Challenges in implementing clinical governance: A qualitative study in Yazd, Iran

Background: Clinical Governance is considered as a system or strategy to improving performance standards and quality of healthcare services.Objective: To explore barriers in implementing clinical governance and propose related solutions in Teaching Hospitals of Shahid Sadoughi University of Medical Sciences.Design: A qualitative study.Setting: Hospitals affiliated to Shahid Sadoughi University of Medical Sciences in Yazd, Iran.Subjects: Thirteen participants selected among clinical governance executives of under study hospitals and members of clinical governance office in curative deputy of the University.Results: Eight major challenges in implementing clinical governance were identified including inadequate staff, unsupportive culture, inappropriate training, lack of financial and physical resources, weaknesses in management performance,  inadequate monitoring and lack of regulation. To facilitate successful  implementation of the programme, appropriate infrastructure, managers’ commitment, supporting culture and adequate knowledge were proposed.Conclusion: Managers and policy makers can accelerate clinical governance implementation by identification and elimination of barriers to remedy existing challenges and improve quality of healthcare services

Association of Maternal Working Condition with Low Birth Weight: The Social Determinants of Health Approach

Background: The socioeconomic conditions have made more job opportunities available to women. This has created interest to conduct studies on the effect of working lifestyle on pregnancy outcomes. Aim: This study was conducted with the aim to assess the relationship between mothers’ working status as a social determinant and the incidence of low birth weight (LBW) of the newborn. Subjects and Methods: This case–control study was conducted on 500 women with normal weight infants (control group) and 250 women with LBW infants (case group) in selected hospitals in Tehran. Data were collected using a researcher‑made questionnaire, designed to assess the effect of mothers’ prenatal lifestyle, as a social determinant, on LBW of the newborn. A section of the questionnaire involved assessment of mother’s working condition in terms of the work environment, activities, and job satisfaction. Data were analyzed using Chi‑square and logistic regression tests. Results: LBW among employed mothers was 5 times more likely than unemployed ones (odds ratio = 5.35, P < 0.001). Unfavorable work conditions such as humid environment, contact with detergents, and being in one standing or sitting position for long hours were significantly associated with LBW (P < 0.001). Conclusion: The present study showed that unfavorable work conditions were associated with LBW; therefore, they need special attention.Keywords: Low birth weight, Pregnancy, Socioeconomic factors, Working condition

Validating the Farsi version of the Pregnancy Worries and Stress Questionnaire (PWSQ): An exploratory factor analysis.

INTRODUCTION: Biological, environmental, inter- and intrapersonal changes during the antenatal period can result in anxiety and stress in pregnant women. It is pivotal to identify potential stressors and prevent their foetal and maternal consequences. The present study was conducted to validate and examine the factor structure of the Farsi version of the Pregnancy Worries and Stress Questionnaire (PWSQ). METHODS: In 2015, 502 Iranian healthy pregnant women, referred to selected hospitals in Tehran for prenatal care at 8-39 weeks of pregnancy, were recruited through a randomized cluster sampling. The PWSQ was translated into Farsi, and its validity and reliability were examined using exploratory factor analysis by SPSS version 21. RESULTS: The content validity of items on the PWSQ was between 0.63-1. The content validity index for relevance, clarity and simplicity were 0.92, 0.98, and 0.98, respectively, with a mean of 0.94. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.863. Test-retest reliability showed high internal consistency (α=0.89; p<0.0001). CONCLUSION: The psychometric evaluation and exploratory factor analysis showed that the translated questionnaire is a valid and reliable tool to identify stress in Iranian pregnant women. Application of the questionnaire can facilitate the diagnosis of stress in pregnant women and assist health care providers in providing timely support and minimizing negative outcomes of stress and anxiety in pregnant women and their infants

The relationship of social support and quality of life with the level of stress in pregnant women using the PATH model

Background: Lack of adequate social support, stress, and generally poor quality of life during pregnancy leads to adverse pregnancy outcomes for both the mother and the baby. Objectives: This study aimed to investigate the relationship of social support and quality of life with level of stress during pregnancy. Materials and Methods: This was a descriptive-correlative study conducted on 210 pregnant women (meeting study criteria), attending Shahriar Social Services Hospital during 2012. Purposive convenient sampling was used. Study subjects completed questionnaires of obstetrics and demographics, VAUX social support, World Health Organization quality of life, and stress during pregnancy. Data were analyzed with SPSS-19 and Lisrel 8.8, utilizing statistical path analysis. Results: The final path model fitted well (CF1 = 1, RMSEA = 0.00) and showed that direct quality of life paths with β = -0.2, and indirect social support with β = -0.088 had the most effects on reduction of stress during pregnancy. Conclusion: Social support indirectly and quality of life directly affect stress during pregnancy. Thus, health officials should attempt to establish measures to further enhance social support and quality of life of pregnant women to reduce stress and its consequences during this time. © 2013, Iranian Red Crescent Medical Journal

Domestic violence and its association with domains of reproductive health in women: A systematic review

Background and purpose: Violence is one of the main aspects of gender inequality that is a major barrier to achieving the goals of global reproductive health. It is directly associated with women's access to health care and health outcomes. In a systematic review, we aimed to investigate the articles on the relationship between intimate partner violence and women's reproductive health. Materials and methods: Electronic databases including, Scopus, ProQuest, PubMed, and Google Scholar were searched for articles published in English between 2010 and 2017. Results: After evaluation, 31 articles were selected. The lowest and highest prevalence of violence was associated with physical violence (2.8) and psychological violence (75.9), respectively. Moreover, violence was found to be associated with six domains of reproductive health including, not using contraceptive methods, abortion, genital tract diseases, poor pregnancy outcomes, and not using reproductive health services. Conclusion: Systematic review of studies investigated, showed a strong relationship between domestic violence and major aspects of reproductive health. Therefore, it is necessary to prevent domestic violence in order to promote the health of whole community. © 2018, Mazandaran University of Medical Sciences. All rights reserved

Domestic violence and its association with domains of reproductive health in women: A systematic review

Background and purpose: Violence is one of the main aspects of gender inequality that is a major barrier to achieving the goals of global reproductive health. It is directly associated with women's access to health care and health outcomes. In a systematic review, we aimed to investigate the articles on the relationship between intimate partner violence and women's reproductive health. Materials and methods: Electronic databases including, Scopus, ProQuest, PubMed, and Google Scholar were searched for articles published in English between 2010 and 2017. Results: After evaluation, 31 articles were selected. The lowest and highest prevalence of violence was associated with physical violence (2.8) and psychological violence (75.9), respectively. Moreover, violence was found to be associated with six domains of reproductive health including, not using contraceptive methods, abortion, genital tract diseases, poor pregnancy outcomes, and not using reproductive health services. Conclusion: Systematic review of studies investigated, showed a strong relationship between domestic violence and major aspects of reproductive health. Therefore, it is necessary to prevent domestic violence in order to promote the health of whole community. © 2018, Mazandaran University of Medical Sciences. All rights reserved

UniMorph 4.0:Universal Morphology

The Universal Morphology (UniMorph) project is a collaborative effort providing broad-coverage instantiated normalized morphological inflection tables for hundreds of diverse world languages. The project comprises two major thrusts: a language-independent feature schema for rich morphological annotation and a type-level resource of annotated data in diverse languages realizing that schema. This paper presents the expansions and improvements made on several fronts over the last couple of years (since McCarthy et al. (2020)). Collaborative efforts by numerous linguists have added 67 new languages, including 30 endangered languages. We have implemented several improvements to the extraction pipeline to tackle some issues, e.g. missing gender and macron information. We have also amended the schema to use a hierarchical structure that is needed for morphological phenomena like multiple-argument agreement and case stacking, while adding some missing morphological features to make the schema more inclusive. In light of the last UniMorph release, we also augmented the database with morpheme segmentation for 16 languages. Lastly, this new release makes a push towards inclusion of derivational morphology in UniMorph by enriching the data and annotation schema with instances representing derivational processes from MorphyNet