scholarly journals Brazilian network of COVID-19 during pregnancy (REBRACO: a multicentre study protocol)

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051284
Author(s):  
Maria Laura Costa ◽  
Renato T Souza ◽  
Rodolfo C Pacagnella ◽  
Silvana F Bento ◽  
Carolina C Ribeiro-do-Valle ◽  
...  
Keyword(s):  
Multicentre Study ◽  
Perinatal Outcomes ◽  
Monitoring And Evaluation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Prospective Multicentre Study ◽  
Maternity Hospitals ◽  
Pregnancy And Postpartum ◽  
Ethical Approval ◽  
Five Axes

IntroductionThe aim of this study was to evaluate the clinical, epidemiological and laboratory aspects of SARS-CoV-2 infection during pregnancy and postpartum in 16 maternity hospitals.Methods and analysisA prospective multicentre study, with five axes. First, the prevalence of SARS-CoV-2 infection among women admitted for childbirth will be described in a cross-sectional study. Second, maternal and perinatal outcomes will be assessed in a prospective cohort study including pregnant or postpartum women with suspected COVID-19. Third, a cohort of positive COVID-19 cases with sampling of a variety of biological material. Histopathological and viral analysis of biological maternal and neonatal samples will be performed, and the assessment of nutritional variables to evaluate the association between vitamin D and severity of infection. Fourth, a monitoring and evaluation committee to collect relevant healthcare information and plan actions in centres facing the pandemic. Furthermore, qualitative studies will be performed to study pregnant women, their families and health professionals. Fifth, an ecological study will monitor the number of live births, stillbirths and other outcomes to explore any trend among the periods before, during and after the pandemic. Data will systematically be collected in an electronic platform following standardised operational procedures. For quantitative study components, an appropriate statistical approach will be used for each analysis. For qualitative data, in-depth interviews recorded in audio will be transcribed, checking the text obtained with the recording. Subsequently, thematic analysis with the aid of the NVivo programme will be performed.Ethics and disseminationEthical approval was obtained (letters of approval numbers 4.047.168, 4.179.679 and 4.083.988). All women will be fully informed to sign the consent form before enrolment in the study. Findings will be disseminated through peer-reviewed journals and scientific conferences.

scholarly journals Knowledge on postnatal care among postpartum mothers during discharge in maternity hospitals in Asmara: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ghirmay Ghebreigziabher Beraki ◽  
Eyasu H. Tesfamariam ◽  
Amanuel Gebremichael ◽  
Berhanemeskel Yohannes ◽  
Kessete Haile ◽  
...  
Keyword(s):  
Breast Feeding ◽  
Educational Level ◽  
Postnatal Care ◽  
Knowledge Score ◽  
Cross Sectional Study ◽  
Postnatal Period ◽  
Danger Sign ◽  
Cross Sectional ◽  
Maternity Hospitals ◽  
Postpartum Mothers

Abstract Background The early postnatal period is a dangerous time for both mother and baby where morbidity and mortality are highly prevalent if proper care is not done. Post natal care (PNC) knowledge has significant role in reducing such complications. In this study, the knowledge of postpartum mothers on PNC and its determinants were determined. Methods A cross-sectional quantitative study was conducted in postpartum mothers (PpM) who attended all maternal delivery services in Asmara. Data was collected by a structured questionnaire. All (n = 250) PpM who gave birth in December, 2017 were included in the study. Independent samples t-test and one way ANOVA were used to compare the scores in knowledge across categories of background characteristics using SPSS. Bonferroni post-hoc test was performed for variables that were found to be significant while using ANOVA tool. P-values less than 0.05 were considered as significant. Results The percentage of PpM who cited vaginal bleeding, as a maternal danger sign, and fever, as a baby danger sign, were 83.2 and 58.8%, respectively. The majority (96%) of PpM responded the correct answer on where to go if they note any danger signs. In addition, more than nine tenth of PpM correctly identified injectable contraceptives (92.7%) and oral contraceptive (91.5%). The percentages of knowledge in recognizing the necessary nutrients ranged from 87.6% for carbohydrates to 46% for minerals. The percentages of correct knowledge regarding first baby bath, frequency of breast feeding, umbilical care, duration of exclusive breast feeding, need and purpose of vaccine were 40.1, 81.9, 77.4, 94.8, and 99.2% respectively. The mean PNC knowledge score was 24.89/60. The score of knowledge on postnatal care was found to significantly differ across the categories of residence (p < 0.001) and ethnicity (p = 0.015). An increasing trend of knowledge score was observed with increase in age group (p < 0.001), educational level (p = 0.021), gravida (p < 0.001) and para (p < 0.001). Conclusion Considerable gaps in knowledge regarding postnatal care among postpartum mothers were evident. Special attention should be laid on rural residents, single/living together, junior/below in educational level, primigravida/para, non-Tigrigna ethnicity, and 17 to 25 years old mothers.

Prevalence of Gingival Pigmentation and its Association with Gingival Biotype and Skin Colour

2021 ◽  
Vol 5 (1) ◽  
pp. 19-25
Author(s):  
Arjun Hari Rijal ◽  
Bhageshwar Dhami ◽  
Nashib Pandey ◽  
Deepa Aryal
Keyword(s):  
Strong Association ◽  
Cross Sectional Study ◽  
Skin Colour ◽  
Facial Skin ◽  
Cross Sectional ◽  
Attached Gingiva ◽  
Ethical Approval ◽  
Gingival Epithelium ◽  
Interdental Papilla ◽  
Gingival Biotype

Introduction: The facial appearance depends on several oral and extraoral factors including colour of facial skin and pigmentation of gingival epithelium. The colour of the gingiva varies among individuals and is thought to be associated with cutaneous pigmentation which ranges from light to dark brown or black colour. Objective: To assess the prevalence of physiological gingival pigmentation, gingival biotype and their association with skin colur in Nepalese subjects visiting Kantipur Dental College and Hospital (KDCH). Methods: This was an analytical cross-sectional study which was carried out from February 2020 to June 2020 in all patients of age-group 16 to 80 years visiting the Department of Periodontics at KDCH after ethical approval. Patients were recruited by convenience sampling and examined thoroughly to find out gingival biotype and extent of gingival pigmentation intraorally as well as skin colour extraorally. Results: In this study, 210 patients were examined among which, 105 (50%) were males and 105 (50%) were females. Out of 210, 33 (15.7%) had pink tissue without pigmentation, 84 (40%) had pigmentation only in attached gingiva, 58 (27.6%) in attached gingiva and interdental papilla, 32 (15.2%) had diffuse pigmentation involving all parts of gingiva, 2 (1%) had in marginal gingiva only, and 1 (0.5%) in marginal gingiva and interdental papilla. Conclusion: A strong association was found between gingival pigmentation and facial skin colour in present study (P <0.001). Establishing the pattern of gingival pigmentation in Nepalese population will help to choose a specific depigmentation therapy that will harmonise with skin colour.  

Diagnostic and Therapeutic Knowledge and Practices in the Management of Congenital Syphilis by Pediatricians in Public Maternity Hospitals in Brazil

2017 ◽  
Vol 49 (2) ◽  
pp. 322-342 ◽  
Author(s):  
Raquel Rodrigues dos Santos ◽  
Roberta Pereira Niquini ◽  
Francisco Inácio Bastos ◽  
Rosa Maria Soares Madeira Domingues
Keyword(s):  
Congenital Syphilis ◽  
Cross Sectional Study ◽  
Case Definition ◽  
Educational Work ◽  
Correct Treatment ◽  
Cross Sectional ◽  
Treatment Protocols ◽  
Missed Opportunities ◽  
Maternity Hospitals ◽  
Definition Of

The study aimed to assess conformity with Brazil’s standard protocol for diagnostic and therapeutic practices in the management of congenital syphilis by pediatricians in public maternity hospitals. A cross-sectional study was conducted in 2015 with 41 pediatricians working in all the public maternity hospitals in Teresina, the capital of Piauí State, Northeast Brazil, through self-completed questionnaires. The study assessed the conformity of knowledge and practices according to the Brazilian Ministry of Health protocols. The study has made evident low access to training courses (54%) and insufficient knowledge of the case definition of congenital syphilis (42%) and rapid tests for syphilis (39%). Flaws were observed in the diagnostic workup and treatment of newborns. Requesting VDRL (88%) and correct treatment of neurosyphilis (88%) were the practices that showed the highest conformity with standard protocols. Low conformity with protocols leads to missed opportunities for identifying and adequately treating congenital syphilis. Based on the barriers identified in the study, better access to diagnostic and treatment protocols, improved recording on prenatal cards and hospital patient charts, availability of tests and medicines, and educational work with pregnant women should be urgently implemented, aiming to reverse the currently inadequate management of congenital syphilis and to curb its spread.

scholarly journals Prevalence of Postpartum Family Planning Service Coverage in Selected Referral Facilities of Nepal

2020 ◽  
Vol 58 (221) ◽  
Author(s):  
Kusum Thapa ◽  
Rolina Dhital ◽  
Sameena Rajbhandari ◽  
Shikha Thapa ◽  
Sabina Pokhrel ◽  
...  
Keyword(s):  
Family Planning ◽  
Intrauterine Device ◽  
Cross Sectional Study ◽  
Planning Method ◽  
Family Planning Method ◽  
Postpartum Contraception ◽  
Cross Sectional ◽  
Postpartum Family Planning ◽  
Ethical Approval ◽  
Service Coverage

Introduction: Nepal Society of Obstetricians and Gynecologists jointly with the Nepalese governmentand with the support from the International Federation of Obstetrics and Gynecology hasimplemented an initiative to institutionalize postpartum family planning services in selected majorreferral facilities of Nepal to address the gap of low uptake of postpartum family planning in Nepal.The aim of the study is to find the prevalence of the service coverage of postpartum contraception inthe selected facilities. Methods: A descriptive cross-sectional study was conducted in seven major referral facilities acrossNepal. Data were collected from the hospital records of all women who delivered in these facilitiesbetween October 2018 and March 2019. Ethical approval for this study was obtained from NepalHealth Research Council. Data analysis was done with SPSS version 23. Results: Among the 29,072 deliveries from all the facilities, postpartum family planning counselingcoverage was 27,301 (93.9%). The prevalence of uptake of Postpartum Intrauterine Device is 1581(5.4%) and female sterilization is 1830 (6.3%). In total 11387 mothers (52.2%) had the intention tochoose a postpartum family planning method. However, 36% of mothers neither used nor had theintention to choose a postpartum family planning method. Conclusions: The coverage of Postpartum Intrauterine Device counseling service coverage in Nepal ishigher in 2018 as compared to 2016-2017 and in other countries implementing Postpartum IntrauterineDevice initiatives. However, the prevalence of service coverage of immediate Postpartum FamilyPlanning methods, mainly Postpartum Intrauterine Device in 2018 is lower in Nepal as compared to2016-2017, and other countries implementing Postpartum Intrauterine Device initiative. More effortsare needed to encourage mothers delivering in the facilities to use the postpartum family planningmethod.

scholarly journals Visual Acuity Changes during Pregnancy and Postpartum: A Cross-Sectional Study in Iran

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Khashayar Mehdizadehkashi ◽  
Shahla Chaichian ◽  
Abolfazl Mehdizadehkashi ◽  
Ebrahim Jafarzadepour ◽  
Zeinab Tamannaie ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Refractive Error ◽  
Postpartum Period ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Second Trimester ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pregnancy And Postpartum ◽  
Myopic Shift

In this research, we represent the changes in visual acuity during pregnancy and after delivery. Changes as myopic shift start during second trimester and will be stopped after delivery; however it is obtained that women will have the same refractive error as what they had in the first trimester, after postpartum. So, any change in their spectacle prescription during this period is forbidden. As a result, not only changing in hormones can cause myopic shift in vision, but also overweight has its retributive role. What we are trying to do is to notify gynecologists and optometrists to be aware of these changes, so as to leave spectacle prescription writing to the session after postpartum period.

scholarly journals Prevalence and Perinatal Outcomes of Singleton Term Breech Delivery in Wolisso Hospital, Oromia Region, Southern Ethiopia: A Cross-Sectional Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Temesgen Debero Mere ◽  
Tilahun Beyene Handiso ◽  
Abera Beyamo Mekiso ◽  
Markos Selamu Jifar ◽  
Shabeza Aliye Ibrahim ◽  
...  
Keyword(s):  
Perinatal Mortality ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Perinatal Outcomes ◽  
Cross Sectional Study ◽  
Fetal Weight ◽  
Sectional Study ◽  
Cross Sectional ◽  
Breech Delivery

Background.Breech deliveries have always been topical issues in obstetrics. Neonates undergoing term breech deliveries have long-term morbidity up to the school age irrespective of mode of delivery.Objective. To determine prevalence and perinatal outcomes of singleton term breech delivery.Methods. Hospital based cross-sectional study was conducted on 384 participants retrospectively. Descriptive and analytical statistics was used.Result. A total of 384 breech deliveries were included. Prevalence of singleton breech deliveries in the hospital was 3.4%. The perinatal outcome of breech deliveries was 322 (83.9%). Adverse perinatal outcome of singleton term breech delivery was significantly associated with women’s age of greater than or equal to 35 years (AOR = 2.62, 95% CI = 1.14–6.03), fully dilated cervix (AOR = 0.48, 95% CI = 0.25–0.91), ruptured membrane (AOR = 5.11, 95% CI = 2.25–11.6), and fetal weight of <2500 g (AOR = 6.77, 95% CI = 3.22–14.25).Conclusion. Entrapment of head, birth asphyxia, and cord prolapse were the most common causes of perinatal mortality. Factors like fetal weight <2500 gm, mothers of age 35 years and above, those mothers not having a fully dilated cervix, and mothers with ruptured membrane were associated with increased perinatal mortality.

scholarly journals The affordability of prescription medicines in Australia: are copayments and safety net thresholds too high?

2013 ◽  
Vol 37 (1) ◽  
pp. 32 ◽  
Author(s):  
Andrew Searles ◽  
Evan Doran ◽  
Thomas A Faunce ◽  
David Henry
Keyword(s):  
Financial Burden ◽  
Monitoring And Evaluation ◽  
Access To Medicines ◽  
Safety Net ◽  
Cross Sectional Study ◽  
Self Report ◽  
Cross Sectional ◽  
Prescription Medicines ◽  
Main Determinants ◽  
The Cost

Objective. To create and report survey-based indicators of the affordability of prescription medicines for patients in Australia. Method. A cross-sectional study of 1502 randomly selected participants in the Hunter Region of NSW, were interviewed by telephone. Main outcome measure. The self-reported financial burden of obtaining prescription medicines. Results. Data collection was completed with a response rate of 59.0%. Participants who had received and filled at least one prescription medicine in the previous 3 months, and eligible for analysis (n=952), were asked to self-report the level of financial burden from obtaining these medicines. Extreme and heavy financial burdens were reported by 2.1% and 6.8% of participants, respectively. A moderate level of burden was experienced by a further 19.5%. Low burden was recorded for participants who said that their prescription medicines presented either a slight burden (29.0%) or were no burden at all (42.6%). Conclusion. A substantial minority of participants who had obtained prescription medicines in the 3 months prior to survey experienced a level of financial burden from the cost of these medicines that was reported as being moderate to extreme. What is known about the topic? The Australian National Medicines Policy aims to, amongst other things, facilitate access to medicines at a cost that is affordable to individuals and the community. Copayments combined with the safety net and brand price premium are the main determinants of the amount that patients pay for PBS listed prescription medicines. Previous surveys have reported on selected aspects of medicine affordability in Australia and have shown some groups in the population experience difficulty with the cost of their medicines. What does this paper add? This paper develops and reports on a set of indicators that can be used to periodically measure the level of self-reported financial burden experienced by Australians when obtaining prescription medicines. The analysis assesses affordability issues for both general patients and patients who are able to access prescription medicines using a concession card. What are the implications? Our research suggests that, as they stand, the copayment and safety net thresholds are not protecting nearly one-third of Australian patients from financial burden. Ongoing monitoring and evaluation is required to ensure the copayment and safety net thresholds do not jeopardise the National Medicines Policy’s principle of equitable and affordable access to medicines.

scholarly journals Active health Ombudsman service

2018 ◽  
Vol 52 ◽  
pp. 76 ◽  
Author(s):  
Karlo Jozefo Quadros de Almeida ◽  
Francis Nakle de Roure ◽  
Roberto José Bittencourt ◽  
Regina Maria Dias Buani dos Santos ◽  
Fernanda Viana Bittencourt ◽  
...  
Keyword(s):  
Health Professionals ◽  
Public Management ◽  
Federal District ◽  
Maternity Hospital ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
Cross Sectional ◽  
Initial Care ◽  
Maternity Hospitals

OBJECTIVE: To evaluate the active health Ombudsman service as an instrument to evaluate the quality of delivery and birth care in the Cegonha Network of the Federal District of Brazil. METHODS: This is a cross-sectional study of the telephone survey type carried out with 1,007 mothers with deliveries between October 15, 2013 and November 19, 2013 in the twelve public maternity hospitals that make up the Cegonha Network of the Federal District of Brazil. The instrument has 25 multiple choice or Likert scale questions, including sociodemographic data and acceptability evaluation in five domains: accessibility, relationship between the patient and health professionals, conditions of the structure of the service, information to the patient, and equity and opinion of the patient. We have studied qualitative or categorical variables according to the frequency and distribution of proportions. We have used the score transformed into a scale from zero to 100 for the analysis of the Likert-type scale questions. Results have been expressed as mean and standard deviation. RESULTS: Access to prenatal appointments was evaluated as good or excellent by 86.1% of the participants and laboratory tests was evaluated as good or excellent by 85.2% of them. The access to imaging tests was evaluations as good or excellent by 45.7% of the women; 79.5% of the interviewees had their delivery in the maternity hospital where they sought initial care and 18.3% received a home visit by a community health agent after discharge. Most women reported that newborns were placed skin-to-skin immediately after birth, 48.9% had a companion at the time of the delivery, 76.3% were advised about the first appointment of the newborn, and 94.8% were advised on breastfeeding in the maternity hospital. Regarding the evaluation of health professionals, 85.9% of the women considered reception and cordiality as good or excellent at the prenatal care and 94.8% considered it as good or excellent at the maternity hospital. CONCLUSIONS: The active health Ombudsman service has contributed to evaluate the quality of public management by allowing the incorporation of the perspective of users of the health service in the evaluation of the acceptability of the Cegonha Network in the Federal District of Brazil.

scholarly journals Cross-sectional mixed-methods study protocol exploring the enablers and barriers for people with severe and enduring mental illness in Jamaica when accessing healthcare for chronic physical illness

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e038245
Author(s):  
Patrice Whitehorne-Smith ◽  
Sharyn Burns ◽  
Ben Milbourn ◽  
Wendel Abel ◽  
Robyn Martin
Keyword(s):  
Mental Illness ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Ethics Committee ◽  
Physical Illness ◽  
Caribbean Region ◽  
Cross Sectional ◽  
Chronic Physical Illness ◽  
Ethical Approval ◽  
The University

IntroductionExtant international research suggests that people with severe and enduring mental illness (PWSEMI) experience increased rates of chronic physical illness (CPI), reduced life expectancy and higher mortality than those in the general population. The high prevalence of CPI among PWSEMI is associated with a number of barriers that this population experiences when accessing physical healthcare. Although substantial research has been conducted in North America, Europe and Australia, there appears to be a paucity of research exploring CPI among PWSEMI in the Caribbean region, although this region has reported very high rates of non-communicable diseases within its populations. The current study will be situated in Jamaica and will explore the enablers and barriers to PWSEMI accessing healthcare for CPI.Methods and analysisA convergent mixed-method design will explore the enablers and barriers to accessing healthcare for CPI among PWSEMI. This cross-sectional study will collect data from PWSEMI, caregivers and family members, community health aides, primary care physicians, psychiatrists and health policymakers.Ethics and disseminationThe study findings will provide baseline data describing the prevalence of CPI among PWSEMI in Jamaica and will identify enablers for, and barriers to, PWSEMI accessing CPI care. Findings will be disseminated widely in Jamaica and internationally to key stakeholders through publications and conferences. Institutional ethical approval was granted from Jamaica’s Ministry of Health and Wellness Medico-legal Ethics Review Panel (# 2019/49), the Curtin University Human Research and Ethics Committee (HRE 2020–0022) and the University of the West Indies FMS Ethics Committee (ECP 101, 19/20).

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