Women’s Utilisation, Experiences and Satisfaction with Postnatal Follow-up Care: Systematic literature review

Postnatal follow-up care is reported to be the ‘underutilised’ aspect of the maternity care continuum. This review explores women’s utilisation of early and late postnatal follow-up and their experiences and satisfaction with it. Five online databases were searched for English or Arabic articles published between 2011 and 2021. Methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool; the Andersen healthcare utilisation model was the framework for data analysis. A total of 19 articles met all inclusion criteria. Utilisation facilitators included complications, travel distance, knowledge of the importance for attending and being offered a telephonecall and home visit or clinic visit as options for follow-up. Impediments included lack of perceived need and notbeing provided with information about postnatal care. Comprehensive discussions with and examination by health providers were reported as positive experiences and influenced repeat utilisation. Dissatisfaction was associated with inconsistent information provided by health providers.Keywords: Postpartum Period; Postnatal Care; Women; Literature Review

Women’s Views on Factors that Influence Utilisation of Postnatal Follow-Up in Oman: A descriptive, qualitative study

Objective: Postnatal follow-up care (PNFC) is important to promote maternal and newborn health and wellbeing. In Oman, women’s utilisation of postnatal follow-up services has declined with rates as low as 0.29 (mean visits) in some Governorates; well below the recommended postnatal follow up visits at two- and six-weeks for assessment of mother and newborn. The reasons for low utilisation are not well understood. The aim of this study is to explore women’s views and identify factors that influence their utilisation of postnatal follow-up services. Methods: Purposive sampling and semi-structured telephone interviews with 15 women aged 20 to 39 years at six to eight weeks post childbirth between May 2021 to August 2022. Data were analysed using Erlingsson and Brysiewicz content analysis approach. Results: Six categories were identified as influencing PNFC utilisation: 1) need for information; 2) experiences and expectations; 3) family support, expectations and customs; 4) sociocultural beliefs and practice; 5) impact of Covid-19 and 6) the healthcare environment. Influencing factors within each category include the need to: empower women, provide individualised care, address family and community expectations, offer alternatives to face-to-face clinic visits, provide organised, scheduled appointments. Conclusion: Women in Oman identified the need for consistent information from health care providers (HCPs), a more organised postnatal follow-up service including scheduled appointments and a woman-centred approach to PNFC. Keywords: Postnatal care; postpartum period; qualitative research

Characterization of greater middle eastern genetic variation for enhanced disease gene discovery

The Greater Middle East (GME) has been a central hub of human migration and population admixture. The tradition of consanguinity, variably practiced in the Persian Gulf region, North Africa, and Central Asia1-3, has resulted in an elevated burden of recessive disease4. Here we generated a whole-exome GME variome from 1,111 unrelated subjects. We detected substantial diversity and admixture in continental and subregional populations, corresponding to several ancient founder populations with little evidence of bottlenecks. Measured consanguinity rates were an order of magnitude above those in other sampled populations, and the GME population exhibited an increased burden of runs of homozygosity (ROHs) but showed no evidence for reduced burden of deleterious variation due to classically theorized ‘genetic purging’. Applying this database to unsolved recessive conditions in the GME population reduced the number of potential disease-causing variants by four- to sevenfold. These results show variegated genetic architecture in GME populations and support future human genetic discoveries in Mendelian and population genetics

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Improving Waiting Times in Hand Surgery Clinic at Rumailah Hospital, Qatar

Background: The quality and efficiency of healthcare delivery are key drivers that influence hospital quality as well as patient satisfaction. The patient waiting time is the period of time that passes between patients first seeking medical treatment from the healthcare system and their admittance for consultation and diagnosis. The hand surgery clinic at Rumailah Hospital (RH) in Qatar has seen that only 12% of new patients who had been referred for urgent treatment from the accident and emergency department had received an appointment within 14 days. Aim: To increase the percentage of patients with new, urgent referrals to the hand surgery clinic at Rumailah Hospital from the accident and emergency department to be seen within 14 days from the current 12% to 20% by the end of October 2019 and from 20% to 60% by the end of April 2020. Methodology: This is a Quality improvement Project used the Institute for Healthcare Improvement model for improvement, the team used the root cause analysis to identify the bottleneck in the process, the Plan- Do - Study - Act (PDSA) cycles facilitates testing the selected changes: increase capacity, triage acciedent and emergency referrals, and clear the back log. Results: After implementing the changes, we observed increase in the proportion of patients who received appointments within 14 days of the referral, from 22% in July to 26% in August and 40% in September and October, 2019. Conclusion: The project team did extensive research in understanding the complex process of OPD appointment and clinic consultation. The project team tested three change ideas that yielded to manage the percentage of patients who received appointments within 14 days. The team is planning to test the next change idea to improve the triaging process by implementing electronic triaging, which is expected to reduce the waiting time for an appointment in the clini

Microscopical and phylogenetic analysis of Theileria annulata in Iraqi local breed cattle

The development of cattle industry in Iraq and its neighboring countries may be hampered by Theileria annulata (T. annulata) infection. In the present work, the cytochrome b gene (cyt-b) sequences were used to infer the phylogenetic relationships of T. annulata. Fifty blood samples collected randomly from 10 farms of Iraqi local breed cattle in Al-Diwaniyah province were analyzed for piroplasm using microscopic and molecular techniques. Microscopic examination revealed that 37 (74%) of the 50 blood samples examined were infected. In addition, the PCR test showed that 23 (62.2%) of the 37 blood samples (which tested positive (microscopically) were positive. The analysis of the cyt-b 1092 bp gene of T. annulata reported the presence of six genetically related clones. These six clones have been deposited in GenBank as [ON706262, ON706263, ON706264, ON706265, ON706266, and ON706267], and when compared to the T. annulata cyt-b gene (XM949625) from the GenBank database, a unique polymorphism at sixteen sites was discovered. Furthermore, the alignment of our amino acid sequences with the reference sequence reveals thirteen non-synonymous mutations in codons 11, 22, 33, 63, 103, 128, 130, 129, 172,178, and 190, and three silent mutations in codons 124, 128, and 275. Moreover, phylogenetically, our study clones were related to Iraqi, Indian, and Turkish clones. In conclusion, depending on the phylogenetic analysis the current study identified six T. annulata parasite isolates in Iraqi local breed cattle that were genetically related to the Indian, Iraqi, and Turkish clones

Evaluating the performance of the Arabic language department implementers in light of coordination thinking skills

The aim of the current research is to (evaluating the performance of the applicators of the Arabic language department in the light of coordination thinking skills) ( Not available), and the researchers made sure of the tool’s validity and reliability, and the researchers applied their research tool to a sample of the applicators of the Arabic language department in the College of Basic Education at the University of Babylon, which amounted to (61) applied and applied for the academic year (2021 2022 AD) and after applying the tool and unloading, analyzing and processing data Statistically using the Statistical Package for Social Sciences (SPSS) program. The researchers reached a number of results, the most prominent of which were: The performance of the implementers of the Arabic language department was positive

<b>Update on Management of Placenta Previa and Placenta Accreta Spectrum</b>

Placenta previa is a major risk factor for postpartum hemorrhage and can lead to morbidity and mortality of the mother and neonate. This situation prevents a safe vaginal delivery and requires the delivery of the neonate to be via cesarean delivery. The presence of placenta previa can also increase a woman's risk for placenta accreta spectrum (PAS).Objectives: In this article; we aimed to review the update on management of placenta previa and placenta accreta spectrum, Methods: These databases were searched for articles published in English in 3 data bases [PubMed – Google scholarscience direct] and Boolean operators (AND, OR, NOT) had been used such as [Diagnosis of Placenta Accreta and Placenta Accreta Spectrum OR PAS] and in peer-reviewed articles between June 2005 and February 2023. Documents in a language apart from English have been excluded as sources for interpretation was not found. Papers apart from main scientific studies had been excluded: documents unavailable as total written text, conversation, conference abstract papers and dissertations. Conclusion: The timely diagnosis of abnormal placentation is of great importance since, the earliest diagnosis implies less risky, less costly and successful management. Ultrasonography may successfully achieve this goal. Furthermore, MRI imaging, in cases of diagnostic dilemmas may be particularly useful and lead to safer and more precise diagnosisDOI:10.6084/m9.figshare.24201264</p