Obstetric Violence in Spain (Part I): Women’s Perception and Interterritorial Differences

The decentralization of health systems can have direct repercussions on maternity care. Some inequalities can be noted in outcomes, like neonatal and child mortality in Spain. This study aimed to make the presence of obstetric violence in Spain visible as an interterritorial equity criterion. A descriptive, restrospective and cross-sectional study was conducted between January 2018 and June 2019. The sample comprised 17,541 questionnaires, which represented all Spanish Autonomous Communities. Of our sample, 38.3% perceived having suffered obstetric violence; 44.4% perceived that they had undergone unnecessary and/or painful procedures, of whom 83.4% were not requested to provide informed consent. The mean satisfaction with the attention women received obtained 6.94 points in the general sample and 4.85 points for those women who viewed themselves as victims of obstetric violence. Spain seems to have a serious problem with public health and respecting human rights in obstetric violence. Offering information to women and requesting their informed consent are barely practiced in the healthcare system, so it is necessary to profoundly reflect on obstetric practices with, and request informed consent from, women in Spain.

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Obstetric Violence in Spain (Part III): Healthcare Professionals, Times and Areas

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073359 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3359

Author(s):

Desirée Mena-Tudela ◽

Susana Iglesias-Casás ◽

Víctor Manuel González-Chordá ◽

María Jesús Valero-Chillerón ◽

Laura Andreu-Pejó ◽

...

Keyword(s):

Public Health ◽

Primary Care ◽

Informed Consent ◽

Healthcare Professionals ◽

Public Health Problem ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Lack Of Information ◽

Obstetric Violence

Background: Obstetric violence is a worldwide public health problem, which seems greater in Spain. As no studies were found that identify the most representative healthcare professionals, times, and areas involved in obstetric violence, the objective of this work was to study at what time of maternity, with which professionals, and in what areas women identified obstetric violence. Methods: This descriptive, retrospective, and cross-sectional study was performed from January 2018 to June 2019. The main variables were the area (hospital, primary care, both), the time (pregnancy, birth, puerperium), and the professionals attending to women. Results: Our sample comprised 17,541 participants. The area identified with the most obstetric violence for the different studied variables was hospitals. Women identified more obstetric violence at time of birth. Findings such as lack of information and informed consent (74.2%), and criticism of infantile behavior and treatment (87.6%), stood out. The main identified healthcare professionals were midwives and gynecologists, and “other” professionals repeatedly appeared. Conclusions: Having identified the professionals, times, and areas of most obstetric violence in Spain, it seems necessary to reflect on not only the Spanish National Health System’s structure and management but also on healthcare professionals’ training.

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Obstetric Violence in Spain (Part II): Interventionism and Medicalization during Birth

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010199 ◽

2020 ◽

Vol 18 (1) ◽

pp. 199

Author(s):

Desirée Mena-Tudela ◽

Susana Iglesias-Casás ◽

Víctor Manuel González-Chordá ◽

Águeda Cervera-Gasch ◽

Laura Andreu-Pejó ◽

...

Keyword(s):

Cross Sectional Study ◽

Female Empowerment ◽

Public Healthcare ◽

Sectional Study ◽

Cross Sectional ◽

Autonomous Communities ◽

Private Healthcare ◽

Healthcare Settings ◽

Obstetric Violence ◽

The Mean

Background: obstetric violence can partially be represented by the high number of interventions and medicalization rates during the birthing process. The objective of the present study was to determine the interventionism and medicalization levels during childbirth in Spain. Methods: a descriptive, retrospective, and cross-sectional study was conducted between January 2018 and June 2019. Results: the intervention percentages were 34.2% for Kristeller maneuver and 39.3% for episiotomy. Differences appeared in public, private, and mixed healthcare settings (p < 0.001). The mean satisfaction, with healthcare in the different settings, was estimated at 6.88 points (SD ± 2.146) in public healthcare, 4.76 points (SD ± 3.968) in private healthcare, and 8.03 points (SD ± 1.930) in mixed healthcare (p < 0.001). No statistically significant differences were found in Spanish autonomous communities. Conclusions: births in Spain seem to be highly intervened. In this study, a certain equity criterion was found concerning interventionism during childbirth in Spain. Healthcare influenced female intervention, satisfaction, and perception levels for obstetric violence; this evidences that female empowerment plays an important role.

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Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

Nepal Medical College Journal ◽

10.3126/nmcj.v22i3.32638 ◽

2020 ◽

Vol 22 (3) ◽

pp. 141-145

Author(s):

Krishna Chandra Devkota ◽

S Hamal ◽

PP Panta

Keyword(s):

Pleural Effusion ◽

Cross Sectional Study ◽

Pleural Space ◽

Sectional Study ◽

Inclusion Criteria ◽

Cross Sectional ◽

Medical College ◽

The Common ◽

The Mean ◽

Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

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Disposal Practices of Unused Medications Among Patients in Public Health Centers of Dessie Town, Northeast Ethiopia: A Cross-sectional Study

Current Drug Safety ◽

10.2174/1574886315666200331140400 ◽

2020 ◽

Vol 15 (2) ◽

pp. 105-110

Author(s):

Haile Kassahun ◽

Dugessa Tesfaye

Keyword(s):

Public Health ◽

Health Care Professionals ◽

Cross Sectional Study ◽

Health Centers ◽

Sectional Study ◽

Cross Sectional ◽

Global Challenge ◽

Northeast Ethiopia ◽

Unused Medications ◽

At Home

Background: Disposal of pharmaceutical waste among patients is a global challenge especially in developing countries like Ethiopia. Improper medication disposal can lead to health problems and environmental contaminations. Therefore, the present study aimed to assess disposal practices of unused medications among patients in public health centers of Dessie town, Northeast Ethiopia. Methods: A descriptive cross-sectional study was conducted among 263 patients in four public health centers of Dessie town, Ethiopia from March to June, 2019. Face-to-face interviews using structured questionnaires were used to collect data from each study subject. Results: The majority of the respondents, 224 (85.17%) had unused medications at their home during the study period. The most commonly reported disposal method in the present study was flushing down into a toilet 66 (25.09%). None of the respondents practiced returning unused medications to Pharmacy. Moreover, 85 (32.31%) of the respondents reported never disposing their medications and believed that it is acceptable to store medications at home for future use. Conclusion: In the present study, there was a high practice of keeping medications at home and most of the disposal practices were not recommended methods. In addition, most of the respondents did not get advice from pharmacists and other health care professionals on how to dispose off unused medications. Hence, there is a need for proper education and guidance of patients regarding disposal practices of unused medications.

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Effect of Medialization of the Trochlear Groove and Lateralization of the Tibial Tubercle on TT-TG Distance: A Cross-sectional Study of Dysplastic and Nondysplastic Knees

The American Journal of Sports Medicine ◽

10.1177/0363546520987819 ◽

2021 ◽

pp. 036354652098781

Author(s):

Mathias Paiva ◽

Lars Blønd ◽

Per Hölmich ◽

Kristoffer Weisskirchner Barfod

Keyword(s):

Trochlear Dysplasia ◽

Cross Sectional Study ◽

Magnetic Resonance Images ◽

Tibial Tubercle ◽

Control Group ◽

Trochlear Groove ◽

Sectional Study ◽

Cross Sectional ◽

Mean Values ◽

The Mean

Background: Tibial tubercle–trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning. Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 84 knees (28 normal [NK], 28 with trochlear dysplasia [TD], and 28 with patellar dislocation without TD [PD]) were examined. The medial border of the posterior cruciate ligament (PCL) was chosen as the central anatomic landmark. The distance from the TT to PCL (TT-PCL) was measured to examine the lateralization of the TT. The distance from the TG to the PCL (TG-PCL) was measured to examine the medialization of the TG. Between-group differences were investigated by use of 1-way analysis of variance. Results: The mean values for TT-TG distance were 8.7 ± 3.6 mm for NK, 12.1 ± 6.0 mm for PD, and 16.7 ± 4.3 mm in the TD group ( P < .01). The mean values for TT-PCL distance were 18.5 ± 3.6 mm for NK, 18.5 ± 4.5 mm for PD, and 21.2 ± 4.2 mm in the TD group ( P = .03). The mean values for TG-PCL distance were 9.6 ± 3.0 mm for NK, 7.1 ± 3.4 mm for PD, and 5.1 ± 3.3 mm in the dysplastic group ( P < .01). Conclusion: The present results indicate that increased TT-TG distance is due to medialization of the TG and not lateralization of the TT. Knees with TD had increased TT-TG distance compared with the knees of the control group and the knees with PD. The TT-PCL distance did not differ significantly between groups, whereas the TG-PCL distance declined with increased TT-TG.

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A cross-sectional study to identify the determinants of non-communicable diseases among fishermen in Southern India

BMC Public Health ◽

10.1186/s12889-021-10376-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Akhila Doddamani ◽

A. B. Kirthinath Ballala ◽

Sharath P. Madhyastha ◽

Asha Kamath ◽

Muralidhar M. Kulkarni

Keyword(s):

Risk Factors ◽

Substance Use ◽

Waist Circumference ◽

Cross Sectional Study ◽

Modifiable Risk Factors ◽

Sectional Study ◽

Cross Sectional ◽

Non Communicable Diseases ◽

Dietary Practice ◽

The Mean

Abstract Background India is currently facing a rising epidemic of Non-Communicable Diseases (NCDs). Identification of modifiable risk factors is of paramount importance to curb this menace. Fishermen are one of the most vulnerable occupational groups with unique characteristics that make them prone to acquire NCDs, as a significant share of their life is spent at sea. Hence, this study was planned to ascertain the burden of NCDs, determine various risk factors of NCDs, and measure the association between risk factors and NCDs among fishermen of Coastal Karnataka in South India. Methods A cross-sectional study was conducted among 681 fishermen aged 18 years and above as per the semi-structured interview schedule for two years (2017–2019). A convenience sampling strategy was adopted. The data was entered and analyzed using SPSS v.15.0. The results were described in terms of proportions and their 95% confidence intervals. Continuous data were summarized using the mean and standard deviation or median and interquartile range depending on the skewness of data. Chi-square test was used to study the association between NCDs and modifiable risk factors. Multiple logistic regression was used to identify risk factors of NCDs. Results The mean (SD) age of the population was 42.5 (SD 12.5) years. The mean years involved in fishing was 19.8 years (SD 10.9). More than half (59.5%) of the study participants had severe stress and most (80.3%) were ever substance users. Advancing age, not being able to contact family while at sea, poor dietary practice, ever substance use, increasing waist circumference were significant correlates of NCDs. Conclusions The commonly prevalent risk factors of NCDs among fishermen included poor dietary practice, higher stress levels, substance use, increasing waist circumference, and inability to contact with family while at sea. Hypertension and Diabetes were the two common NCDs in the study population. There is a need for immediate attention in managing NCDs’ risk factors by promoting a healthy lifestyle by primary health care providers through a sustainable community awareness program targeting fishermen at a convenient time and location, either at the sea-port or meeting places. Harmful effects of substance use, healthy dietary practices, and the importance of physical activity outside their job need emphasis. In addition, screening programs should be organized with the help of boat owners and fishing associations at-least once a year to pick up NCDs at an early stage.

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A cross sectional study: The association between sleeping quality and stress among second and third medical students at the University of Jordan

The International Journal of Psychiatry in Medicine ◽

10.1177/00912174211011287 ◽

2021 ◽

pp. 009121742110112

Author(s):

AA Toubasi ◽

BR Khraisat ◽

RB AbuAnzeh ◽

HM Kalbouneh

Keyword(s):

Logistic Regression ◽

Medical Students ◽

Cross Sectional Study ◽

Regular Exercise ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

The Mean ◽

University Of Jordan ◽

The University

Objective Medicine is considered one if not the most stressful educational field. Thus, the aim of this study is to investigate the prevalence of stress and poor sleeping quality among medical students and the association between them. Method This cross-sectional study was conducted at the University of Jordan on second- and third-year medical students. The questionnaire consisted of: 1) Demographics; 2) The assessment tools which were Pittsburgh Quality of Sleep Index (PSQI) and Kessler Psychological Distress Status (K10). Binary logistic regression, chi-square and linear regression were used to investigate the association between PSQI, K10, and their determinants. Results The mean for PSQI score was 6.76 ± 3.32. PSQI scores interpretation revealed that 61.7% of the 282 participants of this study were poor sleepers. Logistic regression results showed that only the category of not napping at all from the napping hours variable was significantly associated with sleeping quality. Furthermore, the mean of K10 scores was 24.5 ± 8.5. K10 scores revealed that 66.3% of the participants were stressed. Logistic regression results showed that gender and regular exercise were significantly associated with psychological distress. Additionally, chi-square test, logistic regression and linear regression showed that PSQI was significantly associated with K10 (P <0.01). Conclusions Stress and poor sleeping quality in medical students at the University of Jordan were highly prevalent and strongly associated. What determined PSQI was daytime napping, and for K10 were regular exercise and gender. Further investigations into stress and sleep quality in the Arabian region are needed.

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Ultra-processed food consumption in Barbados: evidence from a nationally representative, cross-sectional study

Journal of Nutritional Science ◽

10.1017/jns.2021.21 ◽

2021 ◽

Vol 10 ◽

Author(s):

Rachel M. Harris ◽

Angela M. C. Rose ◽

Suzanne Soares-Wynter ◽

Nigel Unwin

Keyword(s):

Communicable Disease ◽

Population Based ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Targeted Interventions ◽

Sweetened Beverages ◽

Group 4 ◽

The Mean ◽

Nationally Representative

Abstract Our objective was to describe, for the first time in an English-speaking Caribbean country, the contribution of ultra-processed foods (UPFs) to nutrients linked to non-communicable disease. Using a cross-sectional study design, dietary data were collected from two non-consecutive 24-h dietary recalls. Recorded food items were then classified according to their degree of processing by the NOVA system. The present study took place in Barbados (2012–13). A representative population-based sample of 364 adult Barbadians (161 males and 203 females) aged 25–64 years participated in the study. UPFs represented 40⋅5 % (838 kcal/d; 95 % CI 791, 885) of mean energy intake. Sugar-sweetened beverages made the largest contribution to energy within the UPF category. Younger persons (25–44 years) consumed a significantly higher proportion of calories from UPF (NOVA group 4) compared with older persons (45–64 years). The mean energy shares of UPF ranged from 22⋅0 to 58⋅9 % for those in the lowest tertile to highest tertile. Within each tertile, the energy contribution was significantly higher in the younger age group (25–44 years) compared with the older (45–64 years). One-quarter of persons consume ≥50 % of their daily calories from UPF, this being significantly higher in younger persons. The ultra-processed diet fraction contained about six times the mean of free sugars and about 0⋅8 times the dietary fibre of the non-ultra-processed fraction (NOVA groups 1–3). Targeted interventions to decrease the consumption of UPF especially in younger persons is thus of high priority to improve the diet quality of Barbadians.

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