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Aryal, Binod. „Continuing the Legacy of Editorial of the First Issue of Journal of Karnali Academy of Health Sciences“. Journal of Karnali Academy of Health Sciences 1, Nr. 2 (06.10.2018): 4. http://dx.doi.org/10.3126/jkahs.v1i2.24126.
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Professor Dr MN Marhatta wrote in detail about the 'Milestones of Medical Education in Karnali Academy of Health Sciences' in the first issue of Journal of Karnali Academy of Health Sciences (JKAHS). By the time of this second issue of JKAHS, there has been substantial progress in achieving the goals set and plans put forward by the Academy.
Two bachelor programs, i.e., Bachelor in Midwifery Sciences (BMS) and Bachelor in Public Health (BPH) studies are going to start from Mangsir 2075. Certified Anesthesia Assistant (CAA) training course is running smoothly. The Academic Council has prepared and the panel of experts has endorsed the curriculum of Masters in Obstetrics and Gynecology (MD), Masters in Orthopedics and Trauma Surgery (MS), and Masters in Anesthesiology and Critical Care (MD). Masters in General Practice and Emergency Medicine (MDGP) curriculum was prepared in the presence of experts of the various subjects, endorsed by the Academic Council of the Academy and submitted to the Nepal Medical Council (NMC) for approval and accreditation. The NMC has already agreed to take the process forward and has decided to visit KAHS for feasibility study and inspection of its preparation.
KAHS is reasonably prepared to start its first Masters academic program. The Academic Council has appointed two professors in MDGP, one each in Obstetrics and Gynecology, Orthopedics, and General surgery, which is an essential and major asset for starting residency programs in the Academy. As per the criteria set by the NMC, the Academic Council has appointed the faculties in the Departments of Psychiatry and Dermatology, and the departments in Basic Medical Sciences including Anatomy, Physiology, Pharmacology, and Microbiology have been established. The class/ lecture rooms are well set up and the faculties of various department are excited and ready to welcome the first batch of MDGP residents in Jumla.
There has been huge progress in the field of research and publication as well. The Nepal Health research Council has agreed to permit establishing Institutional Review Committee (IRC) in the Academy, which, we believe, will encourage the faculties and the students to participate in various national as well as locallevel scientific studies and research. There was overwhelming response from the Academy faculties as well as the faculties from various other academic institutes during the call for papers for publication in this journal.
The future of Karnali Academy of Health Sciences is looking bright as this Academy was established to provide education and health services to the most marginalized people of the country. This Academy is located in a unique geography which has a huge possibility of becoming a unique institute in the field of medical education. And, this journal will continue to publish cutting-edge research and studies done in this Academy and elsewhere in the country.
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Trabold, Nicole, Marc Swogger, James McMahon, Catherine Cerulli und Ellen Poleshuck. „A Brief Motivational Intervention to Address Intimate Partner Violence Victimization: A Pilot Study“. Research on Social Work Practice 30, Nr. 6 (17.01.2020): 633–42. http://dx.doi.org/10.1177/1049731519900652.
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Purpose: Intimate partner violence (IPV) is public health crisis that often goes unrecognized. Victims often report ongoing long-term physical and mental health consequences; however, health-care responses to address IPV have not been maximized. The standard of care of screening and referring to community organizations is not enough to help victims. Method: This mixed-methods pilot study enhanced the screening and referral standard of care by offering a brief motivational intervention (BNI-V) to six patients in an obstetrics and gynecology clinic. Results: Preliminary results indicate improved engagement into care and improvements in quality of life, trauma symptoms, and self-efficacy. Participants expressed high satisfaction with the intervention and improved perception of self. Discussion: This study demonstrates a feasible way to build on the screening and referral practices typically found in the health-care system.
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Ong Tone, Stephan, Sagar Dugani, Harry Marshall, Mohammed Farid Shamji, Jean-Christophe Murray und Dominick Bossé. „Scientific Overview of the CSCI-CITAC 2009 Conference“. Clinical & Investigative Medicine 33, Nr. 1 (01.02.2010): 69. http://dx.doi.org/10.25011/cim.v33i1.11840.
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From September 21st-23rd 2009, the Clinical Investigator Trainee Association of Canada – Association des cliniciens-chercheurs en formation du Canada (CITAC-ACCFC) and the Canadian Society for Clinician Investigators (CSCI), held their annual conference in Ottawa. Participants included clinician investigators and trainees from across the country. The conference featured many excellent guest speakers including this year’s recipient of the Henry G. Friesen International Prize in Health Research, Sir John Bell. There were several forums focusing on professional development, with topics such as “sustaining the clinician investigator in Canada”, “succeeding as a clinician investigator”, and “collaborating internationally with MD+ trainees”, alongside networking opportunities to help establish relationships with potential mentors and collaborators. Further, the CSCI-CITAC annual conference featured some of the cutting edge research that MD+ trainees throughout Canada are engaged in. Trainees presented their research either at the Young Investigators Forum poster session or at the oral plenary. This scientific overview aims to highlight some of the research presented by trainees at the annual conference. The broad themes of scientific interest included topics from both basic science and clinical research. In this article, we summarize some of the major research questions that are being investigated by clinician-investigator trainees in the following areas: neurological sciences, cell biology, medicine, immunology, obstetrics, gynecology, neonatology, orthopedics, rheumatology, and public health.
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Chan, Stephanie J., Veronica I. Nutting, Talia A. Natterson und Barbara N. Horowitz. „Impacts of Psychopharmaceuticals on the Neurodevelopment of Aquatic Wildlife: A Call for Increased Knowledge Exchange across Disciplines to Highlight Implications for Human Health“. International Journal of Environmental Research and Public Health 18, Nr. 10 (12.05.2021): 5094. http://dx.doi.org/10.3390/ijerph18105094.
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The global use of psychopharmaceuticals such as antidepressants has been steadily increasing. However, the environmental consequences of increased use are rarely considered by medical professionals. Worldwide monitoring efforts have shown that pharmaceuticals are amongst the multitude of anthropogenic pollutants found in our waterways, where excretion via urine and feces is thought to be the primary mode of pharmaceutical contamination. Despite the lack of clarity surrounding the effects of the unintentional exposure to these chemicals, most notably in babies and in developing fetuses, the US Environmental Protection Agency does not currently regulate any psychopharmaceuticals in drinking water. As the underlying reasons for the increased incidence of mental illness—particularly in young children and adolescents—are poorly understood, the potential effects of unintentional exposure warrant more attention. Thus, although links between environmental contamination and physiological and behavioral changes in wildlife species—most notably in fish—have been used by ecologists and wildlife biologists to drive conservation policy and management practices, we hypothesize that this knowledge may be underutilized by medical professionals. In order to test this hypothesis, we created a hierarchically-organized citation network built around a highly-cited “parent” article to explore connections between aquatic toxicology and medical fields related to neurodevelopment. As suspected, we observed that studies in medical fields such as developmental neuroscience, obstetrics and gynecology, pediatrics, and psychiatry cite very few to no papers in the aquatic sciences. Our results underscore the need for increased transdisciplinary communication and information exchange between the aquatic sciences and medical fields.
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Hamamoto Filho, Pedro Tadao, Pedro Luiz Toledo de Arruda Lourenção, Joélcio Francisco Abbade, Dario Cecílio-Fernandes, Jacqueline Teixeira Caramori und Angélica Maria Bicudo. „Exploring pooled analysis of pretested items to monitor the performance of medical students exposed to different curriculum designs“. PLOS ONE 16, Nr. 9 (10.09.2021): e0257293. http://dx.doi.org/10.1371/journal.pone.0257293.
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Several methods have been proposed for analyzing differences between test scores, such as using mean scores, cumulative deviation, and mixed-effect models. Here, we explore the pooled analysis of retested Progress Test items to monitor the performance of first-year medical students who were exposed to a new curriculum design. This was a cross-sectional study of students in their first year of a medical program who participated in the annual interinstitutional Progress Tests from 2013 to 2019. We analyzed the performance of first-year students in the 2019 test and compared it with that of first-year students taking the test from 2013 to 2018 and encountering the same items. For each item, we calculated odds ratios with 95% confidence intervals; we also performed meta-analyses with fixed effects for each content area in the pooled analysis and presented the odds ratio (OR) with a 95% confidence interval (CI). In all, we used 63 items, which were divided into basic sciences, internal medicine, pediatrics, surgery, obstetrics and gynecology, and public health. Significant differences were found between groups in basic sciences (OR = 1.172 [CI95% 1.005 CI 1.366], p = 0.043) and public health (OR = 1.54 [CI95% CI 1.25–1.897], p < 0.001), which may reflect the characteristics of the new curriculum. Thus, pooled analysis of pretested items may provide indicators of different performance. This method may complement analysis of score differences on benchmark assessments.
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Balcha, Wondu Feyisa, Azezu Asres Nigussie, Fentahun Yenealem Beyene und Azimeraw Arega Tesfu. „Awareness and Its Associated Factors of Obstetrics Fistula among Antenatal Care Attendees in Injibara Town Health Institutions, Awi Zone, North West, Ethiopia, 2019“. Journal of Pregnancy 2020 (01.07.2020): 1–7. http://dx.doi.org/10.1155/2020/7306108.
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Background. Obstetric fistula is abnormal passageway between the vagina and bladder or rectum, and it has the most devastating effects on physical, social, and economic levels and represents a major public health issue of thousands of women, which failed to provide accessible and appropriate intrapartum care for women within a developing country, particularly in Ethiopia. Therefore, we tried to assess the awareness and its associated factors of obstetrics fistula among pregnant mothers attending antenatal care clinics. Methods. A health institutional-based cross-sectional study was employed from March 4 to 29/2019 among 413 pregnant women. Data was collected by a systematic random sampling technique and entered into a computer using Epi data 3.5, edited and analyzed using Statistical Package of Social Sciences 23.0 version. Bivariate and multivariate logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and p value of less than 0.05 considered statically significant. Result. This study identified that 39.5% with 95% confidence interval (34.6-44.6%) of pregnant women had good awareness about obstetrics fistula. Multivariate logistic regression analysis showed that living in urban [AOR=1.98, 95% CI=1.07−3.69], attending formal education [AOR=2.11, 95% CI=1.06−4.12], having history antenatal care [AOR=3.87, 95% CI=1.60−9.68], and childbirth at health institution [AOR=7.10, 95% CI=2.52−2.02] were significantly associated with awareness of obstetrics fistula. Conclusion and recommendation. This study showed that awareness of obstetrics fistula was low. Residency, education, and occupation of the women, having history of antenatal care and childbirth at health institution was significantly associated with awareness of obstetrics fistula. Still, there is a gap on awareness of obstetrics fistula; therefore, it is good to emphasize on providing information on maternal health care issues, particularly about obstetrics fistula.
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Sobkowski, Maciej, und Tomasz Opala. „Practical aspects of change management at the Obstetrics and Gynecology Clinic at the University Hospital of Medical Sciences in Poznań, Poland“. Annals of Agricultural and Environmental Medicine 21, Nr. 2 (10.06.2014): 314–19. http://dx.doi.org/10.5604/1232-1966.1108596.
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Joshi, Sulbha, und Varsha Kose. „Pregnancy Outcome in Viral Hepatitis“. Journal of South Asian Federation of Obstetrics and Gynaecology 5, Nr. 2 (2013): 60–63. http://dx.doi.org/10.5005/jp-journals-10006-1225.
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ABSTRACT Introduction Hepatitis in pregnancy is an important medical disorder seen more often in developing countries than in developed ones. Viral hepatitis is a major public health problem in India. Hepatitis in pregnancy is commonly associated with abortion, premature delivery, postpartum hemorrhage, coagulation defect, obstetric shock, coma, death and increased perinatal mortality and morbidity. This study was carried out to know the effect of viral hepatitis on pregnancy and to study its maternal and fetal outcome. Materials and methods This prospective clinical study was conducted in the Department of Obstetrics and Gynecology NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Nagpur, from January 2010 to December 2012. All the antenatal cases attended Obstetrics and Gynecology Department were investigated for HBsAg and looked for any symptoms and signs suggesting hepatitis like fever, jaundice, nausea, vomiting. If present, they were admitted and further investigated to detect viral hepatitis. Patients were counseled for follow-up and strict hospital delivery. Patients with viral hepatitis were analyzed for the effect on pregnancy, maternal and fetal outcome. Results There were total 30 cases of viral hepatitis 24 (80%) cases were HBsAg positive, but all were asymptomatic 6 (20%) cases were hepatitis E positive. No HAV, HCV, HDV and hepatitis G infected cases were detected in our study. Maternal and fetal morbidity was significantly higher in hepatitis E infected women. Fetal mortality was observed in one case. Conclusion Pregnancy with viral hepatitis requires early diagnosis, hospitalization and treatment. In the present study hepatitis E was found to be the chief etiological agent associated with increased maternal morbidity, and high fetal morbidity and mortality. How to cite this article Kose V, Joshi S. Pregnancy Outcome in Viral Hepatitis. J South Asian Feder Obst Gynae 2013;5(2): 60-63.
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Haile, Yosef, Fikru Tafese, Tesfaye Dagne Weldemarium und Mulugeta Hailu Rad. „Partograph Utilization and Associated Factors among Obstetric Care Providers at Public Health Facilities in Hadiya Zone, Southern Ethiopia“. Journal of Pregnancy 2020 (30.04.2020): 1–8. http://dx.doi.org/10.1155/2020/3943498.
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Background. A partograph is a graphic representation of labor which is used by health professionals for monitoring labor progress and fetal and maternal wellbeing. However, its utilization and associated factors have not been studied yet in Hadiya Zone, Southern Ethiopia. Hence, the aim of this study was to determine partograph utilization and associated factors among obstetric care providers at public health facilities in Hadiya Zone, Southern Ethiopia. Methods. A facility-based cross-sectional study was conducted on 436 health professionals. The study was conducted from March 04 to April 07, 2019. A simple random sampling method was carried out to select 19 health facilities and study participants from selected facilities. Data was collected using a pretested structured questionnaire, entered into EPI-data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics and binary and multivariable logistic regression analyses were done. P values less than 0.05 were used to declare significant association between dependent and independent variables. Results. The overall magnitude of partograph utilization was found to be 54.4%, and finding from data abstraction from a document revealed that out of 18 parameters, only 10 parameters were recorded completely. Type of health facility (hospital as compared to HC) (AOR=2.96; CI=1.71, 5.12), received on-the-job training on partograph (AOR=7.06; CI=4.3, 11.37), knowledgeable about partograph (AOR=2.12; CI=1.3, 3.9), and favorable attitude toward partograph use (AOR=1.8; CI=1.12−2.97) were significantly associated with partograph use. Conclusion. Overall partograph utilization was low, and incomplete recording of required parameters on partograph was observed in this study. Participants who received on-the-job training on partograph, who are working in a hospital, who are knowledgeable about partograph, and who have favorable attitude toward partograph use were factors affecting partograph use positively.
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Oliveira, Lorraine Ariel Duarte, Carolina Alves Araújo Rocha und Ledismar José Silva. „Chronic Postoperative Pain: Comprehending It to Intervene“. Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 39, Nr. 03 (07.02.2020): 170–80. http://dx.doi.org/10.1055/s-0039-3402489.
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AbstractIt is estimated that between 266.2 and 359.5 million operations were performed in 2012 worldwide, and this number is on the rise. Chronic postoperative pain (CPOP) is the most important and still neglected postoperative complication, with a multifactorial causality, leading to a major impact on morbidity rates, high costs for the public health system, and direct and negative effects on the quality of life of the patients. The present systematic literature review aimed to elucidate the processes of postoperative pain chronification, biopsychosocial factors, risk factors, management of pain, and types of surgical procedures mainly associated with it. The review was based on the methodological recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The following databases were consulted: the Medical Literature, Analysis, and Retrieval System Online (MEDLINE), the Latin American and Caribbean Health Sciences Literature (LILACS), the Scientific Electronic Library Online (SciELO), and the Cochrane Central Register of Controlled Trials (CENTRAL). After reading the selected articles, the following surgical specialties were chosen to be addressed: general, orthopedics, breast cancer, gynecology, obstetrics, and thoracic. In conclusion, a deficient management of acute postoperative pain is the main risk factor for the development of CPOP. To prevent CPOP, training programs for healthcare professionals should be implemented to improve their skills and knowledge of the management of pain before, during, and after surgeries. It is also necessary to conduct more in-depth studies on the evaluation and management of this condition.
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Hafeez, S., Z. Hafeez, Sana Hafeez, S. Riaz, R. R. Khan und A. Yousaf. „Maternofetal Outcomes of Acute Hepatitis E in Pregnancy; A Cross Sectional Study“. Pakistan Journal of Medical and Health Sciences 15, Nr. 5 (30.05.2021): 1341–43. http://dx.doi.org/10.53350/pjmhs211551341.
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Objective: To identify the maternofetal outcomes of Acute Hepatitis E in Pregnancy Methods: A cross-sectional study was conducted at the Obstetrics and Gynecology Department of Services Institute of Medical Sciences, Lahore. It included 41 women with gestational age >32 weeks, singleton pregnancy, presenting with Hepatitis E infection. Their demographic and pregnancy-related characteristics were included. Maternal and fetal outcomes were assessed. Data was entered and analyzed using SPSS v.25. Results: Mean age of the participatns was 27.12 ± 3.85 years; the mean gestational age was 31.00 ± 6.15 weeks. Thirty one patients (75.6%) were admitted through the emergency. Twenty four (58.5%) needed packed cell transfusion and 32 (78%) needed fresh frozen plasma transfusion. Eleven patients (26.8%) developed hepatic encephalopathy and all of them required intensive care admission. The maternal mortality rate was 4 (9.8%). Thirty eight (92.1%) pregnancies were viable at the time of arrival. The fetal mortality rate was 7 (17.1%). Conclusion: HEV infections significantly contribute to materno-fetal morbidity and mortality. Screening for and monitoring HEV infection earlier during the pregnancy should be of primary public health importance. Improving awareness in women of childbearing age regarding HEV transmission and its adverse fetal effects should be prioritized. Key words: Hepatitis E virus, Maternofetal Outcomes, pregnancy, Childbearing age
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Hemann, Brian A., Steven J. Durning, William F. Kelly, Ting Dong, Louis N. Pangaro und Paul A. Hemmer. „The Association of Students Requiring Remediation in the Internal Medicine Clerkship With Poor Performance During Internship“. Military Medicine 180, suppl_4 (01.04.2015): 47–53. http://dx.doi.org/10.7205/milmed-d-14-00567.
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ABSTRACT Purpose: To determine whether the Uniformed Services University (USU) system of workplace performance assessment for students in the internal medicine clerkship at the USU continues to be a sensitive predictor of subsequent poor performance during internship, when compared with assessments in other USU third year clerkships. Method: Utilizing Program Director survey results from 2007 through 2011 and U.S. Medical Licensing Examination (USMLE) Step 3 examination results as the outcomes of interest, we compared performance during internship for students who had less than passing performance in the internal medicine clerkship and required remediation, against students whose performance in the internal medicine clerkship was successful. We further analyzed internship ratings for students who received less than passing grades during the same time period on other third year clerkships such as general surgery, pediatrics, obstetrics and gynecology, family medicine, and psychiatry to evaluate whether poor performance on other individual clerkships were associated with future poor performance at the internship level. Results for this recent cohort of graduates were compared with previously published findings. Results: The overall survey response rate for this 5 year cohort was 81% (689/853). Students who received a less than passing grade in the internal medicine clerkship and required further remediation were 4.5 times more likely to be given poor ratings in the domain of medical expertise and 18.7 times more likely to demonstrate poor professionalism during internship. Further, students requiring internal medicine remediation were 8.5 times more likely to fail USMLE Step 3. No other individual clerkship showed any statistically significant associations with performance at the intern level. On the other hand, 40% of students who successfully remediated and did graduate were not identified during internship as having poor performance. Conclusions: Unsuccessful clinical performance which requires remediation in the third year internal medicine clerkship at Uniformed Services University of the Health Sciences continues to be strongly associated with poor performance at the internship level. No significant associations existed between any of the other clerkships and poor performance during internship and Step 3 failure. The strength of this association with the internal medicine clerkship is most likely because of an increased level of sensitivity in detecting poor performance.
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Yetwale, Aynalem, und Eneyew Melkamu. „Fear of Childbirth and Associated Factors Among Pregnant Mothers Who Attend Antenatal Care Service at Jinka Public Health Facilities, Jinka Town, Southern Ethiopia“. International Journal of Childbirth 11, Nr. 3 (01.06.2021): 101–11. http://dx.doi.org/10.1891/ijcbirth-d-20-00029.
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BACKGROUNDWomen face many challenges from conception to postpartum, and fear of childbirth is one of the challenges the women encounter during pregnancy. This could have resulted from different perspectives and it could in turn lead to various pregnancy and childbirth problems. Thus, understanding childbirth fear and factors associated with this is of paramount importance and this study was aimed at addressing this issue.METHODOLOGYA facility-based cross-sectional study was done on 423 pregnant mothers who came for antenatal care services at Jinka hospital and Jinka health center. The study was conducted from June 1to 30, 2018. The sample size was calculated using the single population proportion formula and samples were taken after proportional allocation was done for the hospital and health center using the proportion allocation formula. Individual participants were selected with a systematic sampling technique using k-value of 2 for both the hospital and health center and the first participant was selected by the lottery method from the first two samples. Data were entered into epi-data version 3.1.1. and exported into statistical packages for social sciences version 21.0 for cleaning and further analysis. The level of significance was declared at a p value of less than 0.05 in multivariable logistic regression model. Narratives, figures, and tables were used to put the result.RESULTFrom 423 samples, two of the questionnaires were incomplete and thus 421 were used for analysis giving a response rate of 99.5%. Around a quarter of 102 (24.2%) mothers had fear of childbirth and the remaining 319 (75.8%) had no fear of childbirth. From the factors under consideration, history of previous pregnancy complications, previous history of labor and delivery complications, educational status, and depression status were significantly associated with a mother's fear of childbirth.CONCLUSIONEven though it is physiological to have some fear of childbirth, the figure obtained is relatively higher. Factors found to have a significant effect on childbirth fear are those which could be tackled through improved health literacy and integrated maternal health services.
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Horan, Holly, Melissa Cheyney, Yvette Piovanetti und Vanessa Caldari. „La Crisis de la Atención de Maternidad: Experts’ Perspectives on the Syndemic of Poor Perinatal Health Outcomes in Puerto Rico“. Human Organization 80, Nr. 1 (01.03.2021): 2–16. http://dx.doi.org/10.17730/1938-3525-80.1.2.
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The purpose of this study was to center the voices of maternal and infant health care (MIH) clinicians and public health experts to better understand factors associated with persistently high rates of poor perinatal health outcomes in Puerto Rico. Currently, Puerto Rican physicians, midwives, and other care providers’ perspectives are absent from the literature. Guided by a syndemics framework, data were collected during eighteen months of ethnographic fieldwork and through open-ended, semi-structured interviews (n=20). Three core themes emerged. The first two themes: (1) Los estresores diarios: poor nutrition, contaminated water, and psychosocial stress; and (2) Medicina defensiva: solo obstetrics and fear-based medicine, describe contributing factors to Puerto Rico’s high preterm and cesarean birth rates. The third theme: (3) Medicina integrada: midwives, doulas, and comprehensive re-education explores potential solutions to the island’s maternity care crisis that include improved integration of perinatal care services and educational initiatives for both patients and providers. Collectively, participants’ narratives expose a syndemic of poor perinatal health outcomes that emerges from the structural vulnerability generated by decades of colonial domination embedded in the daily lives of island residents and in the Puerto Rican maternity care system.
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Tandon, Neha Pruthi, Sumitra Bachani, Shreya Kaura, Rupali Dewan und Renu Arora. „The unmet needs of PCPNDT act in the women of the general population in North India“. International Journal Of Community Medicine And Public Health 7, Nr. 12 (25.11.2020): 5044. http://dx.doi.org/10.18203/2394-6040.ijcmph20205182.
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Background: Government of India has taken measures to stabilize the sex ratio by introducing Pre-Conception and Pre-natal diagnostic techniques act (PCPNDT). Despite various amendments, awareness about the act amongst women appears suboptimal. Present study was aimed to assess the knowledge and attitude regarding PCPNDT act in women attending tertiary care hospital and to determine the lacunae regarding its implementation.Methods: Cross-sectional study was conducted by Department of Obstetrics and Gynecology. Total of 1000 women were included and a pre-designed questionnaire was used to get information regarding socio-demographic details and to assess the knowledge and attitude towards the PCPNDT Act. Data was analyzed using Statistical package of social sciences (SPSS) 16.0.Results: In the present study, 75% women were in the age group 21-40 years and were Hindus. Only 25% (n=256) knew about PC-PNDT act. Majority of the subjects (n=880, 88%) had no knowledge that the doctors are also punishable. Attitude of women was also not a benchmark as 40 % women were keen to know the sex of their unborn child and 66% of the participants said that having a male was important for the family.Conclusions: The knowledge about PC‑PNDT act was below the expected standards. The attitude of women towards sex determination of unborn child and sociocultural influences favoring male child are still deeply rooted in society. Active involvement of media, social workers and health staff for dissemination of information to the public and to bring change in attitude of women is the need of the hour.
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Albuquerque, Ana Paula dos Santos, Ana Carolina Rodarti Pitangui, Poliana Maria Gaspar Rodrigues und Rodrigo Cappato de Araújo. „Prevalence of rapid repeat pregnancy and associated factors in adolescents in Caruaru, Pernambuco“. Revista Brasileira de Saúde Materno Infantil 17, Nr. 2 (Juni 2017): 347–54. http://dx.doi.org/10.1590/1806-93042017000200008.
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Abstract Objectives: to determine the prevalence and factors associated with the rapid repeat pregnancy (RRP) in pregnant adolescents. Methods: a cross-sectional study was carried out with pregnant adolescents assisted at the Family Health Strategies in Caruaru-PE from March to August 2013. A questionnaire with sociodemographic, economic, schooling, gynecological, obstetric and contraceptive characteristics was used. The data were analyzed in the Statistical Package for Social Sciences (SPSS), version 20. Binary logistic regression models were used. Results: among the 204 pregnant adolescents interviewed, the data of 26.5% (n = 54) multiparous were analyzed. The occurrence of RRP was 42.6% (n = 23) [95% CI 29.23-56.79]. The variables associated with RRP were non-use of contraceptive methods [OR 7.40 (CI95% 1.56-3.49)] and no previous pregnancy planning [OR 0.19 (95% CI 0.05-0.78)]. Conclusions: the percentage of RRP in adolescents was high. The non-use of contracep-tive methods increased the chances of RRP, while the no previous pregnancy planning decreased the chances of adolescents getting pregnant again without previous program-ming.
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Verma, Vandana, Soniya Vishwakarma, Ramesh Chand und Umesh Kumar Gupta. „Study of prevalence of maternal anaemia and its fetal outcome at rural tertiary care centre“. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, Nr. 10 (26.09.2018): 4077. http://dx.doi.org/10.18203/2320-1770.ijrcog20184131.
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Background: Anaemia is a major public health problem especially among low socioeconomic class of the population in developing countries. Prevalence of anaemia among pregnant women in developing countries is 51%. Anaemia is defined by the WHO as haemoglobin levels of less than 11 gm. % in pregnancy. The present study was aimed to find out prevalence of anaemia in rural tertiary care centre to see the foetal outcome in anaemic women.Methods: This is a retrospective observational study done in the Department of Obstetrics and Gynaecology, University of medical sciences Saifai, Etawah from June 2017 to November 2017. All the women admitted to labour room in third trimester and delivered here were included in the study excluding the patients with pre-eclampsia, eclampsia, gestational diabetes mellitus, heart disease, patients with other medical disorders and patients with twin pregnancy, antepartum haemorrhage and the patients who did not deliver here.Results: Prevalence of anaemia was 87.3 %. severe anaemia was found in 3.5 % women. The percentage of preterm births was more in anaemic women that is 16.9 %.Conclusions: Anaemia in pregnancy is a major public health problem in India. The number of IUGR and LBW babies were more in anaemic women. Anaemia is related to serious consequences in mother and baby if not diagnosed and treated timely. It can be prevented by increasing the awareness regarding need of iron intake during pregnancy.
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Bharti, Juhi, Aprajita Kumari, Rinchen Zangmo, Sonia Mathew, Sunesh Kumar und Aparna K. Sharma. „Establishing the practice of birth companion in labour ward of a tertiary care centre in India—a quality improvement initiative“. BMJ Open Quality 10, Suppl 1 (Juli 2021): e001409. http://dx.doi.org/10.1136/bmjoq-2021-001409.
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BackgroundBirth companion is a key component for providing respectful maternity care and has been recommended by WHO and Government of India. It is a low-cost beneficial intervention that is vital in improving quality of care during labour and delivery.Local problemDespite the available evidence on benefits of birth companion, there was no policy on allowing birth companion at our hospital in the past.Methods and interventionsWe aimed to establish the practice of allowing birth companions in all eligible women in labour ward from existing 0% to 50% in 6 weeks’ duration. This study was conducted in the Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi. A quality improvement (QI) team was formed, and after obtaining the baseline data, problems were analysed using fish bone chart. A new policy of allowing birth companion was made and efforts made to sensitise and train the doctors and nurses posted in labour ward. Changed ideas were executed in multiple plan-do-study-act (PDSA) cycles. Simple interventions such as dress code for birth companions, curtains for ensuring privacy, display of posters and frequent reminders on WhatsApp groups were planned .ResultsThe median value of women accompanied by birth companion marginally increased to 25% after the first PDSA cycle. Implementation of further changed ideas led to increase in median, which reached 66.6%. Thereafter, there was a decline, but by the end of 6 months, it was possible to attain the goal and sustain it.ConclusionsSimple steps of QI methodology can be used to address the prevalent problems in our healthcare. Implementation of any new practice comes with major challenges, but we could achieve our goal because of a motivated team working together on multiple changed ideas applied sequentially in PDSA cycles.
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Grubb, Gary S. „Women's perceptions of the safety of the pill: a survey in eight developing countries“. Journal of Biosocial Science 19, Nr. 3 (Juli 1987): 313–21. http://dx.doi.org/10.1017/s0021932000016965.
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SummaryIn January 1985, a Gallup poll sponsored by the American College of Obstetrics and Gynecologists reported that 76% of the US women sampled thought that there were substantial risks with using the pill, 31% thought the pill caused cancer and 64% thought the risk of childbearing was equal to or less than that in taking the pill. To assess the perceptions of the pill's safety internationally, a survey of 100–150 urban, middle-class women aged 18–45 years was conducted in each of eight countries in the developing world. There were striking similarities in perceptions of the pill's health effects between countries: (1) taking the pill is considered to have substantial health risks by 50–75% and is thought to be more hazardous than childbearing by over 40% of respondents except those in the African samples; (2) women who had used the pill are as unaware as those who had not of possible serious cardiovascular adverse effects; (3) the protective effects of the pill are virtually unknown; (4) the greatest inconsistency with scientific evidence concerns the risks of sterility and birth defects attributed to pill use. With information from this survey, family planning programmes can rectify almost universal misperceptions of the pill's safety when counselling new and continuing pill users.
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Buges, Naiana Mota, Karylleila dos Santos Andrade Klinger und Renata Junqueira Pereira. „New mothers and their understanding about breast milk donation“. Revista Brasileira de Saúde Materno Infantil 20, Nr. 1 (März 2020): 213–25. http://dx.doi.org/10.1590/1806-93042020000100012.
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Abstract Objective: to analyze the understanding of mothers about the donation of human milk. Methods: a qualitative and quantitative study with 13 potential milk donors who answered a sociodemographic and obstetric background questionnaire, as well as a semi-structured interview guide on milk donation. Mothers were approached in the hospital environment, after delivery and the visit of the milk bank. Data were analyzed in Statistical Package for Social Sciences 20.0 and NVivo 11 Starter. Results: the mean age was 24.62 ± 3.95 years; 84.6% had more than eleven years of formal education; 38.5% declared themselves housewives; 46.2% were in a stable union and 76.9% had an income of up to two minimum wages. Most of the mothers (69.2%) experienced previous pregnancy; 76.9% had 6 or more prenatal consultations and 62.5% had previously breastfed. The motivating factors of the donation were altruism; empathy with other mothers; recognition of the primacy of breast milk; the child's understanding of breast milk need; excess milk production and family support. Unawareness of the process, limited time available, and lack of transportation and collection points can make donation difficult. Conclusions: there was a desire for information and support for breastfeeding and donation, which made the donation act complex and distant from reality.
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Cheyney, Melissa. „Understanding Recent Home-Birth Research: An Interview With Drs. Melissa Cheyney and Jonathan Snowden“. Journal of Perinatal Education 25, Nr. 2 (2016): 80–86. http://dx.doi.org/10.1891/1058-1243.25.2.80.
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ABSTRACTIn the past month, two new studies have been released—one in The New England Journal of Medicine (NEJM; Snowden et al., 2015) and the other in the Canadian Medical Association Journal (Hutton et al., 2015)—comparing out-of-hospital birth outcomes to hospital birth outcomes. These studies join a growing body of literature that consistently shows high rates of obstetric intervention in hospitals and also show low risk to neonates regardless of setting. However, the recent NEJM study found a small but statistically significant increase in risk for perinatal mortality for babies born out of hospital. Jeanette McCulloch of BirthSwell (http://www.birthswell.com) interviews Melissa Cheyney, PhD, CPM, LDM, medical anthropologist, chair of the Midwives Alliance Division of Research, and lead author on the largest study of outcomes for planned home births in the United States to date (Cheyney et al., 2014a), and Jonathan Snowden, PhD, epidemiologist and assistant professor in the Department of Obstetrics and Gynecology and School of Public Health at Oregon Health and Science University. Snowden is also the lead author of the recent NEJM study.
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Seher, Umbreen, Nidhi Chauhan und Mishu Mangla. „Study the effect of mifepristone on clinical symptoms and its side effects in patients with fibroid uterus“. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, Nr. 12 (26.11.2018): 4853. http://dx.doi.org/10.18203/2320-1770.ijrcog20184928.
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Background: Fibroid can lead to a variety of clinical symptoms including pain, menorrhagia, and lump in abdomen. The availability of a safe and efficient medical management options for symptomatic fibroid is of considerable clinical and public health importance. The present study is designed to see the safety and efficacy of mifepristone in the medical management of uterine fibroids.Methods: The study was conducted in the Department of Obstetrics and Gynaecology, Himalayan Institute of Medical Sciences, Swami Ram Nagar, Dehradun over a period of 12 months. A total of 40 patients were included in the study.Results: Amount of bleeding was assessed by PBAC score, which significantly reduced by 83.9% at the end of treatment. And 62% patients developed amenorrhoea due to mifepristone. Similarly, pain abdomen/dysmenorrhoea was assessed by Numeric Pain Rating Scale, which also showed a significant reduction in 55% patients with no pain at the end of 3 months.Conclusions: The study clearly shows that Mifepristone is a safe and effective option to manage fibroid uterus and its associated symptoms.
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Chavkin, Wendy, und Kelly Blanchard. „The Ellertson Fellowship: Advancing Reproductive Health Through Social Science and Public Health Research“. Women's Health Issues 21, Nr. 3 (Mai 2011): S2—S4. http://dx.doi.org/10.1016/j.whi.2011.02.012.
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Dias, Janaína Silva, Tatiana de Oliveira Vieira und Graciete Oliveira Vieira. „Factors associated to nipple trauma in lactation period: a systematic review“. Revista Brasileira de Saúde Materno Infantil 17, Nr. 1 (März 2017): 27–42. http://dx.doi.org/10.1590/1806-93042017000100003.
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Abstract Objectives: To identify the characteristics associated to nipple trauma in nursing mothers and propose a theoretical model explaining in hierarchical levels its determining factors. Methods: a systematic review of the literature based on the search of epidemiological studies of factors associated to nipple trauma in the databases of Medical Literature Analysis and Retrieval System Online/Pubmed, Literatura Latino-Americana and Caribe em Ciências da Saúde (Latin American Literature and Caribbean Health Sciences) and ScienceDirect. The conduct on searching articles occurred until June 2016. Results: 17 articles were selected which investigated 27 variables and found a significant association between 16 of these variables and nipple trauma. The factors associated to nipple trauma reported in two or more studies were: mother of race/color white or yellow, primiparity, inadequate position between mother and child during breastfeeding and handling the infant incorrectly to the mother's breast. Guidance received on handling and positioning the infant during prenatal care was a protective factor against nipple trauma. Conclusions: in the theoretical model explaining the factors associated to nipple trauma in hierarchical levels, the variables classified at the proximal level were the most investigated and were identified as risk factors in selected studies, indicating that in the postpartum care period is an important protective factor against nipple trauma.
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Oliveira, Thais da Costa, Tâmara Silva de Lucena, Jovânia Marques de Oliveira e. Silva, Patrícia de Carvalho Nagliate, Regina Célia Sales Santos Veríssimo und Maria Lucélia da Hora Sales. „Adverse outcomes of childbirth in high-risk maternity hospitals“. Revista Brasileira de Saúde Materno Infantil 20, Nr. 1 (März 2020): 193–201. http://dx.doi.org/10.1590/1806-93042020000100011.
Annotation:
Abstract Objectives: to analyze adverse outcomes in teaching maternity hospitals in Maceió, Alagoas, Brazil. Methods: a cross-sectional, retrospective and analytical study was carried out with a random sample of 480 medical records of postpartum women in 2016 using the Adverse Outcome Index: in-hospital maternal death, neonatal in-hospital death> 2500g and> 37 weeks, uterine rupture, unplanned maternal admission to intensive care unit, delivery trauma to the newborn, return to the operating room, admission to an intensive neonatal unit with >2500g and > 37 weeks for more than one day, Apgar <7 at the fifth minute, maternal hemotransfusion and fourth-degree perineal laceration. The data were analyzed using the Statistical Package for Social Sciences software version 22.0. Results: the results showed a 21% rate of adverse outcomes, at a rate of 26.4 for every 1,000 births, with a greater occurrence of neonatal intensive care admission with>2500g and>37 weeks for more than one day (52. 5%), maternal blood transfusion (20.8%) and unplanned maternal admission in intensive care (17.8%). Conclusions: the evaluation of adverse outcomes evidenced a high proportion of births with undesirable results, which allowed the analysis of the outlook of unfavorable outcomes related to safety in maternity wards through the use of indicators.
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Kanwar, Geetanjali, Shweta Rani Prasad und Rekha Ratnani. „Incidence of anemia in pregnancy and its maternal-fetal outcome in admitted ANC patients in tertiary care center, Bhilai, Chhattisgarh, India“. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, Nr. 4 (24.03.2021): 1411. http://dx.doi.org/10.18203/2320-1770.ijrcog20211112.
Annotation:
Background: Anemia in pregnancy is an important public health problem in developing countries like India. Anemia results in poor pregnancy outcome and also affects fetal outcome. The present study was conducted to asses maternal and fetal outcome in relation anemia. Aim and objectives of the study was to determine incidence, risk factors and maternal-fetal outcome of anemia in the admitted pregnant women attending obstetrics and gyanecology department, shanakarcharya institute of medical sciences, Bhilai.Methods: This is retrospective observational study conducted among pregnant women admitted in labor room over a period of one year after getting approval from the institutional ethical committee.Results: Out of total 1503 delivery during study period 675 patients were found to be anaemic which gives incidence of 44.5%. Most the pregnant women were moderately anaemic i.e. 50.96% followed by mild (45.04%) and severe (4%) repectively. Among the pregnant women most common type of anaemia is Iron deficiency anaemia (69.65%) followed by Sickle cell anaemia (15.4%). In the present study,90.4% of subject received oral iron, 26.9% received parenteral iron and 19.4% received blood transfusion. Common maternal outcome related to anemia found to be low birth weight (25.2%) followed by premature delivery (22.96%) and fetal outcome in anemic mother in the form of preterm (22.9%) followed by NICU admission (14.37%) and FGR (8.6%).Conclusions: Anemia being one of the most important cause of poor feto maternal outcome should be treated preconceptionaly. There is a need of health education programmes and adequate intake of iron rich diet during pregnancy, to be strengthened for safe maternal and foetal outcomes.
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Galvão, Ana Patrícia Fonseca Coelho, Vitória Barros Pinto, Rafael Mondego Fontenele, Natalie Rosa Pires Neves, Nayra Michelle Anjos Amorim und Raylena Pereira Gomes. „A ampla conceituação da violência obstétrica: uma revisão integrativa“. Revista Recien - Revista Científica de Enfermagem 9, Nr. 28 (28.12.2019): 44–54. http://dx.doi.org/10.24276/rrecien2358-3088.2019.9.28.44-54.
Annotation:
A violência obstétrica consiste em qualquer conduta ou ato que leva à apropriação indevida dos processos corporais e reprodutivos das mulheres. O objetivo do presente estudo foi identificar as formas de violência obstétrica apontadas na literatura brasileira. Tratou-se de uma revisão integrativa da literatura, através das bases de dados Scientific Eletronic Library Online (Scielo), Latino Americana e do Caribe em Ciências da Saúde (Lilacs), Base de Dados de Enfermagem (BDENF). Constatou-se que há mais de 40 caracterizações da violência obstétrica dentre os estudos revisados. Os tipos de violência física, verbal e psicológica, assim como a realização de procedimentos desnecessários estão presentes em 100% das pesquisas. Concluiu-se que há necessidade de divulgação do tema através de políticas públicas e conscientização da população sobre o parto normal humanizado, assim como a mudança de modelo assistencial e na formação dos profissionais, pois ambos se baseiam em práticas intervencionistas.Descritores: Violência, Parto, Obstetrícia. The broad conceptualization of obstetric violence: an integrative reviewAbstract: Obstetric violence consists of any conduct or act that leads to the misappropriation of women's bodily and reproductive processes. The objective of the present study was to identify the forms of obstetric violence pointed out in the Brazilian literature. This was an integrative review of the literature, using the Scientific Electronic Library Online (Scielo), Latin American and Caribbean in Health Sciences (Lilacs), Nursing Database (BDENF) databases. It was found that there were more than 40 characterizations of obstetric violence among the reviewed studies. The types of physical, verbal and psychological violence, as well as the performance of unnecessary procedures are present in 100% of the researches. Concludes that there is a need for disclouse the topic through public policies and public awareness about normal humanized delivery, as well as a change in care model and the training of professionals, since both are based on interventionist practices.Descriptors: Violence, Parturition, Obstetrics. La amplia conceptualización de la violencia obstétrica: una revisión integrativaResumen: La violencia obstétrica consiste en cualquier conducta o acto que conduzca a la apropiación indebida de los procesos corporales y reproductivos de las mujeres. El objetivo de este estudio fue identificar las formas de violencia obstétrica señaladas en la literatura brasileña. Esta fue una revisión integradora de la literatura, a través de la Biblioteca Electrónica Científica En Línea (Scielo), bases de datos latinoamericanas y caribeñas en Ciencias de la Salud (Lilacs), Base de Datos de Enfermería (BDENF). Se encontró que hay más de 40 caracterizaciones de violencia obstétrica entre los estudios revisados. Los tipos de violencia física, verbal y psicológica, así como la realización de procedimientos innecesarios están presentes en el 100% de los estudios. Se llegó a la conclusión de que es necesario difundir el tema a través de políticas públicas y la concienciación de la población sobre la prestación normal humanizada, así como el cambio de modelo de atención y la formación de los profesionales, porque ambos se basan en prácticas Intervencionista.Descriptores: Violencia, Parto, Obstetricia.
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PARRA-CORDERO, MAURO. „SHOULD A FIRST-TRIMESTER RISK ASSESSMENT FOR PRE-ECLAMPSIA BE ROUTINELY OFFERED?“ Fetal and Maternal Medicine Review 24, Nr. 2 (Mai 2013): 129–33. http://dx.doi.org/10.1017/s0965539513000041.
Annotation:
From a scientific point of view, the answer to the question might be quite straightforward in favour of routinely screening all pregnant women for pre-eclampsia (PE) during the first trimester of pregnancy. However, irrespective of the large amount of good evidence and expert opinion favourable for universally screening for obstetric syndromes, such as PE, public health policies do not always align with pure clinical science.
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Naseer, Syed, Syed Uzma Andrabi, Syed Ishfa Andrabi und Humaira Tabasum. „Management of pregnant women in times of COVID-19 our experience from Kashmir valley“. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, Nr. 4 (24.03.2021): 1379. http://dx.doi.org/10.18203/2320-1770.ijrcog20210988.
Annotation:
Background: The coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, is a global public health emergency. COVID-19 is a rapidly evolving situation, and there is limited data reporting its impact on pregnant women. Our study aimed to find the symptomatology, clinical courses and outcome of pregnant women with COVID-19 and to assess the vertical transmission potential of COVID-19 in pregnancy.Methods: This prospective observational study was conducted at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Medical College, Department of Gynaecology and obstetrics, Srinagar from May 2020 to September 2020. All COVID-19 positive pregnant patients admitted in our institution were included in our study.Results: The study included 100 Covid-19 positive pregnant women. Most of them were between 30 to 40 years of age. Median gestational age was 32.8 weeks. Comorbidity was present in 18 of our patients. 7 patients had gestational diabetes and 1 with overt diabetes, 5 were hypertensive, 3 had hypothyroidism, 1 with anti-phospholipid antibody syndrome (APLA) and 1 with asthma.44 patients were primigravidae and 56 were multigravidae. 27 patients delivered preterm and 44 with term pregnancy. 47 had undergone caesarean section and 24 normal vaginal delivery.88% of our patients were asymptomatic for covid-19 disease while as 12 patients had Covid-19 disease symptoms. The main complaints reported by patients related to covid-19 disease was mild dry cough and fever (9%). Two patients developed severe covid-19 pneumonia with ARDS and were put on ventilator, expired after 20 days of illness. All neonates were subjected to RT-PCR with none producing positive results.Conclusions: Appropriate and timely management of Covid-19 positive pregnant women is a principle for safe motherhood and healthy offspring in times of global pandemic. The present data do not suggest an increased risk of severe disease among pregnant women. We encourage the breast feeding immediately after delivery as benefits overweigh any potential risks of virus transmission if any.
30
Voskresensky, V. V., S. M. Kuznetsov, V. A. Maydan, S. V. Zaymagov und M. A. Bokharev. „Contribution of Institute of preventive sciences of Z.P. Solovyov of Military Medical Academy to development of military health care“. Bulletin of the Russian Military Medical Academy 20, Nr. 4 (15.12.2018): 294–98. http://dx.doi.org/10.17816/brmma12406.
Annotation:
Here you can find information based on documentary data about the establishment and activities of Z.P. Solovyov`s Institute of Preventive Sciences of Military Medical Academy from 1925 to 1928. The institute was organized to develop hygienic thinking on November 21 1925, and became one of the first foundations of the Soviet Union, which provided training for preventive specialists. In the order №216 signed by the chief of the Head Military and sanitary department and the deputy national commissioner of health care Z.P. Solovyov on November 19, 1925, were defined strategic objectives of creation of institute among which: 1) full coherence and improvement of teaching a cycle of sanitary and preventive disciplines according to requirements of army; 2) educate listeners and doctors in accordance with the basic principles of Soviet medicine, which gives the lead to disease prevention. As the building for new institute, the three-storyed obstetric and gynecologic clinic of the academician G.E. Rein at Mikhaylovsky hospital of the baronet Villiye which was a part of Imperial Military Medical Academy has served. Many departments in the academic institute were united, among which three were prophylactic: Department of Microbiology with epidemiology and disinfection course, Departments of General and Military, Social Hygiene. On the example of educational, research and public work of departments of a hygienic profile of institute the contribution of an educational institution as in the system of training of highly qualified specialists in the health sector, and in the system of health protection of the military personnel reveals. It has been established that studying by a staff of departments of a number of questions on a perspective of preservation and promotion of health of soldiers and officers, has an exclusive character in our country.
31
Dennerstein, Lorraine. „Gender, health, and Ill-health“. Women's Health Issues 5, Nr. 2 (Juni 1995): 53–59. http://dx.doi.org/10.1016/1049-3867(95)00027-2.
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Neravi, Asha, Namrata Kulkarni, M. Usha Brindhini und V. Udayashree. „A comparative study of maternal and fetal outcome in trial of labour after caesarean delivery and elective repeat caesarean delivery“. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, Nr. 3 (26.02.2019): 1171. http://dx.doi.org/10.18203/2320-1770.ijrcog20190900.
Annotation:
Background: Globally, high rates of caesarean section (CS) are an issue of public health concern. For women who have had a previous caesarean, choices for mode of birth in their next pregnancy are either a trial of vaginal birth after caesarean (TOLAC) or an elective repeat caesarean delivery (ERCD). Both ERCD and TOLAC have benefits and risks associated.Methods: A prospective comparative study was conducted in the Department of Obstetrics and Gynecology at SDM college of medical science and hospital, Dharwad, Karnataka, India. The study included 80 women with one previous lower segment caesarean section over a period of 1 year. A 40 women underwent TOLAC and 40 women had a repeat caesarean section. The maternal and fetal outcomes in trial of labour after caesarean delivery and repeat caesarean delivery were compared.Results: In this study maternal morbidity was more common in ERCD group than in the TOLAC group. Neonatal outcome was the same in both the study groups. Conclusions: In our study the TOLAC success rate was 70-80%, pregnant woman with one previous lower segment Caesarean section should be given the option of TOLAC, unless contraindicated.
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Miller, Kirk, Berwood Yost, Sean Flaherty, Marianne M. Hillemeier, Gary A. Chase, Carol S. Weisman und Anne-Marie Dyer. „Health Status, Health Conditions, and Health Behaviors Among Amish Women“. Women's Health Issues 17, Nr. 3 (Mai 2007): 162–71. http://dx.doi.org/10.1016/j.whi.2007.02.011.
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Arrossi, Silvina, Sarah Temin, Suzanne Garland, Linda O’Neal Eckert, Neerja Bhatla, Xavier Castellsagué, Sharifa Ezat Alkaff et al. „Primary Prevention of Cervical Cancer: American Society of Clinical Oncology Resource-Stratified Guideline“. Journal of Global Oncology 3, Nr. 5 (Oktober 2017): 611–34. http://dx.doi.org/10.1200/jgo.2016.008151.
Annotation:
Purpose To provide resource-stratified (four tiers), evidence-based recommendations on the primary prevention of cervical cancer globally. Methods The American Society of Clinical Oncology convened a multidisciplinary, multinational panel of oncology, obstetrics/gynecology, public health, cancer control, epidemiology/biostatistics, health economics, behavioral/implementation science, and patient advocacy experts. The Expert Panel reviewed existing guidelines and conducted a modified ADAPTE process and a formal consensus-based process with additional experts (consensus ratings group) for one round of formal ratings. Results Existing sets of guidelines from five guideline developers were identified and reviewed; adapted recommendations formed the evidence base. Five systematic reviews, along with cost-effectiveness analyses, provided evidence to inform the formal consensus process, which resulted in agreement of ≥ 75%. Recommendations In all resource settings, two doses of human papillomavirus vaccine are recommended for girls age 9 to 14 years, with an interval of at least 6 months and possibly up to 12 to 15 months. Individuals with HIV positivity should receive three doses. Maximal and enhanced settings: if girls are age ≥ 15 years and received their first dose before age 15 years, they may complete the series; if no doses were received before age 15 years, three doses should be administered; in both scenarios, vaccination may be through age 26 years. Limited and basic settings: if sufficient resources remain after vaccinating girls age 9 to 14 years, girls who received one dose may receive additional doses between age 15 and 26 years. Maximal, enhanced, and limited settings: if ≥ 50% coverage in the priority female target population, sufficient resources, and cost effectiveness, boys may be vaccinated to prevent other noncervical human papillomavirus–related cancers and diseases. Basic settings: vaccinating boys is not recommended. It is the view of the American Society of Clinical Oncology that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines.
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Kane, Sumit, Prarthna Dayal, Tanmay Mahapatra, Sanjiv Kumar, Shikha Bhasin, Aboli Gore, Aritra Das et al. „Enabling change in public health services: Insights from the implementation of nurse mentoring interventions to improve quality of obstetric and newborn care in two North Indian states“. Gates Open Research 4 (18.06.2020): 61. http://dx.doi.org/10.12688/gatesopenres.13134.1.
Annotation:
Background: Few studies have explicitly examined the implementation of change interventions in low- and middle-income country (LMIC) public health services. We contribute to implementation science by adding to the knowledge base on strategies for implementing change interventions in large, hierarchical and bureaucratic public services in LMIC health systems. Methods: Using a mix of methods, we critically interrogate the implementation of an intervention to improve quality of obstetric and newborn services across 692 facilities in Uttar Pradesh and Bihar states of India to reveal how to go about making change happen in LMIC public health services. Results: We found that focusing the interventions on a discreet part of the health service (labour rooms) ensured minimal disruption of the status quo and created room for initiating change. Establishing and maintaining respectful, trusting relationships is critical, and it takes time and much effort to cultivate such relationships. Investing in doing so allows one to create a safe space for change; it helps thaw entrenched practices, behaviours and attitudes, thereby creating opportunities for change. Those at the frontline of change processes need to be enabled and supported to: lead by example, model and embody desirable behaviours, be empathetic and humble, and make the change process a positive and meaningful experience for all involved. They need discretionary space to tailor activities to local contexts and need support from higher levels of the organisation to exercise discretion. Conclusions: We conclude that making change happen in LMIC public health services, is possible, and is best approached as a flexible, incremental, localised, learning process. Smaller change interventions targeting discreet parts of the public health services, if appropriately contextualised, can set the stage for incremental system wide changes and improvements to be initiated. To succeed, change initiatives need to cultivate and foster support across all levels of the organisation.
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Kane, Sumit, Prarthna Dayal, Tanmay Mahapatra, Sanjiv Kumar, Shikha Bhasin, Aboli Gore, Aritra Das et al. „Enabling change in public health services: Insights from the implementation of nurse mentoring interventions to improve quality of obstetric and newborn care in two North Indian states“. Gates Open Research 4 (01.10.2020): 61. http://dx.doi.org/10.12688/gatesopenres.13134.2.
Annotation:
Background: Few studies have explicitly examined the implementation of change interventions in low- and middle-income country (LMIC) public health services. We contribute to implementation science by analyzing the implementation of an organizational change intervention in a large, hierarchical and bureaucratic public service in a LMIC health system. Methods: Using qualitative methods, we critically interrogate the implementation of an intervention to improve quality of obstetric and newborn services across 692 facilities in Uttar Pradesh and Bihar states of India to reveal how to go about making change happen in LMIC public health services. Results: We found that focusing the interventions on a discreet part of the health service (labour rooms) ensured minimal disruption of the status quo and created room for initiating change. Establishing and maintaining respectful, trusting relationships is critical, and it takes time and much effort to cultivate such relationships. Investing in doing so allows one to create a safe space for change; it helps thaw entrenched practices, behaviours and attitudes, thereby creating opportunities for change. Those at the frontline of change processes need to be enabled and supported to: lead by example, model and embody desirable behaviours, be empathetic and humble, and make the change process a positive and meaningful experience for all involved. They need discretionary space to tailor activities to local contexts and need support from higher levels of the organisation to exercise discretion. Conclusions: We conclude that making change happen in LMIC public health services, is possible, and is best approached as a flexible, incremental, localised, learning process. Smaller change interventions targeting discreet parts of the public health services, if appropriately contextualised, can set the stage for incremental system wide changes and improvements to be initiated. To succeed, change initiatives need to cultivate and foster support across all levels of the organisation.
37
Kane, Sumit, Prarthna Dayal, Tanmay Mahapatra, Sanjiv Kumar, Shikha Bhasin, Aboli Gore, Aritra Das et al. „Enabling change in public health services: Insights from the implementation of nurse mentoring interventions to improve quality of obstetric and newborn care in two North Indian states“. Gates Open Research 4 (29.04.2021): 61. http://dx.doi.org/10.12688/gatesopenres.13134.3.
Annotation:
Background: Few studies have explicitly examined the implementation of change interventions in low- and middle-income country (LMIC) public health services. We contribute to implementation science by analyzing the implementation of an organizational change intervention in a large, hierarchical and bureaucratic public service in a LMIC health system. Methods: Using qualitative methods, we critically interrogate the implementation of an intervention to improve quality of obstetric and newborn services across 692 facilities in Uttar Pradesh and Bihar states of India to reveal how to go about making change happen in LMIC public health services. Results: We found that focusing the interventions on a discreet part of the health service (labour rooms) ensured minimal disruption of the status quo and created room for initiating change. Establishing and maintaining respectful, trusting relationships is critical, and it takes time and much effort to cultivate such relationships. Investing in doing so allows one to create a safe space for change; it helps thaw entrenched practices, behaviours and attitudes, thereby creating opportunities for change. Those at the frontline of change processes need to be enabled and supported to: lead by example, model and embody desirable behaviours, be empathetic and humble, and make the change process a positive and meaningful experience for all involved. They need discretionary space to tailor activities to local contexts and need support from higher levels of the organisation to exercise discretion. Conclusions: We conclude that making change happen in LMIC public health services, is possible, and is best approached as a flexible, incremental, localised, learning process. Smaller change interventions targeting discreet parts of the public health services, if appropriately contextualised, can set the stage for incremental system wide changes and improvements to be initiated. To succeed, change initiatives need to cultivate and foster support across all levels of the organisation.
38
Hillard, Paula J. Adams. „COVID, Science, Vaccines, and Public Trust“. Journal of Pediatric and Adolescent Gynecology 33, Nr. 6 (Dezember 2020): 617–18. http://dx.doi.org/10.1016/j.jpag.2020.10.010.
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Sah, RB, L. Subedi, U. Shah und N. Jha. „Health seeking behavior during pregnancy and delivery in Morang District of Nepal“. Janaki Medical College Journal of Medical Science 2, Nr. 1 (03.11.2014): 4–9. http://dx.doi.org/10.3126/jmcjms.v2i1.11389.
Annotation:
Background and objectives: Importance of maternal health has been recognized over the last decade, however information about the perception of illness and health care behavior of obstetric complication is lacking. So, this study was conducted to find out the prevalence of taking care during pregnancy and delivery, and to find out the association between sociodemographic characteristics and taking care during pregnancy and delivery. Material and Methods: The study is a cross-sectional study conducted among the residents of Rangeli VDC of Morang District in Eastern Nepal where 300 households were taken as subjects. Semi-structured questionnaire was used and face to face interview was conducted. Chi-square test was applied to find out the association between sociodemographic characteristics and taking care during pregnancy and delivery. Results: Almost forty percent of pregnant women have taken care during pregnancy and delivery i.e. delivery conducted in Health Care Center (HCC). Only 21.8% of women were applied antiseptics after cutting cord and sixty three percent of women have fed colostrums to their babies. All of the women with Brahmin/ Chhetri have conducted delivery in Health Care Center. The women with SLC and higher education have conducted delivery at HCC more (91.1%) than below SLC (51%) and illiterate (12.5%). The women with service have conducted delivery at HCC more than other occupational groups. Conclusion: The problem of taking care during pregnancy and delivery is common and has become a key public health concern for all. Lack of education and poor occupation of wife and husband led some of the respondents not taking care during pregnancy and delivery. DOI: http://dx.doi.org/10.3126/jmcjms.v2i1.11389 Janaki Medical College Journal of Medical Sciences (2014) Vol. 2 (1): 4-9
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Perry, Nicholas S., und A. Rani Elwy. „The Role of Implementation Science in Reducing Sexual and Gender Minority Mental Health Disparities“. LGBT Health 8, Nr. 3 (01.04.2021): 169–72. http://dx.doi.org/10.1089/lgbt.2020.0379.
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Katz, Rebecca, und D. Richard Mauery. „Women and Public Health Emergency Preparedness“. Women's Health Issues 20, Nr. 1 (Januar 2010): 3–6. http://dx.doi.org/10.1016/j.whi.2009.05.002.
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Moos, Merry-K. „Preconception health“. Women's Health Issues 16, Nr. 4 (Juli 2006): 156–58. http://dx.doi.org/10.1016/j.whi.2006.03.004.
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Wood, Susan F. „Women's Health“. Women's Health Issues 19, Nr. 1 (Januar 2009): 1–2. http://dx.doi.org/10.1016/j.whi.2008.11.001.
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Johnson, Avita Rose, Sobin Sunny, Ramola Nikitha, Sulekha Thimmaiah und Suman P. N. Rao. „A Case-Control Study on the Predictors of Neonatal Near-Miss: Implications for Public Health Policy and Practice“. Neonatal Medicine 28, Nr. 3 (31.08.2021): 124–32. http://dx.doi.org/10.5385/nm.2021.28.3.124.
Annotation:
Purpose: Neonatal near miss (NNM) allows for the detection of risk factors associated with serious newborn complications and death, the prevention of which could reduce neonatal mortality. This study was conducted with the objective of identifying predictors for NNM in a tertiary hospital in Bangalore city.Methods: This was an unmatched case-control study involving 120 NNM cases and 120 controls. NNM was determined using Pileggi-Castro’s pragmatic and management criteria. Data was collected from in-patient hospital records and interviews of postpartum mothers. Multiple logistic regression of exposure variables was performed to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI).Results: Significant predictors were maternal age ≥30 years (AOR, 5.32; 95% CI, 1.12 to 9.29; P=0.041), inadequate antenatal care (ANC) (AOR, 8.35; 95% CI, 1.98 to 51.12; P=0.032), <3 ultrasound scans during pregnancy (AOR, 12.5; 95% CI, 1.60 to 97.27; P=0.016), maternal anaemia (AOR, 18.96; 95% CI, 3.10 to 116.02; P=0.001), and any one obstetric complication (hypertensive disorder in pregnancy, diabetes in pregnancy, preterm premature rupture of membranes, prolonged labour, obstructed labour, malpresentation) (AOR, 4.34; 95% CI, 1.26 to 14.95; P=0.02).Conclusion: The predictors of NNM identified has important implications for public health policy and practice whose modifications can improve NNM. These include expanding essential ANC package to include ultrasound scans, ensuring World Health Organization recommendations of eight ANC visits, capacity building at all levels of health care to strengthen routine ANC and obstetric care for effective screening, referral and management of obstetric complications.
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Lamichhane, Binit, Binita Pudasaini, Bishnu Upadhyay, Mohan Sharma und Shyam Prasad Khanal. „Prevalence of Serum Antibodies to TORCH Infections among the Women of Child Bearing Age Visiting National Public Health Laboratory, Teku“. Nepal Journal of Science and Technology 15, Nr. 2 (16.02.2015): 85–90. http://dx.doi.org/10.3126/njst.v15i2.12120.
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The primary infection of Toxoplasma gondii, Rubella virus, Cytomegalovirus (CMV) and Herpes simplex virus (HSV) abbreviated as TORCH, remain a major problem in the women of child bearing age in Nepal. The main aim of this study was to determine the seroprevalence of TORCH infections among the women of child bearing age visiting the National Public Health Laboratory (NPHL), Kathmandu. Serum samples collected from 302 patients were tested for TORCH infections by IgM Enzyme Linked Immunosorbent Assay (ELISA). The seropositivity rate was found to be 18.82% (54/287) for T. gondii, 10.07% (28/278) for Rubella, 16.49% (46/279) for CMV and 23.34% (67/287) for HSV. The seropositivity rates in pregnant women were 17.92% (19/106) for T. gondii, 11.54% (12/104) for Rubella, 19.23% (20/104) for CMV and 25% (26/104) for HSV, the statistical association of TORCH infections with pregnancy was insignificant (P>0.05). Similarly, the seropositivity rates in women with bad obstetric history (BOH) were 17.84% (43/241) for T. gondii, 11.06% (26/235) for Rubella, 18.57% (44/237) for CMV and 26.14% (63/241) for HSV. The statistical association of CMV and HSV with previous obstetric performance were significant (P>0.05) while that of T. gondii and Rubella were insignificant (P<0.05). The seropositivity rate was found to be highest for HSV infection (23.34%) followed by T. gondii (18.82%), Cytomegalovirus (16.49%) and Rubella (10.07%).DOI: http://dx.doi.org/njst.v15i2.12120Nepal Journal of Science and Technology Vol. 15, No.2 (2014) 85-90
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Karna, Jahnavi, und Varun M. Malhotra. „Prevalence and determinants of caesarean section in a rural community of Nalgonda District, Telangana“. International Journal Of Community Medicine And Public Health 4, Nr. 8 (22.07.2017): 3022. http://dx.doi.org/10.18203/2394-6040.ijcmph20173365.
Annotation:
Background: The rapid increase of caesarean section rates globally is a public health concern because rates higher than those recommended by WHO do not contribute to improved maternal health and pregnancy outcome. This study aims to estimate the prevalence of caesarean section, establish relationship of relevant variables with caesarean section, and identify temporal trends of c-sec rates in rural populace of Nalgonda. Methods: A community-based cross-sectional analytic study was undertaken in rural field practice area of Kamineni Institute of Medical Sciences. Data were collected on structured questionnaire from selected and consenting women in reproductive age group who had delivered since 01 January 2000. Results: Our study included 224 study subjects who have undergone 389 deliveries. Of these 54% were by caesarean section and 46% were normal deliveries. Age of mother, type of family, educational status of mother, height of mother and place of delivery were identified as relevant variables. Their association with C-sec rates and time trend of c-sec rates are presented. Conclusions: Multi centre, large-sampled and ‘in depth’ studies are needed to analyze the problem of very high caesarean section rates. These would provide qualitative and quantitative data to plan strategies to reduce the prevalence of a surgical procedure that if carried out on ‘non-medical grounds’ has the potential to cause obstetrical and neonatal complications, and significant economical and health-planning implications.
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Moore, Travis R., Elizabeth N. Foster, Christina Mair, Jessica G. Burke und Robert W. S. Coulter. „Leveraging Complex Systems Science to Advance Sexual and Gender Minority Youth Health Research and Equity“. LGBT Health 8, Nr. 6 (01.09.2021): 379–85. http://dx.doi.org/10.1089/lgbt.2020.0297.
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Jackson, Fleda Mask, Kweli Rashied-Henry, Paula Braveman, Tyan Parker Dominguez, Diana Ramos, Noble Maseru, William Darity et al. „A Prematurity Collaborative Birth Equity Consensus Statement for Mothers and Babies“. Maternal and Child Health Journal 24, Nr. 10 (16.06.2020): 1231–37. http://dx.doi.org/10.1007/s10995-020-02960-0.
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Abstract Introduction In 2016, March of Dimes (MOD) launched its Prematurity Collaborative to engage a broad cross section of national experts to address persistent and widening racial disparities in preterm birth by achieving equity and demonstrated improvements in preterm birth. African-American and Native American women continue to have disproportionate rates of preterm birth and maternal death. As part of the Collaborative, MOD created the Health Equity Workgroup whose task was the creation of a scientific consensus statement articulating core values and a call to action to achieve equity in preterm birth utilizing health equity and social determinants of health frameworks. Methods Health Equity Workgroup members engaged in-person and virtually to discuss key determinant contributors and resolutions for disparate maternal and birth outcomes. Workgroup members then drafted the Birth Equity Consensus Statement that contained value statements and a call to action. The birth equity consensus statement was presented at professional conferences to seek broader support. This article highlights the background and context towards arriving at the core values and call to action, which are the two major components of the consensus statement and presents the core values and call to action themselves. Results The result was the creation of a birth equity consensus statement that highlights risks and protections of social determinants based on the prevailing science, and identifies promising solutions for reducing preterm birth and eliminating racial disparities. Conclusion The birth equity consensus statement provides a mandate, guiding the work of March of Dimes and the broader MCH community, for equity-based research, practice, and policy advocacy at local, state, and federal levels. Significance This field report adds to the current knowledge base on racial and ethnic disparities in birth and maternal health outcomes. Research has documented the science behind eliminating health disparities. Scientists and practitioners should continue to explore in practice how the social determinants of birth and maternal health, which manifest historically and contemporarily, can be addressed.
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Shrivastava, Surbhi, und Muthusamy Sivakami. „Evidence of ‘obstetric violence’ in India: an integrative review“. Journal of Biosocial Science 52, Nr. 4 (14.11.2019): 610–28. http://dx.doi.org/10.1017/s0021932019000695.
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AbstractThe term ‘obstetric violence’ has been used to describe the mistreatment, disrespect and abuse or dehumanized care of women during childbirth by health care providers. This is a review of the existing literature in India on violence against women during childbirth. The review used the typology of Bohren et al. (2015). An internet search of PubMed, Google Scholar and JSTOR was conducted using the terms ‘obstetric violence’, ‘mistreatment’, ‘disrespect and abuse’ and ‘dehumanized care’. Studies based on empirical research on women’s experiences during childbirth in health facilities in India were included in the review. The search yielded sixteen studies: one case study, two ethnographic studies, two mixed-methods studies, three cross-sectional qualitative studies, seven cross-sectional quantitative studies and one longitudinal quantitative study. The studies were analysed using the seven categories of mistreatment outlined by Bohren et al. (2015): 1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. An additional category of ‘harmful traditional practices and beliefs’ emerged from the Indian literature, which was also included in the review. Although geographically limited, the selected research highlighted varying prevalences of the different forms of ‘obstetric violence’ in both public and private birth facilities in India. ‘Obstetric violence’ in India was found to be associated with socio-demographic factors, with women of lower social standing experiencing greater levels of mistreatment. In response to this normalized public health issue, a multi-pronged, rights-based framework is proposed that addresses the social, political and structural contexts of ‘obstetric violence’ in India.
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Ahmed, Sohel M. G., Amna Mustafa Ali, Tayseer Salih Mohamed, Mohamed Sayed M. Hajnour, Hayat O. Elfil, Samahir F. M. Hussein, Dalia Abdelrahman et al. „Current Status of Obstetric Anaesthesia Services (OASIS); A Cross-sectional Survey of Public Hospitals in Khartoum State, Sudan“. Open Public Health Journal 12, Nr. 1 (30.06.2019): 294–99. http://dx.doi.org/10.2174/1874944501912010294.
Annotation:
Background: Medical services in general, and anaesthetic services in particular, in Sudan have been vulnerable to changes secondary to the socio-economic factors over the last few decades. Objective: This cross-state survey aims to identify the current set up of obstetric anaesthesia services in 19 hospitals - representing all public hospitals in Khartoum State with maternity units- and audit them against internationally set standards. Methodology: This is a cross-sectional descriptive non-interventional study. Questionnaires- based on the World Federation of Societies of Anaesthesiologists (WFSA) Safe Anaesthesia Standards- were distributed to Anaesthetic departments’ heads at the time of the study (first to fourteenth of May 2016) of 19 public hospitals. This is the total number of public hospitals delivering obstetric services in Khartoum State. All filled out questionnaires were returned (response rate 100%). Collected information/data provided were subsequently entered into an Excel sheet and analysed. Results were tabulated. Results: There was a considerable variation in the capacity of the surveyed hospitals in terms of human resources, caseload and set up. Improper utilisation of already deficient anaesthesiologist in covering high load obstetrics services was also noticed. All the hospitals fell short of recommendations for minimum standards set by the World Federation of Societies of Anaesthesiologists (WFSA). Conclusion: There is a vast gap between international set standards and the current set up of obstetric anaesthesia in Khartoum State public hospitals. Necessary concerted efforts from governmental, non-governmental and professional bodies are warranted to improve obstetric anaesthetic services in Khartoum State.