The effect of prenatal education classes on the birth expectations of Spanish women

Maternity care has focused on lowering maternal and neonatal morbidity, though women's beliefs and expectations of care have been set aside. Women face childbirth with preconceived expectations, some of which could be expressed on their birth plan. The latter could beinfluenced by health professionals through prenatal education classes, though this has not been measured before. Antenatal classes have been argued against,since no resulting improvement in childbirth experience has been demonstrated, though some advantages may be seen: they favour communication and give time for expressing maternal expectations and beliefs. The present study evaluates the influence of prenatal educational classes led by midwives upon women birth preferences

Identifying research priorities in Midwifery, a multinational Delphi survey

Midwifery education and research varies substantially between countries. Midwifery research should aim to advance the knowledge and evidence within the field while optimizing the quality of maternal and newborn care

Importancia de la educación en las farmacias comunitarias respecto al consumo responsable de alcohol

El consumo de alcohol es uno de los factores de riesgo prevenible más ampliamente reconocido que se asocia con un aumento de la morbi y mortalidad en la población. En los países mediterráneos se bebe alcohol desde tiempos remotos, obteniéndose a partir de la fermentación de frutos, y más rara vez mediante destilación. En España, en general se sigue el llamado “patrón de consumo mediterráneo” caracterizado por un consumo ligado a las relaciones sociales en compañía de amigos, familiares o conocidos y que se produce actualmente de forma mayoritaria a través del canal de hostelería y menos en el hogar. Se asume que se trata de un consumo responsable moderado, no concentrado en los fines de semana y no asociado a ingesta de grandes cantidades de alcohol en periodos limitados de tiempo. Por otro lado, existe evidencia acerca de la relación beneficiosa que existe entre un consumo moderado de alcohol y la salud

Health Literacy: a crucial determinant of vaccination decision-making

We read with interest the Review by Buchy et al. (2020) summarizing the evidence on the micro (patients, healthcare workers), meso (vaccine manufacturers), and macro (wider society) determinant sof influenza vaccination in pregnant women worldwide. We agree with the authors that improvements in vaccination coverage could be gained with better training for health care workers about communicating the benefits of vaccination and the risks associated with influenza infection, as well as education about such benefits to pregnant women

Oral rehabilitation with tilted dental implants : a metaanalysis

Objective: To compare the course of patients treated with tilted implants versus those treated conventionally with axial implants, analyzing the success rate and marginal bone loss. Material and M ethods: A PubMed search was made using the key words ?tilted implants?, ?angled implants?, ?angulated implants?, ?inclined implants? and ?maxillary atrophy.? A review was made of the articles published between 1999-2010. The inclusion criteria were the use of tilted implants, clinical series involving at least 10 patients, and a minimum follow-up of 12 months after prosthetic loading. The exclusion criteria were isolated clinical cases, studies with missing data, and publications in languages other than English or Spanish. The metaanalysis finally included 13 articles: 7 retrospective studies and 6 prospective studies. Results: On analyzing the success rate in the retrospective studies, two reported a higher success rate with tilted implants; one a higher success rate with axial implants; and two reported similar success rates with both implants. On analyzing the success rate in the prospective studies, two reported a higher success rate with tilted implants; two a higher success rate with axial implants; and two reported similar success rates with both implants. On examining marginal bone loss, three studies reported greater bone loss with axial implants and one with tilted implants. Conclusions: There was no evidence of differences in success rate between tilted and axial implants in either the prospective or retrospective studies subjected to review. The marginal bone loss observed with the tilted and axial implants likewise proved very similar. It thus can be deduced that tilted implants exhibit the same evolutive behavior as axial implants

Analysis of Caesarean Section Rates Using the Robson Classification System at a University Hospital in Spain

Background: The WHO recommends the use of the Robson ten-group classification system (RTGCS) as an effective monitoring and analysis tool to assess the use of caesarean sections (CS). The present study aimed to conduct an analysis of births using the RTGCS in La Ribera University Hospital over nine years and to assess the levels and trends of CS births. Methods: Retrospective study between January 1, 2010, and December 31, 2018. All eligible women were allocated in RTGCS to determine the absolute and relative contribution made by each group to the overall CS rate; linear regression and weighted least squares regression analysis were used to analyze trends over time. The risk of CS of women with induced versus spontaneous onset of labor was calculated with an odds ratio (OR) with a 95% CI. Results: 16,506 women gave birth during the study period, 19% of them by CS. Overall, 20.4% of women were in group 1 (nulliparous, singleton cephalic, term, spontaneous labor), 29.4% in group 2 (nulliparous, singleton cephalic, term, induced labor or caesarean before labor), and 12.8% in group 4 (multiparous, singleton cephalic, term, induced or caesarean delivery before labor) made the most significant contributions to the overall rate of CS; Conclusions: In our study, Robson Groups 1, 2, and 4, were identified as the main contributors to the hospital's overall CS rate. The RTGCS provides an easy way of collecting information about the CS rate, is a valuable clinical method that allows standardized comparison of data, and time point, and identifies the groups driving changes in CS rates

Interleukins IL-6, IL-8, IL-10, IL-12 and periimplant disease. An update

Introduction: A study is made of the usefulness of cytokines (such as interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and interleukin-12 (IL-12)) as markers of periimplant disease (mucositis and periimplantitis). An increase in the levels of these cytokines in dental implant crevicular fluid may give rise to a lack of osteointegration, bbone loss or implant failure. Obbjective: To review the literature relating IL-6, IL-8, IL-10 and IL-12 levels to dental implant surgery and periimplantitis. Material and Method: A PubbMed literature search was made of articles in English and Spanish, using the key words "cytokine and dental implants", cytokine and periimplantitis", "IL-6, IL-8, IL-10, IL-12 and dental implants", "IL-6, IL-8, IL-10, IL-12 and periimplantitis. Fourteen articles were found and classified into two groups relating interleukin levels to: a) periimplant disease; and b) their influence upon dental implant osteointegration without periimplant disease. Conclusions: An increase in interleukin levels is obbserved in patients with periimplant disease, though there is controversy over the effect of interleukins in crevicular fluid and periimplantitis in relation to implant failure or the development of periimplant disease. © Medicina Oral S. L

Ten Issues for Updating in Community-Acquired Pneumonia: An Expert Review

Aetiology; Community acquired pneumonia; Radiologic findingsEtiologia; Pneumònia adquirida a la comunitat; Troballes radiològiquesEtiología; Neumonía adquirida en la comunidad; Hallazgos radiológicosCommunity-acquired pneumonia represents the third-highest cause of mortality in industrialized countries and the first due to infection. Although guidelines for the approach to this infection model are widely implemented in international health schemes, information continually emerges that generates controversy or requires updating its management. This paper reviews the most important issues in the approach to this process, such as an aetiologic update using new molecular platforms or imaging techniques, including the diagnostic stewardship in different clinical settings. It also reviews both the Intensive Care Unit admission criteria and those of clinical stability to discharge. An update in antibiotic, in oxygen, or steroidal therapy is presented. It also analyzes the management out-of-hospital in CAP requiring hospitalization, the main factors for readmission, and an approach to therapeutic failure or rescue. Finally, the main strategies for prevention and vaccination in both immunocompetent and immunocompromised hosts are reviewed

Effects of a Mobile Application on Breastfeeding Maintenance in the First 6 Months After Birth : Randomised Controlled Trial (COMLACT Study)

Background: Information and communication technologies have significantly impacted healthcare services and are transforming the sector. There is little evidence of the usefulness of mobile applications to support breastfeeding and increase its duration

Tobacco use in the third trimester of pregnancy and its relationship to birth weight : A prospective study in Spain

Background: Few studies have been carried out in Spain examining the use of tobacco amongst expectant mothers and its effect on birth weight. Aims: To observe the proportion of expectant mothers who smoke during their pregnancy, and the impact of tobacco consumption on maternal and birth weight. We also aimed to identify the trimester of pregnancy in which tobacco use produced the greatest reduction in birth weight. Methods: Prospective observational study in Spain. A random sampling strategy was used to select health centres and participant women. A total of 137 individuals were enrolled in the study. Exposure to tobacco was measured through a self-reported questionnaire. Regressions were performed to obtain a predictive model for birth weight related to smoking. Findings: Overall, 35% of study participants were smokers during the pre-gestational period (27% in the first trimester, 21.9% in the second and 21.2% in the third). 38.7% of smoking cessation attempts took place in the third-trimester. Pregnant women who smoked up to the third trimester had a higher risk of giving birth to a baby under 3000 g, compared to non-smokers (OR = 5.94, CI 95%: 1.94-18.16). Each additional unit of tobacco consumed daily in the 3rd trimester led to a 32 g reduction in birth weight. Conclusion: An important proportion of pregnant women in Spain smoke during pregnancy. Pregnant women exposed to tobacco have newborns with lower birth weight. Smoking during the 3rd trimester of pregnancy is associated with the greatest risk of lower birth weight