Effects of an individualized nutritional educational program in pregnant women: A randomized controlled trial in Japan.

AIM: To evaluate the effectiveness of an individualized nutritional education program in promoting adequate nutrient intake in pregnant women. METHODS: A stratified randomized controlled trial was conducted. Participants were stratified by factors affecting the primary outcome and randomly assigned to the intervention or control groups. Intervention group participants received an individualized 30-min booklet-based education program in their 2nd and 3rd trimesters; the control group received usual care. The primary outcome was protein intake after the intervention, which was compared between the intervention and control groups. Secondary outcomes included comparing the amount of increase of protein before and after the intervention. Nutrient intake was measured using a self-administered short dietary history questionnaire, and analyses of covariance and t tests were performed. RESULTS: Of the 130 participants, 66 were assigned to the intervention group and 64 to the control group. There was no difference in protein intake between the two groups after the intervention (p = .051, 95% CI [-0.021, 12.4]). Comparing the increase in protein intake before and after intervention, the intervention group was 7.4 g/day higher than that of the control group (p = .040; F = 4.31; effect size = 0.36). CONCLUSIONS: The primary outcome, a comparison of protein intake between the groups after the program, revealed no significant differences. However, on comparing the amount of protein increase before and after the intervention, the intervention group's increase was significantly higher than that of the control group. Results indicate the potential for individualized face-to-face interventions for pregnant women in Japan.

Effects of web-based learning for nurses on their care for pregnant women with hiesho (sensitivity of hands or feet to cold): A randomized controlled trial.

AIM: Hiesho is a condition characterized by having a cold sensation in the hands or feet (i.e., sensitivity of the hands or feet to cold). This condition is common among Japanese women and is an important health problem. In this study, we aimed to evaluate a hiesho intervention program for nurses called "Preventing Hiesho: Intervention Program for Educating Nurses" in terms of its effectiveness in improving the knowledge and perceptions of nurses about the importance of hiesho care. METHODS: A total of 130 nurses from Japanese hospitals and clinics providing prenatal care participated in our randomized controlled trial. Sixty-eight nurses participated in the "Preventing Hiesho: Intervention Program for Educating Nurses" for 2 weeks (intervention group). Sixty-two nurses received a pamphlet on hiesho care (control group). The responses of the participants to the questionnaire survey were collected by postal mail. An intention-to-treat analysis of the results was conducted. RESULTS: One week after the implementation of the web-based learning program, the scores of knowledge and perceptions of the importance of administering hiesho care were significantly higher in the intervention group than in the control group. CONCLUSIONS: A 2-week web-based learning program for educating nurses on preventing hiesho significantly improved their knowledge and perceptions of the importance of hiesho care.

Randomized Controlled Trial to Assess the Effectiveness of a Self-Care Program for Pregnant Women for Relieving Hiesho.

OBJECTIVE: To assess differences in improvement of hiesho (sensitivity to cold) through a randomized controlled trial (RCT) of one group that used a self-care program (the Home Care Package Program for Relieving Hiesho) and another that did not. METHODS: Participants were pregnant women experiencing hiesho in the 28th to 33rd weeks of pregnancy. The group carried out the intervention program for 4 weeks by wearing leg warmers, performing exercises, and pressing acupuncture points. The control group did not take any specific actions. Hiesho condition was assessed by using thermography to measure temperature in the four limbs; the changes were analyzed. RESULTS: Findings for 140 pregnant women (73 in the experimental group and 67 in the control group) were analyzed. Participants' body temperatures were measured after completion of the program for 4 weeks and compared to their temperatures before start of the program. Compared with the control group, the experimental group had arm skin temperature 3.0°C (p < 0.001) higher and leg skin temperature 1.93°C (p = 0.02) higher; both differences were significant. CONCLUSION: The Home Care Package Program for Relieving Hiesho self-care program significantly relieved hiesho.

Relationship between advanced maternal age, hiesho (sensitivity to cold) and abnormal delivery in Japan.

BACKGROUND: In Japan, the proportion of women aged 35 and older giving birth has greatly increased in recent years, and maternal age is continuing to increase. Advanced maternal age is a risk factor for abnormal delivery, as is hiesho (sensitivity to cold). RESEARCH QUESTION: This study aimed to assess whether advanced maternal age and hiesho precipitate premature delivery, premature rupture of membranes, weak labor pains, prolonged labor and atonic bleeding. METHOD: The study design was a descriptive comparative study with a retrospective cohort group design. Subjects in this study were 2,810 Japanese women in hospital after childbirth. The research methods employed were a paper questionnaire and extraction of data from medical records. RESULTS: Comparing the rate of occurrence of abnormal delivery among women aged 35 to 39 according to whether or not they had hiesho, results were premature delivery OR: 3.51 (95% CI: 1.66-7.43), premature rupture of membranes OR: 1.25 (95% CI: 0.90-1.74), weak labor pains OR: 2.94 (95% CI: 1.65-5.24), prolonged labor OR: 2.56 (95% CI: 1.23-5.26), and atonic bleeding, OR: 1.65 (95% CI: 0.14-2.40) when hiesho was present. Among women aged 40 and over, results were premature delivery OR: 5.09 (95% CI: 1.16-22.20), premature rupture of membranes OR: 1.60 (95% CI: 0.73-3.46), weak labor pains OR: 7.02 (95% CI: 1.56-31.55), prolonged labor OR:7.19 (95% CI: 1.49-34.60) and atonic bleeding OR: 2.00 (95% CI: 0.64-6.23). CONCLUSIONS: Regardless of maternal age, the presence of hiesho is a risk factor that can precipitate premature delivery, premature rupture of membranes, weak labor pains, prolonged labor and atonic bleeding. Furthermore, hiesho coupled with advanced maternal age increases the incidence of premature delivery, weak labor pains and prolonged labor.

[Relationship between pregnant women's sensitivity to cold (hiesho) and premature labor assessed using propensity scores for adjusting confounding factors].

OBJECTIVES: The purpose of this study is to analyze the influence of sensitivity to cold or hiesho in pregnant Japanese women and to examine the relationship between hiesho and premature labor. METHODS: In this retrospective cohort study in Japanese women after delivery, information for the approximately 12 months between October 19, 2009 and October 8, 2010 was obtained using questionnaire surveys and medical records at 6 hospitals with obstetric and pediatric departments in the Greater Tokyo Metropolitan Area. Further, in this analysis, confounding factors were adjusted by performing analysis of covariance and stratified analysis using propensity scores. The Research Ethics Review Committee of St. Luke's College of Nursing (09-057) approved this study. RESULTS: Analysis of data from 2,810 women was performed. Regarding the correlation between hiesho and premature labor, the incidence of premature labor was 3.38 times higher (analysis of covariance) or 3.47 times higher (stratified analysis) among pregnant women with hiesho than among those without hiesho (P < 0.001). The results of this study proved the existing discussions that there is a correlation between hiesho CONCLUSION: during the latter stages of pregnancy and incidence of premature labor.

Expression of human ABCB5 confers resistance to taxanes and anthracyclines.

Human ABCB5, an ATP-binding cassette (ABC) transporter gene, has two major mRNA species. One transcript encodes an 812 amino acid polypeptide, ABCB5ß, with a transmembrane domain and a nucleotide-binding domain. We isolated the cDNA of another ABCB5 mRNA that encodes a 1257 amino acid polypeptide. The translated ABCB5 protein is a full-sized ABC transporter that has an internally duplicated structure with two transmembrane domains and two nucleotide-binding domains. The 5' and 3' parts of the ABCB5 mRNA were expressed in the prostate and testis. HEK293 cells transfected with the ABCB5 cDNA expressed a 150-160kDa protein. The ABCB5 transfectants showed approximately 1.5-fold higher resistance to doxorubicin, and 2- to 3-fold higher resistance to paclitaxel and docetaxel. Cellular uptake of radiolabeled paclitaxel and docetaxel in the transfectants was lower than that in the parental HEK293 cells. Treatment of the transfectants with ABCB5-targeted siRNA lowered their resistance to docetaxel. Revertant cells that express a reduced amount of ABCB5 also showed a lowered level of docetaxel resistance. These results indicated that the expression of ABCB5 conferred resistance to taxanes and anthracyclines. Membrane vesicles prepared from ABCB5 baculovirus-infected Sf21 cells showed higher vanadate-sensitive ATPase activity than the Sf21 control vesicles. The k(m) and V(max) values of ATPase activity in the ABCB5 vesicles were 1.8mM and 65nmol/min/mg protein, respectively. ABCB5 ATPase activity was 1.25-fold higher in the presence of 100µM docetaxel than it was in the absence of docetaxel. These results indicates that the full-length ABCB5 protein has ATPase activity that is sensitive to docetaxel.

Pregnant women's awareness of sensitivity to cold (hiesho) and body temperature observational study: A comparison of Japanese and Brazilian women.

BACKGROUND: Sensitivity to cold (hiesho) is a serious health problem in Japan, yet it is minimally understood within Western cultures. The purpose of this study was to clarify the divergence between pregnant Japanese woman living in Japan and pregnant Brazilian women living in Brazil in awareness of hiesho and differences between core body and peripheral temperatures. METHODS: The subjects of this study were 230 pregnant Japanese women living in Japan and 200 pregnant Brazilian women living in Brazil. Data was collected in June/July and November 2005 in Japan and from October 2007 to February 2008 in Brazil. The survey methods consisted of measurement of deep body temperatures and questionnaires. RESULTS: 67.0% of Japanese women and 57.0% of Brazilian women were aware of hiesho, which showed a significant difference between the Japanese and Brazilian women (p = 0.034). The difference between forehead and sole temperatures was 2.0°C among Japanese and 2.8°C among Brazilians in June-July (p = 0.01). But in November the difference between those temperatures was 5.2°C among Japanese and 2.8°C among Brazilians (p < 0.001). CONCLUSIONS: There are differences between Japanese and Brazilians both in awareness of hiesho and in body temperatures.