research Cycle of constructing, planning, taking and evaluating action. Data were analysed using a thematic content analysis framework. Participants experienced varying levels of uncertainty about how to support women with perinatal mental health needs. Cooperative inquiry supported participants in making sense of how they understood perinatal mental health and how they managed challenges experienced when caring for women with perinatal mental health issues. Participants developed a referral pathway, highlighted the significance of education to support women with perinatal mental health issues and identified the value of using open questions to promote conversation with pregnant women about mental health. Midwives value education and support to identify and refer women at risk of perinatal mental health issues. Cooperative inquiry, with a focus on action and shared reflection, facilitated the drawing together of two professional groups with diverse knowledge bases to work together to develop practice in an area of mutual concern. Perinatal mental health is a significant public health issue and midwives need support to make psychosocial assessments and to negotiate access to specialist services where available and when required. © 2017 John Wiley & Sons

Perinatal Asphyxia in a Nonhuman Primate Model

PubMed Central

Misbe, Elizabeth N. Jacobson; Richards, Todd L.; McPherson, Ronald J.; Burbacher, Thomas M.; Juul, Sandra E.

2011-01-01

Perinatal asphyxia is a leading cause of brain injury in neonates, occurring in 2–4 per 1,000 live births, and there are limited treatment options. Because of their similarity to humans, nonhuman primates are ideal for performing preclinical tests of safety and efficacy for neurotherapeutic interventions. We previously developed a primate model of acute perinatal asphyxia using 12–15 min of umbilical cord occlusion. Continuing this research, we have increased cord occlusion time from 15 to 18 min and extended neurodevelopmental follow-up to 9 months. The purpose of this report is to evaluate the increase in morbidity associated with 18 min of asphyxia by comparing indices obtained from colony controls, nonasphyxiated controls and asphyxiated animals. Pigtail macaques were delivered by hysterotomy after 0, 15 or 18 min of cord occlusion, then resuscitated. Over the ensuing 9 months, for each biochemical and physiologic parameters, behavioral and developmental evaluations, and structural and spectroscopic MRI were recorded. At birth, all asphyxiated animals required resuscitation with positive pressure ventilation and exhibited biochemical and clinical characteristics diagnostic of hypoxic-ischemic encephalopathy, including metabolic acidosis and attenuated brain activity. Compared with controls, asphyxiated animals developed long-term physical and cognitive deficits. This preliminary report characterizes the acute and chronic consequences of perinatal asphyxia in a nonhuman primate model, and describes diagnostic imaging tools for quantifying correlates of neonatal brain injury as well as neurodevelopmental tests for evaluating early motor and cognitive outcomes. PMID:21659720

Perinatal asphyxia in a nonhuman primate model.

PubMed

Jacobson Misbe, Elizabeth N; Richards, Todd L; McPherson, Ronald J; Burbacher, Thomas M; Juul, Sandra E

2011-01-01

Perinatal asphyxia is a leading cause of brain injury in neonates, occurring in 2-4 per 1,000 live births, and there are limited treatment options. Because of their similarity to humans, nonhuman primates are ideal for performing preclinical tests of safety and efficacy for neurotherapeutic interventions. We previously developed a primate model of acute perinatal asphyxia using 12-15 min of umbilical cord occlusion. Continuing this research, we have increased cord occlusion time from 15 to 18 min and extended neurodevelopmental follow-up to 9 months. The purpose of this report is to evaluate the increase in morbidity associated with 18 min of asphyxia by comparing indices obtained from colony controls, nonasphyxiated controls and asphyxiated animals. Pigtail macaques were delivered by hysterotomy after 0, 15 or 18 min of cord occlusion, then resuscitated. Over the ensuing 9 months, for each biochemical and physiologic parameters, behavioral and developmental evaluations, and structural and spectroscopic MRI were recorded. At birth, all asphyxiated animals required resuscitation with positive pressure ventilation and exhibited biochemical and clinical characteristics diagnostic of hypoxic-ischemic encephalopathy, including metabolic acidosis and attenuated brain activity. Compared with controls, asphyxiated animals developed long-term physical and cognitive deficits. This preliminary report characterizes the acute and chronic consequences of perinatal asphyxia in a nonhuman primate model, and describes diagnostic imaging tools for quantifying correlates of neonatal brain injury as well as neurodevelopmental tests for evaluating early motor and cognitive outcomes. Copyright © 2011 S. Karger AG, Basel.

Perinatal complications in women with kidney transplant.

PubMed

Vázquez-Rodríguez, Juan G; Ríos-Chavarría, Ana L

2012-01-01

Pregnancy in patients with kidney grafts is considered high-risk. Determine perinatal complications in women with kidney transplants treated by our hospital and compare them with complications reported in national and international literature. We studied perinatal complications in 18 patients with renal transplantation who delivered 19 newborns and were treated between 1 January 2009 and 31 December 2010. Results were compared with previous reports. Maternal age: 28.27 ± 4.70 years old, parity: 2, interval from transplant to conception: 7.52 ± 6.20 years, first prenatal visit 14.35 ± 6.74 weeks, prenatal care: 18.88 ± 9.18 weeks, 6 prenatal visits, gestational age at birth: 33.11 ± 8.72 weeks. Maternal complications: cesarean section: 88.88%, blood transfusion: 38.88%, anaemia: 33.33%, premature rupture of membranes: 22.22%, preterm delivery: 22.22%, urinary tract infection: 16.66%, preeclampsia: 11.11%, uncontrolled hypertension: 11.11%, miscarriage: 11.11%, uterine antony: 5.55%, gestational diabetes: 0%, and mortality: 0%. Foetal complications: premature birth: 52.63%, mortality: 21.05%, intensive care: 21.05%, and low birth weight due to growth restriction: 10.52%. Transplantation complications: filtration impairment without need for dialysis: 5.55%, graft rejection: 0%, and graft loss: 0%. The frequency of perinatal complications was high. Pregnancy had no adverse effect on renal function and patient survival. Stable renal grafts in women of childbearing age is not necessarily a contraindication for pregnancy.

Globalization and perinatal medicine--how do we respond?

PubMed

Kurjak, Asim; Di Renzo, Gian Carlo; Stanojevic, Milan

2010-04-01

Globalization is both inevitable and usually desirable and contains advantageous and disadvantageous issues. It is a source of both hope and of apprehension and is an accelerating process in flow of information, technology, goods and services, and production means. Globalization has a complex influence on perinatal health. The bonds that link perinatologists together transcend geographic, political, religious, and lingual differences, resulting in a globalization that optimizes perinatal care. In this review, we will discuss some of the global problems facing modern perinatologists. Close to 1.5 billion people in the world, live in extreme poverty, a situation which is particularly stark in the developing world, where 80% of them live. Poor people have little or no access to qualified health services and education, and do not participate in the decisions critical to their day-to-day lives. Poverty cannot be defined solely in terms of lack of income. A person, a family, even a nation is not deemed poor only because of low economic resources. Little or no access to health services, lack of access to safe water and adequate nutrition, illiteracy or low educational level, and a distorted perception of rights and needs are also essential components of poverty. Expression of poverty in perinatal health care in developing countries are high maternal death and morbidity rates, huge perinatal and childhood losses, and high birth rates. There are good reasons to define it as a global tragedy in our time. Although the mankind has come quite far because the development of civilization and more advances in the health care were made during the past 100 years than in all previous human history, some inhabitants of our planet are not able to experience it. According to some data, every 3 s a newborn dies, and every minute a pregnant woman dies in the globalized world. All together over 10 million deaths every year, which indicates that health security is not strong enough. It is

Perinatal transmission of human papilomavirus DNA

PubMed Central

Rombaldi, Renato L; Serafini, Eduardo P; Mandelli, Jovana; Zimmermann, Edineia; Losquiavo, Kamille P

2009-01-01

The purpose was to study the perinatal transmission of human papillomavirus DNA (HPV-DNA) in 63 mother-newborn pairs, besides looking at the epidemiological factors involved in the viral DNA transmission. The following sampling methods were used: (1) in the pregnant woman, when was recruited, in cervix and clinical lesions of the vagina, vulva and perineal region; (2) in the newborn, (a) buccal, axillary and inguinal regions; (b) nasopharyngeal aspirate, and (c) cord blood; (3) in the children, buccal was repeated in the 4th week and 6th and 12th month of life. HPV-DNA was identified using two methodologies: multiplex PCR (PGMY09 and MY11 primers) and nested-PCR (genotypes 6/11, 16, 18, 31, 33, 42, 52 and 58). Perinatal transmission was considered when concordance was found in type-specific HPV between mother/newborn or mother/child. HPV-DNA genital was detected in 49 pregnant women submitted to delivery. Eleven newborns (22.4%, n = 11/49) were HPV-DNA positive. In 8 cases (16.3%, n = 8/49) there was type specific HPV concordance between mother/newborn samples. At the end of the first month of life three children (6.1%, n = 3/49) became HPV-DNA positive, while two remained positive from birth. In 3 cases (100%, n = 3/3) there was type specific HPV concordance between mother/newborn samples. In the 6th month, a child (2%, n = 1/49) had become HPV-DNA positive between the 1st and 6th month of life, and there was type specific HPV concordance of mother/newborn samples. All the HPV-DNA positive children (22.4%, n = 11/49) at birth and at the end first month of life (6.1%, n = 3/49) became HPV-DNA negative at the age of 6 months. The HPV-DNA positive child (2%, n = 1/49) from 1st to the 6th month of life became HPV-DNA negative between the 6th and 12th month of life and one child had anogenital warts. In the twelfth month all (100%, n = 49/49) the children studied were HPV-DNA negative. A positive and significant correlation was observed between perinatal transmission

Japanese Experiment Module (JEM)

NASA Technical Reports Server (NTRS)

2003-01-01

The Japanese Experiment Module (JEM) pressure module is removed from its shipping crate and moved across the floor of the Space Station Processing Facility at Kennedy Space Center (KSC) to a work stand. A research laboratory, the pressurized module is the first element of the JEM, named 'Kibo' (Hope) to arrive at KSC. Japan's primary contribution to the International Space Station, the module will enhance unique research capabilities of the orbiting complex by providing an additional environment in which astronauts will conduct experiments. The JEM also includes an exposed facility or platform for space environment experiments, a robotic manipulator system, and two logistics modules. The various JEM components will be assembled in space over the course of three Shuttle missions.

US and territory telemedicine policies: identifying gaps in perinatal care.

PubMed

Okoroh, Ekwutosi M; Kroelinger, Charlan D; Smith, Alexander M; Goodman, David A; Barfield, Wanda D

2016-12-01

Perinatal regionalization is a system of maternal and neonatal risk-appropriate health care delivery in which resources are ideally allocated for mothers and newborns during pregnancy, labor and delivery, and postpartum, in order to deliver appropriate care. Typically, perinatal risk-appropriate care is provided in-person, but with the advancement of technologies, the opportunity to provide care remotely has emerged. Telemedicine provides distance-based care to patients by consultation, diagnosis, and treatment in rural or remote US jurisdictions (states and territories). We sought to summarize the telemedicine policies of states and territories and assess if maternal and neonatal risk-appropriate care is specified. We conducted a 2014 systematic World Wide Web-based review of publicly available rules, statutes, regulations, laws, planning documents, and program descriptions among US jurisdictions (N = 59) on telemedicine care. Policies including language on the topics of consultation, diagnosis, or treatment, and those specific to maternal and neonatal risk-appropriate care were categorized for analysis. Overall, 36 jurisdictions (32 states; 3 territories; and District of Columbia) (61%) had telemedicine policies with language referencing consultation, diagnosis, or treatment; 29 (49%) referenced consultation, 30 (51%) referenced diagnosis, and 35 (59%) referenced treatment. In all, 26 jurisdictions (22 states; 3 territories; and District of Columbia) (44%), referenced all topics. Only 3 jurisdictions (3 states; 0 territories) (5%), had policy language specifically addressing perinatal care. The majority of states have published telemedicine policies, but few specify policy language for perinatal risk-appropriate care. By ensuring that language specific to the perinatal population is included in telemedicine policies, access to maternal and neonatal care can be increased in rural, remote, and resource-challenged jurisdictions. Published by Elsevier Inc.

Detection and Prevention of Perinatal Infection: Cytomegalovirus and Zika Virus.

PubMed

Wood, Amber M; Hughes, Brenna L

2018-06-01

Congenital cytomegalovirus is the most common viral congenital infection, and affects up to 2% of neonates. Significant sequelae may develop after congenital cytomegalovirus, including hearing loss, cognitive defects, seizures, and death. Zika virus is an emerging virus with perinatal implications; a congenital Zika virus syndrome has been identified, and includes findings such as microcephaly, fetal nervous system abnormalities, and neurologic sequelae after birth. Screening, diagnosis, prevention, and treatment of these perinatal infections are reviewed in this article. Copyright © 2018 Elsevier Inc. All rights reserved.

A theoretical framework for treating perinatal depression using couple-based interventions.

PubMed

Cohen, Matthew J; Schiller, Crystal E

2017-12-01

Between 10% and 20% of women will experience depression in the perinatal period, which begins during pregnancy and extends into the first year after delivery. Perinatal depression (PD) is associated with significant emotional and social impairments that impact women, their children, and their partners. Although the majority of women with PD do not seek treatment, a considerable proportion of those who engage in treatment do not achieve remission. The couples and depression literature suggests that interpersonal processes are central in the development and maintenance of depressive disorders and thus, as researchers seek safe and effective treatments for perinatal populations, there may be therapeutic benefit in examining the role that partners play in women's recovery. The primary goal of this practice review is to highlight the utility of including partners in treatment for maternal PD and propose a model for practitioners to guide their work with couples within this domain. Specifically, this model involves three key components of treatment: psychoeducation, communication training, and behavioral activation. Each component addresses distinct risk factors for women and couples in the perinatal period in hopes of offering guidance to practitioners for how to address PD symptomology through a dyadic lens. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Japanese Encephalitis: Frequently Asked Questions

MedlinePlus

... the vaccine, what should I do? What is Japanese encephalitis? Japanese encephalitis (JE) is a potentially severe ... cause inflammation of the brain (encephalitis). Where does Japanese encephalitis occur? JE occurs in Asia and parts ...

Role of self-compassion in psychological well-being among perinatal women.

PubMed

Felder, Jennifer N; Lemon, Elizabeth; Shea, Kerry; Kripke, Kate; Dimidjian, Sona

2016-08-01

Self-compassion is associated with depression and anxiety in general samples. Although recent research indicates that dysfunctional maternal attitudes predict the development of perinatal depression and anxiety symptoms, no research to date has examined the construct of self-compassion and its relationship with psychological well-being in perinatal women. Pregnant and postpartum women (N = 189) completed self-report measures of depression and anxiety history, current depression and anxiety symptom severity, and self-compassion. Women with higher depression and anxiety symptom severity had significantly lower self-compassion. Additionally, women with self-reported prior history of depression or anxiety had significantly lower self-compassion even while controlling for current depression or anxiety symptom severity, respectively. Our results suggest that self-compassion warrants further attention in the study of the development, maintenance, and treatment of perinatal mood and anxiety disorders.

Longitudinal study of perinatal maternal stress, depressive symptoms and anxiety.

PubMed

Liou, Shwu-Ru; Wang, Panchalli; Cheng, Ching-Yu

2014-06-01

to understand the trends in, and relationships between, maternal stress, depressive symptoms and anxiety in pregnancy and post partum. a prospective longitudinal survey study was undertaken to explore maternal psychological distress throughout the perinatal period. The participants were recruited after 24 completed weeks of gestation, and were followed-up monthly until one month post partum (four surveys in total). participants were recruited from a single hospital in southern Taiwan, and asked to complete questionnaires in the hospital waiting area. inclusion criteria were: age ≥18 years, able to read and write Chinese, ≥24 weeks of gestation, singleton pregnancy and no pregnancy complications (including a diagnosis of antenatal depression or anxiety disorder). In total, 197 women completed all four surveys (response rate 74.62%). stress was measured with the 10-item Perceived Stress Scale, depressive symptoms were measured with the Center for Epidemiologic Studies' Depression scale, and anxiety was measured with the Zung Self-reported Anxiety Scale. Participants were followed-up at four time points: T1 (25-29 gestational weeks), T2 (30-34 gestational weeks), T3 (>34 gestational weeks) and T4 (4-6 weeks post partum). Appointments for data collection were made in accordance with the participants' antenatal and postnatal check-ups. The three types of maternal distress had different courses of change throughout the perinatal period, as levels of depressive symptoms remained unchanged, anxiety levels increased as gestation advanced but declined after birth, and stress decreased gradually during pregnancy but returned to the T1 level after birth. There was a low to high degree of correlation in maternal stress, depressive symptoms and anxiety in pregnancy and post partum. around one-quarter of the study participants had depressive symptoms during pregnancy and post partum. Stress and anxiety showed opposing courses during the perinatal period. Regardless of the

Building Perinatal Case Manager Capacity Using Quality Improvement

PubMed Central

Fitzgerald, Elaine

2015-01-01

ABSTRACT Improving breastfeeding rates among Black women is a potential strategy to address disparities in health outcomes that disproportionately impact Black women and children. This quality improvement (QI) initiative aimed to improve perinatal case manager knowledge and self-efficacy to promote breastfeeding among Black, low-income women who use services through Boston Healthy Start Initiative. QI methodology was used to develop and test a two-part strategy for perinatal case managers to promote and support breastfeeding. A positive change was observed in infant feeding knowledge and case manager self-efficacy to promote breastfeeding. Among the 24 mothers participating in this QI initiative, 100% initiated and continued breastfeeding at 1 week postpartum, and 92% were breastfeeding at 2 weeks postpartum. PMID:26937160

Providing perinatal loss care: satisfying and dissatisfying aspects for midwives.

PubMed

Fenwick, Jennifer; Jennings, Belinda; Downie, Jill; Butt, Janice; Okanaga, Mayumi

2007-12-01

There is limited midwifery research that focuses on midwives experiences and attitudes to providing care for women who experience the death of a baby. There is also limited research investigating care components, and evidence to inform the basis of clinical practice in Australia and internationally. This paper presents the qualitative findings of a small study that aimed to investigate midwives experience, confidence and satisfaction with providing care for women who experienced perinatal loss. Eighty-three Western Australian midwives responded to an open ended question asking them to describe the most and least satisfying aspects of their role when providing care to women who experienced a perinatal loss. Thematic analysis was used to analyse the data. The analysis revealed that Australian midwives gained most satisfaction from providing skilled midwifery care that they considered made a difference to women. This was enabled when midwives were afforded the opportunity to provide continuity of midwifery carer to women throughout the labour, birth and early postnatal period. In terms of the least satisfying aspects of care, midwives identified that they struggled with the emotional commitment needed to provide perinatal loss care, as well as with how to communicate openly and share information with women. Within the context of the study setting, midwifery care for women following perinatal loss reflects the care components espoused in the literature. There are, however, organisational issues within health care that require commitment to continuity of care and further education of practitioners to enhance outcomes for clients.

Using perinatal morbidity scoring tools as a primary study outcome.

PubMed

Hutcheon, Jennifer A; Bodnar, Lisa M; Platt, Robert W

2017-11-01

Perinatal morbidity scores are tools that score or weight different adverse events according to their relative severity. Perinatal morbidity scores are appealing for maternal-infant health researchers because they provide a way to capture a broad range of adverse events to mother and newborn while recognising that some events are considered more serious than others. However, they have proved difficult to implement as a primary outcome in applied research studies because of challenges in testing if the scores are significantly different between two or more study groups. We outline these challenges and describe a solution, based on Poisson regression, that allows differences in perinatal morbidity scores to be formally evaluated. The approach is illustrated using an existing maternal-neonatal scoring tool, the Adverse Outcome Index, to evaluate the safety of labour and delivery before and after the closure of obstetrical services in small rural communities. Applying the proposed Poisson regression to the case study showed a protective risk ratio for adverse outcome following closures as compared with the original analysis, where no difference was found. This approach opens the door for considerably broader use of perinatal morbidity scoring tools as a primary outcome in applied population and clinical maternal-infant health research studies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Localized intestinal perforations as a potential complication of brain hypothermic therapy for perinatal asphyxia.

PubMed

Nishizaki, Naoto; Maiguma, Atsuko; Obinata, Kaoru; Okazaki, Tadaharu; Shimizu, Toshiaki

2016-01-01

Brain hypothermic therapy (BHT) is becoming a frequently used standard of care for perinatal asphyxia. Although cardiovascular side effects, coagulation disorders, renal impairment, electrolyte abnormalities, impaired liver function, opportunistic infections, and skin lesions are well-known adverse effects of BHT in newborns, little information is available on the clinical features of intestinal perforation-related BHT. We herein report a case of therapeutic brain cooling for perinatal asphyxia complicated by localized intestinal perforation. In practice, the neonatologist should be aware that intestinal perforation in an infant with perinatal asphyxia is possible, particularly following BHT.

Perinatal asphyxia: CNS development and deficits with delayed onset

PubMed Central

Herrera-Marschitz, Mario; Neira-Pena, Tanya; Rojas-Mancilla, Edgardo; Espina-Marchant, Pablo; Esmar, Daniela; Perez, Ronald; Muñoz, Valentina; Gutierrez-Hernandez, Manuel; Rivera, Benjamin; Simola, Nicola; Bustamante, Diego; Morales, Paola; Gebicke-Haerter, Peter J.

2013-01-01

Perinatal asphyxia constitutes a prototype of obstetric complications occurring when pulmonary oxygenation is delayed or interrupted. The primary insult relates to the duration of the period lacking oxygenation, leading to death if not re-established. Re-oxygenation leads to a secondary insult, related to a cascade of biochemical events required for restoring proper function. Perinatal asphyxia interferes with neonatal development, resulting in long-term deficits associated to mental and neurological diseases with delayed clinical onset, by mechanisms not yet clarified. In the experimental scenario, the effects observed long after perinatal asphyxia have been explained by overexpression of sentinel proteins, such as poly(ADP-ribose) polymerase-1 (PARP-1), competing for NAD+ during re-oxygenation, leading to the idea that sentinel protein inhibition constitutes a suitable therapeutic strategy. Asphyxia induces transcriptional activation of pro-inflammatory factors, in tandem with PARP-1 overactivation, and pharmacologically induced PARP-1 inhibition also down-regulates the expression of proinflammatory cytokines. Nicotinamide has been proposed as a suitable PARP-1 inhibitor. Its effect has been studied in an experimental model of global hypoxia in rats. In that model, the insult is induced by immersing rat fetus into a water bath for various periods of time. Following asphyxia, the pups are delivered, treated, and nursed by surrogate dams, pending further experiments. Nicotinamide rapidly distributes into the brain following systemic administration, reaching steady state concentrations sufficient to inhibit PARP-1 activity for several hours, preventing several of the long-term consequences of perinatal asphyxia, supporting the idea that nicotinamide constitutes a lead for exploring compounds with similar or better pharmacological profiles. PMID:24723845

Marked Liver Tumorigenesis by Helicobacter hepaticus Requires Perinatal Exposure

PubMed Central

Diwan, Bhalchandra A.; Sipowicz, Marek; Logsdon, Daniel; Gorelick, Peter; Anver, Miriam R.; Kasprzak, Kazimierz S.; Anderson, Lucy M.

2008-01-01

Background Although severe hepatitis and liver tumors occur in a high percentage of A/J male mice naturally infected with Helicobacter hepaticus, these effects have not been observed after injection of adult mice with the bacteria. Objectives We tested the hypothesis that perinatal exposure to the bacteria is required for liver tumorigenesis. Methods A/J female mice were infected by intragastric (ig) or intraperitoneal (ip) treatment with 1.5 × 108 H. hepaticus before pregnancy. We examined offspring at progressive time intervals, including some kept until natural death in old age. A/J, BALB/c, and C57BL/6 weanling male mice were similarly treated ig with the bacteria and observed for up to 2 years. Results After ip bacterial infection of A/J females, 41% of their male offspring developed hepatitis and 33% had hepatocellular tumors, including 18% with hepatocellular carcinoma. Treatment by the ig route resulted in a similar incidence of hepatitis in offspring (35%) but fewer total liver tumors (8%) and carcinomas (4%). By contrast, ig instillation of H. hepaticus in weanling A/J, C57BL/6, or BALB/c mice resulted in low incidence of hepatitis (0–20%) and few liver tumors, despite presence of bacteria confirmed in feces. Conclusions Results indicate that a high incidence of liver tumors in mice infected with H. hepaticus requires perinatal exposure. Contributing perinatal factors could include known high sensitivity of neonatal liver to tumor initiation, and/or modulation of immune response to the bacterium or its toxins. Mechanisms of human perinatal sensitivity to such phenomena can be studied with this model. PMID:18941577

Perinatal asphyxia, hypoxia, ischemia and hearing loss. An overview.

PubMed

Borg, E

1997-01-01

Birth hypoxia, asphyxia and ischemia have often been thought to be major causes of early hearing loss or deafness. The purpose of the present review is to focus on the role of these particular factors for perinatal auditory disorders. On the whole, only a small proportion of neonatal hearing loss is caused by perinatal factors. The exact etiology of neonatal hearing loss in children with complicated deliveries is difficult to evaluate due to the large number of causative factors that might be involved. After reviewing the literature covering the past 15-20 years, it is not possible to say that we understand the relative importance of different factors and their interactions. However, in the majority of studies, birth asphyxia is not correlated with hearing loss in babies with complicated deliveries Prolonged artificial ventilation, the presence of severe hypoxic ischemic encephalopathy or persistent pulmonary hypertension are important factors. The brain is more susceptible to anoxia than the ear and both are more likely to be damaged after prolonged pre-, peri- and postnatal hypoxia-ischemia than pure hypoxia during delivery. Perinatal hypoxia is more likely to cause a temporary hearing loss than a permanent one. Preterm babies are more vulnerable than term babies. The total number of risk factors, e.g. medicated by total length of stay in the neonatal intensive care unit and length of artificial ventilation, is the best predictor of risk for hearing loss of perinatal origin. The similarities between hearing loss and cerebral palsy are pointed out; only 8% of the cases of cerebral palsy are considered to be caused by conditions during delivery.

Study on the ethical concepts of the Japanese writer Yukio Mishima, ultra-nationalist.

PubMed

Yamamoto, K

2000-12-01

After WWII, ultra-nationalism, which was the leading ideology of wartime Japan, seemed to have lost its power to inspire the Japanese. In the 1960s, when the Japanese began to enjoy economic prosperity, Yukio Mishima, deploring that the Japanese were losing the traditional spirit and morality of the nation, was one of those citizens who felt a strong nostalgia for wartime Japan. In an attempt to revive the spiritual exaltation of wartime Japan, Mishima took radical action as an ultra-nationalist, and killed himself by Hara-kiri. Mishima's ethical concepts, which center on the ethos of warriors who dedicate themselves to the defense of their commune, have structural similarities to the ethical structure of the Kanun, which may be called the ethics of "blood". Mishima's theory of ultra-nationalism has a paradoxical logic, which seems to be related to the ethical concepts of a society without state power.

Unpiloted Japanese Kounotori HTV-2 Transfer Vehicle

NASA Image and Video Library

2011-01-27

ISS026-E-020844 (27 Jan. 2011) --- The unpiloted Japanese Kounotori2 H-II Transfer Vehicle (HTV2) approaches the International Space Station. The Japan Aerospace Exploration Agency (JAXA) launched HTV2 aboard an H-IIB rocket from the Tanegashima Space Center in southern Japan at 12:37 a.m. (EST) (2:27 p.m. Japan time) on Jan. 22, 2011. HTV2 is the second unpiloted cargo ship launched by JAXA to the station and will deliver more than four tons of food and supplies to the station and its crew members.

Unpiloted Japanese Kounotori HTV-2 Transfer Vehicle

NASA Image and Video Library

2011-01-27

ISS026-E-020916 (27 Jan. 2011) --- The unpiloted Japanese Kounotori2 H-II Transfer Vehicle (HTV2) approaches the International Space Station. The Japan Aerospace Exploration Agency (JAXA) launched HTV2 aboard an H-IIB rocket from the Tanegashima Space Center in southern Japan at 12:37 a.m. (EST) (2:27 p.m. Japan time) on Jan. 22, 2011. HTV2 is the second unpiloted cargo ship launched by JAXA to the station and will deliver more than four tons of food and supplies to the space station and its crew members.

Acculturation of Personality: A Three-Culture Study of Japanese, Japanese Americans, and European Americans

PubMed Central

Güngör, Derya; Bornstein, Marc H.; De Leersnyder, Jozefien; Cote, Linda; Ceulemans, Eva; Mesquita, Batja

2013-01-01

The present study tests the hypothesis that involvement with a new culture instigates changes in personality of immigrants that result in (a) better fit with the norms of the culture of destination and (b) reduced fit with the norms of the culture of origin. Participants were 40 Japanese first-generation immigrants to the United States, 57 Japanese monoculturals, and 60 U.S. monoculturals. All participants completed the Jackson Personality Inventory (JPI) as a measure of the Big Five; immigrants completed the Japanese American Acculturation Scale. Immigrants’ fits with the cultures of destination and origin were calculated by correlating Japanese American mothers’ patterns of ratings on the Big Five with the average patterns of ratings of European Americans and Japanese on the same personality dimensions. Japanese Americans became more “American” and less “Japanese” in their personality as they reported higher participation in the U.S. culture. The results support the view that personality can be subject to cultural influence. PMID:23935211

KENNEDY SPACE CENTER, FLA. - - In the Space Station Processing Facility, STS-114 Mission Specialist Stephen Robinson (left) learns about the Japanese Experiment Module (JEM) from Jennifer Goldsmith (center), with United Space Alliance at Johnson Space Center, and Louise Kleba (right), with USA at KSC. Crew members are at KSC to become familiar with Shuttle and mission equipment. The mission is Logistics Flight 1, which is scheduled to deliver supplies and equipment plus the external stowage platform to the International Space Station.

NASA Image and Video Library

2004-03-05

KENNEDY SPACE CENTER, FLA. - - In the Space Station Processing Facility, STS-114 Mission Specialist Stephen Robinson (left) learns about the Japanese Experiment Module (JEM) from Jennifer Goldsmith (center), with United Space Alliance at Johnson Space Center, and Louise Kleba (right), with USA at KSC. Crew members are at KSC to become familiar with Shuttle and mission equipment. The mission is Logistics Flight 1, which is scheduled to deliver supplies and equipment plus the external stowage platform to the International Space Station.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, STS-114 Mission Specialist Stephen Robinson (right) learns about the Japanese Experiment Module (JEM) from Louise Kleba (left), with United Space Alliance at KSC, and Jennifer Goldsmith (center), with USA at Johnson Space Center. Crew members are at KSC becoming familiar with Shuttle and mission equipment. The mission is Logistics Flight 1, which is scheduled to deliver supplies and equipment plus the external stowage platform to the International Space Station.

NASA Image and Video Library

2004-03-05

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, STS-114 Mission Specialist Stephen Robinson (right) learns about the Japanese Experiment Module (JEM) from Louise Kleba (left), with United Space Alliance at KSC, and Jennifer Goldsmith (center), with USA at Johnson Space Center. Crew members are at KSC becoming familiar with Shuttle and mission equipment. The mission is Logistics Flight 1, which is scheduled to deliver supplies and equipment plus the external stowage platform to the International Space Station.

Influence of farewell rituals and psychological vulnerability on grief following perinatal loss in monochorionic twin pregnancy.

PubMed

Druguet, Mònica; Nuño, Laura; Rodó, Carlota; Arévalo, Silvia; Carreras Moratonas, Elena; Gómez-Benito, Juana

2017-11-02

The aim of this study is to analyze whether the absence of farewell rituals and previous psychological vulnerability are associated with the intensity of grief following perinatal loss in monochorionic twin pregnancy. The sample comprised 28 women who experienced perinatal loss following fetal surgery. Sociodemographic and clinical data and information about farewell rituals were collected through interview. The women also completed a questionnaire about perinatal grief. A history of psychological and/or psychopharmacological treatment was associated with more intense grief following perinatal loss. Women with a history of psychological difficulties are particularly vulnerable to a complicated grief reaction after experiencing perinatal loss. However, the intensity of grief did not differ significantly according to whether or not the women performed some kind of farewell ritual. Further studies are needed to investigate these relationships and to encourage and facilitate the development of specific interventions for this population.

Perinatal Morbidity and Mortality in Offsprings of Diabetic Mothers in Qatif, Saudi Arabia.

ERIC Educational Resources Information Center

Al-Dabbous, Ibrahim A. Al-; And Others

1995-01-01

Studied perinatal and neonatal morbidity and mortality of diabetic mothers and their offspring in Qatif, Saudi Arabia. Suggests diabetes mellitus in pregnancy may be a common problem in Saudi Arabia, as poor maternal diabetic control results in high perinatal morbidity and mortality. Results suggest that health education and improved coverage of…

Perinatal Depression Algorithm: A Home Visitor Step-by-Step Guide for Advanced Management of Perinatal Depressive Symptoms

ERIC Educational Resources Information Center

Laszewski, Audrey; Wichman, Christina L.; Doering, Jennifer J.; Maletta, Kristyn; Hammel, Jennifer

2016-01-01

Early childhood professionals do many things to support young families. This is true now more than ever, as researchers continue to discover the long-term benefits of early, healthy, nurturing relationships. This article provides an overview of the development of an advanced practice perinatal depression algorithm created as a step-by-step guide…

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Executive Director of NASDA Koji Yamamoto (right) looks at the newly arrived Japanese Experiment Module (JEM)/pressurized module. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of JEM.

NASA Image and Video Library

2003-06-12

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Executive Director of NASDA Koji Yamamoto (right) looks at the newly arrived Japanese Experiment Module (JEM)/pressurized module. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of JEM.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Executive Director of NASDA Koji Yamamoto (left) looks at the newly arrived Japanese Experiment Module (JEM)/pressurized module. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of JEM.

NASA Image and Video Library

2003-06-12

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Executive Director of NASDA Koji Yamamoto (left) looks at the newly arrived Japanese Experiment Module (JEM)/pressurized module. Mr. Yamamoto is at KSC for a welcome ceremony involving the arrival of JEM.

Short- and long-term results of lateral pancreaticojejunostomy for chronic pancreatitis: a retrospective Japanese single-center study.

PubMed

Sudo, Takeshi; Murakami, Yoshiaki; Uemura, Kenichiro; Hashimoto, Yasushi; Kondo, Naru; Nakagawa, Naoya; Sueda, Taijiro

2014-06-01

The study aim was to determine the short- and long-term results of lateral pancreaticojejunostomy for chronic pancreatitis at a single center in Japan. The records of 64 consecutive patients were retrospectively reviewed. All patients underwent surgery at Hiroshima University Hospital between December 1996 and April 2013. Long-term follow-up was performed in 58 patients (91%) for a median period of 34 months. The 53 men (83%) and 11 women (17%) had a mean age of 55 years. The etiology of pancreatitis was chronic alcohol abuse in 44 patients (69%). The major indication for surgery was acute pancreatitis exacerbation (80%). There was no postoperative mortality. Postoperative morbidity occurred in 21 patients (33%), with severe complications requiring non-surgical intervention in four (6%). The percentage of pain-free patients after surgery was 91%, and further acute exacerbation was prevented in 95%. Four patients (7%) required subsequent surgery for pancreatitis-related complications. Of the patients that completed follow-up, 33 (57%) had diabetes mellitus, including 11 patients (19%) with new-onset diabetes; 30 patients (56%) developed pancreatic exocrine insufficiency. Full-length lateral pancreaticojejunostomy is safe, feasible, and effective for managing chronic pancreatitis. The technique prevents further exacerbations and maintains appropriate pancreatic endocrine and exocrine function. © 2013 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Perinatal home care: one entrepreneur's experience.

PubMed

Eaton, D G

1994-10-01

Nurses have responded to the entrepreneurial movement by entering into various nontraditional roles and starting their own businesses. This article describes the author's experience in establishing a perinatal home-care business. The characteristics of women and nurse entrepreneurs are discussed, as are the components of a business plan and how to manage a business.

Homogamy and Intermarriage of Japanese and Japanese Americans With Whites Surrounding World War II.

PubMed

Ono, Hiromi; Berg, Justin

2010-10-01

Although some sociologists have suggested that Japanese Americans quickly assimilated into mainstream America, scholars of Japanese America have highlighted the heightened exclusion that the group experienced. This study tracked historical shifts in the exclusion level of Japanese and Japanese Americans in the United States surrounding World War II with homogamy and intermarriage with Whites for the prewar (1930-1940) and resettlement (1946-1966) marriage cohorts. The authors applied log-linear models to census microsamples (N = 1,590,416) to estimate the odds ratios of homogamy versus intermarriage. The unadjusted odds ratios of Japanese Americans declined between cohorts and appeared to be consistent with the assimilation hypothesis. Once compositional influences and educational pairing patterns were adjusted, however, the odds ratios increased and supported the heightened exclusion hypothesis.

Advances and hope for perinatal HIV remission and cure in children and adolescents.

PubMed

Rainwater-Lovett, Kaitlin; Uprety, Priyanka; Persaud, Deborah

2016-02-01

The known timing of HIV infection in perinatal transmission, combined with the capacity for early antiretroviral therapy (ART) initiation and immune reconstitution, can provide unique insights into HIV persistence. The scientific basis for a pediatric-specific research agenda aimed at HIV remission and cure is discussed. Accumulating evidence supports a favorable biomarker profile for immunotherapeutic interventions in early treated, perinatally infected individuals. HIV DNA concentrations in infected cells of early treated infants decrease over the first few years of life and, after more than 10 years of ART, the overwhelming majority of noninduced proviral genomes are replication-deficient. With early ART initiation, approximately half of perinatally infected individuals become seronegative. Studies of untreated infants and vaccine trials indicate that infected infants can generate HIV-specific humoral responses. Taken together, this evidence suggests that early treatment results in low levels of replication-competent provirus, an absence of HIV-specific immunity, and the capacity to generate immune responses to potential immunotherapeutic interventions. Perinatally HIV-infected individuals require lifelong ART because of the prompt establishment of viral latency in long-lived resting memory CD4 T cells that rekindle viremia upon treatment cessation. However, intense research efforts are ongoing to perturb HIV latency toward reservoir clearance for virologic remission and cure in which perinatally infected individuals can discontinue ART.

[Surgical treatment of perinatal ovarian cysts].

PubMed

Armas Alvarez, A L; Taboada Santomil, P; Pradillos Serna, J M; Rivera Chavez, L L; Méndez Gallart, R; Estévez Martínez, E; Rodríguez Barca, P; Bautista Casasnovas, A; Varela Cives, R

2010-10-01

Actually, the perinatal ovarian cysts are increasingly being diagnosed by prenatal and neonatal ultrasound. We reported our experience in the surgical management of perinatal ovarian cysts. Patients and methods. We have reviewed the clinical charts of 10 female newborns diagnosed of ovarian cysts who underwent surgical management in our hospital from 1989 to 2009. The ovarian cysts were diagnosed antenatally in 8 cases and period neonatal in 2 cases. The clinical presentation was asymptomatic abdominal mass in 7 cases. Ultrasound confirmed the ovarian mass in 8 patients. CT scan and MRI were necessary for confirm suspected diagnosis in two patients. Ultrasonography showed 7 complex cysts and 3 simple cysts. Surgery of the complicated cysts revealed ovarian torsion in 5 cases and 1 hemorragic cyst. At surgery, 5 patients underwent salpingooophorectomy, 2 patients needed oophorectomy and in 3 cases only cystectomy were necessary. The ovarian torsion is the most common complication and the cause of loss of the ovary. The neonatal ovarian cysts greater than 5 centimetres, symptomatic cysts, complex cysts and cysts persisting for more than 6 months need surgical intervention.

Vitamin B-12 and Perinatal Health.

PubMed

Finkelstein, Julia L; Layden, Alexander J; Stover, Patrick J

2015-09-01

Vitamin B-12 deficiency (<148 pmol/L) is associated with adverse maternal and neonatal outcomes, including developmental anomalies, spontaneous abortions, preeclampsia, and low birth weight (<2500 g). The importance of adequate vitamin B-12 status periconceptionally and during pregnancy cannot be overemphasized, given its fundamental role in neural myelination, brain development, and growth. Infants born to vitamin B-12-deficient women may be at increased risk of neural tube closure defects, and maternal vitamin B-12 insufficiency (<200 pmol/L) can impair infant growth, psychomotor function, and brain development, which may be irreversible. However, the underlying causal mechanisms are unknown. This review was conducted to examine the evidence that links maternal vitamin B-12 status and perinatal outcomes. Despite the high prevalence of vitamin B-12 deficiency and associated risk of pregnancy complications, few prospective studies and, to our knowledge, only 1 randomized trial have examined the effects of vitamin B-12 supplementation during pregnancy. The role of vitamin B-12 in the etiology of adverse perinatal outcomes needs to be elucidated to inform public health interventions. © 2015 American Society for Nutrition.

Trust in One’s Physician: The Role of Ethnic Match, Autonomy, Acculturation, and Religiosity Among Japanese and Japanese Americans

PubMed Central

Tarn, Derjung M.; Meredith, Lisa S.; Kagawa-Singer, Marjorie; Matsumura, Shinji; Bito, Seiji; Oye, Robert K.; Liu, Honghu; Kahn, Katherine L.; Fukuhara, Shunichi; Wenger, Neil S.

2005-01-01

PURPOSE Trust is a cornerstone of the physician-patient relationship. We investigated the relation of patient characteristics, religiosity, acculturation, physician ethnicity, and insurance-mandated physician change to levels of trust in Japanese American and Japanese patients. METHODS A self-administered, cross-sectional questionnaire in English and Japanese (completed in the language of their choice) was given to community-based samples of 539 English-speaking Japanese Americans, 340 Japanese-speaking Japanese Americans, and 304 Japanese living in Japan. RESULTS Eighty-seven percent of English-speaking Japanese Americans, 93% of Japanese-speaking Japanese Americans, and 58% of Japanese living in Japan responded to trust items and reported mean trust scores of 83, 80, and 68, respectively, on a scale ranging from 0 to 100. In multivariate analyses, English-speaking and Japanese-speaking Japanese American respondents reported more trust than Japanese respondents living in Japan (P values <.001). Greater religiosity (P <.001), less desire for autonomy (P <.001), and physician-patient relationships of longer duration (P <.001) were related to increased trust. Among Japanese Americans, more acculturated respondents reported more trust (P <.001), and Japanese physicians were trusted more than physicians of another ethnicity. Among respondents prompted to change physicians because of insurance coverage, the 48% who did not want to switch reported less trust in their current physician than in their former physician (mean score of 82 vs 89, P <.001). CONCLUSIONS Religiosity, autonomy preference, and acculturation were strongly related to trust in one’s physician among the Japanese American and Japanese samples studied and may provide avenues to enhance the physician-patient relationship. The strong relationship of trust with patient-physician ethnic match and the loss of trust when patients, in retrospect, report leaving a preferred physician suggest unintended

Linking databases on perinatal health: a review of the literature and current practices in Europe

PubMed Central

Szamotulska, K.; Hindori-Mohangoo, A.D.; Blondel, B.; Macfarlane, A.J.; Dattani, N.; Barona, C.; Berrut, S.; Zile, I.; Wood, R.; Sakkeus, L.; Gissler, M.; Zeitlin, J.

2016-01-01

Background: International comparisons of perinatal health indicators are complicated by the heterogeneity of data sources on pregnancy, maternal and neonatal outcomes. Record linkage can extend the range of data items available and thus can improve the validity and quality of routine data. We sought to assess the extent to which data are linked routinely for perinatal health research and reporting. Methods: We conducted a systematic review of the literature by searching PubMed for perinatal health studies from 2001 to 2011 based on linkage of routine data (data collected continuously at various time intervals). We also surveyed European health monitoring professionals about use of linkage for national perinatal health surveillance. Results: 516 studies fit our inclusion criteria. Denmark, Finland, Norway and Sweden, the US and the UK contributed 76% of the publications; a further 29 countries contributed at least one publication. Most studies linked vital statistics, hospital records, medical birth registries and cohort data. Other sources were specific registers for: cancer (70), congenital anomalies (56), ART (19), census (19), health professionals (37), insurance (22) prescription (31), and level of education (18). Eighteen of 29 countries (62%) reported linking data for routine perinatal health monitoring. Conclusion: Research using linkage is concentrated in a few countries and is not widely practiced in Europe. Broader adoption of data linkage could yield substantial gains for perinatal health research and surveillance. PMID:26891058

[Research activities in Kobe-Indonesia Collaborative Research Centers].

PubMed

Utsumi, Takako; Hayashi, Yoshitake; Hotta, Hak

2013-01-01

Kobe-Indonesia Collaborative Research Center was established in Institute of Tropical Disease (ITD), Airlangga University, Surabaya, Indonesia in 2007 under the program of ''Founding Research Centers for Emerging and Reemerging Infectious Diseases'' supported by the Ministry of Education, Culture, Sports, Science and Technology, Japan, and then it has been under the Japan Initiative for Global Research Network on Infectious Diseases (J-GRID) since 2010. Japanese researchers have been stationed at ITD, conducting joint researches on influenza, viral hepatitis, dengue and infectious diarrhea. Also, another Japanese researcher has been stationed at Faculty of Medicine, University of Indonesia, Jakarta, carrying out joint researches on'' Identification of anti-hepatitis C virus (HCV) substances and development of HCV and dengue vaccines'' in collaboration with University of Indonesia and Airlangga University through the Science and Technology Research Partnership for Sustainable Development (SATREPS) supported by the Japan Science and Technology Agency (JST) and Japan International Cooperation Agency (JICA) since 2009. In this article, we briefly introduce the background history of Kobe University Research Center in Indonesia, and discuss the research themes and outcomes of J-GRID and SATREPS activities.

Japanese plan for SSF utilization

NASA Technical Reports Server (NTRS)

Mizuno, Toshio

1992-01-01

The Japanese Experiment Module (JEM) program has made significant progress. The JEM preliminary design review was completed in July 1992; construction of JEM operation facilities has begun; and the micro-G airplane, drop shaft, and micro-G experiment rocket are all operational. The national policy for JEM utilization was also established. The Space Experiment Laboratory (SEL) opened in June '92 and will function as a user support center. Eight JEM multiuser facilities are in phase B, and scientific requirements are being defined for 17 candidate multiuser facilities. The National Joint Research Program is about to start. Precursor missions and early Space Station utilization activities are being defined. This paper summarizes the program in outline and graphic form.

Cross-cultural comparison of the sleep-disordered breathing prevalence among Americans and Japanese

PubMed Central

Yamagishi, Kazumasa; Ohira, Tetsuya; Nakano, Hiroshi; Bielinski, Suzette J.; Sakurai, Susumu; Imano, Hironori; Kiyama, Masahiko; Kitamura, Akihiko; Sato, Shinichi; Konishi, Masamitsu; Shahar, Eyal; Folsom, Aaron R.; Iso, Hiroyasu; Tanigawa, Takeshi

2010-01-01

To compare the sleep-disordered breathing prevalence among Hispanic and white Americans and Japanese, we performed a one-night sleep study with a single channel airflow monitor on 211 Hispanics and 246 whites from the Minnesota Field Center of the Multi-Ethnic Study of Atherosclerosis (MESA), and 978 Japanese from three community-based cohorts of the Circulatory Risk in Communities Study (CIRCS) in Japan. The respiratory disturbance index and sleep-disordered breathing, defined as respiratory disturbance index ≥ 15 disturbances/hr, were estimated. The sleep-disordered breathing prevalence was higher in men (34.2%) than women (14.8%), and higher among Hispanics (36.5%) and whites (33.3%) than among Japanese (18.4%), corresponding to differences in body mass index. Within body mass index strata, the race difference in sleep-disordered breathing was attenuated. This was also true when we adjusted for body mass index instead of stratification. The strong association between body mass index and sleep-disordered breathing was similar in Japanese and Americans. The sleep-disordered breathing prevalence was lower among Japanese than the Americans. However, the association of body mass index with sleep-disordered breathing was strong, and similar among the race/ethnic groups studied. The majority of the race/ethnic difference in sleep-disordered breathing prevalence was explained by a difference in body mass index distribution. PMID:20110399

The Relationship Between Maternal Glycemia and Perinatal Outcome

PubMed Central

Landon, Mark B.; Mele, Lisa; Spong, Catherine Y.; Carpenter, Marshall W.; Ramin, Susan M.; Casey, Brian; Wapner, Ronald J.; Varner, Michael W.; Rouse, Dwight J.; Thorp, John M.; Sciscione, Anthony; Catalano, Patrick; Harper, Margaret; Saade, George; Caritis, Steve N; Sorokin, Yoram; Peaceman, Alan M.; Tolosa, Jorge E.; Anderson, Garland D.

2014-01-01

Objective To examine the relationship between varying degrees of maternal hyperglycemia and pregnancy outcomes. Methods This was a secondary analysis of a treatment trial for mild gestational diabetes (GDM) including four cohorts: 1) 473 women with untreated mild GDM; 2) 256 women with a positive 50-gram screen and one abnormal oral glucose tolerance test (OGTT) value; 3) 675 women with a positive screen and no abnormal OGTT values; and 4) 437 women with a normal 50-gram screen. Groups were compared by test of trend for a composite perinatal outcome (neonatal hypoglycemia, hyperbilirubinemia, elevated cord c-peptide level, and perinatal trauma or death), frequency of large-for-gestational-age (LGA) infant, shoulder dystocia, and pregnancy-related hypertension. Three-hour OGTT levels (fasting, 1, 2, and 3 hour) levels were divided into categories and analyzed for their relationship to perinatal and maternal outcomes. Results There were significant trends by glycemic status among the four cohorts for the composite and all other outcomes (p<0.001). Analysis for trend according to OGTT categories showed an increasing relationship between fasting and all post load levels and the various outcomes (p<0.05). Fasting glucose ≥ 90 mg/dl and 1 hour ≥ 165 mg/dl were associated with an increased risk for the composite outcome, odds ratios and 95% CI of 2.0 (1.03-4.15) and 1.46 (1.02-2.11) to 1.52 (1.08-2.15), for the fasting and 1 hour, respectively. A 1 hour glucose ≥ 150 mg/dl was associated with an increased risk for LGA (odds ratios 1.8 (1.02-3.18) to 2.35 (1.35-4.14), however 2 and 3 hour glucose levels did not increase the risk for the composite or LGA until well beyond current GDM diagnostic thresholds. Conclusion A monotonic relationship exists between increasing maternal glycemia and perinatal morbidity. Current OGTT criteria require re-evaluation in determining thresholds for the diagnosis and treatment of GDM. PMID:21309194

The modern Japanese color lexicon.

PubMed

Kuriki, Ichiro; Lange, Ryan; Muto, Yumiko; Brown, Angela M; Fukuda, Kazuho; Tokunaga, Rumi; Lindsey, Delwin T; Uchikawa, Keiji; Shioiri, Satoshi

2017-03-01

Despite numerous prior studies, important questions about the Japanese color lexicon persist, particularly about the number of Japanese basic color terms and their deployment across color space. Here, 57 native Japanese speakers provided monolexemic terms for 320 chromatic and 10 achromatic Munsell color samples. Through k-means cluster analysis we revealed 16 statistically distinct Japanese chromatic categories. These included eight chromatic basic color terms (aka/red, ki/yellow, midori/green, ao/blue, pink, orange, cha/brown, and murasaki/purple) plus eight additional terms: mizu ("water")/light blue, hada ("skin tone")/peach, kon ("indigo")/dark blue, matcha ("green tea")/yellow-green, enji/maroon, oudo ("sand or mud")/mustard, yamabuki ("globeflower")/gold, and cream. Of these additional terms, mizu was used by 98% of informants, and emerged as a strong candidate for a 12th Japanese basic color term. Japanese and American English color-naming systems were broadly similar, except for color categories in one language (mizu, kon, teal, lavender, magenta, lime) that had no equivalent in the other. Our analysis revealed two statistically distinct Japanese motifs (or color-naming systems), which differed mainly in the extension of mizu across our color palette. Comparison of the present data with an earlier study by Uchikawa & Boynton (1987) suggests that some changes in the Japanese color lexicon have occurred over the last 30 years.

Homogamy and Intermarriage of Japanese and Japanese Americans With Whites Surrounding World War II

PubMed Central

Ono, Hiromi; Berg, Justin

2010-01-01

Although some sociologists have suggested that Japanese Americans quickly assimilated into mainstream America, scholars of Japanese America have highlighted the heightened exclusion that the group experienced. This study tracked historical shifts in the exclusion level of Japanese and Japanese Americans in the United States surrounding World War II with homogamy and intermarriage with Whites for the prewar (1930–1940) and resettlement (1946–1966) marriage cohorts. The authors applied log-linear models to census microsamples (N = 1,590,416) to estimate the odds ratios of homogamy versus intermarriage. The unadjusted odds ratios of Japanese Americans declined between cohorts and appeared to be consistent with the assimilation hypothesis. Once compositional influences and educational pairing patterns were adjusted, however, the odds ratios increased and supported the heightened exclusion hypothesis. PMID:21116449

KENNEDY SPACE CENTER, FLA. - Japanese astronaut Koichi Wakata (left) works with a tray extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

NASA Image and Video Library

2003-09-24

KENNEDY SPACE CENTER, FLA. - Japanese astronaut Koichi Wakata (left) works with a tray extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Japanese astronaut Koichi Wakata looks over the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

NASA Image and Video Library

2003-09-24

KENNEDY SPACE CENTER, FLA. - In the Space Station Processing Facility, Japanese astronaut Koichi Wakata looks over the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

KENNEDY SPACE CENTER, FLA. - Japanese astronaut Koichi Wakata (right) works with a tray extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

NASA Image and Video Library

2003-09-24

KENNEDY SPACE CENTER, FLA. - Japanese astronaut Koichi Wakata (right) works with a tray extended from inside the Pressurized Module, or PM, part of the Japanese Experiment Module (JEM). The PM provides a shirt-sleeve environment in which astronauts on the International Space Station can conduct microgravity experiments. There are a total of 23 racks, including 10 experiment racks, inside the PM providing a power supply, communications, air conditioning, hardware cooling, water control and experiment support functions.

Pathophysiology and neuroprotection of global and focal perinatal brain injury: lessons from animal models

PubMed Central

Manganozzi, Lucilla; Moretti, Raffaella; Vexler, Zinaida S.; Gressens, Pierre

2016-01-01

BACKGROUND Arterial ischemic stroke occurs most frequently in term newborns than in the elderly, and brain immaturity affects mechanisms of ischemic injury and recovery. The susceptibility to injury of the brain was assumed to be lower in the perinatal period as compared to childhood. This concept was recently challenged by clinical studies showing marked motor disabilities after stroke in neonates, with the severity of motor and cortical sensory deficits similar in both perinatal and childhood ischemic stroke. The understanding of the triggers and the pathophysiological mechanisms of perinatal stroke has greatly improved in recent years, but many aspects remain still unclear. METHODS In this review, we will focus on the pathophysiology of perinatal stroke and on therapeutic strategies that can protect the immature brain from the consequences of stroke by targeting inflammation and brain microenvironment. RESULTS Studies in neonatal rodent models of cerebral ischemia have shown a potential role for soluble inflammatory molecules as important modulators of injury and recovery. A great effort has been made and is still in act to try neuroprotective molecules based on the new physiopatological acquisition. CONCLUSION In this review we aim to give a comprehensive view of new insights concerning pathophysiological mechanism of focal and global perinatal brain injury and its new therapeutic approaches. PMID:26002050

Development and Evaluation of a Peer Support Program for Parents Facing Perinatal Loss.

PubMed

Diamond, Rachel M; Roose, Rosmarie E

2016-01-01

The purpose of this program evaluation was to understand the perspectives of peer parents and parents receiving support within a peer support program for perinatal bereavement at a midsized hospital within the midwestern United States. To document participants' perceptions of the program, a focus group was conducted with peer parents, and surveys were completed by both peer parents and parents receiving support. In this article we review our model of a peer support program for perinatal bereavement and report on parents' evaluation of the program. Recommendations through which other organizations can develop peer support programs for parents who have experienced a perinatal loss are provided. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

Perinatal outcome of pregnancies complicated by threatened abortion.

PubMed

Verma, S K; Premi, H K; Gupta, T V; Thakur, S; Gupta, K B; Randhawa, I

1994-11-01

One hundred and two cases of viable pregnancies with threatened abortion were studied in the department of obstetrics and gynaecology, Kamla Nehru Hospital, IG Medical College, Shimla between November 1987 and February 1989 and their perinatal outcome was evaluated. The pregnancies continued beyond 28 weeks in 61.7% of the cases. The incidence of prematurity was 19.0%. The incidence of low birth weight (LBW) babies was 23.8%. Apgar score was less than 7 in 22.3%. The incidence of neonatal complications was 25.3%. There was no perinatal mortality. In a control group of 50 cases, the incidence of prematurity and LBW was 8% and 4% respectively. Apgar score less than 7 was noted in 4% and neonatal complications were observed only in 4% of newborns.

Childhood adversity, social support, and telomere length among perinatal women.

PubMed

Mitchell, Amanda M; Kowalsky, Jennifer M; Epel, Elissa S; Lin, Jue; Christian, Lisa M

2018-01-01

Adverse perinatal health outcomes are heightened among women with psychosocial risk factors, including childhood adversity and a lack of social support. Biological aging could be one pathway by which such outcomes occur. However, data examining links between psychosocial factors and indicators of biological aging among perinatal women are limited. The current study examined the associations of childhood socioeconomic status (SES), childhood trauma, and current social support with telomere length in peripheral blood mononuclear cells (PBMCs) in a sample of 81 women assessed in early, mid, and late pregnancy as well as 7-11 weeks postpartum. Childhood SES was defined as perceived childhood social class and parental educational attainment. Measures included the Childhood Trauma Questionnaire, Center for Epidemiologic Studies-Depression Scale, Multidimensional Scale of Perceived Social Support, and average telomere length in PBMCs. Per a linear mixed model, telomere length did not change across pregnancy and postpartum visits; thus, subsequent analyses defined telomere length as the average across all available timepoints. ANCOVAs showed group differences by perceived childhood social class, maternal and paternal educational attainment, and current family social support, with lower values corresponding with shorter telomeres, after adjustment for possible confounds. No effects of childhood trauma or social support from significant others or friends on telomere length were observed. Findings demonstrate that while current SES was not related to telomeres, low childhood SES, independent of current SES, and low family social support were distinct risk factors for cellular aging in women. These data have relevance for understanding potential mechanisms by which early life deprivation of socioeconomic and relationship resources affect maternal health. In turn, this has potential significance for intergenerational transmission of telomere length. The predictive value of

The Effect of Childbirth Self-Efficacy on Perinatal Outcomes

PubMed Central

Tilden, Ellen L.; Caughey, Aaron B.; Lee, Christopher S.; Emeis, Cathy

2016-01-01

Objective To synthesize and critique the quantitative literature on measuring childbirth self-efficacy and the effect of childbirth self-efficacy on perinatal outcomes. Data Sources Eligible studies were identified through searching MEDLINE, CINAHL, Scopus, and Google Scholar databases. Study Selection Published research using a tool explicitly intended to measure childbirth self-efficacy and also examining outcomes within the perinatal period were included. All manuscripts were in English and published in peer-reviewed journals. Data Extraction First author, country, year of publication, reference and definition of childbirth self-efficacy, measurement of childbirth self-efficacy, sample recruitment and retention, sample characteristics, study design, interventions (with experimental and quasi-experimental studies), and perinatal outcomes were extracted and summarized. Data Synthesis Of 619 publications, 23 studies published between 1983 and 2015 met inclusion criteria and were critiqued and synthesized in this review. Conclusions There is overall consistency in how childbirth self-efficacy is defined and measured among studies, facilitating comparison and synthesis. Our findings suggest that increased childbirth self-efficacy is associated with a wide variety of improved perinatal outcomes. Moreover, there is evidence that childbirth self-efficacy is a psychosocial factor that can be modified through various efficacy-enhancing interventions. Future researchers will be able to build knowledge in this area through: (a) utilization of experimental and quasi-experimental design; (b) recruitment and retention of more diverse samples; (c) explicit reporting of definitions of terms (e.g. ‘high risk’); (d) investigation of interventions that increase childbirth self-efficacy during pregnancy; and, (e) investigation regarding how childbirth self-efficacy enhancing interventions might lead to decreased active labor pain and suffering. Exploratory research should

The Effect of Childbirth Self-Efficacy on Perinatal Outcomes.

PubMed

Tilden, Ellen L; Caughey, Aaron B; Lee, Christopher S; Emeis, Cathy

2016-01-01

To synthesize and critique the quantitative literature on measuring childbirth self-efficacy and the effect of childbirth self-efficacy on perinatal outcomes. Eligible studies were identified through searches of MEDLINE, CINAHL, Scopus, and Google Scholar databases. Published research articles that used a tool explicitly intended to measure childbirth self-efficacy and that examined outcomes within the perinatal period were included. All articles were in English and were published in peer-reviewed journals. First author, country, year of publication, reference and definition of childbirth self-efficacy, measurement of childbirth self-efficacy, sample recruitment and retention, sample characteristics, study design, interventions (with experimental and quasiexperimental studies), and perinatal outcomes were extracted and summarized. Of 619 publications, 23 studies published between 1983 and 2015 met inclusion criteria and were critiqued and synthesized in this review. There is overall consistency in how childbirth self-efficacy is defined and measured among studies, which facilitates comparison and synthesis. Our findings suggest that increased childbirth self-efficacy is associated with a wide variety of improved perinatal outcomes. Moreover, there is evidence that childbirth self-efficacy is a psychosocial factor that can be modified through various efficacy-enhancing interventions. Future researchers will be able to build knowledge in this area through (a) use of experimental and quasiexperimental design, (b) recruitment and retention of more diverse samples, (c) explicit reporting of definitions of terms (e.g., high risk), (d) investigation of interventions that increase childbirth self-efficacy during pregnancy, and (e) investigation about how childbirth self-efficacy-enhancing interventions might lead to decreased active labor pain and suffering. Exploratory research should continue to examine the potential association between higher prenatal childbirth self

Mothers on the margins: implications for eradicating perinatal HIV.

PubMed

Lindau, Stacy Tessler; Jerome, Jessica; Miller, Kate; Monk, Elizabeth; Garcia, Patricia; Cohen, Mardge

2006-01-01

Tactics aimed at reducing perinatal transmission of HIV are proving ineffective at accomplishing complete eradication: a group of women with HIV remain at very high risk for transmitting the virus to their newborns. This study engaged a uniquely high-risk group of HIV-infected mothers as expert informants on childbearing with HIV to inform strategies to eradicate perinatal HIV transmission. The sample draws from an Illinois Department of Children and Family Services (DCFS) database of 1104 HIV-seropositive women with children in protective services between 1989 and 2001. Of these, 32 women knew their HIV-positive status and gave birth to at least two children after 1997 (zidovudine widely implemented as standard of care). Twelve were accessible and consented to participate. Three others, currently pregnant, also participated. Fifteen interviews were completed. The 15 women had given birth to 78 children (9 HIV-infected), fathered by 62 men. Respondents were severely socioeconomically marginalized. They were aware of their HIV status and the benefits of prophylaxis, most desired healthy babies to parent, and most delivered their babies in hospitals equipped to provide adequate prophylaxis. Yet most received inadequate or no prenatal care and did not disclose their HIV status at delivery. Women indicated that denial and substance use were the primary intrinsic barriers and disrespectful treatment was the primary extrinsic barrier to disclosure and care. Women's recommendations about eradication of perinatal HIV transmission emphasized the problem of substance use, the need for private and thorough communication with medical and DCFS personnel, and the need for positive social relationships to enable HIV positive mothers to engage in care. Attention to potent social and institutional barriers that impair the ability of the most marginalized women to disclose their HIV status and accept care is essential to realize eradication of perinatal transmission.

Robotic Quantification of Position Sense in Children With Perinatal Stroke.

PubMed

Kuczynski, Andrea M; Dukelow, Sean P; Semrau, Jennifer A; Kirton, Adam

2016-09-01

Background Perinatal stroke is the leading cause of hemiparetic cerebral palsy. Motor deficits and their treatment are commonly emphasized in the literature. Sensory dysfunction may be an important contributor to disability, but it is difficult to measure accurately clinically. Objective Use robotics to quantify position sense deficits in hemiparetic children with perinatal stroke and determine their association with common clinical measures. Methods Case-control study. Participants were children aged 6 to 19 years with magnetic resonance imaging-confirmed unilateral perinatal arterial ischemic stroke or periventricular venous infarction and symptomatic hemiparetic cerebral palsy. Participants completed a position matching task using an exoskeleton robotic device (KINARM). Position matching variability, shift, and expansion/contraction area were measured with and without vision. Robotic outcomes were compared across stroke groups and controls and to clinical measures of disability (Assisting Hand Assessment) and sensory function. Results Forty stroke participants (22 arterial, 18 venous, median age 12 years, 43% female) were compared with 60 healthy controls. Position sense variability was impaired in arterial (6.01 ± 1.8 cm) and venous (5.42 ± 1.8 cm) stroke compared to controls (3.54 ± 0.9 cm, P < .001) with vision occluded. Impairment remained when vision was restored. Robotic measures correlated with functional disability. Sensitivity and specificity of clinical sensory tests were modest. Conclusions Robotic assessment of position sense is feasible in children with perinatal stroke. Impairment is common and worse in arterial lesions. Limited correction with vision suggests cortical sensory network dysfunction. Disordered position sense may represent a therapeutic target in hemiparetic cerebral palsy. © The Author(s) 2016.

Between the West and Asia: "Humanistic" Japanese Family Planning in the Cold War.

PubMed

Homei, Aya

2016-12-01

This paper studies the formation of Japanese ventures in family planning deployed in various villages in Asia from the 1960s onward in the name of development aid. By critically examining how Asia became the priority area for Japan's international cooperation in family planning and by analyzing how the adjective "humanistic" was used to underscore the originality of Japan's family planning program overseas, the paper shows that visions of Japanese actors were directly informed by Japan's delicate position in Cold War geopolitics, between the imagined West represented by the United States and "underdeveloped" Asia, at a time when Japan was striving to (re-)establish its position in world politics and economics. Additionally, by highlighting subjectivities and intra-Asian networks centered on Japanese actors, the paper also aims to destabilize the current historiography on population control which has hitherto focused either on Western actors in the transnational population control movement or on non-Western "acceptors" subjected to the population control programs.

[Maternal hemoglobin in Peru: regional differences and its association with adverse perinatal outcomes].

PubMed

Gonzales, Gustavo F; Tapia, Vilma; Gasco, Manuel; Carrillo, Carlos

2011-01-01

To evaluate hemoglobin (Hb) levels in pregnant women from different geographical regions from Peru; to establish anemia and erythrocytocis rates and to establish the role of Hb on adverse perinatal outcomes using the Perinatal Information System (PIS) database of Peruvian Ministry of Health. Data were obtained from 379,816 births of 43 maternity care units between 2000 and 2010. Anemia and erythrocytocis rates were determined in each geographical region as well as rates of adverse perinatal outcomes. To analyze data the STATA program (versión 10.0,Texas, USA) was used. The results were considered significant at p<0.01. Mild anemia rate was higher in the coast (25.8%) and low forest (26.2%). Moderate/severe anemia rate in low forest was 2.6% and at the coast was 1.0%. In the highland, the highest rate of moderate/severe anemia was in the southern highlands (0.6%). The highest rate of erythrocytocis was found in the central highland (23.7%), 11.9% in the southern highland and 9.5% in the north highland. Severe anemia and erythrocytocis were associated with adverse perinatal outcomes. There are differences by Peruvian geographical region in anemia rates. In the central highlands were found the highest rates of erythrocytocis due to hypoxia effect in the high altitudes; however in the southern highlands, erythrocytocis was lower. Severe anemia and erythrocytosis were associated with increased adverse perinatal outcomes.

Development, reliability, and validity of the Alberta Perinatal Stroke Project Parental Outcome Measure.

PubMed

Bemister, Taryn B; Brooks, Brian L; Kirton, Adam

2014-07-01

Perinatal stroke is a leading cause of cerebral palsy and lifelong disability, although parent and family outcomes have not yet been studied in this specific population. The Alberta Perinatal Stroke Project Parental Outcome Measure was developed as a 26-item questionnaire on the impact of perinatal stroke on parents and families. The items were derived from expert opinion and scientific literature on issues salient to parents of children with perinatal stroke, including guilt and blame, which are not well captured in existing measures of family impact. Data were collected from 82 mothers and 28 fathers who completed the Parental Outcome Measure and related questionnaires (mean age, 39.5 years; mean child age, 7.4 years). Analyses examined the Parental Outcome Measure's internal consistency, test-retest reliability, validity, and factor structure. The Parental Outcome Measure demonstrated three unique theoretical constructs: Psychosocial Impact, Guilt, and Blame. The Parental Outcome Measure has excellent internal consistency (Cronbach α = 0.91) and very good test-retest reliability more than 2-5 weeks (r = 0.87). Regarding validity, the Parental Outcome Measure is sensitive to condition severity, accounts for additional variance in parent outcomes, and strongly correlates with measures of anxiety, depression, stress, quality of life, family functioning, and parent adjustment. The Parental Outcome Measure contributes to the literature as the first brief measure of family impact designed for parents of children with perinatal stroke. Copyright © 2014 Elsevier Inc. All rights reserved.

Perinatal Risks in "Late Motherhood" Defined Based On Parity and Preterm Birth Rate - an Analysis of the German Perinatal Survey (20th Communication).

PubMed

Schure, V; Voigt, M; Schild, R L; Hesse, V; Carstensen, M; Schneider, K T M; Straube, S

2012-01-01

Aim: "Late motherhood" is associated with greater perinatal risks but the term lacks precise definition. We present an approach to determine what "late motherhood" associated with "high risk" is, based on parity and preterm birth rate. Materials and Methods: Using data from the German Perinatal Survey of 1998-2000 we analysed preterm birth rates in women with zero, one, or two previous live births. We compared groups of "late" mothers (with high preterm birth rates) with "control" groups of younger women (with relatively low preterm birth rates). Data of 208 342 women were analysed. For women with zero (one; two) previous live births, the "control" group included women aged 22-26 (27-31; 29-33) years. Women in the "late motherhood" group were aged > 33 (> 35; > 38) years. Results: The "late motherhood" groups defined in this way were also at higher risk of adverse perinatal events other than preterm birth. For women with zero (one; two) previous live births, normal cephalic presentation occurred in 89 % (92.7 %; 93.3 %) in the "control" group, but only in 84.5 % (90 %; 90.4 %) in the "late motherhood" group. The mode of delivery was spontaneous or at most requiring manual help in 71.3 % (83.4 %; 85.8 %) in the "control" group, but only in 51.4 % (72.2 %; 76.4 %) in the "late motherhood" group. Five-minute APGAR scores were likewise worse for neonates of "late" mothers and the proportion with a birth weight ≤ 2499 g was greater. Conclusion: "Late motherhood" that is associated with greater perinatal risks can be defined based on parity and preterm birth rate.

Association of maternal KIR gene content polymorphisms with reduction in perinatal transmission of HIV-1

PubMed Central

Omosun, Yusuf O.; Blackstock, Anna J.; Williamson, John; van Eijk, Anne Maria; Ayisi, John; Otieno, Juliana; Lal, Renu B.; ter Kuile, Feiko O.; Slutsker, Laurence

2018-01-01

The role of killer cell immunoglobulin-like receptors (KIRs) in the transmission of HIV-1 has not been extensively studied. Here, we investigated the association of KIR gene content polymorphisms with perinatal HIV-1 transmission. The KIR gene family comprising 16 genes was genotyped in 313 HIV-1 positive Kenyan mothers paired with their infants. Gene content polymorphisms were presented as presence of individual KIR genes, haplotypes, genotypes and KIR gene concordance. The genetic data were analyzed for associations with perinatal transmission of HIV. There was no association of infant KIR genes with perinatal HIV-1 transmission. After adjustment for gravidity, viral load, and CD4 cell count, there was evidence of an association between reduction in perinatal HIV-1 transmission and the maternal individual KIR genes KIR2DL2 (adjusted OR = 0.50; 95% CI: 0.24–1.02, P = 0.06), KIR2DL5 (adjusted OR = 0.47; 95% CI: 0.23–0.95, P = 0.04) and KIR2DS5 (adjusted OR = 0.39; 95% CI: 0.18–0.80, P = 0.01). Furthermore, these maternal KIR genes were only significantly associated with reduction in perinatal HIV transmission in women with CD4 cell count ≥ 350 cells/ μl and viral load <10000 copies/ml. Concordance analysis showed that when both mother and child had KIR2DS2, there was less likelihood of perinatal HIV-1 transmission (adjusted OR = 0.44; 95% CI: 0.20–0.96, P = 0.039). In conclusion, the maternal KIR genes KIR2DL2, KIR2DL5, KIR2DS5, and KIR2DS2 were associated with reduction of HIV-1 transmission from mother to child. Furthermore, maternal immune status is an important factor in the association of KIR with perinatal HIV transmission. PMID:29360870

Combination of Serum Interleukin-1β and 6 Levels in the Diagnosis of Perinatal Asphyxia.

PubMed

Boskabadi, Hassan; Maamouri, Gholamali; Tavakkol Afshari, Jalil; Zakerihamidi, Maryam; Kalateh Molaee, Maryam; Bagheri, Fatemeh; Parizadeh, Mustafa; Ghayour-Mobarhan, Majid; Moradi, Ali; Ferns, Gordon A A

2016-05-01

Perinatal asphyxia is an important cause of death, as well as permanent neurological and developmental complications. Diagnosing in time would lead to better prognosis and applying the most proper treatment. We sought to define the predictive values of serum concentrations of interleukin-1β (IL-1β) and interleukin-6 (IL-6) in newborns with perinatal asphyxia to see if there is a relation between the short-term neurological deficit and serum IL-1β and IL-6 concentrations. This was a prospective (case-control) study conducted between March 2006 and April 2013, at the Neonatal Intensive Care Unit, Mashhad, Iran. Serum IL-1β and IL-6 levels were measured at birth in 38 consecutive uninfected neonates with perinatal asphyxia (blood pH < 7.2, low Apgar score, signs of fetal distress) and 47 randomly selected healthy newborns. The results were compared between the groups, using Chi-Square, t-tests, and Mann-Whitney tests, as well as receiver operator characteristics (ROC) curves and regression models. Serum IL-1β and IL-6 concentrations in the infants who developed perinatal asphyxia were significantly higher compared to values in the normal infants [16.88 vs  3.34 pg/mL for IL-1β, (P = 0.006), and 88.15 vs 6.74 pg/ mL for IL-6, (P < 0.001) respectively]. The sensitivity and  specificity for the diagnosis of perinatal asphyxia using serum IL-6 were 80.5% and 81.6% respectively. The sensitivity and specificity using serum IL-1β were 71% and 89.1%, respectively. Evaluating serum IL-6 and 1β simultaneously, could improve the sensitivity and specificity of early diagnosis of the perinatal  asphyxia. The most appropriate indicator of perinatal asphyxia is combined measurement of interleukin 1β and interleukin 6.

Perinatal mortality in second- vs firstborn twins: a matter of birth size or birth order?

PubMed

Luo, Zhong-Cheng; Ouyang, Fengxiu; Zhang, Jun; Klebanoff, Mark

2014-08-01

Second-born twins on average weigh less than first-born twins and have been reported at an elevated risk of perinatal mortality. Whether the risk differences depend on their relative birth size is unknown. The present study aimed to evaluate the association of birth order with perinatal mortality by birth order-specific weight difference in twin pregnancies. In a retrospective cohort study of 258,800 twin pregnancies without reported congenital anomalies using the US matched multiple birth data 1995-2000 (the available largest multiple birth dataset), conditional logistic regression was applied to estimate the odds ratio (OR) of perinatal death adjusted for fetus-specific characteristics (sex, presentation, and birthweight for gestational age). Comparing second vs first twins, the risks of perinatal death were similar if they had similar birthweights (within 5%) and were increasingly higher if second twins weighed progressively less (adjusted ORs were 1.37, 1.90, and 3.94 if weighed 5.0-14.9%, 15.0-24.9%, and ≥25.0% less, respectively), and progressively lower if they weighed increasingly more (adjusted ORs were 0.67, 0.63, and 0.36 if weighed 5.0-14.9%, 15.0-24.9%, and ≥25.0% more, respectively) (all P < .001). The perinatal mortality rates were not significantly different in cesarean deliveries or preterm (<37 weeks) vaginal deliveries but were significantly higher in second twins in term vaginal deliveries (3.1 vs 1.8 per 1000; adjusted OR, 2.15; P < .001). Perinatal mortality risk differences in second vs first twins depend on their relative birth size. Vaginal delivery at term is associated with a substantially greater risk of perinatal mortality in second twins. Copyright © 2014 Mosby, Inc. All rights reserved.

Cultural Competence in Business Japanese.

ERIC Educational Resources Information Center

Koike, Shohei

Cultural competence in business Japanese requires more than superficial knowledge of business etiquette. One must truly understand why Japanese people think and act differently from their American counterparts. For example, instruction in the use of Japanese taxis must be accompanied by instruction in the concept and implications of seating order…

Psychosocial challenges facing women living with HIV during the perinatal period in rural Uganda.

PubMed

Ashaba, Scholastic; Kaida, Angela; Coleman, Jessica N; Burns, Bridget F; Dunkley, Emma; O'Neil, Kasey; Kastner, Jasmine; Sanyu, Naomi; Akatukwasa, Cecilia; Bangsberg, David R; Matthews, Lynn T; Psaros, Christina

2017-01-01

The complexities of navigating pregnancy while living with HIV predispose women to additional stress. Finding ways to minimize psychosocial challenges during the perinatal period may maximize the well-being of mothers living with HIV and their children. The goal of this study was to explore psychosocial challenges experienced by women living with HIV (WLWH) during pregnancy and the postpartum. We conducted individual in-depth interviews with 20 WLWH recruited from an HIV treatment cohort study in Mbarara, Uganda as part of a larger study exploring perinatal depression. We conducted content analyses to identify themes related to challenges of WLWH during pregnancy and the postpartum. Participants had a median age of 33 years [IQR: 28-35], a median of 3 living children [IQR: 2-5], and 95% had achieved HIV-RNA suppression. Challenges were organized around the following themes: HIV -related stigma from health professionals, HIV status disclosure dilemma, unintended pregnancy and intimate partner violence, HIV and environmental structural barriers and distress and fear related to maternal and child health. Stigma centered on discrimination by health care professionals and personal shame associated with being pregnant as a WLWH. This led to difficulty engaging in HIV care, particularly when coupled with structural barriers, such as lack of transportation to clinic. Participants experienced intimate partner violence and lacked support from their partners and family members. Distress and fear about the health and uncertainty about the future of the unborn baby due to maternal deteriorating physical health was common. The perinatal period is a time of stress for WLWH. Challenges experienced by WLWH may compromise successful engagement in HIV care and may reduce quality of life for women and their children. Strategies aimed at alleviating the challenges of WLWH should involve the larger structural environment including partners, family and community member as well as policy

Psychosocial challenges facing women living with HIV during the perinatal period in rural Uganda

PubMed Central

Ashaba, Scholastic; Burns, Bridget F.; Dunkley, Emma; O’Neil, Kasey; Kastner, Jasmine; Sanyu, Naomi; Akatukwasa, Cecilia; Bangsberg, David R.

2017-01-01

The complexities of navigating pregnancy while living with HIV predispose women to additional stress. Finding ways to minimize psychosocial challenges during the perinatal period may maximize the well-being of mothers living with HIV and their children. The goal of this study was to explore psychosocial challenges experienced by women living with HIV (WLWH) during pregnancy and the postpartum. We conducted individual in-depth interviews with 20 WLWH recruited from an HIV treatment cohort study in Mbarara, Uganda as part of a larger study exploring perinatal depression. We conducted content analyses to identify themes related to challenges of WLWH during pregnancy and the postpartum. Participants had a median age of 33 years [IQR: 28–35], a median of 3 living children [IQR: 2–5], and 95% had achieved HIV-RNA suppression. Challenges were organized around the following themes: HIV -related stigma from health professionals, HIV status disclosure dilemma, unintended pregnancy and intimate partner violence, HIV and environmental structural barriers and distress and fear related to maternal and child health. Stigma centered on discrimination by health care professionals and personal shame associated with being pregnant as a WLWH. This led to difficulty engaging in HIV care, particularly when coupled with structural barriers, such as lack of transportation to clinic. Participants experienced intimate partner violence and lacked support from their partners and family members. Distress and fear about the health and uncertainty about the future of the unborn baby due to maternal deteriorating physical health was common. The perinatal period is a time of stress for WLWH. Challenges experienced by WLWH may compromise successful engagement in HIV care and may reduce quality of life for women and their children. Strategies aimed at alleviating the challenges of WLWH should involve the larger structural environment including partners, family and community member as well as

Statistics in Japanese universities.

PubMed Central

Ito, P K

1979-01-01

The teaching of statistics in the U.S. and Japanese universities is briefly reviewed. It is found that H. Hotelling's articles and subsequent relevant publications on the teaching of statistics have contributed to a considerable extent to the establishment of excellent departments of statistics in U.S. universities and colleges. Today the U.S. may be proud of many well-staffed and well-organized departments of theoretical and applied statistics with excellent undergraduate and graduate programs. On the contrary, no Japanese universities have an independent department of statistics at present, and the teaching of statistics has been spread among a heterogeneous group of departments of application. This was mainly due to the Japanese government regulation concerning the establishment of a university. However, it has recently been revised so that an independent department of statistics may be started in a Japanese university with undergraduate and graduate programs. It is hoped that discussions will be started among those concerned on the question of organization of the teaching of statistics in Japanese universities as soon as possible. PMID:396154

Perinatal Asphyxia and Brain Development: Mitochondrial Damage Without Anatomical or Cellular Losses.

PubMed

Lima, Jean Pierre Mendes; Rayêe, Danielle; Silva-Rodrigues, Thaia; Pereira, Paula Ribeiro Paes; Mendonca, Ana Paula Miranda; Rodrigues-Ferreira, Clara; Szczupak, Diego; Fonseca, Anna; Oliveira, Marcus F; Lima, Flavia Regina Souza; Lent, Roberto; Galina, Antonio; Uziel, Daniela

2018-03-26

Perinatal asphyxia remains a significant cause of neonatal mortality and is associated with long-term neurodegenerative disorders. In the present study, we evaluated cellular and subcellular damages to brain development in a model of mild perinatal asphyxia. Survival rate in the experimental group was 67%. One hour after the insult, intraperitoneally injected Evans blue could be detected in the fetuses' brains, indicating disruption of the blood-brain barrier. Although brain mass and absolute cell numbers (neurons and non-neurons) were not reduced after perinatal asphyxia immediately and in late brain development, subcellular alterations were detected. Cortical oxygen consumption increased immediately after asphyxia, and remained high up to 7 days, returning to normal levels after 14 days. We observed an increased resistance to mitochondrial membrane permeability transition, and calcium buffering capacity in asphyxiated animals from birth to 14 days after the insult. In contrast to ex vivo data, mitochondrial oxygen consumption in primary cell cultures of neurons and astrocytes was not altered after 1% hypoxia. Taken together, our results demonstrate that although newborns were viable and apparently healthy, brain development is subcellularly altered by perinatal asphyxia. Our findings place the neonate brain mitochondria as a potential target for therapeutic protective interventions.

Reaching perinatal women online: the Healthy You, Healthy Baby website and app.

PubMed

Hearn, Lydia; Miller, Margaret; Lester, Leanne

2014-01-01

Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs) to offer healthy lifestyle counselling. In response, today's Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the findings of a project designed to develop an online resource to promote healthy lifestyles during the perinatal period. The methodology involved focus groups and interviews with perinatal women and PHCPs to determine what online information was needed, in what form, and how best it should be presented. The outcome was the development of the Healthy You, Healthy Baby website and smartphone app. This clinically-endorsed, interactive online resource provides perinatal women with a personalised tool to track their weight, diet, physical activity, emotional wellbeing, and sleep patterns based on the developmental stage of their child with links to quality-assured information. One year since the launch of the online resource, data indicates it provides a low-cost intervention delivered across most geographic and socioeconomic strata without additional demands on health service staff.

Reaching Perinatal Women Online: The Healthy You, Healthy Baby Website and App

PubMed Central

Hearn, Lydia; Miller, Margaret; Lester, Leanne

2014-01-01

Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs) to offer healthy lifestyle counselling. In response, today's Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the findings of a project designed to develop an online resource to promote healthy lifestyles during the perinatal period. The methodology involved focus groups and interviews with perinatal women and PHCPs to determine what online information was needed, in what form, and how best it should be presented. The outcome was the development of the Healthy You, Healthy Baby website and smartphone app. This clinically-endorsed, interactive online resource provides perinatal women with a personalised tool to track their weight, diet, physical activity, emotional wellbeing, and sleep patterns based on the developmental stage of their child with links to quality-assured information. One year since the launch of the online resource, data indicates it provides a low-cost intervention delivered across most geographic and socioeconomic strata without additional demands on health service staff. PMID:24872891

Gender dependent association between perinatal morbidity and estrogen receptor-alpha Pvull polymorphism.

PubMed

Derzbach, László; Treszl, András; Balogh, Adám; Vásárhelyi, Barna; Tulassay, Tivadar; Rigó J, János

2005-01-01

Assuming the importance of estrogen in perinatal physiology, we tested the association of an estrogen receptor-alpha (ER-alpha) gene Pvull pP polymorphism with perinatal morbidity in premature infants. The ER-alpha Pp genotype was determined in 69 low-birth weight (LBW) boys and 72 LBW girls, 86 term boys and 81 term girls. The association between risk factors, genotype, gender and perinatal morbidity was tested with binary logistic regression analysis. Boys carrying "p" allele were at lower risk for necrotizing enterocolitis (OR [95% Cl]: 0.24 [0.07-0.83]) and patent ductus arteriosus (OR [95% Cl]: 0.24 [0.05-0.97]). The carrier state of the "p" allele was associated with a 34-h shorter period of oxygen supplementation on average (P=0.0018). Boys with pp genotype were at greater risk for intraventricular hemorrhage (OR [95% Cl]: 4.39 [1.15-16.82]). No association between ER-alpha Pvull polymorphism and morbidity was present in girls. Since homozygocity for any Pvull alleles (i.e. having PP or pp genotype) increases the risk for at least one of the most common perinatal complications, it is likely that the heterozygous carrier state of Pvull genotypes has a protective effect, which is gender-dependent.

Efficacy, Feasibility, and Acceptability of Perinatal Yoga on Women's Mental Health and Well-Being: A Systematic Literature Review.

PubMed

Sheffield, Karen M; Woods-Giscombé, Cheryl L

2016-03-01

Perinatal major depressive disorder affects 20% of women, while perinatal anxiety affects 10% of women. Although pharmacological treatment has shown effectiveness, many pregnant women are concerned about potential adverse effects on the fetus, maternal-infant bonding, and child development. Approximately 38% of American adults use complementary and alternative medicine, including yoga and other mind-body strategies. Although complementary and alternative medicine has been less studied in the perinatal population, it potentially offers women and their providers alternatives to traditional medication for treatment of perinatal depression and anxiety. Thus, the purpose of this systematic review was to examine existing empirical literature on yoga and its effects on women's health and well-being during the perinatal period. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systemic literature reviews, literature searches using relevant search terms were performed in four major electronic databases: CINAHL, PubMed, PsycINFO, and EMBASE. Thirteen publications met inclusion criteria. Results indicated that yoga interventions are generally effective in reducing anxiety and depression in pregnant women. The use of yoga in the perinatal period shows promise in improving mental health and well-being for women and infants. This review can inform future yoga intervention studies and clinical practice with the perinatal population. © The Author(s) 2015.

Relationship between parent demographic characteristics, perinatal and early childhood behaviors, and body mass index among preschool-age children.

PubMed

Messiah, Sarah E; Asfour, Lila; Arheart, Kristopher L; Selem, Sarah M; Uhlhorn, Susan B; Natale, Ruby

2015-04-01

Approximately 25% of US 2-to-5-year olds are overweight and ethnic minority groups are disproportionately affected. We explored the relationship between parent demographic characteristics, various perinatal/early childhood (EC) factors, and child body mass index (BMI) to determine possible contributors to these disparities. A preschool-based randomized controlled (N = 28 centers) obesity prevention intervention was conducted among multiethnic 2-to-5 year olds. Baseline assessment of demographic characteristics, various perinatal/EC factors, and child BMI were analyzed via generalized linear mixed models and logistic regression analysis. Foreign-born parents were almost 2.5 times as likely to have an obese child versus children of US-born parents (OR 2.43, 95% CI 1.53-3.87). Families who spoke Spanish only or a combination of Creole/English at home were over twice as likely to have an obese preschool child versus families who spoke English only at home. Parent place of birth and language spoken at home plays a significant role in early childhood obesity. Future early childhood healthy weight initiatives should incorporate strategies that take into account these particular parent characteristics.

Basic English Writers' Japanese-English Wordbook.

ERIC Educational Resources Information Center

Daniels, F. J.

The author of this Japanese-English wordbook suggests that it may be used by Japanese writers of English, by those translating from Japanese into English, and by learners of Japanese, in addition to its main intended uses as an aid to the preparation of teaching material and as a work of reference for teachers. A translator will need to supplement…

Perinatal Generalized Anxiety Disorder: Assessment and Treatment

PubMed Central

Abizadeh, Jasmin; Sanders, Shawn; Swift, Elena

2015-01-01

Abstract Perinatal generalized anxiety disorder (GAD) has a high prevalence of 8.5%–10.5% during pregnancy and 4.4%–10.8% postpartum. Despite its attendant dysfunction in the patient, this potentially debilitating mental health condition is often underdiagnosed. This overview will provide guidance for clinicians in making timely diagnosis and managing symptoms appropriately. A significant barrier to the diagnosis of GAD in the perinatal population is difficulty in distinguishing normal versus pathological worry. Because a perinatal-specific screening tool for GAD is nonexistent, early identification, diagnosis and treatment is often compromised. The resultant maternal dysfunction can potentially impact mother–infant bonding and influence neurodevelopmental outcomes in the children. Comorbid occurrence of GAD and major depressive disorder changes the illness course and its treatment outcome. Psychoeducation is a key component in overcoming denial/stigma and facilitating successful intervention. Treatment strategies are contingent upon illness severity. Cognitive behavior therapy (CBT), relaxation, and mindfulness therapy are indicated for mild GAD. Moderate/severe illness requires pharmacotherapy and CBT, individually or in combination. No psychotropic medications are approved by the FDA or Health Canada in pregnancy or the postpartum; off-label pharmacological treatment is instituted only if the benefit of therapy outweighs its risk. SSRIs/SNRIs are the first-line treatment for anxiety disorders due to data supporting their efficacy and overall favorable side effect profile. Benzodiazepines are an option for short-term treatment. While research on atypical antipsychotics is evolving, some can be considered for severe manifestations where the response to antidepressants or benzodiazepines has been insufficient. A case example will illustrate the onset, clinical course, and treatment strategies of GAD through pregnancy and the postpartum. PMID:26125602

Perinatal mortality rate in the Netherlands compared to other European countries: a secondary analysis of Euro-PERISTAT data.

PubMed

de Jonge, Ank; Baron, Ruth; Westerneng, Myrte; Twisk, Jos; Hutton, Eileen K

2013-08-01

the poor perinatal mortality ranking of the Netherlands compared to other European countries has led to questioning the safety of primary care births, particularly those at home. Primary care births are only planned at term. We therefore examined to which extent the perinatal mortality rate at term in the Netherlands contributes to its poor ranking. secondary analyses using published data from the Euro-PERISTAT study. women that gave birth in 2004 in the 29 European regions and countries called 'countries' included in the Euro-PERISTAT study (4,328,441 women in total and 1,940,977 women at term). odds ratios and 95% confidence intervals were calculated for the comparison of perinatal mortality rates between European countries and the Netherlands, through logistic regression analyses using summary country data. combined perinatal mortality rates overall and at term. Perinatal deaths below 28 weeks, between 28 and 37 weeks and from 37 weeks onwards per 1000 total births. compared to the Netherlands, perinatal mortality rates at term were significantly higher for Denmark and Latvia and not significantly different compared to seven other countries. Eleven countries had a significantly lower rate, and for eight the term perinatal mortality rate could not be compared. The Netherlands had the highest number of perinatal deaths before 28 weeks per 1000 total births (4.3). the relatively high perinatal mortality rate in the Netherlands is driven more by extremely preterm births than births at term. Although the PERISTAT data cannot be used to show that the Dutch maternity care system is safe, neither should they be used to argue that the system is unsafe. The PERISTAT data alone do not support changes to the Dutch maternity care system that reduce the possibility for women to choose a home birth while benefits of these changes are uncertain. Copyright © 2013 Elsevier Ltd. All rights reserved.

Exposure to Pre- and Perinatal Risk Factors Partially Explains Mean Differences in Self-Regulation between Races.

PubMed

Barnes, J C; Boutwell, Brian B; Miller, J Mitchell; DeShay, Rashaan A; Beaver, Kevin M; White, Norman

2016-01-01

To examine whether differential exposure to pre- and perinatal risk factors explained differences in levels of self-regulation between children of different races (White, Black, Hispanic, Asian, and Other). Multiple regression models based on data from the Early Childhood Longitudinal Study, Birth Cohort (n ≈ 9,850) were used to analyze the impact of pre- and perinatal risk factors on the development of self-regulation at age 2 years. Racial differences in levels of self-regulation were observed. Racial differences were also observed for 9 of the 12 pre-/perinatal risk factors. Multiple regression analyses revealed that a portion of the racial differences in self-regulation was explained by differential exposure to several of the pre-/perinatal risk factors. Specifically, maternal age at childbirth, gestational timing, and the family's socioeconomic status were significantly related to the child's level of self-regulation. These factors accounted for a statistically significant portion of the racial differences observed in self-regulation. The findings indicate racial differences in self-regulation may be, at least partially, explained by racial differences in exposure to pre- and perinatal risk factors.

Dusukasi-The Heart That Cries: An Idiom of Mental Distress Among Perinatal Women in Rural Mali.

PubMed

Lasater, Molly E; Beebe, Madeleine; Warren, Nicole E; Souko, Fatoumata; Keita, Mariam; Murray, Sarah E; Bass, Judith K; Surkan, Pamela J; Winch, Peter J

2018-04-25

Perinatal mental health problems such as depression and anxiety are prevalent in low and middle-income countries. In Mali, the lack of mental health care is compounded by few studies on mental health needs, including in the perinatal period. This paper examines the ways in which perinatal women experience and express mental distress in rural Mali. We describe a process, relying on several different qualitative research methods, to identify understandings of mental distress specific to the Malian context. Participants included perinatal women, maternal health providers, and community health workers in rural southwest Mali. Participants articulated several idioms of distress, including gèlèya (difficulties), tôôrô (pain, suffering), hamin (worries, concerns), and dusukasi (crying heart), that occur within a context of poverty, interpersonal conflict, and gender inequality. These idioms of distress were described as sharing many key features and operating on a continuum of severity that could progress over time, both within and across idioms. Our findings highlight the context dependent nature of experiences and expressions of distress among perinatal women in Mali.

Unpiloted Japanese Kounotori HTV-2 Transfer Vehicle

NASA Image and Video Library

2011-01-27

ISS026-E-020887 (27 Jan. 2011) --- Backdropped by a colorful part of Earth, the unpiloted Japanese Kounotori2 H-II Transfer Vehicle (HTV2) approaches the International Space Station. The Japan Aerospace Exploration Agency (JAXA) launched HTV2 aboard an H-IIB rocket from the Tanegashima Space Center in southern Japan at 12:37 a.m. (EST) (2:27 p.m. Japan time) on Jan. 22, 2011. HTV2 is the second unpiloted cargo ship launched by JAXA to the station and will deliver more than four tons of food and supplies to the space station and its crew members.

Unpiloted Japanese Kounotori HTV-2 Transfer Vehicle

NASA Image and Video Library

2011-01-27

ISS026-E-020850 (27 Jan. 2011) --- Backdropped by a cloud-covered part of Earth, the unpiloted Japanese Kounotori2 H-II Transfer Vehicle (HTV2) approaches the International Space Station. The Japan Aerospace Exploration Agency (JAXA) launched HTV2 aboard an H-IIB rocket from the Tanegashima Space Center in southern Japan at 12:37 a.m. (EST) (2:27 p.m. Japan time) on Jan. 22, 2011. HTV2 is the second unpiloted cargo ship launched by JAXA to the station and will deliver more than four tons of food and supplies to the space station and its crew members.

A behavioral science/behavioral medicine core curriculum proposal for Japanese undergraduate medical education.

PubMed

Tsutsumi, Akizumi

2015-01-01

Behavioral science and behavioral medicine have not been systematically taught to Japanese undergraduate medical students. A working group under the auspices of Japanese Society of Behavioral Medicine developed an outcome-oriented curriculum of behavioral science/behavioral medicine through three processes: identifying the curriculum contents, holding a joint symposium with related societies, and defining outcomes and proposing a learning module. The behavioral science/behavioral medicine core curriculum consists of 11 units of lectures and four units of practical study. The working group plans to improve the current core curriculum by devising formative assessment methods so that students can learn and acquire attitude as well as the skills and knowledge necessary for student-centered clinical practice.

Clinical and scientific results in perinatal care of pregnancy complicated by insulin dependent diabetes mellitus in Croatia.

PubMed

Djelmis, J

1998-01-01

At the Department of Obstetrics and Gynecology, Perinatal Unit for Diabetes and Fetal Growth, School of Medicine, Zagreb, perinatal care of pregnancies complicated with insulin dependent diabetes melitus (IDDM), has been performed for more than 36 years. The intention of this review is to show our own results in the management of IDDM pregnancies and the latest clinical advances in perinatal care of such pregnancies. Pregnancy complicated with IDDM is at risk because of numerous maternal, fetal and neonatal complications. Recent advances in medicine, especially in diabetology and perinatology, helps clinician avoid or lessen antenatal or perinatal complications in IDDM pregnancies. The main result of improved perinatal care is that today fetal and neonatal mortality in IDDM pregnancy is almost equal to that of healthy pregnant population. Intensive preconceptual care and optimal regulation of IDDM have resulted not only in decreased perinatal mortality but also in a decreased rate of congenital malformation. Tight glycemia control during pregnancy has a beneficial effect on fetal growth. Intensive control of fetal growth, verification of lung maturation at term by amniocenthesis, and control of fetal oxygenation will result in delivery of a mature eutrophic newborn with the lowest rate of neonatal complications possible. Perinatal mortality of less than 2% in IDDM pregnancy can be obtained by planned delivery between 38 and 39 weeks of gestation by either vaginal route or cesarean section, depending on indications. After delivery, intensive care of the newborn is necessary.

Perinatal mortality--a suitable index of health worldwide?

PubMed

Savage, A

1986-11-22

As a result of cultural factors, perinatal mortality may not be the most appropriate measure of health. Comparisons of the health of different countries should not be based on only 1 criterion unless general attitudes are the same. In developed countries, where abortion is widely available, unwanted pregnancies are handled before delivery. In some developing countries in Africa, however, population control may take the form of allowing a newborn to die of starvation, for example. Given this cultural difference, Third World countries rank lowest in perinatal health. It is suggested that mortality and morbidity should be calculated decade by decade before an index is derived. A 20-year old from a developing country, where there is no drug problem and attempted suicide is rare, might receive a higher health rating than his counterpart in developed countries.

Japanese Nationalism

DTIC Science & Technology

1989-06-01

United States. The chief function of this principle is to cut--it separates all things. It classifies everything into black and white, good and bad . The...content included articles on masturbation , petting, and 99 intercourse. One of Japan’s all time best selling books in recent years, Totto-chan, is a...to the th: every Japanese will be judged by whether he celebrates this or not. That is how people will be determined to be good Japanese or bad 112

Impact of prenatal evaluation and protocol-based perinatal management on congenital diaphragmatic hernia outcomes.

PubMed

Lazar, David A; Cass, Darrell L; Rodriguez, Manuel A; Hassan, Saif F; Cassady, Christopher I; Johnson, Yvette R; Johnson, Karen E; Johnson, Anthony; Moise, Kenneth J; Belleza-Bascon, Bella; Olutoye, Oluyinka O

2011-05-01

Although intuitive, the benefit of prenatal evaluation and multidisciplinary perinatal management for fetuses with congenital diaphragmatic hernia (CDH) is unproven. We compared the outcome of prenatally diagnosed patients with CDH whose perinatal management was by a predefined protocol with those who were diagnosed postnatally and managed by the same team. We hypothesized that patients with CDH undergoing prenatal evaluation with perinatal planning would demonstrate improved outcome. Retrospective chart review of all patients with Bochdalek-type CDH at a single institution between 2004 and 2009 was performed. Patients were stratified by history of perinatal management, and data were analyzed by Fisher's Exact test and Student's t test. Of 116 patients, 71 fetuses presented in the prenatal period and delivered at our facility (PRE), whereas 45 infants were either outborn or postnatally diagnosed (POST). There were more high-risk patients in the PRE group compared with the POST group as indicated by higher rates of liver herniation (63% vs 36%, P = .03), need for patch repair (57% vs 27%, P = .004), and extracorporeal membrane oxygenation use (35% vs 18%, P = .05). Despite differences in risk, there was no difference in 6-month survival between groups (73% vs 73%). Patients with CDH diagnosed prenatally are a higher risk group. Prenatal evaluation and multidisciplinary perinatal management allows for improved outcome in these patients. Copyright © 2011 Elsevier Inc. All rights reserved.

The value of customised centiles in assessing perinatal mortality risk associated with parity and maternal size.

PubMed

Gardosi, J; Clausson, B; Francis, A

2009-09-01

We wanted to compare customised and population standards for defining smallness for gestational age (SGA) in the assessment of perinatal mortality risk associated with parity and maternal size. Population-based cohort study. Sweden. Swedish Birth Registry database 1992-1995 with 354 205 complete records. Coefficients were derived and applied to determine SGA by the fully customised method, or by adjustment for fetal sex only, and using the same fetal weight standard. Perinatal deaths and rates of small for gestational age (SGA) babies within subgroups stratified by parity, body mass index (BMI) and maternal size within the BMI range of 20.0-24.9. Perinatal mortality rates (PMR) had a U-shaped distribution in parity groups, increased proportionately with maternal BMI, and had no association with maternal size within the normal BMI range. For each of these subgroups, SGA rates determined by the customised method showed strong association with the PMR. In contrast, SGA based on uncustomised, population-based centiles had poor correlation with perinatal mortality. The increased perinatal mortality risk in pregnancies of obese mothers was associated with an increased risk of SGA using customised centiles, and a decreased risk of SGA using population-based centiles. The use of customised centiles to determine SGA improves the identification of pregnancies which are at increased risk of perinatal death.

Effect of amnioinfusion for meconium stained amniotic fluid on perinatal outcome.

PubMed

Ashfaq, F; Shah, A A

2004-06-01

To see the effect of amnioinfusion on perinatal outcome in cases of meconium staining of liquor. This study was conducted in department of Obstetrics and Gynaecology, unit 1, Jinnah Postgraduate Medical Centre, Karachi, from 1st January 1998 to 31st December 2000. Four hundred patients were included in this study, assigning 200 for amnioinfusion and 200 as control. All patients were matched in both the groups with respect to age, antenatal booking, parity, gestational age, stage of labour, colour of amniotic fluid and fetal birth weight. Both the groups were found to be comparable. The rate of Caesarean section was found to be 37% in amnioinfusion group, which collaborates with other international studies. The fetal outcome was better i.e. 91% alive and healthy, after amnioinfusion due to dilution of meconium stained amniotic fluid with physiological solutions. The perinatal outcome was recorded by Apgar score at 5 minutes. The perinatal morbidity and mortality both were significantly lowered and was found to be 6% as compared to 14% in control, which was also noticed by less number of admissions in nursery i.e. 12% and perinatal deaths. The incidence of meconium aspiration syndrome was found to be 56% in control and was reduced to 22% after amnioinfusion in the other arm of the study. These results are very encouraging and suggestion can be safely made that in future amnioinfusion will be the ideal method of preventing fetal distress due to meconium stained amniotic fluid.

Are all immigrant mothers really at risk of low birth weight and perinatal mortality? The crucial role of socio-economic status.

PubMed

Racape, Judith; Schoenborn, Claudia; Sow, Mouctar; Alexander, Sophie; De Spiegelaere, Myriam

2016-04-08

Increasing studies show that immigrants have different perinatal health outcomes compared to native women. Nevertheless, we lack a systematic examination of the combined effects of immigrant status and socioeconomic factors on perinatal outcomes. Our objectives were to analyse national Belgian data to determine 1) whether socioeconomic status (SES) modifies the association between maternal nationality and perinatal outcomes (low birth weight and perinatal mortality); 2) the effect of adopting the Belgian nationality on the association between maternal foreign nationality and perinatal outcomes. This study is a population-based study using the data from linked birth and death certificates from the Belgian civil registration system. Data are related to all singleton births to mothers living in Belgium between 1998 and 2010. Perinatal mortality and low birth weight (LBW) were estimated by SES (maternal education and parental employment status) and by maternal nationality (at her own birth and at her child's birth). We used logistic regression to estimate the odds ratios for the associations between nationality and perinatal outcomes after adjusting for and stratifying by SES. The present study includes, for the first time, all births in Belgium; that is 1,363,621 singleton births between 1998 and 2010. Compared to Belgians, we observed an increased risk of perinatal mortality in all migrant groups (p < 0.0001), despite lower rates of LBW in some nationalities. Immigrant mothers with the Belgian nationality had similar rates of perinatal mortality to women of Belgian origin and maintained their protection against LBW (p < 0.0001). After adjustment, the excess risk of perinatal mortality among immigrant groups was mostly explained by maternal education; whereas for sub-Saharan African mothers, mortality was mainly affected by parental employment status. After stratification by SES, we have uncovered a significant protective effect of immigration against LBW and

Comparative electrophysiological study of response to botulinum toxin type B in Japanese and Caucasians.

PubMed

Arimura, Kimiyoshi; Arimura, Yumiko; Takata, Yoshiharu; Nakamura, Tomonori; Kaji, Ryuji

2008-01-30

Ethnic differences in the muscle-relaxing effect of botulinum toxin type B (BTX-B) were examined by means of electrophysiological measurements in Japanese and Caucasian volunteers. This was a randomized, single-blinded, single-center study of 24 Japanese and 24 Caucasian healthy adult male subjects in Japan. BTX-B (20 U, 100 U, or 500 U/0.2 mL) or placebo was administered to the extensor digitorum brevis (EDB) muscle in the left lower limb as a single dose (in each dose group, 6 subjects received the test drug and two received placebo). The inhibitory effect of BTX-B on the M wave amplitude of EDB muscle generated by stimulation of the deep peroneal nerve was measured frequently during 2 weeks after administration, and then at weeks 4 (day 28) and 12 (day 84). The inhibitory effect of BTX-B on the M wave amplitude of EDB muscle was dose-dependent in both Japanese and Caucasian subjects, and the dose-response curves were similar. These findings demonstrate that the muscle-relaxing effect of BTX-B in Japanese subjects is electrophysiologically similar to that in Caucasians. 2007 Movement Disorder Society

[The alteration of Japanese anatomical terminology in the early Showa period and the Japanese language reform campaign].

PubMed

Sawai, Tadashi; Sakai, Tatsuo

2010-03-01

In the second decade of the Showa period, great changes were made in the Japanese anatomical terms. It has been proposed that the presentation of JNA (Jenaer nomina anatomica) was one of the factors leading to the change. The Japanese language reform campaign, however, played an important role. The party kokugoaigo doumei and its successor kokugo kyokai required concise and unified technical terms. The anatomical nomenclature committee of the Japanese Association of Anatomists worked to satisfy this requirement. The committee consulted with nomenclature committees of other medical associations and took account of their opinions. The anatomical nomenclature committee abandoned the literal translation from Latin to Japanese and shaped a succinct Japanese terminology. Modern Japanese anatomical terms are based on this terminology.

A comprehensive perinatal patient safety program to reduce preventable adverse outcomes and costs of liability claims.

PubMed

Simpson, Kathleen Rice; Kortz, Carol C; Knox, G Eric

2009-11-01

To achieve the goal of safe care for mothers and infants during labor and birth, Catholic Healthcare Partners (CHP; Cincinnati) conducted on-site risk assessments at the 16 hospitals with perinatal units in 2004-2005, with follow-up visits in 2006 through 2008. ON-SITE RISK ASSESSMENTS: In addition to assessing overall organizational risk, the assessments provided each hospital a gap analysis demonstrating up-to-date and outdated practices and strategies and resources necessary to make all practices consistent with current evidence and national guidelines and standards. CRITICAL ASPECTS OF CLINICAL CARE: Review of claims and near-miss data indicate that fetal assessment, labor induction, and second-stage labor care comprise the majority of risk of perinatal harm. Therefore, these clinical areas were the focus of strategies to promote safety. To promote consistency in knowledge and practice, in 2004 a variety of strategies were recommended, including interdisciplinary fetal monitoring education and routine medical record reviews to monitor ongoing adherence to appropriate practice and documentation. Success in implementing essential structural and process components of the perinatal patient safety program have resulted in improvement from 2003 to 2008 in specific outcomes for the 16 perinatal units surveyed, including reduction of perinatal harm, number of claims, and costs of claims. The program continues to evolve with modifications as needed as more evidence becomes available to guide best perinatal practices and new guidelines/standards are published. A patient safety program guided and supported by a health care system can result in safer clinical environments in individual hospitals and in decreased risk of preventable perinatal harm and liability costs.

Psychosocial impact of mothers with perinatal loss and its contributing factors: an insight.

PubMed

Sutan, Rosnah; Amin, Rosnah Mohamad; Ariffin, Khatija Banu; Teng, Tang Zoun; Kamal, Mohd Faiz; Rusli, Rusli Zaim

2010-03-01

To evaluate the psychosocial impact among mothers with perinatal loss and its contributing factors. A cross sectional study was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) from April 2008 to May 2009 using Edinburgh Postnatal Depression Scale (EPDS) and self administered questionnaire. Sixty-two respondents were included and most of them were working mothers (77.4%). The mean age of the respondents was (31.0+/-5.6) years and a majority of the subjects aged between 20-34 years (77.4%). According to the EPDS score, 53.2% of the respondents had a psychosocial impact with a total score of >9, out of 30. There was a significant relationship between psychosocial impact after perinatal loss and support from friends (P=0.019). However, there were no significant differences between psychosocial impact and history of previous perinatal loss, ethnicity, occupation, educational level, age or total income. Mothers with perinatal loss should be screened for psychosocial impact and offered support when needed. Family and friends should continue to provide emotional support. People who have experienced similar problem before will be able to provide better support than those who have not.

Psychosocial impact of mothers with perinatal loss and its contributing factors: an insight*

PubMed Central

Sutan, Rosnah; Amin, Rosnah Mohamad; Ariffin, Khatija Banu; Teng, Tang Zoun; Kamal, Mohd Faiz; Rusli, Rusli Zaim

2010-01-01

Objective: To evaluate the psychosocial impact among mothers with perinatal loss and its contributing factors. Methods: A cross sectional study was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) from April 2008 to May 2009 using Edinburgh Postnatal Depression Scale (EPDS) and self administered questionnaire. Results: Sixty-two respondents were included and most of them were working mothers (77.4%). The mean age of the respondents was (31.0±5.6) years and a majority of the subjects aged between 20–34 years (77.4%). According to the EPDS score, 53.2% of the respondents had a psychosocial impact with a total score of >9, out of 30. There was a significant relationship between psychosocial impact after perinatal loss and support from friends (P=0.019). However, there were no significant differences between psychosocial impact and history of previous perinatal loss, ethnicity, occupation, educational level, age or total income. Conclusion: Mothers with perinatal loss should be screened for psychosocial impact and offered support when needed. Family and friends should continue to provide emotional support. People who have experienced similar problem before will be able to provide better support than those who have not. PMID:20205307

Depressive symptomatology and grief in Spanish women who have suffered a perinatal loss.

PubMed

Ridaura, Isabel; Penelo, Eva; Raich, Rosa M

2017-02-01

Perinatal grief differs from other types of mourning. Two goals were set: to describe the progression of the process of grief and the symptoms of depression throughout the year following perinatal loss, and to study its association with socio-economic and obstetric factors. The study involved the participation of 70 women who had suffered a medical termination of pregnancy or a prenatal/postnatal death. Three assessments were made after the loss (after 1 month, 6 months and 1 year) with the Perinatal Grief Scale (PGS) to assess grief and the Beck Depression Inventory (BDI) for depressive symptomatology. Symptoms pertaining to grief and depression were observed in the first month after the loss, and a significant decrease in scores over the two follow-ups. No significant differences were observed in grief and depression depending on the type of loss, no significant associations were found with the age of the mother, her socioeconomic level, or obstetric factors (week of gestation of the loss, having a child or having suffered a previous miscarriage). Perinatal grief is a complex construct, with multiple variables involved, and one which involves significant emotional discomfort.

Effects of perinatal fluoride exposure on the expressions of miR-124 and miR-132 in hippocampus of mouse pups.

PubMed

Wang, Jixiang; Zhang, Yuliang; Guo, Zhenzhen; Li, Rui; Xue, Xingchen; Sun, Zilong; Niu, Ruiyan

2018-04-01

To investigate the effects of perinatal fluoride exposure on learning and memory ability of mouse offspring, ICR female mice were received different doses of sodium fluoride (0, 25, 50, 100 mg/L NaF) from pregnant day 7 to lactational day 21. Pups were exposed to fluoride through the cord blood and breast milk. Open field test showed that compared to the control group, perinatal fluoride exposure significantly decreased the number of entries into the center zone in 100 mg/L NaF group. In the eight-arm maze test, the number of working memory errors, reference memory errors, and the total arm entries were significantly increased in fluoride treatment groups, compared to the control group. Additionally, 100 mg/L NaF significantly elevated the expression levels of miR-124, miR-132, and DiGeorge syndrome chromosomal region 8 (DGCR8) in hippocampus of mouse pups at postnatal day (PND) 21. Contrarily, methyl CpG binding protein 2 (MeCP2) were dramatically reduced in 50 and 100 mg/L NaF groups, while cAMP-response element binding protein (CREB) mRNA level was significantly decreased in all fluoride groups. These findings suggested that the impairment of learning and memory in mouse offspring induced by perinatal fluoride exposure may partly result from the enhanced miR-124 and miR-132 and the alterations of their target genes. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Perinatal complications in patients with chronic renal insufficiency on hemodialysis].

PubMed

Vázquez-Rodríguez, Juan Gustavo; del Angel-García, Guadalupe

2010-09-01

Pregnant patients with chronic renal insufficiency treated with hemodialysis experience adverse perinatal results. To compare perinatal complications of patients with chronic renal insufficiency undergoing hemodialysis who become pregnant vs. the complications of women with chronic renal insufficiency not undergoing dialysis but who then require dialysis during gestation. Transversal and retrospective study that included three patients with chronic renal insufficiency on chronic hemodialysis who became pregnant (group A) and three patients with chronic renal insufficiency without hemodialysis at the time of conception but who required dialysis during gestation (group B). Perinatal results were compared. Statistical analysis was performed with measures of central tendency and dispersion and Student t-test. Group A had 25 sessions vs. group B with 29 hemodialysis sessions (p = 0.88). Maternal complications were anemia 100% (six cases), Cesarean delivery 83.3% (group A 2 cases vs. group B 2 cases), preeclampsia 50% (group A 2 cases vs. group B 1 case), uncontrolled hypertension 50% (group A 2 cases vs. group B 1 case), preterm delivery 50% (group A 2 cases vs. group B 1 case), transfusion 33.3% (group A 2 cases), polyhydramnios 33.3% (group A 1 case vs. group B 1 case) and abortion 16.6% (group A 1 case). Fetal complications included fetal loss 16.6% (group A 1 case), neonatal mortality 33.3% (group A 1 cases vs. group B 1 case), prematurity 50% (group A2 cases vs. group B 1 case), fetal distress 50% (group A 1 case vs. group B 2 cases), respiratory failure 33.3% (group A 2 cases) and fetal growth restriction 16.6% (group A 1 case). Frequency of perinatal complications is elevated in both groups.

Transport as a system: reorganization of perinatal assistance in Northern Lombardy.

PubMed

Martinelli, Stefano; Vergani, Patrizia; Zanini, Rinaldo; Bellù, Roberto; Farina, Clotilde; Tagliabue, Paolo

2011-10-01

The organization of perinatal care has been a pivotal mean for improvement in neonatal survivals. Despite the excellent standard of assistance in Lombardy, Obstetrics and Neonatal Units of MBBM Foundation-Monza, Manzoni Hospital-Lecco and Niguarda Hospital-Milan put forward a pilot project proposing reorganization of perinatal care in the northern part of Lombardy. The main goals of the project are implementation of maternal transport system and use of neonatal back transport as a system to increase the availability of intensive care beds. The project's fundamental steps and critical points will be discussed.

Prenatal and Perinatal Risk Factors for Autism in China

PubMed Central

Zhang, Xin; Lv, Cong-Chao; Tian, Jiang; Miao, Ru-Juan; Xi, Wei; Hertz-Picciotto, Irva

2010-01-01

We conducted a case–control study using 190 Han children with and without autism to investigate prenatal and perinatal risk factors for autism in China. Cases were recruited through public special education schools and controls from regular public schools in the same region (Tianjin), with frequency matching on sex and birth year. Unadjusted analyses identified seven prenatal and seven perinatal risk factors significantly associated with autism. In the adjusted analysis, nine risk factors showed significant association with autism: maternal second-hand smoke exposure, maternal chronic or acute medical conditions unrelated to pregnancy, maternal unhappy emotional state, gestational complications, edema, abnormal gestational age (<35 or >42 weeks), nuchal cord, gravidity >1, and advanced paternal age at delivery (>30 year-old). PMID:20358271

Characterization of U.S. State Laws Requiring Health Care Provider Reporting of Perinatal Substance Use.

PubMed

Jarlenski, Marian; Hogan, Caroline; Bogen, Debra L; Chang, Judy C; Bodnar, Lisa M; Van Nostrand, Elizabeth

State policies pertaining to health care provider reporting of perinatal substance use have implications for provider screening and referral behavior, patients' care seeking and access to prenatal substance use disorder treatment, and pregnancy and birth outcomes. This study sought to characterize specific provisions enacted in state statutes pertaining to mandates that health care providers report perinatal substance use, and to determine the proportion of births occurring in states with such laws. We conducted a systematic content analysis of statutes in all U.S. states that mentioned reporting by health care providers of substance use by pregnant women or infants exposed to substances in utero; inter-rater reliability was high. We calculated the number of states, and proportion of U.S. births occurring in states, with processes for mandatory reporting of perinatal substance use to authorities, and substance use disorder treatment provision for individuals who are reported. Twenty states (corresponding with 31% of births) had laws requiring health care providers to report perinatal substance use to child protective authorities, and four states (18% of births) had laws requiring reporting only when a health care provider believed the substance use was associated with child maltreatment. About one-half of states (13) with any reporting law had a provision promoting substance use disorder treatment in the perinatal period. Findings inform the ongoing debate about how health policies may be used to reduce the population burden of perinatal substance use. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Perinatal Yellow Fever: A Case Report.

PubMed

Diniz, Lilian Martins Oliveira; Romanelli, Roberta Maia Castro; de Carvalho, Andréa Lucchesi; Teixeira, Daniela Caldas; de Carvalho, Luis Fernando Andrade; Cury, Verônica Ferreira; Filho, Marcelo Pereira Lima; Perígolo, Graciele; Heringer, Tiago Pires

2018-04-09

An outbreak of yellow fever in Brazil made it possible to assess different presentations of disease such as perinatal transmission. A pregnant woman was admitted to hospital with yellow fever symptoms. She was submitted to cesarean section and died due to fulminant hepatitis. On the 6th day the newborn developed liver failure and died 13 days later. Yellow fever PCR was positive for both.

Compliment Responses: Comparing American Learners of Japanese, Native Japanese Speakers, and American Native English Speakers

ERIC Educational Resources Information Center

Tatsumi, Naofumi

2012-01-01

Previous research shows that American learners of Japanese (AJs) tend to differ from native Japanese speakers in their compliment responses (CRs). Yokota (1986) and Shimizu (2009) have reported that AJs tend to respond more negatively than native Japanese speakers. It has also been reported that AJs' CRs tend to lack the use of avoidance or…

Chromobacterium violaceum nosocomial pneumonia in two Japanese patients at an intensive care unit.

PubMed

Hagiya, Hideharu; Murase, Tomoko; Suzuki, Masato; Shibayama, Keigo; Kokumai, Yumi; Watanabe, Naoto; Maki, Miyako; Otsuka, Fumio

2014-02-01

Chromobacterium violaceum is sensitive to temperature and the infection is usually confined to tropical or subtropical regions. Since Japan has a warm climate, C. violaceum has been scarcely isolated from clinical specimens. With global warming, however, the geographical distribution of C. violaceum infection is likely to change. We report two cases of C. violaceum nosocomial pneumonia that occurred at an intensive care center in Japan. C. violaceum was first detected from a patient in the same center as a pathogenic organism of pneumonia. Later, the organism was isolated from sputum and a ventilator circuit tube of another patient in the center. The two patients were admitted to the center in nearby beds for several days. All of the pathogens were confirmed to be C. violaceum by the nucleic acid sequence of the 16S rRNA gene and were proven to be genetically identical organisms by pulsed field gel electrophoresis. Both patients were managed with well-humidified and heated oxygen using a venturi mask and ventilator to promote excretion of sputum. It was thought that the medical respiratory care devices that provide a humid and warm environment, an optimal condition for proliferation of C. violaceum, can contribute to C. violaceum infection in a hospital environment. Copyright © 2013 Japanese Society of Chemotherapy and The Japanese Association for Infectious Disease. Published by Elsevier Ltd. All rights reserved.

Maternal stress and perinatal features in autism and attention deficit/hyperactivity disorder.

PubMed

Say, Gökçe Nur; Karabekiroğlu, Koray; Babadağı, Zehra; Yüce, Murat

2016-04-01

We investigated the shared and non-shared perinatal risk factors for autism spectrum disorders (ASD) and attention deficit/hyperactivity disorder (ADHD) in a clinical sample. Additionally, we compared these groups regarding pre/postpartum maternal stress and the duration of breastfeeding. Children aged 3-18 years old with ASD (n = 100) were compared with age- and gender-matched children with ADHD (n = 100) and with age- and gender-matched healthy controls (n = 80). Prematurity of the neonate and maternal stress/depressive mood in pregnancy were common risk factors shared by ASD and ADHD. Postpartum maternal depressive mood may be more specific to ASD, while shorter duration of breastfeeding may be related to ADHD. ASD and ADHD may have some perinatal features in common. Identification of perinatal factors for ASD and ADHD carries clinical implications in terms of primary prevention. © 2015 Japan Pediatric Society.

Maternal education and perinatal outcomes among Spanish women residing in southern Spain (2001-2011).

PubMed

Juárez, Sol; Revuelta-Eugercios, Bárbara A; Ramiro-Fariñas, Diego; Viciana-Fernández, Francisco

2014-10-01

Evidence suggests that educational differences in perinatal outcomes have increased in some countries (Eastern Europe) while remained stable in others (Scandinavian countries). However, less is known about the experience of Southern Europe. This study aims to evaluate the association between maternal education and perinatal outcomes derived from birthweight (low birthweight and macrosomia) and gestational age (pre-term and post-term births) among Spaniards living in the Autonomous Community of Andalusia during the period 2001-2011 (around 19 % of births in Spain); and to evaluate whether the educational differences narrowed or widened during that period, which includes both an economic boom (2001-2008) and the global economic crisis (2009-2011). This study uses the Andalusian Population Longitudinal Database and the Vital Statistics Data provided by the Spanish National Statistics Institute. We study live and singleton births of Spanish mothers who lived in Andalusia at the time of delivery (n = 404,951). ORs with 95 % confidence intervals (crude and adjusted) were estimated using multinomial regression models. A negative educational gradient is observed in all perinatal outcomes studied (i.e., the higher the educational status, the lower the risk of negative perinatal outcomes). However, when disaggregating the sample in two periods, the gradient is only statistically significant for pre-term birth during 2001-2008, while a full gradient is observed in all perinatal indicators in the period 2009-2011 with an increase in the educational inequalities in macrosomia and post-term. Further studies are needed in order to confirm whether there is a causal association between the widening of the educational differences in perinatal outcomes and the onset of the economic crisis in Spain, or the widening can be explained by other factors, such as changes in childbearing patterns and the composition of women accessing motherhood.

Text messaging to support a perinatal collaborative care model for depression: A multi-methods inquiry.

PubMed

Bhat, Amritha; Mao, Johnny; Unützer, Jürgen; Reed, Susan; Unger, Jennifer

Mental health care integrated into obstetric settings improves access to perinatal depression treatments. Digital interactions such as text messaging between patient and provider can further improve access. We describe the use of text messaging within a perinatal Collaborative Care (CC) program, and explore the association of text messaging content with perinatal depression outcomes. We analyzed data from an open treatment trial of perinatal CC in a rural obstetric clinic. Twenty five women with Patient Health Questionnaire-9 score of ≥10 enrolled in CC, and used text messaging to communicate with their Care Manager(CM). We used surveys and focus groups to assessacceptability of text messaging with surveys and focus groups. We calculated the number of text messages exchanged, and analyzed content to understand usage patterns. We explored association between text messaging content and depression outcomes. CMs initiated 85.4% messages, and patients responded to 86.9% messages. CMs used text messaging for appointment reminders, and patients used it to obtain obstetric and parenting information. CMs had concerns about the likelihood of boundary violations. Patients appreciated the asynchronous nature of text messaging. Text messaging is feasible and acceptable within a perinatal CC program. We need further research into the effectiveness of text messaging content, and response protocols. Copyright © 2018 Elsevier Inc. All rights reserved.

Perinatal thiamine deficiency-induced spontaneous abortion and pup-killing responses in rat dams.

PubMed

Bâ, Abdoulaye

2013-03-01

The current study attempts to determine whether thiamine (B1 vitamin) deficiency and chronic alcohol-related thiamine-deficient (TD) status, disturb maternal behavior towards pups. During gestation and lactation, Wistar rat dams were exposed to the following treatments: (i) prenatal TD dams; (ii) perinatal TD dams; (iii) postnatal TD dams; (iv) 12% alcohol/water drinking mothers; (v) ad libitum control dams. Pair-feeding treatments controlled malnutrition related to thiamine deficiency; (vi) prenatal pair-fed (PF) dams; (vii) perinatal PF dams; (viii) postnatal PF dams and included also the control of alcohol consummation: (ix) PF saccharose dams. Dams were observed for gestation outcome and for apparent disorders of the maternal behavior related to the pups at parturition. From the nine experimental groups studied, only pre- and perinatal TD dams exhibited spontaneous abortion (33.36 and 41.66%, respectively) followed by pups-killing responses where, respectively, 4 dams/7 (57.14%) and 5 dams/7 (71.43%) showed disruption of maternal behavior and appearance of cannibalism towards pups which all were killed within 48 hours after parturition. Spontaneous abortion and pup-killing responses were not observed in the dams of any other experimental group, suggesting that perinatal disturbances of hormonal factors underlay these maternal disorders. Previous studies reported that thiamine deficiency-induced degeneration of dopamine neurons may be related to mouse-killing aggression in rats. The present study suggests that perinatal thiamine deficiency-induced alteration of dopaminergic neurons in maternal brain could be a trigger factor of pup-killing responses. Central dopamine and oxytocin have been strongly associated with both the onset and maintenance of maternal behavior and the regulation of maternal aggressiveness as well. Our studies suggest that estrogen control oxytocin levels in brain structures of pregnancy-terminated rats via dopamine transmission. Thiamine

Redefining Perinatal Experience: A Philosophical Exploration of a Hypothetical Case of Gender-Diversity in Labour and Birth.

PubMed

Richardson, Brianna; Price, Sheri; Campbell-Yeo, Marsha

2018-05-18

Using a queer phenomenological approach, the objective of this philosophical analysis is to explore the transgender experience in highly gendered clinical areas, such as the birth unit, and make recommendations on how to provide perinatal care that is inclusive of gender diversity within these areas. This paper aims to describes a hypothetical clinical experience to provide insight on the institutional barriers that currently exist and to provide nurses and midwives with pragmatic strategies to enhance gender-diverse care in general and gendered clinical areas. Currently, general healthcare providers are not sufficiently educated on how to care for and meet the needs of people who identify as lesbian, gay, bisexual, trans, queer, queer or questioning and other communities (LGBTQ+). This vulnerable population continually faces stigma, discrimination, and marginalization, which act as barriers to accessing healthcare services. Although transgender people often have difficulty accessing healthcare in general settings, they experience an even greater challenge within traditionally gendered clinical care areas. Queer Phenomenology was used to guide a critical philosophical analysis of hypothetical case reflecting a clinical scenario regarding a transgender man's experience in labour and birth. Healthcare professionals often provide insufficient care to transgender persons, inadvertently leading to further marginalization of this vulnerable population. Special consideration to provide gender-diverse care throughout the perinatal period is needed. Structures and supports are essential to enhance the care from providers in attending to the unique needs of transgender individuals and reduce oppressive effects from heteronormative environments. Nurses and midwives are leading exemplars of providing person-centered care and are capable of advocating for equitable care amongst all populations to influence systemic change. Strategies for implementing changes that address LGBTQ

Diagnosis and management of perinatal depression and anxiety in general practice: a meta-synthesis of qualitative studies.

PubMed

Ford, Elizabeth; Lee, Suzanne; Shakespeare, Judy; Ayers, Susan

2017-08-01

Up to 20% of women experience anxiety and depression during the perinatal period. In the UK, management of perinatal mental health falls under the remit of GPs. This review aimed at synthesising the available information from qualitative studies on GPs' attitudes, recognition, and management of perinatal anxiety and depression. Meta-synthesis of the available published qualitative evidence on GPs' recognition and management of perinatal anxiety and depression. A systematic search was conducted on Embase, Medline, PsycInfo, Pubmed, Scopus, and Web of Science, and grey literature was searched using Google, Google Scholar, and British Library EThOS. Papers and reports were eligible for inclusion if they reported qualitatively on GPs' diagnosis or treatment of perinatal anxiety or depression. The synthesis was constructed using meta-ethnography. Five themes were established from five eligible papers: labels: diagnosing depression; clinical judgement versus guidelines; care and management; use of medication; and isolation: the role of other professionals. GPs considered perinatal depression to be a psychosocial phenomenon, and were reluctant to label disorders and medicalise distress. GPs relied on their own clinical judgement more than guidelines. They reported helping patients make informed choices about treatment, and inviting them back regularly for GP visits. GPs sometimes felt isolated when dealing with perinatal mental health issues. GPs often do not have timely access to appropriate psychological therapies and use several strategies to mitigate this shortfall. Training must focus on these issues and must be evaluated to consider whether this makes a difference to outcomes for patients. © British Journal of General Practice 2017.

Associations of maternal lifetime trauma and perinatal traumatic stress symptoms with infant cardiorespiratory reactivity to psychological challenge

PubMed Central

Enlow, Michelle Bosquet; Kullowatz, Antje; Staudenmayer, John; Spasojevic, Jelena; Ritz, Thomas; Wright, Rosalind J.

2010-01-01

Objective Trauma influences on perinatal maternal-child interactions may affect the organization of offspring physiological systems involved in health outcomes. This study used a novel advanced system recently adapted for infants to examine associations of maternal lifetime trauma and related psychological symptoms in the perinatal period with infant cardiorespiratory reactivity and behavioral distress in response to a laboratory stressor. Methods Mothers self-reported lifetime exposure to trauma, perinatal traumatic stress, and current symptoms of posttraumatic stress disorder (PTSD) and depression. Heart rate and indices of respiratory volume, timing, and thoraco-abdominal coordination were continuously recorded using a non-invasive respiratory inductance plethysmography device from 23 infants during the Still-Face Paradigm, a videotaped mother-infant dyadic assessment that included baseline, stressor, and recovery phases. Infant behavioral distress during the procedure was also assessed. Results Infants of mothers with low exposure to trauma and perinatal traumatic stress showed expected increases in behavioral distress and cardiorespiratory activation from baseline to stressor and decreases in these parameters from stressor to recovery. Infants of mothers exposed to multiple traumas and with elevated perinatal traumatic stress showed similar patterns of activation from baseline to stressor but failed to show decreases during recovery. These patterns were maintained after controlling for current maternal PTSD and depressive symptoms. Conclusions Maternal lifetime trauma exposure and traumatic stress during the perinatal period were associated with disrupted infant cardiorespiratory regulation and behavioral distress during a stressor protocol. These results support the concept of perinatal programming and its potential role in physical and mental health outcomes. PMID:19553287

PREGNANCY AND PERINATAL HEALTH, BAMEN, INNER MONGOLIA, CHINA

EPA Science Inventory

For developing countries, especially in remote rural areas, measures of maternal and perinatal health may be difficult to obtain because it is not systematically collected and/or electronic data is not available. We assisted the public health officials of Bayingnormen (BaMen), In...

Impact of Fetal Versus Perinatal Hypoxia on Sex Differences in Childhood Outcomes: Developmental Timing Matters

PubMed Central

Anastario, Michael; Salafia, Carolyn M.; Fitzmaurice, Garrett; Goldstein, Jill M.

2013-01-01

Purpose To examine how the timing of hypoxic exposure results in specific childhood outcomes and whether there is a differential effect by sex. Methods A sample of 10,879 prospectively followed pregnancies was drawn from the Boston and Providence sites (New England-NE) of the National Collaborative Perinatal Project. Based on placental pathology, we developed and validated a measure of probable chronic fetal hypoxia (CHP) and contrasted the effects of acute perinatal hypoxia on age 7 emotional, behavioral, and cognitive outcomes. Results Perinatal hypoxia had a significant impact on multiple behavioral and cognitive outcomes in boys and girls by age 7, in contrast to probable CHP which had a differential effect on girls and boys such that there was decreased verbal IQ and increased inhibition in females alone. Conclusions Findings underscore the importance of considering the timing of obstetric complications and offspring sex in investigations of the impact of fetal and perinatal hypoxia on offspring’s outcomes throughout the life course. PMID:21327969

Japanese and American public health approaches to preventing population weight gain: A role for paternalism?

PubMed

Borovoy, Amy; Roberto, Christina A

2015-10-01

Controlling population weight gain is a major concern for industrialized nations because of associated health risks. Although Japan is experiencing rising prevalence of obesity and overweight, historically they have had and continue to maintain a low prevalence relative to other developed countries. Therefore, Japan provides an interesting case study of strategies to curb population weight gain. In this paper we explore Japanese approaches to obesity and diet through observational and ethnographic interviews conducted between June 2009 and September 2013. Nineteen interviews were conducted at four companies and three schools in Tokyo, as well as at a central Tokyo community health care center and school lunch distribution center. Interviewees included physicians, a Ministry of Health bureaucrat, human resources managers, welfare nurses employed by health insurance organizations, school nurses (also government employees), school nutritionists, and a school counselor. We highlight the role of culture and social norms in encouraging healthful behavior in Japan, focusing on the Ministry of Health, Labor, and Welfare's metabolic syndrome screening program (implemented in 2005) and the Japanese national school lunch program. The Japanese government prescribes optimal body metrics for all Japanese citizens and relies on institutions such as schools and health insurance organizations that are in some instances closely affiliated with the workplace to carry out education. Japan's socio-cultural approach leads us reflect on the cultural and social conditions that make different policy prescriptions more politically feasible and potentially effective. It also provokes us to question whether limited behavioral modifications and "nudging" can lead to broader change in an environment like the United States where there are fewer broadly shared socio-cultural norms regarding acceptable health behavior. Copyright © 2015 Elsevier Ltd. All rights reserved.

Japanese American Identity Dilemma.

ERIC Educational Resources Information Center

Maykovich, Minako K.

The major theme of this book is the label "Quiet American" for the Japanese American. In order to locate Japanese Americans sociologically and psychologically in the structure of American society, various concepts such as "marginal man,""alienation," and "inauthenticity" are examined, specifying these…

Vitamin B-12 and Perinatal Health123

PubMed Central

Finkelstein, Julia L; Layden, Alexander J; Stover, Patrick J

2015-01-01

Vitamin B-12 deficiency (<148 pmol/L) is associated with adverse maternal and neonatal outcomes, including developmental anomalies, spontaneous abortions, preeclampsia, and low birth weight (<2500 g). The importance of adequate vitamin B-12 status periconceptionally and during pregnancy cannot be overemphasized, given its fundamental role in neural myelination, brain development, and growth. Infants born to vitamin B-12-deficient women may be at increased risk of neural tube closure defects, and maternal vitamin B-12 insufficiency (<200 pmol/L) can impair infant growth, psychomotor function, and brain development, which may be irreversible. However, the underlying causal mechanisms are unknown. This review was conducted to examine the evidence that links maternal vitamin B-12 status and perinatal outcomes. Despite the high prevalence of vitamin B-12 deficiency and associated risk of pregnancy complications, few prospective studies and, to our knowledge, only 1 randomized trial have examined the effects of vitamin B-12 supplementation during pregnancy. The role of vitamin B-12 in the etiology of adverse perinatal outcomes needs to be elucidated to inform public health interventions. PMID:26374177

Perinatal outcomes among immigrant mothers over two periods in a region of central Italy

PubMed Central

2011-01-01

Background The number of immigrants has increased in Italy in the last twenty years (7.2% of the Italian population), as have infants of foreign-born parents, but scanty evidence on perinatal outcomes is available. The aim of this study was to investigate whether infants of foreign-born mothers living in Italy have different odds of adverse perinatal outcomes compared to those of native-born mothers, and if such measures changed over two periods. Methods The source of this area-based study was the regional hospital discharge database that records perinatal information on all births in the Lazio region. We analysed 296,739 singleton births born between 1996-1998 and 2006-2008. The exposure variable was the mother's region of birth. We considered five outcomes of perinatal health. We estimated crude and adjusted odds ratios and 95% confidence intervals (CIs) to evaluate the association between mother's region of birth and perinatal outcomes. Results Perinatal outcomes were worse among infants of immigrant compared to Italian mothers, especially for sub-Saharan and west Africans, with the following crude ORs (in 1996-1998 and 2006-2008 respectively): 1.80 (95%CI:1.44-2.28) and 1.95 (95%CI:1.72-2.21) for very preterm births, and 1.32 (95%CI:1.16-1.50) and 1.32 (95%CI:1.25-1.39) for preterm births; 1.18 (95%CI:0.99-1.40) and 1.17 (95%CI:1.03-1.34) for a low Apgar score; 1.22 (95%CI:1.15-1.31) and 1.24 (95%CI:1.17-1.32) for the presence of respiratory diseases; 1.47 (95%CI:1.30-1.66) and 1.45 (95%CI:1.34-1.57) for the need for special or intensive neonatal care/in-hospital deaths; and 1.03 (95%CI:0.93-1.15) and 1.07 (95%CI:1.00-1.15) for congenital malformations. Overall, time did not affect the odds of outcomes differently between immigrant and Italian mothers and most outcomes improved over time among all infants. None of the risk factors considered confounded the associations. Conclusion Our findings suggest that migrant status is a risk factor for adverse perinatal

Guidelines on treatment of perinatal depression with antidepressants: An international review

PubMed Central

Kamperman, Astrid M; Boyce, Philip; Bergink, Veerle

2018-01-01

Objective: Several countries have developed Clinical Practice Guidelines regarding treatment of perinatal depressive symptoms and perinatal use of antidepressant. We aimed to compare guidelines to guide clinicians in best clinical practice. Methods: An extensive search in guideline databases, MEDLINE and PsycINFO was performed. When no guidelines were (publicly) available online, we contacted psychiatric-, obstetric-, perinatal- and mood disorder societies of all first world countries and the five largest second world countries. Only Clinical Practice Guidelines adhering to quality criteria of the Appraisal of Guidelines for Research and Evaluation instrument and including a systematic review of evidence were included. Data extraction focussed on recommendations regarding continuation or withdrawal of antidepressants and preferred treatment in newly depressed patients. Results: Our initial search resulted in 1094 articles. After first screening, 40 full-text articles were screened. Of these, 24 were excluded for not being an official Clinical Practice Guidelines. In total, 16 Clinical Practice Guidelines were included originating from 12 countries. Eight guidelines were perinatal specific and eight were general guidelines. Conclusion: During pregnancy, four guidelines advise to continue antidepressants, while there is a lack of evidence supporting this recommendation. Five guidelines do not specifically advise or discourage continuation. For new episodes, guidelines agree on psychotherapy (especially cognitive behavioural therapy) as initial treatment for mild to moderate depression and antidepressants for severe depression, with a preference for sertraline. Paroxetine is not preferred treatment for new episodes but switching antidepressants for ongoing treatment is discouraged (three guidelines). If mothers use antidepressants, observation of the neonate is generally recommended and breastfeeding encouraged. PMID:29506399

Guidelines on treatment of perinatal depression with antidepressants: An international review.

PubMed

Molenaar, Nina M; Kamperman, Astrid M; Boyce, Philip; Bergink, Veerle

2018-04-01

Several countries have developed Clinical Practice Guidelines regarding treatment of perinatal depressive symptoms and perinatal use of antidepressant. We aimed to compare guidelines to guide clinicians in best clinical practice. An extensive search in guideline databases, MEDLINE and PsycINFO was performed. When no guidelines were (publicly) available online, we contacted psychiatric-, obstetric-, perinatal- and mood disorder societies of all first world countries and the five largest second world countries. Only Clinical Practice Guidelines adhering to quality criteria of the Appraisal of Guidelines for Research and Evaluation instrument and including a systematic review of evidence were included. Data extraction focussed on recommendations regarding continuation or withdrawal of antidepressants and preferred treatment in newly depressed patients. Our initial search resulted in 1094 articles. After first screening, 40 full-text articles were screened. Of these, 24 were excluded for not being an official Clinical Practice Guidelines. In total, 16 Clinical Practice Guidelines were included originating from 12 countries. Eight guidelines were perinatal specific and eight were general guidelines. During pregnancy, four guidelines advise to continue antidepressants, while there is a lack of evidence supporting this recommendation. Five guidelines do not specifically advise or discourage continuation. For new episodes, guidelines agree on psychotherapy (especially cognitive behavioural therapy) as initial treatment for mild to moderate depression and antidepressants for severe depression, with a preference for sertraline. Paroxetine is not preferred treatment for new episodes but switching antidepressants for ongoing treatment is discouraged (three guidelines). If mothers use antidepressants, observation of the neonate is generally recommended and breastfeeding encouraged.

Perinatal stress and food allergy: a preliminary study on maternal reports.

PubMed

Polloni, L; Ferruzza, E; Ronconi, L; Lazzarotto, F; Toniolo, A; Bonaguro, R; Muraro, A

2015-01-01

Maternal stress in fetal and early life has been associated with the development of respiratory allergies, but no studies exist about food allergy. Stressful events and the quality of caregiving provided, as they affect the emotional and physiologic regulation of the infant, could alter the hypothalamic-pituitary-adrenal and immune system, facilitating an increased allergic response. This study aimed to investigate the influence of perinatal stress, as perceived by mothers, on developing food allergy in childhood. A survey on pregnancy and the first three months after giving birth was submitted to 59 Italian mothers of at least one child suffering from severe food allergy and one completely healthy child, for a total of 118 children examined. The presence of stressful events and the quality of perinatal period for each child were assessed retrospectively. The food allergic children's data were compared to siblings' data through inferential statistics. The results showed a significantly higher number of stressful events occurred during patients' perinatal period, compared to siblings, in particular bereavements in pregnancy and parenting difficulties in postpartum. Mothers reported harder pregnancies and more stressful, harder, and, in general, worse postpartum when referring to their food-allergic children, in comparison with their siblings (p < .05). Psychological aspects are demonstrated to be involved in the development of allergic diseases. This study constitutes the first step to examine the role of early stress and perinatal psychosocial factors in the pathogenesis of food allergy; further studies are necessary to understand individual psychological impact and its relations with genetic and biological factors.

Depression Literacy and Awareness of Psychopathological Symptoms During the Perinatal Period.

PubMed

Fonseca, Ana; Silva, Sheila; Canavarro, Maria Cristina

To characterize women's depression literacy during the perinatal period, including their ability to recognize clinically significant symptoms of depression. A quantitative, cross-sectional, survey design. Internet communities and Web sites focused on the topics of pregnancy and motherhood. A total of 194 women during the perinatal period (32.5% pregnant, 67.5% postnatal) completed the survey; 34.0% had clinically significant psychopathological symptoms. Most women were married/cohabiting (82.0%) and employed (71.8%). Women answered self-report questionnaires to assess depression literacy, symptoms of depression, emotional competence, and awareness/recognition of psychopathological symptoms. Women had moderate levels of depression literacy during the perinatal period, with higher literacy levels concerning depression-related characteristics than depression-related treatments. Lower education and lower income were associated with poor depression literacy, whereas prior history of psychiatric problems or treatments was associated with higher levels of depression literacy. An indirect effect through emotional competence in the relationship between depression literacy and awareness/recognition of symptoms was found: women with poor depression literacy tended to have a greater lack of emotional clarity, which negatively affected their symptom awareness and recognition. Our results support the need to improve women's mental health literacy during the perinatal period. Education on mental health topics in the context of a trusting relationship with health professionals may contribute to the promotion of women's depression literacy and emotional competence. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Perinatal features of the RASopathies: Noonan syndrome, cardiofaciocutaneous syndrome and Costello syndrome.

PubMed

Myers, Angela; Bernstein, Jonathan A; Brennan, Marie-Luise; Curry, Cynthia; Esplin, Edward D; Fisher, Jamie; Homeyer, Margaret; Manning, Melanie A; Muller, Eric A; Niemi, Anna-Kaisa; Seaver, Laurie H; Hintz, Susan R; Hudgins, Louanne

2014-11-01

The RASopathies are a family of developmental disorders caused by heritable defects of the RAS/MAPK signaling pathway. While the postnatal presentation of this group of disorders is well known, the prenatal and neonatal findings are less widely recognized. We report on the perinatal presentation of 10 patients with Noonan syndrome (NS), nine with Cardiofaciocutaneous syndrome (CFCS) and three with Costello syndrome (CS), in conjunction with the results of a comprehensive literature review. The majority of perinatal findings in NS, CS, and CFCS are shared: polyhydramnios; prematurity; lymphatic dysplasia; macrosomia; relative macrocephaly; respiratory distress; hypotonia, as well as cardiac and renal anomalies. In contrast, fetal arrhythmia and neonatal hypoglycemia are relatively specific to CS. NS, CS, and CFCS should all be considered as a possible diagnosis in pregnancies with a normal karyotype and ultrasound findings of a RASopathy. Recognition of the common perinatal findings of these disorders should facilitate both their prenatal and neonatal diagnosis. © 2014 Wiley Periodicals, Inc.

Short and long term prognosis in perinatal asphyxia: An update

PubMed Central

Ahearne, Caroline E; Boylan, Geraldine B; Murray, Deirdre M

2016-01-01

Interruption of blood flow and gas exchange to the fetus in the perinatal period, known as perinatal asphyxia, can, if significant, trigger a cascade of neuronal injury, leading on to neonatal encephalopathy (NE) and resultant long-term damage. While the majority of infants who are exposed to perinatal hypoxia-ischaemia will recover quickly and go on to have a completely normal survival, a proportion will suffer from an evolving clinical encephalopathy termed hypoxic-ischaemic encephalopathy (HIE) or NE if the diagnosis is unclear. Resultant complications of HIE/NE are wide-ranging and may affect the motor, sensory, cognitive and behavioural outcome of the child. The advent of therapeutic hypothermia as a neuroprotective treatment for those with moderate and severe encephalopathy has improved prognosis. Outcome prediction in these infants has changed, but is more important than ever, as hypothermia is a time sensitive intervention, with a very narrow therapeutic window. To identify those who will benefit from current and emerging neuroprotective therapies we must be able to establish the severity of their injury soon after birth. Currently available indicators such as blood biochemistry, clinical examination and electrophysiology are limited. Emerging biological and physiological markers have the potential to improve our ability to select those infants who will benefit most from intervention. Biomarkers identified from work in proteomics, metabolomics and transcriptomics as well as physiological markers such as heart rate variability, EEG analysis and radiological imaging when combined with neuroprotective measures have the potential to improve outcome in HIE/NE. The aim of this review is to give an overview of the literature in regards to short and long-term outcome following perinatal asphyxia, and to discuss the prediction of this outcome in the early hours after birth when intervention is most crucial; looking at both currently available tools and introducing

Short and long term prognosis in perinatal asphyxia: An update.

PubMed

Ahearne, Caroline E; Boylan, Geraldine B; Murray, Deirdre M

2016-02-08

Interruption of blood flow and gas exchange to the fetus in the perinatal period, known as perinatal asphyxia, can, if significant, trigger a cascade of neuronal injury, leading on to neonatal encephalopathy (NE) and resultant long-term damage. While the majority of infants who are exposed to perinatal hypoxia-ischaemia will recover quickly and go on to have a completely normal survival, a proportion will suffer from an evolving clinical encephalopathy termed hypoxic-ischaemic encephalopathy (HIE) or NE if the diagnosis is unclear. Resultant complications of HIE/NE are wide-ranging and may affect the motor, sensory, cognitive and behavioural outcome of the child. The advent of therapeutic hypothermia as a neuroprotective treatment for those with moderate and severe encephalopathy has improved prognosis. Outcome prediction in these infants has changed, but is more important than ever, as hypothermia is a time sensitive intervention, with a very narrow therapeutic window. To identify those who will benefit from current and emerging neuroprotective therapies we must be able to establish the severity of their injury soon after birth. Currently available indicators such as blood biochemistry, clinical examination and electrophysiology are limited. Emerging biological and physiological markers have the potential to improve our ability to select those infants who will benefit most from intervention. Biomarkers identified from work in proteomics, metabolomics and transcriptomics as well as physiological markers such as heart rate variability, EEG analysis and radiological imaging when combined with neuroprotective measures have the potential to improve outcome in HIE/NE. The aim of this review is to give an overview of the literature in regards to short and long-term outcome following perinatal asphyxia, and to discuss the prediction of this outcome in the early hours after birth when intervention is most crucial; looking at both currently available tools and introducing

Perinatal hypoxia increases susceptibility to high-altitude polycythemia and attendant pulmonary vascular dysfunction

PubMed Central

Gonzales, Marcelino; Rodriguez, Armando; Bellido, Diva; Salmon, Carlos Salinas; Ladenburger, Anne; Reardon, Lindsay; Vargas, Enrique; Moore, Lorna G.

2015-01-01

Perinatal exposures exert a profound influence on physiological function, including developmental processes vital for efficient pulmonary gas transfer throughout the lifespan. We extend the concept of developmental programming to chronic mountain sickness (CMS), a debilitating syndrome marked by polycythemia, ventilatory impairment, and pulmonary hypertension that affects ∼10% of male high-altitude residents. We hypothesized that adverse perinatal oxygenation caused abnormalities of ventilatory and/or pulmonary vascular function that increased susceptibility to CMS in adulthood. Subjects were 67 male high-altitude (3,600–4,100 m) residents aged 18–25 yr with excessive erythrocytosis (EE, Hb concentration ≥18.3 g/dl), a preclinical form of CMS, and 66 controls identified from a community-based survey (n = 981). EE subjects not only had higher Hb concentrations and erythrocyte counts, but also lower alveolar ventilation, impaired pulmonary diffusion capacity, higher systolic pulmonary artery pressure, lower pulmonary artery acceleration time, and more frequent right ventricular hypertrophy, than controls. Compared with controls, EE subjects were more often born to mothers experiencing hypertensive complications of pregnancy and hypoxia during the perinatal period, with each increasing the risk of developing EE (odds ratio = 5.25, P = 0.05 and odds ratio = 6.44, P = 0.04, respectively) after other factors known to influence EE status were taken into account. Adverse perinatal oxygenation is associated with increased susceptibility to EE accompanied by modest abnormalities of the pulmonary circulation that are independent of increased blood viscosity. The association between perinatal hypoxia and EE may be due to disrupted alveolarization and microvascular development, leading to impaired gas exchange and/or pulmonary hypertension. PMID:26092986

Perinatal hypoxia increases susceptibility to high-altitude polycythemia and attendant pulmonary vascular dysfunction.

PubMed

Julian, Colleen Glyde; Gonzales, Marcelino; Rodriguez, Armando; Bellido, Diva; Salmon, Carlos Salinas; Ladenburger, Anne; Reardon, Lindsay; Vargas, Enrique; Moore, Lorna G

2015-08-15

Perinatal exposures exert a profound influence on physiological function, including developmental processes vital for efficient pulmonary gas transfer throughout the lifespan. We extend the concept of developmental programming to chronic mountain sickness (CMS), a debilitating syndrome marked by polycythemia, ventilatory impairment, and pulmonary hypertension that affects ∼10% of male high-altitude residents. We hypothesized that adverse perinatal oxygenation caused abnormalities of ventilatory and/or pulmonary vascular function that increased susceptibility to CMS in adulthood. Subjects were 67 male high-altitude (3,600-4,100 m) residents aged 18-25 yr with excessive erythrocytosis (EE, Hb concentration ≥18.3 g/dl), a preclinical form of CMS, and 66 controls identified from a community-based survey (n = 981). EE subjects not only had higher Hb concentrations and erythrocyte counts, but also lower alveolar ventilation, impaired pulmonary diffusion capacity, higher systolic pulmonary artery pressure, lower pulmonary artery acceleration time, and more frequent right ventricular hypertrophy, than controls. Compared with controls, EE subjects were more often born to mothers experiencing hypertensive complications of pregnancy and hypoxia during the perinatal period, with each increasing the risk of developing EE (odds ratio = 5.25, P = 0.05 and odds ratio = 6.44, P = 0.04, respectively) after other factors known to influence EE status were taken into account. Adverse perinatal oxygenation is associated with increased susceptibility to EE accompanied by modest abnormalities of the pulmonary circulation that are independent of increased blood viscosity. The association between perinatal hypoxia and EE may be due to disrupted alveolarization and microvascular development, leading to impaired gas exchange and/or pulmonary hypertension. Copyright © 2015 the American Physiological Society.

Mindfulness-based Intervention for Perinatal Grief after Stillbirth in Rural India

PubMed Central

Roberts, Lisa R.; Montgomery, Susanne B.

2015-01-01

We explored the concept of using a Mindfulness-based intervention to reduce perinatal grief among Indian women. Data were collected using mixed methods to explore concept acceptability, receptivity, modality, and feasibility of the intervention. The intervention was piloted and evaluated with measures of perinatal grief, psychosocial wellbeing, religious coping, perceived social provision of support, and mindfulness. The intervention was well received and effective in teaching skills to help women deal with high levels of grief and subsequent mental health challenges. To overcome attendance barriers modification is necessary. Partnership with a local nursing school is critical to enhance sustainability of the intervention. PMID:25898268

Population structure in Japanese rice population

PubMed Central

Yamasaki, Masanori; Ideta, Osamu

2013-01-01

It is essential to elucidate genetic diversity and relationships among even related individuals and populations for plant breeding and genetic analysis. Since Japanese rice breeding has improved agronomic traits such as yield and eating quality, modern Japanese rice cultivars originated from narrow genetic resource and closely related. To resolve the population structure and genetic diversity in Japanese rice population, we used a total of 706 alleles detected by 134 simple sequence repeat markers in a total of 114 cultivars composed of 94 improved varieties and 20 landraces, which are representative and important for Japanese rice breeding. The landraces exhibit greater gene diversity than improved lines, suggesting that landraces can provide additional genetic diversity for future breeding. Model-based Bayesian clustering analysis revealed six subgroups and admixture situation in the cultivars, showing good agreement with pedigree information. This method could be superior to phylogenetic method in classifying a related population. The leading Japanese rice cultivar, Koshihikari is unique due to the specific genome constitution. We defined Japanese rice diverse sets that capture the maximum number of alleles for given sample sizes. These sets are useful for a variety of genetic application in Japanese rice cultivars. PMID:23641181

Prevalence of and risk factors for substance use among perinatally human immunodeficiency virus-infected and perinatally exposed but uninfected youth.

PubMed

Alperen, Julie; Brummel, Sean; Tassiopoulos, Katherine; Mellins, Claude A; Kacanek, Deborah; Smith, Renee; Seage, George R; Moscicki, Anna-Barbara

2014-03-01

This study examined risk factors associated with recent substance use (SU) among perinatally human immunodeficiency virus (HIV)-infected (PHIV+) and perinatally exposed, uninfected (PHEU) youth and compared SU lifetime prevalence with the general population of United States (U.S.) adolescents. We conducted cross-sectional and longitudinal analyses of 511 PHIV+ and PHEU youth (mean age at study entry, 13.2 years; 51% female; 69% PHIV+; and 72% African-American) enrolled in a U.S. multisite prospective cohort study between 2007 and 2009. Substance use data were collected by audio computer-assisted self-interview. Youth Risk Behavior Surveillance System and Monitoring the Future data were used to compare SU lifetime prevalence with U.S. samples. Perinatal HIV infection was not a statistically significant risk factor for alcohol or marijuana use. Risk factors for alcohol use among PHIV+ youth included higher severity of emotional and conduct problems and alcohol and marijuana use in the home by the caregiver or others. Risk factors for marijuana use among PHIV+ youth included marijuana use in the home, higher severity of conduct problems, and stressful life events. Similar SU risk factors among PHEU youth included SU in the home and higher severity of conduct and emotional problems. Overall lifetime prevalence of SU by age was similar to that in national surveys. Although SU lifetime prevalence and risk factors for PHIV+ and PHEU adolescents were similar to national norms, the negative consequences are potentially greater for PHIV+ youth. Prevention efforts should begin before SU initiation and address the family and social environment and youth mental health status. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Preventing maternal and early childhood obesity: the fetal flaw in Australian perinatal care.

PubMed

Miller, Margaret; Hearn, Lydia; van der Pligt, Paige; Wilcox, Jane; Campbell, Karen J

2014-01-01

Almost half of Australian women of child-bearing age are overweight or obese, with a rate of 30-50% reported in early pregnancy. Maternal adiposity is a costly challenge for Australian obstetric care, with associated serious maternal and neonatal complications. Excess gestational weight gain is an important predictor of offspring adiposity into adulthood and higher maternal weight later in life. Current public health and perinatal care approaches in Australia do not adequately address excess perinatal maternal weight or gestational weight gain. This paper argues that the failure of primary health-care providers to offer systematic advice and support regarding women's weight and related lifestyle behaviours in child-bearing years is an outstanding 'missed opportunity' for prevention of inter-generational overweight and obesity. Barriers to action could be addressed through greater attention to: clinical guidelines for maternal weight management for the perinatal period, training and support of maternal health-care providers to develop skills and confidence in raising weight issues with women, a variety of weight management programs provided by state maternal health services, and clear referral pathways to them. Attention is also required to service systems that clearly define roles in maternal weight management and ensure consistency and continuity of support across the perinatal period.

Assisted reproductive technology with donor sperm: national trends and perinatal outcomes.

PubMed

Gerkowicz, Sabrina A; Crawford, Sara B; Hipp, Heather S; Boulet, Sheree L; Kissin, Dmitry M; Kawwass, Jennifer F

2018-04-01

Information regarding the use of donor sperm in assisted reproductive technology, as well as subsequent treatment and perinatal outcomes, remains limited. Outcome data would aid patient counseling and clinical decision making. The objectives of the study were to report national trends in donor sperm utilization and live birth rates of donor sperm-assisted reproductive technology cycles in the United States and to compare assisted reproductive technology treatment and perinatal outcomes between cycles using donor and nondonor sperm. We hypothesize these outcomes to be comparable between donor and nondonor sperm cycles. This was a retrospective cohort study using data from all US fertility centers reporting to the Centers for Disease Control and Prevention's National Assisted Reproductive Technology Surveillance System, accounting for ∼98% of assisted reproductive technology cycles (definition excludes intrauterine insemination). The number and percentage of assisted reproductive technology cycles using donor sperm and rates of pregnancy, live birth, preterm birth (<37 weeks), and low birthweight (<2500 g) were the primary outcomes measured. Treatments assessed include use of donor vs nondonor sperm. The trends analysis included all banking and fresh assisted reproductive technology cycles using donor and autologous oocytes performed between 1996 and 2014 (n = 1,710,034). The outcomes analysis was restricted to include only fresh autologous cycles performed between 2010 and 2014 (n = 437,569) to focus on cycles with a potential outcome and cycles reflective of current practice, thereby improving the clinical relevance. Cycles canceled prior to retrieval were excluded. Statistical analysis included linear regression to explore polynomial trends and log-binomial regression to estimate relative risk for outcomes among cycles using donor and nondonor sperm. Of all banking and fresh donor and autologous oocyte assisted reproductive technology cycles performed between

The Polomeno Family Intervention Framework for Perinatal Education: Preparing Couples for the Transition to Parenthood

PubMed Central

Polomeno, Viola

2000-01-01

Couples face many challenges as they transform themselves from dyad to triad. For some couples, these challenges are life-enriching experiences, while for others, chaos ensues, potentially leading to separation and divorce. The transition to first-time parenthood, even for well-functioning couples, is fraught with potential disorganization. At the same time, it provides opportunities for simultaneous self-growth and conjugal enrichment. What role can perinatal educators play in preparing couples to deal with the changes associated with this transition? To answer this vital question, the author presents her conceptualization of perinatal education as a primary family intervention framework during the perinatal period. PMID:17273190

Non-Native Japanese Listeners' Perception of Vowel Length Contrasts in Japanese and Modern Standard Arabic (MSA)

ERIC Educational Resources Information Center

Tsukada, Kimiko

2012-01-01

This study aimed to compare the perception of short vs. long vowel contrasts in Japanese and Modern Standard Arabic (MSA) by four groups of listeners differing in their linguistic backgrounds: native Arabic (NA), native Japanese (NJ), non-native Japanese (NNJ) and Australian English (OZ) speakers. The NNJ and OZ groups shared the first language…

Perinatal Risks in “Late Motherhood” Defined Based On Parity and Preterm Birth Rate – an Analysis of the German Perinatal Survey (20th Communication)

PubMed Central

Schure, V.; Voigt, M.; Schild, R. L.; Hesse, V.; Carstensen, M.; Schneider, K. T. M.; Straube, S.

2012-01-01

Aim: “Late motherhood” is associated with greater perinatal risks but the term lacks precise definition. We present an approach to determine what “late motherhood” associated with “high risk” is, based on parity and preterm birth rate. Materials and Methods: Using data from the German Perinatal Survey of 1998–2000 we analysed preterm birth rates in women with zero, one, or two previous live births. We compared groups of “late” mothers (with high preterm birth rates) with “control” groups of younger women (with relatively low preterm birth rates). Data of 208 342 women were analysed. For women with zero (one; two) previous live births, the “control” group included women aged 22–26 (27–31; 29–33) years. Women in the “late motherhood” group were aged > 33 (> 35; > 38) years. Results: The “late motherhood” groups defined in this way were also at higher risk of adverse perinatal events other than preterm birth. For women with zero (one; two) previous live births, normal cephalic presentation occurred in 89 % (92.7 %; 93.3 %) in the “control” group, but only in 84.5 % (90 %; 90.4 %) in the “late motherhood” group. The mode of delivery was spontaneous or at most requiring manual help in 71.3 % (83.4 %; 85.8 %) in the “control” group, but only in 51.4 % (72.2 %; 76.4 %) in the “late motherhood” group. Five-minute APGAR scores were likewise worse for neonates of “late” mothers and the proportion with a birth weight ≤ 2499 g was greater. Conclusion: “Late motherhood” that is associated with greater perinatal risks can be defined based on parity and preterm birth rate. PMID:25253904

Body composition and anthropometry in Japanese and Australian Caucasian males and Japanese females.

PubMed

Kagawa, Masaharu; Binns, Colin B; Hills, Andrew P

2007-01-01

The total amount and location of fat deposition are important factors in the development of obesity and the metabolic syndrome. To date there have been no reported studies of ethnic and gender differences in body composition and fat distribution patterns in Japanese and Australian young adults. The aim of this study was to assess body composition of young Japanese and Australian Caucasian adults using whole-body dual energy x-ray absorptiometry (DXA) and anthropometry to examine body fat deposition patterns. Body composition of 45 Japanese males and 42 Australian Caucasian males living in Australia (aged 18-40 years) and 139 Japanese females living in Japan (aged 18-27 years) were measured using whole-body DXA scanning and anthropometry. Differences in relationships between BMI and waist circumference (WC), sum of skinfolds (SigmaSF) and %BF obtained from DXA were assessed using multivariate analyses. Distinct gender and ethnic differences (p<0.05) in bone density and waist circumference were observed but no gender differences in BMI and bone mineral content and no ethnic differences in sum of skinfolds and %BF. Both Japanese males and females showed a greater %BF at given BMI, WC and SigmaSF values (p<0.05). The results indicate differences in relationships between %BF and anthropometric measures in young Japanese compared to Caucasians and the importance of population-specific cut-off points for these indices. These findings also have implications for the development of chronic disease and further research, including studies in other Asian countries, is recommended.

Perinatal outcome and financial impact of Eritrean and Sudanese refugees delivered in a tertiary hospital in Tel Aviv, Israel.

PubMed

Michaan, Nadav; Gil, Yaron; Amzalag, Sagi; Laskov, Ido; Lessing, Joseph; Many, Ariel

2014-06-01

A growing number of Eritrean and Sudanese refugees seek medical assistance in the labor and delivery ward of our facility. Providing treatment to this unique population is challenging since communication is limited and pregnancy follow-up is usually absent. To compare the perinatal outcome of refugees and Israeli parturients. The medical and financial records of all refugees delivered between May 2010 and April 2011 were reviewed. Perinatal outcome was compared to that of native Israeli controls. During this period 254 refugees were delivered (2.3% of deliveries). Refugees were significantly younger and leaner. They had significantly more premature deliveries under 37 weeks (23 vs. 10, P = 0.029) and under 34 weeks gestation (9 vs. 2, P = 0.036) with more admissions to the neonatal intensive care unit (15 vs. 5, P = 0.038). Overall cesarean section rate was similar but refugees required significantly more urgent surgeries (97% vs. 53%, P = 0.0001). Refugees had significantly more cases of meconium and episiotomies but fewer cases of epidural analgesia. There were 2 intrauterine fetal deaths among refugees, compared to 13 of 11,239 deliveries during this time period (P = 0.036), as well as 7 pregnancy terminations following sexual assault during their escape. Sixty-eight percent of refugees had medical fees outstanding with a total debt of 2,656,000 shekels (US$ 767,250). The phenomenon of African refugees giving birth in our center is of unprecedented magnitude and bears significant medical and ethical implications. Refugees proved susceptible to adverse perinatal outcomes compared to their Israeli counterparts. Setting a pregnancy follow-up plan could, in the long run, prevent adverse outcomes and reduce costs involved in treating this population.

Trends in concurrent maternal and perinatal deaths at a teaching hospital in Ghana: the facts and prevention strategies.

PubMed

Lassey, Anyetei T; Obed, Sam A

2004-09-01

To determine the trend of concurrent maternal and perinatal mortality at the Korle-Bu Teaching Hospital (KBTH), Ghana, and to propose measures for its prevention. A retrospective study, from January 1995 to December 2002, of all concurrent maternal and perinatal deaths in which the woman was 28 weeks' gestation or more (or, if gestational age was not known, the baby weighed 1000 g or more) and died either undelivered or in the perinatal period (within 1 week of delivery) at the KBTH. Over the 8-year study period, there was a total of 93 622 deliveries at the KBTH with 108 concurrent maternal and perinatal mortalities, giving a ratio of 115.4 concurrent maternal and perinatal deaths per 100 000 deliveries. More than 80% of the mothers who died had little or no formal education. Of the 108 mothers, 22 died undelivered. The leading cause of death was a medical condition in pregnancy along with eclampsia/gestational hypertension. Of the 86 delivered mothers, the leading cause of concurrent death was a medical condition in pregnancy. Approximately two-thirds (72/108) of the perinatal deaths were stillbirths. Over the study period, there was a rising trend of the obstetric disaster of losing both mother and baby. There is a rising trend of concurrent maternal and perinatal mortality at the KBTH. It is suggested that a regular antenatal clinic be established with both an internist and obstetrician to jointly see and manage women with medical problems. There is a need for improved and adequate resources to improve outcomes for both mother and baby. A waiver of user fees for maternity services may be one way to improve access for needy and at-risk mothers. Concurrent maternal and perinatal death is the latest negative reproductive health index of the deteriorating socioeconomic situation in developing countries and needs to be tackled decisively.

Perinatal health outcomes and care among asylum seekers and refugees: a systematic review of systematic reviews.

PubMed

Heslehurst, Nicola; Brown, Heather; Pemu, Augustina; Coleman, Hayley; Rankin, Judith

2018-06-12

Global migration is at an all-time high with implications for perinatal health. Migrant women, especially asylum seekers and refugees, represent a particularly vulnerable group. Understanding the impact on the perinatal health of women and offspring is an important prerequisite to improving care and outcomes. The aim of this systematic review was to summarise the current evidence base on perinatal health outcomes and care among women with asylum seeker or refugee status. Twelve electronic database, reference list and citation searches (1 January 2007-July 2017) were carried out between June and July 2017. Quantitative and qualitative systematic reviews, published in the English language, were included if they reported perinatal health outcomes or care and clearly stated that they included asylum seekers or refugees. Screening for eligibility, data extraction, quality appraisal and evidence synthesis were carried out in duplicate. The results were summarised narratively. Among 3415 records screened, 29 systematic reviews met the inclusion criteria. Only one exclusively focussed on asylum seekers; the remaining reviews grouped asylum seekers and refugees with wider migrant populations. Perinatal outcomes were predominantly worse among migrant women, particularly mental health, maternal mortality, preterm birth and congenital anomalies. Access and use of care was obstructed by structural, organisational, social, personal and cultural barriers. Migrant women's experiences of care included negative communication, discrimination, poor relationships with health professionals, cultural clashes and negative experiences of clinical intervention. Additional data for asylum seekers and refugees demonstrated complex obstetric issues, sexual assault, offspring mortality, unwanted pregnancy, poverty, social isolation and experiences of racism, prejudice and stereotyping within perinatal healthcare. This review identified adverse pregnancy outcomes among asylum seeker and refugee

Perinatal and paediatric post-mortem magnetic resonance imaging (PMMR): sequences and technique

PubMed Central

Norman, Wendy; Jawad, Noorulhuda; Jones, Rod; Taylor, Andrew M

2016-01-01

As post-mortem MRI (PMMR) becomes more widely used for investigation following perinatal and paediatric deaths, the best possible images should be acquired. In this article, we review the most widely used published PMMR sequences, together with outlining our acquisition protocol and sequence parameters for foetal, perinatal and paediatric PMMR. We give examples of both normal and abnormal appearances, so that the reader can understand the logic behind each acquisition step before interpretation, as a useful day-to-day reference guide to performing PMMR. PMID:26916282

The Japanese containerless experiments

NASA Technical Reports Server (NTRS)

Azuma, Hisao

1990-01-01

There are three sets of Japanese containerless experiments. The first is Drop dynamics research. It consists of acoustic levitation and large amplitude drop oscillation. The second is Optical materials processing in an acoustic levitation furnace. And the third is Electrostatic levitator development by two different Japanese companies.

Perinatal development of conjugative enzyme systems.

PubMed Central

Lucier, G W

1976-01-01

The problems and priorities involved in studying the role of conjugagive enzymes in developmental pharmacology are discussed and evaluated. The relative rates of UDP glucuronyltransferase and beta-glucuronidase were studied during perinatal development in hepatic and extrahepatic tissues to determine the net balance of glucuronidation or deglucuronidation at different developmental stages. In general, deglucuronidation predominated over glucuronidation in fetal tissues whereas the converse was evident in adults. 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), an extremely toxic contaminant of some organochlorine compounds, was shown to be a potent inducer of some hepatic and extrahepatic drug-metabolizing enzymes. TCDD, administered during gestation, induced the postnatal activities of p-nitrophenol glucuronyltransferase and benzpyrene hydroxylase in rats. Foster mother experiments revealed that the postnatal induction was caused primarily by newborn exposure to TCDD in the mother's milk. Tissue distribution experiments with TCDD-14C confirmed these findings. Although TCDD induced non-steroid glucuronidation, no significant effects were evident on the postnatal development of steroid glucuronidation. The synthetic estrogen diethylstilbestrol (DES) is metabolized primarily by glucuronidation. The postnatal development of DES glucuronidation, like the steroid pathway, was not affected by gestational TCDD treatment. The fetal distribution of DES and DES-glucuronide, at different stages of development, correlated well with the perinatal development of steroid glucuronyltransferase activity. PMID:829487

Pharmacokinetic Profiles of Ticagrelor Orodispersible Tablets in Healthy Western and Japanese Subjects.

PubMed

Teng, Renli; Hammarberg, Maria; Carlson, Glenn F; Bokelund-Singh, Sara; Ruderfelt, Terese; Blychert, Eva

2017-11-01

Ticagrelor is an antiplatelet agent for patients with acute coronary syndrome or a history of myocardial infarction. Two studies compared pharmacokinetic profiles of orodispersible (OD) ticagrelor tablets versus immediate-release (IR) tablets in Western and Japanese subjects. Both studies were open-label, randomized, crossover, single-center trials. Thirty-six healthy subjects (94% white, 6% other race; Western study NCT02400333) and 42 Japanese healthy subjects (Japanese study NCT02436577) received a single 90-mg ticagrelor dose as an OD tablet [with/without water, and via a nasogastric tube (Western study only)], and an IR tablet; washout between treatments was ≥7 days. Assessments included ticagrelor and AR-C124910XX (active metabolite) plasma concentrations for pharmacokinetic analyses, and safety evaluations. In the Western study, the 90% confidence intervals (CIs) of the geometric mean ratios (GMRs) for ticagrelor and AR-C124910XX maximum plasma concentration (C max ) and area under the plasma concentration-time curve (AUC) were within the acceptance interval (80%-125%) for OD tablets (with/without water, via a nasogastric tube) versus the IR tablet; except for an ~15% lowering of ticagrelor C max (90% CI: 76.77%-93.78%) for the OD tablet taken with water. In the Japanese study, 90% CIs of the GMRs for AUC and C max of both ticagrelor and AR-C124910XX were all within the acceptance intervals for the OD (with/without water) versus IR tablet. No new safety issues were identified. Ticagrelor administered as an OD tablet to Western (without water, and via a nasogastric tube) and Japanese (with/without water) subjects was bioequivalent to the IR tablet.

2010 Perinatal GBS Prevention Guideline and Resource Utilization

PubMed Central

Mukhopadhyay, Sagori; Dukhovny, Dmitry; Mao, Wenyang; Eichenwald, Eric C.

2014-01-01

OBJECTIVES: To quantify differences in early-onset sepsis (EOS) evaluations, evaluation-associated resource utilization, and EOS cases detected, when comparing time periods before and after the implementation of an EOS algorithm based on the Centers for Disease Control and Prevention (CDC) 2010 guidelines for prevention of perinatal Group B Streptococcus (GBS) disease. METHODS: Retrospective cohort study of infants born at ≥36 weeks’ gestation from 2009 to 2012 in a single tertiary care center. One 12-month period during which EOS evaluations were based on the CDC 2002 guideline was compared with a second 12-month period during which EOS evaluations were based on the CDC 2010 guideline. A cost minimization analysis was performed to determine the EOS evaluation-associated costs and resources during each time period. RESULTS: During the study periods, among well-appearing infants ≥36 weeks’ gestation, EOS evaluations for inadequate GBS prophylaxis decreased from 32/1000 to <1/1000 live births; EOS evaluation-associated costs decreased by $6994 per 1000 live births; and EOS evaluation-associated work hours decreased by 29 per 1000 live births. We found no increase in EOS evaluations for other indications, total NICU admissions, frequency of infants evaluated for symptoms before hospital discharge, or incidence of EOS during the 2 study periods. CONCLUSIONS: Implementation of an EOS algorithm based on CDC 2010 GBS guidelines resulted in a 25% decrease in EOS evaluations performed among well-appearing infants ≥36 weeks’ gestation, attributable to decreased evaluation of infants born in the setting of inadequate indicated GBS prophylaxis. This resulted in significant changes in EOS evaluation-associated resource expenditures. PMID:24446442

Intercultural Communication Problems in Japanese Multinationals.

ERIC Educational Resources Information Center

Nishiyama, Kazuo

Many large Japanese-owned multinational corporations have established successful subsidiaries in the United States, but distinct ethnic and cultural differences have caused communication problems between Japanese managers and American laborers and business people. Many top executives of the Japanese subsidiaries are sent to the United States on a…

Shattering Myths: Japanese American Educational Issues.

ERIC Educational Resources Information Center

Yoshiwara, Florence M.

An historical review of the immigration and resettlement patterns, and a demographic profile of Japanese Americans reveals a myth of the "successful minority." Since the founding of the Japanese American Citizens League in 1928, Japanese Americans have defeated alien land laws, discriminatory immigration quotas, anti-miscengenation laws,…

[History of Japanese Committee for Anatomical Nomenclature].

PubMed

Kimura, Kunihiko

2008-12-01

This paper records a history of the Japanese Committee of Anatomical Nomenclature since 1990, as a supplement to the previous report (1991), explains a progressing of the edition of Japanese medical terms by the Japanese Association of Medical Sciences and the Ministry of Education, Sciences and Culture, and points out of some problems on terms in Japanese.

NASDA President Communicates With Japanese Crew Member Aboard the STS-47 Spacelab-J Mission

NASA Technical Reports Server (NTRS)

1992-01-01

The science laboratory, Spacelab-J (SL-J), flown aboard the STS-47 flight was a joint venture between NASA and the National Space Development Agency of Japan (NASDA) utilizing a manned Spacelab module. The mission conducted 24 materials science and 20 life science experiments, of which 35 were sponsored by NASDA, 7 by NASA, and two collaborative efforts. Materials science investigations covered such fields as biotechnology, electronic materials, fluid dynamics and transport phenomena, glasses and ceramics, metals and alloys, and acceleration measurements. Life sciences included experiments on human health, cell separation and biology, developmental biology, animal and human physiology and behavior, space radiation, and biological rhythms. Test subjects included the crew, Japanese koi fish (carp), cultured animal and plant cells, chicken embryos, fruit flies, fungi and plant seeds, and frogs and frog eggs. From the Huntsville Operations Support Center (HOSC) Spacelab Payload Operations Control Center (SL POCC), NASDA President, Mr. Yamano, speaks to Payload Specialist Mamoru Mohri, a Japanese crew member aboard the STS-47 Spacelab J mission.

Can facility delivery reduce the risk of intrapartum complications-related perinatal mortality? Findings from a cohort study.

PubMed

Khanam, Rasheda; Baqui, Abdullah H; Syed, Mamun Ibne Moin; Harrison, Meagan; Begum, Nazma; Quaiyum, Abdul; Saha, Samir K; Ahmed, Saifuddin

2018-06-01

Intrapartum complications increase the risk of perinatal deaths. However, population-based data from developing countries assessing the contribution of intrapartum complications to perinatal deaths is scarce. Using data from a cohort of pregnant women followed between 2011 and 2013 in Bangladesh, this study examined the rate and types of intrapartum complications, the association of intrapartum complications with perinatal mortality, and if facility delivery modified the risk of intrapartum-related perinatal deaths. Trained community health workers (CHWs) made two-monthly home visits to identify pregnant women, visited them twice during pregnancy and 10 times in the first two months postpartum. During prenatal visits, CHWs collected data on women's prior obstetric history, socio-demographic status, and complications during pregnancy. They collected data on intrapartum complications, delivery care, and pregnancy outcome during the first postnatal visit within 7 days of delivery. We examined the association of intrapartum complications and facility delivery with perinatal mortality by estimating odds ratios (OR) and 95% confidence intervals (CI) adjusting for covariates using multivariable logistic regression analysis. The overall facility delivery rate was low (3922/24 271; 16.2%). Any intrapartum complications among pregnant women were 20.9% (5,061/24,271) and perinatal mortality was 64.7 per 1000 birth. Compared to women who delivered at home, the risk of perinatal mortality was 2.4 times higher (OR = 2.40; 95% CI = 2.08-2.76) when delivered in a public health facility and 1.3 times higher (OR = 1.32, 95% CI = 1.06-1.64) when delivered in a private health facility. Compared to women who had no intrapartum complications and delivered at home, women with intrapartum complications who delivered at home had a substantially higher risk of perinatal mortality (OR = 3.45; 95% CI = 3.04-3.91). Compared to women with intrapartum complications who

Prediction of perinatal depression from adolescence and before conception (VIHCS): 20-year prospective cohort study.

PubMed

Patton, George C; Romaniuk, Helena; Spry, Elizabeth; Coffey, Carolyn; Olsson, Craig; Doyle, Lex W; Oats, Jeremy; Hearps, Stephen; Carlin, John B; Brown, Stephanie

2015-08-29

Perinatal depression is a neglected global health priority, affecting 10-15% of women in high-income countries and a greater proportion in low-income countries. Outcomes for children include cognitive, behavioural, and emotional difficulties and, in low-income settings, perinatal depression is associated with stunting and physical illness. In the Victorian Intergenerational Health Cohort Study (VIHCS), we aimed to assess the extent to which women with perinatal depressive symptoms had a history of mental health problems before conception. VIHCS is a follow-up study of participants in the Victorian Adolescent Health Cohort Study (VAHCS), which was initiated in August, 1992, in the state of Victoria, Australia. In VAHCS, participants were assessed for health outcomes at nine timepoints (waves) from age 14 years to age 29 years. Depressive symptoms were measured with the Revised Clinical Interview Schedule and the General Health Questionnaire. Enrolment to VIHCS began in September, 2006, during the ninth wave of VAHCS; depressive symptoms at this timepoint were measured with the Composite International Diagnostic Interview. We contacted women every 6 months (from age 29 years to age 35 years) to identify any pregnancies. We assessed perinatal depressive symptoms with the Edinburgh Postnatal Depression Scale (EPDS) by computer-assisted telephone interview at 32 weeks of gestation, 8 weeks after birth, and 12 months after birth. We defined perinatal depression as an EPDS score of 10 or more. From a stratified random sample of 1000 female participants in VAHCS, we enrolled 384 women with 564 pregnancies. 253 (66%) of these women had a previous history of mental health problems at some point in adolescence or young adulthood. 117 women with a history of mental health problems in both adolescence and young adulthood had 168 pregnancies, and perinatal depressive symptoms were reported for 57 (34%) of these pregnancies, compared with 16 (8%) of 201 pregnancies in 131 women

Perinatal Factors, Parenting Behavior, and Reactive Aggression: Does Cortisol Reactivity Mediate This Developmental Risk Process?

ERIC Educational Resources Information Center

Ryan, Stacy R.; Schechter, Julia C.; Brennan, Patricia A.

2012-01-01

Little is known about the mechanisms of action that link perinatal risk and the development of aggressive behavior. The aim of this study was to examine whether perinatal risk and parenting interacted to specifically predict reactive aggression, as opposed to general aggressive behavior, and to examine cortisol reactivity as a mediator of this…

Project Pró-natal: population-based study of perinatal and infant mortality in natal, Northeast Brazil.

PubMed

Ramos, A M; Maranhão, T D; Macedo, A S; Pollock, J I; Emond, A M

2000-01-01

The Pró-Natal project is a collaborative initiative that aims to improve maternal and infant health in a deprived community in Natal, Northeast Brazil. To assess the perinatal and infant mortality in this population of 40,000, we have collected over a 2-year period a consecutive series of 39 autopsy examinations on deaths under 1 year of age. During this period there were 2212 live births in the study population. The 14 perinatal deaths are described using the Wrigglesworth classification, and the 25 infant deaths, using a clinicopathological system. The contribution of normally formed stillbirths was small (14%), which probably reflects the underreporting of stillbirths in this community. The most common cause of death in the live births was complications of prematurity (43%). Specific causes (22%) of perinatal deaths were predominantly infections, including one case of congenital syphilis. Perinatal asphyxia was diagnosed in 14%, and there was one case (7%) of a chromosome abnormality. Infant deaths were predominantly due to respiratory (45%) and gastrointestinal infections (28%), with chronic malnutrition as an underlying cause in 80% of cases. Prenatal care could theoretically have prevented three of the perinatal deaths, and a further six deaths could have been avoided by improved management of labor and the immediate neonatal period. Prevention of malnutrition and improved treatment of acute infections would contribute to a reduction in infant mortality in this population. The Pró-Natal project will use these data to design preventative interventions to reduce perinatal and infant mortality in this community.

Detection and treatment rates for perinatal depression in a state Medicaid population.

PubMed

Geier, Michelle L; Hills, Nancy; Gonzales, Marco; Tum, Karoline; Finley, Patrick R

2015-02-01

The purpose of this investigation was to assess detection and treatment rates for perinatal depression among women enrolled in the California State Medicaid (Medi-Cal) program in comparison to female beneficiaries of reproductive age who did not give birth during the same study period. Investigators conducted a retrospective longitudinal cohort analysis of women between the ages of 18 and 39 years old who were continuously enrolled in the Medi-Cal fee-for-service program between January 2006 and December 2009. The perinatal cohort consisted of women with evidence of a live birth occurring between October 2007 and March 2009. The control cohort consisted of women in the same age group and health plan without evidence of pregnancy during this time frame. The primary outcome of this investigation was diagnosis of depression during 3 contiguous 9-month time frames: immediately prior to presumed conception, during pregnancy, and throughout the postpartum period. Secondary outcomes included within-group and cohort comparisons of treatment patterns (antidepressant or psychotherapy). A multivariable analysis of demographic factors predicting depression diagnosis or treatment was conducted as well. A total of 6030 women was identified in the perinatal cohort, and 56,709 women were included in the control group. The perinatal cohort was significantly less likely than nonpregnant controls to receive a diagnosis of depression both during pregnancy (prevalence=1.6% vs 3.5%; OR=0.45; 95% CI=0.35-0.55) and postpartum (2.2% vs 3.6%; OR=0.59; 95% CI=0.50-0.71). Similar differences were noted in antidepressant prescribing patterns apparent during these 2 time frames. A subgroup analysis of women who received a depression diagnosis revealed that only 48% of the perinatal cohort was provided any treatment during pregnancy (vs 72% of the control group; p<0.0001) or postpartum (57% vs 73%; p<0.0001). Specific demographic factors predicting a lower prevalence of depression detection or

Japanese Media in English.

ERIC Educational Resources Information Center

Tanaka, Sachiko Oda

1995-01-01

Describes the use of English in the media in Japan, focusing on the role and history of English-language newspapers, radio, and television programs, as well as the proliferation of English-language films shown in Japanese cinemas. Discusses the implications of English in the Japanese media. (20 references) (MDM)

Ordinal Expressions in Japanese. Papers in Japanese Linguistics, Vol. 2, No. 1.

ERIC Educational Resources Information Center

Backus, Robert L.

The varied forms and semantic factors of Japanese ordinal expressions are related to one another in a coherent system. In Japanese, the cardinal number form is a numeral compound in construction with a referent. The numeral compound consists of a number and a numeral adjunct. Numeral adjuncts are derived from bound forms, or numeral suffixes, and…

Perinatal methadone exposure affects dopamine, norepinephrine, and serotonin in the weanling rat.

PubMed

Robinson, S E; Maher, J R; Wallace, M J; Kunko, P M

1997-01-01

On gestational day 7 pregnant rats were implanted with osmotic minipumps containing either methadone hydrochloride (initial dose, 9 mg/kg/day) or sterile water. Their offspring were cross-fostered so that they were exposed to methadone prenatally and/or postnatally. On postnatal day 21, dopamine (DA), norepinephrine (NE), serotonin (5-HT), and their metabolites were analyzed. Perinatal methadone exposure disrupted dopaminergic, noradrenergic, and serotonergic activity in a brain region- and gender-specific fashion. The ratio of the DA metabolite 3,4-dihydroxyphenylacetic acid (DOPAC) to DA was reduced in the frontal cortex of males exposed to methadone postnatally. No effects of perinatal methadone exposure were observed on DA and DOPAC in the striatum. The ratio of 3-methoxy-4-hydroxyphenylglycol (MOPEG) to NE in the hippocampus was increased significantly in males exposed to methadone prenatally. Striatal and parietal cortical 5-hydroxyindoleacetic acid (5-HIAA), but not its ratio to 5-HT, was increased slightly in rats exposed to methadone postnatally. Although parietal cortical 5-HT, 5-HIAA, and 5-hydroxytryptophan were all affected by perinatal methadone exposure, the ratios of metabolite and precursor to 5-HT were not affected. Effects of methadone exposure appeared to depend upon the developmental stage at which exposure occurred and did not appear to result from the phenomenon of neonatal withdrawal. Changes in activity of these three neurotransmitter systems may contribute to the effect of perinatal methadone on the activity of other neurons, such as cholinergic neurons.

Japanese Interest in “Hotaru” (Fireflies) and “Kabuto-Mushi” (Japanese Rhinoceros Beetles) Corresponds with Seasonality in Visible Abundance

PubMed Central

Takada, Kenta

2012-01-01

Seasonal changes in the popularity of fireflies [usually Genji-fireflies (Luciola cruciata Motschulsky) in Japan] and Japanese rhinoceros beetles [Allomyrina dichotoma (Linne)] were investigated to examine whether contemporary Japanese are interested in visible emergence of these insects as seasonal events. The popularity of fireflies and Japanese rhinoceros beetles was assessed by the Google search volume of their Japanese names, “Hotaru” and “Kabuto-mushi” in Japanese Katakana script using Google Trends. The search volume index for fireflies and Japanese rhinoceros beetles was distributed across seasons with a clear peak in only particular times of each year from 2004 to 2011. In addition, the seasonal peak of popularity for fireflies occurred at the beginning of June, whereas that for Japanese rhinoceros beetles occurred from the middle of July to the beginning of August. Thus seasonal peak of each species coincided with the peak period of the emergence of each adult stage. These findings indicated that the Japanese are interested in these insects primarily during the time when the two species are most visibly abundant. Although untested, this could suggest that fireflies and Japanese rhinoceros beetles are perceived by the general public as indicators or symbols of summer in Japan. PMID:26466535

Association of Temporal Changes in Gestational Age With Perinatal Mortality in the United States, 2007-2015.

PubMed

Ananth, Cande V; Goldenberg, Robert L; Friedman, Alexander M; Vintzileos, Anthony M

2018-05-14

Whether the changing gestational age distribution in the United States since 2005 has affected perinatal mortality remains unknown. To examine changes in gestational age distribution and gestational age-specific perinatal mortality. This retrospective cohort study examined trends in US perinatal mortality by linking live birth and infant death data among more than 35 million singleton births from January 1, 2007, through December 31, 2015. Year of birth and changes in gestational age distribution. Changes in the proportion of births at gestational ages 20 to 27, 28 to 31, 32 to 33, 34 to 36, 37 to 38, 39 to 40, 41, and 42 to 44 weeks; changes in perinatal mortality (stillbirth at ≥20 weeks, and neonatal deaths at <28 days) rates; and contribution of gestational age changes to perinatal mortality. Trends were estimated from log-linear regression models adjusted for confounders. Among the 34 236 577 singleton live births during the study period, the proportion of births at all gestational ages declined, except at 39 to 40 weeks, which increased (54.5% in 2007 to 60.2% in 2015). Overall perinatal mortality declined from 9.0 to 8.6 per 1000 births (P < .001). Stillbirths declined from 5.7 to 5.6 per 1000 births (P < .001), and neonatal mortality declined from 3.3 to 3.0 per 1000 births (P < .001). Although the proportion of births at gestational ages 34 to 36, 37 to 38, and 42 to 44 weeks declined, perinatal mortality rates at these gestational ages showed annual adjusted relative increases of 1.0% (95% CI, 0.6%-1.4%), 2.3% (95% CI, 1.9%-2.8%), and 4.2% (95% CI, 1.5%-7.0%), respectively. Neonatal mortality rates at gestational ages 34 to 36 and 37 to 38 weeks showed a relative adjusted annual increase of 0.9% (95% CI, 0.2%-1.6%) and 3.1% (95% CI, 2.1%-4.1%), respectively. Although the proportion of births at gestational age 39 to 40 weeks increased, perinatal mortality showed an annual relative adjusted decline of -1.3% (95% CI, -1.8% to -0.9%). The

First Course in Japanese: Character Workbook.

ERIC Educational Resources Information Center

Niwa, Tamako

This character workbook is an introduction to Japanese writing designed to be used in conjunction with Parts One and Two of this introductory course in Japanese. All the "hiragana", several "katakana", and 88 Japanese characters are introduced in this text. The workbook, consisting of 30 lessons, is divided into three parts.…

Developing Instructional Materials for Business Japanese.

ERIC Educational Resources Information Center

Koike, Shohei

Business Japanese should be the study of Japanese language and culture for business communication and should include values and beliefs and institutional constraints on which the Japanese act as well as business etiquette and terminology. Topics to be covered in instruction will vary depending on the role (seller, buyer, or colleague) played by…

The National Perinatal Depression Initiative: An evaluation of access to general practitioners, psychologists and psychiatrists through the Medicare Benefits Schedule.

PubMed

Chambers, Georgina M; Randall, Sean; Hoang, Van Phuong; Sullivan, Elizabeth A; Highet, Nicole; Croft, Maxine; Mihalopoulos, Cathrine; Morgan, Vera A; Reilly, Nicole; Austin, Marie-Paule

2016-03-01

To evaluate the impact of the National Perinatal Depression Initiative on access to Medicare services for women at risk of perinatal mental illness. Retrospective cohort study using difference-in-difference analytical methods to quantify the impact of the National Perinatal Depression Initiative policies on Medicare Benefits Schedule mental health usage by Australian women giving birth between 2006 and 2010. A random sample of women of reproductive age enrolled in Medicare who had not given birth where used as controls. The main outcome measures were the proportions of women giving birth each month who accessed a Medicare Benefits Schedule mental health items during the perinatal period (pregnancy through to the end of the first postnatal year) before and after the introduction of the National Perinatal Depression Initiative. The proportion of women giving birth who accessed at least one mental health item during the perinatal period increased from 88 to 141 per 1000 between 2007 and 2010. The difference-in-difference analysis showed that while there was an overall increase in Medicare Benefits Schedule mental health item access as a result of the National Perinatal Depression Initiative, this did not reach statistical significance. However, the National Perinatal Depression Initiative was found to significantly increase access in subpopulations of women, particularly those aged under 25 and over 34 years living in major cities. In the 2 years following its introduction, the National Perinatal Depression Initiative was found to have increased access to Medicare funded mental health services in particular groups of women. However, an overall increase across all groups did not reach statistical significance. Further studies are needed to assess the impact of the National Perinatal Depression Initiative on women during childbearing years, including access to tertiary care, the cost-effectiveness of the initiative, and mental health outcomes. It is recommended that new

Does perinatal asphyxia induce apoptosis in the inner ear?

PubMed

Schmutzhard, Joachim; Glueckert, Rudolf; Sergi, Consolato; Schwentner, Ilona; Abraham, Irene; Schrott-Fischer, Annelies

2009-04-01

Pre- and perinatal asphyxia is known to be an important risk factor in the development of neonatal hearing impairment. This study aims to evaluate the role of apoptosis, which is known to play an essential role in the development of the inner ear structures, in the development of neonatal hearing loss caused by pre- and perinatal asphyxia. Eight temporal bones of six different newborns were included. We performed a morphologic analysis by both light microscopy, and transmission electron microscopy, as well as immunohistochemical staining to detect the cleaved form of caspase 3 as apoptosis marker and Bcl 2 as anti-apoptotic marker. Early and late phases of apoptosis were evidenced by condensation of chromatin (electron-dense, black structure along nuclear membrane) and fragmentation of the nucleus, respectively. Changes in nuclear morphology during apoptosis correlate with cleavage by caspase 3 located downstream of Bcl 2 action. The immunohistochemistry for cleaved caspase 3 showed a particular predilection for the inner and outer hair cells, spiral ganglion cells and the marginal cells of the stria vascularis. The brain of all examined cases did not show signs of apoptosis. In summary, this investigation suggests that apoptosis takes place before brain tissue apoptosis and is probably an earlier event than thought. Apoptosis of the cochlea is known to play an essential role in the development of the inner ear. Additionally, this study shows that apoptosis may play an important role in the development of hearing impairment, caused by pre- and perinatal asphyxia.

Japanese Quality Control Circles.

ERIC Educational Resources Information Center

Nishiyama, Kazuo

In recent years, United States scholars with an interest in international business and organizational communication have begun to notice the success of Japanese "quality control circles." These are small groups, usually composed of seven to ten workers, who are organized at the production levels within most large Japanese factories. A…

Current reinforcement model reproduces center-in-center vein trajectory of Physarum polycephalum.

PubMed

Akita, Dai; Schenz, Daniel; Kuroda, Shigeru; Sato, Katsuhiko; Ueda, Kei-Ichi; Nakagaki, Toshiyuki

2017-06-01

Vein networks span the whole body of the amoeboid organism in the plasmodial slime mould Physarum polycephalum, and the network topology is rearranged within an hour in response to spatio-temporal variations of the environment. It has been reported that this tube morphogenesis is capable of solving mazes, and a mathematical model, named the 'current reinforcement rule', was proposed based on the adaptability of the veins. Although it is known that this model works well for reproducing some key characters of the organism's maze-solving behaviour, one important issue is still open: In the real organism, the thick veins tend to trace the shortest possible route by cutting the corners at the turn of corridors, following a center-in-center trajectory, but it has not yet been examined whether this feature also appears in the mathematical model, using corridors of finite width. In this report, we confirm that the mathematical model reproduces the center-in-center trajectory of veins around corners observed in the maze-solving experiment. © 2017 Japanese Society of Developmental Biologists.

Focus on Perinatal Substance Abuse. MCH Program Interchange.

ERIC Educational Resources Information Center

MCH Program Interchange, 1991

1991-01-01

This document provides information about selected materials related to perinatal substance abuse. Materials include books, reports, directories, and other items issued from 1987 to 1991. Most citations provide author, title, date, contact, ordering information, and a brief abstract. The resource guide describes 13 materials from state and local…

Safety of Perinatal Exposure to Antiretroviral Medications: Developmental Outcomes in Infants

PubMed Central

Sirois, Patricia A.; Huo, Yanling; Williams, Paige L.; Malee, Kathleen; Garvie, Patricia A.; Kammerer, Betsy; Rich, Kenneth; Van Dyke, Russell B.; Nozyce, Molly L.

2013-01-01

Background This study evaluated effects of perinatal exposure to antiretroviral (ARV) medications on neurodevelopment of HIV-exposed, uninfected infants. Methods HIV-exposed, uninfected infants (age 9-15 months) enrolled in SMARTT, a multisite prospective surveillance study, completed the Bayley Scales of Infant and Toddler Development—Third Edition (Bayley-III), assessing cognition, language, motor skills, social-emotional development, and adaptive behavior. Linear regression models were used to evaluate associations between Bayley-III outcomes in infants with and without perinatal and neonatal ARV exposure, by regimen (combination ARV [cARV] versus non-cARV), type of regimen (defined by drug class), and individual ARVs (for infants with cARV exposure), adjusting for maternal and infant health and demographic covariates. Results As of May 2010, 374 infants had valid Bayley-III evaluations. Median age at testing was 12.7 months; 49% male, 79% black, 16% Hispanic. Seventy-nine percent were exposed to regimens containing protease inhibitors (PIs; 9% of PI-containing regimens also included non-nucleoside reverse transcriptase inhibitors [NNRTIs]), 5% to regimens containing NNRTIs (without PI), and 14% to regimens containing only nucleoside reverse transcriptase inhibitors (NRTIs). Overall, 83% were exposed to cARV. No Bayley-III outcome was significantly associated with overall exposure to cARV, ARV regimen, or neonatal prophylaxis. For individual ARVs, following sensitivity analyses, the adjusted group mean on the Language domain was within age expectations but significantly lower for infants with perinatal exposure to atazanavir (p=0.01). Conclusions These results support the safety of perinatal ARV use. Continued monitoring for adverse neurodevelopmental outcomes in older children is warranted, and the safety of atazanavir merits further study. PMID:23340561

DHA suppresses chronic apoptosis in the lung caused by perinatal inflammation.

PubMed

Ali, Mehboob; Heyob, Kathryn M; Velten, Markus; Tipple, Trent E; Rogers, Lynette K

2015-09-01

We have previously shown that an adverse perinatal environment significantly alters lung growth and development and results in persistently altered cardiopulmonary physiology in adulthood. Our model of maternal LPS treatment followed by 14 days of neonatal hyperoxia exposure causes severe pulmonary disease characterized by permanent decreases in alveolarization and diffuse interstitial fibrosis. The current investigations tested the hypothesis that dysregulation of Notch signaling pathways contributes to the permanently altered lung phenotype in our model and that the improvements we have observed previously with maternal docosahexaenoic acid (DHA) supplementation are mediated through normalization of Notch-related protein expression. Results indicated that inflammation (IL-6 levels) and oxidation (F2a-isoprostanes) persisted through 8 wk of life in mice exposed to LPS/O2 perinatally. These changes were attenuated by maternal DHA supplementation. Modest but inconsistent differences were observed in Notch-pathway proteins Jagged 1, DLL 1, PEN2, and presenilin-2. We detected substantial increases in markers of apoptosis including PARP-1, APAF-1, caspase-9, BCL2, and HMGB1, and these increases were attenuated in mice that were nursed by DHA-supplemented dams during the perinatal period. Although Notch signaling is not significantly altered at 8 wk of age in mice with perinatal exposure to LPS/O2, our findings indicate that persistent apoptosis continues to occur at 8 wk of age. We speculate that ongoing apoptosis may contribute to persistently altered lung development and may further enhance susceptibility to additional pulmonary disease. Finally, we found that maternal DHA supplementation prevented sustained inflammation, oxidation, and apoptosis in our model. Copyright © 2015 the American Physiological Society.

Perinatal Risk Factors for Mild Motor Disability

ERIC Educational Resources Information Center

Hands, Beth; Kendall, Garth; Larkin, Dawne; Parker, Helen

2009-01-01

The aetiology of mild motor disability (MMD) is a complex issue and as yet is poorly understood. The aim of this study was to identify the prevalence of perinatal risk factors in a cohort of 10-year-old boys and girls with (n = 362) and without (n = 1193) MMD. Among the males with MMD there was a higher prevalence of postpartum haemorrhage,…

Perinatal outcome and later implications of intrauterine growth restriction.

PubMed

Pallotto, Eugenia K; Kilbride, Howard W

2006-06-01

This chapter reviews outcomes for children who have intrauterine growth retardation (IUGR) or small-for-gestation-age (SGA) status at birth. Such infants are at risk for increased perinatal mortality, birth adaptation complications, including perinatal acidosis, hypoglycemia, hypothermia, coagulation abnormalities, and selected immunologic deficiencies. IUGR infants also appear to be at great risk for complications of prematurity, including chronic lung disease and necrotizing enterocolitis. Childhood implications for IUGR include an increased risk for short stature, cognitive delays with decreased academic achievement, and a small but significant increased risk of neurologic disorders, including cerebral palsy. Low socioeconomic status is correlated with the occurrence of IUGR and is significantly related to long-term disabilities. Morbidities associated with preterm delivery appear to be additive to those associated with fetal growth restriction so IUGR, preterm infants may be at great risk for poor neurodevelopmental outcome.

Risk factors associated with the different categories of piglet perinatal mortality in French farms.

PubMed

Pandolfi, F; Edwards, S A; Robert, F; Kyriazakis, I

2017-02-01

We aimed to identify mortality patterns and to establish risk factors associated with different categories of piglet perinatal mortality in French farms. At farm level, the analyses were performed on data from 146 farms that experienced perinatal mortality problems. At piglet level, the analyses were performed on data from 155 farms (7761 piglets). All data were collected over a period of 10 years (2004-14) by a consulting company, using a non-probability sampling at farm level and a random sampling at sow level. Six main categories of mortality, determined by standardised necropsy procedure, represented 84.5% of all the perinatal deaths recorded. These six categories were, in order of significance: Death during farrowing, Non- viable, Early sepsis, Mummified, Crushing and Starvation. At farm level, the percentage of deaths due to starvation was positively correlated to the percentage of deaths due to crushing and the percentage of deaths during farrowing (r>0.30, P<0.05) .The percentage of deaths due to crushing was negatively correlated to the percentage of deaths due to early sepsis (r<-0.30, P<0.05) and positively correlated to the deaths due to acute disease (r>0.30, P<0.05). Patterns of perinatal mortality at farm level were identified using a principal component analysis. Based on these, the farms could be classified, using ascending hierarchical classification, into three different clusters, highlighting issues that underlie farm differences. Risk factors were compared at piglet level for the different categories of death. Compared to other categories of death, deaths during farrowing were significantly fewer during the night than during the day. Compared to other categories of death, the likelihood of non-viable piglets tended to be higher in summer than other seasons. A smaller number of deaths in the litter was also identified for the piglets classified as non-viable or mummified. For the six main categories of perinatal mortality, the piglets which died

CSEP-Japan: The Japanese node of the collaboratory for the study of earthquake predictability

NASA Astrophysics Data System (ADS)

Yokoi, S.; Tsuruoka, H.; Nanjo, K.; Hirata, N.

2011-12-01

Collaboratory for the Study of Earthquake Predictability (CSEP) is a global project of earthquake predictability research. The final goal of this project is to have a look for the intrinsic predictability of the earthquake rupture process through forecast testing experiments. The Earthquake Research Institute, the University of Tokyo joined the CSEP and started the Japanese testing center called as CSEP-Japan. This testing center constitutes an open access to researchers contributing earthquake forecast models for applied to Japan. A total of 91 earthquake forecast models were submitted on the prospective experiment starting from 1 November 2009. The models are separated into 4 testing classes (1 day, 3 months, 1 year and 3 years) and 3 testing regions covering an area of Japan including sea area, Japanese mainland and Kanto district. We evaluate the performance of the models in the official suite of tests defined by the CSEP. The experiments of 1-day, 3-month, 1-year and 3-year forecasting classes were implemented for 92 rounds, 4 rounds, 1round and 0 round (now in progress), respectively. The results of the 3-month class gave us new knowledge concerning statistical forecasting models. All models showed a good performance for magnitude forecasting. On the other hand, observation is hardly consistent in space-distribution with most models in some cases where many earthquakes occurred at the same spot. Throughout the experiment, it has been clarified that some properties of the CSEP's evaluation tests such as the L-test show strong correlation with the N-test. We are now processing to own (cyber-) infrastructure to support the forecast experiment as follows. (1) Japanese seismicity has changed since the 2011 Tohoku earthquake. The 3rd call for forecasting models was announced in order to promote model improvement for forecasting earthquakes after this earthquake. So, we provide Japanese seismicity catalog maintained by JMA for modelers to study how seismicity

Grief reactions of couples to perinatal loss: A one-year prospective follow-up.

PubMed

Tseng, Ying-Fen; Cheng, Hsiu-Rong; Chen, Yu-Ping; Yang, Shu-Fei; Cheng, Pi-Tzu

2017-12-01

To explore couples' perceptions of the effects of perinatal loss on their marital relationship, social support and grief 1 year postloss, and analyse what factors changed the severity of their grief. Perinatal losses are traumatic events in the lives of families and can have serious long-term consequences for the psychological health of parents and any subsequent children. A prospective follow-up study. We recruited, at a teaching hospital in southern Taiwan, a convenience sample of 30 couples whose babies either miscarried or were stillborn. At 1 month (T1), 3 months (T2), 6 months (T3) and 1 year (T4) after the pregnancy loss, all participants completed four questionnaires. To analyse the changing status of their grief and its related factors, we used a generalised estimating equation (GEE) to account for correlations between repeated observations. Postbereavement grief levels fell over the four time-points. Mothers reported feeling more grief than did the fathers. Couples with a history of infertility, no religious beliefs or no living children before the loss felt more grief from a perinatal miscarriage or stillbirth. Furthermore, couples reported more grief if their marital satisfaction level was low, if their socioemotional support from husband's parents was low or if they had never participated in a ritual for their deceased baby. Six months postloss is the crucial period for bereaved parents after a perinatal loss. Being a mother, having no previous living children and low-level socioemotional support from the husband's parents are significant high-risk factors for a high level of grief 1 year after perinatal death. We recommend that health professionals increase their ability to identify the factors that psychologically affect postloss grief. Active postloss follow-up programmes should focus on these factors to offer specific support and counselling. © 2017 John Wiley & Sons Ltd.

Perinatal depressive symptoms, sociodemographic correlates, and breast-feeding among Chinese women.

PubMed

Lau, Ying; Chan, Kin Sun

2009-01-01

The objectives of the study were to (1) investigate the relationship between breast-feeding initiation and duration and patterns of perinatal depressive symptoms and (2) identify the sociodemographic correlates of such initiation and duration. A sample of 2365 women in their second and third trimesters and 6 weeks postdelivery was recruited via systematic sampling from 6 regional public hospitals in Hong Kong. The women were identified as having perinatal depressive symptoms, using the Edinburgh Postnatal Depression Scale. Their sociodemographic variables were investigated using the empirical evidence. A total of 285 (47.66%) of the participants were found to have initiated breast-feeding, of whom 222 had breast-fed for more than 3 weeks. Logistic regression analysis revealed a monthly family income less than HK$5000 to be significantly associated with breast-feeding initiation and that housewives or part-time workers with antenatal depressive symptoms at 32 weeks of gestation were significantly more likely to breast-feed for longer duration. These findings help explicate breast-feeding practices among Chinese women and indicate that effective breast-feeding promotion should consider sociodemographic correlates and perinatal depressive symptoms. The study's limitations and implications are discussed.