The impact of COVID-19 on the provision of respectful maternity care: Findings from a global survey of health workers

BackgroundSignificant adjustments to maternity care in response to the COVID-19 pandemic and the direct impacts of COVID-19 can compromise the quality of maternal and newborn care.AimTo explore how the COVID-19 pandemic negatively affected frontline health workers’ ability to provide respectful maternity care globally.MethodsWe conducted a global online survey of health workers to assess the provision of maternal and newborn healthcare during the COVID-19 pandemic. We collected qualitative data between July and December 2020 among a subset of respondents and conducted a qualitative content analysis to explore open-ended responses.FindingsHealth workers (n = 1127) from 71 countries participated; and 120 participants from 33 countries provided qualitative data. The COVID-19 pandemic negatively affected the provision of respectful maternity care in multiple ways. Six central themes were identified: less family involvement, reduced emotional and physical support for women, compromised standards of care, increased exposure to medically unjustified caesarean section, and staff overwhelmed by rapidly changing guidelines and enhanced infection prevention measures. Further, respectful care provided to women and newborns with suspected or confirmed COVID-19 infection was severely affected due to health workers’ fear of getting infected and measures taken to minimise COVID-19 transmission.DiscussionMultidimensional and contextually-adapted actions are urgently needed to mitigate the impacts of the COVID-19 pandemic on the provision and continued promotion of respectful maternity care globally in the long-term.ConclusionsThe measures taken during the COVID-19 pandemic had the capacity to disrupt the provision of respectful maternity care and therefore the quality of maternity care.     

Material consumption and social well-being within the periphery of the world economy: An ecological analysis of maternal mortality

The degree to which social well-being is predicated upon levels of material consumption remains under-examined from a large-N, quantitative perspective. The present study analyzes the factors influencing levels of maternal mortality in 2005 among 92 peripheral countries. We incorporate into regression analysis the ecological footprint, a comprehensive measure of natural resource consumption, and alternative explanatory variables drawn from previous research. Results illustrate ecological footprint consumption has a moderately strong direct influence shaping lower levels of maternal mortality. Path analysis reveals export commodity concentration has a negative effect on level of ecological footprint demand net the strong positive influence of income per capita. This illustrates cross-national trade dependency relations directly influence natural resource consumption opportunities and thereby indirectly contribute to higher maternal mortality levels within the periphery of the world economy. The results confirm material consumption is an important dimension of improvement in maternal mortality.     

Early education and care quality: Does it matter for maternal working hours?

This study investigates whether mothers whose children enter early childhood education and care (ECEC) centers of higher quality are more likely to work longer hours. The empirical analysis links the Socio-Economic Panel (SOEP) Study with the K²iD-SOEP extension study, which collected ECEC quality information from childcare centers across Germany. Based on a sample of 556 mothers of 628 children with a mean age of 2.6 years at center entry, the authors applied change score models with entropy balancing to account for differences in a rich set of observable characteristics. The findings show that higher levels of quality with respect to child-teacher-ratio and partly also activities promoting child learning and offered services for parents are associated with greater increases in working hours for mothers since the year before using the ECEC center. No significant relationships emerged for group size and equipment.     

An integrative review of interventions for limiting gestational weight gain in pregnant women who are overweight or obese

ProblemExcessive gestational weight gain in women who are overweight or obese puts them at risk of poor short- and long-term outcomes for maternal and neonatal health. Several interventions have been trialled to encourage women who are overweight or obese to limit gestational weight gain during pregnancy.AimThe aim of this review was to analyse the evidence on interventions to limit gestational weight gain in pregnant women who are overweight or obese.MethodAn integrative review guided by the Joanna Briggs Institute approach was conducted. An unlabeled search query of pregnancy, weight, and obesity was conducted in Medline, Scopus and CINAHL, limited to English language, 2010–2020 publications, and primary research on humans. Unlabeled search query of “((pregnancy outcome) OR (prenatal care) OR (pregnancy complications)) AND ((weight loss) OR (weight gain) OR (weight management)) AND (obesity) was used. Additional 9 records were identified through reference lists. Following a critical appraisal, 21 primary research articles were included in this review. A thematic synthesis was undertaken.FindingsFour major themes were identified. These are (1) mixed findings of lifestyle interventions for weight management, (2) ineffectiveness of probiotics or metformin for weight management, (3) psycho-behavioural interventions for weight management, and (4) midwifery role as an integral component in multidisciplinary intervention for weight management.ConclusionThe literature suggests a need for longer duration of behavioural lifestyle intervention sessions led by the same midwife trained in motivational interviewing to limit weight gain in pregnant women who are overweight or obese.     

Are maternal and community risk factors associated with the presence of asthma among children placed in foster care?

Objective

The occurrence of pediatric asthma has been associated with exposure to chronic stress. This study examined the relationship between maternal and community risk factors and asthma in a sample of maltreated children in foster care.

Method

Interviews were conducted with 365 maltreated children in foster care. Measures included youth/caregiver reports of asthma, an index of maternal risk based on data abstracted from child welfare records and community violence exposure.

Results

After controlling for demographic variables, maternal risk was associated with the presence of asthma (OR = 1.314, 95% CI = 1.09–1.58). Community violence exposure, however, was not related to the presence of asthma.

Conclusion

Maternal risk factors were significantly associated with the presence of asthma in a foster care population. Physicians who care for maltreated children in foster care should be particularly attuned to the presence of these additional risk factors that may place high-risk children at increased risk for chronic health problems.     

试论张承志小说中的宗教精神

张承志的宗教精神在他的各个阶段的小说中表现出由朦胧到最终的皈依宗教,这与他生活的社会文化背景、经历有着密切的关系。四年的内蒙古的插队生活、大学毕业的考察生活以及对历史学、宗教史的潜心研究,逐步地在小说中表现了他的宗教精神。     

MODELLING EPIDEMIC DISEASES

This paper traces the development of mathematical models for epidemics from the 18th century to the present day. The models are shown to be of use in predicting and controlling the spread of infection.     

Relating mothers' social framing to their children's entry competence with peers

The purpose of this study was to examine how mothers view and construct meaning their children's social interactions, and to understand the interpretive frames they bring to filtering the social world and conveying meaning to their children. Maternal narrations to their children' videotaped entry behavior revealed narration patterns related to their children' entry behavior and the group's response. Generally, when their children were behaving competently, mothers appeared to have a broad based, context embedded view of the interaction, but focused more specifially when difficulties arose, These narration patterns were influenced ny the mothers' own remembered childhood social competence and recollections of positive and anxious peer experiences. Implications of these results for the socialization process were discussed.