Nursing staffing, nursing workload, the work environment and patient outcomes

Nurse staffing (fewer RNs), increased workload, and unstable nursing unit environments were linked to negative patient outcomes including falls and medication errors on medical/surgical units in a mixed method study combining longitudinal data (5 years) and primary data collection.

Website: https://www.arjonline.org/medicine-and-health-care/american-research-journal-of-nursing/

Compassion fatigue in nurses

Compassion fatigue, trigger situations, and coping strategies were investigated in hospital and home care nurses. The Professional Quality of Life Scale measured compassion fatigue, compassion satisfaction, and burnout. Narrative questions elicited trigger situations and coping strategies. Compassion fatigue scores were significantly different between nurses who worked 8- or 12-hour shifts. Fifteen percent of the participants had scores indicating risk of the compassion fatigue. There were significant differences in compassion satisfaction, depending on the unit worked and time as a nurse. The most common category of trigger situations was caring for the patient. Work-related and personal coping strategies were identified.

Website: https://www.arjonline.org/medicine-and-health-care/american-research-journal-of-nursing/

Posttraumatic stress among mothers of very low birthweight infants at 6 months after discharge from the neonatal intensive care unit

This correlational study examined how mother's posttraumatic stress disorder (PTSD) symptoms are related to characteristics of the mother and her infant, as well as to mother-infant interaction and infant development, in 21 mothers of very low birthweight infants. Twenty-three percent of mothers scored in the clinical range on a measure of PTSD. How ill the infant was during the NICU hospitalization was related to mothers' PTSD symptoms. Mothers with greater PTSD symptoms were less sensitive and effective at structuring interaction with their infant. © 2011.

Website: https://www.arjonline.org/medicine-and-health-care/american-research-journal-of-nursing/

The “Big 5” and beyond: Nurses, paid carers, and adults with developmental disability discuss communication needs in hospital

Adults with developmental disability and little or no speech need to communicate with nurses in hospital to (a) express physical needs, (b) discuss health, (c) convey intelligence and emotions, (d) connect socially, and (e) control the environment. All stakeholders need access to a variety of communication strategies to support communication of these needs.

Website:https://www.arjonline.org/medicine-and-health-care/american-research-journal-of-nursing/ 

Influence of exercise mode on pregnancy outcomes: ENHANCED by mom project

In the ENHANCED by Mom study authors aim to determine the effects of different modes of exercise training (aerobic, circuit, and resistance) throughout pregnancy on childhood health by controlling individual exercise programs and assessing the effects of each on fetal and neonatal health adaptations. A better understanding on the effects of exercise training during pregnancy on fetal and neonatal health could have a profound impact on the prevention and development of chronic diseases such as obesity, hypertension, and diabetes.

ENHANCED by mom is a cross sectional comparison study utilizing 3 intervention groups in comparison to a control group.

Participants will complete three 5 min warmup + 45 min sessions weekly from 16 weeks to 36 weeks gestation of aerobic, resistance, or circuit training, in comparison to non–exercising controls.

Maternal physical measurements will occur every 4 weeks throughout the intervention period.

Fetal morphometric and heart measurements will occur at 34 weeks gestation.

Neonatal measurements will be acquired at birth and at 1 month, 6 months, and 12 months.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Outcomes of transobturator tape surgery with safyre T slings for female stress urinary incontinence after 96 months of follow-up

Authors conducted a clinical follow–up study of 153 patients diagnosed with SUI between January 2005 and December 2014.

Patients were provided with detailed a priori information pertaining to the TOT procedure and were invited to attend follow–up visits at 1, 3, 12, 24, 48, 72 and 96 months.

Follow–up visits included physical examination involving sling palpation, checking of the vaginal mucosa for erosion, cough test, as well as validated Urinary Distress Inventory–6 (UDI–6) and Incontinence Impact Questionnaire–7 (IIQ–7) questionnaires.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Pregnancy complications and birth outcomes among women experiencing nausea only or nausea and vomiting during pregnancy in the norwegian mother and child cohort study

Pregnancies from the Norwegian Mother and Child Cohort Study (n = 51675), a population–based prospective cohort study, were examined.

Data on nausea and/or vomiting during gestation and birth outcomes were collected from three questionnaires answered between gestation weeks 15 and 30, and linked with data from the Medical Birth Registry of Norway.Chi–squared tests, one way analysis of variance, multiple linear and logistic regression analyses were used.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Availability of Obstetric And Neonatale Mergency Cares (Emonc) In Benin

Itis a descriptive, analytical and transversal study such as SARA (Service Availability and

ReadinessAssessment) which took place from January 1 to August 31, 2013. The sample consisted of health facilities in public and private sectors located in both urban and rural areas.

Results: The delivery services were available in 82% of health facilities (97.7% of hospitals, 92.2% of Health Centers (HC), 40.5% of Primary Care Centers (PCC), 86.1% of public’s health facilities have and 75.7% of private).Qualified personnel was available in 88.4% of health-centers. Parenteral administration of antibiotics, oxytocic and anticonvulsants were available respectively 94.2%, 94.2% and 76.1%. The assisted vaginal delivery, the manual removal of placenta and uterine evacuation maneuvers were respectively found in 42.6%, 88.4% and 54.8% of health facilities which practice birth. Neonatal resuscitation was available in 83.9% of facilities including all hospitals, 83% of HC and 47% of PCC. Only a quarter of institutions offering delivery (25.8%) were real BEmONC centers.Cesarean section was available in all hospitals and 3.2% HC. Blood transfusion was available in 25.8% of health facilities surveyed. Actual CEmONC health facilities represent 18.1% of all health facilities offering delivery services.

Conclusion: Efforts are still needed to ensure better availability of all EmONC functions to achieve the MDGs.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Hemoperitoneum Caused by Spontaneous Uterine Varicose Vein Rupture in the Third Trimester of Pregnancy-A Case Report

Spontaneous rupture of uterine varicose veins is a rare and poorly understood complication during pregnancy. Its clinical presentation is misleading and non-specific. Due to the high maternal and fetal mortality, the diagnosis of a hemoperitoneum must be done quickly.

We report a case of spontaneous rupture of uterine varicose veins revealed by an abundant hemoperitoneum that occurred in a 35 year-old pregnant patient at 32 weeks of gestation. A laparotomy enabled the diagnosis and the treatment of this complication in addition to the extraction through a cesarean section of a healthy newborn.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Preterm Birth and Associated Factors among Mothers Who gave Birth in Debremarkos Town Health Institutions, 2013 Institutional Based Cross Sectional Study

Background: The birth of a preterm infant results in significant health consequences to the infant and emotional and economic costs for families and communities. About 75% of perinatal deaths and 50% of neurological abnormalities are directly attributed to preterm. The main aim of this study was to assess the prevalence and associated factors of pre-term birth North West Ethiopia.

Methods: An institutional based cross sectional study was conducted. Systematic sampling was used to get the total sample size of 422 participants. The data was entered, cleaned and edited using EPI INFO version 2002 and exported to SPSS version 16.0 software packages for analysis. Both bivariate and multiple logistic regression were fitted and odds ratio and 95% CI were computed to identify associated factors and determine the strength of association. A p-value of <0.05 was considered as statistical significant.

Website:  http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Retroperitoneal Endometriotic Cyst Mimicking a Tumor

Ectopic endometrial tissues are rarely observed on the serosal surfaces of bowel and laparotomy incisions, in the lungs, bones and in the urinary tract. Recto-sigmoid junction is the most common site of extra-genital endometriosis,with less frequent sites being the rectovaginal septum, small intestine, cecum and appendix. Endometriotic cyst in a retroperitoneal location mimicking a retroperitoneal tumor through the mesentery of sigmoid colon is an extremely

rare presentation. Only few cases of retroperitoneal presentation of endometriotic cyst have been reported in the English literature. Retroperitoneal endometriotic cyst may mimic a retroperitoneal tumor in view of the location.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

The Relationship between Vitamin D, Insulin Resistance and Infertility in PCOS Women

It has been speculated that the majority of individuals in the India are deficient in Vitamin D and that Vitamin D deficiency has become an epidemic in our country. There is widespread prevalence of varying degrees (50- 90%) of Vitamin D deficiency with low dietary calcium intake in Indian population according to various studies published earlier. A deficiency of Vitamin D not only causes poor bone mineralization but also has been implicated in numerous us chronic diseases. Vitamin D deficiency is common in women with polycystic ovary syndrome (PCOS),

with the 67-85% of women with PCOS having serum concentrations of 25-hydroxy Vitamin D (25OHD) <20 ng/ml. Vitamin D deficiency may intensify symptoms of PCOS, with observational studies showing lower 25OHD levels were associated with insulin resistance, ovulatory and menstrual irregularities, lower pregnancy success rate,hirsutism, hyper-androgenism, obesity and elevated cardiovascular disease risk factors. There is some, but limited,evidence for beneficial effects of Vitamin D supplementation on menstrual dysfunction and insulin resistance in women with PCOS. Vitamin D deficiency may play a role in exacerbating PCOS, and there may be a place for Vitamin D supplementation in the management of this syndrome, but current evidence is limited and additional randomized controlled trials are required to confirm the potential benefits of Vitamin D supplementation in this population.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Bariatric Surgery before Pregnancy — Is This a Solution to a Big Problem?

Obesity has reached epidemic levels in the United States. According to data from the Centers for Disease Control and Prevention (CDC), in 1990 no state in the United States had a prevalence of obesity of 15% or more, but by 2010, no state had a prevalence of obesity below 20%, and a third of states had a prevalence of 30% or higher.1 This trend extends to pregnancy; almost a third of women entering pregnancy in the United States are obese.2 Moreover, the prevalence of extreme obesity is also increasing. For example, in pregnant women, the subcategories of obesity that are . . .

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Outcomes of Pregnancy after Bariatric Surgery

We identified 627,693 singleton pregnancies in the Swedish Medical Birth Register from 2006 through 2011, of which 670 occurred in women who had previously undergone bariatric surgery and for whom presurgery weight was documented. For each pregnancy after bariatric surgery, up to five control pregnancies were matched for the mother’s presurgery body-mass index (BMI; we used early-pregnancy BMI in the controls), age, parity, smoking history, educational level, and delivery year. We assessed the risks of gestational diabetes, large-for-gestational-age and small-for-gestational-age infants, preterm birth, stillbirth, neonatal death, and major congenital malformations.

Website: http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/

Goserelin for Ovarian Protection during Breast-Cancer Adjuvant Chemotherapy

We randomly assigned 257 premenopausal women with operable hormone-receptor–negative breast cancer to receive standard chemotherapy with the GnRH agonist goserelin (goserelin group) or standard chemotherapy without goserelin (chemotherapy-alone group). The primary study end point was the rate of ovarian failure at 2 years, with ovarian failure defined as the absence of menses in the preceding 6 months and levels of follicle-stimulating hormone (FSH) in the postmenopausal range. Rates were compared with the use of conditional logistic regression. Secondary end points included pregnancy outcomes and disease-free and overall survival.

Website:  http://www.arjonline.org/medicine-and-health-care/american-research-journal-of-gynecology/