Exploring health care professionals' experiences and knowledge of woman-centred care in a university hospital.

Inspired by the six quality-of-care goals developed by the Institute of Medicine, woman-centred care (WCC) as model of care is used in maternity services as it gives an emphasis on the woman as an individual and not her status as a patient. Bringing stronger attention to women's needs and values, is proven to have clear benefits for perinatal outcomes, but fails to be known or recognised by healthcare professionals' (HCPs) and implemented. Using a mixed-methods approach, this study aimed to explore HCPs definitions of WCC and identify the degree of agreement and knowledge regarding perinatal indicators when a WCC model of care is implemented.

Estimation of Aortic Stiffness with Bramwell-Hill Equation: A Comparative Analysis with Carotid-Femoral Pulse Wave Velocity.

Aortic stiffness is an important clinical parameter for predicting cardiovascular events. Carotid-femoral pulse wave velocity (cf-PWV) has been proposed for performing this evaluation non-invasively; however, it requires dedicated equipment and experienced operators. We explored the possibility of measuring aortic stiffness using ultrasound scans of the abdominal aorta coupled with the Bramwell-Hill equation.

Putting midodrine on the MAP: An approach to liberation from intravenous vasopressors in vasodilatory shock.

Purpose: Prolonged duration of intravenous (IV) vasopressor dependence in critically ill adult patients with vasodilatory shock results in increased length of stay in both the intensive care unit (ICU) and hospital, translating to higher risk of infection, delirium, immobility, and cost. Acceleration of vasopressor liberation can aid in reducing these risks. Midodrine is an oral α 1-adrenergic receptor agonist that offers a potential means of liberating patients from IV vasopressor therapy.

Stress and Maladaptive Coping of Italians Health Care Professionals during the First Wave of the Pandemic.

Stress during the pandemic has had an impact on the mental health of healthcare professionals (HCPs). However, little is known about coping and "maladaptive" coping behaviours of this population. This study investigates "maladaptive" coping behaviours and their correlation with stress, anxiety and insomnia of Italian HCPs during the pandemic.

Initial setting of high-flow nasal oxygen post extubation based on mean inspiratory flow during a spontaneous breathing trial.

Purpose: High flow nasal cannula (HFNC) is commonly used post-extubation in intensive care (ICU). Patients' comfort during HFNC is affected by flow rate. The study aims to describe the relationship between pre-extubation inspiratory flow requirements and the post-extubation flow rates on HFNC that maximises patient's comfort.

Cross-cultural validation and psychometrics' evaluation of women's experience of maternity care scale in French: the ESEM.

Background: Evaluating women's satisfaction should reflect the entire maternity care experience (antenatal, intrapartum and postnatal). The Women's Experience Maternity Care Scale (WEMCS) questionnaire enables this assessment. The purpose of this study was to translate in French, adapt and explore the psychometric properties of the WEMCS and to determine the best cut-off on the optimal satisfaction for the three scales.

Human milk fatty acid profile across lactational stages after term and preterm delivery: A pooled data analysis.

Background: Lipids in human milk (HM) provide the majority of energy for developing infants, as well as crucial essential fatty acids (FA). The FA composition of HM is highly variable and influenced by multiple factors. We sought to increase understanding of the variation in HMFA profiles and their development over the course of lactation, and after term and preterm delivery, using a pooled data analysis.

Maintaining the knowledge and neonatal resuscitation skills of student midwives 6 months after an educational program.

Background: Training student midwives in neonatal resuscitation is essential because the midwife is present at every birth and must be able to perform resuscitation procedures when needed. The objective of this study was to evaluate student midwives' retention of theoretical knowledge about resuscitation as well as their practical application of that knowledge 6 months after training.

Method: A cross-sectional study was conducted for two consecutive years, 2015 and 2016, among 49 student midwives in the middle of their second and final year of training at the University of Applied Sciences in Western Switzerland.

Comprehensive maternity support and shared care in Switzerland: Comparison of levels of satisfaction.

Background: According to the woman-centred care model, continuous care by a midwife has a positive impact on satisfaction. Comprehensive support is a model of team midwifery care implemented in the large Geneva University Hospitals in Switzerland, which has organised shared care according to the biomedical model of practice. This model of care insures a follow up by a specific group of midwives, during perinatal period.

Influence of obstetrical events on satisfaction and anxiety during childbirth: a prospective longitudinal study.

The aim of this study was to investigate the feelings of anxiety and satisfaction among 79 primiparas who had uncomplicated pregnancies, at the time of hospital admission and after birth, considering the mode of delivery, analgesia, and pain levels. Questionnaires were completed at admission to the hospital and two months after delivery, using the State-Trait Anxiety Inventory (STAI) state scale and the Labour Agentry Scale. The mean (SD) STAI state score was higher at admission (36.

Association between anxiety and pain in the latent phase of labour upon admission to the maternity hospital: a prospective, descriptive study.

This study investigated the association between anxiety experienced by the mother, a request for analgesia, and the level of pain at maternity hospital admission in early labour. Anxiety levels were measured by the State-Trait Anxiety Inventory and pain was assessed using a Visual Analogue Scale. Anxiety and Visual Analogue Scale scores were compared using a linear regression model and indicated a statistically significant association between the anxiety state and degree of pain (p < 0.

Arthroscopic patellar reinsertion of the MPFL in acute patellar dislocations.

Purpose: The objective of this study was to evaluate the mid-term results of a new technique for the arthroscopic repair of MPFL after an acute patellar dislocation (APD).

Materials: The series included 17 patients (11 men and 6 women) with a first episode of acute patellar dislocation; treated over a period of 6 years. Re-dislocation, subjective symptoms and functional limitations were evaluated at an average follow-up of 2.

Shared decision-making in neonatology: an utopia or an attainable goal?

Medical decision making is sometimes considered as a relatively simple process in which a decision may be made by the physician, by the patient, or by both patient and physician working together. There are three main models of decision making--paternalism, patient informed choice, and shared decision-making (SDM), having each one of these drawbacks and limitations. Historically, the most adopted one was the paternalism (strongly 'Doctor knows best'), where the professional made the decision based on what he/she considered to be as the patient's best interest, not necessarily contemplating patient's will and wishes.

[Translation and validation in French of a multidimensional scale to evaluate the degree of satisfaction during childbirth].

Background: Validation of the French version of the questionnaire: Women's Views of Birth Labour Satisfaction Questionnaire, version 4 (WOMBLSQ4). This self-administered questionnaire measures patient satisfaction with care dispensed during childbirth.

Methods: The WOMBLSQ4 comprises 30 items divided into ten dimensions.

Women's health 18 years after rupture of the anal sphincter during childbirth: I. Fecal incontinence.

Objective: We studied the long-term outcome after an anal sphincter tear.

Study Design: From a cohort of 4569 women who gave birth in 1982 to 1983, we identified 445 (9.7%) who sustained a sphincter tear and 445 controls.

Women's health 18 years after rupture of the anal sphincter during childbirth: II. Urinary incontinence, sexual function, and physical and mental health.

Objective: We studied maternal health 18 years postpartum in women having sustained an anal sphincter tear and controls.

Study Design: We assessed symptoms with the short form of the urogenital distress inventory, the female sexual function index, and physical and mental health with the Short Form-12 summary scales.

Results: Women with a sphincter tear had no increased risk of urinary symptoms (54 of 251, 22%, versus 51 of 273, 19%, risk ratio 1.

Diagnosis of anal sphincter tears to prevent fecal incontinence: a randomized controlled trial.

Objective: Maternal anal sphincter tears after vaginal delivery are frequently not diagnosed clinically and are associated with subsequent fecal incontinence. This study examined whether diagnosis of these tears by ultrasonography, followed by immediate surgical repair, reduces the occurrence of incontinence.

Methods: We conducted a randomized trial involving 752 primiparous women without a clinically evident anal sphincter tear to evaluate the benefit of adding endoanal ultrasonography immediately after vaginal delivery to the standard clinical examination of the perineum.

Abnormal uterine bleeding: medical treatment with vaginal danazol and five-year follow-up.

Study Objective: To evaluate the clinical efficacy and patient satisfaction of long-term danazol delivered vaginally as treatment for heavy menstrual bleeding.

Design: Prospective study (Canadian Task Force classification II-3).

Setting: University hospital.

Pattern of bone markers during pregnancy and their changes after delivery.

Objective: To investigate whether bone resorption markers change during pregnancy and lactation, and how they are correlated with human placental lactogen (hPL) and PRL.

Subjects: Young women before pregnancy, during pregnancy and during a 12-month post-delivery period (study group; n = 22); and age- and weight-matched normal cycling women (control group; n = 22) for a 20-month-period participated in the study.

Results: In the study group, women both during pregnancy (from the 8th up to the 38th week) and during a 6-month period of lactation, pyridinoline and deoxypyridinoline urinary levels were significantly higher than those of pre-pregnancy and control women.

Does a second delivery increase the risk of anal incontinence?

Objective: To evaluate the prevalence of anal incontinence and anal sphincter defects after a first vaginal delivery and assess the effect of a second delivery.

Design: Prospective cohort study using postal questionnaires assessing incontinence to flatus and stools at three and thirty months postnatally and anal endosonography at three months following delivery.

Setting: Recruitment was from the antenatal clinic at the University Hospitals of Geneva, Switzerland.

Anal incontinence in women with third or fourth degree perineal tears and subsequent vaginal deliveries.

We contacted 208 women 13 years after they suffered an obstetrical anal sphincter tear in order to estimate the effect of subsequent vaginal deliveries on anal continence. Among the 177 eligible responders, 129 sustained a partial or complete 3rd degree and 48 a 4th degree tear; 114 women had subsequent vaginal deliveries. Anal incontinence was more common in women with 4th (25.

HLA-DMA alleles are possible new markers of rheumatoid arthritis: study of a Corsican group.

The HLA-DMA gene, along with the HLA-DMB gene, encodes the not classical class II molecule. This molecule catalyzes the class-II-associated invariant-chain peptide (CLIP)-antigen peptide exchange in classical class II molecule peptide-binding groove. As such, the DM heterodimer is an antigen presentation regulator and may be linked to immune system deficiencies such as those observed in autoimmune diseases.

HLA-B35 frequency variations correlate with malaria infection in Sardinia.

The hypothesis of a possible selective role of malaria in HLA allele frequency variations was investigated in Sardinia by typing completely 1,039 individuals for HLA: 536 from six lowland villages exposed to malaria until 1948, and 503 from six highland villages with no history of malaria. Another 1,928 individuals from 136 villages scattered all over the island were studied to establish if the HLA allele frequencies among villages correlated with the malaria incidence and/or altitude above sea level. Only the HLA-B35 allele yielded significantly higher frequencies in the lowland versus the highland villages (P<1 x 10(-5)).