Impact of different obstetric interventions and types of delivery on breastfeeding: a nationwide cross-sectional survey of Hungarian women.

BACKGROUND: We assessed the effect of different obstetric interventions and types of delivery on breastfeeding. METHODS: A quantitative, cross-sectional study was carried out using an online questionnaire. Data collection was performed in 2021 in Hungary. We included biological mothers who had raised their at least 5-year-old child(ren) at home (N = 2,008). The questionnaire was completed anonymously and voluntarily. In addition to sociodemographic data (age, residence, marital status, education, occupation, income status, number of biological children, and anthropometric questions about the child and the mother), we asked about the interventions used during childbirth, and the different ways of infant feeding used. Statistical analysis was carried out using Microsoft Excel 365 and SPSS 25.0. Descriptive statistics, two-sample t tests, χ2 tests and ANOVA were used to analyse the relationship or differences between the variables (p < 0,05). RESULTS: We found that in deliveries where synthetic oxytocin was used for both induction and acceleration, there was a higher incidence of emergency cesarean section. However, the occurrence of vaginal deliveries was significantly higher in cases where oxytocin administration was solely for the purpose of accelerating labour (p < 0.001).Mothers who received synthetic oxytocin also received analgesics (p < 0.001). Women giving birth naturally who used oxytocin had a lower success of breastfeeding their newborn in the delivery room (p < 0.001). Children of mothers who received obstetric analgesia had a higher rate of complementary formula feeding (p < 0.001). Newborns born naturally had a higher rate of breastfeeding in the delivery room (p < 0.001) and less formula feeding in the hospital (p < 0.001). Infants who were breastfed in the delivery room were breastfed for longer periods (p < 0.001). Exclusive breastfeeding up to six months was longer for infants born naturally (p = 0.005), but there was no difference in the length of breastfeeding (p = 0.081). CONCLUSIONS: Obstetric interventions may increase the need for further interventions and have a negative impact on early or successful breastfeeding. TRIAL REGISTRATION: Not relevant.

A pilot study of trained ICU doulas providing early psychological support to critically ill patients.

BACKGROUND: Over a third of critical illness survivors suffer from mental health problems following hospitalization. Memories of delusional experiences are a major risk factor. In this project, ICU doulas delivered a unique positive suggestion intervention targeting the vulnerable time period during critical illness when these memories are formed. METHODS: Adult critically ill patients were recruited for this single-arm, prospective pilot study. These ICU patients received a positive suggestion intervention daily during their ICU stay in parallel with their medical treatment. The intervention was designed to be delivered over a minimum of two sessions. Feasibility was defined as intervention delivery on ≥ 70% of ICU days after patient enrollment. As a secondary analysis, psychometric questionnaires were compared to those of a historic control cohort of patients receiving standard care in the ICU using adjusted linear regression models. RESULTS: Of the 97 patients who received the intervention and were alive at the end of their ICU course, 54 were excluded from analyses mostly for having received only one session because of a short ICU length of stay of < 2 days, transitioning to comfort care or not wanting to answer the study questionnaires. Forty-three patients who completed 2 or more sessions of the positive therapeutic suggestion intervention provided by two trained ICU doulas received it for a median of 4 days (IQR 3, 5), with each session lasting for a median of 20 min (IQR 14, 25). The intervention was delivered on 71% of days, meeting our pre-determined feasibility goal. Compared to historical controls (N = 299), patients receiving the intervention had higher severity of illness and longer length of stay. When adjusted for baseline differences, patients both with and without mechanical ventilation who received the intervention scored lower on the Hospital Anxiety and Depression Scale (HADS)-Depression subscale. The intervention was also associated with reduced HADS-Anxiety subscale among ventilated patients. CONCLUSIONS: Positive therapeutic suggestion delivered by ICU doulas is feasible in the ICU setting. A randomized trial is warranted to better delineate the role that positive suggestion and ICU doulas may play in ongoing interprofessional efforts to humanize critical care medicine. The study was registered on clinicaltrials.gov (NCT03736954) on 03/14/2018 prior to the first patient enrollment https://clinicaltrials.gov/ct2/show/NCT03736954?cond=ICU+Doulas+Providing+Psychological+Support&draw=2&rank=1 .

Assessing fear of childbirth and its predictors among Hungarian pregnant women using Wijma Delivery Expectancy/Experience Questionnaire subscales.

This study aimed to assess fear of childbirth (FOB) among Hungarian pregnant women and determine predictors based on WDEQ-A subscales. This cross-sectional study was conducted among 423 healthy pregnant women during their third trimester. A socio-demographic and obstetrics characteristics, the Hungarian version of WDEQ-A, Beck Depression Inventory-Short Form and Beck Anxiety Inventory were used. The analysis was performed using multivariate linear regression. Among four WDEQ-A subscales, Fear (19%) and Lack of positive emotion (13%) obtained the largest and smallest percentages of cases with severe FOB. The nulliparous obtained significantly higher mean score in subscales Isolation and Lack of positive emotion compared to the multiparous. Anxiety was the most common predictor for all subscales in both groups. In the nulliparous group, significant predictors included economic hardship for Moment of birth, being a housewife for Fear, and wanted pregnancy for Lack of positive emotion. In the multiparous women, the strongest significant predictors were being married, previous elective caesarean section and being a housewife for subscales Isolation, Moment of birth, and Fear, respectively. Assessing FOB using WDEQ-A among Hungarian women revealed different mean scores and predisposing factors for each subscale. The topic should be further explored relative to its constituent factors.

Gene-sex interaction in Hypercompetitive Attitude suggests beneficial effect of the DRD4 7-repeat allele in adaptation.

Twin studies provide evidence for the heritability of social attitudes, e.g. competitiveness, however, there are no psychogenetic association results linking competitive attitudes to genetic polymorphisms. Candidate gene studies report association with competitiveness-related phenotypes, risk taking for example was linked with the 7-repeat allele of the dopamine D4 receptor gene. This polymorphism has been studied extensively with novelty seeking and certain psychiatric disorders, as it plays a crucial role in molecular genetic mechanisms driving behavioral responses to the environment, especially modulating behavior through the reward circuitry. In the present study, we examined association of the DRD4 48-bp VNTR and competitiveness using self-report data from 399 non-related Caucasians. We found an interesting gene-sex interaction: 7-carrier males were more hypercompetitive as compared to non-carriers, while 7-carrier females were less hypercompetitive as compared to non-carriers. This finding remained significant after Bonferroni correction for multiple testing. Interestingly, among females we observed a significant positive correlation between hypercompetitiveness and mood characteristic variables, however, no such relationship could be detected in males. In 7-carrier females the association of hypercompetitiveness and anxiety or depression was more robust as compared to non-carrier females. These results highlight the importance of cultural influences in interpreting gene-sex interaction effects. Our results underlies interaction between genes and the environment; suggesting that the 7-repeat allele plays an important role in adaptivity, enabling sex-specific behavior to social expectations.

Does the Electrodermal System "Take Sides" When It Comes to Emotions?

Traditionally, electrodermal research measurements were taken from the non-dominant hand. This was considered a valid measurement of arousal for the whole body. Some, however argue for a complex and asynchronous electrodermal system in terms of lateral and dermatome differences in emotional responding. The present study measured skin conductance responses to emotionally laden musical stimuli from the left and right index and middle fingers, as well as the left and right plantar surface of right handed participants (N = 39). The 7-s musical segments conveyed four emotional categories: fear, sadness, happiness and peacefulness. Our results suggest, that the electrodermal system responds to emotional musical stimuli in a lateralized manner on the palmar surfaces. Fear, sadness and peacefulness prompted right hand dominance while happiness elicited left hand dominant response. Lateralization of the palmar and plantar surfaces differed significantly. Moreover, an association between lateralization of the electrodermal system in response to fear and state anxiety was found. Results of the present study suggest that the electrodermal system displays lateral preferences, reacting with varying degree of intensity to different emotions. Apart from lateral differences, music induced emotions show dermatome differences as well. These findings fit well with Multiple Arousal Theory, and prompt for revaluating the notion of uniform electrodermal arousal.

[Effects of therapeutic suggestions on the recovery of patients undergoing major orthopaedic surgery]. / Az ortopédiai nagymutétek során alkalmazott terápiás szuggesztiók hatása a beteg gyógyulására.

INTRODUCTION AND AIM: Hip and knee replacement surgery is very demanding for patients. Medication consumption is further increased by perioperative anxiety. Besides pain killer and anxiolytic medications, patients' recovery can be enhanced by applying therapeutic suggestions, which are easily applicable during the patient-physician communication. METHOD: In our prospective, randomized, controlled study we examined the effects of positive suggestions on patients undergoing hip or knee arthroplasty in spinal anaesthesia. Members of the suggestion group received the therapeutic suggestions during a pre-surgery physician visit, and by listening to an audio recording during surgery. RESULTS: Compared to the control group (n = 50), in the suggestion group (n = 45) the need of medication (pain killer and adjuvant pain medication) during the surgery was lower (p = 0.037), the mean change from baseline in the well-being of the patients was better on the 2nd [1.31 (0.57; 2.04); p<0.001] and 4th [0.97 (0.23; 1.7); p = 0.011] postoperative day and less transfusion had to be administered (OR: 2.37; p = 0.004). However, there was no difference between the two groups in the postoperative need of medications, in the length of hospitalisation and in the frequency of complications. Conslusion: Our results indicate that the administration of therapeutic suggestions in the perioperative period may be beneficial for orthopaedic surgery patients. Orv Hetil. 2018; 159(48): 2011-2020.

Dreaming under anesthesia: is it a real possiblity? Investigation of the effect of preoperative imagination on the quality of postoperative dream recalls.

BACKGROUND: Images evoked immediately before the induction of anesthesia by means of suggestions may influence dreaming during anesthesia. This study is a retrospective re-evaluation of the original prospective randomized trial. METHODS: Dream reports were studied in two groups. In group 1. dreams of patients who received suggestions, and in group 2, those of the control group of patients who did not. The incidence of dream reports and the characteristics and the theme of the reported dreams were compared among the groups. RESULTS: In general, the control and the psychological intervention groups were different in terms of dreaming frequency, and non-recall dreaming. The incidence of dream reports was significantly higher in the suggestion group (82/190 at 10 min and 71/190 at 60 min respectively) than in the control group (16/80 at 10 min and 13/80 at 60 min, respectively; p10 = 0.001 and p60 = 0.002). There were no differences in the nature (thought- like or cinematic), quality (color or B&W) and the mood (positive vs. negative) of the recalled dreams. In general, the contents of the imaginary favorite place and the reported dream were identical in 73.2 %. Among the topics most successfully applied in the operating theater were loved ones (83.8 %), holiday (77.8 %) and sport (63.6 %). CONCLUSION: The results of the present study suggest that dreams during anesthesia are influenced by suggestions administered immediately preceding anesthesia. TRIAL REGISTRATION: The study was registered in ClinicalTrials.gov. Identifier: Q1 NCT01839201 , Date: 12 Apr. 2013.

The effect of preoperative suggestions on perioperative dreams and dream recalls after administration of different general anesthetic combinations: a randomized trial in maxillofacial surgery.

BACKGROUND: Images evoked immediately before the induction of anesthesia with the help of suggestions may influence dreaming during anesthesia.The aim of the study was to assess the incidence of evoked dreams and dream recalls by employing suggestions before induction of anesthesia while administering different general anesthetic combinations. METHODS: This is a single center, prospective randomized including 270 adult patients scheduled for maxillofacial surgical interventions. Patients were assigned to control, suggestion and dreamfilm groups according to the psychological method used. According to the anesthetic protocol there were also three subgroups: etomidate & sevoflurane, propofol & sevoflurane, propofol & propofol groups. Primary outcome measure was the incidence of postoperative dreams in the non-intervention group and in the three groups receiving different psychological interventions. Secondary endpoint was to test the effect of perioperative suggestions and dreamfilm-formation training on the occurrance of dreams and recallable dreams in different general anesthesiological techniques. RESULTS: Dream incidence rates measured in the control group did not differ significantly (etomidate & sevoflurane: 40%, propofol & sevoflurane: 26%, propofol & propofol: 39%). A significant increase could be observed in the incidence rate of dreams between the control and suggestion groups in the propofol & sevoflurane (26%-52%) group (p = 0.023). There was a significant difference in the incidence of dreams between the control and dreamfilm subgroup in the propofol & sevoflurane (26% vs. 57%), and in the propofol & propofol group (39% vs.70%) (p = 0.010, and p = 0.009, respectively). Similar to this, there was a significant difference in dream incidence between the dreamfilm and the suggestion subgroups (44% vs. 70%) in the propofol & propofol group (p = 0.019). Propofol as an induction agent contributed most to dream formation and recalls (χ2-test p value: 0.005). The content of images and dreams evoked using suggestions showed great agreement using all three anesthetic protocols. CONCLUSION: The psychological method influenced dreaming during anesthesia. The increase of the incidence rate of dreams was dependent on the anesthetic agent used, especially the induction agent. The study was registered in ClinicalTrials.gov. Identifier: NCT01839201.

The effectiveness of suggestive techniques in reducing postoperative side effects: a meta-analysis of randomized controlled trials.

BACKGROUND: Suggestive interventions such as hypnosis and therapeutic suggestions are frequently used to alleviate surgical side effects; however, the effectiveness of therapeutic suggestion intervention has not yet been systematically evaluated. In the present study, we tested the hypotheses that (1) suggestive interventions are useful for reducing postoperative side effects; (2) therapeutic suggestions are comparable in effectiveness to hypnosis; (3) live presentation is more effective than recordings; and (4) suggestive interventions would be equally effective used in minor and major surgeries. METHODS: We performed random effect meta-analysis with meta-regression and sensitivity analysis by moderating factors on a pool of 26 studies meeting the inclusion criteria (N = 1890). Outcome variables were postoperative anxiety, pain intensity, pain medication requirement, and nausea. RESULTS: Suggestive interventions reduced postoperative anxiety (g = 0.40; 99% confidence interval [CI] = 0.13-0.66; P < 0.001) and pain intensity (g = 0.25; 99% CI = 0.00-0.50; P = 0.010), but did not significantly affect postoperative analgesic drug consumption (g = 0.16; 99% CI = -0.16 to 0.47; P = 0.202) and nausea (g = 0.38; 99% CI = -0.06 to 0.81; P = 0.026). No significant differences were found for intervention type, presentation method, and severity of surgery; however, sensitivity analysis only supported the effectiveness of hypnosis (g = 0.62; 99% CI = 0.31-0.92; P < 0.001) and live presentation (g = 0.55; 99% CI = 0.23-0.88; P < 0.001) for decreasing postoperative anxiety, and that of live presentation for alleviating postoperative pain (g = 0.44; 99% CI = 0.07-0.82; P = 0.002). Sensitivity analyses also suggested that suggestive interventions are only effective for decreasing pain intensity during minor surgical procedures (g = 0.39; 99% CI = 0.00-0.78; P = 0.009). CONCLUSIONS: Suggestive techniques might be useful tools to alleviate postoperative anxiety and pain; however, strength of the evidence is weak because of possible bias in the reviewed articles. The lack of access to within-subjects data and the overlap between moderator conditions also limit the scope of the analysis. More methodologically correct studies are required with sensitivity to moderating factors and to within-subjects changes. For clinical purposes, we advise the use of hypnosis with live presentation to reduce postoperative anxiety and pain, until convincing evidence is uncovered for the effectiveness of therapeutic suggestions and recorded presentation. Pain management with adjunct suggestive interventions is mostly encouraged in minor rather than major surgeries.

[Correlations of consciousness and the default function of the brain]. / A tudat és az agy alapmuködési hálózatának a kapcsolata.

Neural correlation with consciousness represents a main topic of neuroscience studies. New results of consciousness researches proved that based on a coherent function in between its components the default mode network activity is the condition for awake consciousness. The subject of consciousness is self. Tasks related with the self were proving a high default mode network activity. Using connections inside the network, results which were related with self, could be considered to represent a polymodal integration system are they are participating in fine processing of the highly integrated associative information. It could be a result of the convergence of cognitive binding. There is a strong connection between the level of consciousness and praecuneal activation. It was proved that the network activity is changing during sleeping (normal condition), trauma or under drug induced altered consciousness. The default network activity can be considered as the neural correlate of consciousness. Further researches are warranted to answer the question: is the activity of the network the cause or is just accompanying the development of human consciousness?

Calm Contact Technique Based on the Endocrinological Mechanism of Hypnosis-A Theoretical Proposal.

This paper proposes the "calm contact" technique: an imaginative scenario where someone is in gentle contact with a loved one where the essence of the experience is to enjoy safety and calmness in peaceful social contact. The theoretical background is outlined by combining the brain mechanisms of stress reactions and hypnosis. In addition to the ancient stress responses (flight or fight or freeze), there are oxytocin-based options at the human level: tend and befriend behavior and the state of calm and connection, which is not a stress reaction but a resting reaction. These social-based reactions could prevent the organism from the primitive freezing response. Some studies proved that "hypnosis" as a setting reduces cortisol levels and could raise oxytocin levels. The beneficial mechanisms of the "calm contact" technique are analyzed in relation to "social support" and the psychoaffective effects of central oxytocin. The subjective effects of the proposed technique are outlined based on reports of healthy volunteers. The "calm contact" technique could be an alternative or adjunct to the "safe place" technique, applying the recent findings of endocrinological brain mechanisms of hypnosis. Clinical implications and limitations are briefly summarized.

Power of a Few Vagrant Words: Effects of Direct and Indirect Suggestions for Self-Representation in Art-Based Online Interventions.

This study compares two groups of university students with differing instructions participating in an object drawing task as a part of an art therapy-based self-help online intervention. The intervention aimed to help participants enhance positive mood and subjective feeling of self-control and reduce negative mood. The object task contained suggestive elements in the instructions similar to self-hypnosis with an indirect and a direct way of formulation. Quantitative (positive affect and negative affect scale and Self-Assessment Manikin scale) and qualitative methods (text and picture rating) were used to investigate the difference between the outcome effects on the two groups. The results found a significant decrease in negative mood for indirect suggestion, while a significant increase of positive mood for the direct suggestion condition. Based on qualitative analyses, findings indicated that hidden implications in the art-making instructions modified the chosen imaginary and emotional changes related to art-making. Suggestions in the instructions can make a difference in one's mood and this should also be considered while designing guidelines for self-hypnosis.

Assessing the Implementation of the Baby-Friendly Hospital Initiative in Hungary: A Cross-Sectional Study.

We assessed the prevalence of the "Ten Steps to Successful Breastfeeding" in Hungary and identified possible associations of the steps with breastfeeding. Our quantitative, cross-sectional research was conducted anonymously online in Hungary with a self-administered questionnaire in 2021. Targeted sampling was used, with biological motherhood and having at least one child no older than 60 months as inclusion criteria (n = 2008). The implementation of the "Ten Steps to Successful Breastfeeding" was analyzed separately for breastfeeding and non-breastfeeding mothers. A breastfeeding mother was defined as breastfeeding for at least six months. Descriptive statistics, χ2 test, and t-test were calculated with SPSSv25 (p < 0.05). No significant differences were found between breastfeeding and non-breastfeeding mothers in terms of supplementary feeding at the advice of a health professional (p = 0.624) and in terms of assistance with breastfeeding or suggested breastfeeding positions during hospitalization (p = 0.413). Significant differences were found for receiving breastfeeding-friendly recommendations by staff (p = 0.006), valuing breastfeeding (p < 0.001), skin-to-skin contact within 1 h (p = 0.002), receiving supplementary feeding (p < 0.001), rooming-in (p < 0.001), responsive feeding, recognizing hunger signs (p < 0.001), pacifier/bottle use (p < 0.001), and availability of breastfeeding support (p = 0.005). Significant differences were observed between breastfeeding and non-breastfeeding subsamples regarding the implementation of baby-friendly steps (p < 0.001). Breastfeeding mothers experienced the implementation of more baby-friendly steps and a higher rate of breastfeeding, while there was no significant difference in the duration of exclusive (p = 0.795) and partial breastfeeding (p = 0.250) based on the results. We concluded that exposure to the Baby-Friendly Hospital Initiative may be associated with increased 6-month breastfeeding but may not influence longer durations.

The Impact of Mode of Delivery and Postpartum Conditions on Breastfeeding: A Cross-Sectional Study.

Breast milk is the optimal and essential source of nutrients for babies. Many women, however, do not breastfeed or stop early after giving birth, often due to lack of support. For newborns delivered by caesarean section, there is often a delay, or no skin-to-skin contact after birth; thus, early breastfeeding is not achieved. Separation, complementary feeding or pacifier use also limits the mother's ability to breastfeed. A quantitative, cross-sectional study was conducted. Sociodemographic data, the mode of delivery and postpartum circumstances, information on breastfeeding, and the method and duration of feeding were collected (n = 2008). Two-thirds of children born by caesarean section did not have skin-to-skin contact after birth (p < 0.001). Lack of rooming-in placement increased the incidence of more frequent complementary feeding (p < 0.001) and shortened the duration of exclusive breastfeeding (p < 0.001). The duration of breastfeeding may also be negatively affected by scheduled feeding (p = 0.007) and pacifier utilization (p < 0.001). The mode of delivery and postpartum circumstances directly affecting the mother and the newborn can affect the feasibility of breastfeeding and the duration of exclusive and partial breastfeeding. For positive breastfeeding outcomes, skin-to-skin contact immediately after birth, rooming-in and unrestricted, demand breastfeeding, as well as the avoidance of the use of pacifiers, are recommended.

Best Practice Recommendations for Conducting and Reporting Controlled Trials in Clinical Hypnosis Research.

There is an abundance of outcomes research for clinical hypnosis showing promising results. Nonetheless, hypnosis is still underutilized in clinical care. For a behavioral intervention to enter mainstream clinical care, efficacy needs to be demonstrated with exceptionally high quality of evidence, and its reporting needs to be complete and sufficiently clear to enable replication and clinical use. The present article provides best practice guidelines formulated by the Task Force for Establishing Efficacy Standards for Clinical Hypnosis for conducting and reporting clinical hypnosis research.The recommendations are presented in two tiers. Tier I recommendations include essential best practices, such as a call for the use of detailed research and intervention manuals, plans for and reporting of participant-education about hypnosis, the use of hypnotizability scales with good psychometric properties, and clear reporting of the hypnotizability measurement. Tier I also includes the sharing of intervention manuals, the reporting of the induction procedure, the labeling of the intervention for participants, and the definition of hypnosis used. Tier II includes preferred recommendations, calling for measurement of adherence to home practice, measurement of hypnotizability using scales with both subjective and behavioral measures of responsiveness, and the involvement of participants from the full hypnotizability spectrum. Tier II also includes the assessment of variables related to proposed mechanisms of action, the reporting of participants prior hypnosis experiences, and the relationship of expectancies and treatment outcomes.This list of recommendations will be useful for researchers, reviewers, and journal editors alike when conducting, reporting, or evaluating studies involving clinical hypnosis.

Communication in the ICU: An Unintended Nocebo Effect?

To identify medical phrases utilized by the critical care team that may have an unintended impact on the critically ill patient, we administered an anonymous survey to multi-professional critical care team members. We elicited examples of imprecise language that may have a negative emotional impact on the critically ill. Of the 1600 providers surveyed, 265 offered 1379 examples (912 unique) which were clustered into 5 categories. Medical jargon (eg, "riding the vent") was most prevalent (n = 549). There were 217 negative suggestions (eg, "you will feel a stick and a burn"). Hyperboles (eg, "black cloud") were common (n = 198) while homonyms (ie "he fibbed") accounted for 150 examples. Phrases such as "code brown in there" were categorized as metonyms (n = 144). 121 metaphors/similes (eg, "rearranging deck chairs on the Titanic") were provided. Phrases that have the potential to negatively impact critically ill patient perceptions are commonplace in critical care practice. Whether these everyday communication habits lead to an unintended nocebo effect on mental health outcomes of the critically ill deserves further study.

Collective cell streams in epithelial monolayers depend on cell adhesion.

We report a spontaneously emerging, randomly oriented, collective streaming behavior within a monolayer culture of a human keratinocyte cell line, and explore the effect of modulating cell adhesions by perturbing the function of calcium-dependent cell adhesion molecules. We demonstrate that decreasing cell adhesion induces narrower and more anisotropic cell streams, reminiscent of decreasing the Taylor scale of turbulent liquids. To explain our empirical findings, we propose a cell-based model that represents the dual nature of cell-cell adhesions. Spring-like connections provide mechanical stability, while a cellular Potts model formalism represents surface-tension driven attachment. By changing the relevance and persistence of mechanical links between cells, we are able to explain the experimentally observed changes in emergent flow patterns.

[Comparison of the feeding habits of breastfeeding and non-breastfeeding mothers and the sociodemographic factors influencing breastfeeding]. / A szoptató és a nem szoptató gyermekágyas anyák táplálkozási szokásainak összehasonlítása, valamint az anyatejes táplálást befolyásoló szociodemográfiai tényezok.

INTRODUCTION: Breastfeeding is the most ideal form of infant feeding, the biological norm that affects the mother's nutrition as well as certain sociodemographic factors. OBJECTIVE: The aim of this research is to compare the nutritional habits of breastfeeding and non-breastfeeding mothers during the postpartum period, and to further examine the correlations of sociodemographic factors with breast milk feeding. METHOD: Our quantitative, cross-sectional study was conducted between 26. 03. 2021 and 18. 07. 2021. During the non-random, targeted, expert sample selection, the target group included those biological mothers who raised at least one child born alive after the 37th gestational week in their own care. Exclusion criteria included adoption, pregnancy with the first child, inadequate completion of the mandatory questions, and reports of a congenital and/or acquired physical or mental illness that makes breastfeeding impossible. 2008 people met the inclusion and exclusion criteria. The survey was carried out anonymously via a self-filled questionnaire online. The statistical analysis was performed using the IBM SPSS 25 program, the significance level was determined at p<0.05. RESULTS: There was a significant difference between the group of breastfeeding mothers and non-breastfeeding mothers in terms of age (p<0.001), place of residence (p<0.001), marital status (p<0.001), education (p<0.001), income status (p<0.001), the number of children (p = 0.005), the method of delivery (p = 0.018), how many children completed the questionnaire (p = 0.021). Varied nutrition was characteristic in a significantly higher proportion during the postpartum period among breastfeeding mothers (p = 0.006). There was a relationship between the two groups in terms of energy intake (p = 0.002) and daily vitamin/mineral/trace element intake (p = 0.044). CONCLUSION: During the period of childbirth, breastfeeding mothers pay more attention to their nutrition than non-breastfeeding mothers. Breastfeeding can be significantly influenced by certain sociodemographic factors. Orv Hetil. 2023; 164(43): 1693-1700.

LC3-associated phagocytosis promotes glial degradation of axon debris after injury in Drosophila models.

Glial engulfment of neuron-derived debris after trauma, during development, and in neurodegenerative diseases supports nervous system functions. However, mechanisms governing the efficiency of debris degradation in glia have remained largely unexplored. Here we show that LC3-associated phagocytosis (LAP), an engulfment pathway assisted by certain autophagy factors, promotes glial phagosome maturation in the Drosophila wing nerve. A LAP-specific subset of autophagy-related genes is required in glia for axon debris clearance, encoding members of the Atg8a (LC3) conjugation system and the Vps34 lipid kinase complex including UVRAG and Rubicon. Phagosomal Rubicon and Atg16 WD40 domain-dependent conjugation of Atg8a mediate proper breakdown of internalized axon fragments, and Rubicon overexpression in glia accelerates debris elimination. Finally, LAP promotes survival following traumatic brain injury. Our results reveal a role of glial LAP in the clearance of neuronal debris in vivo, with potential implications for the recovery of the injured nervous system.

Current Practices, Experiences, and Views in Clinical Hypnosis: Findings of an International Survey.

An online survey of 691 clinicians who use hypnosis was conducted in 31 countries to gain a broad real-world picture of current practices, views, and experiences in clinical hypnosis. Among 36 common clinical uses, stress reduction, wellbeing and self-esteem-enhancement, surgery preparations, anxiety interventions, mindfulness facilitation, and labor and childbirth applications were the most frequently rated as highly effective (each by ≥70% of raters) in the clinicians' own experience. Adverse hypnosis-associated effects had been encountered by 55% of clinicians but were generally short-lived and very rarely judged as serious. The most common hypnosis approaches used were Ericksonian (71%), hypnotic relaxation therapy (55%), and traditional hypnosis (50%). Almost all respondents reported regularly using other therapeutic modalities alongside hypnosis. Among a range of client variables potentially affecting therapy, most clinicians rated hypnotist-client rapport (88%) and client motivation (75%) as very or extremely important factors for successful hypnotherapy. The majority of respondents had conducted hypnosis treatment via teletherapy, and 54% of those estimated it to be as effective as in-person treatment.