A psycho‑educational intervention programme for parents with SGA foetuses supported by an adaptive mHealth system: design, proof of concept and usability assessment

Background: Technology-based approaches during pregnancy can facilitate the self-reporting of emotional health issues and improve well-being. There is evidence to suggest that stress during pregnancy can affect the foetus and result in restricted growth and preterm birth. Although a number of mobile health (mHealth) approaches are designed to monitor pregnancy and provide information about a specific aspect, no proposal specifically addresses the interventions in parents at risk of having small-for-gestational-age (SGA) or premature babies. Very few studies, however, follow any design and usability guidelines which aim to ensure end-user satisfaction when using these systems. Results: We have developed an interactive, adaptable mHealth system to support a psycho-educational intervention programme for parents with SGA foetuses. The relevant results include a metamodel to support the task of modelling current or new intervention programmes, an mHealth system model with runtime adaptation to changes in the programme, the design of a usable app (called VivEmbarazo) and an architectural design and prototype implementation. The developed mHealth system has also enabled us to conduct a proof of concept based on the use of the mHealth systems and this includes data analysis and assesses usability and acceptance. Conclusions: The proof of concept confirms that parents are satisfied and that they are enthusiastic about the mHealth-supported intervention programme. It helps to technically validate the results obtained in the other stages relating to the development of the solution. The data analysis resulting from the proof of concept confirms that the stress experienced by parents who followed the mHealth-supported intervention programme was significantly lower than among those who did not follow it. This implies an improvement in the emotional health not only of the parents but also of their child. In fact, the babies of couples who followed the mHealth-supported programme weigh more than the babies of couples under traditional care. In terms of user acceptance and usability, the analysis confirms that mothers place greater value on the app design, usefulness and ease of use and are generally more satisfied than their partners. Although these results are promising in comparison with more traditional and other more recent technology- based approaches.MCIN/AEI PID2019-109644RB-I00Andalusia Ministry of Health (Junta de Andalucia-Spain) PC-0526-2016052

The Relationship Between Self-Efficacy and Informed Decision-Making on Primiparous Women During the Birthing Process

Childbirth is a very intense and vulnerable experience, especially for first-time mothers. Across the globe, the prevalence of traumatic and unsatisfying births has become an increasingly troublesome issue for women. There is extensive evidence of maltreatment, and a large portion of the problem has to do with the client’s medical team. To combat this dilemma, the best course of action would be to prepare women for this possibility by increasing the client’s self-efficacy and decision-making abilities. Self-efficacy, also known as confidence in one’s skills, is an important trait to have when it comes to patients being able to advocate for themselves. Since it is most common for first-time mothers to face these problems in the hospital, it would be more beneficial to become more educated in pregnancy, thus creating higher confidence. It will be more likely for clients to have an easier time making choices for themselves and their care due to the development of preparedness through proper education. Education and collaboration are some of the most effective ways to increase self-efficacy. It has been found that there is a gap in the research to support the positive relationship between education implementation and self-efficacy so this will be the focal point. This thesis will focus on displaying the prevalence of obstetric maltreatment and why it is such an important problem in our society. There will be further divulging into solutions that have been implemented to increase self-efficacy, thus also increasing informed decision-making in primiparous women. Topics will all be analyzed more deeply in a literature review where conclusions will be drawn about the main topic overall. Afterward, a study proposal will be formulated in relation to the literature review that will describe how educational methods can improve self-efficacy and its effectiveness in creating high birth satisfaction rates in first time mothers

CARE 1000: randomized controlled trial for the evaluation of the effectiveness of a mHealth app for supporting the first 1000 days of life

Background Recent developments in eHealth and mobile health (mHealth), as well as the introduction of information and communication technology innovations in clinical practice, such as telemedicine, telemonitoring, and remote examinations, are already changing the current scenario and will continue to generate innovations in the coming decades. The widespread use of mobile devices, with an estimated nearly 30 billion devices and more than 325,000 apps worldwide, will provide various opportunities for people to take control of their own health. Already in 2017, most of the apps available were focused on pregnancy support, more than any other medical field. There have been some reported experiences with social media and mHealth that could benefit the promotion of maternal physical and mental health during pregnancy. However, many apps targeting the first 1000 days of a child's life do not consider the continuity between the prenatal and postnatal periods and their joint impact on maternal and child health. The aim of this study is to evaluate the effectiveness of this mHealth app to support women during the first 1000 days (from conception to 24 months of age) and to improve health prevention behaviours such as immunizations during pregnancy, weight gain during pregnancy, abstinence from smoking and alcohol consumption, and adherence to the routine childhood immunization schedule. In addition, the study aims to understand the level of appreciation of this mHealth app as a tool to overcome information and communication gaps between patients and institutions. MethodsConduction of a randomized controlled trial. DiscussionOur results will be relevant for improving this mHealth app to promote health and prevention and to support the first 1000 days of life for both mother and child. Our results will be relevant to the future expansion of such an mHealth app to promote positive health-related outcomes in patients and co-user satisfaction and to support the organization of health services

Contraceptive Sabotage

This Article responds to the alarm recently sounded by the American College of Obstetricians and Gynecologists over “birth control sabotage”—the “active interference [by one partner] with [the other] partner’s contraceptive methods in an attempt to promote pregnancy.” Currently, sabotage is not a crime, and existing categories of criminal offenses fail to capture the essence of the injury it does to victims. This Article argues that sabotage should be a separate crime—but only when perpetrated against those partners who can and do get pregnant as a result of having sabotaged sex. Using the principle of self-possession—understood as a person’s basic right to self-ownership—this Article argues that women have a self-possessory interest in maintaining their reproductive capacity in its non-pregnant state during and after having sex to the extent they seek to establish with the use or planned use of contraception. Sabotage by sexual partners—typically male—violates this interest and merits criminal punishment. This Article proposes statutory language to criminalize sabotage that should be added to the revision of the Model Penal Code currently underway. Not only would this addition likely survive any Equal Protection challenge, it would arguably serve to strengthen the existing constitutional right to non-procreative sex by setting meaningful limits on one partner’s ability to interfere unilaterally with the other partner’s contraceptive decisions

Breastfeeding Support in Your Pocket: Evaluating the Impact of a Mobile App on Maternal Success

Background: Breastfeeding has well-known benefits for both the nursing infant and the birthing parent. It bolsters the newborn immune system, and reduces the risk of future health conditions in both parties. Due to these advantages, several health organizations internationally recommend exclusive breastfeeding until 6 months of age. However, only a fraction of infants in the United States meet this goal each year. Improved rates and duration of exclusive breastfeeding will lead to better long-term health outcomes for patients. The use of smartphone applications for breastfeeding education and support has not been thoroughly researched. Objective: This thesis explores the feasibility of smartphone apps for breastfeeding education, as well as their effect on parental self-efficacy level, and actual breastfeeding outcomes. The goal of the proposed intervention is to increase exclusive breastfeeding rates and duration through 6 months postpartum. Methods: A literature review will be conducted with current articles that research the use of app-based education and support in breastfeeding. Then, a proposal for further study will detail a randomized controlled trial with an evidence-based educational intervention. The control group will receive standard perinatal care and education, while the experimental group will receive access to a breastfeeding educational app, in addition to standard care and education. The proposed app will include both written and video content, as well as a breastfeeding tracking feature. Data will be collected on infant feeding plans, breastfeeding self-efficacy, and actual breastfeeding outcomes at baseline, 36 weeks gestation, and at 2 days, 3 months, and 6 months postpartum. Statistical analyses will be used to compare the two groups and determine if the study results are statistically significant

Legal Impediments to Service: Women in the Military and the Rule of Law

Some of those who served did so by disguising themselves as men.6 A number of women had served as spies, as was the case of Rose O\u27Neal Greenhow, who was arrested and imprisoned for supplying the Confederate Army with information, and Pauline Cushman, who was sentenced to be executed as a Union spy during the War Between the States.7 The first woman to receive the Congressional Medal of Honor, Dr. Mary Walker, provided her services as a doctor free of charge to Union forces in Virginia and Tennessee.8 She had asked the Union Army to hire her as a doctor, but it refused.9 Despite its refusal to hire her, Dr. Walker continued to provide medical services to Union soldiers.10 Eventually, she was captured by Confederate soldiers.11 After her release from Confederate prison as part of a prisoner exchange, she was given an official position of Acting Assistant Surgeon, the first woman to be given such a title.12 Dr. Walker received the Congressional Medal of Honor after the war.13 In 1917, however, the U.S. Congress attempted to remove the honor from her, stating that only those who fought in combat were entitled to the award.14 When the Congress decided that the Medal had been awarded in error, Walker refused to return the medal.15 Even after her death, Dr Walker\u27s family continued to battle to resolve her status as a Medal of Honor recipient. [...] women were not afforded the right to vote in any state in any election before achieving the right to vote in school board elections in Kentucky in 1838.18 Passage of the Nineteenth Amendment in 1920 gave women the right to vote in national elections across the country.19 Similarly, women were not entitled to administer estates, own property, or enter into contract in their personal capacity.\n Perhaps it is unsurprising that, more than forty years after the Civil Rights Act of 1964, members of the legislative branch, as well as those in positions to engender policy for and within the U.S. military, continue to limit opportunities for women in fields in which they have a proven competence

Work/Community Engagement Requirement Stakeholder Roundtable

Over the next twelve months, New Hampshire will transition to a new coverage model for the Medicaid expansion program (the Granite Advantage Program ), and will implement a demonstration engagement requirement, approved focus on the population covered by an emphasis on work status and New Hampshire, see Covering the Care: A Focus on the NH Marketplace)

C.K. v. NJ Dept HHS

USDC for the District of New Jerse