Improving apgar scores and reducing perineal injuries through midwife-led quality improvements: an observational study in Uganda.

Background: Globally, the quality of maternal and newborn care remains inadequate, as seen through indicators like perineal injuries and low Apgar scores. While midwifery practices have the potential to improve care quality and health outcomes, there is a lack of evidence on how midwife-led initiatives, particularly those aimed at improving the use of dynamic birth positions, intrapartum support, and perineal protection, affect these outcomes.

Objective: To explore how the use of dynamic birth positions, intrapartum support, and perineal protection impact the incidence of perineal injuries and the 5-min Apgar score within the context of a midwife-led quality improvement intervention.

Evaluation of the use of intraosseous access on adult patients presenting to the emergency department in urban South Africa.

Background: Timely vascular access forms a necessary part of patient management in the Emergency Department (ED). Factors such as hypotension, intravenous drug use, obesity, dark skin, patients at extremes of age, and patients with multiple injuries may make peripheral intravenous cannulation difficult. The intraosseous route remains a suitable alternative for emergency circulatory access.

Examining individual- versus population-level social determinants of health in a cluster randomized trial of health coaches for patients with multiple chronic conditions.

Introduction: Social determinants of health (SDOH) are an important contributor to health status and health outcomes. In this analysis, we compare SDOH measured both at the individual and population levels in patients with high comorbidity who receive primary care at Federally Qualified Health Centers in New York and Chicago and enrolled in the Tipping Points trial.

Methods: We analyzed individual- and population-level measures of SDOH in 1,488 patients with high comorbidity (Charlson Comorbidity Index ≥ 4) enrolled in Tipping Points.

The effect of incline walking on lower extremity and trunk mechanics in older adults.

Older adults are at an increased risk of developing knee osteoarthritis. High internal knee abduction moment during daily activities may elevate the risk of knee osteoarthritis. Incline walking exercise has been found to decrease knee abduction moment in healthy young adults.