What matters to women in the postnatal period: A meta-synthesis of qualitative studies

Introduction: The postnatal period is an underserved aspect of maternity care. Guidelines for postnatal care are not usually informed by what matters to the women who use it. This qualitative systematic review was undertaken to identify what matters to women in the postnatal period, to inform the scope of a new World Health Organization (WHO) postnatal guideline. Methods: We searched MEDLINE, CINAHL, PsycINFO, POPLINE, Global Index Medicus, EMBASE, LILACS, AJOL, and reference lists of eligible studies published January 2000–July 2019, reporting qualitative data on women’s beliefs, expectations, and values relating to the postnatal period. Data collection and analysis: Author findings were extracted, coded and synthesised using techniques derived from thematic synthesis. Confidence in the quality, coherence, relevance and adequacy of data underpinning the resulting findings was assessed using GRADE-CERQual. Results: We included 36 studies from 15 countries, representing the views of more than 800 women. Confidence in most results was moderate to high. What mattered to women was a positive postnatal experience where they were able to adapt to their new self-identity and develop a sense of confidence and competence as a mother; adjust to changes in their intimate and family relationships, including their relationship to their baby; navigate ordinary physical and emotional challenges; and experience the dynamic achievement of personal growth as they adjust to the ‘new normal’ of motherhood and parenting in their own cultural context. Conclusion: This review provides evidence that what matters to women in the postnatal period is achieving positive motherhood (including maternal self‐esteem, competence, and autonomy), as well as fulfilling adaptation to changed intimate and family relationships, and (re)gaining health and wellbeing for both their baby, and themselves. Where this process is optimal, it also results in joy, self-confidence, and an enhanced capacity to thrive in the new integrated identity of ‘woman and mother’

What matters to women during childbirth: A systematic qualitative review

Introduction Design and provision of good quality maternity care should incorporate what matters to childbearing women. This qualitative systematic review was undertaken to inform WHO intrapartum guidelines. Methods Using a pre-determined search strategy, we searched Medline, CINAHL, PsycINFO, AMED, EMBASE, LILACS, AJOL, and reference lists of eligible studies published 1996-August 2016 (updated to January 2018), reporting qualitative data on womens’ childbirth beliefs, expectations, and values. Studies including specific interventions or health conditions were excluded. PRISMA guidelines were followed. Data collection and analysis Authors’ findings were extracted, logged on a study-specific data form, and synthesised using meta-ethnographic techniques. Confidence in the quality, coherence, relevance and adequacy of data underpinning the resulting themes was assessed using GRADE-CERQual. A line of argument synthesis was developed. Results 35 studies (19 countries) were included in the primary search, and 2 in the update. Confidence in most results was moderate to high. What mattered to most women was a positive experience that fulfilled or exceeded their prior personal and socio-cultural beliefs and expectations. This included giving birth to a healthy baby in a clinically and psychologically safe environment with practical and emotional support from birth companions, and competent, reassuring, kind clinical staff. Most wanted a physiological labour and birth, while acknowledging that birth can be unpredictable and frightening, and that they may need to ‘go with the flow’. If intervention was needed or wanted, women wanted to retain a sense of personal achievement and control through active decision-making. These values and expectations were mediated through womens’ embodied (physical and psychosocial) experience of pregnancy and birth; local familial and sociocultural norms; and encounters with local maternity services and staff. Conclusions Most healthy childbearing women want a positive birth experience. Safety and psychosocial wellbeing are equally valued. Maternity care should be designed to fulfil or exceed womens’ personal and socio-cultural beliefs and expectations

Barcelona como laboratorio de innovación democrática (2015-2020)

Este artículo tiene por finalidad conocer el diseño e implementación de las nuevas formas de co-producción de gobernanza relacional y democrática que se han desarrollado en la ciudad de Barcelona durante el periodo 2015-2020 coincidiendo con el primer mandato del gobierno municipal de Barcelona en Comú. Para ello, nos centramos en el análisis de tres procesos de innovación democrática -la gestión cívica de equipamientos públicos, la producción de comunes urbanos y la democratización de la innovación digital- que ejemplificamos a través de tres casos de estudio: el Centro LGTBI de Barcelona, el proyecto cooperativo Can Batlló y el Canódromo - Ateneo de Innovación Digital y Democrática. Tal y como se evidencia en la comparación desarrollada, estos tres modelos suponen un cambio respecto a los modelos tradicionales de gestión pública al permitir articular una nueva relación entre movimiento e institución, su orientación hacia la autogestión y su articulación con un nuevo marco normativo, dentro del marco conceptual de la cooperación público-comunitari

Infection-related severe maternal outcomes and case fatality rates in 43 low and middle-income countries across the WHO regions: results from the Global Maternal Sepsis Study (GLOSS)

The highest toll of maternal mortality due to infections is reported in low and middle-income countries (LMICs). However, more evidence is needed to understand the differences in infection-related severe maternal outcomes (SMO) and fatality rates across the WHO regions. This study aimed to compare the burden of infection-related SMO and case fatality rates across the WHO regions using the Global Maternal Sepsis Study (GLOSS) data. GLOSS was a hospital-based one-week inception prospective cohort study of pregnant or recently pregnant women admitted with suspected or confirmed infection in 2017. Four hundred and eight (408) hospitals from 43 LMICs in the six WHO regions were considered in this analysis. We used a logistic regression model to compare the odds of infection-related SMOs by region. We then calculated the fatality rate as the proportion of deaths over the total number of SMOs, defined as maternal deaths and near-misses. The proportion of SMO was 19.6% (n = 141) in Africa, compared to 18%(n = 22), 15.9%(n = 50), 14.7%(n = 48), 12.1%(n = 95), and 10.8%(n = 21) in the Western Pacific, European, Eastern Meditteranean, Americas, and South-Eastern Asian regions, respectively. Women in Africa were more likely to experience SMO than those in the Americas (aOR = 2.41, 95%CI: [1.78 to 2.83]), in South-East Asia (aOR = 2.60, 95%CI: [1.57 to 4.32]), and the Eastern Mediterranean region (aOR = 1.58, 95%CI: [1.08 to 2.32]). The case fatality rate was 14.3%[3.05% to 36.34%] (n/N = 3/21) and 11.4%[6.63% to 17.77%] (n/N = 16/141) in the South-East Asia and Africa, respectively. Infection-related SMOs and case fatality rates were highest in Africa and Southeast Asia. Specific attention and actions are needed to prevent infection-related maternal deaths and severe morbidity in these two regions

Gendering fibulae: animals and gender roles in Iberian Iron Age societies

Desde la Antigüedad, los animales domésticos y salvajes han sido parte integrante de la vida del ser humano como alimento para su supervivencia, como transporte y también como iconos en la construcción del imaginario cultural. En la cultura ibérica las representaciones figuradas en diversos soportes (cerámica, escultura en piedra, terracotas, metales y monedas), “lo imaginario”, y los restos faunísticos de poblados, necrópolis y lugares cultuales, “lo real”, ilustran las relaciones entre las sociedades de la Edad del Hierro de la mitad SE de la Península Ibérica con los animales de su entorno. En este trabajo se analiza un tipo de objeto de la indumentaria íbera: las fíbulas, como ejemplo para aproximarnos al género como constructo cultural. Estas fíbulas, por su elaboración en metales nobles y la ornamentación que portan con escenas de caza o animales individualizados, debieron ser piezas de especial significación entre determinados grupos sociales y de poder. El estudio de los contextos y de imágenes similares en otros soportes y su comparación con los restos faunísticos documentados aportan información sobre el rango y el género de sus portadores y nos aproximan al significado que determinados animales tuvieron para los íberos.Since ancient times, domestic and wild animals have been an integral part of human life as food for survival, as transportation and as icons on the construction of the cultural imagery. Iberian culture during the Iron Age depicted such animals in ceramics, stone and terracotta sculpture, metals objects, and coins. These “imaginary” remains and the “real” faunal assemblages of settlements, necropoleis, and cultic places both reflect the ongoing relationships between human societies and other living things in the same environment –in this case the southeast area of the Iberian Peninsula. In this paper we analyze animal depictions in Iberian fibulae (brooches) as a means from which to approach gender as a cultural construct. These fibulae were made in precious metals and decorated with hunting scenes or individual animals. They should be considered objects of special significance in specific social groups and elites wielding power among the Iberians. Studying contexts and comparing similar images that appear in other media with documented faunal assemblages provides us insights into Iberian social status, the gender of the wearer, and the meaning of certain animals

Vídeo-juegos como recurso didáctico para mejorar el aprendizaje de la tabla periódica

El propósito de esta investigación es emplear los video-juegos como herramienta didáctica, para mejorar aprendizaje de la tabla periódica, de 42 jóvenes del primer año de Bachillerato, paralelo C de la Unidad Educativa Fiscal Portoviejo, considerando que en la sociedad actual, los videojuegos se muestran como recursos mediadores de integración de distintos colectivos, como actividades de entretenimiento que forjan lazos familiares en ocasiones inexistentes, en muchas ocasiones como trampolines para la autoestima, en pocas ocasiones como material educativo para la enseñanza de valores, y últimamente como uno de los peligros que acechan a los jóvenes. Al surgir estas herramientas distractoras del siglo XXI, “el joven aprende por medio de la imitación de sus modelos que tiene a su alrededor” (Vygotsky). En esta investigación, se establece que los videojuegos como herramienta educativa, favorecen el desarrollo de determinados aspectos de la inteligencia de este grupo de jóvenes, al usarlos como recurso en la enseñanza de la Tabla periódica, pues las calificaciones de ese parcial de estos estudiantes están en el rango de alcanzan el aprendizaje requerido (AAR). PALABRAS CLAVE: Video-juegos; recursos; inteligencia. Video-games as a didactic resource to improve the learning of the periodic table ABSTRACT The purpose of this research is to use video games as a didactic tool, to improve learning of the periodic table, of 42 young people of the first year of Baccalaureate, parallel C of the Fiscal Education Unit Portoviejo, considering that in today's society, video games they are shown as mediating resources for the integration of different groups, as entertainment activities that forge family ties on non-existent occasions, often as springboards for self-esteem, rarely as educational material for teaching values, and lately as one of the dangers that stalk young people. When these distracting tools of the 21st century arise, “the young man learns through the imitation of his models around him” (Vygotsky). In this research, it is established that video games as an educational tool, favor the development of certain aspects of the intelligence of this group of young people, by using them as a resource in the teaching of the Periodic Table, since the qualifications of this part of these students are in the range, they achieve the required learning (AAR). KEYWORDS: Video games; resources; intelligence