2,353 results match your criteria Labor and Delivery in the Emergency Department


Efficacy of an ultrasound training program for nurse midwives to assess high-risk conditions at labor triage in rural Uganda.

PLoS One 2020 30;15(6):e0235269. Epub 2020 Jun 30.

Department of Emergency Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, United States of America.

Many high-risk conditions of pregnancy are undetected until the time of delivery in low-income countries. We developed a point-of-care ultrasound training protocol for providers in rural Uganda to detect fetal distress or demise, malpresentation, multiple gestation, placenta previa, oligohydramnios and preterm delivery. This was a mixed-methods study to evaluate the 2-week training curriculum and trainees' ability to perform a standard scanning protocol and interpret ultrasound images. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235269PLOS

Simulation-based low-dose, high-frequency plus mobile mentoring versus traditional group-based trainings among health workers on day of birth care in Nigeria; a cluster randomized controlled trial.

BMC Health Serv Res 2020 Jun 26;20(1):586. Epub 2020 Jun 26.

USAID's Maternal and Child Survival Program/Jhpiego, Nigeria, 971 Reuben Okoya Crescent, Wuye District, Abuja, Nigeria.

Background: The aim of this study was to compare health workers knowledge and skills competencies between those trained using the onsite simulation-based, low-dose, high frequency training plus mobile mentoring (LDHF/m-mentoring) and the ones trained through traditional offsite, group-based training (TRAD) approach in Kogi and Ebonyi states, Nigeria, over a 12-month period.

Methods: A prospective cluster randomized controlled trial was conducted by enrolling 299 health workers who provided healthcare to mothers and their babies on the day of birth in 60 health facilities in Kogi and Ebonyi states. These were randomized to either LDHF/m-mentoring (intervention, n = 30 facilities) or traditional group-based training (control, n = 30 facilities) control arm. Read More

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http://dx.doi.org/10.1186/s12913-020-05450-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318405PMC

The Association of Death Notification and Related Training with Burnout among Emergency Medical Services Professionals.

Prehosp Emerg Care 2020 Jun 25:1-14. Epub 2020 Jun 25.

ESO; Austin, Texas, USA.

Death notification is a difficult task commonly encountered during prehospital care and may lead to burnout among EMS professionals. Lack of training could potentiate the relationship between death notification and burnout. The first objective of this study was to describe EMS professionals' experience with death notification and related training. Read More

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http://dx.doi.org/10.1080/10903127.2020.1785599DOI Listing

Epidemiology of oxytocin administration in out-of-hospital births attended by paramedics.

Prehosp Emerg Care 2020 Jun 25:1-9. Epub 2020 Jun 25.

Queensland Ambulance Service, Queensland Government Department of Health, Brisbane, Queensland, Australia.

Primary postpartum hemorrhage (PPH) is a life-threatening obstetric emergency that can be mitigated through the administration of a uterotonic to actively manage the third stage of labor. This study describes the prehospital administration of oxytocin by paramedics following attendance of out-of-hospital (OOH) births. A retrospective analysis was undertaken of all OOH births between the 1 January 2018 and 31 December 2018 attended by the Queensland Ambulance Service. Read More

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http://dx.doi.org/10.1080/10903127.2020.1786613DOI Listing

A systematic review of opioid overdose interventions delivered within emergency departments.

Drug Alcohol Depend 2020 May 23;213:108009. Epub 2020 May 23.

Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Peninsula Campus, Moorooduc Hwy, Frankston, 3199, Victoria, Australia. Electronic address:

Background: People with opioid use disorders are at higher risk of fatal opioid overdose and attend emergency departments (ED) more frequently compared to the general population. This review aimed to synthesise evidence on the ED-based delivery of opioid overdose prevention interventions.

Methods: Using the PRISMA guidelines, four databases (Medline; Embase; Scopus; PsycINFO) were searched for peer-reviewed articles on ED based interventions to prevent opioid overdose, published January 1998 to October 2018. Read More

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http://dx.doi.org/10.1016/j.drugalcdep.2020.108009DOI Listing

DIEER: Delay-Intolerant Energy-Efficient Routing with Sink Mobility in Underwater Wireless Sensor Networks.

Sensors (Basel) 2020 Jun 19;20(12). Epub 2020 Jun 19.

Institute of Research and Development, Duy Tan University, Da Nang 550000, Vietnam.

Underwater Wireless Sensor Networks (UWSNs) are an enabling technology for many applications in commercial, military, and scientific domains. In some emergency response applications of UWSN, data dissemination is more important, therefore these applications are handled differently as compared to energy-focused approaches, which is only possible when propagation delay is minimized and packet delivery at surface sinks is assured. Packet delivery underwater is a serious concern because of harsh underwater environments and the dense deployment of nodes, which causes collisions and packet loss. Read More

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http://dx.doi.org/10.3390/s20123467DOI Listing

A Forensic Aspect of Fetal Shoulder Dystocia.

Z Geburtshilfe Neonatol 2020 Jun 23. Epub 2020 Jun 23.

Department for Gynecology and Obstetrics, General Hospital Tešanj and University of Tuzla, Faculty of Medicine, Tuzla, Bosnia and Herzegovina.

Fetal shoulder dystocia (FSD) is an unpredictable and critical obstetric intrapartum emergency, where an objective problem is the relationship between the mother's pelvis and the child, i. e., an anthropometric disorder of delivery mechanics and dynamics. Read More

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http://dx.doi.org/10.1055/a-1192-7254DOI Listing

Access to Chagas disease treatment in the United States after the regulatory approval of benznidazole.

PLoS Negl Trop Dis 2020 Jun 22;14(6):e0008398. Epub 2020 Jun 22.

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.

Approximately 300,000 persons in the United States (US) are infected with Trypanosoma cruzi, the protozoan that causes Chagas disease, but less than 1% are estimated to have received antiparasitic treatment. Benznidazole was approved by the US Food and Drug Administration (FDA) for treatment of T. cruzi infection in 2017 and commercialized in May 2018. Read More

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http://dx.doi.org/10.1371/journal.pntd.0008398DOI Listing

Feasibility of Interprofessional Education in a Community Pharmacy.

J Pharm Pract 2020 Jun 22:897190020930532. Epub 2020 Jun 22.

Pharmacy Program, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA.

Objective: To evaluate student learning, preceptor opinions, and feasibility of conducting interprofessional education in a community pharmacy.

Methods: Six pharmacy and 6 physician assistant students from 2 universities were paired to practice together in a community pharmacy for 1 day and clinic or emergency department for 1 day. Investigator-developed surveys were completed anonymously by students and preceptors. Read More

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http://dx.doi.org/10.1177/0897190020930532DOI Listing

Factors obstetricians, family physicians and midwives consider when counselling women about a trial of labour after caesarean and planned repeat caesarean: a qualitative descriptive study.

BMC Pregnancy Childbirth 2020 Jun 18;20(1):367. Epub 2020 Jun 18.

Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON, M4N 3M5, Canada.

Background: Repeat caesarean sections (CSs) are major contributors to the high rate of CS in Canada and globally. Women's decisions to have a planned repeat CS (PRCS) or a trial of labour after CS (TOLAC) are influenced by their maternity care providers. This study explored factors maternity care providers consider when counselling pregnant women with a previous CS, eligible for a TOLAC, about delivery method. Read More

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http://dx.doi.org/10.1186/s12884-020-03052-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301440PMC

Paramedic experiences of using an enhanced stroke assessment during a cluster randomised trial: a qualitative thematic analysis.

Emerg Med J 2020 Jun 16. Epub 2020 Jun 16.

Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK.

Background: Intravenous thrombolysis is a key element of emergency treatment for acute ischaemic stroke, but hospital service delivery is variable. The Paramedic Acute Stroke Treatment Assessment (PASTA) multicentre cluster randomised controlled trial evaluated whether an enhanced paramedic-initiated stroke assessment pathway could improve thrombolysis volume. This paper reports the findings of a parallel process evaluation which explored intervention paramedics' experience of delivering the enhanced assessment. Read More

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http://dx.doi.org/10.1136/emermed-2019-209392DOI Listing

Fecal Calprotectin May Predict Adverse Pregnancy-Related Outcomes in Patients with Inflammatory Bowel Disease.

Dig Dis Sci 2020 Jun 12. Epub 2020 Jun 12.

Division of Gastroenterology, Mount Sinai Hospital, Sinai Health System, University of Toronto, Suite 441-600 University Avenue, Toronto, ON, M5G 1X5, Canada.

Background: The role of fecal calprotectin in predicting pregnancy-related outcomes in inflammatory bowel disease (IBD) remains unknown.

Aim: To determine whether increased fecal calprotectin during pregnancy is associated with adverse pregnancy outcomes in IBD.

Methods: This is a multicenter cohort study of women with IBD who underwent fecal calprotectin monitoring during pregnancy. Read More

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http://dx.doi.org/10.1007/s10620-020-06381-5DOI Listing

Association Between Pregnancy and Cervical Artery Dissection.

Ann Neurol 2020 Jun 11. Epub 2020 Jun 11.

Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York.

Objective: To determine whether pregnancy is associated with cervical artery dissection.

Methods: We performed a case-control study using claims data from all nonfederal emergency departments and acute care hospitals in New York and Florida between 2005-2015. Cases were women 12-42 years of age hospitalized with cervical artery dissection, defined using validated diagnosis codes for carotid/vertebral artery dissection. Read More

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http://dx.doi.org/10.1002/ana.25813DOI Listing

Transcultural influence on female genital mutilation done in late pregnancy: A case report.

Niger J Clin Pract 2020 Jun;23(6):883-886

Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City, Nigeria.

A complicated case of female genital mutilation (FGM) type 2b done in late-pregnancy is presented and the interplay of Yoruba and Kwale culture, in this case, is discussed. A Yoruba who grew up among Kwales/Urhobos had FGM at 38 weeks and 4 days gestation (to assure vaginal delivery) and presented with vulvar hematoma, septicemia, obstructed labor, and a distressed fetus. 5 days after FGM procedure, she had an emergency cesarean section (EmCS), repair of FGM site and baby was admitted in special care. Read More

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http://dx.doi.org/10.4103/njcp.njcp_372_18DOI Listing

Understanding the costs and the cost structure of a community-based HIV and gender-based violence (GBV) prevention program: the Woza Asibonisane Community Responses Program in South Africa.

BMC Health Serv Res 2020 Jun 10;20(1):526. Epub 2020 Jun 10.

Health Economics and Epidemiology Research Office, Department of Internal Medicine,Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.

Background: The Woza Asibonisane Community Responses (CR) Programme was developed to prevent HIV infections and gender-based violence (GBV) within four provinces in South Africa. The Centre for Communication Impact (CCI) in collaboration with six partner non-governmental organizations (NGOs) implemented the programme, which was comprised of multiple types of group discussion and education activities organized and facilitated by each NGO. To date, little information exists on the cost of implementing such multi-objective, multi-activity, community-based programmes. Read More

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http://dx.doi.org/10.1186/s12913-020-05385-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288692PMC

Informed consent in obstetrics - a survey of pregnant women to set a new standard for consent in emergency obstetric interventions.

J Obstet Gynaecol 2020 Jun 10:1-5. Epub 2020 Jun 10.

Department of Obstetrics and Gynaecology, Raigmore Hospital, Inverness, UK.

Informed consent is necessary for all medical, surgical and obstetric interventions. Whilst informed consent can be obtained for elective procedures, it is much more challenging to obtain for emergency interventions. It can be difficult for women to understand the need for emergency intervention when pregnancy has been low risk. Read More

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http://dx.doi.org/10.1080/01443615.2020.1755624DOI Listing

: a case study on the delivery of maternal and child health and nutrition interventions in the conflict-affected regions of Mali.

Confl Health 2020 27;14:36. Epub 2020 May 27.

Centre for Global Child Health, the Hospital for Sick Children, Toronto, Canada.

Abstract:

Background: Mali is currently in the midst of ongoing conflicts which involve jihadist groups, rebels, and the state. This conflict has primarily centered in the North of the country. Humanitarian actors delivering services in these geographies must navigate the complex environment created by conflict. Read More

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http://dx.doi.org/10.1186/s13031-020-0253-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7254666PMC

Abandoning the blind legacy passed on horde of routine intra-abdominal drain insertion in cesarean section.

Prz Menopauzalny 2020 Mar 27;19(1):25-29. Epub 2020 Apr 27.

Department of Obstetrics and Gynecology, Jordan University Hospital, Amman, Jordan.

Introduction: Cesarean section (CS) delivery is the most common major obstetrical surgical operation carried out in and is increasing in incidence throughout the world. The major involves some risks that might include: infection, coagulation problem, loss of blood, bowel or bladder injury, abnormalities of the placenta in subsequent pregnancies.

Aim Of The Study: To evaluate the clinical effectiveness of postoperative CS intra-abdominal drain insertion. Read More

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http://dx.doi.org/10.5114/pm.2020.95332DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7258367PMC

Responding to COVID-19: how an academic infectious diseases division mobilized in Singapore.

BMC Med 2020 06 8;18(1):179. Epub 2020 Jun 8.

Division of Infectious Diseases, Department of Medicine, National University Hospital, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 10, Singapore, 119228, Singapore.

Background: On January 30, COVID-19 was declared a Public Health Emergency of International Concern-a week after Singapore's first imported case and 5 days before local transmission. The National University Hospital (NUH) is Singapore's third largest hospital with 1200 beds, heavy clinical workloads, and major roles in research and teaching.

Main Body: With memories of SARS still vivid, there was an urgent requirement for the NUH Division of Infectious Diseases to adapt-undergoing major reorganization to face rapidly changing priorities while ensuring usual essential services and standards. Read More

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http://dx.doi.org/10.1186/s12916-020-01641-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7276279PMC

Variables Influencing Radiology Volume Recovery During the Next Phase of the Coronavirus Disease 2019 (COVID-19) Pandemic.

J Am Coll Radiol 2020 Jun 1. Epub 2020 Jun 1.

Department of Radiology, Stanford University School of Medicine, Stanford, California. Electronic address:

The coronavirus disease 2019 (COVID-19) pandemic has reduced radiology volumes across the country as providers have decreased elective care to minimize the spread of infection and free up health care delivery system capacity. After the stay-at-home order was issued in our county, imaging volumes at our institution decreased to approximately 46% of baseline volumes, similar to the experience of other radiology practices. Given the substantial differences in severity and timing of the disease in different geographic regions, estimating resumption of radiology volumes will be one of the next major challenges for radiology practices. Read More

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http://dx.doi.org/10.1016/j.jacr.2020.05.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262523PMC
June 2020
2.283 Impact Factor

A comprehensive assessment for community-based, person-centered care for older adults.

BMC Geriatr 2020 Jun 5;20(1):193. Epub 2020 Jun 5.

Gary and Mary West Health Institute, 10350 N. Torrey Pines Road, La Jolla, CA, 92037, USA.

Background: Many health and social needs can be assessed and met in community settings, where lower-cost, person-centered, preventative and proactive services predominate. This study reports on the development and implementation of a person-centered care model integrating dental, social, and health services for low-income older adults at a community dental clinic co-located within a senior wellness center.

Methods: A digital comprehensive geriatric assessment (CGA) and referral system linking medical, dental, and psychosocial needs by real-time CGA-derived metrics for 996 older adults (age ≥ 60) was implemented in 2016-2018 as part of a continuous quality improvement project. Read More

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http://dx.doi.org/10.1186/s12877-020-1502-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275322PMC

Women's, partners' and healthcare providers' views and experiences of assisted vaginal birth: a systematic mixed methods review.

Reprod Health 2020 Jun 1;17(1):83. Epub 2020 Jun 1.

Research in Childbirth and Health Unit, University of Central Lancashire, Preston, PR1 2HE, UK.

Background: When certain complications arise during the second stage of labour, assisted vaginal delivery (AVD), a vaginal birth with forceps or vacuum extractor, can effectively improve outcomes by ending prolonged labour or by ensuring rapid birth in response to maternal or fetal compromise. In recent decades, the use of AVD has decreased in many settings in favour of caesarean section (CS). This review aimed to improve understanding of experiences, barriers and facilitators for AVD use. Read More

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http://dx.doi.org/10.1186/s12978-020-00915-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268509PMC

Management of a delivery suite during the COVID-19 epidemic.

Eur J Obstet Gynecol Reprod Biol 2020 May 20. Epub 2020 May 20.

College of Life Sciences, University of Leicester, Leicester LE1 7RH, UK.

Background: Since the first report of the new coronavirus (COVID-19) infection in December of 2019, it has become rapidly prevalent and been declared as a Public Health Emergency of International Concern by the World Health Organization. There are quite a few cases reported involving delivery with COVID-19 infection, but little valuable suggestion was provided about what healthcare providers of obstetrics and neonatology should do in their clinic practice for unknown status or presumed negative women. Here, we summarized the current practice of delivery management in China that successfully prevented rapid increase in adverse pregnancy outcomes and nosocomial infection in departments of obstetrics and neonatology during the pandemic of COVID-19. Read More

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http://dx.doi.org/10.1016/j.ejogrb.2020.05.031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239021PMC

[Clinical investigation in the methods for complete placenta previa labor induction in the second trimester].

Zhonghua Fu Chan Ke Za Zhi 2020 May;55(5):317-321

Department of Obstetrics and Gyneclogy, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Critical Care Center of Pregnant Women, Guangzhou 510150, China.

To investigate the appropriate method of labor induction in the second trimester for complete placenta previa patients. The labor induction outcomes of 85 cases with complete placenta previa in the second trimester were retrospectively analyzed. Twenty patients in group A were treated with cesarean section, 30 patients in group B were treated with ethacridine and mifepristone combined with uterine artery embolization (UAE), and 35 patients in group C were induced by using ethacridine and mifepristone. Read More

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http://dx.doi.org/10.3760/cma.j.cn112141-20191124-00639DOI Listing

Patient Medication Adherence Among Pharmacies Participating in a North Carolina Enhanced Services Network.

J Manag Care Spec Pharm 2020 Jun;26(6):718-722

University of Minnesota College of Pharmacy, Minneapolis.

Background: Improving medication adherence can reduce health care spending, and studies have demonstrated community pharmacists can positively affect adherence through the provision of enhanced services. The North Carolina (NC) Community Pharmacy Enhanced Services Network (CPESN) was formed in early 2014 with the goal of enhancing the care provided through its network pharmacies.

Objective: To evaluate differences in medication adherence performance scores between pharmacies that participated in the NC-CPESN and control pharmacies in NC that did not. Read More

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http://dx.doi.org/10.18553/jmcp.2020.26.6.718DOI Listing

Nanostructured Fibers Containing Natural or Synthetic Bioactive Compounds in Wound Dressing Applications.

Materials (Basel) 2020 May 23;13(10). Epub 2020 May 23.

Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Eroii Sanitari St. 8, 050474 Bucharest, Romania.

The interest in wound healing characteristics of bioactive constituents and therapeutic agents, especially natural compounds, is increasing because of their therapeutic properties, cost-effectiveness, and few adverse effects. Lately, nanocarriers as a drug delivery system have been actively investigated and applied in medical and therapeutic applications. In recent decades, researchers have investigated the incorporation of natural or synthetic substances into novel bioactive electrospun nanofibrous architectures produced by the electrospinning method for skin substitutes. Read More

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http://dx.doi.org/10.3390/ma13102407DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287851PMC

Work-Family Conflict among Iranian Emergency Medical Technicians and Its Relationship with Time Management Skills: A Descriptive Study.

Emerg Med Int 2020 11;2020:7452697. Epub 2020 May 11.

Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

Background: Work-Family Conflict (WFC) is a form of interrole conflict in which an active participation in occupational activities causes strain and interferes with family roles of workers and vice versa. It is a major source of occupational stress among workers and personnel. Emergency Medical Technicians (EMTs) are an important part of the healthcare system that respond to emergencies. Read More

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http://dx.doi.org/10.1155/2020/7452697DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238339PMC

Decision support tool and suggestions for the development of guidelines for the helicopter transport of patients with COVID-19.

Scand J Trauma Resusc Emerg Med 2020 May 25;28(1):43. Epub 2020 May 25.

LifeFlight Retrieval Medicine, PO box 15166, City East, QLD, 4002, Australia.

The novel coronavirus SARS-CoV2 emerged in December 2019 and is now pandemic. Initial analysis suggests that 5% of infected patients will require critical care, and that respiratory failure requiring intubation is associated with high mortality.Sick patients are geographically dispersed: most patients will remain in situ until they are in need of critical care. Read More

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http://dx.doi.org/10.1186/s13049-020-00736-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247287PMC

Incidence, clinical outcomes, and transmission dynamics of severe coronavirus disease 2019 in California and Washington: prospective cohort study.

BMJ 2020 May 22;369:m1923. Epub 2020 May 22.

The Care Management Institute, Kaiser Permanente, Oakland, California 94612.

Objective: To understand the epidemiology and burden of severe coronavirus disease 2019 (covid-19) during the first epidemic wave on the west coast of the United States.

Design: Prospective cohort study.

Setting: Kaiser Permanente integrated healthcare delivery systems serving populations in northern California, southern California, and Washington state. Read More

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http://dx.doi.org/10.1136/bmj.m1923DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243800PMC

How the COVID-19 infection tsunami revolutionized the work of respiratory physiotherapists: an experience from Northern Italy.

Monaldi Arch Chest Dis 2020 May 19;90(2). Epub 2020 May 19.

Cardiac Rehabilitation, ICS Maugeri IRCCS, Institute of Lumezzane.

Due to COVID-19 outbreak, to lighten the burden of acute and critical care hospitals, some respiratory rehabilitation departments have been used to host patients with COVID-19 in the post-acute phase. This new and unexpected situation required a change of roles and scheduling of the rehabilitation teams. In this manuscript we describe the unexpected and urgent organizational change of the Cardio-Pulmonary Rehabilitation (CPR) service during the COVID-19 emergency in a Northern Italian rehabilitation hospital, focusing on the Respiratory Physiotherapists' (RPTs) role. Read More

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http://dx.doi.org/10.4081/monaldi.2020.1085DOI Listing

Improving the usefulness of evidence concerning the effectiveness of implementation strategies for knowledge products in primary healthcare: protocol for a series of systematic reviews.

Syst Rev 2020 May 19;9(1):112. Epub 2020 May 19.

Health and Social Services Systems, Knowledge Translation and Implementation Component of the Quebec SPOR SUPPORT Unit, Laval University, Quebec, Quebec, Canada.

Background: The literature on the implementation of knowledge products is extensive. However, this literature is still difficult to interpret for policymakers and other stakeholders when faced with choosing implementation strategies likely to bring about successful change in their health systems. This work has the particularity to examine the scope of this literature, and to clarify the effectiveness of implementation strategies for different knowledge products. Read More

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http://dx.doi.org/10.1186/s13643-020-01382-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236932PMC

Intracranial emergencies during pregnancy requiring urgent neurosurgical treatment.

Clin Neurol Neurosurg 2020 May 12;195:105905. Epub 2020 May 12.

Department of Neurosurgery, Hannover Medical School, Hannover, Germany.

Objective: Despite contemporary diagnostic and therapeutic techniques intracranial emergencies in the obstetric setting pose still a major challenge for the clinicians. There are limited guidelines and differing ethical views. Multidisciplinary teams are needed to support the pregnant woman in a way that she can deliver a viable and healthy child. Read More

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http://dx.doi.org/10.1016/j.clineuro.2020.105905DOI Listing

Augmentation of labor with oxytocin and its association with delivery outcomes: A large-scale cohort study in 12 public hospitals in Nepal.

Acta Obstet Gynecol Scand 2020 May 19. Epub 2020 May 19.

Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Introduction: The use of oxytocin to augment labor is increasing in many low-resource settings; however, little is known about the effects of such use in contexts where resources for intrapartum monitoring are scarce. In this study, we sought to assess the association between augmentation of labor with oxytocin and delivery outcomes.

Material And Methods: We conducted a cohort study in 12 public hospitals in Nepal, including all deliveries with and without augmentation of labor with oxytocin, but excluding elective cesarean sections, women with missing information on augmentation of labor, and women without fetal heart rate on admission. Read More

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http://dx.doi.org/10.1111/aogs.13919DOI Listing

Has COVID-19 played an unexpected "stroke" on the chain of survival?

J Neurol Sci 2020 07 6;414:116889. Epub 2020 May 6.

Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste - ASUGI, University of Trieste, Strada di Fiume, 447, 34149 Trieste, Italy.

Background: The COVID-19 pandemics required several changes in stroke management and it may have influenced some clinical or functional characteristics. We aimed to evaluate the effects of the COVID-19 pandemics on stroke management during the first month of Italy lockdown. In addition, we described the emergency structured pathway adopted by an Italian University Hub Stroke Unit in the cross-border Italy-Slovenia area. Read More

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http://dx.doi.org/10.1016/j.jns.2020.116889DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201240PMC

'Your country needs you': the ethics of allocating staff to high-risk clinical roles in the management of patients with COVID-19.

J Med Ethics 2020 Jul 14;46(7):436-440. Epub 2020 May 14.

Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK.

As the COVID-19 pandemic impacts on health service delivery, health providers are modifying care pathways and staffing models in ways that require health professionals to be reallocated to work in critical care settings. Many of the roles that staff are being allocated to in the intensive care unit and emergency department pose additional risks to themselves, and new policies for staff reallocation are causing distress and uncertainty to the professionals concerned. In this paper, we analyse a range of ethical issues associated with changes to staff allocation processes in the face of COVID-19. Read More

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http://dx.doi.org/10.1136/medethics-2020-106284DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246092PMC

Vaginal delivery or caesarean section - Severity of early symptoms of postpartum depression and assessment of pain in Polish women in the early puerperium.

Midwifery 2020 Aug 7;87:102731. Epub 2020 May 7.

Clinical Ward of Obstetrics and Gynecology, Department of Women's Health in Ruda Śląska, Medical University of Silesia, W. Lipa Street 2, Ruda Śląska, Poland. Electronic address:

Objectives: The primary objective of this study is to examine the differences between women following vaginal delivery and caesarean section (elective or emergency) in terms of early symptoms of postpartum depression, and to evaluate pain during labour and in the early puerperium. An additional goal was to determine if pain evaluation is associated with depressive symptoms.

Materials And Methods: A cross-sectional study was conducted among 224 women in the early puerperium recruited from a public hospital in Poland, who were divided into three groups by method of delivery: caesarean section - elective and emergency, and a vaginal delivery. Read More

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http://dx.doi.org/10.1016/j.midw.2020.102731DOI Listing

Obstetric triage systems: a systematic review of measurement properties (Clinimetric).

BMC Pregnancy Childbirth 2020 May 6;20(1):275. Epub 2020 May 6.

Midwifery Department, Social Determinants of Health Research Center, Tabriz University of Medical sciences, Tabriz, Iran.

Background: Since labor and delivery units often serve as emergency units for pregnant women, the use of obstetric triage systems with poor or inadequate quality can lead to unintended consequences such as over and under-triage and so a waste of humans and financial resources. Therefore, this systematic review was conducted to evaluate the measurement properties of obstetric triage tools.

Methods: PubMed, EMBASE, and Medline were searched to identify studies in October 2018 and were updated in May 2019. Read More

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http://dx.doi.org/10.1186/s12884-020-02974-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203833PMC
May 2020
2.190 Impact Factor

Is it home delivery or health facility? Community perceptions on place of childbirth in rural Northwest Tanzania using a qualitative approach.

BMC Pregnancy Childbirth 2020 May 6;20(1):270. Epub 2020 May 6.

Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive, NW, Calgary, AB, Canada.

Background: In low and middle-income countries, pregnancy and delivery complications may deprive women and their newborns of life or the realization of their full potential. Provision of quality obstetric emergency and childbirth care can reduce maternal and newborn deaths. Underutilization of maternal and childbirth services remains a public health concern in Tanzania. Read More

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http://dx.doi.org/10.1186/s12884-020-02967-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201655PMC
May 2020
2.190 Impact Factor

Towards scheduled pre-parturient caesarean sections in bitches.

Reprod Domest Anim 2020 May 6. Epub 2020 May 6.

Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.

Elective caesarean section (CS) is the safest means of delivering the litter in bitches in specific situations. Timeously performing elective pre-parturient CSs at a fixed time would be convenient and prevent emergency CSs and foetal demise. This review proposes a method of performing elective pre-parturient CSs which is safe for both the bitch and puppies. Read More

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http://dx.doi.org/10.1111/rda.13669DOI Listing

Burnout and job satisfaction among emergency and intensive care providers in a public hospital.

Rev Bras Med Trab 2019 15;17(3):300-312. Epub 2020 Apr 15.

Department of Preventive and Social Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.

Background: New technologies and inadequate management of work might have negative impact on the mental health of workers.

Objective: To investigate factors associated with the prevalence of burnout and levels of job satisfaction among emergency department and intensive care providers in a large public hospital.

Methods: Cross-sectional study with 91 healthcare workers, who were administered the self-report questionnaires Maslach Burnout Inventory - Human Services Survey (MBI-HSS) and Job Satisfaction Scale (JSS20/23). Read More

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http://dx.doi.org/10.5327/Z1679443520190404DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195890PMC

Trends Among Rural and Urban Medicare Beneficiaries in Care Delivery and Outcomes for Acute Stroke and Transient Ischemic Attacks, 2008-2017.

JAMA Neurol 2020 May 4. Epub 2020 May 4.

Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts.

Importance: Over the last decade or so, there have been substantial investments in the development of stroke systems of care to improve access and quality of care in rural communities. Whether these have narrowed rural-urban disparities in care is unclear.

Objective: To describe trends among rural and urban patients with acute ischemic stroke or transient ischemic attack in the type of health care centers to which patients were admitted, what care was provided, and the outcomes patients experienced. Read More

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http://dx.doi.org/10.1001/jamaneurol.2020.0770DOI Listing

Mitigating the Psychological Impact of COVID-19 on Healthcare Workers: A Digital Learning Package.

Int J Environ Res Public Health 2020 04 26;17(9). Epub 2020 Apr 26.

REMEDI Emergency Department, Royal Derby Hospital, Uttoxeter Rd, Derby DE22 3NE, UK.

The coronavirus pandemic (COVID-19) will undoubtedly have psychological impacts for healthcare workers, which could be sustained; frontline workers will be particularly at risk. Actions are needed to mitigate the impacts of COVID-19 on mental health by protecting and promoting the psychological wellbeing of healthcare workers during and after the outbreak. We developed and evaluated a digital learning package using Agile methodology within the first three weeks of UK outbreak. Read More

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http://dx.doi.org/10.3390/ijerph17092997DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246821PMC

Understanding health professional role integration in complex adaptive systems: a multiple-case study of physician assistants in Ontario, Canada.

BMC Health Serv Res 2020 Apr 29;20(1):365. Epub 2020 Apr 29.

Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.

Background: To meet the complex needs of healthcare delivery, the Ministry of Health and Long Term Care (MOHLTC) introduced Physician Assistants (PAs) into the Ontario health care system in 2006 with the goal of helping to increase access to care, decrease wait times, improve continuity of care and provide a flexible addition to the healthcare workforce. The characterization of healthcare organizations as complex adaptive systems (CAS) may offer insight into the relationships and interactions that optimize and restrict successful PA integration. The aim of this study is to explore the integration of PAs across multiple case settings and to understand the role of PAs within complex adaptive systems. Read More

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http://dx.doi.org/10.1186/s12913-020-05087-8DOI Listing
April 2020
1.659 Impact Factor

Uterine didelphys with dicavitary twin gestation: A case report.

Case Rep Womens Health 2020 Jul 3;27:e00199. Epub 2020 Apr 3.

Department of Obstetrics and Gynaecology, Nepean Hospital, Penrith, Australia.

Uterine didelphys is a rare type of congenital uterine anomaly resulting from incomplete fusion of the paramesonephric ducts during embryogenesis. We report the case of a 27-year-old multiparous woman who presented with ovulation-induced dicavitary dichorionic diamniotic twins in known uterine didelphys. At 29 + 5 weeks of gestation, the patient had preterm prelabour rupture of membranes followed by threatened preterm labour in the right uterus only, which settled with tocolysis. Read More

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http://dx.doi.org/10.1016/j.crwh.2020.e00199DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7163069PMC

Leg massage during pregnancy with unrecognized deep vein thrombosis could be life threatening: a case report.

BMC Pregnancy Childbirth 2020 Apr 22;20(1):237. Epub 2020 Apr 22.

Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.

Background: Traditional massage seems to be safe but not entirely risk free, though serious adverse events are very rare. This report is aimed at illustrating a rare but fatal presentation of massive pulmonary embolism caused by leg massage and also to encourage both massage providers and pregnant women to be aware of undetected or subtle deep vein thrombosis, which could be a life threatening condition as a consequence of leg massage.

Case Presentation: A 25-year-old primigravid Thai woman underwent massage at a traditional massage shop at 25th week of gestation. Read More

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http://dx.doi.org/10.1186/s12884-020-02924-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7178622PMC

High dose and low dose oxytocin regimens as determinants of successful labor induction: a multicenter comparative study.

BMC Pregnancy Childbirth 2020 Apr 21;20(1):232. Epub 2020 Apr 21.

Department of Epidemiology, Jimma University, Jimma, Ethiopia.

Background: Induction of labor by Oxytocin is a routine obstetric procedure. However, little is known regarding the optimal dose of oxytocin so as to bring successful induction. This study was aimed at comparing the effects of high dose versus low dose oxytocin regimens on success of labor induction. Read More

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http://dx.doi.org/10.1186/s12884-020-02938-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7175564PMC
April 2020
2.190 Impact Factor

Perinatal outcomes of cesarean deliveries in Sierra Leone: A prospective multicenter observational study.

Int J Gynaecol Obstet 2020 Apr 19. Epub 2020 Apr 19.

Institute of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.

Objective: To analyze the indications for cesarean deliveries and factors associated with adverse perinatal outcomes in Sierra Leone.

Methods: Between October 2016 and May 2017, patients undergoing cesarean delivery performed by medical doctors and associate clinicians in nine hospitals were included in a prospective observational study. Data were collected perioperatively, at discharge, and during home visits after 30 days. Read More

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http://dx.doi.org/10.1002/ijgo.13172DOI Listing

The nature and activity of liaison mental services in acute hospital settings: a multi-site cross sectional study.

BMC Health Serv Res 2020 Apr 15;20(1):308. Epub 2020 Apr 15.

Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.

Background: To describe the clinical activity patterns and nature of interventions of hospital-based liaison psychiatry services in England.

Methods: Multi-site, cross-sectional survey. 18 acute hospitals across England with a liaison psychiatry service. Read More

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http://dx.doi.org/10.1186/s12913-020-05165-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7157982PMC