Fetal Doppler Parameters at Term in Pregnancies Affected by Gestational Diabetes: Role in the Prediction of Perinatal Outcomes

2018 ◽  
Vol 41 (06) ◽  
pp. 675-680 ◽  
Author(s):  
Alessandra Familiari ◽  
Caterina Neri ◽  
Chiara Vassallo ◽  
Giulia Di Marco ◽  
Serafina Garofalo ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Apgar Score ◽  
Adverse Outcome ◽  
Small Sample Size ◽  
Perinatal Outcomes ◽  
Expectant Management ◽  
Well Being ◽  
Good Clinical Practice ◽  
Small Sample ◽  
Fetal Doppler

Abstract Objective The timing of delivery for women affected by gestational diabetes (GDM) is still controversial. Good clinical practice often suggests offering induction of labor at term in order to reduce the complications associated with this condition, while recent evidence supports expectant management. Fetal Doppler parameters represent a validated tool for testing fetal well-being at term and can select pregnancies that need increased surveillance. The aim of the present study was to evaluate the role of fetal Doppler parameters at term for the prediction of pregnancy outcomes in patients affected by GDM. Methods Prospective cohort study in a single center. Evaluation of umbilical artery (UA) PI, middle cerebral artery (MCA) PI, cerebroplacental ratio (CPR) and umbilical-to-cerebral ratio (UCR) at > 37 weeks of gestation in singleton, morphologically normal pregnancies affected by GDM, was performed in order to estimate the association between ultrasound measurements at term and perinatal outcome. Regression linear analysis was used to estimate the association between fetal Doppler parameters and neonatal pH, neonatal Apgar score, neonatal weight and a composite adverse outcome. The receiver operating characteristic (ROC) curve was used to estimate the possible predictive value of the above association. Results Our results on 130 women showed MCA PI to be the best predictor of perinatal outcomes in terms of low Apgar score at the 1st minute (p = 0.00), pH (p = 0.02) and composite adverse outcome (p = 0.05). UCR showed a significant correlation with neonatal pH (p = 0.02). No significant correlations for UA PI and CPR MoMs have been demonstrated in our population. However, the small sample size is a limitation of the study. Conclusion Evaluation of MCA Doppler and eventually UCR at term can be a useful tool to discriminate pregnancies affected by GDM that can benefit from IOL before 41 weeks in order to reduce complications related to this condition.

An influence of social isolation on the level of physical activity as well as on well-being and mental state of people during the coronavirus COVID-19 pandemic

2019 ◽  
Vol 129 (4) ◽  
pp. 127-131
Author(s):  
Agnieszka Parfin ◽  
Krystian Wdowiak ◽  
Marzena Furtak-Niczyporuk ◽  
Jolanta Herda
Keyword(s):  
Physical Activity ◽  
Social Isolation ◽  
Small Sample Size ◽  
Statistical Tests ◽  
Population Group ◽  
Well Being ◽  
Small Sample ◽  
Subjective Well Being ◽  
Tract Infections ◽  
The Impact

AbstractIntroduction. The COVID-19 is the name of an infectious disease caused by a new strain of coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). It was first diagnosed in December 2019 in patients in Wuhan City, Hubei Province, China. The symptoms are dominated by features of respiratory tract infections, in some patients with a very severe course leading to respiratory failure and, in extreme cases to death. Due to the spread of the infection worldwide, the WHO declared a pandemic in March 2020.Aim. An investigation of the impact of social isolation introduced due to the coronavirus pandemic on selected aspects of life. The researchers focused on observing changes in habits related to physical activity and their connections with people’s subjective well-being and emotional state.Material and methods. The study was carried out within the international project of the group „IRG on COVID and exercise”. The research tool was a standardized questionnaire.Results. Based on the data collected and the analysis of the percentage results, it can be observed that the overwhelming majority of people taking up physical activity reported a better mood during the pandemic. However, statistical tests do not confirm these relationships due to the small sample size.Conclusions. Isolation favours physical activity. Future, in-depth studies, by enlarging the population group, are necessary to confirm the above observations.

scholarly journals Mediterranean Diet and Lifestyle Habits during Pregnancy: Is There an Association with Small for Gestational Age Infants? An Italian Single Centre Experience

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1941
Author(s):  
Rachele De Giuseppe ◽  
Manuela Bocchi ◽  
Silvia Maffoni ◽  
Elsa Del Bo ◽  
Federica Manzoni ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Mediterranean Diet ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Small Sample Size ◽  
Demographic Data ◽  
Small Sample ◽  
Activity Level ◽  
Lifestyle Habits ◽  
Increased Risk

Background. The small-for-gestational-age (SGA) in infants is related to an increased risk of developing Non-Communicable Diseases later in life. The Mediterranean diet (MD) is related to lower odds of being SGA. The study explored retrospectively the association between SGA, maternal MD adherence, lifestyle habits and other SGA risk factors during pregnancy. Methods. One hundred women (16–44 years) with a pregnancy at term were enrolled. Demographic data, parity, pre-gestational BMI, gestational weight gain, pregnancy-related diseases, and type of delivery were collected. The MD adherence (MEDI-LITE score ≥ 9), physical activity level, and smoking/alcohol consumption were registered. SGA neonates were diagnosed according to the neonatal growth curves. Results. Women were divided into “SGA group” vs. “non-SGA group”. The MD was adopted by 71% of women and its adherence was higher in the “non-SGA group” (p = 0.02). The prevalence of pregnancy-related diseases (gestational diabetes/pregnancy-induced hypertension) was higher in the “SGA group” (p = 0.01). The logistic regression showed that pregnancy-related diseases were the only independent risk factor for SGA. Conclusions. MD may indirectly reduce the risk of SGA since it prevents and exerts a positive effect on pregnancy-related diseases (e.g., gestational diabetes and hypertension). The small sample size of women in the SGA group of the study imposes a major limitation to the results and conclusions of this research, suggesting however that it is worthy of further investigation.

scholarly journals Maternal Exercise Uncovers Placental Insufficiency in Diabetic Mothers

2019 ◽  
pp. 91-93
Author(s):  
Petrikovsky BM ◽  
Zharov EV ◽  
Plotkin D ◽  
Petrikovsky E
Keyword(s):  
Gestational Diabetes ◽  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Fetal Monitoring ◽  
Well Being ◽  
Adverse Outcomes ◽  
Exercise Regimen ◽  
Maternal Exercise ◽  
Nicu Admission ◽  
Diabetic Mothers

Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes, and enhances patient’s psychological well-being. We studied the possibility to use maternal exercise to test placental reserves in diabetic mothers. We used a motorized treadmill in a moderate exercise regimen (15-minute fast walk at a speed of 3 mph with an incline of 15-25 degrees). Fetal monitoring was provided by using standard Phillips equipment (Avalon CTS and FM40). Adverse fetal outcomes were considered if one or more of the following were present: Category III Fetal Heart Rate (FHR) tracing, 5-minute Apgar score of less than 7, admission to the neonatal intensive care nursery, fetal growth restriction, and fetal and early neonatal death. A total of 819 fetal assessments were performed: 160 patients had gestational diabetes, 80 had pregestational diabetes. The most common complication in fetuses with positive prenatal test results was abnormal FHR in labor (36%) followed by low Apgar score (21%) and need for NICU admission (19%). Most of the adverse outcomes had good correlation with positive results of the exercise test. In conclusion, it appears that maternal exercise causes changes in FHR, which may be used to assess placental and fetal reserves.

scholarly journals Italian Children’s Well-Being after Lockdown: Predictors of Psychopathological Symptoms in Times of COVID-19

2021 ◽  
Vol 18 (21) ◽  
pp. 11429
Author(s):  
Marcella Caputi ◽  
Barbara Forresi ◽  
Ludovica Giani ◽  
Giovanni Michelini ◽  
Simona Scaini
Keyword(s):  
Small Sample Size ◽  
Well Being ◽  
Small Sample ◽  
Novelty Seeking ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Childhood Experiences ◽  
Adverse Experiences ◽  
Adverse Childhood ◽  
Cross Sectional Design

The first Italian lockdown imposed to fight the spread of COVID-19 caused important disruptions in families’ everyday lives. The main aim of this research was to investigate the predictors of psychopathology in children aged 5–10 years, immediately after the national 2-month lockdown. A total of 158 Italian parents (148 mothers, 10 fathers, mean age = 41 years) were recruited and asked to complete an online research concerning their 158 children (76 boys, mean age = 7.4 years). Parents completed questionnaires on parent–child conflict, resilience, temperament, behavior, and previous adverse childhood experiences. Hierarchical regressions showed that children’s psychopathology was predicted by low child resilience, high novelty seeking and harm avoidance, adverse experiences, and high flooding levels. Moreover, girls exposed to adverse experiences appeared more vulnerable to psychopathology. The recruitment of a convenience sample, the small sample size, and the cross-sectional design of our study limit the generalizability and interpretation of the present findings. Nonetheless, this research extends our knowledge of children’s functioning in such an exceptional period. Shedding light on predictors of children’s psychopathology following prolonged quarantine can indeed guide effective psychological interventions now and in future similar situations.

Extra care housing: exploring motivations, expectations and perceptions

2020 ◽  
Vol 23 (1) ◽  
pp. 15-26
Author(s):  
Michael James Buckland ◽  
Anthea Tinker
Keyword(s):  
Social Life ◽  
Housing Association ◽  
Small Sample Size ◽  
Well Being ◽  
Small Sample ◽  
Structured Interviews ◽  
Content Type ◽  
High Expectations ◽  
Health And Social Care ◽  
Extra Care Housing

Purpose The purpose of this paper is to explore and compare the motivations and expectations that older people have when choosing to move into either a private or housing association (HA) extra care housing (ECH) scheme, and any effects this had on its residents. Design/methodology/approach This qualitative study is based on findings from four HA schemes in Tower Hamlets, London, and one private scheme in Warwickshire. Eight semi-structured interviews were conducted with five women and three men of varying backgrounds, from schemes managed by different associations and companies. Interview transcripts were coded and analysed thematically. Findings All residents moved into ECH in response to deteriorating health. However, almost all residents had felt obliged to move by others, generally their children. Few residents had any expectations of ECH on arrival, but many developed high expectations of an increased sense of independence and security and of an improved social life. ECH appeared to be beneficial for residents’ health and well-being. Research limitations/implications The inability to recruit an equal number of people from HA and private scheme, alongside the small sample size, may compromise the external validity of any conclusions drawn from any comparisons. Practical implications This research identifies a lack of knowledge about ECH among the general population and offers insight into areas of poor management within ECH schemes which could be improved. Social implications Inadequacies in the ECH model could be attributed to failures in the current health and social care system. Differences between expectations and perceptions of HA vs private schemes should be acknowledged and responded to. Originality/value This is a rare example of research exploring the relationships between ECH residents’ motivations and expectations (Hillcoat-Nallétamby and Sardani, 2019), and between those in HA vs private schemes.

The Supervisor’s Perceived Role in Employee Well-Being: Results From Mayo Clinic

2018 ◽  
Vol 33 (2) ◽  
pp. 300-311 ◽  
Author(s):  
Kaisa C. Wieneke ◽  
Karen S. Schaepe ◽  
Jason S. Egginton ◽  
Sarah M. Jenkins ◽  
Nicole C. Block ◽  
...  
Keyword(s):  
Role Model ◽  
Small Sample Size ◽  
Health Care Organization ◽  
Qualitative Interviews ◽  
Well Being ◽  
Small Sample ◽  
Care Organization ◽  
Positive Role ◽  
Worksite Health ◽  
Administrative Units

Purpose: Novel approaches are needed to enhance employee well-being and perhaps supervisors can be an effective agent for worksite health promotion. The aim of this study was to examine the supervisor’s perceived needs, barriers, and role for influencing employee well-being for incorporation into program development. Design: Semistructured, qualitative interviews of supervisors. Setting: Large, integrated academic health-care organization with over 30 000 employees and 2600 supervisors having access to comprehensive well-being programs and a successful well-being champion network comprised of 600 champions. Participants: Twenty supervisors representing clinical, research, and administrative units. Methods: Semistructured, one-on-one interviews were conducted and audio recorded. Analysis included content log development and open coding by a trained analyst to reveal key themes. More formalized content coding using specialized software for qualitative analyses was also conducted. Results: Supervisor responses were wide ranging regarding their perceived and desired role in promoting workplace well-being. Barriers from the supervisor perspective included high current workload, ambivalence about promoting wellness, lack of support from leadership, lack of flexibility and control at work, and difficulty accessing on-site resources. They perceived their potential role in well-being as remaining a positive role model and encouraging their staff in wellness activities. Conclusion: Although findings are generated from a small sample size, these qualitative data provide compelling and early insights into building a workplace well-being strategy leveraging an underutilized key stakeholder, the workplace supervisor.

scholarly journals Reducing workplace burnout: The relative benefits of cardiovascular and resistance exercise

2014 ◽  
Author(s):  
Rachel J Bretland ◽  
Einar B Thorsteinsson
Keyword(s):  
Psychological Distress ◽  
Resistance Exercise ◽  
Perceived Stress ◽  
Emotional Exhaustion ◽  
Small Sample Size ◽  
Relative Effectiveness ◽  
Maslach Burnout Inventory ◽  
Well Being ◽  
Small Sample ◽  
Personal Accomplishment

Objectives. With 43% of Australians experiencing occupational burnout therapies for burnout reduction are paramount to organisational efficiency. Exercise has potential to provide a multilevel and cost effective burnout intervention. The current study aims to extend the literature by comparing cardiovascular with resistance exercise to assess their relative effectiveness against well-being, perceived stress, and burnout. Design. Participants were 49 (36 females and 13 males) previously inactive volunteers ranging in age from 19 to 68 that completed a four week exercise program of either cardiovascular, resistance, or no exercise (control). Method. Participants were measured against the Subjective Exercise Experience Scale, the Perceived Stress Scale, and the Maslach Burnout Inventory. Results. After four weeks of exercise participants had greater positive well-being and personal accomplishment, and concomitantly less psychological distress, perceived stress, and emotional exhaustion. Cardiovascular exercise was found to increase well-being and decrease psychological distress, perceived stress, and emotional exhaustion. Resistance training was noticeably effective in increasing well-being and personal accomplishment and to reduce perceived stress. Our preliminary findings revealed large effect sizes suggesting that exercise may be an effective treatment for burnout. However, given a small sample size further research needs to be conducted. Conclusion. Different types of exercise may thus help protect against burnout as exercise seems to increase well-being and personal accomplishment while decreasing psychological distress, perceived stress, and emotional exhaustion. Organisations that want to address burnout can assist by improving their employees’ access to regular exercise programs.

scholarly journals An Enlightened Environment? Workplace Bullying and Incivility in Irish Higher Education

SAGE Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 215824401989427 ◽  
Author(s):  
Margaret Hodgins ◽  
Patricia Mannix McNamara
Keyword(s):  
Higher Education ◽  
Workplace Bullying ◽  
Small Sample Size ◽  
Academic Staff ◽  
Well Being ◽  
Small Sample ◽  
Organizational Response ◽  
Organizational Responses ◽  
Bullying Policy ◽  
Negative Impacts

This study explores the experiences of workplace ill-treatment of academic staff in the Irish Higher Education sector, with a focus on organizational response to experienced or witnessed workplace bullying and/or incivility. Workplace bullying is a significant problem, affecting approximately 15% of the workforce, with considerable variation by sector. Educational workplaces typically display prevalence rates that exceed average workplace bullying rates. The negative impacts on health and well-being are well documented and evidence is also emerging to show that organizational responses are less than optimal. The data collected comprise 11 qualitative in-depth interviews with academic staff in three of Ireland’s seven Universities. Applying a phenomenological analysis approach, data revealed that participants’ experiences were overwhelmingly negative in respect of organizational response, despite the fact that each University had an anti-bullying policy. This is explored and discussed in the context of failure to address the complex power relations, which are particularly relevant in professional organizations, intensified by current changes in the higher educational sector. Study limitations include the small number of Universities and small sample size, thus limiting generalizability.

Job insecurity fluctuations and support towards Italian precarious schoolteachers

2020 ◽  
Vol 25 (6) ◽  
pp. 631-647
Author(s):  
Marianna Giunchi ◽  
Pedro Marques-Quinteiro ◽  
Chiara Ghislieri ◽  
Anne-Marie Vonthron
Keyword(s):  
Social Support ◽  
Job Insecurity ◽  
Small Sample Size ◽  
Well Being ◽  
School Principal ◽  
Small Sample ◽  
Limited Attention ◽  
Negative Consequences ◽  
Content Type ◽  
Over Time

PurposeThe negative consequences of job insecurity on the well-being of individuals are well known. However, the perceptions of job insecurity over time and how some factors such as social support may affect them have received limited attention. This study follows precarious schoolteachers for three weeks before the end of their contract to explore how their perceptions of job insecurity evolve over time.Design/methodology/approachThe participants were 47 precarious schoolteachers who first completed a general questionnaire, then a diary survey on nine occasions over the course of the three weeks. Data was analysed with MPLUS 7.3.FindingsThe results suggest intra-individual differences regarding the way job insecurity was perceived over time. An additional discovery was that support provided by the school principal was negatively related to changes in job insecurity over time.Research limitations/implicationsThe relatively small sample size, which includes only precarious schoolteachers, and the methodology complexity of the diary are limitations of this study.Practical implicationsThis study highlights the subjective nature of the perceptions of job insecurity. It also shows the importance of the school principal's social support towards precarious schoolteachers; therefore, practitioners should propose interventions to enhance the quality of principal–teachers relationships.Originality/valueThis study contributes to the literature by investigating how perceptions of job insecurity evolve over time and the role of social support.

Transitional leadership to resolve conflict, facilitate change and restore wellbeing

2019 ◽  
Vol 27 (4) ◽  
pp. 1053-1072
Author(s):  
Tim J. Pratt ◽  
Roy K. Smollan ◽  
Edwina Pio
Keyword(s):  
Small Sample Size ◽  
Well Being ◽  
Small Sample ◽  
Future Research ◽  
Unique Contribution ◽  
Content Type ◽  
Non Profit ◽  
Transitional Leadership ◽  
The Impact ◽  
Christian Denomination

Purpose This paper aims to explore the experiences of church ministers who played the role of transitional leaders in congregational situations involving conflict. Design/methodology/approach Grounded theory was chosen as a suitable approach to investigate phenomena that occasionally penetrate religious publications and even less frequently scholarly management journals. Accordingly, in-depth interviews were conducted with six church ministers who had been transitional leaders in one Christian denomination in New Zealand. Findings Participants indicated that the drivers of transitional ministry were conflict, dysfunction and loss of direction; the goals were to heal the damage caused by conflict and restore functionality and well-being; the process, underpinned by a leadership philosophy of affirmation, trust-building, engagement and communication, involved working with church members to instil hope, establish operational structures, identify and resolve dysfunction, envision a future and ultimately recruit a permanent minister. Research limitations/implications The limitations of a small sample size in one Christian denomination could be addressed by using wider samples in other contexts. It is suggested that insights into transitional leadership after conflict will be of interest to researchers as well as practitioners in other religious organizations, the wider non-profit sector and the private sector. Future research into the impact of transitional leadership, against a background of conflict and organizational change, will add to this empirical foundation. Originality/value The model of transitional ministry is a unique contribution to religious literature and practice. It also offers insight into how other types of organization could deal with the exit of its permanent leader, in circumstances of conflict, and manage the transition phase of a temporary replacement, so that the organization returns to a state of well-being with a renewed sense of purpose.

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