Types Of Delivery Research Articles

Porous Substrate-Based Electroporation with Transepithelial Electrical Impedance Monitoring.

Porous substrate electroporation (PSEP) is an emerging method of electroporation that provides high throughput and consistent delivery. Like many other types of intracellular delivery, PSEP relies heavily on fluorescent markers and fluorescent microscopy to determine successful delivery. To gain insight into the intermediate steps of the electroporation process, a PSEP platform with integrated transepithelial electrical impedance (TEEI) monitoring was developed. Cells are cultured in commercially available inserts with porous membranes. After a 12 h incubation period to allow for the formation of a fully confluent cell monolayer, the inserts are placed in transfection media located in the wells of the PSEP device. The cell monolayers are then subjected to a user-defined waveform, and delivery efficiency is confirmed through fluorescent microscopy. This workflow can be significantly enhanced with TEEI measurements between pulsing and fluorescent microscopy to collect additional data on the PSEP process, and this additional TEEI data is correlated with delivery metrics such as delivery efficiency and viability. This article describes a protocol for performing PSEP with TEEI measurements.

Hospital at home worldwide: Program and clinician characteristics from the World Hospital at Home Congress survey.

Hospital at home (HaH) delivers hospital-level care to acutely ill patients at home as a substitute for brick-and-mortar hospital care. The clinician and program characteristics of HaH programs worldwide are relatively unknown. We sought to describe the world's HaH clinicians and their programs' characteristics. We analyzed a survey administered to all attendees of the 2023 World Hospital at Home Congress. Clinician characteristics included age, years worked in HaH, profession, burnout, and experience. Program characteristics included location, daily census, types of care delivery, and clinical capabilities. Of 670 attendees, about 305 were clinicians and 129 responded (42% response rate for clinicians). The majority of clinicians were 30-49 years old (65.1%), new to the field (70.5% worked less than 10 years), and part-time (18% dedicated >74% effort to HaH). Clinicians reported overall satisfaction with their job and low burnout. About half of programs were in Europe (52.1%), newly operational (44.7% less than 5 years), mostly operated in urban environments (87.2%), and mostly had a daily census of less than 25 patients (62.8%). Most programs operated 7-days per week (88.3%), performed intermittent or continuous remote monitoring (81.4%), used video communication (63.8%), and had some advanced capabilities such as in-home imaging (47.9%) and advanced procedures (23.4%). Visit frequencies to the patient's home were variable: most programs had physicians visit the home, nearly all had nurses visit the home, and fewer performed virtual visits. HaH clinicians and programs have significant similarities but also a fair number of divergent practices, much like brick-and-mortar hospital care. Further standardization of the care model will help to unify the field across the globe.

The study of vaginal wall thickness in adults based on histopathological measurements

To accurately measure the vaginal mucosa thickness across different age groups using histopathologic techniques and investigate the factors that may influence the thickness changes. This study aims to provide clinicians with objective evidence of variations in vaginal mucosal thickness, facilitating personalized medical decisions for patients. A retrospective analysis was conducted on clinical data from 348 patients who underwent local vaginal wall resection at the West China Second University Hospital, Sichuan University, from January 2021 and May 2022. The thickness of vaginal mucosa, epithelium and lamina propria was measured precisely under the microscope. And the 10th, 25th, 50th, 75th, and 90th percentile values of vaginal mucosa thickness across different age groups were counted and charted a dot-line plot. The percentile values for vaginal mucosa thickness exhibited a decreasing trend with increasing age; vaginal mucosa thickness showed significant correlations with times of delivery (P = 0.031) and age (P < 0.001), both of which were negatively associated. And vaginal mucosa thickness demonstrated no significant correlation with body mass index (BMI) (P = 0.325), times of abortions (P = 0.511), times of gestation (P = 0.101), menstrual cycle (P = 0.533), or types of delivery (P = 0.056); epithelial thickness showed significant associations with age (P < 0.001) and types of delivery (P = 0.017), both of which were negative correlations. Moreover, BMI (P = 0.429), times of abortions (P = 0.764), delivery (P = 0.079), gestation (P = 0.475), and menstrual cycle (P = 0.950) were nonassociated with epithelial thickness; lamina propria thickness displayed a significant correlation only with age (P = 0.002), and there were no obvious correlations observed between lamina propria thickness and BMI (P = 0.374), times of abortion (P = 0.417), delivery (P = 0.053), gestation (P = 0.101), types of delivery (P = 0.132) and menstrual cycle (P = 0.495). Moreover, when the age segmentation was thresholded at 35 and 50 years, both epithelial thickness and vaginal mucosa thickness were significantly correlated with age (P < 0.05). Lamina propria thickness was associated with age when the age threshold was set at 35 years (P = 0.007), whereas it showed no strong link with age when the age threshold was 50 years (P = 0.072). This study has innovatively established percentile reference values for vaginal mucosa thickness based on histopathology, furnishing clinicians with objective evidence of variations in vaginal mucosal thickness to facilitate personalized medical decisions for patients. The findings demonstrated a strong link between vaginal mucosa thickness and age, with epithelium likely playing a predominant role, while the association with lamina propria appeared to be less significant. Further research involving a larger sample size is warranted to elucidate the potential relationship with the lamina propria.

Awareness and Attitude regarding Modes of Delivery among Pregnant Women Visiting Antenatal Clinic of University Hospital of Nepal: Cross-sectional Study

BACKGROUND The ultimate outcome of a nine-month pregnancy is considered delivery. There are two types of delivery: natural and artificial, also known as spontaneous vaginal delivery and cesarean section (CS), respectively. The purpose of this study was to determine pregnant women's awareness and attitudes toward modes of delivery when they visited the ANC clinic. METHODS The quantitative descriptive cross-sectional study was conducted among 369 pregnant women visiting the ANC clinic of a university hospital. Non-probability sampling was used for sample determination. An interview technique was used for data collection. RESULTS Among 369 participants' with an average age of 28.3 ± 4.9 years. The majority (90.2%) agreed with the statement that vaginal delivery is a natural procedure .Moreover, 22.6% agreed that CS is preferable to vaginal delivery, and 37.7% strongly agreed that the mother should have the freedom to perform a caesarean section in her choice. Only about one fifth of the respondent had moderate level of knowledge regarding modes of delivery. The level of knowledge is associated with the level of education (p = 0.020) and the decision-making role of the respondent (p = 0.002) but the attitude is found associated with type of the family (p = 0.037) and no. of ANC visits (p = 0.001) CONCLUSION The participants demonstrated moderate level of knowledge regarding modes of delivery and positive attitude towards normal delivery. Women having the right to make decisions regarding their preferred modes of delivery, including the freedom to choose CS.

Measuring childbirth-related posttraumatic stress disorder: Psychometric properties of the Italian version of the City Birth Trauma Scale (City BiTS).

The City Birth Trauma Scale (City BiTS) assesses postpartum posttraumatic stress disorder (PTSD) based on the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria. Although it has been validated worldwide, predictive validity has not been previously examined. Moreover, no Italian version of the scale exists. This study aimed to test the bifactor latent structure and alternative models, internal consistency, test-retest reliability, convergent validity, divergent validity, and predictive validity of the City BiTS. Women (N = 629) who had given birth within the past 3 months completed an online survey including sociodemographic and obstetric characteristics, the City BiTS, the Impact of Event Scale-Revised, and the Edinburgh Postnatal Depression Scale. After 3 months, women completed the City BiTS again and reported their intention to breastfeed during the 1-year postpartum. Exploratory factor analysis confirmed the two-factorial structure. In confirmatory factor analysis, the two-factorial solution showed the best model fit. Internal consistency was good to excellent for the subscales and the total scale. Correlation analyses showed strong convergent validity with the Impact of Event Scale-Revised, high divergent validity with the Edinburgh Postnatal Depression Scale, high test-retest reliability, and good predictive validity with the intention to exclusively breastfeed. Moreover, the Birth-Related Symptoms subscale distinguished between different types of delivery. The City BiTS-Italian is the first measure evaluating and diagnosing childbirth-related PTSD symptoms based on Diagnostic and Statistical Manual of Mental Disorders (5th ed.) in Italy. The factorial structure and validity reported in other cultural contexts were confirmed; moreover, findings add evidence to the scale's temporal stability and predictive validity. Besides contributing to clinical purposes, the City BiTS-Italian will facilitate international comparability regarding the prevalence of PTSD following childbirth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Impact of different obstetric interventions and types of delivery on breastfeeding: a nationwide cross-sectional survey of Hungarian women

BackgroundWe assessed the effect of different obstetric interventions and types of delivery on breastfeeding.MethodsA quantitative, cross-sectional study was carried out using an online questionnaire. Data collection was performed in 2021 in Hungary. We included biological mothers who had raised their at least 5-year-old child(ren) at home (N = 2,008). The questionnaire was completed anonymously and voluntarily. In addition to sociodemographic data (age, residence, marital status, education, occupation, income status, number of biological children, and anthropometric questions about the child and the mother), we asked about the interventions used during childbirth, and the different ways of infant feeding used. Statistical analysis was carried out using Microsoft Excel 365 and SPSS 25.0. Descriptive statistics, two-sample t tests, χ2 tests and ANOVA were used to analyse the relationship or differences between the variables (p < 0,05).ResultsWe found that in deliveries where synthetic oxytocin was used for both induction and acceleration, there was a higher incidence of emergency cesarean section. However, the occurrence of vaginal deliveries was significantly higher in cases where oxytocin administration was solely for the purpose of accelerating labour (p < 0.001).Mothers who received synthetic oxytocin also received analgesics (p < 0.001). Women giving birth naturally who used oxytocin had a lower success of breastfeeding their newborn in the delivery room (p < 0.001). Children of mothers who received obstetric analgesia had a higher rate of complementary formula feeding (p < 0.001). Newborns born naturally had a higher rate of breastfeeding in the delivery room (p < 0.001) and less formula feeding in the hospital (p < 0.001). Infants who were breastfed in the delivery room were breastfed for longer periods (p < 0.001). Exclusive breastfeeding up to six months was longer for infants born naturally (p = 0.005), but there was no difference in the length of breastfeeding (p = 0.081).ConclusionsObstetric interventions may increase the need for further interventions and have a negative impact on early or successful breastfeeding.Trial registrationNot relevant.

Study on the Association between Cesarean Section Birth and Asthma Risk in the Pediatric Population of the Health Area of Palencia between 1993 and 2020.

Both asthma prevalence and the percentage of cesarean sections have increased in parallel in recent years. Research studies suggest an increased risk of developing atopic diseases and asthma after cesarean section birth compared to vaginal delivery. The main objective of this study is to analyze the risk of asthma admission after cesarean section birth compared to vaginal delivery in the pediatric population. Retrospective observational analytical case-control study from 1993 to 2020. The cases include all admitted patients to our health area hospital, for patients aged 7 to 16 diagnosed with asthma. For each case, a control without a diagnosis of asthma is selected with the same age, and that has also caused an episode of admission. A total of 290 admission episodes with a diagnosis of asthma were obtained, caused by 155 patients. Out of these, 145 cases with documented delivery types were selected. For cases, 155 controls were selected. The historical proportion of cesarean sections in the asthmatic group is 18.6%, compared to 14.2% in the non-asthmatic group. There is a statistically non-significant difference of 4.4% more cesarean sections in the asthmatic group compared to the control group. We have not demonstrated a statistically significant association between being born by cesarean section and an increased risk of asthma admission. Based on this finding, we cannot conclude that there is an association between being born by cesarean section and a higher risk of suffering from asthma, unlike what has been postulated in other research studies.

Comparative Analysis of Therapeutic Showers and Bathtubs for Pain Management and Labor Outcomes-A Retrospective Cohort Study.

Hydrotherapy, including the use of therapeutic showers and bathtubs, has been studied for its potential benefits in labor pain management. Previous research has indicated that hydrotherapy can alleviate pain, but comparative studies between therapeutic showers and bathtubs are scarce. Objective: This study aims to compare the effects of therapeutic showers and bathtubs on pain perception, labor duration, use of epidural analgesia, and maternal and neonatal outcomes during labor. Methods: A total of 124 pregnant women were included in this study. Participants were divided into two groups: those who used a therapeutic shower and those who used a bathtub during labor. Pain levels were measured using a visual analog scale (VAS). Labor duration, use of epidural analgesia, types of delivery, maternal outcomes (postpartum hemorrhage, perineal status, maternal hypotension, fever, and breastfeeding), and neonatal outcomes (APGAR scores, fetal heart rate, complications, and neonatal unit admissions) were recorded and analyzed. Results: Both the therapeutic shower and the bathtub effectively reduced pain perception, with the bathtub showing a greater reduction in VAS scores. The therapeutic shower group experienced a significantly shorter labor duration compared to the bathtub group. The majority of participants in both groups did not require epidural analgesia, with no significant differences between the groups. There were no significant differences in the types of delivery. Maternal outcomes indicated a lower incidence of perineal tears and episiotomies in the therapeutic shower group. Neonatal outcomes, including APGAR scores and fetal heart rate, were similar between the groups, with no significant differences in complications or neonatal unit admissions. Conclusions: Both therapeutic showers and bathtubs are effective for pain relief during labor, with the bathtub showing a higher reduction in pain intensity. The therapeutic shower is associated with a shorter labor duration and a lower incidence of perineal tears and episiotomies. Both methods are safe for neonatal well-being, making hydrotherapy a viable non-pharmacological option for pain management in labor. However, the therapeutic shower may offer additional benefits in terms of labor duration and maternal outcomes.

1D-CNN: Classification of normal delivery and cesarean section types using cardiotocography time-series signals

Abstract Cardiotocography (CTG) is considered the gold standard for monitoring fetal heart rate (FHR) during pregnancy and labor to estimate the danger of oxygen deprivation. Visual interpretation of CTG traces is complex and frequently results in high rates of false positives and false negatives, leading to unfavorable and unwanted outcomes such as fetal mortality or needless cesarean surgery. If the data are well-balanced, which is uncommon in medical datasets, machine learning techniques can be helpful in interpretation. This study is designed to determine classification performance under various data balance approaches. We propose a robust methodology for the automated extraction of features that use a deep learning model based on the one-dimensional convolutional neural network (1D-CNN). We used a public database containing 552 intrapartum CTG recordings. Due to the imbalance in the dataset, the experiments were conducted under a variety of conditions such as (i) an unbalanced dataset, (ii) undersampling, (iii) a weighted binary cross-entropy approach, and (iv) oversampling utilizing the synthetic minority oversampling technique (SMOTE). We found an excellent sensitivity (99.80% for the unbalanced dataset, 96.25% for the weighted binary cross-entropy approach, and 99.81% with SMOTE) except for the under sampling situation, in which the sensitivity was 85.71%. Moreover, the 1D-CNN model incorporating SMOTE yielded promising results in 88% specificity, 93.72% quality index (QI), and 95.10% area under the curve. The model exhibited excellent performance in terms of sensitivity in every scenario except for undersampling. The oversampling of training data with SMOTE yielded a decent level of specificity, demonstrating the model’s strong predictive capacity. In addition, the SMOTE scenario resulted in fewer training epochs, which is another accomplishment.

Staff-Family Communication Methods in Long-Term Care Homes: An Integrative Review

Context: Communication methods have been trialled to promote staff-family relations and facilitate person-centred care for residents living in long-term care homes. A review and synthesis of the common methods will inform the development of staff-family communication methods, policy and best practice guidelines. Objectives: 1) synthesise and summarise common communication methods, and types(s) of delivery, used for staff-family communication in long-term care homes; and 2) identify any challenges that impacted the implementation of the communication method(s). Methods: An integrative review was employed to incorporate papers with diverse research designs. It involved a comprehensive database and grey literature search, and study selection based on inclusion criteria. Data from included studies were extracted, coded and categorised by common communication method, delivery type(s) and challenges; studies were assessed for quality. Findings: A total of 3,183 potential papers were retrieved from seven international databases. Twenty-four original papers from six countries meeting inclusion criteria were reviewed and assessed for quality (M = 30; SD = 3.8). Common communication methods (structured education, meetings and takeaway resources) and challenges to implementation (confusion, misunderstanding and disagreement; lack of time; and technological difficulties) were identified and summarised. Limitations: The exclusion of papers published more than 20 years ago, geographical concentration of studies in high-income countries, and absence of stakeholder consultation may limit the generalisability and depth of the findings. Implications: Staff professional development and education, technology training and support, and accessibility of information in pamphlets and resources for family are crucial for facilitating staff-family communication in long-term care homes.

Analysis of Heart Rate Variability in Newborns Dogs with Different Types of Delivery during the First 35 Days of Life.

The present study aimed to evaluate the influence of the autonomic nervous system on cardiovascular function during the first 35 days of life in different types of delivery, using heart rate variability (HRV) indices. Thirty newborns were equally divided into two groups based on delivery type: eutocic delivery (EG) and emergency cesarean section (CG). Electrocardiographic evaluation was performed at birth (T0), 24 h postpartum (T1), and at 7, 14, 21, 28, and 35 days of life (T2 to T6). Physical parameters, neonatal reflexes, and Apgar scores were recorded. Over 35 days, the values of the time domain indices were higher in the GE group and increased with age. In the frequency domain, the low frequency (LF) index was higher in the CG, and the opposite occurred for the high frequency (HF) index. Since the CG presented lower HRV than the EG, it was shown that the type of delivery should be considered for the assessment of autonomic nervous system activity in neonates. Thus, as predictive factors of vitality, HRV and Apgar scores can help in the face of neonatal depression, demonstrating that delivery by emergency cesarean section can predispose newborns to delays in the autonomic influence on the heart.

Implementation of Educational Opportunities for Social Determinants of Health in Health Professions Education: A Scoping Review

Objective Health professions programs have recently increased their efforts to educate health care professionals about the social determinants of health (SDH); however, there seems to be a disconnect between graduate medical education and its applicability to other peer health professions. The current scoping review aims to map the literature that explores the implementation of educational opportunities focused on SDH in health professions education programs. Data Sources PubMed, CINAHL, ERIC, Education Source, and the Health Policy Reference Center were searched to identify relevant articles. Study Selection To be included in our review, articles had to have been published in the last 5 years and describe how material related to SDH was implemented into a graduate health professions education program. Outcomes were analyzed by thematic categories by type of curricular delivery (didactic, clinical education, service-learning experience, or reflection), timing of the implementation in the program, methods of implementation, and assessment after implementation. Data Extraction Our search identified 2006 articles that were reviewed by study authors; 36 were included in our full-text review. Information extracted included the study design, type of graduate education, aims of the studies, description of technique, timing of implementation, type of curricular delivery, and outcomes. Data Synthesis The majority (23, 63.9%) of studies used an observational design and used 2 or more (27, 75.0%) types of curricular delivery presented to medical students. Didactic (19, 52.8%) and small-group discussion (14, 38.9%) methods were used most often. Assessments were mostly student reflections or self-report items. Overall, students reported increased knowledge and satisfaction with activities. Conclusions Results of our scoping review indicated that various education opportunities related to SDH exist in graduate health professions education but are likely insufficient. More studies are necessary to investigate the purposeful implementation of SDH and the best methods to assess student knowledge of SDH. Future research should also investigate how to objectively assess student learning of SDH.

The prevalence, consequences, and outcome of perinatal asphyxia in term and late preterm live-born neonatesA A case-control study from Iran

Background: Despite several investigations reporting the prevalence of asphyxia in developed and developing countries, very few studies from Iran have demonstrated the rate of neonatal asphyxia and its affecting factors. Objectives: This study aimed to determine the prevalence of asphyxia, its consequences, and neonatal outcomes among Iranian term and late preterm live-born neonates. Methods: A case-control study was conducted in three hospitals; Vali-e-Asr, Yas, and Ziaean from April 2019 to March 2020. The case group included neonates with a history of perinatal asphyxia. Twice gestational age-matched subjects without such a history also entered the study as the control group. All maternal and neonatal data were collected from participants’ medical records. Determining the prevalence of neonatal asphyxia was the primary outcome of the present study. Results: Totally 48 subjects as the case and control groups were included and 16 asphyxiated cases were observed equal to 3.3 per 1000 live-born neonates. Concerning the type of delivery, cesarean section in the control group and vaginal delivery in the case group were the most frequent types of delivery (p=0.041). Comparing neonatal variables, the results showed a significant difference regarding the groups’ genders (p=0.036). Apgar scores in the case group were also significantly lower than the control group (p=0.0001). More cases also required PPV compared to the controls (12 vs. 0; p=0.0001). Hypoxic-ischemic encephalopathy (HIE) grade 1 was also significantly more frequent in the case group than the controls (p=0.0001). The means of pH and base excess in the case group were significantly lower than the control group (p=0.0001). Conclusion: The results showed the prevalence rate of asphyxia among term and late preterm participants was 3.3 cases per 1000 live-born neonates. Apgar scores&lt;5 accompanied with metabolic acidosis, HIE, and requirement of PPV could be predictive variables for perinatal asphyxia. Observing such clinical risk factors may indicate the need of early diagnosis and timely interventions to improve neonatal outcomes.

Fast Healthcare Interoperability Resources-Based Support System for Predicting Delivery Type: Model Development and Evaluation Study.

The escalating prevalence of cesarean delivery globally poses significant health impacts on mothers and newborns. Despite this trend, the underlying reasons for increased cesarean delivery rates, which have risen to 36.3% in Portugal as of 2020, remain unclear. This study delves into these issues within the Portuguese health care context, where national efforts are underway to reduce cesarean delivery occurrences. This paper aims to introduce a machine learning, algorithm-based support system designed to assist clinical teams in identifying potentially unnecessary cesarean deliveries. Key objectives include developing clinical decision support systems for cesarean deliveries using interoperability standards, identifying predictive factors influencing delivery type, assessing the economic impact of implementing this tool, and comparing system outputs with clinicians' decisions. This study used retrospective data collected from 9 public Portuguese hospitals, encompassing maternal and fetal data and delivery methods from 2019 to 2020. We used various machine learning algorithms for model development, with light gradient-boosting machine (LightGBM) selected for deployment due to its efficiency. The model's performance was compared with clinician assessments through questionnaires. Additionally, an economic simulation was conducted to evaluate the financial impact on Portuguese public hospitals. The deployed model, based on LightGBM, achieved an area under the receiver operating characteristic curve of 88%. In the trial deployment phase at a single hospital, 3.8% (123/3231) of cases triggered alarms for potentially unnecessary cesarean deliveries. Financial simulation results indicated potential benefits for 30% (15/48) of Portuguese public hospitals with the implementation of our tool. However, this study acknowledges biases in the model, such as combining different vaginal delivery types and focusing on potentially unwarranted cesarean deliveries. This study presents a promising system capable of identifying potentially incorrect cesarean delivery decisions, with potentially positive implications for medical practice and health care economics. However, it also highlights the challenges and considerations necessary for real-world application, including further evaluation of clinical decision-making impacts and understanding the diverse reasons behind delivery type choices. This study underscores the need for careful implementation and further robust analysis to realize the full potential and real-world applicability of such clinical support systems.

Systematic Reviews and Synthesis without Meta-Analysis on Hydrotherapy for Pain Control in Labor

Background: Although there is scientific evidence regarding the use of water immersion during labor, this evidence is primarily focused on the first stage of labor. There is limited scientific evidence on water immersion during the second stage of labor. Objective: The objective of this study was to conduct a comprehensive systematic review and synthesis of contemporary evidence related to water birth, with a specific focus on the second stage of labor. Methods: A systematic review of the scientific literature published between January 2018 and October 2023 was carried out. A synthesis of the results was conducted following the Synthesis without Meta-Analysis (SWiM) guidelines. PubMed, Scopus, and the Cochrane Library were utilized as information sources. The search strategy was designed using the keywords “immersion” and “parturition”, along with their relevant synonyms. Inclusion criteria encompassed studies employing randomized controlled trials (RCTs), systematic reviews, and quantitative and qualitative approaches focusing on pregnant women undergoing water immersion at any stage of the labor process. Results: Eleven articles were selected: two systematic reviews (one quantitative and one qualitative), five cohort studies, one case–control study, one cross-sectional observational study, and two qualitative studies. A thorough assessment of the methodology was performed using several specific tools: the Cochrane RoB 2 (Risk of Bias 2) tool for systematic reviews, JBI Critical Appraisal Checklist for Qualitative Research for qualitative studies, STROBE for observational descriptive studies, and CASPe for qualitative studies. The results provided fundamental insights that will contribute to conceptual standardization regarding the effects of water birth on maternal and fetal health. Additionally, a synthesis of the results was performed concerning types of delivery, analgesia use, pain perception, and maternal satisfaction with the water birth experience. Conclusions: In this study, we conclude that the results regarding delivery types, labor durations, and analgesia use found in the literature, along with statistically significant maternal/fetal effects, are crucial for making recommendations regarding the use of water during labor in any of its stages if the woman desires it safely.

Identifying the Socioeconomic and Demographic factors affecting the Maternal health care and delivery types of Santal women’s of Dinajpur, Bangladesh

Utilization of maternal healthcare properly is an important factor to reduce maternal mortality and infant mortality. This study was conducted to see the knowledge and practice regarding maternal healthcare (MHC) among santal women of Dinajpur. Santal are one of the largest tribal group of Bangladesh mainly living in Rangpur and Rajshahi division. They have their own culture and language. In this study 209 santal women having at least one child of age less than 5 years has been interviewed. Due to restricted sampling unit and lack of sampling frame, connivance sampling has been used for selecting sample from different region of Dinajpur district. It has been found from the study that 23.9% respondents gets married within 15 years and the majorities (63.3%) get married at age group 15 to 20 years. Maximum women experience their first baby birth in the age group 15 to 20 years which is 57.4%. About one third of the respondents had experienced a pregnancy that miscarried or ended by a stillbirth. Among the respondents 81.3% was hearted about menstruation before they enter in this group and almost half of the total respondents took part in a program arranged by NGO about maternal health care awareness. Almost 50% of the total respondents give birth in NGO sector. From the bivariate analysis it has been found that type of delivery has significant association with respondent current age, age at first birth and at age marriage. Also the place of delivery and respondent education level has significant association with type of delivery. From the binary logistic regression it has been found that lower middle class and middle class groups has higher chance of caesarean delivery than the poor group. Also, the respondents who get married or give birth their first baby after more than 25 years has higher rate of caesarean delivery than the reference group less than 15 years.

Enhancing Food Supply Chain Efficiency: A Consolidation Shipping Approach For Multi-Product and Multiechelon

This research applies the application of delivery consolidation in the context of a multi-product and multi-echelon food supply chain, as a strategy to address operational efficiency and cost management. The aim is to implement consolidation in multi-product and multi-echelon distribution systems, in order to optimize product placement and distribution efficiently. The method adopted is the Linear Programming model, which considers key variables such as the number of goods to be sent, delivery route, resource allocation, fleet capacity and delivery time limit. The research results show that shipment consolidation, by scheduling shipments that are delayed until the second or third day, allows combining orders into one large shipment, thereby increasing load and route efficiency, reducing trip frequency, and achieving significant transportation cost savings. This strategy successfully increased load and route efficiency, reduced the number of trips required, and resulted in substantial transportation cost savings. Using this method, the total shipping and storage costs are 1,328,834. This consolidation strategy has proven crucial in optimizing delivery types, in addition to facilitating more effective route planning, reducing travel distances and times, and resulting in significant operational cost savings.

Expansion of Communication Contact Between the State, Business and Society in the Republic of Kazakhstan

Main problem: digital transformation of Kazakhstan’s society leads to emergence of new communication business models, including the so-called proactive data-based service, which implies expansion of communication contact between the state, business and society. Digital transformation of economic sectors and the service sector has objectively caused discussion of issues related to various aspects of its implementation. These include digitalization of society spheres within framework of public administration [1], problems of interaction between business and government [2], mechanisms of interaction between subjects in the private-public partnership model of government and business [3], description of communication models of business types, government and public sector [4], history of emergence of electronic trade, its forms and types of goods delivery to a consumer [5], organizational and managerial relations and processes arising in enterprises, working in field of online marketing and e-commerce [6]. In Kazakhstan, digitalization of spheres and the economy sectors is one of strategic priorities of its development. Use of information and communication technologies in the service sector creates additional impulses to its dynamics, therefore, has impact on improving population’s life quality. In this regard, it is necessary to identify trends and patterns of communication interaction between the state, business and society, to consider and clarify their content. The purpose: the research of state and trends in the development of Kazakhstan service sector under the influence of digital solutions and expansion of communicative contact between the state, business and society. Methods: the performed analysis in the research is based on the materials of the statistical reviews and their analysis using the methods of grouping, generalization, logical analysis, system description and interpretation. Results and their value: a range of the key problems of communication interaction between the state, business and society is investigated and determined. Recommendations are proposed to accelerate the development of e-commerce in Kazakhstan as a tool for communication interaction between business and society and improving population’s life quality.

Associated factors of sexual dysfunction among postpartum women in Taiwan- a cross-sectional study.

Sexual function among postpartum women is often overlooked by health-care professionals. This study aimed to investigate associated factors of sexual dysfunction among postpartum women. This study used a cross-sectional study design. A total of 135 postpartum women from a teaching hospital in northern Taiwan who met the inclusion criteria were recruited. SPSS version 22.0 was used to analyze data including descriptive and bivariate analysis. A multiple linear regression was using to identify the predictors of sexual dysfunction among Taiwanese postpartum women. Results indicated that the categories of sexual dysfunction that most commonly experienced in postpartum women were lack of sexual desire, delay or absence of orgasm, pain during intercourse, and inability to become physically aroused. Parity, types of delivery, perineal laceration, breastfeeding, postpartum fatigue, and postpartum depression were significantly associated with sexual dysfunction (p< .05). Sexual counseling and mental support should be necessary for women at risk of postpartum sexual problems such as nulliparous with perineal laceration, breastfeeding mothers, experiencing postpartum fatigue and depressive symptoms to improve their sexual health and quality of life.

Comparison of the effectiveness of dornase alfa in chronic rhinosinusitis with nasal polyposis using different types of drug delivery

Introduction. When using the drug dornase alfa in children with cystic fibrosis (CF) in the form of inhalations through a compressor inhaler with a pulsating aerosol supply, a high concentration of aerosol is achieved in the nasal cavity and paranasal sinuses, which reduces the severity of rhinological pathology, namely chronic rhinosinusitis, including those with nasal polyposis. There is also a positive effect on the function of external respiration, due to a decrease in the negative impact of rhinological pathology on the respiratory tract, primarily due to descending infection.Aim. To evaluate the effect of intranasal dornase alfa therapy as part of a complex treatment on lung function and indicators of physical development in children with CF.Materials and methods. The study compared the effectiveness of the drug dornase alfa for chronic rhinosinusitis with nasal polyposis using different types of drug delivery in children who did not receive targeted therapy for CF. A group of children who received two inhalations of dornase alfa (n = 43), information about patients in this group was taken from the 2020 register, and a group of children who received inhalation of dornase alfa only in the lower respiratory tract were compared (n = 28), information about patients in this group was taken from the 2016 register.Results. The effect of additional intranasal inhalation of the drug dornase alfa was observed in the form of an increase in FEV and FVC. In addition, there was an improvement in body weight and height in the group of patients receiving intranasal inhalations, but the identified difference did not reach significant values.Conclusion. The results obtained in the form of an increase in FEV1 and FVC allow us to draw a conclusion about the effectiveness of prescribing additional intranasal inhalation of the drug dornase alfa.