BACKGROUND

Postpartum depression (PPD) is the most common perinatal psychiatric disorder and women are at greatest risk of developing this during their first postpartum year. Extraneous factors and events indirectly related to maternity like the quarantine measures imposed during the COVID-19 pandemic can add to the already burdensome mental effects of pregnancy.

The aim of the study is to determine the prevalence of and possible risk factors for PPD during the COVID-19 pandemic using the Edinburgh Postnatal Depression Scale in Filipino (EPDS-F) in a tertiary government hospital.

This is a cross-sectional study involving patients 18 years of age and above who delivered vaginally or through cesarean section to a live or dead fetus more than 20 weeks age of gestation and more than 500 g, preterm or term during the pandemic. Patients included were those who tested positive for COVID 19 infection who delivered 48 h up to 8 week postpartum. All the patients who consented and fulfilled the inclusion criteria answered the EPDS-F questionnaire to determine the prevalence rate of PPD. A score of 13 or greater suggests the presence of major depressive symptoms.

There was a total of 61 postpartum patients who were delivered in a tertiary hospital from September 2022 to October 2022. Out of 61 patients, 20 scored 13 points and above in the EPDS-F questionnaire showing a PPD prevalence of 32.8%. Patient’s age showed a statistically significant association with the likelihood of having PPD (P = 0.0148), the highest prevalence observed at an average age of 25 and a lower prevalence at 29 years old.

Although age seems to have a significant association with PPD, direct causality is difficult to establish as the likelihood of having PPD depends on the mother’s personal qualities and traits, the societal background, and her coping mechanisms during an extraordinary circumstance such as this global COVID-19 pandemic.

Objective: To determine the accuracy, sensitivity, specificity, positive predictive values, and use of the Reflexive Behavioral “Baah” Test and NHSRC Level 1 and Level 2 Questionnaires in detecting hearing impairment in rural health communities. Methods: This was a prospective cross-sectional study conducted at the rural health unit of five municipalities. Infants less than six months old were screened for hearing impairments using the OAE device (standard), the Reflexive Behavioral “Baah” test, and the NHSRC Level 1 and Level 2 Questionnaires. The “Baah” test and the filling out of the NHSRC Level 1 and 2 Questionnaires were done by trained health workers while OAE was done by an audiologist. Results: A total of 103 babies, with a mean age of 41.9 days at the time of testing and a male to female ratio of 1.02:1 (52 males and 51 females) were tested. A hearing impairment prevalence of 4.9% (5 out of 103) was noted. The “Baah” test showed to have a sensitivity of 60%, specificity of 97.96% and an accuracy rate of 96.12%. The NHSRC Level 1 and Level 2 Questionnaires showed sensitivity, specificity, and accuracy rate of 40%, 67.35% and 66.02%, respectively for the former and 40%, 85.71% and 83.50%, respectively for the latter. Analysis of the complimentary use of the NHSRC Level 1 and Level 2 Questionnaires with the “Baah” test also showed no significant improvement to using the “Baah” test as a stand-alone screening tool with sensitivity, specificity, and accuracy of 60%, 67.35% and 66.99%, respectively for the “Baah” test and Level 1 Questionnaire, and 60%, 83.67% and 82.52%, respectively for the “Baah” test and Level 2 Questionnaire. Conclusion The Reflexive Behavioral “Baah” test is a potentially accurate, sensitive, specific, and acceptable standalone hearing screening test to identify infants with higher risk of hearing impairment in the rural health community setting. On the other hand, the use of the NHSRC Questionnaires as a stand-alone or complementary tool for “Baah” is unnecessary as it results to more false positive and false negative results.
Surveys and Questionnaires ; Infant, Newborn ; Audiometry ; Behavior Rating Scale

BACKGROUND: An inability to cope with threatening dental stimuli, i.e., sight, sound, and sensation of airotor, manifests as anxiety and behavioral management problems. Behavior modification techniques involving pre-exposure to dental equipment will give children a first-hand experience of their use, sounds, and clinical effects. The aim of this study was to compare the techniques of Tell-Show-Play-doh, a smartphone dentist game, and a conventional Tell-Show-Do method in the behavior modification of anxious children in the dental operatory. METHODS: Sixty children in the age group of 4-8 years, with Frankl's behavior rating score of 2 or 3, requiring Class I and II cavity restorations were divided into three groups. The groups were Group 1: Tell-Show-Play-doh; Group 2: smartphone dentist game; and Group 3: Tell-Show-Do technique and each group comprised of 20 children. Pulse rate, Facial Image Scale (FIS), Frankl's behavior rating scale, and FLACC (Face, Leg, Activity, Cry, Consolability) behavior scales were used to quantify anxious behavior. Operator compliance was recorded through a validated questionnaire. RESULTS: The results showed lower mean pulse rates, lower FIS and FLACC scores, higher percentage of children with Frankl's behavior rating score of 4, and better operator compliance in both the Tell-Show-Play-doh and smartphone dentist game groups than in the conventional Tell-Show-Do group. CONCLUSION: The Tell-Show-Play-doh and smartphone dentist game techniques are effective tools to reduce dental anxiety in pediatric patients.
Anxiety ; Behavior Rating Scale ; Behavior Therapy ; Child ; Compliance ; Dental Anxiety ; Dental Equipment ; Dentists ; Heart Rate ; Humans ; Leg ; Methods ; Pediatric Dentistry ; Sensation ; Smartphone ; Weights and Measures

PURPOSE: This study was designed to develop a valid and reliable scale for the evaluation of preconception health behavior in women preparing for pregnancy. METHODS: The initial strategy included a literature review, interviews, and construction of a conceptual framework. The preliminary items were evaluated twice for content validity by experts, and modified two preliminary investigations. Participants in the 2 main investigations and the confirmation investigation were tested for reliability and validity of the preliminary scale in women preparing for pregnancy. The data were analyzed for different items exploratory and confirmatory factors. RESULTS: The 5-point Likert scale consisted of 6 factors and 27 items. The 6-factors included ‘hazardous substance factor,’ ‘medical management factor,’ ‘rest and sleep factor,’ ‘stress management factor,’ ‘information acquisition factor,’ and ‘resource preparation factor.’ Goodness of fit of the final research model was very appropriate and based on the following measures: Q=1.98, comparative fit index=.91, Tucker-lewis index=.89, standardized root mean square residual=.07, and root mean square error of approximation=.07. The criterion validity was .64. The reliability coefficient was .92 and the test-retest reliability was .61. CONCLUSION: The study findings indicate that the scale can be used for the development of nursing interventions to promote preconception health behavior in women preparing for pregnancy.
Behavior Rating Scale ; Female ; Health Behavior ; Humans ; Nursing ; Preconception Care ; Pregnancy ; Reproducibility of Results

OBJECTIVE: To assess the role of miRNA-21 and miRNA-223 in a balloon-compression model of spinal cord injury (SCI). METHODS: A total of 50 male Wistar rats (n=50) were divided into the three groups: the group A (n=15, insertion of the unflated Fogarty balloon catheter), the group B (n=15, insertion of the Fogarty balloon catheter at a volume of 20 μL) and the group C (n=15, insertion of the Fogarty balloon catheter at a volume of 50 μL). After the behavioral test, RNA isolation, microRNA expression profiling using microarrays and quantitative polymerase chain reaction, measurements were compared between the three groups. RESULTS: Despite a lack of significant differences in time-dependent changes in miRNA-21 expression levels between the three groups at 4 hours, there were significant differences in them at 1, 3, and 7 days (p<0.05). Moreover, there were significant differences in time-dependent changes in miRNA-223 expression levels between the three groups at 4 hours and 1, 3, and 7 days (p<0.05). Furthermore, miRNA-223 expression levels reached the highest at 1 day but were decreased with time thereafter in all the three groups. CONCLUSION: Expression levels of miRNA-21 and miRNA-223 might be associated with the severity and acute phase of SCI, respectively. It is mandatory, however, to analyze changes in levels of inflammatory markers and the relevant biological pathways.
Behavior Rating Scale ; Catheters ; Gene Expression Regulation ; Humans ; Male ; MicroRNAs ; Polymerase Chain Reaction ; Rats, Wistar ; RNA ; Spinal Cord Injuries ; Spinal Cord

Behavioral analysis in mice provided important contributions in helping understand and treat numerous neurobehavioral and neuropsychiatric disorders. The behavioral performance of animals and humans is widely different among individuals but the neurobehavioral mechanism of the innate difference is seldom investigated. Many neurologic conditions share comorbid symptoms that may have common pathophysiology and therapeutic strategy. The forced swim test (FST) has been commonly used to evaluate the “antidepressant” properties of drugs yet the individual difference analysis of this test was left scantly investigated along with the possible connection among other behavioral domains. This study conducted an FST-screening in outbred CD-1 male mice and segregated them into three groups: high performers (HP) or the active swimmers, middle performers (MP), and low performers (LP) or floaters. After which, a series of behavioral experiments were performed to measure their behavioral responses in the open field, elevated plus maze, Y maze, three-chamber social assay, novel object recognition, delay discounting task, and cliff avoidance reaction. The behavioral tests battery revealed that the three groups displayed seemingly correlated differences in locomotor activity and novel object recognition but not in other behaviors. This study suggests that the HP group in FST has higher locomotor activity and novelty-seeking tendencies compared to the other groups. These results may have important implications in creating behavior database in animal models that could be used for predicting interconnections of various behavioral domains, which eventually helps to understand the neurobiological mechanism controlling the behaviors in individual subjects.
Animals ; Behavior Rating Scale ; Delay Discounting ; Humans ; Individuality ; Male ; Mice ; Models, Animal ; Motor Activity

PURPOSE: To investigate the effect of eating behavior on nutritional status according to temperament type.METHODS: One thousand one hundred three preschool children aged 2 to 6 years in Gyeongsan, Gyeongsangbuk-do from April to June 2018 were surveyed about their eating behavior and nutritional status using DBT (Dietary Behavior Test) and NQ (Nutrition Quotient) which are proven tests. The dietary behaviors of the children were classified into four categories: approach avoidance, sensory sensitivity, hyperactivity, and irregularity. NQ scores were divided into five categories: balance, diversity, moderation, regularity, and practice.RESULTS: The mean of the children's age was 3.42 ± 1.4 (596 boys and 507 girls). The percentage distribution of the NQ grade was as follows: 5.5% (highest), 12.5% (high), 47.1% (medium), 22.2% (low), and 12.6% (lowest). The risk group of approach avoidance and sensory sensitivity had significantly (p < 0.001) lower scores than the normal group in balance factor (51.9 ± 12.0 vs. 57.8 ± 15.9 in approach avoidance type, 52.6 ± 17.6 vs. 57.7 ± 15.9 in sensory sensitivity type) and diversity factor (32.5 ± 24.4 vs. 50.1 ± 22.4 in approach avoidance type, and 32.5 ± 24.0 vs. 50.7 ± 22.2 in sensory sensitivity type). The scores of the hyperactivity risk group were significantly lower in moderation factor (78.2 ± 12.1 vs. 81.2 ± 11.9), and those of the irregular risk group were significantly lower in variety (35.9 ± 24.5 vs. 48.8 ± 23.2), regularity (57.6 ± 37.1 vs. 66.1 ± 17.6), and practice (57.1 ± 19.4 vs. 65.1 ± 22.5) factors than the normal group (p < 0.001). Especially, the risk group of approach avoidance and sensitivity type had significantly (p < 0.001) lower intakes of whole grain, fruit, bean and bean products, vegetables, and Kimchi.CONCLUSION: This present study suggested that the eating behavior based on temperament of demanding preschool children affected food choice resulting in food consumption diversity of children. Therefore, it is important to provide customized nutrition education programs based on temperament type.
Behavior Rating Scale ; Child ; Child, Preschool ; Eating ; Education ; Feeding Behavior ; Fruit ; Gyeongsangbuk-do ; Humans ; Nutritional Status ; Temperament ; Vegetables ; Whole Grains

Cerebral ischemia is a major cause of neurodegenerative disease. It induces neuronal vulnerability and susceptibility, and leads to neuronal cell death. Resveratrol is a polyphenolic compound that acts as an anti-oxidant. It exerts a neuroprotective effect against focal cerebral ischemic injury. Akt signaling pathway is accepted as a representative cell survival pathway, including proliferation, growth, and glycogen synthesis. This study investigated whether resveratrol regulates Akt/glycogen synthase kinase-3β (GSK-3β) pathway in a middle cerebral artery occlusion (MCAO)-induced ischemic brain injury. Adult male rats were intraperitoneally injected with vehicle or resveratrol (30 mg/kg) and cerebral cortices were isolated 24 h after MCAO. Neurological behavior test, corner test, brain edema measurment, and 2,3,5-triphenyltetrazolium chloride staining were performed to elucidate the neuroprotective effects of resveratrol. Phospho-Akt and phospho-GSK-3β expression levels were measured using Western blot analysis. MCAO injury led to severe neurobehavioral deficit, infraction, and histopathological changes in cerebral cortex. However, resveratrol treatment alleviated these changes caused by MCAO injury. Moreover, MCAO injury induced decreases in phospho-Akt and phospho-GSK-3β protein levels, whereas resveratrol attenuated these decreases. Phosphorylations of Akt and GSK-3β act as a critical role for the suppression of apoptotic cell death. Thus, our finding suggests that resveratrol attenuates neuronal cell death in MCAO-induced cerebral ischemia and Akt/GSK-3β signaling pathway contributes to the neuroprotective effect of resveratrol.
Adult ; Animals ; Behavior Rating Scale ; Blotting, Western ; Brain Edema ; Brain Injuries ; Brain Ischemia ; Cell Death ; Cell Survival ; Cerebral Cortex ; Glycogen ; Humans ; Infarction, Middle Cerebral Artery ; Male ; Middle Cerebral Artery ; Neurodegenerative Diseases ; Neurons ; Neuroprotective Agents ; Phosphorylation ; Rats

OBJECTIVES: Thyroid hormone deficiency during the neurodevelopmental period can impair brain development and induce psychiatric symptoms. This study examined the association between thyroid dysfunction and the severity of symptoms in schizophrenia patients, and the treatment response of patients with schizophrenia. METHODS: Three hundred thirty-eight schizophrenia patients, with no prior history of thyroid disease or taking medication associated with it, were studied. We assessed the blood thyroid hormone level, the Brief Psychiatric Rating Scale (BPRS) scores on the day of admission and discharge, admission period, dose of administered antipsychotics, and the number of antipsychotic combinations. The collected data were subsequently analyzed using the Kruskal-Wallis test and Pearson's chi-square test. RESULTS: The percentage of schizophrenia patients who presented with abnormal thyroid hormone level was 24.6%. High total triiodothyronine (TT3) (p = 0.003), low TT3 (p = 0.001), and high free thyroxine (fT4) (p < 0.001) groups showed a higher BPRS score on admission than did the normal thyroid hormone group, while thyroid stimulating hormone (TSH) levels were not significantly correlated with the severity of symptoms. Furthermore, thyroid hormone was not associated with the treatment response assessed by the rate of BPRS score reduction, admission days, use of clozapine, and dose of antipsychotics. CONCLUSIONS: The TT3 and fT4 hormone levels were significantly associated with the severity of symptoms in schizophrenia patients. These relations suggested that thyroid dysfunction may be associated with the severity of schizophrenia. And hence, further analysis of the results of the thyroid function test, which is commonly used in cases of psychiatric admission, is required.
Antipsychotic Agents ; Brain ; Brief Psychiatric Rating Scale ; Clozapine ; Humans ; Inpatients ; Schizophrenia ; Thyroid Diseases ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Hormones ; Thyrotropin ; Thyroxine ; Triiodothyronine

Exposure to lead during pregnancy is a risk factor for the development of psychiatric disorders in the offspring. In this study, we investigated whether exposure to low levels of lead acetate (0.2%) in drinking water during pregnancy and lactation causes behavioral impairment and affects the expression of proteins associated with neurodevelopment. Lead exposure altered several parameters in rat offspring compared with those unexposed in open-field, social interaction, and pre-pulse inhibition tests. These parameters were restored to normal levels after clozapine treatment. Western blot and immunohistochemical analyses of the hippocampus revealed that several neurodevelopmental proteins were downregulated in lead-exposed rats. The expression was normalized after clozapine treatment (5 mg/kg/day, postnatal day 35–56). These findings demonstrate that downregulation of several proteins in lead-exposed rats affected subsequent behavioral changes. Our results suggest that lead exposure in early life may induce psychiatric disorders and treatment with antipsychotics such as clozapine may reduce their incidence.
Animals ; Antipsychotic Agents ; Behavior Rating Scale ; Blotting, Western ; Clozapine ; Down-Regulation ; Drinking Water ; Female ; Hippocampus ; Incidence ; Interpersonal Relations ; Lactation ; Lead Poisoning ; Models, Animal ; Neurodevelopmental Disorders ; Pregnancy ; Rats ; Risk Factors