Suchergebnisse

Background: Every year around six hundred secret deliveries take place in France, this act is infrequent and remains a delicate subject in France because it exists a debate between the rights of the child and the rights of mothers. As a result, secret childbirth can occur to any midwife during her career, she will be at the centre of this unique support and will have an essential role with those who wish to give birth anonymously, in listening, understanding and supporting.Study design: A qualitative, descriptive and interpretative study was carried out thanks to semi-structured interviews carried out with ten midwives working in maternity hospitals in Auvergne or in PMI. These interviews were then analyzed by thematic manner.Results: Legislative gaps as well as administrative difficulties exist among the midwives interviewed. Regarding the care of these patients, it is appreciably similar to any woman giving birth, it is the exchanges, the wishes, the relationships established witch are differents. This study has permitted to assess their feelings and find solutions to improve care and comfort. We have shown that midwives, according to their own personal history, are committed to providing comprehensive care to these patients.Discussion: When caring for a woman wishing to give birth in secret, the midwife faces an intense emotional state. The latter can give rise to feelings of sadness, empathy, worry. These emotions felt by midwives, whether positive or negative, will influence their care. Each patient reacts in her own way by evoking various feelings; the midwife can not acquire habits and must instead provide individualized support in caring. Indeed, there is no typical situation, it seems impossible to be prepared emotionally for these situations, each of these mothers has a unique story. In order to help midwives to provide administrative support to these women as well as to respond to the research problem and standardize the discourse, a management chart was developed as part of this study. It also ...

BACKGROUND: This study focuses on factors that may disproportionately affect female veterans' mental health, compared to men, and is part of a larger study assessing the prevalence of mental health disorders and treatment seeking among formerly deployed US military service members. METHODS: We surveyed a random sample of 1,730 veterans who were patients in a large non-VA hospital system in the US. Based on previous research, women were hypothesized to be at higher risk for psychological problems. We adjusted our results for confounding factors, including history of trauma, childhood abuse, combat exposure, deployments, stressful life events, alcohol misuse, psychological resources, and social support. RESULTS: Among the veterans studied, 5% were female (n = 85), 96% were White (n = 1,161), 22.9% were Iraq/Afghanistan veterans (n = 398), and the mean age was 59 years old (SD = 12). Compared to males, female veterans were younger, unmarried, college graduates, had less combat exposure, but were more likely to have lifetime PTSD (29% vs. 12%.), depression (46% vs. 21%), suicidal ideation (27% vs. 11%), and lifetime mental health service use (67% vs. 47%). Females were also more likely to have low psychological resilience and to have used psychotropic medications in the past year. Using multivariate logistic regression analyses that controlled for risk and protective factors, female veterans had greater risk for lifetime PTSD, depression, suicidal thoughts, and for lifetime use of psychological services, compared to males. Since 95% of the population in this study were male and these results may have been statistically biased, we reran our analyses using propensity score matching. Results were consistent across these analyses. CONCLUSION: Using a sample of post-deployment veterans receiving healthcare services from a large non-VA health system, we find that female veterans are at greater risk for lifetime psychological problems, compared to male veterans. We discuss these findings and their implications for service ...

BACKGROUND: Sexual and gender-based violence (SGBV) is an epidemic that continues to affect both men and women in East Africa. Despite the high prevalence of SGBV in this region, sexual offense policies are often unclear, poorly enforced, or completely lacking. When policies do exist practitioners who assist survivors in the aftermath of the violation often are unaware of them, or may not implement them for a host of reasons (e.g., culture, personal beliefs, and resource limitations). This scoping review seeks to evaluate the literature on existing sexual offense policies in East Africa and understand the consequences of its implementation, or lack thereof, on a survivor's justice and medical and psychological wellbeing. METHODS: This scoping review will be guided by the amended Arksey and O'Malley framework recommendations (Levac et al., Implementation Science. 2010) and the 2015 Joanna Briggs Institute guidelines (Peters et al., Joanna Briggs Institute Reviewer's Manual, 2020). The results will be presented using the adapted Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Reviews chart (PRISMA-ScR). The search strategy for this scoping review will include entering search terms into electronic databases, including PubMed, SCOPUS, CINAHL Plus, The British Library, and Web of Science. A "cited by" search will be conducted, which will also include entering references from the reference lists from other articles. Grey literature will be included in the review, which will be identified through searching individual country's government websites, and other websites, such as the World Health Organization and the United Nations Human Rights Council. All references will be exported to Endnote library. Two independent reviewers will screen titles, abstracts, and full articles. Thematic analysis will be used to evaluate the included articles. DISCUSSION: Understanding the legal and regulatory context of SGBV in East Africa and its associations with service provision will generate ...

BACKGROUND: Stress fractures are a common and potentially debilitating overuse injury to bone and occur frequently among military recruits and athletes. Recovery from a lower body stress fracture typically requires several weeks of physical rehabilitation. Teriparatide, a recombinant form of the bioactive portion of parathyroid hormone (1–34 amino acids), is used to treat osteoporosis, prevent osteoporotic fractures, and enhance fracture healing due to its net anabolic effect on bone. The study aim is to investigate the effect of teriparatide on stress fracture healing in young, otherwise healthy adults undergoing military training. METHODS: In a two-arm, parallel, prospective, randomised controlled, intention-to-treat trial, Army recruits (n = 136 men and women, 18–40 years) with a magnetic resonance imaging (MRI) diagnosed lower body stress fracture (pelvic girdle, sacrum, coccyx, or lower limb) will be randomised to receive either usual Army standard care, or teriparatide and usual Army standard care. Teriparatide will be self-administered by subcutaneous injections (20 μg/day) for 16 weeks, continuing to 24 weeks where a fracture remains unhealed at week 16. The primary outcome will be the improvement in radiological healing by two grades or more, or reduction to grade zero, 8 weeks after randomisation, assessed using Fredericson grading of MRI by radiologists blind to the randomisation. Secondary outcomes will be time to radiological healing, assessed by MRI at 8, 10, 12, 14, 16, 20 and 24 weeks, until healed; time to clinical healing, assessed using a clinical severity score of injury signs and symptoms; time to discharge from Army physical rehabilitation; pain, assessed by visual analogue scale; health-related quality of life, using the Short Form (36) Health Survey; and adverse events. Exploratory outcomes will include blood and urine biochemistry; bone density and morphology assessed using dual-energy X-ray absorptiometry, peripheral quantitative computed tomography (pQCT), and high-resolution pQCT; ...

Esta investigación aborda la producción deontológica sobre violencias contra las mujeres y medios de comunicación a partir de 58 códigos publicados entre 1999 y 2018. El objetivo principal es analizar el nivel de compromiso de los códigos con un periodismo más sensible para con el tratamiento de estas violencias. La metodología empleada se basa en el diseño de indicadores y subindicadores mediante un proceso inductivo y basado en la bibliografía científica previa. Para la medición del compromiso de cada unidad de análisis se han establecidos tres rangos de valoración: óptimo, aceptable y negativo. Entre los resultados obtenidos se destaca que el 9% de los códigos refleja un nivel de compromiso óptimo, el 53% ofrece un resultado negativo y el resto (38%) se sitúa en el rango de aceptable. Como conclusión principal puede afirmarse que la proliferación exponencial de códigos no se corresponde con un nivel de compromiso alto de los mismos, sino con lo que parece una acción situada en la deseabilidad social y el comportamiento políticamente correcto. ; This research focuses on the study of the deontological production on violence against women (VAW) and media from 1999 to 2018, compiling 58 guidelines. Objective: To analyse the guidelines' commitment level according to a more sensitive journalism for the VAW coverage. Method: indicators have been created through an inductive process and based on the previous scientific literature. For the measurement of the commitment level three ranges of measurement have been established which are optimal, acceptable and negative. Results: only 9% of the guidelines reflect an optimal commitment level, whilst 53% offer a negative result in terms of commitment; the rest (38%) is within the acceptable range. Conclusion: the build-up of guidelines does not correspond to a high level of commitment, but rather seems to be an action based on social desirability and politically correct behavior.

ilustraciones, diagramas, tablas ; Esta investigación se propone profundizar y ampliar las discusiones alrededor de los cuidados en la sociedad contemporánea, a partir de los aportes de teóricas feministas como Nancy Fraser, Carole Pateman, Natalia Magnone, Blanca Rodríguez Ruiz, Tomeu Sales, Denise Najmanovich, entre otras. Para esto, se desarrolla la categoría de CUIdadanía, como una apuesta académica y teórica que pretende visibilizar el poder del cuidado en todos los ámbitos sociales, desde una mirada amplia, integral y diferente del cuidado, para que este no siga siendo visto como el "principal obstáculo para la participación de las mujeres", sino que pueda ser reconocido como práctica política emancipadora. Esto último, en la medida que se reformule la categoría de ciudadanía, históricamente patriarcal, y en su concepción, se incluya el cuidado como un acto político que implica la paridad participativa, con el fin de que las sociedades sean más cuidadas, autónomas y democráticas. Al final de la presente investigación, se encuentra una propuesta metodológica para enseñar y compartir la concepción de CUIdadanía en los movimientos sociales y en las organizaciones sociales y comunitarias. (Texto tomado de la fuente) ; This research aims to deepen and broaden the discussions around care in contemporary society, based on the contributions of feminist theorists such as Nancy Fraser, Carole Pateman, Natalia Magnone, Blanca Rodríguez Ruiz, Tomeu Sales, and Denise Najmanovich, among others. The category of Citizenship of care (CUIdadania in spanish) is developed, as an academic and theoretical commitment that aims to make visible the power of care in all social areas, from a broad, comprehensive, and different perspective of care, so that it is not seen as the " main obstacle for the participation of women", but that it can be recognized as an emancipatory political practice. To the extent that the category of citizenship, historically patriarchal, is reformulated, and in its conception, care is included as a ...

Social media is a means of disseminating information in marketing candidates or political parties. Politicians do branding through text and images in order to shape people's perceptions of themselves. Political branding on social media can be observed from the choice of words used and the issues discussed. This study aims to analyze Tsamara Amany Alatas' content on her personal social media accounts during the 2019 general election campaign. This study used qualitative method, and text analize. The researcher adjusted the content uploaded on Instagram and Twitter with the political branding and brand personality that Tsamara formed on his social media accounts. As a result, Tsamara performed all the criteria for successful branding according to the criteria adapted by Needham. Tsamara offers programs that she will strive for clearly, has distinguishing characteristics as a young lady who is brave and ready to be fired by constituents if she is performing poorly, ready to fight for aspirations and ready to be watched, become a symbol of PSI values, and convince constituents that she can trusted in fighting for aspirations. Tsamara has also formed a brand personality as a young politician who is honest and ready to be transparent to constituents, has high empathy especially for women, is brave, smart and has a technical understanding of constituent problems, and is tough. There are differences in the types of content that Tsamara produces on her Instagram and Twitter social media accounts. Tsamara's Instagram content focuses on forming her political brand, while Twitter content focuses on responding to social and political issues at the time and interacting with supporters. This difference is in accordance with the differences in the superior features of the two social media. Twitter is more interactive, allowing Tsamara to interact and discuss, while Instagram makes it easier for Tsamara to focus on delivering political messages to find voice support for her.

Introducción: el embarazo no planeado o no intencional y el aborto son situaciones que afectan la vida de mujeres anivel mundial, sin distinción de etnia, edad, riqueza, o ubicación geográfica, sin embargo, tiene una mayor posibilidadde presentarse y generar consecuencias negativas en mujeres con ciertas determinantes sociales. Objetivo: mostrarel estado actual de la interrupción voluntaria del embarazo en países de Latinoamérica y del Caribe con énfasis enel reciente avance de la legislación argentina sucedido durante diciembre del 2020. Metodología: se realizó unabúsqueda no estructurada de información sobre la legislación del aborto en países de Latinoamérica y del Caribey se hizo una revisión de tema sobre aspectos actuales y relevantes de la interrupción voluntaria del embarazo.Conclusiones: es necesario que prestadores de servicios de salud y sociedad latinoamericana repasen las leccionesaprendidas de diferentes países sobre las consecuencias negativas para la salud de las mujeres y sus familias debidoa las restricciones para acceder al aborto seguro. El mejoramiento de la calidad y las capacidades de los sistemas desalud en los países de bajos y medianos recursos, con mayor inversión e investigación en temas de salud sexual yreproductiva, resultará en la eliminación de barreras e inequidades en la prestación de atención médica a las mujeres,respetando sus derechos y autonomía. ; Introduction: Unplanned or unintended pregnancy and abortion are situations that affect the lives of womenworldwide without distinction of ethnicity, age, economic level, or geographical location. However, they have agreater probability of occurring and negative consequences in women with certain social determinants. Objective:Our main objective is to show the current state of the Voluntary Interruption of Pregnancy in Latin American andCaribbean countries with special emphasis on the recent advance of the legislation of Argentina that occurred lastDecember. Methodology: An unstructured search for information about Abortion ...

While Malaysia's economy may be driven by large industries where government-linked companies (GLCs) and multi-national corporations predominate, the importance of micro, small, and medium-sized enterprises (MSMEs) should not be underestimated. Almost all (98.5%) registered businesses in Malaysia are MSMEs, and help to stimulate the economy in more ways than one (i.e., providing employment and innovation, among others). Judging by economic performance and administrative resilience following the 14th General Election in 2018, Malaysia's economic growth and development seemed to be on a positive trajectory. However, with the emergence of Covid-19 in late 2019, MSMEs have been badly impacted, with a tremendous number of them closing down temporarily or shutting down operations completely. This is expected to hamper Malaysia's prospects for economic growth for years to come. While the country's economy, overall, will likely experience challenges in future, Malaysia's working people will be the most affected—namely those who are breadwinners for their families. A survey-based study was carried out from July to August 2020 by The Asia Foundation (the Foundation) to identify how Malaysian MSMEs have been affected by the Covid-19 outbreak. This looked at key areas such as businesses': performance prior to the pandemic, operations during Covid-19 restrictions, expectations about survival, coping strategies, perceptions about the government's management in response to the pandemic, and willingness to help women cope with the pandemic. This study also surveyed the impact of Covid-19 on Malaysian workers, and especially during the initial phase of the government's movement control order (MCO), which was introduced and enforced to prevent mass spread of the coronavirus. The study was carried out to analyze the direct and indirect impact that the outbreak and the associated measures put in place by employers and the government had on different groups of workers.

In the fall of 2015, one year before Donald Trump became the U.S. president, Jimmy Morales, an evangelical Christian, won the presidential election in Guatemala. This article examines the political-religious activism, the transnationally-active networks, and the impact of the Christian Right between these two countries. Furthermore, it analyzes the influence of Christian Zionism in this activism and in these networks. Three examples serve to illustrate the complexities at stake: (1) the impact in Guatemala of the "Mexico City Policy", a U.S. policy called the "Global Gag Rule" by its critics; (2) initiative L5272, the "Law for the Protection of Life and the Family;" and the decision of Morales to move the Guatemalan embassy from Tel Aviv to Jerusalem, shortly after the United States did. The article concludes that, with the Trump and Morales administrations, the separation between church and state dissolved; and the so-called "culture war" intensified in both countries in the political and legislative realms, through the efforts of evangelical actors; and further that this phenomenon caused severe setbacks in human rights, especially for women and LGTBQIA+ persons. ; En el otoño de 2015, un año antes de que Donald Trump se convirtiera en el presidente de Estados Unidos, Jimmy Morales, un cristiano evangélico, ganó las elecciones presidenciales en Guatemala. Este artículo examina el activismo político-religioso, las redes transnacionalmente activas y el impacto de la derecha cristiana entre los dos países. Además, se analiza la influencia del sionismo cristiano dentro de este activismo y estas redes. Tres ejemplos sirven para ilustrar las complejidades en juego. Primero, se analiza el impacto de la "Mexico City Policy" en Guatemala, una directiva estadounidense también llamada por sus críticos "ley Mordaza Global". El segundo ejemplo aborda la Iniciativa 5272, que busca aprobar la "Ley Para la Protección de la Vida y la Familia". El tercer ejemplo abarca la decisión de Morales de trasladar la embajada ...

INTRODUCTION: There are limited data on the impact of COVID‐19‐associated disruptions and novel HIV service delivery strategies among key populations (KPs) in low‐ and middle‐income countries. In March 2020, in response to COVID‐19, the Government of India revised HIV service delivery policies to include community antiretroviral therapy (ART) distribution and multi‐month dispensing (MMD) of ART for all people living with HIV (PLHIV). METHODS: To assess the acceptability of these adaptations and impact of the pandemic among KPs, we conducted focus groups in November–December 2020 with purposively sampled men who have sex with men (MSM), female sex workers (FSWs) and transgender women (TGW) in Telangana and Maharashtra. Seven discussions were conducted. Topics included HIV service access, risk behaviours, economic security and feedback to ensure service continuity. Inductive coding identified themes across topics. RESULTS: Forty‐four individuals aged 20–49 years participated in discussions (13 MSM; 16 FSW; and 15 TGW). Twenty‐four participants self‐identified as living with HIV. People not living with HIV reported challenges in accessing HIV antibody testing at hospitals due to travel restrictions and fear of contracting COVID‐19. Participants accessed HIV antibody testing using transportation arranged by community‐based organizations after lockdowns eased. PLHIV reported uninterrupted ART refills and generally consistent adherence; however, there were experiences of delayed CD4 and HIV RNA testing. Participants shared appreciation for MMD as it saved time, money, and reduced exposure to COVID‐19. Participants expressed gratitude for home deliveries which enabled ART access, yet shared concerns about home‐based services causing confidentiality breaches with family/neighbours. Participants voiced preferences for community‐based service provision due to proximity, convenient hours, and welcoming environments compared to public hospitals. Other requests included support for income, employment, nutrient‐rich food and ...

Esta investigación aborda la producción deontológica sobre violencias contra las mujeres y medios de comunicación a partir de 58 códigos publicados entre 1999 y 2018. El objetivo principal es analizar el nivel de compromiso de los códigos con un periodismo más sensible para con el tratamiento de estas violencias. La metodología empleada se basa en el diseño de indicadores y subindicadores mediante un proceso inductivo y basado en la bibliografía científica previa. Para la medición del compromiso de cada unidad de análisis se han establecidos tres rangos de valoración: óptimo, aceptable y negativo. Entre los resultados obtenidos se destaca que el 9% de los códigos refleja un nivel de compromiso óptimo, el 53% ofrece un resultado negativo y el resto (38%) se sitúa en el rango de aceptable. Como conclusión principal puede afirmarse que la proliferación exponencial de códigos no se corresponde con un nivel de compromiso alto de los mismos, sino con lo que parece una acción situada en la deseabilidad social y el comportamiento políticamente correcto. ; This research focuses on the study of the deontological production on violence against women (VAW) and media from 1999 to 2018, compiling 58 guidelines. Objective: To analyse the guidelines' commitment level according to a more sen-sitive journalism for the VAW coverage. Method: indicators have been created through an inductive process and based on the previous scientific literature. For the measurement of the commitment level three ranges of measurement have been established which are optimal, acceptable and negative. Results: only 9% of the guidelines reflect an optimal com-mitment level, whilst 53% offer a negative result in terms of commitment; the rest (38%) is within the acceptable range. Conclusion: the build-up of guidelines does not correspond to a high level of commitment, but rather seems to be an action based on social desirability and politically correct behavior.

Purpose: The aim of this paper was to describe how people living with a neurological disability such as multiple sclerosis, Parkinson's disease and stroke reason regarding using apps to facilitate self-management in everyday life.Material and methods: A qualitative research approach with a focus group methodology was used. The sample comprised 16 participants, 11 men and 5 women, with an average age of 64 years (ranging from 51–80 years). Six participants were diagnosed with multiple sclerosis, six with Parkinson's disease and four with stroke. Data were analyzed using thematic analysis, which is a method for identifying, analyzing and reporting patterns.Results: The results formed two themes. The first theme "using apps to have control of my health" comprises two subthemes; "monitor and take responsibility for a healthy lifestyle" and "compensate to facilitate everyday life". The second theme "using the app as a tool and means for communication" also comprised two subthemes; "dare to trust the app" and "feeling safe when sharing information with health care professionals".Conclusions: The use of apps put increased responsibility on the person and had the possibility to make them more involved in their own care. The use of an app can facilitate a healthy lifestyle and help to monitor disease-specific symptoms. In order to be able to use apps for communication with the health care sector legislation and safety issues need to be considered. Implications for rehabilitation Apps can be used for self-management if they are safe and can be trusted. People with neurological disabilities want to be involved in their healthcare and needs to be addressed by health care professionals. The use of apps grasp over a wide variety of areas this is something that may be considered in health care and something that can be addressed by interdisciplinary approaches. Ordinary health-oriented apps and disease-specific apps were used differently and for different purposes.

IntroductionIn January 2005, the Australian Government increased the consumer medication co-payment by 21%. Previous research found that this affected population-level utilisation of statins, which fell by 5% following the co-payment increase. The subsequent health impact on individuals reducing or ceasing use of statins is unknown.
Objectives and ApproachTo explore the two-year risk of acute coronary syndrome (ACS) or stroke-related hospitalisation among individuals who discontinued, reduced or continued statin medicines after the 2005 PBS co-payments increase. This was achieved through a retrospective cohort study using linked administrative Commonwealth and State datasets for the Western Australian population. Outcomes were assessed using the Fine and Gray competing risks method, with death as the competing risk, adjusting for demographics, comorbidities and medication history.
ResultsThere were 207,066 individuals identified as using statins before the co-payment increase. After the increase, adherence reduced in 12.5% of this cohort, and 3.3% ceased use. There were 4,343 ACS and stroke-related hospitalisations for the cohort in the follow-up period. Multivariate analysis indicated ceasing statins increased the risk of hospitalisation for ACS or stroke-related events by 18% (95%CI=0.1-40%) compared to continuing therapy. The risk was greatest for males <70 years. No differences existed for women or older men who discontinued statins. There was no difference in hospitalisation risk for those who reduced statins compared to those who continued.
Conclusion / ImplicationsYounger men ceasing statins after the 2005 co-payments increase had a higher risk of ACS and stroke hospitalisations compared to individuals who continued using statins. The findings highlight the importance of continued adherence to prescribed statin medication, and that discontinuing therapy for non-clinical reasons (such as cost) can have negative consequences. Additionally, it demonstrates to policymakers that substantial increases in consumer co-payments can result in adverse health outcomes.

IntroductionDispensing claims are used commonly as proxy measures in pharmacoepidemiological studies, however, their validity is often untested.
Objectives and ApproachWe quantified the level of ascertainment and potential biases arising when using dispensing claims to identify incident cancer cases in cohort studies. We used Department of Veterans' Affairs client data linked with the New South Wales (NSW) Cancer Registry and Repatriation and Pharmaceutical Benefits Scheme data. We included clients aged ≥65 residing in NSW between July 2004 and December 2012. We matched clients with a cancer diagnosis to clients without a diagnosis based on demographic characteristics and available observation time. We used dispensing claims for anticancer medicines dispensed between July 2004 and December 2013 as a proxy for cancer diagnosis and calculated sensitivity, specificity, positive predictive values and negative predictive values compared with cancer registry data (gold standard), overall and by cancer site. We illustrated the potential for misclassification by the proxy in a cohort of people initiating opioid therapy.
ResultsWe identified 15,679 incident cancer diagnoses in 14,112 clients from the cancer registry and 62,663 clients without a diagnosis. The proxy's sensitivity was 30% for all cancers and ranged from 10-67% for specific cancers. Specificity was >90% for all cancers. The proxy correctly identified 26% of people with a cancer diagnosis who initiated opioid therapy, failed to identify 74% those with a cancer diagnosis, and was most robust for clients with breast cancer (61% were correctly identified).
Conclusion / ImplicationsUse of anticancer medicine dispensings for identifying people with incident cancer diagnosis is a poor proxy. Excluding people with evidence of anticancer medicine dispensing from cohort studies may remove a disproportionate number of women with breast cancer. Researchers excluding or otherwise using anticancer medicine dispensing to identify people with cancer in pharmacoepidemiological studies should acknowledge the potential biases introduced to their findings.