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BMC Pregnancy and Childbirth Sep 2022Continuity of midwifery-led care during labour and birth is considered optimal. To ensure its sustainability in practice where limited evidence is available, the aim of...
BACKGROUND & OBJECTIVE
Continuity of midwifery-led care during labour and birth is considered optimal. To ensure its sustainability in practice where limited evidence is available, the aim of the present study was to explore midwives' lived experiences of delivering continuous midwife-led intrapartum care.
METHODS
This study took a qualitative approach in meeting its aim. Participants were midwives working in the labour wards of private and public hospitals in Iran. The data were purposefully collected in 2019 through in-depth, semi-structured, and face-to-face interviews with midwives (n = 10) aged between 26 and 55 years. A thematic analysis based on descriptive phenomenology was undertaken to make sense of the data collected.
RESULTS
"Wanting to lead continuous woman-centered care but being unable to" was identified as an overarching theme. Three other themes "emphasis on the non-interventional care", "midwifery-specific focus" and "barriers and challenges of midwifery care" were also identified. Ultimately, midwives described knowing how to and wanting to lead continuous 'woman'-centered care but being unable to. Perceived barriers included lack of familiarity with and knowledge in relation to childbirth, the insignificant role of midwives in decision making, obstetrician utilitarianism, high workloads along with work-related stress argument-driven communication between midwives and obstetricians and an absence of a 'triangle of trust' in care.
CONCLUSION
Future research strategies could usefully include obstetricians and focus on the upscaling of midwifery in Iran using continuity of care models, highlight the value of midwives, identify why uptake of antenatal education in Iran is poor and develop user friendly, evidence based, midwife-led programs. Initiatives aiming to promote mutual professional respect, trust and collegiality and increased remuneration for midwifery work would be also welcomed in pursuit of reducing maternal and infant mortality in Iran.
Topics: Adult; Delivery, Obstetric; Female; Humans; Iran; Middle Aged; Midwifery; Nurse Midwives; Parturition; Pregnancy; Qualitative Research
PubMed: 36151533
DOI: 10.1186/s12884-022-05040-z -
Maternal & Child Nutrition Apr 2022Household gender roles influence infant and young child feeding behaviours and may contribute to suboptimal complementary feeding practices through inequitable...
Household gender roles influence infant and young child feeding behaviours and may contribute to suboptimal complementary feeding practices through inequitable household decision-making, intra-household food allocation and limited paternal support for resources and caregiving. In Igabi local government area of Kaduna State, Nigeria, the Alive & Thrive (A&T) initiative implemented an intervention to improve complementary feeding practices through father engagement. This study describes household gender roles among A&T participants and how they influence maternal and paternal involvement in complementary feeding. We conducted 16 focus group discussions with mothers and fathers of children aged 6-23 months in urban and rural administrative wards and analysed them using qualitative thematic analysis methods. Most mothers and fathers have traditional roles with fathers as 'providers' and 'supervisors' and mothers as 'caregivers'. Traditional normative roles of fathers limit their involvement in 'hands-on' activities, which support feeding and caring for children. Less traditional normative roles, whereby some mothers contributed to the provision of resources and some fathers contributed to caregiving, were also described by some participants and were more salient in the urban wards. In the rural wards, more fathers expressed resistance to fathers playing less traditional roles. Fathers who participated in caregiving tasks reported respect from their children, strong family relationships and had healthy home environments. Our research findings point to the need for more context-specific approaches that address prevalent gender normative roles in complementary feeding in a variety of settings.
Topics: Child; Fathers; Female; Gender Role; Humans; Infant; Infant Nutritional Physiological Phenomena; Male; Mothers; Nigeria
PubMed: 35080111
DOI: 10.1111/mcn.13325 -
European Journal of Sport Science Oct 2016The main aim of this study was to compare the bone mass of female football players with controls of different pubertal stages.
OBJECTIVES
The main aim of this study was to compare the bone mass of female football players with controls of different pubertal stages.
METHODS
Sixty five girls aged 8-14 years (10.14 ± 0.1, Tanner stages I-IV) participated in the study. Twenty participants were prepubertal (10 prepubertal control) and 45 peripubertal (15 peripubertal control). All footballers trained two days per week while the control group did not perform regular physical activity outside of school. Body composition was assessed by Dual-energy X-ray absorptiometry. Analysis of covariance was performed to evaluate differences in lean and bone masses.
RESULTS
Significant differences in lower-body extremities lean mass (LLM) between peripubertal groups were found (P < .05). Additionally, prepubertal footballers showed higher values of bone mineral content (BMC) at the femoral neck (P < .05) while peripubertal footballers exhibited enhanced BMC at the whole-body, trochanter and Wards triangle area. Bone mineral density (BMD) was higher in footballers compared to their non-active peers at the femoral neck and intertrochanter (P < .05, respectively) while in the peripubertal footballers higher BMD values were found in almost all of the studied body sites.
CONCLUSION
Female footballers showed higher bone and lean masses compared to control counterparts; these differences are already detectable at prepubertal ages and more consistent after pubertal spurt.
Topics: Adolescent; Athletes; Bone Density; Case-Control Studies; Child; Female; Humans; Soccer
PubMed: 26902531
DOI: 10.1080/17461391.2016.1144794 -
International Journal of Clinical... Apr 2016Medicines reconciliation-identifying and maintaining an accurate list of a patient's current medications-should be undertaken at all transitions of care and available to...
BACKGROUND
Medicines reconciliation-identifying and maintaining an accurate list of a patient's current medications-should be undertaken at all transitions of care and available to all patients.
OBJECTIVE
A self-completion web survey was conducted for chief pharmacists (or equivalent) to evaluate medicines reconciliation levels in secondary care mental health organisations.
SETTING
The survey was sent to secondary care mental health organisations in England, Scotland, Northern Ireland and Wales.
METHOD
The survey was launched via Bristol Online Surveys. Quantitative data was analysed using descriptive statistics and qualitative data was collected through respondents free-text answers to specific questions.
MAIN OUTCOMES MEASURE
Investigate how medicines reconciliation is delivered, incorporate a clear description of the role of pharmacy staff and identify areas of concern.
RESULTS
Forty-two (52 % response rate) surveys were completed. Thirty-seven (88.1 %) organisations have a formal policy for medicines reconciliation with defined steps. Results show that the pharmacy team (pharmacists and pharmacy technicians) are the main professionals involved in medicines reconciliation with a high rate of doctors also involved. Training procedures frequently include an induction by pharmacy for doctors whilst the pharmacy team are generally trained by another member of pharmacy. Mental health organisations estimate that nearly 80 % of medicines reconciliation is carried out within 24 h of admission. A full medicines reconciliation is not carried out on patient transfer between mental health wards; instead quicker and less exhaustive variations are implemented. 71.4 % of organisations estimate that pharmacy staff conduct daily medicine reconciliations for acute admission wards (Monday to Friday). However, only 38 % of organisations self-report to pharmacy reconciling patients' medication for other teams that admit from primary care.
CONCLUSION
Most mental health organisations appear to be complying with NICE guidance on medicines reconciliation for their acute admission wards. However, medicines reconciliation is conducted less frequently on other units that admit from primary care and rarely completed on transfer when it significantly differs to that on admission. Formal training and competency assessments on medicines reconciliation should be considered as current training varies and adherence to best practice is questionable.
Topics: Guidelines as Topic; Humans; Medication Reconciliation; Mental Health; Mental Health Services; Pharmacists; Secondary Care; Surveys and Questionnaires; United Kingdom
PubMed: 26739128
DOI: 10.1007/s11096-015-0236-7 -
PloS One 2019Uranium (U) measurements in water, soil, and food related to gold mining activities in populated areas in Gauteng Province, South Africa, suggest the possibility of...
Uranium (U) measurements in water, soil, and food related to gold mining activities in populated areas in Gauteng Province, South Africa, suggest the possibility of exposure levels that may lead to adverse health consequences, including cancer. Theoretical considerations on pathways of human uptake of significant exposures are plausible, but few data on directly measured human exposure are available. A cross-sectional study was conducted using human measurements to compare U levels with other settings around the globe (based on literature review), to explore potential exposure variability within the province, and to test the feasibility of recruiting subjects partially coming from vulnerable and difficult-to-reach populations. Wards of potentially high (HE) and low exposure (LE) were identified. Composite hair samples representing the respective local populations were collected from regular customers of selected barber shops over a period of 1-2 months. A total of 70 U concentrations were determined in 27 composite samples from 1332 individuals. U concentrations ranged from 31 μg/kg to 2524 μg/kg, with an arithmetic mean of 192 μg/kg (standard deviation, 310 μg/kg) and a median of 122 μg/kg. Although HE wards collectively showed higher U levels than LE wards (184 vs 134 μg/kg), differences were smaller than expected. In conclusion, detected U levels were higher than those from most other surveys of the general public. The barber-based approach was an efficient hair collection approach. Composite hair samples are not recommended, due to technical challenges in measuring U, and individual hair samples are needed in follow-up studies to determine predictors of exposure.
Topics: Cross-Sectional Studies; Environmental Monitoring; Feasibility Studies; Female; Gold; Hair; Humans; Male; Mining; South Africa; Uranium
PubMed: 31247044
DOI: 10.1371/journal.pone.0219059 -
Nutricion Hospitalaria 2013Cycling has been associated with decreased bone mass during adolescence. Calcium (Ca) and vitamin D (VitD) intake are associated to bone mass and may be important...
INTRODUCTION
Cycling has been associated with decreased bone mass during adolescence. Calcium (Ca) and vitamin D (VitD) intake are associated to bone mass and may be important confounders when studying bone mass.
AIM
To clarify the effect that Ca and VitD may have on bone mass in adolescent cyclists.
METHODS
Bone mineral content (BMC) and density (BMD) of 39 male adolescents (20 cyclists) were measured. Ca and VitD intake were also registered. Different ANCOVA analyses were performed in order to evaluate the influence of Ca and VitD on BMC and BMD.
RESULTS
Cyclists showed lower values of BMC and BMD than controls at several sites and when adjusting by Ca, Wards triangle BMD appeared also to be lower in cyclists than controls.
CONCLUSION
Nutritional aspects might partially explain differences regarding bone mass in adolescent cyclists and should be taken into account in bone mass analysis as important confounders.
Topics: Absorptiometry, Photon; Adolescent; Analysis of Variance; Bicycling; Bone Density; Bone and Bones; Calcium, Dietary; Humans; Male; Nutritional Status; Vitamin D; Vitamins
PubMed: 23889632
DOI: 10.3305/nh.2013.28.4.6490 -
Trials Jul 2023Despite the benefits of breastfeeding, early weaning is a reality, so less than 50% of children worldwide and in Brazil are on exclusive breastfeeding in the sixth month...
BACKGROUND
Despite the benefits of breastfeeding, early weaning is a reality, so less than 50% of children worldwide and in Brazil are on exclusive breastfeeding in the sixth month of life. A strategy to counteract this scenario is breastfeeding counseling. This study aims to verify the effectiveness of individualized counseling by nurses trained in breastfeeding counseling, on the duration of exclusive breastfeeding, compared to standard care.
METHODS
Multicenter, randomized, parallel, and open clinical trial, with primiparous women aged over 18 years, hospitalized in rooming-in wards at participating centers and hemodynamically stable, aware, and oriented, who had a single-fetus pregnancy and gave birth, regardless of the type of delivery, with live child, gestational age of 37 to 42 weeks and birth weight greater than 2500 g. The women will be initially approached in rooming-in wards and, upon consent to participate in the study, will be allocated through randomization by blocks composed of eight participants in two groups: intervention and control. The randomization lists will be organized by a central without involvement with the study, which will manage the allocation groups and be prepared in the Randon® program. Women allocated to the intervention group will receive breastfeeding counseling by trained nurses, and those in the control group will receive standard care at the center participating in the study.
DISCUSSION
The results can contribute to breastfeeding by evidencing possible exclusivity and duration of the counseling trained nurses provide.
TRIAL REGISTRATION
REBEC RBR-4w9v5rq (UTN: U1111-1284-3559) ( https://ensaiosclinicos.gov.br/rg/RBR-4w9v5rq ). Posted on March 20, 2023.
Topics: Pregnancy; Child; Humans; Female; Adult; Middle Aged; Infant; Breast Feeding; Hospitals; Parturition; Parity; Counseling; Randomized Controlled Trials as Topic; Multicenter Studies as Topic
PubMed: 37454111
DOI: 10.1186/s13063-023-07490-y -
BMC Research Notes Nov 2014Pediatric neck masses are one of the common surgical conditions presenting to the pediatric surgical wards and clinics in many centers worldwide. There is paucity of...
BACKGROUND
Pediatric neck masses are one of the common surgical conditions presenting to the pediatric surgical wards and clinics in many centers worldwide. There is paucity of published information regarding pediatric neck masses in Tanzania and the study area in particular. This study determines the etiology, clinico-histopathological patterns and treatment outcome of pediatric neck masses and to identify predictors of outcome in our local setting.
METHODS
This was a prospective cross-sectional hospital based study done in children aged ten years and below with neck masses for a five months period. Statistical data analysis was done using SPSS version 17.0.
RESULTS
A total of 148 patients were studied. Their ages ranged from 2 months to 10 years (median 3 years). The male to female ratio was 2.5:1. Inflammatory lesions were the most frequent cause of neck masses accounting for 43.9% of cases. The median duration of illness was 2 years. Except for the neck mass, 72 (48.6%) of the children had clinically stable health condition on presentation. The posterior triangle was commonly involved in 118 (79.7%) patients. eight (5.4%) were HIV positive. The majority of patients (95.9%) were treated surgically. Postoperative complication rate was 30.4% and surgical site infection was the most frequent complication in 37.5% of cases. The median length of hospital stay was 10 days and was significantly longer in patients with malignant masses and those with surgical site infection (p <0.001). The overall mortality rate in this study was 8.1% and it was significantly associated with malignant masses, associated pre-existing illness, late presentation, HIV positivity, low CD 4 count, high ASA class and presence of surgical site infections (p <0.001). The outcome of patients on discharge was excellent as more than 90% of patients were successfully treated and discharged well.
CONCLUSION
Pediatric neck masses are among the most common causes of paediatric surgical admissions and pose a diagnostic and therapeutic challenge in our setting. We advocate early surgical consultation and thorough and timely histopathological examination of neck masses in children.
Topics: Age Distribution; Child; Child, Preschool; Female; Hospitals, Teaching; Humans; Infant; Male; Neck; Postoperative Complications; Prospective Studies; Tanzania; Treatment Outcome; Universities
PubMed: 25362965
DOI: 10.1186/1756-0500-7-772 -
Perspectives on Sexual and Reproductive... Sep 2008Women's relationship context likely influences both their ability and their motivation to use contraceptives. No recent studies, however, have examined associations...
CONTEXT
Women's relationship context likely influences both their ability and their motivation to use contraceptives. No recent studies, however, have examined associations between women's relationship characteristics and use of different methods.
METHODS
Data were collected in a longitudinal study of 839 low-income women at risk of unintended pregnancy who visited public family planning and postpartum clinics and maternity wards in two Southeastern cities. Simulated probabilities calculated from multivariate analyses assessed associations between a wide range of relationship characteristics and the use of no method, condoms, withdrawal, female methods or dual methods.
RESULTS
Women who had had a child with their partner had an increased likelihood of contraceptive nonuse and use of withdrawal, and a decreased likelihood of using any female method. Respondents who were in a relationship for a relatively long time had an elevated likelihood of nonuse and use of female methods, but a lowered likelihood of condom use. Furthermore, married or cohabiting women were less likely than others to use dual methods. Respondents who had good communication with their partner had an elevated likelihood of using condoms. In addition, women who expected to receive a lot of emotional support from their partner if they became pregnant were more likely than others to report any condom use or dual method use, and less likely to report contraceptive nonuse.
CONCLUSIONS
When counseling family planning clients, providers should consider women in the context of their relationships. Future research exploring factors associated with contraceptive method use should examine variables related to the establishment, quality and expectations of their relationships.
Topics: Adolescent; Adult; Contraception Behavior; Female; Health Surveys; Humans; Interpersonal Relations; Motivation; Poverty; Southeastern United States; Young Adult
PubMed: 18803799
DOI: 10.1363/4017108 -
British Journal of Clinical Pharmacology Oct 19961. We have retrospectively analysed data collected by a local adverse drug reactions reporting scheme in an acute hospital medical setting and have determined the...
1. We have retrospectively analysed data collected by a local adverse drug reactions reporting scheme in an acute hospital medical setting and have determined the numbers and types of reactions that would have merited notification as yellow card reports according to the guidelines of the Committee on Safety of Medicines. 2. The data related to 20,695 consecutive acute general medical admissions on seven general medical wards (140 beds) and were collected over 3 years, from April 1990 to March 1993. 3. Over 3 years there were 1420 reports of suspected adverse drug reactions, a rate of 68.7 per 1000 admissions. 4. If the guidelines for reporting issued by the Committee on Safety of Medicines had been strictly followed, 477 yellow cards would have been sent (23.1 per 1000 admissions). In 357 of these reports (74.8%), the reaction had caused admission to hospital. Only 31 of the 477 potential cards (6.5%) involved black triangle drugs and 10 of these were for minor reactions. 5. Only 30 of the 477 potential yellow cards (6.3%) were known to have been sent. The majority of those reactions not reported were for drug-related admissions, most of which were for well-known reactions to established drugs. 6. We have confirmed and quantified the extent of under-reporting of serious suspected adverse drug reactions to the Committee on Safety of Medicines from our hospital medical unit.
Topics: Adverse Drug Reaction Reporting Systems; Guidelines as Topic; Hospitals; Humans; Retrospective Studies; United Kingdom
PubMed: 8904613
DOI: 10.1046/j.1365-2125.1996.04376.x