Effects of Feedback From Self-Monitoring Devices on Lifestyle Changes in Workers with Diabetes: 3-Month Randomized Controlled Pilot Trial.

BACKGROUND: Although lifestyle interventions are useful in the prevention and management of diabetes, they can be expensive and time-consuming. There is some evidence on the effectiveness of automated mobile technology for health self-monitoring; however, few studies have used such devices in the occupational health field. OBJECTIVE: We aimed to examine the effectiveness of a digital self-monitoring device on glucose levels and activity of workers with diabetes in Japan. The primary outcomes were changes in blood glucose levels, and the secondary outcomes were changes in weight and BMI. METHODS: A 2-arm randomized controlled pilot trial was conducted with workers from 23 organizations. The intervention group (n=50) wore an armband activity monitor, a body composition monitor, and a blood pressure monitor for 3 months and received semiautomated weekly email messages tailored to their device data. The control group (n=53) engaged in no self-monitoring. Messages were developed by a physician and a dietician. Postintervention changes in blood glucose levels, weight, and BMI were compared between the intervention and control groups, using blood tests and questionnaires. RESULTS: At the end of 3 months, the intervention group showed significantly lower blood glucose levels (HbA1c: intervention group mean 6.4% (SD 0.3%) vs control group mean 6.6% (SD 0.3%); Cohen d=0.7, 95% CI 0.2-1.1; P=.009). There were no significant between-group differences in weight and BMI. CONCLUSIONS: Mobile digital self-monitoring was effective in improving blood glucose levels in workers with diabetes. The use of digital health devices is a cost-effective way of implementing health self-monitoring for large numbers of individuals in the workplace. However, due to the large volume of missing values in this study, we need to be careful in interpreting the results, and well-designed intervention studies need to be conducted. TRIAL REGISTRATION: University Hospital Medical Information Network UMIN000023651; https://upload.umin.ac.jp/cgi-open-bin/icdr/ctr_view_cb.cgi?recptno=R000027244&flwp_key=1008PYbOcXKmk7CAg4Th1FWS.

Does maternal postpartum depression affect children's developmental outcomes?

AIM: The etiology of maternal postpartum depression (PPD) remains inconclusive, and there is no consensus concerning whether maternal PPD affects children's developmental outcomes. Consequently, in this literature review, we examined whether maternal PPD affects children's physical, neuromotor, language and general cognitive development. METHODS: We conducted an electronic search using PubMed to select case-control and cohort studies that addressed maternal depression, depressive episodes or depressive symptoms among postpartum (within 6 months) women. We omitted studies that focused on a specific population (e.g. preterm infants). RESULTS: The methodological problems of prior studies indicate that their findings must be interpreted with caution. Insufficient and or inconsistent evidence has supported associations between maternal PPD and children's developmental trajectories. Nevertheless, some key studies have revealed findings that require further analysis, including the associations between maternal PPD and children's stunted growth/being underweight in developed countries, the slight delay in children's fine motor development, and in children's language development. CONCLUSION: Although several studies have investigated the longstanding effects of maternal PPD on children's physical and neurodevelopment, no conclusive evidence has elucidated a relationship between maternal PPD and all four domains of child development - physical, neuromotor, language and general cognitive ability. Therefore, large-scale, longitudinal studies with a long-term follow-up period - extending to school age and beyond - are needed. Moreover, confounding factors should be carefully considered. Specifically, household income, parental education, breastfeeding, bonding/attachment and paternal mental health may be associated with maternal mental health and children's neurodevelopment.

Association of late-onset postpartum depression of mothers with expressive language development during infancy and early childhood: the HBC study.

BACKGROUND: While it has been implied that an infant's exposure to maternal postpartum depression (PPD) may be associated with delayed development of expressive language, it remains unclear whether such a delay persists into childhood and whether the onset of PPD onset-early (within 4 weeks after childbirth) vs. late (between 5 and 12 weeks postpartum)-is relevant in this context. OBJECTIVE: To examine whether children of mothers with early- or late-onset PPD have reduced expressive language scores during infancy and early childhood (up to 40 months of age). METHODS: This longitudinal, observational study was conducted as a part of the Hamamatsu Birth Cohort for Mothers and Children (HBC Study), a population-representative sample in Japan. A total of 969 neonates and their mothers were included in the analysis. EXPOSURES: Early- and late-onset PPD was measured using the Edinburgh Postnatal Depression Scale. MAIN OUTCOMES AND MEASURES: Expressive language development was measured using the Mullen Scales of Early Learning. Six points over time were monitored (10, 14, 18, 24, 32, and 40 months postpartum). The relationship between the exposure variable and any change in expressive language score was evaluated using multiple linear regression analysis and growth curve analysis, both adjusted for covariates. RESULTS: Results from the adjusted regression analysis showed that children of mothers with late-onset PPD had significantly lower expressive language scores at 18 months of age and beyond, with a score reduction of approximately 0.6 standard deviations from the reference value at 40 months of age (95% CI [-0.888 to -0.265], p < .001). This association was confirmed on growth curve analysis, which revealed a significant, monotonic decline of expressive language development between 10 and 40 months of age among children of mothers with late-onset PPD, but not among children of mothers with early-onset PPD. CONCLUSION: Exposure to late-onset PPD may lead to a persistent decline in the rate of expressive language development in offspring during infancy and early childhood, highlighting the significance of monitoring for late-onset PPD to facilitate early detection and intervention.