Effectiveness of coaching for enhancing the health of menopausal Japanese women

We conducted and evaluated a coaching intervention aimed at encouraging menopausal women’s engagement in goal-oriented actions, self-efficacy enhancement, menopausal symptom alleviation, and quality of life improvement. The study was a randomized controlled trial comprising women aged 40–60 who were not receiving hormone therapy. The intervention group received leaflets and three monthly coaching sessions. Instruments included the Simplified Menopausal Index, Medical Outcome Study 36-Item Short Form Health Survey, and goal achievement scale. Participants were measured preintervention, immediately postintervention, and three months postintervention. A 3-month coaching intervention to enhance menopausal women’s health increased their self-efficacy. This effect was not maintained 3 months postintervention.     

The effect of couples education on marital satisfaction in menopausal women

ABSTRACT

Inviting husbands to come to terms with women’s adaptation to the phenomenon of menopause is beneficial. The aim of this research was to uncover the effect of couples education on marital satisfaction. This study was performed on 80 menopausal women accompanied by their husbands. The intervention group received four sessions of couples education. The results showed that the mean increase in the rate of marital satisfaction after couples education in the intervention group was significantly higher than the control. Short-term couples education has a significant positive effect on marital satisfaction. Therefore, this counseling strategy can be integrated into health-care programs.     

The effect of acupressure on the initiation of labor: A randomized controlled trial

Background

Induction of labor is a common obstetric procedure. Acupressure is a natural method that is used for inducing uterine contractions. Nevertheless, few studies have examined the impact of acupressure on the induction of labor.

Castor oil for induction of labor in post-date pregnancies: A randomized controlled trial

Background

Castor oil is a substance used for labor induction in an inpatient setting. However, its efficacy as an agent for the induction of labor, for post-date pregnancies in an outpatient setup is unknown.

Admitting women in active labour: A randomised controlled trial about the effects of protocol use on childbirth method and interventions

AimTo determine the effects of protocol of admitting women in active labour on childbirth method and interventions during labour and childbirth.MethodsThis single-blind randomised clinical trial was conducted in a public hospital in Mazandaran province (Iran) in 2017. Two hundred nulliparous low-risk women were randomly assigned into intervention and control groups. The participant women were admitted in the intervention group using the admission protocol and to the group control by staff midwives and doctors. The admission criteria of the protocol were: the presence of regular, painful contractions, the cervix at least four cm dilated and at least one of the following cues: cervix effaced, and spontaneous rupture of membranes, or “show”. The primary outcome measure was childbirth method. Data were analyzed in SPSS-22 using Mann–Whitney and Chi–square tests. The level of statistical significance was set as p < 0.05.FindingThere were significant differences between the intervention and control groups in the number of caesarian section (CS) (p < 0.001). Two groups had a statistically significant difference in amniotomy (p = 0.003), augmentation by oxytocin (p < 0.001), number of vaginal examinations (p < 0.001) and fundal pressure (p < 0.001).ConclusionsUsing a protocol for admission of low risk nulliparous women in active labour contributed to reduction of the primary caesarean section rate and interventions during childbirth. A risk assessment and using evidence informed guidelines in admission can contribute to reduce unsafe and harmful practices and support normalisation of birth. This is essential for demedicalisation and a useful strategy for reducing primary CS.     

The effects of early pacifier use on breastfeeding: A randomised controlled trial

BackgroundThe majority of observational studies have found associations between pacifier use and shorter breastfeeding duration. Results from four randomised controlled trials did not reveal any difference in breastfeeding outcomes. The relationship between early pacifier use and breastfeeding outcomes remains unclear.AimTo investigate whether a recommendation of early pacifier use affects the proportion of breastfeeding at six months compared to a recommendation to avoid pacifier use during the first two weeks.MethodsAn open, randomised controlled trial with parallel group design; 239 primiparous mothers and their term infants were randomly assigned to an intervention group or a control group. The primary outcome was the proportion of breastfeeding at six months. Secondary outcomes were the proportions of breastfeeding and breastfeeding problems at two and four months. To investigate factors which may influence breastfeeding, a multivariate logistic regressions analysis was performed.FindingsA total of 209 participants (87.5%) completed the study. There were no significant differences between the groups with respect to breastfeeding at six months. No negative association for breastfeeding between early versus late introduction of pacifier was found. Factors significantly associated with cessation of breastfeeding at six months were: use of nipple shield, intention to breastfeed, severe breastfeeding problems at two weeks, pacifier use at two months and lower educational level.ConclusionEarly versus late recommendation of pacifier introduction did not affect the proportion of breastfeeding at six months. However, the compliance to the randomised group was insufficient. No negative association was found in the observational analysis.     

Age at the onset of menopause and its influencing factors in Turkish women in a rural area

This study was performed to identify menopausal age and its determining factors in women over 40 residing in the Dogubeyazit district of Agri, located in Eastern Turkey. This cross-sectional study was performed on a sample of 1,068 women, selected by simple random sampling among all district health center records of women aged 40 and greater, who were each attributed a random serial number. While 35.6% of the subjects had not yet reached menopause, 60.5% had entered it spontaneously and 3.9% surgically. Average age at spontaneous menopause was 47.4 ± 3.7 years and that of surgical menopause 45.1 ± 5.0. Age at marriage, age of last pregnancy, and the age of the subject’s mother at menopause affected menopausal status. Identifying menopausal age and its determining factors may modify the menopausal status of women and their management of the perimenopausal period.     

The effect of protein diets in postmenopausal women with osteoporosis: Systematic review of randomized controlled trials

The main objective of this systematic review was to examine the effectiveness of protein supplementation through diet or dietary supplements on osteoporosis in postmenopausal women as evidenced by randomized controlled trials (RCTs). Five RCTs were included using dietary protein (N = 2), protein supplements (N = 2), and proteins through diet and supplements (N = 1). A total of 677 postmenopausal woman were included, all diagnosed with osteoporosis (T score < –2.5) and aged between 50 and 80 years. Results have found that combined protein administration through diet, mainly from animal sources and supplemental proteins (whey proteins, 86 g/d PRO including 6 g WPI), for a short period of time (up to 12 months) may positively affect osteoporosis in postmenopausal women. In addition, a positive effect can also be achieved by the single administration of a 250 mg/d supplement in which 10 g was WPI for a six-month period. In this review, it is shown that both combined administration of proteins through diet and supplements and single administration through protein supplements may reduce the risk of fracture in postmenopausal osteoporotic women. In contrast, dietary proteins alone, in doses similar to and/or higher than the RDA values, may not have any positive effect on treating osteoporosis.     

Comparing compliance with commencement and use of two partograph designs for women in active labour: A randomised controlled trial

BackgroundDocumentation and assessment of progress in labour using a partograph is recommended by the World Health Organisation to assist in the timely recognition of labour dystocia. Recent studies have tested new designs of partographs that aim to account for more variable rates of labour progress. However, other studies have suggested that poor compliance in the completion of partographs affects utility. The objective of this study was to compare two types of partographs for compliance in documentation and use for managing labour.MethodsLow-risk nulliparous women in spontaneous labour (n = 228) were randomised to either an Action Line (control) (n = 114) or Dystocia Line partograph (intervention) (n = 114). Primary outcome was compliance with instructions for commencement of the partograph following a multifaceted training strategy. Secondary outcomes included compliance with the accompanying clinical management protocol for each partograph; and labour and birth outcomes.ResultsThe compliance rate for commencing the Action line partograph was 43.2% compared to 67.0% (p = 0.02) for the Dystocia line partograph. Other than a reduction in artificial rupture of membranes in the Dystocia Line group there were no other differences in labour management or birth outcomes. The use of centralised electronic display of labour progress may be a contributing factor.ConclusionsCompliance with the commencement and use of either partograph was low. There was little indication that the partograph was being utilized in the assessment and management of prolonged labour. Further studies are needed to explore the current utility of partographs in labour management and the effect of centralised monitoring of progress in high resource settings     

Effects of a novel positive psychological intervention on prenatal stress and well-being: A pilot randomised controlled trial

Problem

Low prenatal well-being has adverse outcomes for mother and infant but few interventions currently exist to promote and maintain prenatal well-being.

Allocation and distribution: A discussion of the educational transition model,with reference to the Italian case

The main characteristic of education in the past century has been its expansion: a major stratification research question associated with this is whether the inequalities of educational opportunities among classes have persisted or changed (diminished) over time. The educational transition model (29 and 30), adopted by the majority of scholars in the field, separates the study of allocation, that is class inequality in education, from that of distribution, the amount of schooling and its expansion, using conditional logits. A consequence of the way this distinction has influenced subsequent research has been the emergence of a sharp gap between macro-level research on the expansion of education and stratification studies.     

Exercise training in thermo-mineral spring water has beneficial effects on hemodynamic and health-related factors in young-older hypertensive women: A randomized control trial

ABSTRACT

The aim of the study was to evaluate the effects of an 8-week aerobic training in mineral geothermal water on hemodynamic variables, VO_2max, and body composition in sedentary hypertensive women. Twenty postmenopausal women (58.55 ± 3.28 years) were divided into an exercise group (2 days/week, 30–40 minutes, 60%–75% of HR_max) and control group. Compared to the control group, a signi?cant reduction in systolic blood pressure, heart rate, rate pressure product, body fat percent, and a signi?cant improvement in VO_2max values was found. Aerobic training in thermo-mineral spring water is a safe and effective training modality in the young-older hypertensive population.     

The influence of physical activity in water on sleep quality in pregnant women: A randomised trial

Introduction

Sleep is a physiological state of self-regulation. The international classification of sleep disorders now includes as a new category those occurring during pregnancy. Regular physical activity is known to improve the quality of life, one aspect of which is sleep quality. During pregnancy, physical activity is decreased but should not be eliminated, as studies have reported a high correlation between sleep disorders and the absence of physical activity. Regular physical exercise during pregnancy, whether performed in water or out of it, provides greater control of gestational weight gain. Furthermore, the reduced weight gain during pregnancy, as a result of physical exercise, is associated with greater physical resistance to the demands of childbirth, combats the fatigue caused by pregnancy and reduces back pain. All of these outcomes tend to enhance sleep quality, among other beneficial effects.

The effect of antenatal pelvic floor muscle exercise on sexual function and labour and birth outcomes: A randomised controlled trial

BackgroundPelvic floor muscle exercises (PFME) are recommended for treatment of urinary incontinence with less evidence available about the effect on female sexual function (FSF) and childbirth.AimTo investigate the effect of antenatal PFME on FSF during pregnancy and the first three months following birth as a primary outcome, and on labour and birth outcomes as a secondary outcome.Method200 nulliparous women were randomised to control (n = 100) and intervention (n = 100) groups. The women in the intervention group (IG) undertook PFME from 20 weeks gestation until birth and had routine antenatal care, while those in the control group (CG) received routine antenatal care only. The Female Sexual Function Index (FSFI) was used to measure FSF at 36 weeks gestation and three months postnatal. Baseline characteristics and childbirth data were also collected and analysed using SPSS.ResultsThere were no statistically significant differences between the two groups in terms of FSF scores during pregnancy and on childbirth outcomes. Sexual satisfaction was slightly higher in the CG [Mean ± SD, CG: 4.35 ± 1.45 vs. IG: 3.70 ± 1.50, (P = 0.03)] at three months after birth. However, 50% of women adhered to the PFME, and 40% of women did not resume sex by three months after the birth.ConclusionThough some trends were observed, the results showed no effect of PFME on sexual function or labour and birth outcomes. This needs to be interpreted considering the 50% adherence to PFME. More research is recommended.     

Combination of a structured aerobic and resistance exercise improves glycaemic control in pregnant women diagnosed with gestational diabetes mellitus. A randomised controlled trial

Problem

Gestational diabetes mellitus, defined as any carbohydrate intolerance first diagnosed during pregnancy, is associated with a variety of adverse outcomes, both for the mother and her child.

Midwifery continuity of care and vaginal birth after caesarean section: A randomised controlled trial

Problem and backgroundCaesarean section (CS) rates in Australia and many countries worldwide are high and increasing, with elective repeat caesarean section a significant contributor.AimTo determine whether midwifery continuity of care for women with a previous CS increases the proportion of women who plan to attempt a vaginal birth in their current pregnancy.MethodsA randomised controlled design was undertaken. Women who met the inclusion criteria were randomised to one of two groups; the Community Midwifery Program (CMP) (continuity across the full spectrum — antenatal, intrapartum and postpartum) (n = 110) and the Midwifery Antenatal Care (MAC) Program (antenatal continuity of care) (n = 111) using a remote randomisation service. Analysis was undertaken on an intention to treat basis. The primary outcome measure was the rate of attempted vaginal birth after caesarean section and secondary outcomes included composite measures of maternal and neonatal wellbeing.FindingsThe model of care did not significantly impact planned vaginal birth at 36 weeks (CMP 66.7% vs MAC 57.3%) or success rate (CMP 27.8% vs MAC 32.7%). The rate of maternal and neonatal complications was similar between the groups.ConclusionModel of care did not significantly impact the proportion of women attempting VBAC in this study. The similarity in the number of midwives seen antenatally and during labour and birth suggests that these models of care had more similarities than differences and that the model of continuity could be described as informational continuity. Future research should focus on the impact of relationship based continuity of care.     

Attitude Toward Menopause and Aging: A Study on Postmenopausal Women of West Bengal

We examined the attitude of postmenopausal women toward menopause and aging with respect to sociodemographic variables and postmenopausal years. Four hundred and eighty postmenopausal women representing Bengali-speaking Hindu ethnic group of West Bengal, India were interviewed about their attitude toward menopause and aging. Information on sociodemographic and reproductive characteristics and menopausal symptoms were also collected. The participants were categorized into four groups based on postmenopausal years (Group 1: ≤2; Group 2: >2 to ≤5; Group 3: >5 to ≤8; and Group 4: >8). The attitude did not differ significantly among different groups, but it differed significantly when compared for residential status and per capita monthly household expenditure (pooled groups), for residential and educational status (Groups 3 and 4), and per capita monthly household expenditure (Group 3). Hierarchical linear regression (stepwise) shows per capita monthly expenditure, age at menopause, years after menopause, and menopausal symptoms (irritability and inability to hold urine) significantly predict attitude.