Association between mistreatment of women during childbirth and symptoms suggestive of postpartum depression

Background: Postpartum depression is a common condition in the pregnancy and postpartum cycle. The development of this condition is multifactorial and can be influenced by previous traumas. This study sought to verify whether there is an association between having been exposed to mistreatment during childbirth and presenting symptoms suggestive of postpartum depression. Methods: This is a cross-sectional study, with the inclusion of 287 women without complications in childbirth, randomly selected from two maternity hospitals of Porto Alegre, southern Brazil, in 2016. Four weeks after delivery, the postpartum women answered a face-to-face interview about socioeconomic aspects, obstetric history, health history, and childbirth experience (practices and interventions applied) and completed the Edinburgh Postnatal Depression Scale (EPDS). From the perception of women regarding the practices performed in the context of childbirth care, a composite variable was created, using item response theory, to measure the level of mistreatment during childbirth. The items that made up this variable were: absence of a companion during delivery, feeling insecure and not welcome, lack of privacy, lack of skin-to-skin contact after delivery, not having understood the information shared with them, and not having felt comfortable to ask questions and make decisions about their care. To define symptoms suggestive of postpartum depression, reflecting on increased probability of this condition, the EPDS score was set at ≥ 8. Poisson Regression with robust variance estimation was used for modeling. Results: Women who experienced mistreatment during childbirth had a higher prevalence of symptoms suggestive of postpartum depression (PR 1.55 95% CI 1.07–2.25), as well as those with a history of mental health problems (PR 1.69 95% CI 1.16–2.47), while higher socioeconomic status (A and B) had an inverse association (PR 0.53 95% CI 0.33–0.83). Conclusions: Symptoms suggestive of postpartum depression seem to be more prevalent in women who have suffered mistreatment during childbirth, of low socioeconomic status, and with a history of mental health problems. Thus, qualifying care for women during pregnancy, childbirth and postpartum and reducing social inequalities are challenges to be faced in order to eliminate mistreatment during childbirth and reduce the occurrence of postpartum depression

Development of an instrument to measure mistreatment of women during childbirth through item response theory

The objective of this study was to structure a proposal for an instrument to measure the mistreatment level of women during childbirth, through item response theory, based on the birth experience of postpartum women. A cross-sectional study was conducted, with the inclusion of 287 women who did not suffer complications during childbirth, randomly selected from two maternity hospitals in the capital of Rio Grande do Sul—Brazil, in 2016. Approximately 30 days after delivery, the women answered questions in a face-to-face interview about their birth experience (practices and interventions applied) and were inquired about their perception of having suffered disrespect, mistreatment or humiliation by health professionals. The set of practices was included in the item response theory model to design the instrument. Of the 36 items included in the model, 21 dealt with practices applied exclusively to women who went into labor, therefore two instruments were developed. The instrument including all women, containing 09 items, identified 23.7% prevalence of mistreatment to women during childbirth, while the instrument for women going into labor included 11 items and identified 22% prevalence. The items with the highest discrimination were: not having had a companion during labor (2.05; and 1.26), not feeling welcome (1.81; and 1.58), and not feeling safe (1.59; and 1.70), for all women and for those who went into labor, respectively. For those who went into labor, the items, did not have a companion during labor (1.22; PE 0.88) and did not feel comfortable asking questions and participating in decisions (1.20; PE 0.43) also showed greater discrimination. In contrast, when directly questioned, only 12.5% of women said they had experienced disrespect or mistreatment, suggesting that harmful practices are often not recognized as violent. Standardizing the measurement of mistreatment of women during childbirth can create more accurate estimates of its prevalence and contribute to the proposal of strategies to eliminate obstetric violence

Ozonioterapia na COVID-19: uma revisão integrativa

The aim was to demonstrate the available evidence on ozone therapy in patients with COVID-19 and its therapeutic applicability through hospital protocols. This is an integrative review, carried out in PubMed and LILACS search sources, from 2011 to 2021. 87 articles were identified, but 11 articles were selected that suited the studied theme. The literature studied indicated that ozone exerts antiviral activity by inhibiting viral replication and direct inactivation of viruses. It is also an adjuvant to antiviral drugs. Combined treatment with ozone and antivirals has been shown to reduce inflammation and lung damage. The routes of ozone administration were systemic (rectal) and autohemotherapy. Conclusions: Ozone therapy is an adjuvant therapy to antiviral treatment in COVID-19-positive patients, in addition to being economically viable and easy to administer.Objetivou-se demonstrar as evidências disponíveis sobre ozonioterapia em pacientes com COVID-19 e sua aplicabilidade terapêutica por meio de protocolos hospitalares. Trata-se de uma revisão integrativa, realizada nas fontes de busca PubMed e LILACS, no período de 2011 a 2021. Foram identificados 87 artigos, mas, selecionados 11 artigos que se adequaram à temática estudada. A literatura estudada apontou que o ozônio exerce atividade antiviral por meio da inibição da replicação viral e da inativação direta dos vírus. Também é um adjuvante às drogas antivirais. O tratamento combinado com ozônio e os antivirais demonstrou redução da inflamação e dos danos pulmonares. As vias de administração do ozônio foram sistêmica (retal) e auto-hemoterapia. Conclusões: A ozonioterapia é uma terapia adjuvante ao tratamento com antivirais em pacientes COVID-19-positivos, além de ser viável economicamente e de fácil administração

Ozonioterapia na COVID-19: uma revisão integrativa

The aim was to demonstrate the available evidence on ozone therapy in patients with COVID-19 and its therapeutic applicability through hospital protocols. This is an integrative review, carried out in PubMed and LILACS search sources, from 2011 to 2021. 87 articles were identified, but 11 articles were selected that suited the studied theme. The literature studied indicated that ozone exerts antiviral activity by inhibiting viral replication and direct inactivation of viruses. It is also an adjuvant to antiviral drugs. Combined treatment with ozone and antivirals has been shown to reduce inflammation and lung damage. The routes of ozone administration were systemic (rectal) and autohemotherapy. Conclusions: Ozone therapy is an adjuvant therapy to antiviral treatment in COVID-19-positive patients, in addition to being economically viable and easy to administer.Objetivou-se demonstrar as evidências disponíveis sobre ozonioterapia em pacientes com COVID-19 e sua aplicabilidade terapêutica por meio de protocolos hospitalares. Trata-se de uma revisão integrativa, realizada nas fontes de busca PubMed e LILACS, no período de 2011 a 2021. Foram identificados 87 artigos, mas, selecionados 11 artigos que se adequaram à temática estudada. A literatura estudada apontou que o ozônio exerce atividade antiviral por meio da inibição da replicação viral e da inativação direta dos vírus. Também é um adjuvante às drogas antivirais. O tratamento combinado com ozônio e os antivirais demonstrou redução da inflamação e dos danos pulmonares. As vias de administração do ozônio foram sistêmica (retal) e auto-hemoterapia. Conclusões: A ozonioterapia é uma terapia adjuvante ao tratamento com antivirais em pacientes COVID-19-positivos, além de ser viável economicamente e de fácil administração

Factors associated with women’s satisfaction with prenatal care in Porto Alegre, Rio Grande do Sul, Brazil

O objetivo deste artigo é identificar fatores associados à plena satisfação com a atenção pré-natal em serviços de saúde de Porto Alegre, Rio Grande do Sul. Estudo transversal, com 287 mulheres que realizaram pré-natal na capital gaúcha. As mulheres foram selecionadas aleatoriamente em duas maternidades de grande porte (pública e privada) e entrevistadas nos seus domicílios, cerca de 30 dias após o parto, entre janeiro e agosto de 2016. A satisfação foi aferida por meio de escala Likert (muito satisfeita a muito insatisfeita). Foram estimadas razões de prevalência (RP) por regressão de Poisson com estimação robusta da variância, utilizando modelo hierarquizado. Os fatores associados à plena satisfação foram: ingresso no ensino superior (RP=1,49; IC95%:1,08- 2,06); atendimento multiprofissional (RP=1,29; IC95%:1,00-1,66); recebimento de orientações sobre amamentação (RP=1,33; IC95%:1,05-1,68) e sobre local do parto (RP=1,56; IC95%:1,12- 2,17); e sentimento da mulher de estar à vontade para fazer perguntas e participar das decisões (RP=5,17; IC95%:1,79-14,96). Os achados sugerem que serviços de pré-natal que oferecem cuidado multiprofissional, que dão orientações, e que oportunizam às gestantes o sentimento de estar à vontade para questionar e decidir sobre seu cuidado, proporcionam maior satisfação.This article aims to identify factors associated with full satisfaction with prenatal care in health services in Porto Alegre (RS), Brazil. This is a cross-sectional study with 287 women that attended prenatal care in the state capital. Women were randomly selected at two large maternity hospitals (public and private) and interviewed at their homes around 30 days after delivery, from January to August 2016. Satisfaction was measured by a Likert scale (very satisfied to very unsatisfied). Prevalence ratios (PR) were estimated by Poisson regression with robust variance, using a hierarchical model. Factors associated with greater satisfaction were higher education (PR=1.49; 95% CI: 1.08-2.06); multiprofessional care (PR=1.29; 95% CI: 1.00-1.66); receiving information about breastfeeding (PR=1.33; 95% CI: 1.05-1.68) and place of delivery (PR=1.56; 95% CI: 1.12-2.17); and women feeling comfortable asking questions and participating in decisions (PR=5.17; 95% CI: 1.79-14.96). The findings suggest that prenatal care services that offer multiprofessional care, provide guidance, and make pregnant women feel comfortable asking and deciding about their care may generate greater satisfaction

Pixel value analysis for detection of simulated early external root resorption

The aim of this study was to determine the efficacy of pixel value analysis using images generated by the Digora™ and Visualix™ systems for the early detection of external root resorption (ERR). Thirty extracted human lower incisors were radiographed using the Digora and Visualix systems; then, ERR was induced by immersing the teeth in 6 mol L-1 of hydrochloric acid for different periods of time (10, 30 and 60 minutes). ERR was confirmed by calcium quantification with an atomic absorption spectrophotometer. One digital image was acquired per time period at 70 kVp, 7 mA, 2.2 mm filtration, focus-film distance of 30 cm, and with exposure times of 0.09 s in the Digora system and 0.05 s in Visualix system. The region of interest was defined using ImageJ software. Statistical analysis was performed using ANOVA and Pearson’s correlation (p < 0.05). There was no statistically significant difference between the time for ERR induction and the pixel values with either system. A positive correlation between the time of ERR induction and the calcium concentration was observed (r = 0.8892; p < 0.001). In conclusion, independent of the site of ERR induction and the digital system, pixel value analysis was not effective for ERR detection