scholarly journals More than just contraception: the impact of the levonorgestrel-releasing intrauterine system on public health over 30 years

2021 ◽  
pp. bmjsrh-2020-200962
Author(s):  
Kristina Gemzell-Danielsson ◽  
Ali Kubba ◽  
Cecilia Caetano ◽  
Thomas Faustmann ◽  
Eeva Lukkari-Lax ◽  
...  
Keyword(s):  
Unplanned Pregnancy ◽  
Universal Access ◽  
Waiting Times ◽  
Hospital Environment ◽  
Future Research ◽  
Reproductive Health Services ◽  
Therapeutic Benefits ◽  
Cost Efficacy ◽  
Long Acting ◽  
The Impact

Universal access to sexual and reproductive health services is essential to facilitate the empowerment of women and achievement of gender equality. Increasing access to modern methods of contraception can reduce the incidence of unplanned pregnancy and decrease maternal mortality. Long-acting reversible contraceptives (LARCs) offer high contraceptive efficacy as well as cost-efficacy, providing benefits for both women and healthcare systems. The levonorgestrel-releasing intrauterine system (LNG-IUS) first became available in 1990 with the introduction of Mirena (LNG-IUS 20), a highly effective contraceptive which can reduce menstrual blood loss and provide other therapeutic benefits. The impact of the LNG-IUS on society has been wide ranging, including decreasing the need for abortion, reducing the number of surgical sterilisation procedures performed, as well as reducing the number of hysterectomies carried out for issues such as heavy menstrual bleeding (HMB). In the context of the COVID-19 pandemic, Mirena can provide a treatment option for women with gynaecological issues such as HMB without organic pathology, minimising exposure to the hospital environment and reducing waiting times for surgical appointments. Looking to the future, research and development in the field of the LNG-IUS continues to expand our understanding of these contraceptives in clinical practice and offers the potential to further expand the choices available to women, allowing them to select the option that best meets their needs.

scholarly journals The Effect of Music Therapy on Self-Reported Affect in Hospitalised Paediatric Patients

2021 ◽  
Author(s):  
◽  
Ruth Elizabeth Armstrong
Keyword(s):  
Music Therapy ◽  
Hospital Environment ◽  
Future Research ◽  
Psychosocial Needs ◽  
Clinical Notes ◽  
Significant Difference ◽  
Before And After ◽  
The Impact ◽  
Therapy Sessions

<p>The present research examines the effect of music therapy on the affect of hospitalised children. It took place on a paediatric ward of a New Zealand public hospital. This study aimed to investigate the role of music therapy in addressing patients' psychosocial needs. Literature on the impact of hospitalisation, and on the use of music therapy in hospitals and paediatrics was reviewed. The research involved an audit of the therapist's clinical notes from music therapy sessions over the course of seven months. The clinical notes included measurements of children's mood from the beginning and end of sessions, using McGrath's (1990) Affective Facial Scale. It was hypothesised that mood measures following music therapy would be higher than pre-music therapy scores. Statistical analysis of the facial scale data did not show a significant difference between 'before' and 'after' measures. These results were discussed with regard to a ceiling effect (this is, the measurements indicated patients were at the happy end of the scale before the music therapy session, so there was little room on the scale for mood to improve following music therapy). The measurement of emotion did not prove to be straightforward. The hospital environment may have influenced the patients' responses in a number of ways. These environmental influences are discussed with reference to examples from the clinical notes. The usefulness of facial scales in this context is discussed, as well as other limitations of the research. Suggestions for future research include the use of other mood measures, and the inclusion of measurements of parental mood and how this affects the child.</p>

scholarly journals The Effect of Music Therapy on Self-Reported Affect in Hospitalised Paediatric Patients

2021 ◽  
Author(s):  
◽  
Ruth Elizabeth Armstrong
Keyword(s):  
Music Therapy ◽  
Hospital Environment ◽  
Future Research ◽  
Psychosocial Needs ◽  
Clinical Notes ◽  
Significant Difference ◽  
Before And After ◽  
The Impact ◽  
Therapy Sessions

<p>The present research examines the effect of music therapy on the affect of hospitalised children. It took place on a paediatric ward of a New Zealand public hospital. This study aimed to investigate the role of music therapy in addressing patients' psychosocial needs. Literature on the impact of hospitalisation, and on the use of music therapy in hospitals and paediatrics was reviewed. The research involved an audit of the therapist's clinical notes from music therapy sessions over the course of seven months. The clinical notes included measurements of children's mood from the beginning and end of sessions, using McGrath's (1990) Affective Facial Scale. It was hypothesised that mood measures following music therapy would be higher than pre-music therapy scores. Statistical analysis of the facial scale data did not show a significant difference between 'before' and 'after' measures. These results were discussed with regard to a ceiling effect (this is, the measurements indicated patients were at the happy end of the scale before the music therapy session, so there was little room on the scale for mood to improve following music therapy). The measurement of emotion did not prove to be straightforward. The hospital environment may have influenced the patients' responses in a number of ways. These environmental influences are discussed with reference to examples from the clinical notes. The usefulness of facial scales in this context is discussed, as well as other limitations of the research. Suggestions for future research include the use of other mood measures, and the inclusion of measurements of parental mood and how this affects the child.</p>

scholarly journals Improving practice in safeguarding at the interface between hospital services and children’s social care: a mixed-methods case study

2015 ◽  
Vol 3 (4) ◽  
pp. 1-164 ◽  
Author(s):  
Susan White ◽  
David Wastell ◽  
Suzanne Smith ◽  
Christopher Hall ◽  
Emilie Whitaker ◽  
...  
Keyword(s):  
Patient Safety ◽  
Mixed Methods ◽  
Child Protection ◽  
Social Care ◽  
Research Programme ◽  
Unintended Consequences ◽  
Primary Site ◽  
Hospital Environment ◽  
Future Research ◽  
The Impact

BackgroundHospital settings have an important impact on children harmed by parents and carers. Concern arises from the capacity of these settings to respond effectively to individual needs despite increased NHS policy awareness and actions on safeguarding. Patient safety initiatives have rarely modelled in detail the social and cultural dynamics of child health settings and children’s safeguarding. This study is focused on supporting and evaluating clinician-led service design in an acute trust. A suite of initiatives and artefacts has been designed, based on sociotechnical principles, on the premise that only a thorough understanding of human, social and organisational challenges will afford effective solutions.ObjectivesThe study addresses the following primary question: ‘Can a safeguarding culture be designed within the hospital environment that will provide the conditions for the detection of children at risk of abuse and support protective actions before discharge, including collaboration with external agencies?’ Objectives include the development of a sociologically rich understanding of why diagnostic failures and communication breakdowns occur; the design of a suite of integrated interventions for promoting a positive safety culture, following a user-centred approach; and the evaluation of the effectiveness of this package, including its generalisability across sites.DesignThe study took place in two sites: the primary site where the initiatives were developed and a further site with the original intention of transferring developments. The investigation follows a broaddesign scienceapproach. The evaluation of a design intervention relies on a rigorous understanding of the realities of everyday practice, and the study thus draws on mixed methods to examine the impact of service redesign on cultures and practices.FindingsThe data suggest that safeguarding children can become mainstream patient safety business. Board support is vital. In our primary site, there has been a steady integration of learning from serious case reviews and other child protection-related processes with ‘patient safety’-related incidents, with growing recognition that similar systemic issues impact on both domains. Making use of a familiar vocabulary to redescribesafeguardingas asafetyissue, and thus as something fundamental to the functions of an acute hospital, has been part of the success. The data suggest that persistence, resilience and vigilance from the safeguarding leadership and executive teams are crucial. Current policy includes the development of the Child Protection Information Sharing project, which is intended to improve information flow between the NHS, particularly hospitals and children’s social care. The findings from this study suggest the importance of good design, piloting, incrementalism and a thorough empirical engagement with everyday practices during implementation of this and any future information systems based reform.ConclusionsSafeguarding takes place in a complex system and even minor changes within any part of that system can impact on the rest in unpredictable ways. It is important that managers adopt a ‘design attitude’ and seek to mitigate unintended consequences through careful experimentation. The findings suggest the need for the design of systems to enhance communication and not simply to ‘share information’. Technological solutions impact on everyday decision-making and can have unintended consequences. Attention to forces of change and stasis in health settings, the factors affecting technology transfer and the impact of the configuration of local authority services are suggested as a key priorities for future research.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Impact of the COVID-19 pandemic on sexual and reproductive health among women with induced abortion

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pengcheng Tu ◽  
Jianan Li ◽  
Xiaomei Jiang ◽  
Kaiyan Pei ◽  
Yiqun Gu
Keyword(s):  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Contraceptive Use ◽  
Induced Abortion ◽  
Future Research ◽  
Reproductive Health Services ◽  
Global Pandemic ◽  
Using Data ◽  
Long Term Impact ◽  
The Impact

AbstractThe coronavirus disease (COVID-19) has already been declared a global pandemic. To our knowledge, there is very little information regarding the effects of COVID-19 on women seeking reproductive health services, specifically abortion. This study was aimed to assess the impact of the COVID-19 pandemic on reproductive and sexual health among women seeking abortion services. We conducted a series of preliminary analyses using data collected from ten maternal and child health hospitals of seven provinces in China before and during the COVID-19 lockdown. The present study showed that a significant decrease was observed in the frequency of sexual intercourse during the COVID-19 pandemic. Moreover, a significant increase in contraceptive use including condom, rhythm method and coitus interruptus whereas a decrease in choosing oral contraceptives were observed during the COVID-19 pandemic. In addition, the pandemic was associated with increased intention of seeking induced abortion due to social factors. Future research should look into the long-term impact of the COVID-19 pandemic on sexual and reproductive health.

Darbepoietin in Autologous Peripheral Blood Stem Cell Transplantation (ASCT): A Pilot Study.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 5101-5101
Author(s):  
Anna Chierichini ◽  
Barbara Anaclerico ◽  
Paola Anticoli Borza ◽  
Susanna Fenu ◽  
Carolina Nobile ◽  
...  
Keyword(s):  
Pilot Study ◽  
Side Effects ◽  
Median Time ◽  
Randomized Study ◽  
Supportive Therapy ◽  
Number Of Patients ◽  
Cost Efficacy ◽  
Long Acting ◽  
The Impact ◽  
Rbc Transfusion

Abstract In patients undergoing ASCT, RBC transfusions are depending on donor availability and correlated with early and late side effects such as immune reactions and infections. Three weeks long acting Darbepoietin is currently available, but its role in ASCT in terms of efficacy, safety and cost has not yet been established. Aim: This pilot study was activated in ASCT patients to test the impact of Darbepoietin on the haemoglobin level; RBC transfusion requirement; the total cost of Darbepoietin therapy during the first 30 days after ASCT. Material and methods. From September 2006 to June 2007, 10 patients - 5 males, median age 57 years (range 20–71) - with Multiple Myeloma (MM n=7) in 1st response, Non-Hodgkin (NHL n=2) and Hodgkin (HL n=1) Lymphoma in 2nd complete remission entered the study. As conditioning regimens, the patients received Mel 200 (n=8) or BEAM (n=2). Baseline Hb and Epo median values were: 12,1g/L (range 10.3 – 16.2 g/L), and 28.7mU/mL (range, 4.1–220 mU/L), respectively. The median value of CD34+ cells infused was 4.99 x109/L (range 3.04 – 5.07) and the median time to engraftment was 10 days (range 8–11). To prevent anaemia, patients were given i.c. single dose 500 U Darbepoietin on day +1, associated with iron therapy and B12 vitamin /weekly, plus folinic acid and B6 vitamin/daily. RBC transfusion was mandatory for Hb level ≤ 8g/L. Results: At day +30, in 9/10 patients (7 MM, 1 NHL and 1HL) the median Hb value was 13.2 g/L (range 10.2 – 15.1g/L), and none of them were transfused. Only 1 NHL received 1 RBC unit on day +7 because of Hb was 8g/L; in this case, the baseline dosage of Epo was high (220 mU/L). On the follow-up (median time 4 months, range 1–11), no thromboembolic events or other side effects occurred. Finally, in our Country the price of 1 vial Darbepoietin and 1 RBC transfusion (packed, filtered and irradiated) is 744.60 and 340 euro, respectively. Therefore,, the cost of the entire supportive therapy in our 10 patients has been 7.786 euro. Comments Despite the small number of patients, from this pilot study we can drawn the conclusion that Darbepoietin seems an effective and safe therapy and could represent an appropriate support in ASCT patients with baseline low/normal Epo level. Only a prospective, randomized study on a large number of patients will be able to answer the question on the Darbepoietin cost-efficacy in ASCT.

From Cervical Cap to Mobile App: Examining the Potential Reproductive Health Impacts of New Technologies

2019 ◽  
Vol 20 (5) ◽  
pp. 642-647 ◽  
Author(s):  
Julie M. Dorland ◽  
Leah R. Fowler ◽  
Stephanie R. Morain
Keyword(s):  
Public Health ◽  
Health Outcomes ◽  
Birth Control ◽  
Low Income ◽  
New Technologies ◽  
Unplanned Pregnancy ◽  
Mobile App ◽  
Hormonal Contraceptives ◽  
Future Research ◽  
The Impact

Web- and application-based prescription services have been heralded as “Uber for birth control,” offering patients the convenience of obtaining hormonal contraceptives at the touch of a smartphone screen. This innovation stands poised to disrupt a system that currently fails to meet the contraceptive needs of many women, particularly adolescents and those who are rural or low-income. The creation of online contraceptive prescribers provides a new and promising avenue for increased access to hormonal birth control. However, the reach and coverage of these services, as well as their implications for public health goals, including unintended pregnancy and various health screenings, remains unclear. In this article, we describe the current landscape of online contraceptive services and identify the potential impacts on unplanned pregnancy and other health outcomes. We find these services may reduce geographic and logistical barriers for rural and low-income populations. However, their impact on access for adolescents is likely to be minimal, as more than half the services do not prescribe to minors. Furthermore, increasing use of telemedicine may reduce rates of screening for public health concerns, including interpartner violence, sexually transmitted infections, and cervical cancer. We offer specific recommendations for future research to evaluate the impact of these services on unplanned pregnancy and other public health outcomes.

The impact of non-urgent patients in emergency departments' operations

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Higor Leite
Keyword(s):  
Emergency Departments ◽  
Waiting Times ◽  
Healthcare Access ◽  
Descriptive Analysis ◽  
Lean Six Sigma ◽  
Future Research ◽  
Content Type ◽  
And Performance ◽  
The Impact ◽  
Practical Implications

PurposeGlobally, the presence of non-urgent patients in emergency departments (EDs) is considered one of the main reasons for creating excessive waiting times and overcrowding in units. This paper aims to understand the impact of non-urgent patients in EDs' operations.Design/methodology/approachThis study is based on qualitative case studies conducted within two Brazilian EDs, and uses interviews and observations to access the data.FindingsFrom a thematic analysis, three key themes emerged: characteristics of non-urgent demands in EDs, negative aspects of non-urgent patients in EDs, and the impact of the healthcare system model on EDs. These themes bring to light the impact that non-urgent patients have in EDs' operations, and provide theoretical and practical implications.Research limitations/implicationsThe limitation of this work is bound by the understanding of the non-urgent demands in EDs. Therefore, a benchmarking approach (investigating state-of-the-art practices to avoid such impact) was not applied but was suggested for future research instead.Practical implicationsThe research provides significant contributions to practitioners and policymakers, aiding future discussions to improve healthcare coverage and performance.Social implicationsThe research provides significant contributions for managers and policymakers, aiding future discussions to improve healthcare. For instance, the use of well-known techniques (e.g. lean, six sigma) are discussed and suggested to enhance healthcare capacity and performance. Furthermore, the policymakers are called upon to evaluate the healthcare access and provide regulations that involve innovative approaches to widen healthcare access.Originality/valueBased upon empirical data, this research extends the discussions related to non-urgent patient in EDs and is not limited merely to descriptive analysis, but by providing practical propositions and discussions related to the impact of these patients' presence in EDs' operations. Finally, the research provides a range of suggestions for future research related to the EDs' operational performance.

Self-Compassion and Quality of Life in Adults Who Stutter

2020 ◽  
Vol 29 (4) ◽  
pp. 2097-2108
Author(s):  
Robyn L. Croft ◽  
Courtney T. Byrd
Keyword(s):  
Quality Of Life ◽  
Social Connectedness ◽  
The Self ◽  
Future Research ◽  
Self Compassion ◽  
Adults Who Stutter ◽  
And Gender ◽  
Relationship Of ◽  
The Impact

Purpose The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter. Method Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter. Results Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life. Conclusions Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion–quality of life relationship.

Pengaruh Lintas Budaya Pada Pemasaran Internasional Dengan Pendekatan Perilaku Konsumen

2017 ◽  
Vol 1 (2) ◽  
pp. 168-176
Author(s):  
Endy Gunanto ◽  
Yenni Kurnia Gusti
Keyword(s):  
Consumer Behavior ◽  
Marketing Strategy ◽  
Consumer Culture ◽  
International Organization ◽  
Future Research ◽  
Special Issue ◽  
Cross Culture ◽  
Several Variables ◽  
Cultural Orientations ◽  
The Impact

In this article we present a conceptual of the effect of cross culture on consumer behavior incorporating the impact of globalization. This conceptual idea shows that culture inûuences various domains of consumer behavior directly as well as through international organization to implement marketing strategy. The conceptual identify several factors such as norm and value in the community, several variables and also depicts the impact of other environmental factors and marketing strategy elements on consumer behavior. We also identify categories of consumer culture orientation resulting from globalization. Highlights of each of the several other articles included in this special issue in Asia region. We conclude with the contributions of the articles in terms of the consumer cultural orientations and identify directions for future research.

Aviation and the Microbiome

2020 ◽  
Vol 91 (8) ◽  
pp. 651-661
Author(s):  
Joshua T. Davis ◽  
Hilary A. Uyhelji
Keyword(s):  
Psychological Health ◽  
Aviation Safety ◽  
Autism Spectrum ◽  
Unintended Consequences ◽  
Microbial Colonization ◽  
Future Research ◽  
Aerospace Medicine ◽  
Medical Certification ◽  
Physical Disorders ◽  
The Impact

INTRODUCTION: Although the impact of microorganisms on their hosts has been investigated for decades, recent technological advances have permitted high-throughput studies of the collective microbial genomes colonizing a host or habitat, also known as the microbiome. This literature review presents an overview of microbiome research, with an emphasis on topics that have the potential for future applications to aviation safety. In humans, research is beginning to suggest relationships of the microbiome with physical disorders, including type 1 and type 2 diabetes mellitus, cardiovascular disease, and respiratory disease. The microbiome also has been associated with psychological health, including depression, anxiety, and the social complications that arise in autism spectrum disorders. Pharmaceuticals can alter microbiome diversity, and may lead to unintended consequences both short and long-term. As research strengthens understanding of the connections between the microbiota and human health, several potential applications for aerospace medicine and aviation safety emerge. For example, information derived from tests of the microbiota has potential future relevance for medical certification of pilots, accident investigation, and evaluation of fitness for duty in aerospace operations. Moreover, air travel may impact the microbiome of passengers and crew, including potential impacts on the spread of disease nationally and internationally. Construction, maintenance, and cleaning regimens that consider the potential for microbial colonization in airports and cabin environments may promote the health of travelers. Altogether, the mounting knowledge of microbiome effects on health presents several opportunities for future research into how and whether microbiome-based insights could be used to improve aviation safety.Davis JT, Uyhelji HA. Aviation and the microbiome. Aerosp Med Hum Perform. 2020; 91(8):651–661.

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