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Benda N, Woode S, Niño de Rivera S, Kalish RB, Riley LE, Hermann A, Masterson Creber R, Costa Pimentel E, Ancker JS. Understanding Symptom Self-Monitoring Needs Among Postpartum Black Patients: Qualitative Interview Study. J Med Internet Res 2024; 26:e47484. [PMID: 38669066 DOI: 10.2196/47484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 02/20/2024] [Accepted: 03/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Pregnancy-related death is on the rise in the United States, and there are significant disparities in outcomes for Black patients. Most solutions that address pregnancy-related death are hospital based, which rely on patients recognizing symptoms and seeking care from a health system, an area where many Black patients have reported experiencing bias. There is a need for patient-centered solutions that support and encourage postpartum people to seek care for severe symptoms. OBJECTIVE We aimed to determine the design needs for a mobile health (mHealth) patient-reported outcomes and decision-support system to assist Black patients in assessing when to seek medical care for severe postpartum symptoms. These findings may also support different perinatal populations and minoritized groups in other clinical settings. METHODS We conducted semistructured interviews with 36 participants-15 (42%) obstetric health professionals, 10 (28%) mental health professionals, and 11 (31%) postpartum Black patients. The interview questions included the following: current practices for symptom monitoring, barriers to and facilitators of effective monitoring, and design requirements for an mHealth system that supports monitoring for severe symptoms. Interviews were audio recorded and transcribed. We analyzed transcripts using directed content analysis and the constant comparative process. We adopted a thematic analysis approach, eliciting themes deductively using conceptual frameworks from health behavior and human information processing, while also allowing new themes to inductively arise from the data. Our team involved multiple coders to promote reliability through a consensus process. RESULTS Our findings revealed considerations related to relevant symptom inputs for postpartum support, the drivers that may affect symptom processing, and the design needs for symptom self-monitoring and patient decision-support interventions. First, participants viewed both somatic and psychological symptom inputs as important to capture. Second, self-perception; previous experience; sociocultural, financial, environmental, and health systems-level factors were all perceived to impact how patients processed, made decisions about, and acted upon their symptoms. Third, participants provided recommendations for system design that involved allowing for user control and freedom. They also stressed the importance of careful wording of decision-support messages, such that messages that recommend them to seek care convey urgency but do not provoke anxiety. Alternatively, messages that recommend they may not need care should make the patient feel heard and reassured. CONCLUSIONS Future solutions for postpartum symptom monitoring should include both somatic and psychological symptoms, which may require combining existing measures to elicit symptoms in a nuanced manner. Solutions should allow for varied, safe interactions to suit individual needs. While mHealth or other apps may not be able to address all the social or financial needs of a person, they may at least provide information, so that patients can easily access other supportive resources.
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Affiliation(s)
- Natalie Benda
- School of Nursing, Columbia University, New York, NY, United States
| | - Sydney Woode
- Department of Radiology, Early Lung and Cardiac Action Program, The Mount Sinai Health System, New York, NY, United States
| | | | - Robin B Kalish
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States
| | - Laura E Riley
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, United States
| | - Alison Hermann
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, United States
| | | | - Eric Costa Pimentel
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States
| | - Jessica S Ancker
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States
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Liu X, Huang X, Yang Y, Narayan A, Du-Skabrin L, Ding X, Chen Y, Zhao J, Chang S, Wang F. Maternal anaemia prevention and control in China: A policy review. Matern Child Nutr 2024:e13653. [PMID: 38624183 DOI: 10.1111/mcn.13653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 03/21/2024] [Accepted: 03/28/2024] [Indexed: 04/17/2024]
Abstract
Maternal anaemia is a major public health problem. Developing maternal anaemia prevention and control policies is an important prerequisite for carrying out evidence-based interventions. This article reviews maternal anaemia prevention and control policies in China, identifies gaps, and provides references for other countries. We examined policies concerning maternal nutrition and other related literature in China, identified through key databases and government websites, and conducted a narrative review of the relevant documentations guided by the Smith Policy-Implementing-Process framework. A total of 65 articles and documents were identified for analysis. We found that Chinese government has committed to reducing maternal anaemia at the policy level, with established objectives and a clear time frame. However, most of policies were not accompanied by operational guidelines, standardized interventions, and vigorous monitoring and evaluation mechanisms, and 85% of the policies don't have quantifiable objectives on anaemia. Maternal anaemia prevention and control services offered in clinical settings were primarily nutrition education and anaemia screening. Population-based interventions such as iron fortification have yet to be scaled up. Furthermore, medical insurance schemes in some regions do not cover anaemia prevention and treatment, and in other regions that offer coverage, the reimbursement rate is low. The number and capacity of health professionals is also limited. Policy changes should focus on the integration of evidence-based interventions into routine antenatal care services and public health service packages, standardization of dosages and provision of iron supplementation, streamline of reimbursement for outpatient expenses, and capacity building of health professionals.
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Affiliation(s)
- Xiaoxi Liu
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | | | | | | | | | - Xue Ding
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yongchao Chen
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jun Zhao
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | | | - Fang Wang
- Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Hudson S, Muspratt-Tucker N, Kudsk-Iversen S. On the ethics of removing Entonox® from labour ward: beyond carbon dioxide equivalents and seeking justice for patients and the planet. Anaesthesia 2024. [PMID: 38606766 DOI: 10.1111/anae.16296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/13/2024]
Affiliation(s)
- Sarah Hudson
- Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Nadia Muspratt-Tucker
- Department of Obstetrics and Gynaecology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Søren Kudsk-Iversen
- Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- University of Oxford, Oxford, UK
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Philibert L, Lapierre J, Mulatris P, Kiki GM, Prophète A, Ntanda GM. Healthcare professionals' experience of teenage pregnancy and motherhood in Haiti. Int J Adolesc Med Health 2024; 0:ijamh-2023-0157. [PMID: 38575145 DOI: 10.1515/ijamh-2023-0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/17/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES The aim of this study was to explore healthcare professionals' experience of pregnant and motherhood in adolescence in Haiti. METHODS The methodology for collecting and analyzing qualitative data was based on John Dewey's social survey. The study was conducted in nine health institutions in the North and North-East departments of Haiti from October 2020 to January 2021. Data were collected through individual semi-structured interviews with 15 healthcare professionals. All interviews were audio-recorded. The recordings were listened to carefully and transcribed in verbatim form. After checking and validation, the verbatims in Word format were exported to QDA Miner software version 6.0.5 for coding. The data were analyzed using Paillé and Mucchielli thematic analyses. RESULTS Health professionals such as gynecologists, nurses, midwives, nursing assistants, matrons and health workers took part in the study. These study participants indicate that teenage pregnancy and motherhood are social and public health problems whose negative consequences affect teenage girls, children, healthcare professionals, the healthcare system, and Haitian society in general. The services offered to adolescent girls are medical, educational, psychological, economic, and social in nature. When caring for pregnant adolescents during the transition to motherhood, healthcare professionals face many challenges that are linked to the socio-economic status and physiological reality of adolescents, as well as the healthcare system. CONCLUSIONS Programs involving home care visits should also be set up to offer ongoing support to pregnant or parenting teenagers. The distribution of food aid or materials such as clothing, hygiene products and baby kits should also be considered.
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Affiliation(s)
- Léonel Philibert
- 647717 Université de l'Ontario français , Toronto, ON, Canada
- Faculty of Nursing, 4440 Université Laval , Québec, QC, Canada
| | - Judith Lapierre
- Faculty of Nursing, 4440 Université Laval , Québec, QC, Canada
| | - Paulin Mulatris
- 647717 Université de l'Ontario français , Toronto, ON, Canada
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Basavaraj C, Grant AD, Aras SG, Erickson EN. Deep Learning Model Using Continuous Skin Temperature Data Predicts Labor Onset. medRxiv 2024:2024.02.25.24303344. [PMID: 38464102 PMCID: PMC10925356 DOI: 10.1101/2024.02.25.24303344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Background Changes in body temperature anticipate labor onset in numerous mammals, yet this concept has not been explored in humans. Methods We evaluated patterns in continuous skin temperature data in 91 pregnant women using a wearable smart ring. Additionally, we collected daily steroid hormone samples leading up to labor in a subset of 28 pregnancies and analyzed relationships among hormones and body temperature trajectory. Finally, we developed a novel autoencoder long-short-term-memory (AE-LSTM) deep learning model to provide a daily estimation of days until labor onset. Results Features of temperature change leading up to labor were associated with urinary hormones and labor type. Spontaneous labors exhibited greater estriol to α-pregnanediol ratio, as well as lower body temperature and more stable circadian rhythms compared to pregnancies that did not undergo spontaneous labor. Skin temperature data from 54 pregnancies that underwent spontaneous labor between 34 and 42 weeks of gestation were included in training the AE-LSTM model, and an additional 40 pregnancies that underwent artificial induction of labor or Cesarean without labor were used for further testing. The model was trained only on aggregate 5-minute skin temperature data starting at a gestational age of 240 until labor onset. During cross-validation AE-LSTM average error (true - predicted) dropped below 2 days at 8 days before labor, independent of gestational age. Labor onset windows were calculated from the AE-LSTM output using a probabilistic distribution of model error. For these windows AE-LSTM correctly predicted labor start for 79% of the spontaneous labors within a 4.6-day window at 7 days before true labor, and 7.4-day window at 10 days before true labor. Conclusion Continuous skin temperature reflects progression toward labor and hormonal status during pregnancy. Deep learning using continuous temperature may provide clinically valuable tools for pregnancy care.
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Affiliation(s)
- Chinmai Basavaraj
- Department of Computer Science, The University of Arizona, Tucson, AZ, USA
| | | | - Shravan G Aras
- Center for Biomedical Informatics and Biostatistics, The University of Arizona Health Sciences, Tucson, AZ, USA
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Nasri NM, Gan WY, Mohd Shukri NH. Mother-infant postnatal experience and its association with maternal emotion and coping during the COVID-19 pandemic. J Reprod Infant Psychol 2024:1-17. [PMID: 38407161 DOI: 10.1080/02646838.2024.2314187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/30/2024] [Indexed: 02/27/2024]
Abstract
INTRODUCTION The COVID-19 pandemic resulted in a partial lockdown in Malaysia known as Movement-Controlled-Order (MCO), which has affected primary care management and social life norms. Thus, psychological health is a concern for mothers, particularly during the postpartum period. This study aimed to determine factors associated with maternal emotional experiences and coping during the pandemic. METHODOLOGY Mothers of infants aged < 18 months (n = 1449) in Malaysia completed an online survey during MCO (July 2020 to February 2021). The survey comprised questions on sociodemographics, pandemic livelihood impact, maternal experiences, and emotions. RESULTS More than one-third of mothers expressed feeling worried (54.7%), annoyed (48.1%), and tired (42.2%) to some or a high extent. Mothers who were younger (p = .001), more educated (p = .001), faced difficulty paying rent (p = .002), and whose husbands were unemployed (p < .001) expressed higher negative emotions. In contrast, mothers who received enough support for health (p = .001) and breastfeeding (p = .008), had infants sleep less (p = .042) and had more time to focus on health (p < .001) expressed better emotions. Higher coping was expressed among mothers with a higher household income (p = .004), had more time to focus on their health (p = .010), received additional breastfeeding support (p = 0.039), and practised traditional postpartum care (p < .001). In contrast, difficulty paying for essentials (p = .023) was associated with negative coping. CONCLUSION Maternal emotional experiences were significantly associated with sociodemographic characteristics, livelihood impact, postnatal experiences, and infant behaviours. Postpartum mental health screening is recommended to prevent severe distress, especially in first-time mothers. Coping interventions for mothers at risk may include comprehensive support and maternity care.
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Affiliation(s)
- Nuruljannah Mohamad Nasri
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Wan Ying Gan
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nurul Husna Mohd Shukri
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Vasilevski V, Ryan D, Crowe G, Askern A, McCormick M, Segond S, Sweet L. Satisfaction with maternity triage following implementation of the Birmingham Symptom-Specific Obstetric Triage System (BSOTS): Perspectives of women and staff. J Adv Nurs 2024; 80:673-682. [PMID: 37501264 DOI: 10.1111/jan.15806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/04/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
AIM To explore the satisfaction and experiences of women and staff with the BSOTS in an Australian hospital. DESIGN Cross-sectional descriptive survey. METHODS Surveys were distributed to women and staff between February and May 2022. Survey questions reflected satisfaction with triage and provision of care under the BSOTS system (for women) and confidence in using the BSOTS system and its impact on triage-related care (for staff). Survey data were summarized using descriptive statistics, and qualitative responses were analysed using content analysis. RESULTS There were 50 women and 40 staff (midwives and doctors) survey respondents. Most women were satisfied with triage wait times, the verbal information they received and the time it took for them to receive care. Nearly all midwife participants indicated they had high knowledge and confidence in using the BSOTS. Most staff indicated that the BSOTS supported the accurate assessment of women and had benefits for women, staff and the hospital. CONCLUSION The findings showed that women and staff were satisfied with receiving and providing care in a maternity triage setting under the BSOTS system. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Implementing standardized maternity triage approaches such as the BSOTS in health settings delivering care to pregnant women is recommended for improving flow of care and perceptions of care quality by women. IMPACT Quality of maternity triage processes is likely to impact the satisfaction of women attending services and the staff providing care. The BSOTS was shown to improve maternity triage processes and was associated with satisfaction of women and staff. Maternity settings can benefit from implementing triage approaches such as the BSOTS as it standardizes and justifies the care provided to women. This is likely to result in satisfaction of women and staff engaged in maternity triage and improve the birth outcomes of women and babies. REPORTING METHOD The reporting of this paper has followed SQUIRE guidelines. PATIENT OR PUBLIC CONTRIBUTION Women engaged with maternity services were participants in the study but did not contribute to the design, conduct or publication of the study.
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Affiliation(s)
- Vidanka Vasilevski
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety Research, Western Health Partnership, Institute for Health Transformation, St Albans, Victoria, Australia
| | - Denise Ryan
- Western Health, St Albans, Victoria, Australia
| | - Grace Crowe
- Western Health, St Albans, Victoria, Australia
| | | | | | | | - Linda Sweet
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
- Centre for Quality and Patient Safety Research, Western Health Partnership, Institute for Health Transformation, St Albans, Victoria, Australia
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Metelmann I, Pietsch UC, Kappelmeyer S, Wessela S, Niethard M, Klotz L. [Thoracic Surgery during Pregnancy and Breastfeeding - an Interdisciplinary Consensus Paper]. Zentralbl Chir 2024; 149:128-132. [PMID: 37187183 PMCID: PMC10914491 DOI: 10.1055/a-2074-7405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/09/2023] [Indexed: 05/17/2023]
Abstract
If thoracic surgery is to remain an attractive career path for young physicians, it is essential to provide opportunities to balance work, residency, and family time. With an increasing proportion of women in thoracic surgery, it has become increasingly important to create a work environment that allows safe employment during pregnancy and breast feeding becomes an important concern.Based on the legal requirements of the German Maternity Protection Act (Mutterschutzgesetz), this interdisciplinary consensus paper was developed by representatives of thoracic surgery, anaesthesiology, and occupational medicine.The vast majority of thoracic operations can be performed by pregnant or breast-feeding surgeons. We established a risk-stratified list of operations with potentially acceptable risk, and a list of operations that pregnant or breast-feeding surgeons should not perform. A checklist aims to aid the individual implementation of thoracic surgery during pregnancy and breast feeding.Thoracic surgery can be performed by pregnant or breast-feeding surgeons when certain protective measures are observed. The prerequisite is the voluntary and independent decision of the surgeon, and the implementation of safety precautions by the employer.
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Affiliation(s)
- Isabella Metelmann
- Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Uta-Carolin Pietsch
- Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Leipzig University, Leipzig, Deutschland
| | - Silke Kappelmeyer
- Arbeitsmedizin und Arbeitssicherheit, Leipzig University, Leipzig, Deutschland
| | - Sven Wessela
- Arbeitsmedizin und Arbeitssicherheit, Leipzig University, Leipzig, Deutschland
| | - Maya Niethard
- Klinik für Tumortherapie, HELIOS Klinikum Berlin-Buch, Berlin, Deutschland
- Klinik und Poliklinik für Orthopädie und Orthopädische Chirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Laura Klotz
- Klinik für Thoraxchirurgie, Thoraxklinik, Heidelberg University, Heidelberg, Deutschland
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Delawarde-Saïas T, Mercerat C, Adamiste M, Pigeon-Gagné É, Delawarde C, Nouchi J, Comtois J, Bakhty S, Poissant J. Is there room for mothers' agency in the choice to breastfeed? A qualitative analysis of mothers' views on messages promoting breastfeeding in Quebec. Eur J Midwifery 2024; 8:EJM-8-02. [PMID: 38192878 PMCID: PMC10772811 DOI: 10.18332/ejm/174931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 10/23/2023] [Accepted: 11/14/2023] [Indexed: 01/10/2024] Open
Abstract
INTRODUCTION This exploratory cross-sectional study focuses on the experiences of mothers regarding health messages promoting breastfeeding. The objective is to describe the content and context in which messages are conveyed. METHODS A total of 944 new mothers responded to a questionnaire (15-31 January 2021) on their perception of health messages promoting breastfeeding and their feeling of agreement towards these messages, their intention to breastfeed, incentives received, and their relationship with the professionals. Frequencies were carried out for all non-textual data and textual data were analyzed using content thematic analysis. The recruitment was made through social media and snowball effect. RESULTS Most of the respondents reported wanting to breastfeed; 91% breastfed their child, 80.8% participants agreed with the messages they received, and 67.9% of respondents strongly agreeing that breastfeeding was the best choice for their child. Moreover, the content of the messages could sometimes be judgmental and coercive, leading to emotions such as guilt. Sixty-two women also reported a lack of support when they expressed their desire or their need to feed their baby in other ways (e.g. breastmilk with bottles or formulas). CONCLUSIONS The perceived issue of breastfeeding messages was not the content itself, but the way in which information was conveyed. Failure to take mothers' difficulties into account and failure to present alternatives to breastfeeding were seen as major issues by women. This study highlights the importance of rethinking the way in which information is provided by professionals, in order to reinforce the autonomy of new mothers regarding the feeding of their child.
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Affiliation(s)
| | | | | | | | - Cécile Delawarde
- Centre hospitalier de l'Universite de Montreal, Montreal, Canada
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Mousa O, Salameh B, Alqahtani M, David M, Almefarfesh AA, Duhilan DA, Ghaly AS, Alsadaan N, Reshia FAA, Alsandal ZMA. Women's attitudes, prevalence, related factors, and perceived barriers of birth companionship in Saudi Arabia. Womens Health (Lond) 2024; 20:17455057231224553. [PMID: 38279816 PMCID: PMC10822074 DOI: 10.1177/17455057231224553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/29/2024]
Abstract
BACKGROUND The World Health Organization recommends companionship as a critical element of respectful maternity care. However, there is paucity of literature regarding women's attitudes, related factors, and barriers of implementation in Saudi Arabia. OBJECTIVE This study aimed to assess women's attitudes toward birth companionship during labor and delivery, related factors, and barriers of implementing labor companionship in Saudi Arabia. DESIGN/METHODS This study was carried out in Al Ahsa, Saudi Arabia, using a cross-sectional design. The data collection took place over a period of approximately 6 months, specifically from 16 August 2021 to 20 February 2022. A total of 418 women who had given birth at three governmental hospitals and three private hospitals in Al Ahsa participated in the survey. The study included women between the ages of 18 and 49 years who had delivered during the study period. RESULTS The study revealed that while around 82.8% of mothers expressed a desire for companionship during labor, only 43.2% actually had a labor companion present during delivery. The primary obstacle to labor companionship reported by 21.5% of respondents was hospital policies. Other barriers identified included husbands' fear of being present during labor (4.7%) and limited availability of time for companionship (3.8%). CONCLUSION The study concludes that birth companionship is highly desired by women in the study area. However, various physical, emotional, and institutional barriers, such as hospital policies and regulations, impede its implementation. Addressing these barriers and promoting supportive policies are essential to facilitate the provision of birth companionship and improve the childbirth experience for women in Al Ahsa.
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Affiliation(s)
- Ola Mousa
- Faculty of Nursing, Minia University, Minia, Egypt
| | - Basma Salameh
- Department of Nursing, Arab American University, Jenin, Palestine
| | - Mohammed Alqahtani
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Alahsa, Saudi Arabia
| | - Maryshela David
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Alahsa, Saudi Arabia
| | - Aishah A Almefarfesh
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Alahsa, Saudi Arabia
| | - Duaa Al Duhilan
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Alahsa, Saudi Arabia
| | - Asmaa Saber Ghaly
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Alahsa, Saudi Arabia
- Obstetric and Gynecologic Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Nourah Alsadaan
- Nursing Administration and Education Department, College of Nursing, Jouf University, Sakaka, Saudi Arabia
| | - Fadia Ahmed Abdelkader Reshia
- Medical Surgical Nursing Department, College of Nursing, Jouf University, Sakaka, Saudi Arabia
- Critical Care and Emergency Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
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Nissen M, Perez CA, Jaeger KM, Bleher H, Flaucher M, Huebner H, Danzberger N, Titzmann A, Pontones CA, Fasching PA, Beckmann MW, Eskofier BM, Leutheuser H. Usability and Perception of a Wearable-Integrated Digital Maternity Record App in Germany: User Study. JMIR Pediatr Parent 2023; 6:e50765. [PMID: 38109377 PMCID: PMC10750977 DOI: 10.2196/50765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/20/2023] [Accepted: 10/02/2023] [Indexed: 12/20/2023] Open
Abstract
Background Although digital maternity records (DMRs) have been evaluated in the past, no previous work investigated usability or acceptance through an observational usability study. Objective The primary objective was to assess the usability and perception of a DMR smartphone app for pregnant women. The secondary objective was to assess personal preferences and habits related to online information searching, wearable data presentation and interpretation, at-home examination, and sharing data for research purposes during pregnancy. Methods A DMR smartphone app was developed. Key features such as wearable device integration, study functionalities (eg, questionnaires), and common pregnancy app functionalities (eg, mood tracker) were included. Women who had previously given birth were invited to participate. Participants completed 10 tasks while asked to think aloud. Sessions were conducted via Zoom. Video, audio, and the shared screen were recorded for analysis. Task completion times, task success, errors, and self-reported (free text) feedback were evaluated. Usability was measured through the System Usability Scale (SUS) and User Experience Questionnaire (UEQ). Semistructured interviews were conducted to explore the secondary objective. Results A total of 11 participants (mean age 34.6, SD 2.2 years) were included in the study. A mean SUS score of 79.09 (SD 18.38) was achieved. The app was rated "above average" in 4 of 6 UEQ categories. Sixteen unique features were requested. We found that 5 of 11 participants would only use wearables during pregnancy if requested to by their physician, while 10 of 11 stated they would share their data for research purposes. Conclusions Pregnant women rely on their medical caregivers for advice, including on the use of mobile and ubiquitous health technology. Clear benefits must be communicated if issuing wearable devices to pregnant women. Participants that experienced pregnancy complications in the past were overall more open toward the use of wearable devices in pregnancy. Pregnant women have different opinions regarding access to, interpretation of, and reactions to alerts based on wearable data. Future work should investigate personalized concepts covering these aspects.
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Affiliation(s)
- Michael Nissen
- Machine Learning and Data Analytics Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Carlos A Perez
- Machine Learning and Data Analytics Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Katharina M Jaeger
- Machine Learning and Data Analytics Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Hannah Bleher
- Department of Social Ethics, University of Bonn, Bonn, Germany
| | - Madeleine Flaucher
- Machine Learning and Data Analytics Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Hanna Huebner
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nina Danzberger
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Adriana Titzmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Constanza A Pontones
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Erlangen University Hospital, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Bjoern M Eskofier
- Machine Learning and Data Analytics Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Heike Leutheuser
- Machine Learning and Data Analytics Lab, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
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12
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Augustyn M, Haskins D, Gross S, Resnik AK, Ducharme-Smith K, Orta-Aleman D, Silbert-Flagg J, Rosenblum N, Caulfield LE. Maternity care experiences and breastfeeding at discharge among Maryland WIC participants: A qualitative analysis. Birth 2023; 50:1009-1017. [PMID: 37533361 DOI: 10.1111/birt.12758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 04/18/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Breastfeeding imparts numerous health and social benefits for families. Barriers deter some individuals from breastfeeding. Rates are lower among certain populations, including participants of the federally funded Women, Infants, and Children's Program (WIC). Women, Infants, and Children's Program provides low-income pregnant and postpartum women and children under 5 with nutrition education, supplemental foods, breastfeeding education and support, and resource linkages. Investigation of WIC participants' hospital experiences and breastfeeding decisions is limited. We explore qualitative themes associated with breastfeeding-related hospital maternity care practices experienced by WIC participants. METHODS Thirty pregnant individuals intending to breastfeed were recruited at WIC clinics to complete in-depth interviews at 2 weeks, 3 months, and 6 months of postpartum. Using the Thematic Framework methodology, we analyzed data from the two-week interviews of 29 participants with respect to hospital breastfeeding experiences. RESULTS Fourteen participants were exclusively breastfeeding at discharge (EBFD). Fifteen were partially breastfeeding at discharge (PBFD). Differences between groups were found in hospital breastfeeding experiences, particularly in staff support. All participants EBFD reported positive breastfeeding-related staff experiences. Most participants PBFD reported limited and ineffective staff interaction, leading to formula introduction. CONCLUSIONS Individuals EBFD and those PBFD reported about the same rate of hospital breastfeeding difficulties, yet half introduced formula within the first few days postpartum. Results reiterate the importance of hospital staff support to breastfeeding exclusivity at 2-3 days postpartum. The challenges that these individuals faced may have been resolved through available, responsive, and effective intervention. Data-driven breastfeeding education programs for hospital health professionals are critical to affect patient breastfeeding outcomes.
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Affiliation(s)
- Marycatherine Augustyn
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Danielle Haskins
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Susan Gross
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Amy Kovar Resnik
- Maryland WIC Program, Maryland Department of Health, Baltimore, Maryland, USA
| | - Kirstie Ducharme-Smith
- Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - Dania Orta-Aleman
- Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
| | - JoAnne Silbert-Flagg
- Pediatric Nurse Practitioner Track, Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Nadine Rosenblum
- Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, Maryland, USA
- Adjunct Faculty, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Laura E Caulfield
- Center for Human Nutrition, Johns Hopkins University Bloomberg School of Public Health (JHUBSPH), Baltimore, Maryland, USA
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13
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Umstead KA, Gill C, Pearsall MS, Stuebe AM, Tully KP. Human-centered design in the context of social determinants of health in maternity care: methods for meaningful stakeholder engagement. Int J Qual Stud Health Well-being 2023; 18:2205282. [PMID: 37099749 PMCID: PMC10134912 DOI: 10.1080/17482631.2023.2205282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
PURPOSE The screening process for social determinants of health (SDoH) includes questions regarding life circumstances and barriers to accessing health care. For patients, these questions may be intrusive, biased, and potentially risky. This article describes human-centered design methods to engage birthing parents and health care team members around SDoH screening and referral in maternity care. METHODS Three phases of qualitative research with birthing parents, health care teams, and hospital administrators were conducted in the United States. Shadowing, interviews, focus groups, and participatory workshops addressed the explicit and tacit concerns of the stakeholders regarding SDoH during maternity care. RESULTS Birthing parents wanted to be informed of the purpose of the clinic collecting SDoH information and how this information is used. Health care teams want to feel they are providing reliable and quality resources to their patients. They would like greater transparency that administrators are acting on SDoH data and the information is reaching people that can assist patients. CONCLUSION As clinics implement patient-centered strategies for addressing SDoH in maternity care, it is important to include patients' perspectives. This human-centered design approach advances understanding of knowledge and emotional needs around SDoH and offers insights to meaningful engagement around sensitive health data.
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Affiliation(s)
- Kelly A Umstead
- Department of Graphic, Experience, and Industrial Design, North Carolina State University, Raleigh, NC, USA
| | - Carolina Gill
- Department of Graphic, Experience, and Industrial Design, North Carolina State University, Raleigh, NC, USA
| | - Marina S Pearsall
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alison M Stuebe
- Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Obstetrics and Gynecology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kristin P Tully
- Department of Obstetrics and Gynecology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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14
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Devidal J, Decornoy C. [Alcohol and pregnancy: talking about it without taboos to prevent pregnancy]. Rev Infirm 2023; 72:28-29. [PMID: 38071013 DOI: 10.1016/j.revinf.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
From the earliest stages of adolescence, the question of alcohol consumption should be addressed by health professionals (GPs, midwives, gynecologists, pediatricians, nurses) working in the field of perinatal care or public health. All alcohol consumption is prohibited during pregnancy. In fact, a 2022 study showed that even low exposure to alcohol in utero has measurable effects on the structure of children's brains.
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Affiliation(s)
- Juliette Devidal
- Service PMI-PS, DT AFMB, 187, rue du Quai, 74970 Marignier, France.
| | - Charlotte Decornoy
- Pôle médico-social des Balmettes, 1-3, avenue Lucien-Boschetti, 74000 Annecy, France
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15
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Carneiro MDNDL, Gomes DL, da Fonseca AA, Ripardo RC. Relationship between Quality of Life and Adult Attachment Factors in Mothers of Children with and without Type 1 Diabetes. Int J Environ Res Public Health 2023; 20:7109. [PMID: 38063539 PMCID: PMC10706471 DOI: 10.3390/ijerph20237109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 12/18/2023]
Abstract
The mothers of children with a specific clinical situation such as type 1 diabetes mellitus may have a higher level of stress, causing a worse perception of their quality of life, greater anxiety, and greater avoidance (adult attachment factors). The objective of this research was to verify if there is a relationship between the adult attachment factors of mothers of children with and without type 1 diabetes mellitus and the perception of the quality of life of these mothers. This survey was carried out from July to September 2022, with mothers of children aged 5 to 10 years, with and without diabetes. The data were collected through an online questionnaire, with socioeconomic data from the attachment scale Experience in Close Relationship-(Reduced), and the questionnaire on the quality of life, the WHOQOL-abbreviated questionnaire. For statistical analysis, the Statistical Package for Social Science 24 was used. A total of 45 mothers of children with DM1 and 55 mothers of healthy children were evaluated. The mothers of children with DM1 had a worse perception of their quality of life when compared to the mothers of healthy children (p < 0.05), with no difference in terms of the attachment style. Therefore, it is understood that actions aimed at improving the quality of life of these mothers are necessary.
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16
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Gayatri M, Silvani Y, Pirade RA, Akingbade O, Harjo IWW, Hastuti NR. Javanese Women's Experiences during the First Pregnancy. Iran J Nurs Midwifery Res 2023; 28:735-739. [PMID: 38205403 PMCID: PMC10775872 DOI: 10.4103/ijnmr.ijnmr_413_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/23/2020] [Accepted: 11/18/2022] [Indexed: 01/12/2024]
Abstract
Background Women experience physical, hormonal, and psychological changes during pregnancy. Similarly, some traditions are prevalent among Javanese women, which could affect their pregnancy. The experiences of first-time pregnant women in this area remain unclear. This study aimed to explore the lived experiences of women during their first pregnancy. Materials and Methods The qualitative study with a phenomenological approach was conducted in Kesambon village in Malang Regency, Indonesia. Eight women in their third trimester were selected purposively. Data were gathered using semi-structured interviews and subsequently open-coded using the NVivo-12 software manufactured by the QS International. Results The participants were married primigravida women aged 17 to 22 years. Four themes emerged as follows: pregnancy is a positive experience, pregnant women are not independent, belief in pregnancy-related myths and traditions, and pregnancy-related information seeking. Conclusions During the first pregnancy, pregnant women believed and practiced Javanese traditions regarding pregnancy. Although they were happy, they were still dependent and lacked the motivation to seek pregnancy-related information. Hence, midwives should provide them with adequate pregnancy-related information while addressing harmful myths and misconceptions. This should culminate in a successful pregnancy.
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Affiliation(s)
- Mergy Gayatri
- Department of Midwifery, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
- Center for Health Financing Policy and Health Insurance Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yulia Silvani
- Department of Midwifery, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Roland A. Pirade
- Center for Health Financing Policy and Health Insurance Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Public Health Policy and Management, School of Global Public Health, New York University, United States
| | - Oluwadamilare Akingbade
- Department of Nursing, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong
- Department of Research and Statistics, Institute of Nursing Research, Osogbo, Osun State, Nigeria
| | - Indhar W. W. Harjo
- Department of Sociology, Faculty of Social Science and Political Science, Universitas Brawijaya, Jawa Timur, Indonesia
| | - Nuraini R. Hastuti
- Department of Midwifery, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
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17
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Pearce G, Bell L, Pezaro S, Reinhold E. Childbearing with Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders: A Large International Survey of Outcomes and Complications. Int J Environ Res Public Health 2023; 20:6957. [PMID: 37887695 PMCID: PMC10606623 DOI: 10.3390/ijerph20206957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/03/2023] [Accepted: 09/15/2023] [Indexed: 10/28/2023]
Abstract
One in 20 births could be affected by hypermobile Ehlers-Danlos syndrome or Hypermobility Spectrum Disorders (hEDS/HSD); however, these are under-diagnosed and lacking research. This study aimed to examine outcomes and complications in people childbearing with hEDS/HSD. A large online international survey was completed by women with experience in childbearing and a diagnosis of hEDS/HSD (N = 947, total pregnancies = 1338). Data were collected on demographics, pregnancy and birth outcomes and complications. Participants reported pregnancies in the UK (N = 771), USA (N = 364), Australia (N = 106), Canada (N = 60), New Zealand (N = 23) and Ireland (N = 14). Incidences were higher in people with hEDS/HSD than typically found in the general population for pre-eclampsia, eclampsia, pre-term rupture of membranes, pre-term birth, antepartum haemorrhage, postpartum haemorrhage, hyperemesis gravidarum, shoulder dystocia, caesarean wound infection, postpartum psychosis, post-traumatic stress disorder, precipitate labour and being born before arrival at place of birth. This potential for increased risk related to maternal and neonatal outcomes and complications highlights the importance of diagnosis and appropriate care considerations for childbearing people with hEDS/HSD. Recommendations include updating healthcare guidance to include awareness of these possible complications and outcomes and including hEDS/HSD in initial screening questionnaires of perinatal care to ensure appropriate consultation and monitoring can take place from the start.
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Affiliation(s)
- Gemma Pearce
- Research Centre for Healthcare and Communities, Coventry University, Coventry CV1 5FB, UK; (L.B.); (S.P.)
| | - Lauren Bell
- Research Centre for Healthcare and Communities, Coventry University, Coventry CV1 5FB, UK; (L.B.); (S.P.)
- Coventry City Council, Coventry CV1 2GN, UK
| | - Sally Pezaro
- Research Centre for Healthcare and Communities, Coventry University, Coventry CV1 5FB, UK; (L.B.); (S.P.)
| | - Emma Reinhold
- Patient and Public Involvement and Medical Advisor, Coventry University, Coventry CV1 5FB, UK;
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18
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Pearce G, Bell L, Magee P, Pezaro S. Co-Created Solutions for Perinatal Professionals and Childbearing Needs for People with Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders. Int J Environ Res Public Health 2023; 20:6955. [PMID: 37887694 PMCID: PMC10606217 DOI: 10.3390/ijerph20206955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/08/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023]
Abstract
Individuals living with hypermobile Ehlers-Danlos syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD) have reported feeling discredited and unsupported by healthcare professionals. However, the level of knowledge about hEDS/HSD among maternity staff remains unknown. Informed by patient and public involvement, this research aimed to investigate maternity staff's knowledge and confidence in supporting people with hEDS/HSD, examine people with hEDS/HSD's experiences of perinatal care, and co-create tools to help maternity staff support people childbearing with hEDS/HSD. Two online mixed-methods international surveys were completed by childbearing people with hEDS/HSD (N = 955) and maternity staff (N = 307). This was followed by the co-creation of three tools with 17 co-creators and a design team. Two main qualitative themes were identified through thematic analysis: (1) a need for recognition of hEDS/HSD in perinatal care and (2) the delivery of appropriate individualised perinatal care. Quantitatively, people with hEDS/HSD perceived maternity professionals to have a low level of knowledge about the conditions. Respectively, maternity staff reported low levels of confidence in supporting people with hEDS/HSD. The co-created tools provide applicable outputs for both education and practice and include an i-learn module hosted by the Royal College of Midwives, a tool for perinatal records, and infomercials.
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Affiliation(s)
- Gemma Pearce
- Research Centre for Healthcare and Communities, Coventry University, Coventry CV1 5FB, UK; (L.B.); (S.P.)
| | - Lauren Bell
- Research Centre for Healthcare and Communities, Coventry University, Coventry CV1 5FB, UK; (L.B.); (S.P.)
- Coventry City Council, Coventry CV1 2GN, UK
| | - Paul Magee
- Centre for Future Transport and Cities, Coventry University, Coventry CV1 5FB, UK;
| | - Sally Pezaro
- Research Centre for Healthcare and Communities, Coventry University, Coventry CV1 5FB, UK; (L.B.); (S.P.)
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19
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Dent M, VanOtterloo L, Brady M. Improving Nurse Management of the Second Stage of Labor. Nurs Womens Health 2023; 27:344-353. [PMID: 37524314 DOI: 10.1016/j.nwh.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/23/2023] [Accepted: 07/11/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE To develop, implement, and evaluate an educational program to improve nurses' management of the second stage of labor. DESIGN Evidence-based practice project guided by the Iowa Model-Revised. SETTING Acute care teaching hospital in central California averaging 2,100 births/year with 12 labor, delivery, and recovery rooms and a Level III nursery. PARTICIPANTS Eighteen registered nurses participated in the educational intervention. INTERVENTION An instructional course addressed contemporary labor management guidelines and delayed and open/closed glottis pushing. Assessment/documentation of maternal-fetal status, progress/fetal descent, and nurse/provider communication were discussed. Participants engaged in an interactive experience regarding maternal positions. MEASUREMENTS Data collected from the electronic health record included the number of position changes, nurse/provider communication interactions, and minutes from 10 cm to birth and minutes in delayed pushing. RESULTS Second-stage labor outcomes for nulliparous patients at term with a singleton in vertex presentation improved with more position changes and percentage of spontaneous vaginal births. Patients of nurses who participated in the educational intervention (n = 18) had a vaginal birth rate of 87.5% and a surgical birth rate of 6.2%. Patients of nurses who did not participate in the educational intervention (n = 31) had a vaginal birth rate of 81.8% and a surgical birth rate of 9.1%. CONCLUSION Based on the positive response to the intervention and improved clinical outcomes, regularly scheduled interactive nursing education focused on strategies to improve the second stage of labor may be beneficial.
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20
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Bull C, Carrandi A, Slavin V, Teede H, Callander EJ. Development, woman-centricity and psychometric properties of maternity patient-reported experience measures: a systematic review. Am J Obstet Gynecol MFM 2023; 5:101102. [PMID: 37517609 DOI: 10.1016/j.ajogmf.2023.101102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 07/06/2023] [Accepted: 07/14/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Valid and reliable maternity patient-reported experience measures are critical to understanding women's experiences of care. They can support clinical practice, health service and system performance measurement, and research. The aim of this review is to identify and critically appraise the risk of bias, woman-centricity (content validity), and psychometric properties of maternity patient-reported experience measures published in the scientific literature. DATA SOURCES MEDLINE, CINAHL Plus, PsycINFO, and Embase were systematically searched for relevant records between January 1, 2010 and July 10, 2021. STUDY ELIGIBILITY CRITERIA We searched for articles describing the instrument development of maternity patient-reported experience measures and measurement properties associated with instrument validity and reliability testing. Articles that described patient-reported experience measures developed outside of the maternity context and articles that did not contribute to the instruments' development, content validation, and/or psychometric evaluation were excluded. METHODS Included articles underwent risk of bias, content validity, and psychometric properties assessments in line with the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) guidance. Patient-reported experience measure results were summarized according to language subgroups. An overall recommendation for use was determined for each patient-reported experience measure language subgroup. RESULTS A total of 54 studies reported on the development and psychometric evaluation of 25 maternity patient-reported experience measures, grouped into 45 language subgroups. The quality of evidence underpinning the instruments' development was generally poor. Only 2 (4.4%) patient-reported experience measures reported sufficient content validity, and only 1 (2.2%) received a level "A" recommendation, required for real-world use. CONCLUSION Maternity patient-reported experience measures demonstrated poor-quality evidence for their measurement properties and insufficient detail about content validity. Future maternity patient-reported experience measure development needs to prioritize women's involvement in deciding what is relevant, comprehensive, and comprehensible to measure. Improving the content validity of maternity patient-reported experience measures will improve overall validity and reliability and facilitate real-world practice improvements. Standardized patient-reported experience measure implementation also needs to be prioritized to support advancements in clinical practice for women.
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Affiliation(s)
- Claudia Bull
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia (Dr Bull, Ms Carrandi, Drs Teede and Callander).
| | - Alayna Carrandi
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia (Dr Bull, Ms Carrandi, Drs Teede and Callander)
| | - Valerie Slavin
- Women-Newborn-Children's Services, Gold Coast Health, Southport, Australia (Dr Slavin)
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia (Dr Bull, Ms Carrandi, Drs Teede and Callander)
| | - Emily J Callander
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Australia (Dr Bull, Ms Carrandi, Drs Teede and Callander)
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21
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Khan MA, Thompson WW, Osinubi A, Meyer Rd WA, Kaufman HW, Armstrong PA, Foster MA, Nelson NP, Wester C. Testing for Hepatitis C During Pregnancy Among Persons With Medicaid and Commercial Insurance: Cohort Study. JMIR Public Health Surveill 2023; 9:e40783. [PMID: 37756048 PMCID: PMC10568399 DOI: 10.2196/40783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 05/31/2023] [Accepted: 08/10/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND The reported incidence of acute hepatitis C virus (HCV) infection is increasing among persons of childbearing age in the United States. Infants born to pregnant persons with HCV infection are at risk for perinatal HCV acquisition. In 2020, the United States Preventive Services Task Force and Centers for Disease Control and Prevention recommended that all pregnant persons be screened during each pregnancy for hepatitis C. However, there are limited data on trends in hepatitis C testing during pregnancy. OBJECTIVE We estimated hepatitis C testing rates in a large cohort of patients with Medicaid and commercial insurance who gave birth during 2015-2019 and described demographic and risk-based factors associated with testing. METHODS Medicaid and commercial insurance claims for patients aged 15-44 years and who gave birth between 2015 and 2019 were included. Birth claims were identified using procedure and diagnosis codes for vaginal or cesarean delivery. Hepatitis C testing was defined as an insurance claim during the 42 weeks before delivery. Testing rates were calculated among patients who delivered and among the subset of patients who were continuously enrolled for 42 weeks before delivery. We also compared the timing of testing relative to delivery among patients with commercial or Medicaid insurance. Multivariable logistic regression was used to identify factors associated with testing. RESULTS Among 1,142,770 Medicaid patients and 1,207,132 commercially insured patients, 175,223 (15.3%) and 221,436 (18.3%) were tested for hepatitis C during pregnancy, respectively. Testing rates were 89,730 (21.8%) and 187,819 (21.9%) among continuously enrolled Medicaid and commercially insured patients, respectively. Rates increased from 2015 through 2019 among Medicaid (from 20,758/108,332, 19.2% to 13,971/52,330, 26.8%) and commercially insured patients (from 38,308/211,555, 18.1% to 39,152/139,972, 28%), respectively. Among Medicaid patients, non-Hispanic Black (odds ratio 0.73, 95% CI 0.71-0.74) and Hispanic (odds ratio 0.53, 95% CI 0.51-0.56) race or ethnicity were associated with lower odds of testing. Opioid use disorder, HIV infection, and high-risk pregnancy were associated with higher odds of testing in both Medicaid and commercially insured patients. CONCLUSIONS Hepatitis C testing during pregnancy increased from 2015 through 2019 among patients with Medicaid and commercial insurance, although tremendous opportunity for improvement remains. Interventions to increase testing among pregnant persons are needed.
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Affiliation(s)
- Mohammed A Khan
- Division of Viral Hepaitits, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - William W Thompson
- Division of Viral Hepaitits, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Ademola Osinubi
- Division of Viral Hepaitits, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | | | | | - Paige A Armstrong
- Division of Viral Hepaitits, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Monique A Foster
- Division of Viral Hepaitits, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Noele P Nelson
- Division of Viral Hepaitits, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Carolyn Wester
- Division of Viral Hepaitits, Centers for Disease Control and Prevention, Atlanta, GA, United States
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22
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Ben Mocha Y, Dahan T, Zou Y, Griesser M, Markman S. Evidence for a reproductive sharing continuum in cooperatively breeding mammals and birds: consequences for comparative research. Proc Biol Sci 2023; 290:20230607. [PMID: 37700641 PMCID: PMC10498043 DOI: 10.1098/rspb.2023.0607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/18/2023] [Indexed: 09/14/2023] Open
Abstract
Extreme reproductive skew occurs when a dominant female/male almost monopolizes reproduction within a group of multiple sexually mature females/males, respectively. It is sometimes considered an additional, restrictive criterion to define cooperative breeding. However, datasets that use this restrictive definition to classify species as cooperative breeders systematically overestimate reproductive skew by including groups in which reproduction cannot be shared by definition (e.g. groups with a single female/male). Here, we review the extent of reproductive sharing in 41 mammal and 37 bird species previously classified as exhibiting alloparental care and extreme reproductive skew, while only considering multi-female or multi-male groups. We demonstrate that in groups where unequal reproduction sharing is possible, extreme reproductive skew occurs in a few species only (11/41 mammal species and 12/37 bird species). These results call for significant changes in datasets that classify species' caring and mating system. To facilitate these changes, we provide an updated dataset on reproductive sharing in 63 cooperatively breeding species. At the conceptual level, our findings suggest that reproductive skew should not be a defining criterion of cooperative breeding and support the definition of cooperative breeding as a care system in which alloparents provide systematic care to other group members' offspring.
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Affiliation(s)
- Yitzchak Ben Mocha
- Department of Evolutionary and Environmental Biology, University of Haifa, 3498838 Haifa, Israel
- Department of Biology and Environment, University of Haifa at Oranim, 36006 Tivon, Israel
- Department of Biology, University of Konstanz, Universitätsstrasse 10, 78457 Konstanz, Germany
- Center for the Advanced Study of Collective Behavior, University of Konstanz, Universitätsstrasse 10, 78457 Konstanz, Germany
| | - Tal Dahan
- Department of Biology and Environment, University of Haifa at Oranim, 36006 Tivon, Israel
| | - Yuqi Zou
- Department of Biology, University of Konstanz, Universitätsstrasse 10, 78457 Konstanz, Germany
| | - Michael Griesser
- Department of Biology, University of Konstanz, Universitätsstrasse 10, 78457 Konstanz, Germany
- Center for the Advanced Study of Collective Behavior, University of Konstanz, Universitätsstrasse 10, 78457 Konstanz, Germany
- Department of Collective Behaviour, Max Planck Institute of Animal Behaviour, Universitätsstrasse 10, 78457 Konstanz, Germany
| | - Shai Markman
- Department of Evolutionary and Environmental Biology, University of Haifa, 3498838 Haifa, Israel
- Department of Biology and Environment, University of Haifa at Oranim, 36006 Tivon, Israel
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Dario JGN, de Oliveira ER, de Souza RP, Theodorovicz S, Bernini GC, Ruiz G, de Carvalho RH, da Silva CA. Capsaicin and 1,25-Dihydroxyvitamin D 3 Glycoside: Effects on the Reproductive Performance of Hyper-Prolific Sows. Animals (Basel) 2023; 13:2794. [PMID: 37685058 PMCID: PMC10486751 DOI: 10.3390/ani13172794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/26/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
This study evaluated the effect of a natural source of vitamin D3 [1,25-(OH)2D3] and capsaicin (CAP) in the dietary supplementation of sows in the final phase (85-114 days) of gestation (Gest) and lactation (Lact) on the reproductive performance of the sows and health of piglets through two experiments (Exp I and II). In Exp I, 120 sows were subjected to four treatments: T1-control (without [1,25-(OH)2D3] and supplemental CAP); T2-3.5 µg 1,25-(OH)2D3/Gest/day and 7.0 µg Vit 1,25-(OH)2D3/Lact/day; T3-7.0 µg CAP/Gest/day and 14.0 µg CAP/Lact/day; T4-1.75 µg Vit 1,25-(OH)2D3 + 3.5 µg CAP/Gest/day and 3.5 µg 1,25-(OH)2D3 + 7.0 µg CAP/Lact/day. In Exp II, 200 sows were randomly blocked, factorial 2 × 2 (without or with Vit 1,25-(OH)2D3 and without or with CAP): T1-control (without Vit 1,25-(OH)2D3 and CAP); T2-3.5 µg Vit 1,25-(OH)2D3/Gest/day and 7.0 µg Vit 1,25-(OH)2D3/Lact/day; T3-7.0 µg CAP/Gest/day and 14.0 µg CAP/Lact/day; T4-3.5 µg Vit 1,25-(OH)2D3 + 7 µg CAP/Gest/day; and 7.0 µg Vit 1,25-(OH)2D3 + 14.0 µg CAP/Lact/day. The duration of delivery (3:48 vs. 4:57 h) and the percentage of stillbirths (5.37% vs. 7.61%) were improved (p < 0.05) in the group that received Vit 1,25-(OH)2D3 (Exp II) compared to the control group. Moreover, the dystocia rate decreased (p < 0.05) in Exp II, which received Vit 1,25-(OH)2D3 (4.21 vs. 27.63%), and in Exp I, which received the combination of Vit 1,25-(OH)2D3 + CAP (12 vs. 40%) compared to the respective control groups. Colostrum production was greater (p < 0.05) in sows that received Vit 1,25-(OH)2D3 supplementation compared to the control group, consequently resulting in higher colostrum intake (p < 0.05) of the piglets (330 vs. 258 g/piglet). The additives reduced the incidence of diarrhea (p < 0.05) in piglets (Exp I and II). Thus, the use of additives improved the reproductive performance of sows and contributed to litter growth.
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Affiliation(s)
- Julie Gabriela Nagi Dario
- Animal Science Program, Center of Agrarian Sciences, State University of Londrina, Londrina 86057-970, PR, Brazil; (J.G.N.D.); (S.T.); (G.C.B.); (G.R.); (R.H.d.C.)
| | - Eduardo Raele de Oliveira
- Project Coordinator and Assistant at NutriQuest TechnoFeed, São Paulo 13025-320, SP, Brazil; (E.R.d.O.); (R.P.d.S.)
| | - Rodrigo Pereira de Souza
- Project Coordinator and Assistant at NutriQuest TechnoFeed, São Paulo 13025-320, SP, Brazil; (E.R.d.O.); (R.P.d.S.)
| | - Sabrina Theodorovicz
- Animal Science Program, Center of Agrarian Sciences, State University of Londrina, Londrina 86057-970, PR, Brazil; (J.G.N.D.); (S.T.); (G.C.B.); (G.R.); (R.H.d.C.)
| | - Giovana Chimentão Bernini
- Animal Science Program, Center of Agrarian Sciences, State University of Londrina, Londrina 86057-970, PR, Brazil; (J.G.N.D.); (S.T.); (G.C.B.); (G.R.); (R.H.d.C.)
| | - Gabriela Ruiz
- Animal Science Program, Center of Agrarian Sciences, State University of Londrina, Londrina 86057-970, PR, Brazil; (J.G.N.D.); (S.T.); (G.C.B.); (G.R.); (R.H.d.C.)
| | - Rafael Humberto de Carvalho
- Animal Science Program, Center of Agrarian Sciences, State University of Londrina, Londrina 86057-970, PR, Brazil; (J.G.N.D.); (S.T.); (G.C.B.); (G.R.); (R.H.d.C.)
| | - Caio Abércio da Silva
- Animal Science Program, Center of Agrarian Sciences, State University of Londrina, Londrina 86057-970, PR, Brazil; (J.G.N.D.); (S.T.); (G.C.B.); (G.R.); (R.H.d.C.)
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Heys S, Main C, Humphreys A, Torrance R. Displaced risk. Keeping mothers and babies safe: a UK ambulance service lens. Br Paramed J 2023; 8:52-56. [PMID: 37674917 PMCID: PMC10477820 DOI: 10.29045/14784726.2023.9.8.2.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Abstract
Aim The aim of this professional practice paper is to provide a critical commentary on displaced risk among perinatal and neonatal patients attended to by the ambulance service. Background NHS services across the United Kingdom are currently facing unprecedented demand and increased scrutiny in their ability to provide safe and personalised care to patients. While current focus in the system centres around addressing social care demand, hospital bed capacity, planned care waiting times, staffing and ambulance handover delays, a less explored cohort of patients impacted by the current healthcare crisis is perinatal and neonatal populations attended to by the ambulance service. Little focus has been paid within national agendas to the care provided to women and babies outside of planned maternity and obstetric care. A case is presented to highlight the importance of considering urgent and emergency maternity care provision provided by the ambulance service, and the impact of 'displaced risk' due to the current pressures within healthcare systems. Conclusion Placed in a national context, drawing upon current independent reviews into maternity services, national transformation agendas and the most recent MBRRACE-UK confidential enquiry into maternal deaths and morbidity, a case is made to commissioners and Integrated Care Systems to focus on and invest in the unplanned pre-hospital care of maternity and neonatal patients. Recognition of the ambulance service as a key provider of care to this cohort of patients is paramount, calling on services and systems to work together on realising and addressing displaced risk for perinatal populations across the United Kingdom. A system approach that acknowledges the need for high-quality care at every point of contact and equitability in access to services for pregnant, postpartum and neonatal patients is vital.
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Affiliation(s)
- Stephanie Heys
- North West Ambulance Service NHS Trust; University of Central Lancashire https://orcid.org/0000-0002-4379-9022
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Cornthwaite K, Hewitt P, van der Scheer JW, Brown IAF, Burt J, Dufresne E, Dixon‐Woods M, Draycott T, Bahl R. Definition, management, and training in impacted fetal head at cesarean birth: a national survey of maternity professionals. Acta Obstet Gynecol Scand 2023; 102:1219-1226. [PMID: 37430482 PMCID: PMC10407013 DOI: 10.1111/aogs.14600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION This study assessed views, understanding and current practices of maternity professionals in relation to impacted fetal head at cesarean birth, with the aim of informing a standardized definition, clinical management approaches and training. MATERIAL AND METHODS We conducted a survey consultation including the range of maternity professionals who attend emergency cesarean births in the UK. Thiscovery, an online research and development platform, was used to ask closed-ended and free-text questions. Simple descriptive analysis was undertaken for closed-ended responses, and content analysis for categorization and counting of free-text responses. Main outcome measures included the count and percentage of participants selecting predefined options on clinical definition, multi-professional team approach, communication, clinical management and training. RESULTS In total, 419 professionals took part, including 144 midwives, 216 obstetricians and 59 other clinicians (eg anesthetists). We found high levels of agreement on the components of an impacted fetal head definition (79% of obstetricians) and the need for use of a multi-professional approach to management (95% of all participants). Over 70% of obstetricians deemed nine techniques acceptable for management of impacted fetal head, but some obstetricians also considered potentially unsafe practices appropriate. Access to professional training in management of impacted fetal head was highly variable, with over 80% of midwives reporting no training in vaginal disimpaction. CONCLUSIONS These findings demonstrate agreement on the components of a standardized definition for impacted fetal head, and a need and appetite for multi-professional training. These findings can inform a program of work to improve care, including use of structured management algorithms and simulation-based multi-professional training.
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Affiliation(s)
- Katie Cornthwaite
- Royal College of Obstetricians & GynaecologistsLondonUK
- Translational Health SciencesUniversity of BristolBristolUK
| | | | - Jan W. van der Scheer
- THIS Institute (The Healthcare Improvement Studies Institute), School of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Imogen A. F. Brown
- THIS Institute (The Healthcare Improvement Studies Institute), School of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Jenni Burt
- THIS Institute (The Healthcare Improvement Studies Institute), School of Clinical MedicineUniversity of CambridgeCambridgeUK
| | | | - Mary Dixon‐Woods
- THIS Institute (The Healthcare Improvement Studies Institute), School of Clinical MedicineUniversity of CambridgeCambridgeUK
| | - Tim Draycott
- Royal College of Obstetricians & GynaecologistsLondonUK
- North Bristol NHS TrustBristolUK
| | | | | | - Rachna Bahl
- Royal College of Obstetricians & GynaecologistsLondonUK
- University Hospitals Bristol and WestonBristolUK
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dos Santos GA, de Oliveira MDC, de Oliveira AMA, Batista VHT, Costa PO, Heck A, Silva CM, Rangel AHDN, de Macedo MF, Moreira RHR. Phytogenic Bioactive Compounds in the Diet of Lactating Sows, Litter Performance, and Milk Characteristics. Animals (Basel) 2023; 13:2764. [PMID: 37685028 PMCID: PMC10487034 DOI: 10.3390/ani13172764] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/12/2023] [Accepted: 07/26/2023] [Indexed: 09/10/2023] Open
Abstract
The objective was to evaluate the effect of phytogenic supplementation in the feed of lactating sows on the performance parameters of sows and suckling piglets. Ninety-three lactating sows of commercial lines (sows TN70) were distributed in a completely randomized design. The treatments adopted were a control diet without phytogenics (control) and a control diet with phytogenic supplementation in the feed. Performance parameters and the behaviors of sows and piglets were evaluated, in addition to milk composition and the biochemical parameters of the animals. The use of phytogenics did not affect the feed intake or tissue mobilization of the sows. However, it improved the production and quality of milk and reduced the possibility of light piglets at weaning by 22.16 percentage points. Regarding biochemical parameters, phytogenics improved animal recovery in the lactation period, as proven by an increase in the serum concentration of total protein and urea. Sows that received phytogenics exhibited increased behaviors of inactivity (3.16%), breastfeeding (1.15%), and water consumption (0.95%). In conclusion, using phytogenics in the feed of lactating sows improves the performance of the litters without affecting the body condition of the sows, with increased milk production and enhanced protein and lactose concentration.
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Affiliation(s)
- Gleyson Araújo dos Santos
- Department of Animal Science, Universidade Federal Rural do Semi-Árido, Mossoró 59625-900, RN, Brazil (P.O.C.)
| | - Maria do Carmo de Oliveira
- Department of Animal Science, Universidade Federal Rural do Semi-Árido, Mossoró 59625-900, RN, Brazil (P.O.C.)
| | | | | | - Priscila Oliveira Costa
- Department of Animal Science, Universidade Federal Rural do Semi-Árido, Mossoró 59625-900, RN, Brazil (P.O.C.)
| | - Augusto Heck
- Department of Veterinary College, Universidade Federal do Rio Grande do Sul, Porto Alegre 90040-060, RS, Brazil;
| | - Camilla Mendonça Silva
- Department of Animal Science, Universidade Federal Rural do Semi-Árido, Mossoró 59625-900, RN, Brazil (P.O.C.)
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Deeming DC. Nest construction in mammals: a review of the patterns of construction and functional roles. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220138. [PMID: 37427481 DOI: 10.1098/rstb.2022.0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
Nesting behaviour in mammals has been investigated in a wide variety of species but to date there has not been any scholarly review of the incidence and roles of these nests. Not all mammals build nests but, while some large species regularly build nests, nest-building behaviour is more commonly associated with small mammals weighing less than a kilogram. Quantitative data for the amounts of different materials used in a nest are rarely reported but mammal nests are typically constructed from fresh (rather than dead) plant materials. Animal-derived materials seem to be rare in nests, but anthropogenic materials are reported. Few studies have examined the roles these different materials play but more physically robust materials provide support for the structure. Many mammal nests have maternity roles, but a variety of other roles were recognized. A wide range of mammalian orders use nests for resting and environmental protection. Less common roles were as sites for torpor or hibernation, or as a refuge from predation, or the materials may have anti-parasite properties. These different roles were often not mutually exclusive. It is hoped that this review will stimulate interest in the functional properties of mammalian nests. It also suggests various themes that would be interesting areas for future research. This article is part of the theme issue 'The evolutionary ecology of nests: a cross-taxon approach'.
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Affiliation(s)
- D Charles Deeming
- School of Life and Environmental Sciences, University of Lincoln, Joseph Banks Laboratories, Lincoln LN6 7DL, UK
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Coulibaly A, Kouanda S. Effects of the Pregnancy and Newborn Diagnostic Assessment (PANDA) App on Antenatal Care Quality in Burkina Faso: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e37136. [PMID: 37556195 PMCID: PMC10448280 DOI: 10.2196/37136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/17/2023] [Accepted: 05/11/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND The Pregnancy and Newborn Diagnostic Assessment (PANDA) system is a digital clinical decision support tool that can facilitate diagnosis and decision-making by health care personnel in antenatal care (ANC). Studies conducted in Madagascar and Burkina Faso showed that PANDA is a feasible system acceptable to various stakeholders. OBJECTIVE This study primarily aims to evaluate the effects of the PANDA system on ANC quality at rural health facilities in Burkina Faso. The secondary objectives of this study are to test the effects of the PANDA system on women's satisfaction, women's knowledge on birth preparedness and complication readiness, maternal and child health service use, men's involvement in maternal health service utilization, and women's contraception use at 6 weeks postpartum. Further, we will identify the factors that hinder or promote such an app and contribute to cost-effectiveness analysis. METHODS This is a randomized controlled trial implementing the PANDA system in 2 groups of health facilities (intervention and comparison groups) randomized using a matched-pair method. We included pregnant women who were <20 weeks pregnant during their first antenatal consultation in health facilities, and we followed up with them until their sixth week postpartum. Thirteen health centers were included, and 423 and 272 women were enrolled in the intervention and comparison groups, respectively. The primary outcome is a binary variable derived from the quality score, coded 1 (yes) for women with at least 75% of the total score and 0 if not. Data were collected electronically using tablets by directly interviewing the women and by extracting data from ANC registers, delivery registers, ANC cards, and health care records. The study procedures were standardized across all sites. We will compare unadjusted and adjusted primary outcome results (ANC quality scores) between the 2 study arms. We added a qualitative evaluation of the implementation of the PANDA system to identify barriers and catalysts. We also included an economic evaluation to determine whether the PANDA strategy is more cost-effective than the usual ANC strategy. RESULTS The enrollment ran from July 2020 to January 2021 due to the COVID-19 pandemic. Data collection ended in September 2022. Data analyses started in January 2023, ended in June 2023, and the results are expected to be published in February 2024. CONCLUSIONS The PANDA system is one of the most comprehensive apps for ANC because it has many features. However, the use of computerized systems for ANC is limited. Therefore, our trial will be beneficial for evaluating the intrinsic capacity of the PANDA system to improve the quality of care. By including qualitative research and economic evaluation, our findings will be significant because electronic consultation registries are expected to be used for maternal health care in the future in Burkina Faso. TRIAL REGISTRATION Pan-African Clinical Trials Registry (PACTR) PACTR202009861550402; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=12374. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/37136.
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Affiliation(s)
- Abou Coulibaly
- Département Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Séni Kouanda
- Département Biomédical et Santé Publique, Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
- Institut Africain de Santé Publique, Ouagadougou, Burkina Faso
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Širvinskienė G, Grincevičienė Š, Pranskevičiūtė‐Amoson R, Kukulskienė M, Downe S. 'To be Informed and Involved': Women's insights on optimising childbirth care in Lithuania. Health Expect 2023; 26:1514-1523. [PMID: 37282753 PMCID: PMC10349258 DOI: 10.1111/hex.13754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/14/2022] [Accepted: 03/03/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION The user expectations and experiences of healthcare services are acknowledged as components of the quality of healthcare evaluations. The aim of the study is to analyse women's experiences and views on childbirth care in Lithuania. METHODS The study used the Babies Born Better (B3) online survey as the data collection instrument. The B3 is an ongoing longitudinal international project, examining the experiences of intrapartum care and developed as part of EU-funded COST Actions (IS0907 and IS1405). Responses to open-ended questions about (1) the best things about the care and (2) things in childbirth care worth changing are included in the current analysis. The participants are 373 women who had given birth within 5 years in Lithuania. A deductive coding framework established by the literature review was used to analyse the qualitative data. The framework involves three main categories: (1) the service, (2) the emotional experience and (3) the individually experienced care, each further divided into subcategories. RESULTS Reflecting the experience and views regarding the service at birthplace women wished empowerment, support for their autonomy and to be actively involved in decisions, the need for privacy, information and counselling, especially about breastfeeding. In terms of emotional experience, women highlighted the importance of comprehensibility/feeling of safety, positive manageability of various situations and possibilities for bonding with the newborn. Individually experienced care was described by feedback on specific characteristics of care providers, such as competence, personality traits, time/availability and encouragement of esteem in women in childbirth. The possibilities of homebirth were also discussed. The findings reflected salutogenic principles. KEY CONCLUSIONS The findings suggest that the Lithuanian healthcare system is in a transition from paternalistic attitude-based practices to a shift towards patient-oriented care. Implementation of the improvements suggested for women in childbirth care in Lithuania would require some additional services, improved emotional and intrapersonal aspects of care and a more active role for women. PATIENT/PUBLIC CONTRIBUTION Patients and the public contributed to this study by spreading information about surveys and research findings through their involvement in service user groups that have an interest in maternity care. Members of the patients' groups and the public were involved in the discussion of the results.
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Affiliation(s)
- Giedrė Širvinskienė
- Department of Health Psychology, Faculty of Public HealthLithuanian University of Health SciencesKaunasLithuania
- Health Research Institute, Faculty of Public HealthLithuanian University of Health SciencesKaunasLithuania
| | - Švitrigailė Grincevičienė
- Department of Biothermodynamics and Drug Design, Institute of Biotechnology, Life Science CentreVilnius UniversityVilniusLithuania
| | | | - Milda Kukulskienė
- Department of Health Psychology, Faculty of Public HealthLithuanian University of Health SciencesKaunasLithuania
| | - Soo Downe
- ReaCH Group, THRIVE CentreUniversity of Central LancasterPrestonUK
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Abstract
Little is known about how autistic people experience pregnancy. We interviewed 24 autistic and 21 non-autistic women during pregnancy to find out about their experiences. Autistic participants had more physical difficulties, such as nausea and pain, during pregnancy than non-autistic participants. They also sometimes felt that healthcare professionals, such as midwives, did not have a good understanding of autism and they did not always feel comfortable telling professionals about their autism diagnosis. Autistic participants told us that they needed professionals to communicate with them clearly and to make changes during appointments such as dimming lights. This research shows that autistic people would benefit from changes to pregnancy appointments and that more training about autism would help maternity care professionals to support autistic people during pregnancy.
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Dong V, Montgomery A, Adily P, Eastwood J. Antenatal depression risk under the NSW SAFE START Strategic Policy: Who is missing out on universal screening? J Paediatr Child Health 2023; 59:906-911. [PMID: 37096736 DOI: 10.1111/jpc.16415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/14/2023] [Accepted: 04/06/2023] [Indexed: 04/26/2023]
Abstract
AIM To examine antenatal depression risk screening coverage under the NSW SAFE START Strategic Policy and to explore maternal and sociodemographic factors associated with under-screening. METHODS Completion rates for the Edinburgh Depression Scale (EDS) were examined in a retrospective dataset of routinely collected antenatal care data including all women who birthed at public health facilities in Sydney Local Health District from 1 October 2019 to 6 August 2020. Potential sociodemographic/clinical factors associated with under-screening were identified using univariate and multivariate logistic regression. Free-text responses regarding reasons for EDS non-completion were examined using qualitative thematic analysis techniques. RESULTS A total of 4810 women (96.6%) in our sample (N = 4980) completed antenatal EDS screening; only 170 (3.4%) were not screened or lacked data to indicate that screening had occurred. Multivariate logistic regression analyses showed that women under certain models of antenatal care (public hospital care, private midwife/obstetrician or no formal care), non-English speaking women who required an interpreter, and women whose smoking status during pregnancy was unknown had a higher odds of missing screening. The reasons for EDS non-completion indicated in the electronic medical record revealed language and time/practical constraints to be the most commonly-reported barriers. CONCLUSIONS Antenatal EDS screening coverage was high in this sample. Refresher training for staff involved can emphasise the need to ensure appropriate screening for women who access shared care in external services (particularly private obstetric care). Additionally, at the service level, improved access to interpreter services and foreign language resources may help minimise EDS under-screening for culturally and linguistically diverse families.
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Affiliation(s)
- Vanessa Dong
- School of Clinical Medicine, Discipline of Psychiatry and Mental Health, UNSW & Black Dog Institute, Sydney, New South Wales, Australia
| | - Alicia Montgomery
- Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Sydney, New South Wales, Australia
- Department of Community Paediatrics, Sydney Local Health District, Sydney, New South Wales, Australia
| | - Pejman Adily
- Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Sydney, New South Wales, Australia
- Department of Community Paediatrics, Sydney Local Health District, Sydney, New South Wales, Australia
| | - John Eastwood
- Sydney Institute for Women, Children and Their Families, Sydney Local Health District, Sydney, New South Wales, Australia
- Department of Community Paediatrics, Sydney Local Health District, Sydney, New South Wales, Australia
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Kachimanga C, Divala TH, Ket JCF, Kulinkina AV, Zaniku HR, Murkherjee J, Palazuelos D, Abejirinde IOO, Akker TVD. Adoption of mHealth Technologies by Community Health Workers to Improve the Use of Maternal Health Services in Sub-Saharan Africa: Protocol for a Mixed Method Systematic Review. JMIR Res Protoc 2023; 12:e44066. [PMID: 37140981 DOI: 10.2196/44066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 02/27/2023] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Studies have shown that mobile health technologies (mHealth) enhance the use of maternal health services. However, there is limited evidence of the impact of mHealth use by community health workers (CHWs) on the use of maternal health services in sub-Saharan Africa. OBJECTIVE This mixed method systematic review will explore the impact of mHealth use by CHWs on the use of the maternal health continuum of care (antenatal care, intrapartum care, and postnatal care [PNC]), as well as barriers and facilitators of mHealth use by CHWs when supporting maternal health services. METHODS We will include studies that report the impact of mHealth by CHWs on the use of antenatal care, facility-based births, and PNC visits in sub-Saharan Africa. We will search 6 databases (MEDLINE, CINAHL, Web of Science, Embase, Scopus, and Africa Index Medicus), with additional articles identified from Google Scholar and manual screening of references of the included studies. The included studies will not be limited by language or year of publication. After study selection, 2 independent reviewers will perform title and abstract screening, followed by full-text screening to identify the final papers to be included. Data extraction and risk-of-bias assessment will be performed using Covidence software by 2 independent reviewers. We will use a Mixed Methods Appraisal Tool to perform risk-of-bias assessments on all included studies. Finally, we will perform a narrative synthesis of the outcomes, integrating information about the effect of mHealth on maternal health use and barriers and facilitators of mHealth use. This protocol follows the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. RESULTS In September 2022, we conducted an initial search in the eligible databases. After removing duplicates, we identified 1111 studies that were eligible for the title and abstract screening. We will finalize the full-text assessment for eligibility, data extraction, assessment of methodological quality, and narrative synthesis by June 2023. CONCLUSIONS This systematic review will present new and up-to-date evidence on the use of mHealth by CHWs along the pregnancy, childbirth, and PNC continuum of care. We anticipate the results will inform program implementation and policy by highlighting the potential impacts of mHealth and presenting contextual factors that should be addressed to ensure the success of the programs. TRIAL REGISTRATION PROSPERO CRD42022346364; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=346364. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44066.
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Affiliation(s)
- Chiyembekezo Kachimanga
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
- Clinical Department, Partners In Health Malawi, Neno, Malawi
| | - Titus H Divala
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Johannes C F Ket
- Athena Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Alexandra V Kulinkina
- Clinical Department, Partners In Health Malawi, Neno, Malawi
- Swiss Center for International Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Haules R Zaniku
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
- Neno District Hospital, Ministry of Health, Neno, Malawi
| | - Joia Murkherjee
- Community Health Department, Partners In Health, Boston, MA, United States
| | - Daniel Palazuelos
- Community Health Department, Partners In Health, Boston, MA, United States
| | - Ibukun-Oluwa Omolade Abejirinde
- Women's College Hospital Institute for Health System Solutions and Virtual Care, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Balfe J, Donnelly J, Tecklenborg S, Walsh A. Exploring the barriers and enablers experienced by people with Cystic Fibrosis and their healthcare professionals in accessing, utilising and delivering maternity and Cystic Fibrosis care during the pre-conception to post-partum period: A mixed methods systematic review protocol. HRB Open Res 2023; 5:22. [PMID: 37251363 PMCID: PMC10220422 DOI: 10.12688/hrbopenres.13500.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 05/31/2023] Open
Abstract
Background Cystic Fibrosis (CF) is an autosomal recessive inherited multi-system disease that primarily affects the lungs and digestive system. New drug therapies and treatments are improving the lives of many people with CF. With improved life expectancy and increased quality of life, many people with CF are now contemplating parenthood and becoming pregnant, an aspiration that decades ago was almost unheard of. Given this quickly evolving and more positive health landscape, it is vital to understand how people with CF experience the care they receive whilst accessing and utilising fertility and maternity services. It is also important to explore the experiences of healthcare professionals involved in providing care during this period. The overall aim of the mixed-methods systematic review will be to explore the barriers and enablers experienced by people with CF and the healthcare professionals involved in their care in the pre-conception to post-partum period. Methods The proposed review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for convergent integrated mixed methods systematic reviews. A systematic search of Medline (Ebsco), Cinahl, Embase, APA PsychINFO and Cochrane Library from inception to February 2022 will be conducted. Quantitative, qualitative and mixed methods studies pertaining to the experience of pre-conception to post-partum care for people with CF and their healthcare professionals will be included. Two independent reviewers will screen titles, abstracts and full texts with disagreements being resolved by a third reviewer. Conclusion This review will help to determine the potential barriers and facilitators experienced by people with Cystic Fibrosis and the health care professionals involved in their care during the pre-conception to post-partum period. The results will be of benefit specifically to the CF population and their healthcare providers when planning further studies in the area of fertility and pregnancy for this population and when delivering care.
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Affiliation(s)
- Jen Balfe
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Jennifer Donnelly
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Rotunda Hospital, Dublin, Ireland
- Mater Misericordiae University Hospital, Dublin, Ireland
- University College Dublin, Dublin, Ireland
| | | | - Aisling Walsh
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Lee AJ, Palanisamy A. Ethnic disparities in obstetric anaesthesia care in England: parallels and paradoxes with care in the USA. Anaesthesia 2023. [PMID: 37013372 DOI: 10.1111/anae.16019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 04/05/2023]
Affiliation(s)
- A J Lee
- Division of Obstetric Anesthesia, Department of Anesthesia, Columbia University, New York, NY, USA
| | - A Palanisamy
- Division of Obstetric Anesthesiology, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA
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Brundell K, Vasilevski V, Farrell T, Sweet L. Rural maternity and media discourse analysis: Framing new narratives. Aust J Rural Health 2023. [PMID: 36920483 DOI: 10.1111/ajr.12978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 01/03/2023] [Accepted: 02/28/2023] [Indexed: 03/16/2023] Open
Abstract
INTRODUCTION Continued rural maternity closure across Australia has seen impacts on women and families such as financial pressures, quality and safety concerns, and emotional pressure. This review aimed at understanding how media coverage of rural maternity and closure are presented and what impact this may have on maternity service sustainability. OBJECTIVE This research seeks to examine media discourse and characteristics of online newspaper articles related to rural maternity services. DESIGN A narrative review was conducted using thematic discourse analysis to examine online newspaper content published in Victoria, Australia from 2010 to June 2021. FINDINGS Local maternity services were a source of community interest for rural people. Coverage of negative outcomes for mothers and babies was highlighted by rural newspapers; however, increased content over the last 12-month period focused on community support for the sustainability of rural maternity services. Recent community support in newspaper articles coincided with maternity services reviews and retaining some of these rural services. DISCUSSION Community support in media may provide a protective social pressure, leading rural health services to consider this when reviewing the sustainability or closure of rural maternity services. CONCLUSION Media attention about sustaining local maternity services by highlighting issues and representing community voices may influence health executive to consider opportunities to remodel and sustain high-quality and safe maternity care in rural settings. Knowing how rural health executives consider media, community pressure, and how it impacts expediency of maternity service closure decisions is unknown and an important gap in knowledge to explore and understand.
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Affiliation(s)
- Kath Brundell
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia.,Institute of Health and Wellbeing, Federation University, Mount Helen, Victoria, Australia
| | - Vidanka Vasilevski
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia.,Centre for Quality and Patient Safety Research, Western Health Partnership, Melbourne, Victoria, Australia
| | - Tanya Farrell
- School of Nursing and Midwifery, Latrobe University, Bundoora, Victoria, Australia.,Safer Care Victoria, Department of Health, Victorian Government, Melbourne, Victoria, Australia
| | - Linda Sweet
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia.,Centre for Quality and Patient Safety Research, Western Health Partnership, Melbourne, Victoria, Australia
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Scendoni R, Fedeli P, Cingolani M. The State of Play on COVID-19 Vaccination in Pregnant and Breastfeeding Women: Recommendations, Legal Protection, Ethical Issues and Controversies in Italy. Healthcare (Basel) 2023; 11:healthcare11030328. [PMID: 36766904 PMCID: PMC9913898 DOI: 10.3390/healthcare11030328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/16/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
To date, extensive research has been conducted on vaccination against COVID-19 during pregnancy to verify the safety and efficacy of the vaccines, despite the fact that pregnant women were excluded from the initial clinical trials. The ever-increasing number of scientific publications has confirmed the absence of biological mechanisms associating mRNA vaccines with adverse effects in pregnancy and breastfeeding, although few studies have been carried out on their effect on fertility. While the Italian legal system provides for maternity protection measures and indemnity for vaccination damages pursuant to law no. 210/1992, it is not exempt from controversy. This contribution describes the state of play on COVID-19 vaccination in pregnant and lactating women, including: current recommendations for pregnant and lactating women; ethical issues related to vaccination hesitancy among pregnant women; the legislative paradox whereby sanctions may be imposed on women in certain professional categories who refuse vaccination because they are pregnant; and the possible legal consequences in the event of harm to the unborn child due to vaccination. All of this is considered in accordance with the principles of medical ethics, taking into account the national legislation.
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Affiliation(s)
- Roberto Scendoni
- Department of Law, Institute of Legal Medicine, University of Macerata, 62100 Macerata, Italy
| | | | - Mariano Cingolani
- Department of Law, Institute of Legal Medicine, University of Macerata, 62100 Macerata, Italy
- Correspondence:
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Cranfield K, Horner D, Vasco M, Victory G, Lucas DN. Current perspectives on maternity critical care. Anaesthesia 2023; 78:758-769. [PMID: 36633911 DOI: 10.1111/anae.15948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 01/13/2023]
Abstract
Maternal critical care is a developing area of clinical practice. Looking after a critically ill woman requires a multidisciplinary team that must endeavour to maintain the relative normality of pregnancy. Whilst consideration of the fetus should be taken when making clinical decisions regarding maternal care, unfounded concerns for the fetus can contribute to therapeutic inertia such that potentially life-saving therapies are denied to pregnant women. The management of a critically ill obstetric patient must reflect, as closely as possible, the management of critical illness outside pregnancy. We will discuss some of the current evidence and concepts around this emerging area in obstetrics, including enhanced maternity care, maternal medicine networks and clinical care.
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Affiliation(s)
- K Cranfield
- Department of Critical Care, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - D Horner
- Department of Anaesthesia and Critical Care, Bradford Teaching Hospitals Foundation Trust, Bradford, UK
| | - M Vasco
- Constitution Committee and WFSA, Medellin, Colombia.,Department of Anesthesia, Universidad CES, Medellin, Colombia
| | | | - D N Lucas
- Department of Anaesthesia, London North-West University Healthcare NHS Trust, London, UK
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Balcha WF, Eteffa T, Arega Tesfu A, Abeje Alemayehu B. Maternal Knowledge of Anemia and Adherence to its Prevention Strategies: A Health Facility-Based Cross-Sectional Study Design. Inquiry 2023; 60:469580231167731. [PMID: 37077150 PMCID: PMC10134107 DOI: 10.1177/00469580231167731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Anemia is a largely preventable and curable medical disease if detected intime. This study aimed to assess maternal knowledge of anemia and its prevention strategies in the public health facilities of Pawi district, Northwest, Ethiopia. A health facility-based cross-sectional study was conducted from February 1/2020 to March 2/2020, among 410 antenatal care attendees in the public health facilities of the Pawi district. The data was collected by systematic random sampling technique and analyzed using SPSS 25.0 version. Logistic regression analyses were done to estimate the crude and adjusted odds ratio with a CI of 95% and a P-value of less than .05 considered statistically significant. Less than half, 184 (44.9%) [95% CI = 40.0-49.8] and almost half, 216 (52.7%) [95% CI = 47.8-57.5] of the pregnant women had good knowledge of anemia and good adherence to its prevention strategies respectively. Women who are found in the age group of 15 to 19, 20 to 24, and 25 to 29 years, rural residency, secondary, and above educational level, vaginal bleeding, third trimester of pregnancy, and medium and high minimum dietary diversification score were significantly associated with knowledge of anemia. On the other hand: women who are found in the age group of 15 to 19 years, secondary above educational level, primigravida women, having ≤2 and 3 to 4 family sizes, second and third trimester of pregnancy, high minimum dietary diversification score, and good knowledge of anemia were significantly associated with adherence to anemia prevention strategies. Maternal knowledge of anemia and adherence to its prevention strategies were low. Nutritional counseling on the consumption of iron-rich foods and awareness creation on the effects of anemia in pregnant women must be strengthened to increase the knowledge of anemia and adherence to its prevention strategies.
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Affiliation(s)
- Wondu Feyisa Balcha
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Azimeraw Arega Tesfu
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Bezawit Abeje Alemayehu
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Sanga NE, Joho AA. Intrapartum violence during facility-based childbirth and its determinants: A cross-sectional study among postnatal women in Tanzania. Womens Health (Lond) 2023; 19:17455057231189544. [PMID: 37650373 PMCID: PMC10475265 DOI: 10.1177/17455057231189544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 07/04/2023] [Accepted: 07/04/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Violence during childbirth indirectly contributes to maternal and neonatal morbidity and mortality. It also causes intrapartum health consequences such as prolonged labor, postpartum hemorrhage, and postpartum psychological problems, including postpartum depression, post-traumatic stress disorder, and other negative feelings that lead to a decreased desire for facility delivery and increase the events of home deliveries which reduce the quality of life. In Tanzania, several efforts have been made to promote respectful maternity care. However, violence during childbirth continues to create a critical barrier for facility-based delivery and is in need of considerable attention throughout the health system. OBJECTIVES This study aimed to assess types of intrapartum violence and its determinants among postnatal women in the Dodoma Region, Tanzania. DESIGN A cross-sectional study using a questionnaire to interview postnatal women at the exit point after being discharged from the health facility to assess intrapartum violence and its determinants. METHODS This study was conducted in Dodoma Region involving 307 postnatal women from April to June 2022. A simple random method was used to select respondents. The Chi-square and Fisher's exact tests were used to assess the association between the categorical variables. The predictors of intrapartum violence were determined using binary logistic regression analysis. Statistical analysis was performed using Statistical Package for Social Science version 25.0. P < 0.05 was considered to be significant. RESULTS Overall, 307 postnatal women participated in the study. Among them, 158 (51.5%) postnatal women experienced at least one form of intrapartum violence. The most common forms of intrapartum violence included breach of confidentiality 205 (66.8%), undignified care/verbal abuse 178 (58%), physical abuse 139 (45.3%), and denial or neglected care by midwives 113 (36.8%). Husband employment, urban residence, and being referred from primary hospitals were significant determinants associated with intrapartum violence (adjusted odds ratio = 0.233, 95% confidence interval = 0.057-0.952, p = 0.043, adjusted odds ratio = 2.67, 95% confidence interval = 1.13-10.93, p = 0.026 and adjusted odds ratio = 3.673, 95% confidence interval = 1.131-11.934, p = 0.030, respectively). CONCLUSION Violence during childbirth was highly prevalent in this study. Understanding the prevalence and types of intrapartum violence is important in order to promote changes in all levels of the health system. This study reveals the need for key interventions to effect change at many levels; including an interventional study to educate women and birth partners on client rights, and strengthening the health system to meet the needs of women during labor and childbirth. Policies and systems that support respectful maternity care are urgently needed in this setting, including universal training of health professionals in respectful maternity care.
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Affiliation(s)
- Neema Egid Sanga
- Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania
| | - Angelina A Joho
- Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania
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40
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Garling KK. No Use Crying Over Spilled Milk. Acad Pediatr 2023; 23:1-2. [PMID: 35781066 DOI: 10.1016/j.acap.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 05/26/2022] [Accepted: 06/08/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Katherine K Garling
- Department of Pediatrics, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC.
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41
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French CD, Shafique MA, Bang H, Matias SL. Perinatal Hospital Practices Are Associated with Breastfeeding through 5 Months Postpartum among Women and Infants from Low-Income Households. J Nutr 2023; 153:322-330. [PMID: 36913468 PMCID: PMC10196577 DOI: 10.1016/j.tjnut.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/26/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Breastfeeding (BF) provides optimal nutrition during the first 6 mo of life and is associated with reduced infant mortality and several health benefits for children and mothers. However, not all infants in the United States are breastfed, and sociodemographic disparities exist in BF rates. Experiencing more BF-friendly maternity care practices at the hospital is associated with better BF outcomes, but limited research has examined this association among mothers enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a population at risk of low BF rates. OBJECTIVES We assessed the association between BF-related hospital practices (rooming-in, support from hospital staff, and provision of a pro-formula gift pack) and the odds of any or exclusive BF through 5 mo among infants and mothers enrolled in WIC. METHODS We analyzed data from the WIC Infant and Toddler Feeding Practices Study II, a nationally representative cohort of children and caregivers enrolled in WIC. Exposures included maternal experience of hospital practices reported at 1 mo postpartum, and BF outcomes were surveyed at 1, 3, and 5 mo. ORs and 95% CIs were obtained using survey-weighted logistic regression, adjusting for covariates. RESULTS Rooming-in and strong hospital staff support were associated with higher odds of any BF at 1, 3, and 5 mo postpartum. Provision of a pro-formula gift pack was negatively associated with any BF at all time points and with exclusive BF at 1 mo. Each additional BF-friendly hospital practice experienced was associated with 47% to 85% higher odds of any BF over the first 5 mo and 31% to 36% higher odds of exclusive BF over the first 3 mo. CONCLUSIONS Exposure to BF-friendly hospital practices was associated with BF beyond the hospital stay. Expanding BF-friendly policies at the hospital could increase BF rates in the United States WIC-served population.
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Affiliation(s)
- Caitlin D French
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | | | - Heejung Bang
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Susana L Matias
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA.
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42
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Kushniruk A, Musitia PM, Mwashigadi GM, Kinshella MLW, Vidler M, Temmerman M, Craik R, von Dadelszen P, Noble JA, Papageorghiou AT. Acceptability and Feasibility of a Low-Cost Device for Gestational Age Assessment in a Low-Resource Setting: Qualitative Study. JMIR Hum Factors 2022; 9:e34823. [PMID: 36574278 PMCID: PMC9832351 DOI: 10.2196/34823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 09/27/2022] [Accepted: 11/09/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Ultrasound for gestational age (GA) assessment is not routinely available in resource-constrained settings, particularly in rural and remote locations. The TraCer device combines a handheld wireless ultrasound probe and a tablet with artificial intelligence (AI)-enabled software that obtains GA from videos of the fetal head by automated measurements of the fetal transcerebellar diameter and head circumference. OBJECTIVE The aim of this study was to assess the perceptions of pregnant women, their families, and health care workers regarding the feasibility and acceptability of the TraCer device in an appropriate setting. METHODS A descriptive study using qualitative methods was conducted in two public health facilities in Kilifi county in coastal Kenya prior to introduction of the new technology. Study participants were shown a video role-play of the use of TraCer at a typical antenatal clinic visit. Data were collected through 6 focus group discussions (N=52) and 18 in-depth interviews. RESULTS Overall, TraCer was found to be highly acceptable to women, their families, and health care workers, and its implementation at health care facilities was considered to be feasible. Its introduction was predicted to reduce anxiety regarding fetal well-being, increase antenatal care attendance, increase confidence by women in their care providers, as well as save time and cost by reducing unnecessary referrals. TraCer was felt to increase the self-image of health care workers and reduce time spent providing antenatal care. Some participants expressed hesitancy toward the new technology, indicating the need to test its performance over time before full acceptance by some users. The preferred cadre of health care professionals to use the device were antenatal clinic nurses. Important implementation considerations included adequate staff training and the need to ensure sustainability and consistency of the service. Misconceptions were common, with a tendency to overestimate the diagnostic capability, and expectations that it would provide complete reassurance of fetal and maternal well-being and not primarily the GA. CONCLUSIONS This study shows a positive attitude toward TraCer and highlights the potential role of this innovation that uses AI-enabled automation to assess GA. Clarity of messaging about the tool and its role in pregnancy is essential to address misconceptions and prevent misuse. Further research on clinical validation and related usability and safety evaluations are recommended.
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Affiliation(s)
| | - Peris Muoga Musitia
- Centre of Excellence in Women & Child Health, Aga Khan University, Nairobi, Kenya.,Health Services Unit, Kenya Medical Research Institute Wellcome Trust Research Programme Nairobi, Nairobi, Kenya
| | | | - Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Marianne Vidler
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Marleen Temmerman
- Centre of Excellence in Women & Child Health, Aga Khan University, Nairobi, Kenya.,Department of Obstetrics and Gynaecology, Aga Khan University, Nairobi, Kenya
| | - Rachel Craik
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom.,Department of Women and Children's Health, King's College London, London, United Kingdom
| | - Peter von Dadelszen
- Department of Women and Children's Health, King's College London, London, United Kingdom
| | - J Alison Noble
- Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Aris T Papageorghiou
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, United Kingdom.,Oxford Maternal & Perinatal Health Institute, University of Oxford, Oxford, United Kingdom
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- See Authors' Contributions,
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Prokopowicz A, Stańczykiewicz B, Uchmanowicz I, Zimmer M. How to Improve the Care of Women after Childbirth in the Rooming-in Unit: A Prospective Observational Study. Int J Environ Res Public Health 2022; 19:16117. [PMID: 36498191 PMCID: PMC9736068 DOI: 10.3390/ijerph192316117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 11/26/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Rooming-in is the WHO-recommended care system for mothers in the puerperium and their babies. This system allows the newborn to stay with the mother in the same room, 24 h a day. We aimed to investigate the need to entrust a newborn (NEN) in the care of maternity rooming-in staff during the COVID-19 pandemic, and its relationship to pain, anxiety, and blood loss after delivery. A prospective study of 200 adult women in the maternity ward operating in the rooming-in system focussed on NEN in the care of maternity rooming-in staff on the first (T1) and the second day of puerperium (T2). Women who declared having NEN were compared with women without NEN for anxiety, pain, and a drop in haemoglobin in the blood after delivery. In T1, 34% and in T2, 27% of women felt NEN in the care of maternity rooming-in staff. The NEN of women after a cesarean section was higher on both days than the NEN of women after vaginal delivery. Women with NEN had higher levels of pain, state anxiety, and higher levels of postpartum anxiety than women without NEN. Further research should be warranted to investigate whether women who give birth in hospitals that satisfy the NEN in the care of maternity rooming-in staff in their rooming-in units experience less pain and anxiety in comparison to those who give birth in hospital units without such a possibility and whether this factor is an important element in reducing anxiety and pain during puerperium.
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Affiliation(s)
- Anna Prokopowicz
- Department of Nursing and Obstetrics, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | | | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Mariusz Zimmer
- 2nd Department of Gynaecology and Obstetrics, Wroclaw Medical University, 50-556 Wroclaw, Poland
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Drandić D, Drglin Z, Mihevc Ponikvar B, Bohinec A, Ćerimagić A, Radetić J, Ružičić J, Kurbanović M, Covi B, Valente EP, Mariani I, Lazzerini M, Drandić D, Kurbanović M, Virginie R, de La Rochebrochard E, Löfgren K, Miani C, Batram‐Zantvoort S, Wandschneider L, Lazzerini M, Valente EP, Covi B, Mariani I, Morano S, Chertok I, Hefer E, Artzi‐Medvedik R, Pumpure E, Rezeberga D, Jansone‐Šantare G, Jakovicka D, Knoka AR, Vilcāne KP, Liepinaitienė A, Kondrakova A, Mizgaitienė M, Juciūtė S, Arendt M, Tasch B, Nedberg IH, Kongslien S, Vik ES, Baranowska B, Tataj‐Puzyna U, Węgrzynowska M, Costa R, Barata C, Santos T, Rodrigues C, Dias H, Otelea MR, Radetić J, Ružičić J, Drglin Z, Ponikvar BM, Bohinec A, Brigidi S, Castañeda LM, Elden H, Sengpiel V, Linden K, Zaigham M, De Labrusse C, Abderhalden A, Pfund A, Thorn H, Grylka S, Gemperle M, Mueller A. Women's perspectives on the quality of hospital maternal and newborn care around the time of childbirth during the COVID-19 pandemic: Results from the IMAgiNE EURO study in Slovenia, Croatia, Serbia, and Bosnia-Herzegovina. Int J Gynaecol Obstet 2022; 159 Suppl 1:54-69. [PMID: 36530003 PMCID: PMC9877897 DOI: 10.1002/ijgo.14457] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the quality of maternal and newborn care (QMNC) in countries of the former Yugoslavia. METHOD Women giving birth in a facility in Slovenia, Croatia, Serbia, and Bosnia-Herzegovina between March 1, 2020 and July 1, 2021 answered an online questionnaire including 40 WHO standards-based quality measures. RESULTS A total of 4817 women were included in the analysis. Significant differences were observed across countries. Among those experiencing labor, 47.4%-62.3% of women perceived a reduction in QMNC due to the COVID-19 pandemic, 40.1%-69.7% experienced difficulties in accessing routine antenatal care, 60.3%-98.1% were not allowed a companion of choice, 17.4%-39.2% reported that health workers were not always using personal protective equipment, and 21.2%-53.8% rated the number of health workers as insufficient. Episiotomy was performed in 30.9%-62.8% of spontaneous vaginal births. Additionally, 22.6%-55.9% of women received inadequate breastfeeding support, 21.5%-62.8% reported not being treated with dignity, 11.0%-30.5% suffered abuse, and 0.7%-26.5% made informal payments. Multivariate analyses confirmed significant differences among countries, with Slovenia showing the highest QMNC index, followed by Croatia, Bosnia-Herzegovina, and Serbia. CONCLUSION Differences in QMNC among the countries of the former Yugoslavia during the COVID-19 pandemic were significant. Activities to promote high-quality, evidence-based, respectful care for all mothers and newborns are urgently needed. CLINICALTRIALS gov Identifier: NCT04847336.
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Affiliation(s)
| | - Zalka Drglin
- National Institute of Public HealthLjubljanaSlovenia
| | | | - Anja Bohinec
- National Institute of Public HealthLjubljanaSlovenia
| | | | | | | | | | - Benedetta Covi
- WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
| | - Emanuelle Pessa Valente
- WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
| | - Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
| | - Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
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Newman M. Research protocol for delivering on the front line: a qualitative exploration of paramedics' experiences of providing pre-hospital maternity care in the United Kingdom. Br Paramed J 2022; 7:44-50. [PMID: 36531803 PMCID: PMC9730195 DOI: 10.29045/14784726.2022.12.7.3.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
Background and aim Maternity patients form a small but significant portion of paramedical workload and this research aims to pragmatically explore East of England Ambulance Service paramedics' experiences of providing pre-hospital maternity care. Methods Through semi-structured individual interviews, participants' thoughts and feelings regarding obstetric confidence and competence will be explored. It will be investigated whether they think their training and equipment is adequate and what they would change about maternity patient management. Data will be thematically analysed and the findings used to improve paramedic training, with a view to improving their confidence and competence. In turn, this should improve patient experiences and outcomes.
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Shamsaei A, Kazemi A, Enteshary-Najafabadi H, Borujeni NK. Essential Criteria for Designing Healthy Maternity Wear: A Narrative Review. Iran J Nurs Midwifery Res 2022; 27:492-495. [PMID: 36712297 PMCID: PMC9881558 DOI: 10.4103/ijnmr.ijnmr_143_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 06/15/2022] [Accepted: 09/12/2022] [Indexed: 01/31/2023]
Abstract
Background During pregnancy, because of unique changes in the body, pregnant women need access to clothes that meet their biological needs and inspire a positive attitude toward the body. Accordingly, the aim of this study was to investigate the essential criteria for healthy designing maternity clothing. Materials and Methods The present study was conducted as a narrative review. Searches were performed in MEDLINE, ISI Web of Science, Scopus, PubMed, EMBASE, ERIC, and ProQuest databases for the documents written between 2000 and 2021 regardless of the research methodology and the employed tools. Results The results of this study were presented in three areas including women's expectations of maternity dress design, psycho-social effects of maternity wear, and maternal clothing designs. Conclusions The results of this study expand the knowledge of healthy maternity wear designers and, consequently, show that maternity clothing should hold three characteristics, adaptability, comfort, and stylishness, and meanwhile minimize the protrusion of enlarged areas of the body.
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Affiliation(s)
- Aida Shamsaei
- Department of Scene Design, School of Cinema and Theater, University of Tehran, Tehran, Iran
| | - Ashraf Kazemi
- Nursing and Midwifery Care Research Centre, Reproductive Health Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Ashraf Kazemi, Department of Reproductive Health, Nursing and Midwifery Care Research Centre, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
| | - Hajar Enteshary-Najafabadi
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Almorbaty H, Ebert L, Dowse E, Chan SW. An integrative review of supportive relationships between child-bearing women and midwives. Nurs Open 2022; 10:1327-1339. [PMID: 36349710 PMCID: PMC9912441 DOI: 10.1002/nop2.1447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 09/10/2022] [Accepted: 10/06/2022] [Indexed: 11/11/2022] Open
Abstract
AIMS To review and evaluate the literature on the factors related to developing supportive relationships between women and midwives, including facilitators and barriers. DESIGN An integrative review. METHOD The search used CINAHL, MEDLINE, Embase, EMcare, Maternity and Infant Care, PsycINFO, and Google Scholar from January 2009-June 2020. Two reviewers screened the eligible studies, and 2,399 records were identified. Quality was assessed with the mixed methods appraisal tool, and 14 articles were included. RESULTS The findings highlight that successful relationships require therapeutic communication, trust, respect, partnership, and shared decision-making. Supportive relationships improve women's satisfaction and birth outcomes, and continuity of care model is an enabling factor. Further research is required to understand supportive relationships in non-continuity of care models and when different cultural backgrounds exist.
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Affiliation(s)
- Hadeer Almorbaty
- School of Nursing and Midwifery, College of Health Medicine and Well‐BeingThe University of Newcastle, University DriveCallaghanNew South WalesAustralia,Nursing DepartmentPrince Sultan Military College of Health SciencesDhahranSaudi Arabia
| | - Lyn Ebert
- Faculty of HealthSouthern Cross UniversityCoffs HarbourNew South WalesAustralia
| | - Eileen Dowse
- School of Nursing and MidwiferyCollege of Health Medicine and Well‐Being, The University of Newcastle, University DriveCallaghanNew South WalesAustralia
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Braoudé I, Radjack R. [Psychosocial factors of vulnerability in teenage pregnancy]. Soins Psychiatr 2022; 43:22-24. [PMID: 36731978 DOI: 10.1016/j.spsy.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Teenage pregnancy remains a major public health problem worldwide. They present somatic, psychological, developmental and socioeconomic risks and consequences for adolescents and their unborn children. A review of the international scientific literature exploring the psychosocial factors of vulnerability at each stage of pregnancy shows that sustainable, multidisciplinary and culturally appropriate support is necessary.
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Affiliation(s)
- Ilan Braoudé
- Maison de Solenn, Maison des adolescents de l'hôpital Cochin, AP-HP, 97 boulevard de Port-Royal, 75014 Paris, France; Team DevPsy, Centre de recherche en épidémiologie et santé des populations, Université Paris-Saclay, UVSQ, Inserm, 16 avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex, France.
| | - Rahmeth Radjack
- Maison de Solenn, Maison des adolescents de l'hôpital Cochin, AP-HP, 97 boulevard de Port-Royal, 75014 Paris, France; Team DevPsy, Centre de recherche en épidémiologie et santé des populations, Université Paris-Saclay, UVSQ, Inserm, 16 avenue Paul-Vaillant-Couturier, 94807 Villejuif cedex, France
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Camara H, Bossuroy M. [From the cultural cradle to the empty cradle, accompanying perinatal mourning]. Soins Psychiatr 2022; 43:29-31. [PMID: 36731980 DOI: 10.1016/j.spsy.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In all societies, births and deaths are important moments that call upon the intimate and collective representations of each person. When death occurs during the perinatal period, bereaved couples may feel the need to refer to the cultural representations they have internalized, and thus re-affiliate themselves with a group to which they belong, likely to accompany them in making sense of what they have experienced. A clinical situation allows us to understand the psychological support of couples from elsewhere who are confronted with perinatal mourning.
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Affiliation(s)
- Hawa Camara
- Maison de Solenn, Hôpital Cochin, AP-HP, 75014 Paris, France; Service de gynécologie-obstétrique, Hôpital André-Grégoire, 93100 Montreuil, France; PCPP, Université Paris Cité, 71 avenue Edouard-Vaillant, 92100 Boulogne-Billancourt, France; CESP, Faculté de médecine - Université Paris Sud/Faculté de médecine - UVSQ, Inserm, Université Paris Saclay, 15-16 avenue Paul-Vaillant-Couturier 94805 Villejuif, France.
| | - Muriel Bossuroy
- Laboratoire UTRPP (EA4403), Hôpital Jean-Verdier, Pôle Mère-enfant, AP-HP, Université Paris Nord, avenue du 14-Juillet, 93140 Bondy, France
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Cautru F, Noto S. [Traumatic motherhood in Covid-19 times]. Soins Psychiatr 2022; 43:32-35. [PMID: 36731981 DOI: 10.1016/j.spsy.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In the context of maternal vital emergency due to Covid-19, dire situations of birth questioned the health practitioners of a neonatal intensive care unit. How can mothers take care of their baby when their own life has been threatened ? The analysis of two clinical cases underlines the importance of talking for these mothers who have been through disastrous experiences, which could lead to a post-traumatic stress disorder. Restoring a connection to outside reality thanks to psychological care in the acute post-trauma period helps these mothers take care of their child.
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Affiliation(s)
- Fabienne Cautru
- Service de médecine et réanimation néonatales de Port-Royal, Hôpitaux universitaires Paris Centre, AP-HP, 123 boulevard de Port-Royal, 75679 Paris, cedex 14, France.
| | - Simone Noto
- Service de médecine et réanimation néonatales de Port-Royal, Hôpitaux universitaires Paris Centre, AP-HP, 123 boulevard de Port-Royal, 75679 Paris, cedex 14, France
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