Fall-related injuries in Amsterdam: Frail older women at risk

ABSTRACT

Unintentional falls are a common cause of injury, especially among older persons. This study evaluates risk factors such as gender and age on morbidity and mortality after unintentional falls. Data were collected retrospectively for patients with a unintentional fall who were presented to the emergency department in 2013. A total of 3,217 patients were included; the majority were female. Patients over 65 years of age had a significant higher mortality and a longer length of hospital stay. Older women are at risk for sustaining a fall-related injury. Female gender is furthermore associated with increased length of stay in the hospital. Prevention should focus especially on these frail patients.     

Risk factors for severe perineal trauma during vaginal childbirth: A Western Australian retrospective cohort study

AimTo determine rates and risk factors for third and fourth degree perineal tears (severe perineal trauma) in a Western Australian context.Design and settingA retrospective hospital-based cohort study was performed using computerised data for 10,408 singleton vaginal deliveries from 28 weeks gestation.MethodsWomen with severe perineal trauma were compared to those without. Logistic regression analysis, stratified by parity, was used to assess demographic and obstetric factors associated with perineal trauma.ResultsSevere perineal trauma incidence was 3% (338/10408), 5.4% (239/4405) for primiparas and 1.7% (99/5990) for multiparas (p < 0.001). Adjusted risk factors associated with trauma and common across parity included Asian or Indian ethnicity, shoulder dystocia and assisted delivery. Epidural analgesia (OR 0.72, 95% CI 0.54–0.96), preterm birth (OR 0.40, 95% CI 0.23–0.72) and episiotomy (OR 0.54, 95% CI 0.39–0.74) were protective in primiparas, while episiotomy was associated with increased risk in multiparas (OR 2.01, 95% CI 1.18–3.45). Additional factors among primiparas were occipito posterior (OP) delivery (OR 3.35, 95% CI 1.75–6.41) and prolonged second stage (OR 1.98, 95% CI 1.46–2.68), and among multiparas included gestational diabetes (OR 1.78, 95% CI 1.04–3.03) and birth weight >4000 g (OR 1.86, 95% CI 1.10–3.15).ConclusionParity differences in risk factors such as episiotomy, infant weight, OP delivery, gestational diabetes and prolonged second stage warrant investigation into clinical management. Although rates differ internationally, and replication evidence has confirmed consistency for certain demographic and obstetric factors, the development of internationally endorsed clinical guidelines and further research around interventions to protect the perineum are recommended.     

A Preliminary Investigation of Risks for Adverse Outcomes of Relationship Seeking on Social Network Sites (SNS): A Descriptive Study of Women Over 50 Seeking Relationships on MySpace in Hillsborough County,Florida

In contrast to younger populations, little attention has been paid to the increase in seniors using Internet-based venues to find relationships and the potential risk for adverse outcomes this poses. This study examined data collected via an online survey from 45 ethnically diverse women aged 50+ “seeking relationships” on MySpace. The majority of women reported a relationship with someone they met online (85%). They also reported experiencing adverse events including financial exploitation (40%), threats (55%), and physical harm (38%) by someone they met online at levels greater than traditional relationship seeking in the general population. Directions for future research are explored.     

Prevalence of frailty and associated factors in Korean older women: The KLoSA study

The purpose of this study was to identify the prevalence of frailty in older women and its associated factors using data from the Korean Longitudinal Study of Aging (KLoSA). The level of frailty was moderate/severe in 20.2% of the women. Age, socioeconomic status, and depressive symptoms were significantly associated with all levels of frailty. Sensory function and grip strength were associated with both mild and moderate/severe frailty. The only factors associated with moderate/severe frailty were marriage status and regular exercise. Understanding the risk factors of frailty may help health care providers to deliver tailored interventions to prevent this condition and its adverse outcomes.     

Influencing factors in midwives’ decision-making during childbirth: A qualitative study in the Netherlands

Background

Dutch maternity care is based on the principle that pregnancy and childbirth are physiological processes. However, the last decade an increase of intra-partum referrals to obstetric-led care has been observed. Most of these referrals are among nulliparous women, non-urgent and occur during the first stage of labour. The increase in referrals seems not associated with better perinatal outcomes.

A pilot study of the application of the transtheoretical model during strength training in older women

A Transtheoretical Model (TTM) goal-setting tool was used during strength training in women. Volunteers (mean age = 69, N = 27) were assigned to a strength training only or strength training/behavior change 12-week intervention. A pre/posttest, quasiexperimental design assessed TTM constructs, Health-Related Quality of Life, and functional fitness measurements. Multiple ANCOVAs revealed significant differences between groups on lower body strength (p = .001), upper body flexibility (p = .002), Decisional Balance (p = .024,) and Stage of Change for Exercise (p = .010). Stage of change progression may be enhanced using a goal-setting tool during strength training in older women.     

Trends and characteristics of women undergoing induction of labour in a tertiary hospital setting: A cross-sectional study

BackgroundIn many well-resourced countries, rising rates of intervention are being observed during pregnancy, labour and childbirth with induction of labour (IOL) fast becoming one of the most common. In Australia, the rate of induction of labour has increased by over 30% since 2007, and today one in three women have their labours induced. We do not however have a good understanding of the contribution of specific obstetric populations to this trend.MethodsWe examine the contribution of specific obstetric populations to induction of labour over a six-year period at one tertiary maternity service, using the Nippita classification system. Average Annual Percentage Changes (AAPC) were calculated along with 95% confidence intervals and P values set at 0.05.ResultsThe overall rate of induction of labour increased from 21.3% in 2012 to 30.9% in 2017, representing an Average Annual Percent Change of 8.1, P < 0.0001 (95% CI 7–9.6). The greatest AAPC was seen in group 5 (parous, no previous caesarean section, 39–40 weeks, single cephalic), followed by group 2 (nulliparous, 39–40 weeks, single cephalic) and 1 (nulliparous, 37–38 weeks, single cephalic).ConclusionsThe use of the Nippita classification system allowed for standardised comparison across timepoints, facilitating identification of the subpopulations driving changes in rates of induction of labour. Rates of induction of labour saw a year on year increase which in this maternity service, it is not being driven by post-dates pregnancies. Further work is required to understand the role of other potential contributors such as diabetes.     

Nowcasting Indicators of Poverty Risk in the European Union: A Microsimulation Approach

The at-risk-of-poverty rate is one of the three indicators used for monitoring progress towards the Europe 2020 poverty and social exclusion reduction target. Timeliness of this indicator is critical for monitoring the effectiveness of policies. However, due to complicated nature of the European Union Statistics on Income and Living Conditions (EU-SILC) poverty risk estimates are published with a 2–3 years delay. This paper presents a method that can be used to estimate (“nowcast”) the current at-risk-of-poverty rate for the European Union (EU) countries based on EU-SILC microdata from a previous period. The EU tax-benefit microsimulation model EUROMOD is used for this purpose in combination with up to date macro-level statistics. The method is validated by using EU-SILC data for 2007 incomes to estimate at-risk-of-poverty rates for 2008–2012 and to compare the predictions with actual EU-SILC and other external statistics. The method is tested on eight EU countries which are among those experiencing the most volatile economic conditions within the period: Estonia, Greece, Spain, Italy, Latvia, Lithuania, Portugal and Romania.     

Prevalence and risk factors for postnatal depression in Sabah,Malaysia: A cohort study

BackgroundPostnatal depression can have serious consequences for both the mother and infant. However, epidemiological data required to implement appropriate early prevention are still lacking in Malaysia.AimTo investigate the prevalence of postnatal depression within six months postpartum and associated risk factors among women in Sabah, Malaysia.MethodsA prospective cohort study of 2072 women was conducted in Sabah during 2009–2010. Participants were recruited at 36–38 weeks of gestation and followed up at 1, 3 and 6 months postpartum. The presence of depressive symptoms was assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale. Logistic regression analyses were performed to ascertain risk factors associated with postnatal depression.FindingsOverall, 14.3% of mothers (95% confidence interval (CI) 12.5–16.2%) had experienced depression within the first six months postpartum. Women depressed during pregnancy (odds ratio (OR) 3.71, 95% CI 2.46–5.60) and those with consistent worries about the newborn (OR 1.68, 95% CI 1.16–2.42) were more likely to suffer from depression after childbirth. Women whose husband assisted with infant care (OR 0.43, 95% CI 0.20–0.97) and mothers who were satisfied with their marital relationship (OR 0.27, 95% CI 0.09–0.81) appeared to incur a reduced risk of postnatal depression.ConclusionA substantial proportion of mothers suffered from postnatal depression in Sabah, Malaysia. Screening and intervention programmes targeting vulnerable subgroups of women during antenatal and early postpartum periods are recommended to deal with the problem.     

The cost of vaginal birth at home,in a birth centre or in a hospital setting in New South Wales: A micro-costing study

BackgroundWomen want greater choice of place of birth in New South Wales, Australia. It is perceived to be more costly to health services for women with a healthy pregnancy to give birth at home or in a birth centre. It is not known how much it costs the health service to provide care for women planning to give birth in these settings.AimThe aim of this study was to determine the direct cost of giving birth vaginally at home, in a birth centre or in a hospital for women at low risk of complications, in New South Wales.MethodsA micro-costing design was used. Observational (time and motion) and resource use data collection was undertaken to identify the staff time and resources required to provide care in a public hospital, birth centre or at home for women with a healthy pregnancy.FindingsThe median cost of providing care for women who plan to give birth at home, in a birth centre and in a hospital were similar (AUD $2150.07, $2100.59 and $2097.30 respectively). Midwifery time was the largest contributor to the cost of birth at home, and overhead costs accounted for over half of the total cost of BC and hospital birth. The cost of consumables was low in all three settings.ConclusionIn this study, we have found there is little difference in the cost to the health service when a woman has an uncomplicated vaginal birth at home, in a birth centre or in a hospital setting.     

香港拾荒老人的生存境遇：以社会排斥为视角

本研究基于对96位60岁或以上的拾荒老人的问卷调查和17名老人的深度访谈,揭示了拾荒老人这一特殊群体的基本生活图景,并辨识出他们面对各种不同形式的社会排斥,包括经济排斥（缺乏工作机会与消费能力）、政治排斥（缺乏工会／机构保护其利益）、社会关系排斥（因拾荒而受到歧视或生活孤独）和福利排斥（没有领取社会保障金和无法企及社会福利服务）。     

The outbreak of coronavirus disease in China: Risk perceptions,knowledge, and information sources among prenatal and postnatal women

BackgroundThe COVID-19 pandemic has created anxiety among members of the public, including all women over the childbirth continuum, who are considered to be at a greater risk of contracting most infectious diseases. Understanding the perspectives of health care consumers on COVID-19 will play a crucial role in the development of effective risk communication strategies. This study aimed to examine COVID-19-related risk perceptions, knowledge, and information sources among prenatal and postnatal Chinese women during the initial phase of the COVID-19 pandemic.MethodsA cross-sectional survey design was adopted, and a four-section online questionnaire was used to collect data. Using a social media platform, the online survey was administered to 161 participants during the outbreak of COVID-19 in Nanjing, China, in February 2020.ResultsThe participants perceived their risk of contracting and dying from COVID-19 to be lower than their risk of contracting influenza, however many of them were worried that they might contract COVID-19. The participants demonstrated adequate knowledge about COVID-19. The three major sources from which they obtained information about COVID-19 were doctors, nurses/midwives, and the television, and they placed a high level of confidence in these sources. There was no significant relationship between the perceived risk of contracting COVID-19 and knowledge about this disease.ConclusionThe present findings offer valuable insights to healthcare professionals, including midwives, who serve on the frontline and provide care to pregnant women. Although the participants were adequately knowledgeable about COVID-19, they had misunderstood some of the recommendations of the World Health Organisation.     

流动人口群体特征变动与失业风险差异

本文采用2014年和2017年流动人口动态监测数据,探讨了中国省际流动人口失业风险的变动趋势以及影响因素.研究发现:2017年省际流动人口失业风险比2014年高出26％.性别、受教育程度、流动原因、流入地地域等变量对流动人口失业风险的边际影响出现了明显上升趋势.Oaxaca分解结果表明,流动人口失业风险上升的63.67...     

中国女性老年人口状况分析

女性老年人口自身的特点决定了女性老年人口问题具有一定的特殊性。本文利用五普数据,详细分析了中国女性年人口的基本状况,包括:人口特征、社会特征和经济特征等,并与四普时的相关状况进行对比,指出了我国女性老年人口的基本现状与存在问题。     

Fear of childbirth in nulliparous women: A cross-sectional multicentre study in China

ObjectiveFew studies have focused on the fear of childbirth (FOC) in China. This study aimed to explore the status of FOC and its associated factors among nulliparous women in China.MethodsUsing a cross-sectional study design, 1039 nulliparous women with singleton pregnancies were recruited from four public hospitals in four cities of China. FOC was evaluated using the Chinese version of the Childbirth Attitude Questionnaire scale. Associations of demographic, obstetric and social–psychological factors with the levels of FOC among nulliparous women were investigated.ResultsThe average score on the Childbirth Attitude Questionnaire scale was 31.30 (standard deviation = 8.43). Generalized linear regression analysis revealed that low self-rated health status (β = 2.26, P = 0.003), higher educational levels (β = 2.06, P = 0.010), lower levels of self-efficacy (β = −0.79, P < 0.001), and use of pregnancy-related smartphone applications (β = 2.42, P < 0.001) were associated with higher levels of FOC.ConclusionThe Childbirth Attitude Questionnaire scale is an appropriate tool to measure FOC. Education levels, self-rated health status, self-efficacy levels, and use of pregnancy-related smartphone applications were predictors of FOC among pregnant women in China. Healthcare professionals should identify the Chinese pregnant women with FOC and implement targeted interventions focused on the above factors.     

The experiences of pregnant women during the COVID-19 pandemic in Turkey: A qualitative study

BackgroundDue to spread and impact of COVID-19 in the world and Turkey lead to fear, stress and anxiety in individuals. This trend is increasing more especially in pregnant women at risk as they are concerned about the safety of themselves and the fetus.AimIn our study, concerns, problems and attitudes of pregnant women related to diseases in the pandemic process will be determined by detailed discussions based on their individual experience, and by increasing the awareness of midwives and nurses about what pregnant women experience in this process.MethodsContent analysis is used as qualitative study pattern. Due to the social isolation rules during the coronavirus pandemic, interviews with pregnant women were planned to be held via mobile phone. The study was completed with 15 pregnant women.ResultsAs a result of the content analysis of the interviews, 3 main themes and 11 sub-themes were identified. The identified themes were as following: (1) not understanding the seriousness and fear of the unknown, (2) coronavirus pandemic and disruption of the routine prenatal care (3) disrupted routines and social lives. Each theme was necessarily discussed separately.ConclusionThe results of the study show that coronavirus pandemic has a significant potential for creating anxiety, adversity and fear, which has a negative emotional effect on pregnant people. It will be useful to provide awareness for midwives and nurses not only about the physical health of pregnant women, but also their mental health, and to cooperate with mental health experts if necessary.