Pregnancy massage reduces prematurity, low birthweight and postpartum depression

Pregnant women diagnosed with major depression were given 12 weeks of twice per week massage therapy by their significant other or only standard treatment as a control group. The massage therapy group women versus the control group women not only had reduced depression by the end of the therapy period, but they also had reduced depression and cortisol levels during the postpartum period. Their newborns were also less likely to be born prematurely and low birthweight, and they had lower cortisol levels and performed better on the Brazelton Neonatal Behavioral Assessment habituation, orientation and motor scales.

Partner relationships during pregnancy in anxious and depressed women and men

To assess anxiety, depression and relationship satisfaction in both women and men during pregnancy, the State Anxiety Inventory (STAI), The Center for Epidemiological Studies-Depression Scale (CES-D) and The Relationship Questionnaire (RQ) were administered during the second trimester to a sample of 59 pregnant women and their partners. Anxious pregnant women rated their relationships as less positive. Depressed pregnant women also rated their relationships as less positive. The women’s anxiety scores were predictive of their positive and negative relationship scores. The women and their partners’ negative relationship scores were also predictive of each others’ negative relationship scores. These results highlight the importance of targeting anxiety as well as depression, and pregnant women as well as their partners in prenatal intervention programs.

Step towards to improve the voluntary interruption of pregnancy by means of business intelligence

With the implementation of Information and Communication Technologies in the health sector, it became possible the existence of an electronic record of information for patients, enabling the storage and the availability of their information in databases. However, without the implementation of a Business Intelligence (BI) system, this information has no value. Thus, the major motivation of this paper is to create a decision support system that allows the transformation of information into knowledge, giving usability to the stored data. The particular case addressed in this chapter is the Centro Materno Infantil do Norte, in particular the Voluntary Interruption of Pregnancy unit. With the creation of a BI system for this module, it is possible to design an interoperable, pervasive and real-time platform to support the decision-making process of health professionals, based on cases that occurred. Furthermore, this platform enables the automation of the process for obtaining key performance indicators that are presented annually by this health institution. In this chapter, the BI system implemented in the VIP unity in CMIN, some of the KPIs evaluated as well as the benefits of this implementation are presented.

Prevalence of Cardiac Arrhythmias During and After Pregnancy in Women with Chagas' Disease without Apparent Heart Disease

OBJECTIVE: To evaluate cardiac arrhythmias during and after pregnancy in women with Chagas' disease without apparent heart disease using dynamic electrocardiography. METHODS: Twenty pregnant women with Chagas' disease without apparent heart disease aged 19 to 42 years (26.96 ± 3.6) and a control group of 20 non-chagasic pregnant patients aged 16 to 34 years (22.5 ± 4.8). The patients were submitted to passive hemagglutination and indirect immunofluorescence for the detection of Trypanosoma cruzi evaluation, and electrocardiography, echocardiography and 24-h dynamic electrocardiography. RESULTS: Supraventricular premature depolarizations were observed in 18 (90%) patients and ventricular premature depolarization in 11 (55%) patients of both groups during pregnancy. After delivery, supraventricular premature depolarizations were present in 13 (60%) chagasic patients and in 16 (89.4%) control patients (P<=0.05). Ventricular premature depolarization were observed in 9 (45%) chagasic patients and 11 (57.8%) control patients. CONCLUSION: The prevalence of ventricular premature depolarization was similar for the chagasic and control groups during and after pregnancy. The incidence of supraventricular premature depolarizations was similar in the two groups during pregnancy, while after delivery a predominance was observed in the control group compared to the chagasic group.

Pregnancy and peripartum cardiomyopathy: a comparative and prospective study

OBJECTIVE: To assess pregnancy outcome in women with peripartum cardiomyopathy and to compare it with idiopathic cardiomyopathy. METHODS: Twenty-six pregnant women, aged 28.4±6.1 years, with dilated cardiomyopathy were followed. Eighteen patients had peripartum cardiomyopathy [11 with persistent left ventricular systolic dysfunction (EF=45.2±2) and 7 with recovered ventricular function (EF=62.3±3.6)]. The 8 remaining patients had idiopathic cardiomyopathy (EF= 43.5±4.1). During the prenatal period, limited physical activity and a low-sodium diet were recommended, and hospitalization was recommended when complications occurred. RESULTS: Of the 26 patients, 11 (42.3%) had a normal delivery; 9(35.5%) had cardiac complications, 6 (22.2%) had obstetric complications. Two patients (7.7%) died. Two preterm pregnancies occurred, with 26 health newborns (2 sets of twins). Two miscarriages took place. The cardiac complication rate during pregnancy was lower (p<0.009) in the peripartum cardiomyopathy group without ventricular dysfunction and greater (p=0.01) in the idiopathic group when compared with the peripartum group with ventricular dysfunction. Changes in left ventricular ejection fraction were not observed (p<0.05) in the postpartum period, when compared with that during pregnancy in the 3 groups. CONCLUSION: Pregnancy in patients with dilated cardiomyopathy is associated with maternal morbidity. Left ventricular function is a prognostic factor and must be the most parameter when counseling patients with peripartum cardiomyopathy about a new pregnancy.

Factores Críticos del Desarrollo Local y Regional Integrado zona serrana y Norte de la Provincia de Córdoba-. Validación causal estadística de Modelos de Ecuaciones Estructurales. Identificación de problemas normativos de las OSC.Critical Factors of Local and Regional Development in north of the Province of Córdoba. Causal validation with Structural Equation Modeling. Legal regulations of civil society.

En la investigación anterior -en la zona pampeana de la Provincia de Córdoba- se demostró teórica y empíricamente, que el desarrollo de la Sociedad Civil muchas veces libradas a su suerte y con limitaciones legales apoyan decididamente el desarrollo local, sin embargo han logrado solo parcialmente sus objetivos, por lo que es necesario comenzar un camino de fortalecimiento en los nuevos roles que deben asumir. Los gobiernos locales, a la vez, intentan trabajosamente con contados éxitos detener el procesos de descapitalización social -financiera y humana- de sus comunidades locales y regionales, peregrinando con escaso éxito a los centros concentrados del poder político y económico, para procurar los recursos financieros y humanos necesarios que no alcanzan a reponer los que se fugan desde hace décadas de sus localidades. Las empresas, con ciclos recurrentes de crecimiento y decrecimiento vinculados a los mercados en que colocan sus productos, también se debaten en la búsqueda de los escasos recursos, financieros y humanos, que les permitan consolidar un desarrollo a mediano y largo plazo. El desarrollo alcanzado en Sistemas de información, instrumentos de relevamiento, análisis y elaboración de propuestas para el Desarrollo Local, nos permite avanzar en: 1. La confirmación empírica de las hipótesis iniciales - factores exógenos y endógenos - en la zona Norte y Serrana de la provincia 2. La validación científica -mediante el Análisis de ecuaciones estructurales. de tales supuestos, para el conjunto de las poblaciones analizadas en ambas etapas. 3. La identificación de los problemas normativos que afectan el desarrollo de las Organizaciones de la Sociedad Civil (OSC). METODOLOGÍA Respecto la validación empírica en la zona norte y serrana 1. Selección de las 4 localidades a relevar de acuerdo a las categorías definidas 2. Elaboración de acuerdos con autoridades e instituciones locales. 3. Relevamiento cualitativo con líderes locales y fuentes de datos secundarias. 4. Adaptación de instrumentos de relevamiento a las realidades locales y estudios previos 5. Relevamiento cuantitativo de campo, capacitación de encuestadores y supervisores. 6. Procesamiento y elaboración de informes finales locales. Respecto de la construcción de modelos de desarrollo 1. Desarrollar las dimensiones especificas y las variables (items) de cada factor crítico. 2. Revisar el instrumento con expertos de cada una de las dimensiones. 3. Validar a nivel exploratorio por medio de un Análisis de Componentes Principales 4. Someter a los expertos la evaluación de una serie de localidades que representan cada uno. Respecto de la identificación de las normas legales que afectan a la Sociedad Civil 1.Relevamiento documental de normas 2. Relevamiento con líderes de instituciones de la Sociedad Civil 3. Análisis de las normas vigentes 4. Elaboración de Informes Finales y Transferencia a líderes e instituciones

An empirical study of the effectiveness of Irish banks’ lending regulations

The objective of this thesis will be to examine the effectiveness of lending regulations for Irish banks both prior to and after the collapse of the banking sector. The research developed a profile of the banking sector in Ireland, then evaluate the levels of stability in the Irish banking sector. In the course of this research, the author tried to establish an understanding of who is responsible for lending regulations for banks in Ireland, Investigate in particular: AIB, Ulster Bank & Anglo Irish Bank’s level of compliance with lending regulations between the Celtic Tiger and the present.

Blood Pressure Variation Throughout Pregnancy According to Early Gestational BMI: A Brazilian Cohort

Background: The maternal cardiovascular system undergoes progressive adaptations throughout pregnancy, causing blood pressure fluctuations. However, no consensus has been established on its normal variation in uncomplicated pregnancies. Objective: To describe the variation in systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels during pregnancy according to early pregnancy body mass index (BMI). Methods: SBP and DBP were measured during the first, second and third trimesters and at 30-45 days postpartum in a prospective cohort of 189 women aged 20-40 years. BMI (kg/m2) was measured up to the 13th gestational week and classified as normal-weight (<25.0) or excessive weight (≥25.0). Longitudinal linear mixed-effects models were used for statistical analysis. Results: A decrease in SBP and DBP was observed from the first to the second trimester (βSBP=-0.394; 95%CI: -0.600- -0.188 and βDBP=-0.617; 95%CI: -0.780- -0.454), as was an increase in SBP and DBP up to 30-45 postpartum days (βSBP=0.010; 95%CI: 0.006-0.014 and βDBP=0.015; 95%CI: 0.012-0.018). Women with excessive weight at early pregnancy showed higher mean SBP in all gestational trimesters, and higher mean DBP in the first and third trimesters. Excessive early pregnancy BMI was positively associated with prospective changes in SBP (βSBP=7.055; 95%CI: 4.499-9.610) and in DBP (βDBP=3.201; 95%CI: 1.136-5.266). Conclusion: SBP and DBP decreased from the first to the second trimester and then increased up to the postpartum period. Women with excessive early pregnancy BMI had higher SBP and DBP than their normal-weight counterparts throughout pregnancy, but not in the postpartum period.

Financial development, labor and market regulations and growth

This paper investigates the importance that market regulation and financial imperfections have on firm growth. We analyse institutions af- fecting labor market as Employment Protection Laws (EP) and Product Market Regulation (PM). We show that together with the beneficial effects of financial development, a firm will get less financing, and thus investless, in a weak financial market (finance effect), the strictness of product and labor market regulations also affect firm growth (labor effect). In particular, we show that the stricter the rules the more detrimental the influence on growth in sectoral value added for a large number of countries. We also show that the labor effect overcomes the positive finance effect.

Women's decision making and experience of subsequent pregnancy following stillbirth.

INTRODUCTION: This study sought to increase understanding of women's thoughts and feelings about decision making and the experience of subsequent pregnancy following stillbirth (intrauterine death after 24 weeks' gestation). METHODS: Eleven women were interviewed, 8 of whom were pregnant at the time of the interview. Modified grounded theory was used to guide the research methodology and to analyze the data. RESULTS: A model was developed to illustrate women's experiences of decision making in relation to subsequent pregnancy and of subsequent pregnancy itself. DISCUSSION: The results of the current study have significant implications for women who have experienced stillbirth and the health professionals who work with them. Based on the model, women may find it helpful to discuss their beliefs in relation to healing and health professionals to provide support with this in mind. Women and their partners may also benefit from explanations and support about the potentially conflicting emotions they may experience during this time.

Differential regulations of AQP4 and Kir4.1 by triamcinolone acetonide and dexamethasone in the healthy and inflamed retina.

PURPOSE: Glucocorticoids are used to treat macular edema, although the mechanisms underlying this effect remain largely unknown. The authors have evaluated in the normal and endotoxin-induced uveitis (EIU) rats, the effects of dexamethasone (dex) and triamcinolone acetonide (TA) on potassium channel Kir4.1 and aquaporin-4 (AQP4), the two main retinal Müller glial (RMG) channels controlling retinal fluid movement. METHODS: Clinical as well as relatively low doses of dex and TA were injected in the vitreous of normal rats to evaluate their influence on Kir4.1 and AQP4 expression 24 hours later. The dose-dependent effects of the two glucocorticoids were investigated using rat neuroretinal organotypic cultures. EIU was induced by footpad lipopolysaccharide injection, without or with 100 nM intraocular dex or TA. Glucocorticoid receptor and channel expression levels were measured by quantitative PCR, Western blot, and immunohistochemistry. RESULTS: The authors found that dex and TA exert distinct and specific channel regulations at 24 hours after intravitreous injection. Dex selectively upregulated Kir4.1 (not AQP4) in healthy and inflamed retinas, whereas TA induced AQP4 (not Kir4.1) downregulation in normal retina and upregulation in EIU. The lower concentration (100 nM) efficiently regulated the channels. Moreover, in EIU, an inflammatory condition, the glucocorticoid receptor was downregulated in the retina, which was prevented by intravitreous injections of the low concentration of dex or TA. CONCLUSIONS: The results show that dex and TA are far from being equivalent to modulate RMG channels. Furthermore, the authors suggest that low doses of glucocorticoids may have antiedematous effects on the retina with reduced toxicity.

Pregnancy Outcome Following Maternal Exposure To Statins: A Multicenter Prospective Study

Introduction: Statin use for the treatment of hypercholesterolemia in women of childbearing age is increasingly common. However, published data on pregnancy outcome after exposure to statins are scarce and conflicting. This contribution addresses the safety of exposure to statins during pregnancy.Method: In a multi-center (n = 11) observational, prospective study we compared the outcomes of 249 women exposed during the 1st trimester of pregnancy to simvastatin (n = 124), atorvastatin (n = 67), pravastatin (n = 32), rosuvastatin (n = 18), fluvastatin (n = 7) or cerivastatin (n = 1) with a control group exposed to agents known to be non-teratogenic (n = 249). The data were collected by members of the European Network of Teratology Information Services (ENTIS) during individual risk counseling between 1990 and 2009. Standardized procedures for data collection were used in each center.Results: The difference in the rate of major birth defects between the statin-exposed group and the control group was not statistically significant (4.0% vs. 2.7% OR 1.5; 95% CI 0.5-4.5, P = 0.44). The crude rate of spontaneous abortions (12.8% vs. 7.1%, OR 1.9, 95% CI 1.0-3.6, P = 0.04) was higher in the exposed group. However, after adjustment to maternal age and gestational age at initial contact, the difference became statistically insignificant. The rate of elective pregnancy-termination (8.8% vs. 4.4%, P = 0.05) was higher and the rate of deliveries resulting in live births was significantly lower in the statin exposed group (77.9% vs. 88.4%, P = 0.002). Prematurity was more frequent in exposed pregnancies (16.1% vs. 8.5%; OR 2.1, 95% CI 1.1-3.8, P = 0.02). Nonetheless, gestational age at birth (median 39 weeks, IQR 37-40 vs. 39 weeks, IQR 38-40, P = 0.27) and birth weight (median 3280 g, IQR 2835-3590 vs. 3250 g, IQR 2880-3600, P = 0.95) did not differ between exposed and non-exposed pregnancies.Conclusion: This study did not detect a clear teratogenic effect of statins. Its statistical power however is not sufficient to reverse the recommendation of treatment discontinuation during pregnancy. At most, the results are reassuring in case of inadvertent exposure.

Assessing excess profits from different entry regulations

Entry regulations affecting professional services such as pharmacies are common practice in many European countries. We assess the impact of entry regulations on profits estimating a structural model of entry using the information provided by a policy experiment. We use the case of different regional policies governing the opening of new pharmacies in Spain to show that structural models of entry ought to be estimated with data from policy experiments to pin down how entry regulations change payoffs functions of the incumbents. Contrary to the public interest rationales, regulations are not boosting only small town pharmacies payoffs nor increasing all pharmacies payoffs alike. The gains from regulations are very unevenly distributed,suggesting that private interests are shaping the current mix of entry and markup regulations.