Who Indicates Caesarean Section in Romania? A Cross-Sectional Survey in Tertiary Level Maternity on Childbirth Patients and Doctors' Profiles

2020 ◽  
Author(s):  
Anca Angela Simionescu ◽  
Alexandra Horobet ◽  
Erika Marin ◽  
Lucian Belascu
Keyword(s):  
Health System ◽  
Statistical Tests ◽  
Statistical Significance ◽  
Tertiary Level ◽  
Delivery Mode ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Indication ◽  
Delivery Modes ◽  
Significant Difference

Abstract Background. C-section rate in Romania is the second-highest in the European Union (44.1% in 2017) and the number of C-sections performed in the country increased by 32.1% between 2009 and 2017. We offer for the first time insights into the practice and perceptions of patients and doctors in Romania towards delivery mode and on health system particularities that lead to increased numbers of C-sections. The objectives are 1) to compare the preferred modes of birth among women 2) to draw a profile of patients in whose case the actual birth method is different from the preferred method, and 3) to outline a profile of doctors and patients based on the modes of delivery. Methods. We conduct a statistical analysis based on an observational, analytical, and cross-sectional survey on 117 singleton pregnant women more than 36 weeks in spontaneous labor in tertiary level maternity in Romania. Various statistical tests have been used to indicate statistical significance. Results. Our results show an increase of almost 58% in actual childbirth mode against preferred childbirth by C-sections, rather difficult to justify based only on medical emergencies. There are 22 patients with non-concordant C-section indications between preferred and actual mode of birth, 7 of them (31.8%) preferred natural birth and 15 (68.2%) preferred C-section. Scarred uterus is the most frequent medical indication for C-section (30.7%). Overall, birth and birth pain assessment correlates to preferred and actual delivery modes, but respondents distinguish clearly between birth pain alone and their overall birth experience. The profiles of patients with concordant and non-concordant delivery modes are different, and indicate a statistically significant difference between the preference for delivery and actual birth method. Patients who preferred vaginal birth, but gave birth by C-section, are mature and more educated women, in the middle to the high-income category, mostly attended by consultant doctors and specialists. Doctors’ profiles show that specialists and consultants attend the largest share of non-concordant births, while residents and young senior doctors attend mostly vaginal births. Conclusions. We emphasize health system particularities in Romania as triggers of high C-section rates that favor womens’ preferences against C-section medical indication.

scholarly journals Who indicates Caesarean section in Romania? A cross-sectional survey in tertiary level maternity on childbirth patients and doctors' profiles 

2020 ◽  
Author(s):  
Anca Angela Simionescu ◽  
Alexandra Horobet ◽  
Erika Marin ◽  
Lucian Belascu
Keyword(s):  
Statistical Tests ◽  
Statistical Significance ◽  
Tertiary Level ◽  
The European Union ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference ◽  
Mode Of Birth ◽  
High Income Category ◽  
Women’S Preferences

Abstract Background. Cesarean section (C-section) rate in Romania is the second-highest in the European Union (44.1% in 2017), and the number of C-sections performed in the country has increased in the past decades. Given how common C-section is now, it is important to gain insight into the practice and perceptions of patients and doctors in countries with high C-section rates. The objectives are 1) to compare the preferred modes of birth among women; 2) to draw a profile of patients and doctors in whose case the actual birth method is different from the preferred method; and 3) to analyze the way Romanian women want to give birth. Methods. We conduct a statistical analysis based on an observational, analytical, and cross-sectional survey on 117 singleton pregnant women more than 36 weeks in spontaneous labor in tertiary level maternity in Romania. Various statistical tests have been used to indicate statistical significance. Results. We calculate an increase of almost 58% in actual childbirth mode against preferred childbirth by C-sections, rather difficult to justify based only on medical emergencies. There are 22 patients with non-concordant C-section indications between preferred and actual mode of birth, 7 of them (31.8%) preferred natural birth and 15 (68.2%) preferred C-section. The profiles of patients with concordant and non-concordant delivery modes are different and indicate a statistically significant difference between the preference for delivery and actual birth method. Patients who preferred vaginal birth, but gave birth by C-section, are mature and more educated women, in the middle to high-income category, mostly attended by consultant doctors and specialists. Doctors’ profiles show that specialists and consultants attend the largest share of non-concordant births, while residents and young senior doctors attend mostly vaginal births. Conclusions. We emphasize health system particularities in Romania as triggers of high C-section rates that favor women’s preferences against C-section medical indication. Improving patients’ confidence in the health care system, built on competence and fitted hierarchical team position may lead to choosing the optimal way of birth for childbirth safety and pain control.

scholarly journals Who indicates Caesarean section in Romania? A cross-sectional survey in tertiary level maternity on childbirth patients and doctors' profiles 

2020 ◽  
Author(s):  
Anca Angela Simionescu ◽  
Alexandra Horobet ◽  
Erika Marin ◽  
Lucian Belascu
Keyword(s):  
Statistical Tests ◽  
Statistical Significance ◽  
Tertiary Level ◽  
The European Union ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference ◽  
Mode Of Birth ◽  
High Income Category ◽  
Women’S Preferences

Abstract Background. Cesarean section (C-section) rate in Romania is the second-highest in the European Union (44.1% in 2017), and the number of C-sections performed in the country has increased in the past decades. Given how common C-section is now, it is important to gain insight into the practice and perceptions of patients and doctors in countries with high C-section rates. The objectives are 1) to compare the preferred modes of birth among women; 2) to draw a profile of patients and doctors in whose case the actual birth method is different from the preferred method; and 3) to analyze the way Romanian women want to give birth. Methods. We conduct a statistical analysis based on an observational, analytical, and cross-sectional survey on 117 singleton pregnant women more than 36 weeks in spontaneous labor in tertiary level maternity in Romania. Various statistical tests have been used to indicate statistical significance. Results. We calculate an increase of almost 58% in actual childbirth mode against preferred childbirth by C-sections, rather difficult to justify based only on medical emergencies. There are 22 patients with non-concordant C-section indications between preferred and actual mode of birth, 7 of them (31.8%) preferred natural birth and 15 (68.2%) preferred C-section. The profiles of patients with concordant and non-concordant delivery modes are different and indicate a statistically significant difference between the preference for delivery and actual birth method. Patients who preferred vaginal birth, but gave birth by C-section, are mature and more educated women, in the middle to high-income category, mostly attended by consultant doctors and specialists. Doctors’ profiles show that specialists and consultants attend the largest share of non-concordant births, while residents and young senior doctors attend mostly vaginal births. Conclusions. We emphasize health system particularities in Romania as triggers of high C-section rates that favor women’s preferences against C-section medical indication. Improving patients’ confidence in the health care system, built on competence and fitted hierarchical team position may lead to choosing the optimal way of birth for childbirth safety and pain control.

scholarly journals CircaCompare: a method to estimate and statistically support differences in mesor, amplitude and phase, between circadian rhythms

2019 ◽  
Author(s):  
Rex Parsons ◽  
Richard Parsons ◽  
Nicholas Garner ◽  
Henrik Oster ◽  
Oliver Rawashdeh
Keyword(s):  
Wave Function ◽  
Statistical Tests ◽  
Statistical Significance ◽  
P Value ◽  
Cross Sectional ◽  
Fundamental Interest ◽  
Response Variable ◽  
Highly Sensitive ◽  
Significant Difference ◽  
Phase Amplitude

Abstract Motivation A fundamental interest in chronobiology is to compare patterns between groups of rhythmic data. However, many existing methods are ill-equipped to derive statements concerning the statistical significance of differences between rhythms that may be visually apparent. This is attributed to both the form of data used (longitudinal versus cross-sectional) and the limitations of the statistical tests used to draw conclusions. Results To address this problem, we propose that a cosinusoidal curve with a particular parametrization be used to model and compare data of two sets of observations collected over a 24-h period. The novelty of our test is in the parametrization, which allows the explicit estimation of rhythmic parameters [mesor (the rhythm-adjusted mean level of a response variable around which a wave function oscillates), amplitude and phase], and simultaneously testing for statistical significance in all three parameters between two or more groups of datasets. A statistically significant difference between two groups, regarding each of these rhythmic parameters, is indicated by a P-value. The method is evaluated by applying the model to publicly available datasets, and is further exemplified by comparison to the currently recommended method, DODR. The results suggest that the method proposed may be highly sensitive to detect rhythmic differences between groups in phase, amplitude and mesor. Availability and implementation https://github.com/RWParsons/circacompare/

scholarly journals Healthworker Preparedness for COVID-19 Management and Implementation Experiences: A Mixed Methods Study in Uganda’s Refugee-Hosting Districts

2021 ◽  
Author(s):  
Gloria Seruwagi ◽  
Catherine Nakidde ◽  
Felix Otieno ◽  
Joshua Kayiwa ◽  
Brian Luswata ◽  
...  
Keyword(s):  
Health System ◽  
Work Environment ◽  
Negative Impact ◽  
Statistical Tests ◽  
Statistical Significance ◽  
Total Sample ◽  
P Value ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
High Level

Abstract Background : The negative impact of COVID-19 on population health outcomes raises critical questions on health system preparedness and resilience, especially in resource-limited settings. This study examined healthworker preparedness for COVID-19 management and implementation experiences in Uganda’s refugee-hosting districts.Methods : A cross sectional, mixed-method descriptive study in 17 health facilities in 7 districts from 4 major regions. Total sample size was 485 including >370 health care workers (HCWs). HCW knowledge, attitude and practices (KAP) was assessed by using a pre-validated questionnaire. The quantitative data was processed and analysed using SPSS 26, and statistical significance assumed at p<0.05 for all statistical tests. Bloom's cutoff of 80% was used to determine threshold for sufficient knowledge level and practices with scores classified as high (80.0%–100.0%), average (60.0%–79.0%) and low (≤59.0%). HCW implementation experiences and key stakeholder opinions were further explored qualitatively using interviews which were audio-recorded, coded and thematically analysed.Results: On average 71% of HCWs were knowledgeable on the various aspects of COVID-19, although there is a wide variation in knowledge. Awareness of symptoms ranked highest among 95% (p value < 0.0001) of HCWs while awareness of the criteria for intubation for COVID-19 patients ranked lowest with only 35% (p value < 0.0001). Variations were noted on falsehoods about COVID-19 causes, prevention and treatment across Central (p value < 0.0356) and West Nile (p value < 0.0161) regions. Protective practices include adequate ventilation, virtual meetings and HCW training. Deficient practices were around psychosocial and lifestyle support, remote working and contingency plans for HCWs safety. The work environment has immensely changed with increased demands on the amount of work, skills and variation in nature of work. HCWs also reported moderate control over their work environment, high level of support from supervisors (88%) and colleagues (93%). Conclusions: HCWs preparedness is inadequate in some aspects. Implementation of healthcare interventions is constrained by the complexity of Uganda’s health system design, top-down approach of the national response to COVID-19 and longstanding health system bottlenecks. We recommend continuous information sharing on COVID-19, a design review with capacity strengthening at all health facility levels and investing in community-facing strategies.

scholarly journals Healthworker preparedness for COVID-19 management and implementation experiences: a mixed methods study in Uganda’s refugee-hosting districts

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Gloria Seruwagi ◽  
Catherine Nakidde ◽  
Felix Otieno ◽  
Joshua Kayiwa ◽  
Brian Luswata ◽  
...  
Keyword(s):  
Health System ◽  
Work Environment ◽  
Negative Impact ◽  
Statistical Tests ◽  
Statistical Significance ◽  
Total Sample ◽  
Cross Sectional ◽  
Resource Limited ◽  
Validated Questionnaire ◽  
High Level

Abstract Background The negative impact of COVID-19 on population health outcomes raises critical questions on health system preparedness and resilience, especially in resource-limited settings. This study examined healthworker preparedness for COVID-19 management and implementation experiences in Uganda’s refugee-hosting districts. Methods A cross sectional, mixed-method descriptive study in 17 health facilities in 7 districts from 4 major regions. Total sample size was 485 including > 370 health care workers (HCWs). HCW knowledge, attitude and practices (KAP) was assessed by using a pre-validated questionnaire. The quantitative data was processed and analysed using SPSS 26, and statistical significance assumed at p < 0.05 for all statistical tests. Bloom's cutoff of 80% was used to determine threshold for sufficient knowledge level and practices with scores classified as high (80.0–100.0%), average (60.0–79.0%) and low (≤ 59.0%). HCW implementation experiences and key stakeholder opinions were further explored qualitatively using interviews which were audio-recorded, coded and thematically analysed. Results On average 71% of HCWs were knowledgeable on the various aspects of COVID-19, although there is a wide variation in knowledge. Awareness of symptoms ranked highest among 95% (p value < 0.0001) of HCWs while awareness of the criteria for intubation for COVID-19 patients ranked lowest with only 35% (p value < 0.0001). Variations were noted on falsehoods about COVID-19 causes, prevention and treatment across Central (p value < 0.0356) and West Nile (p value < 0.0161) regions. Protective practices include adequate ventilation, virtual meetings and HCW training. Deficient practices were around psychosocial and lifestyle support, remote working and contingency plans for HCW safety. The work environment has immensely changed with increased demands on the amount of work, skills and variation in nature of work. HCWs reported moderate control over their work environment but with a high level of support from supervisors (88%) and colleagues (93%). Conclusions HCWs preparedness is inadequate in some aspects. Implementation of healthcare interventions is constrained by the complexity of Uganda’s health system design, top-down approach of the national response to COVID-19 and longstanding health system bottlenecks. We recommend continuous information sharing on COVID-19, a design review with capacity strengthening at all health facility levels and investing in community-facing strategies.

scholarly journals The Impact of COVID-19 on Plastic Surgery Training in the United Kingdom, Canada and Australia—A Cross-Sectional Study

2021 ◽  
Author(s):  
Curtis R Budden ◽  
Francesca Rannard ◽  
Joanna Mennie ◽  
Neil Bulstrode
Keyword(s):  
Plastic Surgery ◽  
Statistical Tests ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The United Kingdom ◽  
Surgical Trainees ◽  
Significant Difference ◽  
The Uk ◽  
The Impact

Abstract Background Surgical trainees worldwide have been thrust into a period of uncertainty, with respect to the implications COVID-19 pandemic will have on their roles, training, and future career prospects. It is currently unclear how plastic surgery trainees are being affected by COVID-19. This study examined the experience of plastic surgery trainees in Canada, the UK, and Australia to determine trainee roles during the early COVID-19 emergency response and how training changed during this time. Methods A cross-sectional survey-based study was designed for plastic surgery trainees in the UK, Canada and Australia. In total, 110 trainees responded to the survey. Statistical tests were conducted to determine differences in responses, based on year of training and country of residence. Results In total, 9.7% (10/103) of respondents reported being deployed to cover another service. There was a significant difference between redeployment based on country (p = 0.001). Within the UK group, 28.9% of respondents were redeployed. For trainees not deployed, 95.5% (85/89) reported that there has been a reduction in operative volume. Ninety-seven (94.1%) respondents reported that there were ongoing teaching activities offered by their program. The majority of trainees (66.4%) were concerned about their training. There was a significant difference between overall concern and country (p < 0.05). Conclusion In these unprecedented times, training programs in plastic surgery should be aware of the major impact that COVID-19 has had on trainees and will have on their training. The majority of plastic surgery trainees have experienced a reduction in surgical exposure but have maintained some form of regular teaching.

scholarly journals KNOWLEDGE ATTITUDE AND PRACTICE TOWARD COVID-19 DISEASE AMONG VARIOUS PROFESSIONALS: A CROSS-SECTIONAL ONLINE SURVEY

2021 ◽  
pp. 60-63
Author(s):  
ABEETHA S ◽  
RAMYA K ◽  
BHAGYASHREE N ◽  
SUMA S ◽  
SUREKA V
Keyword(s):  
Marital Status ◽  
Online Survey ◽  
Statistical Significance ◽  
Local Health Authority ◽  
Local Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Significant Difference ◽  
Knowledge Attitude And Practice

Objectives: This study aims to assess the knowledge, attitude, and practice associated with COVID-19 disease by undertaking a web-based online survey. Methods: A cross-sectional survey was conducted all over India during the initial phase of COVID-19 hit between March 19, 2020, and March 29, 2020. Anyone aged 18 years and above using social media were included in the study. The questionnaire had a section on sociodemography which had questions regarding age, gender, marital status, and occupation. This was followed by questions on knowledge, attitude, and practice regarding the COVID-19 pandemic. The knowledge scores were summarized as median with interquartile range as the data followed a non-normal distribution. Attitude and practice questions were summarized individually as proportions and its association with socio-demographic variables was established using Chi-square test. The statistical significance was set at p<0.05. Results: Occupational groups, marital status, and age group had significant difference between the groups with at least one of the practices with p<0.05. Conclusion: Since the study provides enhancing effect of knowledge toward protective behaviors, the awareness raising activities and health education through mass media and campaigns, this should urgently be conducted focusing on effectiveness of hand washing, cough etiquette, social distancing, and responsibility to inform suspected cases to local health authority to prevent COVID-19.

scholarly journals DOES DENTAL STUDENTS' ATTENDANCE IN CLASSROOM LECTURES DEPEND ON THE MODE OF ATTENDANCE TRACKING?

2021 ◽  
Vol 8 (18) ◽  
pp. 70-78
Author(s):  
Hani Mawardi ◽  
Waad Alharbi ◽  
Waleed Alamoudi ◽  
Osama Felemban ◽  
Soulafa Almazrooa ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Dental Students ◽  
Current Data ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Significant Difference ◽  
Students Attitudes ◽  
Dental Schools

Purpose: The necessity to attend classroom lectures is a disputable topic among dental schools globally. Since there is an ongoing debate on different aspects of this problem in literature, the purpose of this study was to compare students’ attitudes toward classroom attendance and investigate if stricter attendance tracking methods could lead to better classroom attendance at two dental schools utilising different modes of tracking students’ attendance. Method: This was an observational, cross-sectional survey distributed among dental students enrolled at King Abdul-Aziz University (KAU) and King Saud University (KSU) in Saudi Arabia. The survey included questions on demographics, average travel time, student's attitudes toward classroom lectures and common reasons for absenteeism. Collected data were analysed and summarised as frequencies and percentages and then compared using the Chi-square test for statistical significance.  Findings: The study involved 678 participants from KAU and 475 participants from KSU. In general, there was a significant difference in students’ attendance between both schools in which 26.8% of KAU dental students skipped 5 or more lectures/month compared to 11.5% of students at KSU. Among the factors affecting classroom lecture attendance, commuting time was a major one reported by students (44.8% of students at KSU and 51.4% at KAU needed 30-60 min to reach their schools). The availability of lectures through online resources and the necessity to study for exams were additional factors reported by students of both schools. Implications for research and practices: Based on the current data, the school’s method to track students’ attendance may have a role in the pattern of classroom absenteeism.

scholarly journals Aerodontalgia among Airline Pilots of India: A Cross-sectional Survey

2021 ◽  
Author(s):  
Sabreen Gujral ◽  
Shruti Chopra ◽  
Shveta Sood ◽  
Naresh Sharma ◽  
Akshara Singh
Keyword(s):  
Work Experience ◽  
Single Case ◽  
Statistical Significance ◽  
Signs And Symptoms ◽  
Pressure Change ◽  
Dental Pain ◽  
Flight Safety ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference

Introduction: Barometric pressure-induced dental pain is a clinical entity elicited by atmospheric changes in pressure. Barodontalgia (also known as aerodontalgia) among pilots is of marked interest as it can be a potential flight safety hazard and compromise the personnel’s operational capability and performance. Due to its overlapping signs and symptoms, it may also remain unnoticed and represent itself during a pressure change which may be during ascend or descend of flight. Aim: To assess presence of barodontalgia and awareness of the phenomenon among commercial pilots based in India. Materials and Methods: This cross-sectional study was conducted from June to August 2020 using self-reported questionnaire submitted via Google forms (Alphabet, Mountain view, CA, USA) among 410 pilots based in India. It consisted of questions inquiring about the occurrence, localisation, intensity and recurrence of in- flight dental pain. Inferential statistics were performed using Chi- square test, One way analysis of variance (ANOVA) and Independent t-test. The level of statistical significance was set at 0.05. Results: A total of 370 pilots responded to the questionnaire with a response rate of 90.24%. The incidence was reported among 10.54% (n=39) pilots although 42.7% (n=158) lacked awareness regarding the same. Only a single case of recurrence of pain was reported while none reported any risk to flight safety or accident, secondary to barodontalgia. Conclusion: The incidence level of barodontalgia among commercial pilots in India is low. However, the lack of awareness is still an unsettling risk and was not found to be of significant difference when compared on the basis of gender and work experience.

AWARENESS ABOUT INDOOR AIR POLLUTION IN GENERAL POPULATION OF RAWALPINDI AND ISLAMABAD

2018 ◽  
Vol 8 (2) ◽  
pp. 80-83
Author(s):  
Nadia Tariq ◽  
Tamkeen Jaffry ◽  
Rahma Fiaz ◽  
Abdul Majid Rajput ◽  
Sadaf Khalid
Keyword(s):  
Air Pollution ◽  
General Population ◽  
Indoor Air ◽  
Indoor Air Pollution ◽  
Economic Status ◽  
Educational Status ◽  
Epidemiological Studies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Significant Difference

Background: Indoor air pollutants are increasingly being associated with respiratory illnesses leading to high degree of morbidity and mortality. There are not sufficient epidemiological studies from Pakistan which assess level of awareness of indoor air pollution resulting in respiratory diseases in population. Methods: This cross sectional survey was carried out on general population of Rawalpindi/Islamabad. Sample size was 223 study subjects selected by non-probability convenient sampling. Knowledge of the study subjects was determined with regard to indoor air pollution, its effects on health and different sources of indoor air pollution with the help of a questionnaire. The influence of age, gender, educational status and socio economic status on the level of awareness was also analyzed. Results: Out of total 223 participants, 115 were males and108 females. Participants aware of indoor air pollution were 91.5% and adequate awareness about its sources was 80.7%. Those who knew indoor air pollution is detrimental to health were 95.1%. Awareness about building construction dust as source of indoor air pollution was maximum (84.8%). There was significant difference in awareness among participants with different monthly incomes and educational status and also between males and females. Conclusion: This study concludes that general population of Rawalpindi/Islamabad has fairly good awareness about sources of indoor air pollution. Use of harmful material causing indoor air pollution should be limited or substituted with better ones where possible.

Sign in / Sign up

Export Citation Format

Share Document