scholarly journals New Zealand midwives' management of perineal trauma during childbirth: A survey of practice

2021 ◽  
Author(s):  
◽  
Robin Cronin
Keyword(s):  
New Zealand ◽  
Online Survey ◽  
Home Birth ◽  
Interval Data ◽  
Perineal Trauma ◽  
Recent Experience ◽  
International Studies ◽  
Chi Square ◽  
Exact Test ◽  
Second Degree

<p>Background: Perineal trauma is the most common complication of vaginal birth and how this is treated has an impact on the incidence and duration of pain and dysfunction. Responsibility for the management of women’s perinea after uncomplicated births in New Zealand ordinarily rests with midwives although this is a little known aspect of practice. This study aimed to identify how midwives assess and manage second degree perineal trauma, the level to which their practice reflects best evidence, and what influences midwives’ decision-making.  Methods: A descriptive approach using an online survey of 75 questions was used to access the population of 2910 New Zealand midwives. Inclusion criterion was current perineal management. Quantitative data were collected and associations examined using chi-square and Fisher’s exact test. Interval data were analysed with a two-sample t-test.  Results: 818 midwives returned a questionnaire, 744 (25% of the midwifery population) met the inclusion criteria. Evidence-based suturing material for repair of the last second degree tear was used by 96%. Correct suturing technique throughout all layers of repair was 42%. Rectal examination during assessment was performed by 45% increasing to 86% after repair. Confidence to repair was directly related to years since midwifery qualification (p<.001) and self-employment (p<.001). The tear was left unsutured by 7% and associated with reduced confidence with repair (p<.001), lack of recent experience with repair (p<.001), and home birth (p=.002). Unsutured tears were shorter than sutured tears (vaginal/perineal length, p<.001; depth, p=.004) and associated with delayed healing (p=.034). Care to six weeks postpartum was provided by 377 midwives. Perineal analgesia included oral medication (76%), pelvic floor exercises (44%), cooling (38%), and suppositories (31%). Visual assessments of healing were performed by 84% of midwives, 49% of women, and 7% of support people. Complications of infection (2%), pain (2%), and healing delay (3%) were uncommon.  Conclusions: This research has added a New Zealand midwifery practice perspective to the existing literature on second degree perineal care. Potential for reductions in perineal morbidity were identified, even though New Zealand midwifery care already has a low rate of complications compared to international studies.</p>

scholarly journals New Zealand midwives' management of perineal trauma during childbirth: A survey of practice

2021 ◽  
Author(s):  
◽  
Robin Cronin
Keyword(s):  
New Zealand ◽  
Online Survey ◽  
Home Birth ◽  
Interval Data ◽  
Perineal Trauma ◽  
Recent Experience ◽  
International Studies ◽  
Chi Square ◽  
Exact Test ◽  
Second Degree

<p>Background: Perineal trauma is the most common complication of vaginal birth and how this is treated has an impact on the incidence and duration of pain and dysfunction. Responsibility for the management of women’s perinea after uncomplicated births in New Zealand ordinarily rests with midwives although this is a little known aspect of practice. This study aimed to identify how midwives assess and manage second degree perineal trauma, the level to which their practice reflects best evidence, and what influences midwives’ decision-making.  Methods: A descriptive approach using an online survey of 75 questions was used to access the population of 2910 New Zealand midwives. Inclusion criterion was current perineal management. Quantitative data were collected and associations examined using chi-square and Fisher’s exact test. Interval data were analysed with a two-sample t-test.  Results: 818 midwives returned a questionnaire, 744 (25% of the midwifery population) met the inclusion criteria. Evidence-based suturing material for repair of the last second degree tear was used by 96%. Correct suturing technique throughout all layers of repair was 42%. Rectal examination during assessment was performed by 45% increasing to 86% after repair. Confidence to repair was directly related to years since midwifery qualification (p<.001) and self-employment (p<.001). The tear was left unsutured by 7% and associated with reduced confidence with repair (p<.001), lack of recent experience with repair (p<.001), and home birth (p=.002). Unsutured tears were shorter than sutured tears (vaginal/perineal length, p<.001; depth, p=.004) and associated with delayed healing (p=.034). Care to six weeks postpartum was provided by 377 midwives. Perineal analgesia included oral medication (76%), pelvic floor exercises (44%), cooling (38%), and suppositories (31%). Visual assessments of healing were performed by 84% of midwives, 49% of women, and 7% of support people. Complications of infection (2%), pain (2%), and healing delay (3%) were uncommon.  Conclusions: This research has added a New Zealand midwifery practice perspective to the existing literature on second degree perineal care. Potential for reductions in perineal morbidity were identified, even though New Zealand midwifery care already has a low rate of complications compared to international studies.</p>

Audit of Genito-Anal Injuries in male and femal sexual abuse cases - A retrospective study.

2020 ◽  
Vol 1 (3) ◽  
pp. e274
Author(s):  
Saima Gill ◽  
Sarah Mohsin ◽  
Sarah Arif ◽  
Nimra Mumtaz
Keyword(s):  
Sexual Assault ◽  
Data Entry ◽  
Interval Data ◽  
Research Committee ◽  
Chi Square ◽  
Exact Test ◽  
Evidence Collection ◽  
Chi Square Test ◽  
Human Participants ◽  
Assault Victims

Background: Sexual assault is a global issue wherein timely examination of sexual assault victims by medico-legal officers and an understanding of the characteristics and factors influencing their injuries have a crucial impact on medico-legal evidence collection and its use in the court. Genital injury findings improve the level of justice for victims, but the lack of injury does not negate the possibility of sexual violence incurred on the victim. The following study describes in great detail the different factors associated with injury characteristics and the medico-legal importance of all these factors. Methodology: It was a retrospective descriptive study conducted at the Forensic Medicine Department of King Edward Medical University, Lahore, Pakistan. All the cases included that fulfill the predefined inclusion criteria were included. A record chart was designed, and six years’ data was recorded in it from the medical records of the medico-legal clinic. It was entered and edited manually. Methods used to prevent data entry errors included double entry and validation following data entry Difference of proportions between variables, where appropriate, has been calculated by Pearson Chi-Square test and Fischer Exact test at 95% confidence interval. Data were analyzed using SPSS v23. All procedures performed in this study involving human participants were following the ethical standards of the institutional and/or national research committee and the Helsinki declaration. Results: Genito anal injury was present in 28.2% cases and was absent in 71.8% cases. Most of the victims were aged 11 to 15 years. The most common injury in the victims was a tear. In females, the most common injury site was the vagina, while the perianal area was the most injured site in males. There was a significant relation (p<0.05) between type and site of injury, gender, site of injury, and prior sexual intercourse experience and prevalence rate of injury. Conclusion: This study concludes that the presence of injuries in the Genito anal area is suggestive of sexual assault and provides useful court evidence.

scholarly journals Beloved Whiskers: Management Type, Care Practices and Connections to Welfare in Domestic Cats

Animals ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 2308
Author(s):  
Daiana de Souza Machado ◽  
Luana da Silva Gonçalves ◽  
Rogério Ribeiro Vicentini ◽  
Maria Camila Ceballos ◽  
Aline Cristina Sant’Anna
Keyword(s):  
Behavioral Problems ◽  
Online Survey ◽  
Principal Component ◽  
Chi Square ◽  
Exact Test ◽  
Frequent Use ◽  
Chi Square Test ◽  
Categorical Principal Component Analysis ◽  
Care Practices

The quality of cat care practices depends in part on the type of management applied, which either positively or negatively impacts cat welfare. This study investigated whether the type of cat management (indoor vs. outdoor) was related to other cat care practices adopted by cat owners, associated with the quality of human-cat relationships and cat welfare. An online survey was distributed via social networks. Descriptive statistics, categorical Principal Component Analysis, Fisher’s Exact test and Chi-square test in contingency table were applied. A total of 16,302 cat owners returned the survey. Most Brazilian owners reported indoor management of their cats; this was related to owners living in apartments, more frequent use of cat care practices, and more interactions with their pets. Outdoor management was related to cats living in houses or farms, sleeping outdoors or around the neighborhood, and owners had fewer interaction with their pets. In conclusion, owners practicing indoor management seemed to be closer to their cats than owners reporting outdoor management. However, obesity and owner-reported behavioral problems were associated with indoor management.

scholarly journals Maternal Attributes and Child Minimum Acceptable Diet during COVID-19 Pandemic in Indonesia

2021 ◽  
Vol 8 (2) ◽  
pp. 108
Author(s):  
Athiya Fadlina ◽  
Judhiastuty Februhartanty ◽  
Saptawati Bardosono
Keyword(s):  
Online Survey ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
Optimal Growth ◽  
P Value ◽  
Chi Square ◽  
Exact Test ◽  
Infant And Young Children ◽  
The Relationship

<p>Appropriate complementary feeding practices must be sustained during the COVID-19 pandemic for optimal growth and development of a child. However, the studies assessing factors associated with complementary feeding practices during COVID-19 are still limited. The objective of this study was to evaluate maternal attributes and minimum acceptable diet (MAD) of 6-11-month-old children during the COVID-19 pandemic in Indonesia. This study was part of the “COVID-19 Mom-Infant Study” and was conducted in all regions of Indonesia using an online survey. Chi-square or Fisher's exact test was performed to examine the relationship between MAD and maternal attributes, with a significant level at p-value &lt;0.05. From a total of 262 data collected, 74%, 77.1%, 94.3% of the children aged 6-11 months have met MAD, MDD (minimum dietary diversity), and MMF (minimum meal frequency), respectively. Mother’s education level (OR= 3.625; 95%CI [1.805 – 7.280]) and working status (OR= 2.197; 95%CI [1.291 – 3.895] were found associated with child’s MAD. One-third of children did not receive the recommended infant and young children feeding practices. Conducting nutrition interventions to mothers with lower education and not working should be a priority under these circumstances.</p>

scholarly journals P051: Management of subcutaneous abscesses in the emergency department

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S74-S75
Author(s):  
S.M. Friedman ◽  
A. Al-Den ◽  
D. Porplycia
Keyword(s):  
Online Survey ◽  
Tap Water ◽  
Immunocompromised Host ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Standardized Protocol ◽  
Wilcoxon Rank Sum Test ◽  
Practice Variability

Introduction: We sought to characterize the management of uncomplicated subcutaneous abscesses (SA) by Canadian emergency physicians (EPs). Methods: Cross-sectional study of CAEP membership. Subjects were emailed an invitation to an online survey, and two biweekly reminders. Wilcoxon rank sum test was used for association with age, and Chi Square and Fischers exact test were used for binary variables. Results: Response rate was 21.2 % (392 Reponses / 1850 surveyed). Duration of practice ranged from 30.2 % practising <= 5 years, to 25.7% practising >= 20 years. Teaching setting was described in 89.1% of responses. Irrigation with saline is performed by 57.1 % of EPs, tap water 2.1 %, or disinfectant 2.1% of EPs, with 39.1% not doing any irrigation. Approximately half (49.2%) typically do not pack or close wounds, while 40.6 % employ ribbon or gauze packing, and 1.6 % primary closure. Antibiotics are generally not prescribed by 16.8%. EPs prescribe antibiotics when suspecting surrounding cellulitis (84.2%), immunocompromised host (51.6%), MRSA (28.9%), or recurrence within 30 days (27.5 %). Cultures are taken almost always by 28.2%, half the time or less by 33.9%, never by 11.6%, and if MRSA is suspected by 33.9%. Follow-up instructions are with FP (56.7%), ED at 24 hours (5.91 %) or 48 hours (17.74 %), or not required (24.7%). Most EPs (90.9%) report having no standardized protocol for abscess management in their ED. EPs with fewer years in practice are more likely to make cruciate incisions (p=0.009), to generally not irrigate incisions (p=0.02), to culture if MRSA is suspected (p=0.02), and to prescribe antibiotics when suspecting MRSA (p=0.02) immune-compromised host (p=0.03), and in case of spontaneous treatment failure or recurrence (p=0.0004). EPs with more years in practice are more likely to pack with ribbon gauze (p=0.06), and to almost always swab for C&S (p=0.04) Conclusion: Practice variability and deviations from practice guidelines (i.e. IDSA, Choosing Wisely Canada) are noted. A knowledge translation exercise based on the guidelines for Canadian EPs would be useful.

scholarly journals Benzodiazepine use and associated factors in elderly in the city of Dourados, MS, Brazil

2015 ◽  
Vol 64 (3) ◽  
pp. 207-212 ◽  
Author(s):  
Christiane Dias dos Anjos Cunha ◽  
Maria Cristina Corrêa de Souza ◽  
Graziella Almeida Andrade Cattanio ◽  
Stephanie Ramirez Iahnn ◽  
Rosangela da Costa Lima
Keyword(s):  
Associated Factors ◽  
Anatomical Therapeutic Chemical ◽  
The Elderly ◽  
Population Based ◽  
International Studies ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Benzodiazepine Use ◽  
Chi Square Test

ABSTRACT Objective The use of benzodiazepines (BZD) and associated factors in the elderly of Dourados, MS, Brazil was investigated. Methods This is a cross-sectional population-based study using a multistage sampling design. Participants were 1,022 individuals aged ≥ 60 years. Measurements socioeconomic status, schooling, demographic aspects, marital status, physical activity, hospitalizations, self-rated health, use of alcohol beverages and smoking were assessed by standard questionnaire. The drugs used were obtained by checking the prescription or package and classified according to the Anatomical Therapeutic Chemical Index. Chi-square test, Chi-square for linear tendency, Fisher's exact test and Poisson regression were used to assess association between variables. Results The prevalence of use of BZD was 6.5% (CI95%: 5.1-8.2%). The oldest group (PR: 1.60 for 70-79 years and PR: 1.79 for ≥ 80 years), non-use of alcohol (PR: 4.14) and use of antidepressants (PR: 8.73) were the statistically associated characteristics. Conclusions The prevalence of use of BZD in the study population was low, similar to findings of more recent Brazilian studies and lower than those obtained in international studies. The prevalence of use of BZD increased with aging and use of antidepressants.

scholarly journals Parents’ Acceptance of Learning about Mindfulness for Managing Pediatric Asthma

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 262
Author(s):  
Mala Mathur ◽  
Karen Pletta ◽  
Bradley R. Kerr ◽  
Jens Eickhoff ◽  
Robin Puett ◽  
...  
Keyword(s):  
Online Survey ◽  
Test Results ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Income Levels ◽  
Asthma Symptoms ◽  
Parental Views ◽  
Children With Asthma ◽  
Perceived Acceptance

Background: Emerging research suggests mindfulness may reduce stress and asthma symptoms in children, yet there is a gap in understanding parental views towards learning about mindfulness. Objective: This study aimed to compare the perceived acceptance to learn about mindfulness among parents of children with and without asthma, and to understand differences across income levels. Methods: This was a national, cross-sectional, online survey of parents of children 0–18 years. Acceptance was measured with questions on whether parents believe mindfulness could be beneficial while parenting, and if they would be willing to learn about mindfulness. Comparisons of mindfulness acceptance between income level were conducted using chi-square and Fisher’s exact test. Results: Parents of children with asthma were more likely to be interested in learning about mindfulness from their health care provider compared to those without asthma (46% vs. 38%, p < 0.0001). At all income levels examined in the study, parents (63–75%) of children with asthma indicated that they agreed or strongly agreed that mindfulness can be beneficial when parenting. Conclusion: Findings suggest an opportunity to incorporate mindfulness teaching into asthma care for pediatric patients of all income levels.

scholarly journals Exclusive breastfeeding practice and sources of support during COVID-19 pandemic in Indonesia

2021 ◽  
Vol 8 (2) ◽  
pp. 195
Author(s):  
Cahya Ayu Agustin ◽  
Judhiastuty Februhartanty ◽  
Saptawati Bardosono
Keyword(s):  
Exclusive Breastfeeding ◽  
Online Survey ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Breastfeeding Support ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Home Based

<p>In 2018, the national coverage of exclusive breastfeeding among infants aged 0-5 months in Indonesia was still low. The COVID-19 pandemic can be a challenge to increase the coverage of exclusive breastfeeding. This study investigated the association between sources of breastfeeding supports and exclusive breastfeeding practices among mothers with infants aged under 6 months during the COVID-19 pandemic in Indonesia. This study used a cross-sectional study design through an online survey from November 2, 2020, to February 8, 2021. A total of 248 subjects were obtained through convenience sampling. Data analysis was done by bivariate analysis using Chi-square or Fisher’s exact test. Most of the subjects were aged 18-34 years old (90.7%), had higher education level (86.7%), had household income range Rp.3,000,000 – Rp.7,199,999 (39.2%), lived in Java Island (83.1%), had an infant aged ≤ 4 months (76.2%), and had a baby boy (51.2%). The proportion of exclusive breastfeeding was 79.0%. The most common sources of breastfeeding support were obtained from husband (91.1%) and health workers (65.7%), followed by family (62.9%). No significant association was found among all support sources on breastfeeding with exclusive breastfeeding. However, the proportion of exclusive breastfeeding among mothers who received husband support (80.1%) was higher than those who did not (68.2%). The most convenient and feasible breastfeeding supports that mother could obtain during pandemics were home-based supports. Mothers, their husbands, and families should be the priority target for health professionals to provide preventive and promotive breastfeeding intervention.</p>

Venous Thromboembolism and High Grade Gliomas

1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Medical Center ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
High Grade ◽  
Chi Square ◽  
Exact Test ◽  
High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

Evaluation of the effects of Covid-19 in a dentist’s daily routine - A Survey

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 591-601
Author(s):  
Akansha Kishen ◽  
Anjali A K ◽  
Brundha M P ◽  
Muralidharan N P
Keyword(s):  
Online Survey ◽  
Dental Students ◽  
Cross Infection ◽  
Daily Routine ◽  
Significant Extent ◽  
Chi Square ◽  
Daily Routines ◽  
Routine Basis ◽  
Chi Square Test ◽  
Spss Software

Covid 19 is considered to be a pandemic virus infection. SARS-Cov-2 causes it. It is a viral infection that is transmitted through aerosol and droplet contamination, cross-infection, etc. Dentists are at a higher risk due to this corona. It has affected daily routines of dentist's life as they are unavailable to run the clinic and attend to patients. Different search engines like PubMed, and Google Scholar was used. The questionnaire consisting of twenty questions was prepared by using online survey google forms and circulated among the participants. SPSS software was used to evaluate the results and data collection. Statistical analysis was done by chi-square test. Later, results were being tabulated. This survey that is taken among dental students, dentists, and random public, it is seen that the majority of them are well aware of this recent pandemic attack. (COVID-19). It is concluded that dentists are affected to a significant extent due to coronavirus as their daily routine is affected severely. This study aims to identify the effect on dentist life on a routine basis due to the pandemic COVID - 19.

Sign in / Sign up

Export Citation Format

Share Document