scholarly journals Prevalence of and reasons for women’s, family members’, and health professionals’ preferences for cesarean section in Iran: a mixed-methods systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Mahboubeh Shirzad ◽  
Elham Shakibazadeh ◽  
Khadijeh Hajimiri ◽  
Ana Pilar Betran ◽  
Shayesteh Jahanfar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Cesarean Section ◽  
Health Professionals ◽  
Meta Analysis ◽  
Mode Of Delivery ◽  
Family Members ◽  
Risk Level ◽  
Nulliparous Women ◽  
System Factors

Abstract Background Cesarean section (CS) rates have been increasing globally. Iran has one of the highest CS rates in the world (47.9%). This review was conducted to assess the prevalence of and reasons for women’s, family members’, and health professionals’ preferences for CS in Iran. Methods and findings In this mixed-methods systematic review, we searched MEDLINE/PubMed, Embase, CINAHL, POPLINE, PsycINFO, Global Health Library, Google scholar; as well as Iranian scientific databases including SID, and Magiran from 1 January 1990 to 8th October 2019. Primary quantitative, qualitative, and mixed-methods studies that had been conducted in Iran with Persian or English languages were included. Meta-analysis of quantitative studies was conducted by extracting data from 65 cross-sectional, longitudinal, and baseline measurements of interventional studies. For meta-synthesis, we used 26 qualitative studies with designs such as ethnography, phenomenology, case studies, and grounded theory. The Review Manager Version 5.3 and the Comprehensive Meta-Analysis (CMA) software were used for meta-analysis and meta-regression analysis. Results showed that 5.46% of nulliparous women (95% CI 5.38–5.50%; χ2 = 1117.39; df = 28 [p < 0.00001]; I2 = 97%) preferred a CS mode of delivery. Results of subgroup analysis based on the time of pregnancy showed that proportions of preference for CS reported by women were 5.94% (95% CI 5.86–5.99%) in early and middle pregnancy, and 3.81% (95% CI 3.74–3.83%), in late pregnancy. The heterogeneity was high in this review. Most women were pregnant, regardless of their parity; the risk level of participants were unknown, and some Persian publications were appraised as low in quality. A combined inductive and deductive approach was used to synthesis the qualitative data, and CERQual was used to assess confidence in the findings. Meta-synthesis generated 10 emerging themes and three final themes: ‘Women’s factors’, ‘Health professional factors’, andex ‘Health organization, facility, or system factors’. Conclusion Despite low preference for CS among women, CS rates are still so high. This implies the role of factors beyond the individual will. We identified a multiple individual, health facility, and health system factors which affected the preference for CS in Iran. Numerous attempts were made in recent years to design, test and implement interventions to decrease unnecessary CS in Iran, such as mother-friendly hospitals, standard protocols for labor and birth, preparation classes for women, midwives, and gynaecologists, and workshops for specialists and midwives through the “health sector evolution policy”. Although these programs were effective, high rates of CS persist and more efforts are needed to optimize the use of CS.

scholarly journals Prevalence of and reasons for women’s, family members’, and health professionals’ preferences for cesarean section in China: A mixed-methods systematic review

PLoS Medicine ◽  
2018 ◽  
Vol 15 (10) ◽  
pp. e1002672 ◽  
Author(s):  
Qian Long ◽  
Carol Kingdon ◽  
Fan Yang ◽  
Michael Dominic Renecle ◽  
Shayesteh Jahanfar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Cesarean Section ◽  
Health Professionals ◽  
Family Members

scholarly journals The use of telemedicine in the PICU: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252409
Author(s):  
Maria Eulália Vinadé Chagas ◽  
Hilda Maria Rodrigues Moleda Constant ◽  
Vanessa Cristina Jacovas ◽  
Jacqueline Castro da Rocha ◽  
Carina Galves Crivella Steimetz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mortality Rate ◽  
Clinical Outcomes ◽  
Health Professionals ◽  
Full Text ◽  
Meta Analysis ◽  
Family Members ◽  
Patient Characteristics ◽  
Publication Date ◽  
The Impact

The use of telemedicine in ICUs has grown and is becoming increasingly recognized. However, its impact on PICUs remains unclear. This systematic review and meta-analysis aimed to evaluate whether telemedicine in the PICU has the potential to improve clinical and non-clinical outcomes. PubMed, Scopus, LILACS, and CINAHL electronic databases were searched to identify studies that assessed the impact of telemedicine on clinical outcomes, with no publication date restrictions. The reference lists of the selected articles were hand-searched for additional studies that had not been identified by the initial electronic search. Studies were included if they had a cohort design, used telemedicine, were conducted in PICUs or specialized PICUs, and were published in Portuguese, English, or Spanish. Two groups of reviewers independently screened titles and abstracts for inclusion. The same group of reviewers independently assessed the full-text articles for eligibility and extracted the following information: telecommunication method, intervention characteristics, patient characteristics, sample size, and main results. Studies were meta-analyzed using a random-effects model to estimate the pooled prevalence of PICU mortality and length of PICU stay. Risk of bias was assessed using the Newcastle-Ottawa Scale. Of 2703 studies initially identified, 2226 had their titles and abstracts screened. Of these, 53 were selected for full-text reading, of which 10 were included and analyzed. The main results of interest were length of PICU stay, number of deaths or mortality rate, and satisfaction of health professionals and family members. The results of meta-analysis show that the mortality rate reduced by 34% with an increase of the length of PICU stay in the PICUs with the use of telemedicine. Family members and health professionals were satisfied with the use of telemedicine. Telemedicine has the potential to improve PICU outcomes, such as mortality rate and family and staff satisfaction. However, it extended length of PICU stay in the studies included in this systematic review.

scholarly journals Impact of cesarean section on timely initiation of breastfeeding in Ethiopia: a systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Temesgen Getaneh ◽  
Ayenew Negesse ◽  
Getenet Dessie ◽  
Melaku Desta ◽  
Habtamu Temesgen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Health Professionals ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Timely Initiation ◽  
Skin Contact ◽  
The Impact ◽  
Timely Initiation Of Breastfeeding ◽  
Initiation Of Breastfeeding

Abstract Background Timely initiation of breastfeeding is feeding of breast milk within one hour of birth, however, three in five babies were not breastfed in the first hour of birth globally. There is evidence that cesarean section is the major constraint for this low prevalence, but the impact of cesarean section on timely initiation of breastfeeding in Ethiopia is limited. Therefore, this meta-analysis aimed to provide evidence for policy makers, health professionals and program implementers. Methods This systematic review followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. Electronic bibliographic databases such as PubMed/Medline, EMBASE, PsycINFO, CINHAL, Scopus, Google Scholar, Science Direct and Cochrane Library were used to search relevant studies and was conducted up to February 2021. Random effects model meta-analysis was applied to estimate the pooled impact of cesarean section on timely initiation of breastfeeding with 95% confidence intervals (CI). I2 statistical test and, funnel plot and Egger’s test were used to check heterogeneity and publication bias across included studies respectively. Results According to meta-analysis of 17 studies, the pooled estimate of timely initiation of breastfeeding among women who had cesarean section in Ethiopia was 40.1% (95% CI 33.29, 46.92). The meta-analysis of 29,919 study participants showed that cesarean section was associated with a 79% lower odds of timely initiation of breastfeeding compared with vaginal birth (OR 0.21; 95% CI 0.16, 0.28). Conclusions In Ethiopia, almost only one-third of mothers who gave birth by cesarean section initiate breastfeeding within one hour of birth, much lower than the pooled prevalence among general population. Special health promotion, intervention and healthcare provider support during immediate or early skin to skin contact, and having focused breastfeeding guidelines for post-operative patient and trained health professionals should be considered for mothers who give birth through cesarean section.

Maternal and Neonatal Effect of Fentanyl as a Premedication before Induction of General Anesthesia in Cesarean Surgery: A Systematic Review and Meta-analysis of Randomized Clinical Trials

2019 ◽  
Vol 15 (4) ◽  
pp. 232-237
Author(s):  
Mir Hadi Musavi ◽  
Behzad Jodeiri ◽  
Keyvan Mirnia ◽  
Morteza Ghojazadeh ◽  
Zeinab Nikniaz
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Apgar Score ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Intravenous Fentanyl ◽  
Neonatal Effect ◽  
Fentanyl Group

Background: Although, some clinical trials investigated the maternal and neonatal effect of fentanyl as a premedication before induction of general anesthesia in cesarean section, to the best of our knowledge, there is no systematic review to summarize these results. Objectives: The present systematic review and meta-analysis evaluated the maternal and neonatal effect of intravenous fentanyl as a premedication before induction of general anesthesia in cesarean section. Methods: The databases of Pubmed, Embase, Scopus and Cochrane library were searched till July 2017 to identify randomized clinical trials which evaluated the effects of intravenous fentanyl as a premedication before induction of general anesthesia compared with placebo on neonate first and fifth minute Apgar score and maternal heart rate and mean arterial pressure (MAP) in cesarean section. Standard Mean difference (SMD) was calculated and I-square statistic test was used for heterogeneity analysis. Results: The present systematic review and meta-analysis consisted of three clinical trials including 180 women in labor. Considering the results of meta-analysis, there is no significant differences between fentanyl and placebo in the case of Apgar score at 1 minute; however, the Apgar score of 5 minutes was significantly lower in fentanyl group compared with placebo (SMD -0.68, 95%CI: - 0.98, -0.38, p<0.001). In the term of maternal hemodynamics, the heart rate (SMD -0.43, 95%CI: - 0.72, -0.13, p=0.004) and MAP (SMD -0.78, 95% CI: -1.09, -0.48, p<0.001) in fentanyl group were significantly lower compared with placebo group. Conclusion: The present meta-analysis showed that using intravenous fentanyl as a premedication before induction of general anesthesia had adverse effects on neonate Apgar score. However, it had positive effects on preventing adverse consequences of intubation on maternal hemodynamics.

Concerning the article ‘aromatherapy intervention on anxiety and pain during first stage labour in nulliparous women: a systematic review and meta-analysis’

2021 ◽  
pp. 1-1
Author(s):  
Lara Caline Santos Lira ◽  
Melania Maria Amorim ◽  
Alexandre Delgado ◽  
Mariane de Oliveira Menezes ◽  
Maíra Libertad Soligo Takemoto
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Nulliparous Women

scholarly journals The association of mode of delivery and dyspareunia: a systematic review and meta-analysis

2021 ◽  
pp. 1-9
Author(s):  
Nahid Marvi ◽  
Hamid Heidarian Miri ◽  
Elham Hooshmand ◽  
Sedigheh Abdollahpour ◽  
Maryam Zamani
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Mode Of Delivery

scholarly journals Team functioning and implementation of innovations in healthcare and human service settings: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Elizabeth A. McGuier ◽  
David J. Kolko ◽  
Mary Lou Klem ◽  
Jamie Feldman ◽  
Grace Kinkler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Human Service ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Implementation Outcomes ◽  
Services Implementation ◽  
Team Functioning

Abstract Background Healthcare and human services increasingly rely on teams of individuals to deliver services. Implementation of evidence-based practices and other innovations in these settings requires teams to work together to change processes and behaviors. Accordingly, team functioning may be a key determinant of implementation outcomes. This systematic review will identify and summarize empirical research examining associations between team functioning and implementation outcomes in healthcare and human service settings. Methods We will conduct a comprehensive search of bibliographic databases (e.g., MEDLINE, PsycINFO, CINAHL, ERIC) for articles published from January 2000 or later. We will include peer-reviewed empirical articles and conference abstracts using quantitative, qualitative, or mixed methods. We will include experimental or observational studies that report on the implementation of an innovation in a healthcare or human service setting and examine associations between team functioning and implementation outcomes. Implementation outcomes of interest are acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. Two reviewers will independently screen all titles/abstracts, review full-text articles, and extract data from included articles. We will use the Mixed Methods Appraisal Tool to assess methodological quality/bias and conduct a narrative synthesis without meta-analysis. Discussion Understanding how team functioning influences implementation outcomes will contribute to our understanding of team-level barriers and facilitators of change. The results of this systematic review will inform efforts to implement evidence-based practices in team-based service settings. Systematic review registration PROSPERO CRD42020220168

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