Preferred Mode Of Delivery Research Articles

Preferred mode of delivery and its associated factors in pregnant women with a previous cesarean scar at a tertiary care hospital in Ethiopia: institutional-based cross-sectional study

BackgroundVaginal births after cesarean or elective repeat cesarean sections (CS) are the options for delivery after one cesarean scar. However, there is a lack of data regarding the preferred next mode of delivery in Ethiopia after a previous cesarean section. Thus, this study assessed the preferred mode of delivery and determinants after one previous CS in the antenatal clinic at the University of Gondar Comprehensive Specialized Hospital (UoGCSH).MethodsAn institutional-based cross-sectional study was conducted among pregnant mothers with one previous CS at UoGCSH from March to August 2022. Structured questionnaires were used to collect the data. The collected data were entered, cleaned, and edited using Epi-data 4.6 and exported to SPSS version 26 for analysis. A binary logistic regression was performed to assess the determinants of the preferred mode of delivery. A p-value of < 0.05 at the 95% confidence level (CI) was considered statistically significant.ResultsThe majority, 71.5% (95% CI: 64.7, 77.1), of participants preferred the trial of labor after cesarean (TOLAC) as their mode of delivery. Mothers who were married (AOR = 4.47, 95% CI: 1.19–16.85), had a diploma educational level (AOR = 3.77, 95% CI: 1.84–12.36), had previous post-cesarean complications (AOR = 3.25, 95% CI: 1.08–9.74), and knew about the success of the trial of labor after cesarean (AOR = 13.56, 95% CI: 4.52–37.19) were found to prefer the trial of labor compared with their counterparts.ConclusionThis study concluded that most pregnant mothers preferred labor trials after one CS, which is a bit lower but comparable with recommended practice guidelines. Providing adequate information and counseling mothers to make informed decisions about their preferred mode of delivery could be substantial.

Understanding In-Person and Online Exercise Oncology Programme Delivery: A Mixed-Methods Approach to Participant Perspectives.

Alberta Cancer Exercise (ACE) is an exercise oncology programme that transitioned from in-person to online delivery during COVID-19. The purpose of this work was to understand participants' experiences in both delivery modes. Specifically, survivors' exercise facilitators and barriers, delivery mode preference, and experience with programme elements targeting behaviour change were gathered. A retrospective cohort design using explanatory sequential mixed methods was used. Briefly, 57 participants completed a survey, and 19 subsequent, optional interviews were conducted. Most participants indicated preferring in-person programmes (58%), followed by online (32%), and no preference (10%). There were significantly fewer barriers to (i.e., commute time) (p < 0.01), but also fewer facilitators of (i.e., social support) (p < 0.01), exercising using the online programme. Four themes were generated from the qualitative data surrounding participant experiences in both delivery modes. Key differences in barriers and facilitators highlighted a more convenient experience online relative to a more socially supportive environment in-person. For future work that includes solely online delivery, focusing on building social support and a sense of community will be critical to optimising programme benefits. Beyond the COVID-19 pandemic, results of this research will remain relevant as we aim to increase the reach of online exercise oncology programming to more underserved populations of individuals living with cancer.

Preferred mode of delivery association with the body image and genital image in pregnant women - a cross-sectional study

BackgroundPregnant women experience several changes in their appearance, body shape and body image. In some studies, there has been a relationship between these changes and the type of delivery. This study aimed to investigate the relationship of the prenatal body image and genital image with the mode of delivery preferred by pregnant women in Gorgan in 2020.MethodsIn this cross-sectional study, 334 pregnant women were selected by stratified sampling. The Prenatal Body Image Questionnaire (PBIQ), Female Genital Self-Image Scale (FGSIS), pregnant women’s preferences for mode of delivery questionnaire (PPMDQ) and DASS-21 were completed on line. The data was analyzed using Spearman test and linear regression.ResultsThe average score of PBIQ, FGSIS, and PPMDQ was 68.24 (standard deviation = 17.71), 19.25 (standard deviation = 3.3), and 63.12 (standard deviation = 3.3) respectively. Vaginal delivery as a preferred mode of delivery was inversely correlated with dissatisfaction with body image (r=-0.32, P < 0.001), and directly correlated with satisfaction with the genital image (r = 0.19, P < 0.001). There was a significant inverse correlation between prenatal body image dissatisfaction and genital image satisfaction (r=-0.32, P < 0.001). While FGSIS score could not predict PPMDQ, PBIQ score could.ConclusionsSatisfaction with the prenatal body image or genital image is associated with the choice of vaginal delivery. These results can be the basis for prenatal care and childbirth counselling.

The Experience of Women Giving Birth after Cesarean Section-A Longitudinal Observational Study.

Natural childbirth after a previous cesarean section is a debated issue despite scientific research and international recommendations. This study aimed to examine the experiences of women giving birth after a previous cesarean section, their preferences, and changes in attitudes towards childbirth after labor. This longitudinal study involved 288 pregnant women who had a previous cesarean section and completed a web-based questionnaire before and after labor, including information about their obstetric history, birth beliefs, and preferred mode of delivery. Among women who preferred a vaginal birth, nearly 80% tried it and 49.78% finished delivery by this mode. Among women declaring a preference for an elective cesarean section, 30% attempted a vaginal birth. Choosing a hospital where staff supported their decision (regardless of the decision) was the most helpful factor in preparing for labor after a cesarean section (63.19%). Women's birth preferences changed after labor, with women who had a vaginal birth after a cesarean section preferring this mode of delivery in their next pregnancy (89.34%). The mode of birth did not always follow the women's preferences, with some women who preferred a natural childbirth undergoing an elective cesarean section for medical reasons. A variety of changes were noticeable among women giving birth after a cesarean section, with a large proportion preferring natural birth in their next pregnancy. Hospitals should support women's birth preferences after a cesarean section (if medically appropriate), providing comprehensive counseling, resources, and emotional support to ensure informed decisions and positive birth experiences.

Maternal and Perinatal Outcomes of Pregnant Patients with Coronavirus Disease 2019: Data from a University Hospital Setting in Tirana, Albania, May 2020 to November 2021.

Scientific evidence suggests an increased risk of maternal and obstetric complications in pregnant patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study is aimed at evaluating perinatal and maternal outcomes among patients with coronavirus disease 2019 (COVID-19) in a university hospital setting. This was a prospective cohort study of 177 pregnant women with confirmed SARS-CoV-2 infection at a tertiary hospital between May 2020 and November 2021. Both symptomatic and asymptomatic women with a positive reverse transcription-polymerase chain reaction test result at any time during pregnancy were included in this study. For the purpose of this study, we classified COVID-19 cases into two groups: mild and severe cases. The two groups were then compared to predict how the clinical presentation of COVID-19 affected adverse maternal and perinatal outcomes. Gestational age ≥ 20 weeks at the time of infection was significantly associated with the occurrence of severe forms of the disease (relative risk (RR) 3.98, p = 0.01). Cesarean section was the preferred mode of delivery, with 95 women (62.1%) undergoing surgery. A total of 149 neonates were delivered to women who had confirmed SARS-CoV-2 infection at any time during the course of pregnancy of which thirty-five (23.5%) were admitted to the neonatal intensive care unit (NICU). Severe forms of COVID-19 increased the risk of premature delivery (RR 6.69, p < 0.001), emergency cesarean delivery (RR 9.4, p < 0.001), intensive care hospitalization (RR 51, p < 0.001), and maternal death (RR 12.3, p = 0.02). However, severe forms of SARS-CoV-2 infection are not directly responsible for low birth weight or the need for neonatal resuscitation. Our findings suggest that pregnant women presenting with severe COVID-19 disease are at an increased risk of adverse maternal and perinatal outcomes, such as premature delivery, cesarean section, admission to the ICU, and maternal death. Infection after the 20th week of gestation increases the risk of developing severe forms of the disease.

Australian medical radiation practitioners perspectives of continuing professional development: An online cross-sectional study.

Continuing professional development (CPD) is mandatory for registered Australian medical radiation practitioners (MRPs) to maintain competence in their respective scopes of practice. The aim of this study was to explore MRPs attitudes, opinions and satisfaction towards CPD activities offered by the Australian Society of Medical Imaging and Radiation Therapy (ASMIRT). An online cross-sectional survey was emailed to 6398 ASMIRT members and included questions on: demographics, ASMIRT CPD activities, learning mode preferences, barriers and perceptions of CPD outcomes. Data were analysed using descriptive statistics and chi-square tests. The survey was completed by 1018 MRPs. While MRPs were satisfied with face-to-face CPD quality (n = 540, 58.1%) and provision (n = 492, 55.3%), they were dissatisfied with the quantity of online CPD activities (n = 577, 65.1%) delivered by ASMIRT. Online learning was the most preferred mode of CPD delivery (n = 749, 74.2%), followed by face-to-face (n = 643, 64.0%) and collaborative learning (n = 539, 53.4%). Younger participants (19-35 years) had positive opinions regarding ASMIRT CPD activities and outcomes. Access to professional development leave (PDL) supported achievement of mandatory CPD requirements (P < 0.001). Lack of time, lack of access and workload were the highest ranked barriers preventing CPD participation. Rural/remote MRPs were dissatisfied with availability (P = 0.023), access (P < 0.001) and adequacy of ASMIRT provided CPD (P < 0.01) and were more likely to encounter barriers to CPD participation (P < 0.001). Many MRPs experienced barriers which prevented them from participating in CPD. Provision of more online CPD activities by ASMIRT and access to PDL can assist. Future improvements will ensure MRPs remain motivated to engage in CPD to improve clinical skills, patient safety and health outcomes.

Symptoms burden and rehabilitation preference after an episode of COVID-19: A patients survey.

After COVID-19 infection, individuals can experience a variety of symptoms that might require further treatment. Early data showed the value of adapted pulmonary rehabilitation programmes and technology-based interventions. To develop appropriate services, it is important to understand the symptom burden and the preferred mode of rehabilitation delivery. Post-hospital discharge (H) and post-community-managed (C) individuals received a follow-up call. A survey was completed to assess the most burdensome symptoms for which the patients would require support and their preference for the mode of rehabilitation delivery. Overall, 160 individuals who received a follow-up call completed the survey (51.2% male, mean [SD] age 54 [15] years) and 126 (78.8%) were post-hospital, while 34 (21.3%) had community-managed infections. A total of 101 (63.1%) reported that COVID-19-related symptoms were affecting their daily activities, and 106 (66.3%) reported their desire to be more active. The most common symptoms identified as needing support were fatigue and shortness of breath. Both groups expressed a preference for a face-to-face group programme (C: 54.8%; H: 46.8%), while (38.7%) of post-community-managed individuals and (40.3%) post-hospital patients preferred a supported digital rehabilitation programme. Few opted a non-digital home-based programme (C: 3.2%; H:12.9%, respectively). The survey responses indicated a significant symptom burden that may benefit from an intervention such as rehabilitation. Preferences for rehabilitation indicated that a face-to-face intervention was preferred by the majority, with a large proportion preferring digital intervention.

Pharmacy student perceptions of remote learning and wellness during the pandemic: Lessons learned from a metropolitan commuter city

IntroductionThe purpose of this study was to assess pharmacy student perceptions of remote learning experiences and personal well-being during the COVID-19 pandemic in a metropolitan commuter city. MethodsA survey was developed and sent to pharmacy students from the three pharmacy colleges in New York City in January 2021. The survey domains consisted of demographics, personal well-being, classroom experiences, and pandemic and post-pandemic preferred learning modalities and reasons. ResultsFrom a total of 1354 students from professional years one, two, and three across the three colleges, completed responses were received from 268 students (20% response rate). More than half of the respondents (55.6%) reported a negative impact of the pandemic on their well-being. More than half of the respondents (58.6%) reported more time to study. When students were asked their preferred mode of pharmacy education delivery during the pandemic and post-pandemic, a quarter (24.5%) preferred remote learning for all courses during the pandemic, and only a quarter (26.8%) preferred traditional classrooms for all courses post-pandemic. Approximately 60% of the respondents preferred some type of remote learning post-pandemic. ConclusionsPharmacy student learning has been and continues to be impacted by the COVID-19 pandemic, especially for pharmacy students in New York City. This study sheds light on the remote learning experiences and preferences of pharmacy students in a commuter city. Future studies could assess pharmacy student learning experiences and preferences after return to campus.

Prior childbirth experience and attitude towards subsequent vaginal birth after one caesarean delivery in Lagos, Nigeria: a cross-sectional study

BackgroundPrior caesarean delivery (CD) impacts CD rates in many parts of the world. In low and middle-income countries, few women attempt a trial of labour after caesarean delivery (TOLAC) due to inadequate resources for safe vaginal birth after caesarean delivery (VBAC). The CD rates continue to rise as more women undergo repeat CD. In Nigeria, VBAC rate is low and the contribution of women’s prior childbirth experiences and delivery wishes to this situation deserves further investigation. This study examined the parturient factor in the low VBAC rate to recommend strategies for change.ObjectiveTo describe prior caesarean-related childbirth experiences and attitudes towards subsequent vaginal birth in pregnant women with one previous CD.MethodThis cross-sectional study of antenatal clinic attendees in a tertiary hospital employed the convenience sampling method to recruit 216 consenting women with one previous CD. Structured questionnaires were used to collect information on participants' prior caesarean-related birth experiences, attitudes to vaginal birth in the index pregnancy, future delivery intentions and eventual delivery route. Univariate and bivariate analyses compared delivery wishes based on CD type. SPSS version 22.0 was used for data analysis.ResultsThe modal maternal and gestational age groups were 30–39 years (68.1%) and 29–34 weeks (49.1%) respectively; majorities (60.6%) were secundigravida; 61.6% experienced labour before their CDs while 76.9% had emergency CDs. Complications were documented in 1.4% and 11.1% of mothers and babies respectively. Ninety percent reported a satisfactory overall childbirth experience. A majority (83.3%) preferred TOLAC in the index pregnancy because they desired natural childbirth while 16.7% wanted a repeat CD due to the fear of fetal-maternal complications. The previous CD type and desire for more babies were significantly associated with respondents' preferred mode of delivery (p = 0.001 and 0.023 respectively). Women with previous emergency CD were more likely to prefer vaginal delivery.ConclusionsAntenatal women prefer TOLAC in subsequent pregnancies despite prior satisfactory caesarean-related birth experiences. Adoption of TOLAC in appropriately selected cases will impact women's psyche positively and reduce CD rate.

Designing home-based physical activity programs for rural cancer survivors: A survey of technology access and preferences.

While technology advances have increased the popularity of remote interventions in underserved and rural cancer communities, less is understood about technology access and preferences for home-based physical activity programs in this cancer survivor population. To determine access, preferences, and needs, for a home-based physical activity program in rural cancer survivors. A Qualtrics Research Panel was recruited to survey adults with cancer across the United States. Participants self-reported demographics, cancer characteristics, technology access and usage, and preferences for a home-based physical activity program. The Godin Leisure Time Exercise Questionnaire (GLTEQ) assessed current levels of physical activity. Descriptive statistics included means and standard deviations for continuous variables, and frequencies for categorical variables. Independent samples t-tests explored differences between rural and non-rural participants. Participants (N=298; mean age=55.2 ± 16.5) had a history of cancer (mean age at diagnosis=46.5), with the most commonly reported cancer type being breast (25.5%), followed by prostate (16.1%). 74.2% resided in rural hometowns. 95% of participants reported accessing the internet daily. On a scale of 0-100, computer/laptop (M=63.4) and mobile phone (M=54.6) were the most preferred delivery modes for a home-based physical activity intervention, and most participants preferred balance/flexibility (72.2%) and aerobic (53.9%) exercises. Desired intervention elements included a frequency of 2-3 times a week (53.5%) for at least 20 minutes (75.7%). While there were notable rural disparities present (e.g., older age at diagnosis, lower levels of education; ps<.001), no differences emerged for technology access or environmental barriers (ps>.08). However, bias due to electronic delivery of the survey should not be discounted. These findings provide insights into the preferred physical activity intervention (e.g., computer delivery, balance/flexibility exercises) in rural cancer survivors, while highlighting the need for personalization. Future efforts should consider these preferences when designing and delivering home-based interventions in this population.

Factors Associated with Preferences for Long-Acting Injectable Antiretroviral Therapy Among Adolescents and Young People Living with HIV in South Africa

Long-acting injectable anti-retroviral therapy (LAART) may overcome barriers to long-term adherence and improve the survival of adolescents and young people living with HIV (AYLHIV). Research on the acceptability of LAART for this age-group is limited. We asked 953 AYLHIV about their preferred (theoretical) ART mode of delivery (pill, injectable, or other) in 2017–2018, before LAART was available or known to AYLHIV in South Africa. One in eight (12%) AYLHIV preferred LAART over single or multiple pill regimens. In multivariate analyses, six factors were associated with LAART preference: medication stock-outs (aOR = 2.56, 95% CI 1.40–4.68, p = 0.002), experiencing side-effects (aOR = 1.84, 95% CI 1.15–2.97, p = 0.012), pill-burden (aOR = 1.88, 95% CI 1.20–2.94, p = 0.006), past-year treatment changes (aOR = 1.63, 95% CI 1.06–2.51, p = 0.025), any HIV stigma (aOR = 2.22, 95% CI 1.39–3.53, p ≤ 0.001) and recent ART initiation (aOR = 2.02, 95% CI 1.09–3.74, p = 0.025). In marginal effects modelling, 66% of adolescents who experienced all factors were likely to prefer LAART, highlighting the potential high acceptability of LAART among adolescents and young people living with HIV struggling to adhere and have good HIV treatment outcomes. Adolescent boys who reported high ART pill burden were more likely to prefer LAART than their female peers in moderation analyses, suggesting that LAART may be particularly important to improve treatment outcomes among male AYLHIV as they become older. Adding LAART to existing treatment options for AYLHIV, particularly higher risk groups, would support AYLHIV to attain and sustain viral suppression—the third 95, and reduce their risk of AIDS-related mortality.

Women’s preferences of mode of delivery in rural and urban communities- gharbia governorate, Egypt

Background: The birth process carries many risks for women during pregnancy, delivery, and the postpartum period. The delivery route choice is critical to the mother's and child's health. The increasing rate of CS worldwide is an alarming concern for public health and obstetricians. Objective: To identify the frequencies and the determinants for the preferences of mode of delivery in urban and rural communities. Methods: The study was a cross-sectional study carried out on 304 mothers attending vaccination sessions for the scheduled vaccines in the second and ninth months of child age at Said Primary Healthcare Center, and Shobar Primary Healthcare Unit in Al-Gharbia Governorate, Egypt. The data was collected by interviewing the mothers using a predesigned tested questionnaire. Results: Regarding the preferred mode of delivery, CS were preferred by 40.2% and 15% of females in urban and rural communities. However, 83.6% were delivered by CS at the last pregnancy. Immediate contact with the baby, immediate breastfeeding, better care for the baby and hand no scar were the most significant determinants for VD. Being easier than VD and safer for the baby were the most significant determinants for CS. Urban residence, age >25 and living in a separate home, primiparity, no abortion, and previous CS delivery were the most significant determinants of delivery mode. Conclusion: The frequency of CS was higher than VD. Urban residence, age group 25- and living in shared home were the most important determinants for CS.

To Try or Not to Try: A Questionnaire Study among Women with Previous Lower Segment Cesarean Section.

The recent increase in the cesarean section (CS) rate worldwide has led to global concerns and vaginal birth after CS (VBAC) as an effective way to reduce the CS rate. In this study, our main aim was to know about various factors that help women make their preferred mode of delivery following a previous CS. This was a questionnaire-based study conducted in the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), Jodhpur, among 200 women with previous one lower segment CS (LSCS). Elective repeat cesarean delivery (ERCD) was found to be more among uneducated women and those who had complications in their previous babies. The most common reason for opting for ERCD was fear of labor pains. Women who were counseled by senior doctors were more likely to opt for a trial of labor after cesarean section (TOLAC). Improving the education levels of mothers, counseling about advantages associated with vaginal birth, counseling by senior obstetrician, and information regarding labor analgesia can decrease CS rates.

Abstract B052: Integrating HPV (human papillomavirus) vaccination into HIV prevention: Acceptability and information needs among PrEP (pre-exposure prophylaxis) patients at a federally qualified health center

Abstract Background: Anal cancer disproportionally impacts gay, bisexual, and other male sexual minorities (GBM). Human Papillomavirus (HPV) vaccination is a safe and effective method to prevent anal cancer; however, coverage of HPV vaccination among adult GBM is low. Key barriers to vaccination are lack of awareness and knowledge of anal cancer, low motivation to get vaccinated, and lack of access and availability. For many young GBM, regular interactions with the healthcare system center around HIV prevention. Thus, we propose that federally qualified health centers (FQHCs) can increase uptake and reach of HPV vaccination by integrating and promoting HPV vaccination in ongoing HIV preventive care (e.g., Pre-exposure Prophylaxis [PrEP]). The objectives of this project were to (1) assess the acceptability of integrating HPV vaccination with PrEP management and (2) determine needs for informed decision making. Methods: We conducted a web-based cross-sectional survey of unvaccinated GBM (18-45) who received PrEP care at a FQHC in Philadelphia. Data collection took place in 2021 and 2022. The main outcome was intent to initiate HPV vaccination within 12 months (5-point scale). Other measures included beliefs about HPV vaccination in PrEP care, perceived information needs, and preferred information delivery modes. Descriptive and bivariate statistics were used to analyze the data. Results: The sample (N=59) was ethnoracially diverse (50.0% non-White) and in the catchup (23.7%; 18-26 yrs.) or shared clinical decision making (76.3%; 27-45) age ranges. Most were gay identified (71.2%) cisgender men (74.6%). Just 23.7% were aware they were eligible for HPV vaccination and even fewer knew that vaccination could prevent anal cancer (11.9%). Overall vaccine intentions were high (M=3.7; SD=1.0). Intentions were 26.1% higher (M=4.4; SD=1.0) if HPV vaccination was offered during PrEP appointments. Most (88.7%) agreed that offering HPV vaccination during PrEP visits would increase the likelihood that they would get vaccinated; however, 64.4% strongly/somewhat agreed that they needed more information about HPV vaccination prior to making an informed decision. Perceived information need was inversely associated with vaccine intentions (r=-0.31, p=0.02). Most participants (&amp;gt;50%) indicated they wanted to know more about their risk for anal cancer and effectiveness of HPV vaccination. The majority (71.2%) preferred to get medically accurate information on anal cancer prevention from a website that they could go to on their own time. Other delivery modes were iPads at their doctor’s office (28.8%), printed information given to them by their doctor (28.8%), and text messages from a healthcare provider (25.4%). Conclusion: Offering and promoting HPV vaccination as part of PrEP management visits was highly acceptable among PrEP patients. Interventions should focus on raising awareness about anal cancer and promoting informed decision making for anal cancer prevention. Citation Format: Christopher W. Wheldon, Sarah Bass, Bradley Collins. Integrating HPV (human papillomavirus) vaccination into HIV prevention: Acceptability and information needs among PrEP (pre-exposure prophylaxis) patients at a federally qualified health center [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B052.

A Study of Patient’s Perspectives Regarding the Adequacy of the Informed Consent Process before a Caesarean Section

Background: A better diagnosis, early referral, and greater health-care coverage have increased cesarean deliveries at tertiary care hospitals in India. While most cesareans are done in good faith, it does not escape the purview of consumer awareness and protection. Our study aims to audit the awareness, understanding, and adequacy among patients about informed consent (IC) before cesarean sections. Materials and Methods: This was a cross-sectional study. A detailed questionnaire was given to 150 postcesarean patients from July 2016 to July 2017. The questionnaire was then evaluated, and the inference was drawn based on the patients’ answers. Results: About 84.6% of patients knew the exact indication. About 79.3% were well explained the procedure. Ninety-six percentage were satisfied with the outcome of the procedure. Eighty-four percentage preferred the same institute for their subsequent delivery. Twelve percentage reported that consent was forcibly taken. Ninety-four percentage were unaware about the intraoperative complications. Only 4.6% were explained about the preferred mode of delivery for the next pregnancy. Ninety-two percentage wanted a vaginal delivery for the subsequent pregnancy. Conclusion: Thus, an adequate IC during antenatal visits brings about awareness about the risks and complications of cesarean section and helps better decision-making.

Needs assessment in community-dwelling older adults toward digital interventions to promote physical activity: Cross-sectional survey study.

Tackling physical inactivity represents a key global public health challenge. Strategies to increase physical activity (PA) are therefore warranted. Despite the rising availability of digital interventions (DIs), which offer tremendous potential for PA promotion, there has been inadequate attention to the special needs of older adults. The aim was to investigate community-dwelling older adults' needs, requirements, and preferences toward DIs to promote PA. The target population of this cross-sectional study was community-dwelling older adults (≥60 years old) within German-speaking Switzerland. Potential respondents were informed about the study and sent a link to a self-developed and self-administered online survey by our cooperating institutions. Overall, 922 respondents who completed the online survey were included in the final analysis. The mean age of the sample was 72 years (SD 6.4, range 60-98). The preferred delivery mode of DIs to promote PA was a website (428/922, 46.4%) and 80.3% (740/922) preferred video-based structures. Most respondents expressed the need for personal access, personal goals, personal messages, and a personal contact in case of problems or questions (585/817, 71.6%; 546/811, 67.3%; 536/822, 65.2%; 536/822, 65.2%). Memory training, psychological wellbeing, and nutrition were mainly rated as relevant additional content of DIs to promote PA (690/849, 81.2%; 661/845, 78.2%, 619/849, 72.9%). Community-dwelling older adults may be willing to use DIs to promote PA in the long term, but this study identified particular needs and requirements in terms of design, technological realization, delivery mode, support, and individualization/personalization among the sample. Our results can inform future developments of DIs to promote PA specifically tailored to older adults. However, caution is warranted in interpreting the findings due to the sample's high PA and education levels.

Would the Professional Training Sector Take the Advantage of the Virtual Environment that Was Presented Forcefully by COVID-19?

This applied research looks into the effectiveness of the virtual learning environment in the delivery of corporate and professional courses since the training provider was forced to shift to this mode of delivery since March 2020 due to the COVID-19 circumstances. &#x0D; In literature, the effectiveness of virtual delivery in the basic schooling and higher education sectors is well researched and heavily debated amongst scholars and practitioners, especially during this pandemic. This is not the case, however, in the professional and corporate training field as this sector is often regarded as a voluntary provision that warrants the least priority to invest in during a global crisis; the like of COVID-19. The purpose of the research is to measure the effectiveness of virtual training provision, and how this mode of learning can help in developing skills and supporting learning to achieving their learning objectives. The effectiveness evaluation in this research was measured from the perspective of the end-user (the learner). &#x0D; The research involved a quantitative questionnaire that was answered by 367 respondents amongst trainees who were enrolled in various professional training courses, post COVID-19, in virtual mode. The questionnaire items were purposely designed to gauge the learners’ satisfaction as a measure of effectiveness and quality of the virtual training environment. The questionnaire was distributed and administered electronically via a mass emailing campaign. Upon collecting the responses, the data was quantitatively analysed using descriptive quantitative analysis. &#x0D; The analysis of the data indicates indeed high satisfaction rates amongst learners (more than 72% were satisfied, or higher). The effectiveness of virtual learning in helping trainees achieve their learning objectives and make good progress, however, was lower than the overall satisfaction rate. After months of riding the learning curve of the virtual learning experience, the learners showed mixed picture of reflection on their preferred mode of delivery in the future. Almost a third of the learners opted for blended learning mode, whereas nearly another third preferred virtual, and the remaining liked to go back to physical classes. &#x0D; This research indicates that virtual learning is apparently lending itself to be a feasible mode of delivery of professional training courses. Its effectiveness, as perceived by the beneficiaries, is proven to continue improve as it matures over time. The prospect of this virtual learning methodology looks positive indeed despite the newness of its application on a massive scale post the COVID-19 pandemic.

Does Obesity Influence Women's Decision Making about the Mode of Delivery?

Introduction: The ratio of cesarean deliveries (CDs) has been increasing worldwide, with a growing problem of cesarean delivery on maternal request (CDMR) and an alarmingly increasing rate of CD in the private sector. There are numerous factors influencing women’s preferences for the mode of delivery and their opinion about shared decision making (SDM). Material and method: The study was designed as an online survey, filled in by 1040 women. The questionnaire included questions about women’s preferences for the mode of delivery, their opinions about CDMR and the process of decision making regarding the mode of delivery. Results: There were no statistically significant differences found between women with a BMI ≤ 25 kg/m2 and >25 kg/m2, nor with a BMI ≤ 30 kg/m2 and >30 kg/m2, on the subject of the preferred method of delivery, and the opinion regarding SDM and CDMR without medical indications. More than 85% of women in all groups, who preferred CD as the mode of delivery, wanted to have CDMR. Conclusion: We have not found obesity and overweight to be a factor influencing women’s preferred mode of delivery, their opinion about SDM and their preference for CDMR without medical indications. However, the sample size of women with morbid obesity with a BMI ≥ 35 kg/m2 was too small for the results to be considered significant in this group, and it will therefore be subject to further studies.

Undergraduate Student Perceptions on Virtual Online Versus On-campus Teaching – Learning Modes of Delivery and Assessment in Public Universities

On the onset of COVID 19 Pandemic, educational institutions took up either virtual online or blended modes of delivery and learning; as an intervention of solving programmed learning retention, transition and completion concerns among students in institutions of higher learning. In spite of the fact that online learning faces access learning challenges; there seems to be myriad issues with online assessment procedures. Despite this, there is still much debate on whether online assessments, particularly examinations, offer the same academic integrity as the traditional on- campus face to face paper assessment (Paulli and Ferrelli 2020). The purpose of this study was to assess the perceptions of undergraduate students on virtual online versus on-campus teaching- learning mode of delivery and assessment. The study anchored on descriptive survey design. A sample of 200 students across different years of study at the Faculty of Education, Kikuyu Campus, University of Nairobi, were targeted. The study used online google form to collect data. Descriptive statistics were applied in data analysis. Data was presented through tables, percentages and graphs. 140 students participated in the study. 86.1% of the respondents were in learning session and 13.9% were not in session. The most preferred mode of delivery is face to face on campus with 69.7 % responses, Virtual online – 21.8% and both, was 8.5%. The major reason for preference was that there are subjects such as mathematics, Kiswahili and English which require physical classroom student – lecturer real interactions and immediate instructional feedback for quality acquisition of skills, knowledge and values; which is completely lacking in online virtual learning; and that online virtual pedagogy flow is usually interrupted with network issues causing in-consistency in coverage of course content. Blended learning was recommended for courses that require intense practical sessions, while the other courses can take up online mode of pedagogy. Conclusively, there is need for further review of online pedagogical approaches, and curriculum policies in order to have aligned online assessments that consider equity in access to online pedagogy, in line with student socio-economic backgrounds and conducive learning environments. More research is needed for effective online pedagogical alignments.

Factors that influence pregnant women’s decision on mode of delivery after previous obstetric anal sphincter injury

PurposeMaternal request for caesarean section (CS) is increasing. One common reason is following a previous obstetric anal sphincter injury (OASI). We aim to understand which factors bear the greatest influence in driving this women’s decision-making process once they are pregnant after having sustained an OASI. MethodsPregnant women with a previous OASIS who were attending their first antenatal appointment were deemed eligible and were asked to complete two questionnaires on their preferred mode of delivery (MoD) and ongoing pelvic floor symptomatology. Data were analysed with descriptive and inferential statistics using SPSS, and results were presented both quanti- and qualitatively. ResultsData from 63 participants was included in the final analysis. Most women had experienced 3A/3B OASIS (n = 49, 77.78 %), and they were more likely to report bladder pain and difficulties with voiding than those with major tears (p < 0.05). The type of tear did not impact directly on the preferred MoD. However, women still experiencing bladder pain were more likely to request a CS (p < 0.05). Even though all participants who attended a perineal trauma clinic postpartum found it helpful, they reported that ultimately the decision on how to deliver was theirs, and their ideas and concerns played the greatest influence. ConclusionPregnant women with ongoing urinary symptoms rather than sexual or bowel dysfunction seem to favour a planned CS, regardless of the severity of their previous tear. Postpartum follow-up in a perineal trauma clinic is extremely valuable but even more is the need to understand women’s motivations to support them make an informed decision.