Purpose: The purpose of this review was to analyze the characteristics and effectiveness of online-based intervention for infertile women. Methods: We established the PICO (Participant-Intervention-Comparison-Outcome) strategy and conducted a systematic review of 7 literatures retrieved from 3 electronic databases of Ovid-Medline, Ovid-Embase, and the Cochrane Library. Two investigators independently extracted the data and assessed the quality of included studies using Cochrane risk of bias. Results: The pregnancy outcome showed that higher total risk scores (TRS) about lifestyle behavior was significantly associated with lower chance of pregnancy (aHR 0.79, 95% CI 0.72~0.85). Stress was significantly decreased in experimental groups receiving online-based interventions (p<.05). Depression score was significantly lower in groups receiving additional interventions besides on-line interventions than those who used online-based intervention only. The other outcomes, including anxiety, self-efficacy, helpfulness of intervention, perceived social support, and knowledge scores were not significantly different within and between groups in overall. Characteristics of the interventions were heterogeneous. Conclusion: There is evidence that online-based intervention in infertile women enhances the pregnancy and reduces stress levels.
Human pregnancy is a delicate and complex process where multiorgan interactions between two independent systems, the mother, and her fetus, maintain pregnancy. Intercellular interactions that can define homeostasis at the various cellular level between the two systems allow uninterrupted fetal growth and development until delivery. Interactions are needed for tissue remodeling during pregnancy at both fetal and maternal tissue layers. One of the mechanisms that help tissue remodeling is via cellular transitions where epithelial cells undergo a cyclic transition from epithelial to mesenchymal (EMT) and back from mesenchymal to epithelial (MET). Two major pregnancy-associated tissue systems that use EMT, and MET are the fetal membrane (amniochorion) amnion epithelial layer and cervical epithelial cells and will be reviewed here. EMT is often associated with localized inflammation, and it is a well-balanced process to facilitate tissue remodeling. Cyclic transition processes are important because a terminal state or the static state of EMT can cause accumulation of proinflammatory mesenchymal cells in the matrix regions of these tissues and increase localized inflammation that can cause tissue damage. Interactions that determine homeostasis are often controlled by both endocrine and paracrine mediators. Pregnancy maintenance hormone progesterone and its receptors are critical for maintaining the balance between EMT and MET. Increased intrauterine oxidative stress at term can force a static (terminal) EMT and increase inflammation that are physiologic processes that destabilize homeostasis that maintain pregnancy to promote labor and delivery of the fetus. However, conditions that can produce an untimely increase in EMT and inflammation can be pathologic. These tissue damages are often associated with adverse pregnancy complications such as preterm prelabor rupture of the membranes (pPROM) and spontaneous preterm birth (PTB). Therefore, an understanding of the biomolecular processes that maintain cyclic EMT-MET is critical to reducing the risk of pPROM and PTB. Extracellular vesicles (exosomes of 40-160 nm) that can carry various cargo are involved in cellular transitions as paracrine mediators. Exosomes can carry a variety of biomolecules as cargo. Studies specifically using exosomes from cells undergone EMT can carry a pro-inflammatory cargo and in a paracrine fashion can modify the neighboring tissue environment to cause enhancement of uterine inflammation.
It is widely recognized that the embryonic or fetal loss after breeding is common in the cattle and that it is an important factor affecting reproductive efficiency. The causes of this loss have been subject of extensive researches and the results indicate that the embryonic mortality may he primary factor responsible for low pregnancy rates in non-embryo transfer bovine populations as well as embryo transfer programs. However, it's causes are still not clearly understood. The embryonic mortality or pregnancy rate has been influenced by various embryonic and maternal effects related to genetic and environmental factors. The timing and extent of embryonic mortality vanes greatly according to authors and estimating methods, because it is difficult to make direct measurements. The major important factors that may influence the embryonic losses or pregnancy rates after embryo transfer can be summeirized. 1.When an embryo is transferred to unmated recipients, the contralateral transfer to corpus luteum results in a lower survival rate than ipsilateral deposition. When the embryos are transferred for the production of twin calves, their survivals and twin pregnancies have quite inconsistent according to the transfer methods either to the unmated-synchronized or already mated recipients and more works are needed to accurrately clarify the previous results. 2.Although embryos can be cultured in vitro some hours without the great declines in pregnancy rates, the rates differ markedly among culture times and media but may be improved by co-transfer systems. 3.Embryo developmental stages and quality grades clearly affect the survival rate following freezing and the pregnancy rate after transfer and the selection of embryos without chromosome abnormalities and of high fertile semen may also be considered to increase the pregnancy rates. 4.Many researches have attempted to relate the plasma progesterone levels to pregnancy rates and others have done either direct progesterone supplementation or luteal stimulation by hCG treatment in order to increase the pregnancy rates. However, these effects on pregnancy rates are inconsistent and also contradictory. 5.The asynchrony between donors or embryos and recipients may he a major cause of embryo death and low pregnancy rate and the sensitivity to uterine asynchyony differs in according to the quality and stages of embryos. 6.The extremes of poor or over nutrition during early pregnancy in the recipients are detrimental to the survival of embryos and the good body condition is required to prevent a reduejion of pregnancy rates. The uterine pathogens in embryonic mortality or fertility have been questioned but the infection of C.pyogenes and Campylobacter fetus is still important pathogens. 7.The heat stress during early pregnancy may reduce conceptus weight and possibly increase the embryonic mortality.
Purpose: This study explored the prevalence of prenatal and postpartum depression in Korea and its influencing factors from 20 weeks of pregnancy to 12 weeks postpartum. Methods: Using a prospective cohort study design, data on women's depression and its influencing factors were collected at 20, 28, and 36 weeks of pregnancy and at 2, 6, and 12 weeks postpartum. The participants were 219 women and 181 spouses during pregnancy; and 183 mothers and 130 spouses after childbirth. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale and influencing factors were measured by the Postpartum Depression Predictors Inventory-Revised, parity, and spousal depression. Results: The prevalence of maternal depression was 10.5% to 21.5% before birth, and it was 22.4% to 32.8% postpartum. The prevalence slightly decreased during the prenatal period but peaked at 2 weeks postpartum. Antenatal depression was influenced by low socioeconomic status, lower self-esteem, having experienced prenatal depression, having experienced prenatal anxiety, a previous history of depression, lower social support, lower marital satisfaction, and higher life stress. The factors influencing postpartum depression were lower self-esteem, having experienced prenatal depression, having experienced prenatal anxiety, lower social support, lower marital satisfaction, and higher life stress, as well as infant temperament and maternal blues. Parity and spousal depression had no impacts. Conclusion: The prevalence and influencing factors of maternal depression changed over time. Nurses need to screen women accordingly during the perinatal period and should provide education or counseling to prevent depression and promote adjustment to parenthood.
As glucocorticoids are well-known as important regulators of stress and the immune system, their function and clinical use have elicited substantial interest in the field of reproduction. In particular, the effect of glucocorticoid therapy on endometrial receptivity during assisted reproduction, including in vitro fertilization (IVF) cycles, has led to a great deal of interest and controversy. However, previous studies have not been able to provide consistent and reliable evidence due to their small, non-controlled designs and use of different criteria. Considering the potential risk of exposure to glucocorticoids for mothers and fetuses in early pregnancy, the use of glucocorticoids in IVF cycles should be carefully evaluated, including the balance between risk and benefit. To date, there is no conclusive evidence that the use of glucocorticoids improves the pregnancy rate in IVF cycles with unselected subjects, and a further investigation should be considered with a proper study design.
Kim, Tae-Woon;Seo, Jin-Hee;Jung, Sun-Young;Kim, Dae-Young;Kim, Chang-Ju;Lee, Sam-Jun
운동영양학회지
/
제15권4호
/
pp.173-182
/
2011
Post-traumatic stress disorder (PTSD) is a stress-related mental disorder induced by severe external stressors such as assault, disaster or severe accident. We investigated the effects of treadmill exercise on short-term memory in relation to apoptosis and cell proliferation in the hippocampus following PTSD. Stress to the pregnant rats was induced by exposure of maternal rats to the hunting dog in an enclosed room. Exposure time was 10 min, repeated three times per day, with 1 hour interval. Exposure of maternal rats to the hunting dog was continued 7 days after pregnancy until delivery. The pregnant rats in the exercise groups were forced to run on a treadmill for 30 min once a day for the same duration of stress exposure. Step-down avoidance task for short-term memory, western blot for Bcl-2, Bax, and immunohistochemistry for caspase-3, 5-bromo-2'-deoxyuridine (BrdU), and Ki-67 were conducted. Maternal rats exposed to stress during pregnancy showed short-term memory impairment. Expressions of Bax, Bcl-2, ratio of Bax to Bcl-2, and caspase-3 in the hippocampus were increased in the PTSD rats. Cell proliferation in the hippocampal dentate gyrus was decreased in the PTSD rats. Treadmill exercise alleviated short-term memory impairment and suppressed expressions of Bax, the ratio of Bax to Bcl-2, and caspase-3. Treadmill exercise also increased cell proliferation. The present results indicate that treadmill exercise alleviated PTSD-induced short-term memory impairment by suppressing apoptotic cell death and enhancing cell proliferation in the hippocampus.
Purpose: The purpose of this study was to identify factors related to level of satisfaction among mothers of preschoolers. Methods: Participants were 359 mothers of firstborn healthy preschoolers. The questionnaires were collected from August 1 to November 21, 2012. Data were analyzed using SPSS 20.0. Results: The mean score for degree of mothers' parenting satisfaction was 5.94 out of 7. There were significant differences in the level of parenting satisfaction according to mother's job (t=2.48, p=.014), planned pregnancy (t=3.07, p=.002), number of children (t=2.22, p=.027), and parenting education (F=4.33, p=.005). The environmental variables of age of spouse (F=3.06, p=.048) and monthly income of the household (F=2.87, p=.036) also seemed to have an influence. Analysis of predictors such as the mother's job, planned pregnancy, parenting education, overall health problems, parenting stress, perception of emotional status and behaviors in children, age of spouse, and spouse's support explained 31.5% of the variance in mother's parenting satisfaction. Conclusion: The results suggest a need to develop nursing intervention programs for parenting stress reduction, and health programs for fathers to support mothers' child rearing.
In spite of the great progress of the theory and skill of the Nursing Care & Medical area in relation to pregnancy, nurses in clinics face up to many challenges in maternity nursing care areas. The reason is that the mobility and mortality of mothers was sharply decreased and the unknown high-risk diseases of pregnancy woman in the past is made public. That's why it is difficult to meet the pregnancy woman in natural process from pregnancy to delivery in recently. Admission rooms are filled with high-risk pregnancy women. As a matter of fact, we have done nursing care into the surface symptoms and diseases of high-risk pregnancy women so far. We have been indifferent to a long period hospitalization, separation from family, and conflict of repeated examination. Therefore, it is widely spread to understand the emotional conflict experienced by high-risk pregnancy women and to need for nursing intervention to bring up about emotional support and the ability of perception in psychological crisis. Although the pregnancy woman judged in high-risk should carry out normal task of pregnancy, she have to be confronted with secondary risk situation. The health of self & fetus threatened by the risk situation could be decreased through care plan, but psychological stress increases. Therefore, the pregnancy brings into non-control state. It is important to ask that what the hospitalized pregnancy women in high-risk think of themselves status. Because misunderstanding or serious anxiety of themselves status put into mother and fetus in danger. And adaptation mode makes all the difference. I would like to consider how nurses could deal with this high-risk circumstances in the position of pregnancy woman on the basis of the above fact. This study uses phenomenological method to suggest the basis material for nurses to do nursing intervention in view of pregnancy woman. Because this method understands the nature of true life of pregnancy woman throughly. The phenomenological method is the sources to describe or explain affluently the process generated in confirmation areas and environment and is the application for readers to understand and recognize clinic reality and then apply this method to reasoning study place or other places. Specifically, the phenomenon study method, one of the phenomenological method, is applied. The use of that method is to describe and generalize the experience in environment exactly. The study of this study is as follows : Among 187 descriptive stamens from 8 study participants are classified into 42 theme cluster at the stage of the first analysis. Those theme is categorized into 8 sub-subjects such as anxiety of uncertainty, foreknowledge about risk circumstance, will power about overcome, unsettled feeling about hospital, relief, optimistic thought, family support, and indifferences. At the last stage of analysis, those things are categorized into 3 subjects. When high-risk pregnancy woman foretell the situation, they feel unsettlement about uncertainty and untrust feeling about hospital. But they are ease with family support and hospital support. On the other hand, they express indifferent 3-way structure response to the situation having will of overcome and exceeding optimistic thought. In those statements, the experience by pregnancy woman shows 3 respect subjects. 1. They are anxious of this situation and are in desperation and don't recognize their role to be carried out 2. They think of this situation as normal process of pregnancy and are not concerned that this can give themselves and fetus fatal damage. 3. The pregnancy women will never confront this situation. This study shows the pregnancy woman has anxiety and optimistic relief about the situation, and ignores and optimistic relief about the situation, and ignores many things. Therefore, nurses in clinic should give pregnancy woman knowledge and information about the high-risk and help them to deal with the situation spontaneously. High-risk pregnancy woman should have the care plan in respect of the right perception. And the nurse know that their support help out pregnancy woman overcome the crisis in this respect of the special nursing intervention.
Objectives: The purpose of this study is to investigate the characteristics of female infertility patients who come to Korean medicine clinics and analyze the trends of Korean medicine treatment methods and the effects of female infertility by registry data. Methods: We are recruiting study participants from Korean medicine hospitals and clinics. If female infertility patients come, we will ask them to register for this study. After enrollment, we will collect demographic information, treatment methods, pregnancy results, adverse events, and treatment costs. Result: First, we will analyze the characteristics of patients, the status of the use of Korean medicine treatment interventions, the cost status of Korean medicine infertility treatment, and the delivery characteristics of pregnant women after Korean medicine treatment. Second, we will analyze the effectiveness of Korean medicine treatment. The primary outcome is clinical pregnancy rate, and secondary outcomes are 12-week pregnancy maintenance rate, degree of dysmenorrhea and premenstrual syndrome, stress level, and health-related quality of life score. Discussion: This study is the first observational multi-center study in Korea for female infertility. By establishing the registry, we are creating a resource that contains patient-reported outcome measures for female infertility. The registry is expected to provide valuable data for developing Korean medicine Clinical practice guidelines for female infertility.
임신 기간 중 임산부는 체중 증가 및 근골격계 변화로 요통과 골반 통증을 유발한다. 필라테스는 유, 무산소성 복합운동으로 자세 교정 및 근 기능을 강화시키는 것으로 보고되고 있다. 따라서 이 연구는 필라테스 매트 운동이 임산부의 신체구성, 요부근력, 요통 및 임신 스트레스에 미치는 영향을 규명하는데 목적이 있다. 본 연구를 수행하기 위해 임신 중기(16~25주) 임산부 19명을 대상으로 필라테스 매트 운동 실험집단(n=11)과 비교집단(n=8)으로 구분하였으며, 실험집단은 하루 60분, 주 2회 12주간 필라테스 매트 운동을 실시하였다. 신체구성 중 체수분량, 체지방량, 체질량지수, 체지방률 및 기초대사량에는 집단 간 변화가 없는 것으로 나타난 반면 실험집단에서는 골격근량에서 유의한 증가가 나타났다. 또한 요부근력의 경우 엉덩이관절 신전근과 요추 신전 가동범위는 필라테스 매트 운동을 수행한 집단에서 유의하게 증가하였다. 요통 수준과 임신 스트레스 수준을 분석한 결과 집단 간 차이는 없는 것으로 나타났다. 따라서 필라테스 매트 운동은 임산부의 근육량을 증가시키고, 요부근력에는 긍정적인 영향을 나타내어 임산부에게 안전하게 적용할 수 있는 운동이라고 할 수 있다.
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