Safe motherhood in crisis; threats, opportunities, and needs: a qualitative study.

BACKGROUND: The coronavirus disease (COVID)-19 pandemic has affected many aspects of life, including pregnancy, childbirth, and safe motherhood so that pregnancy and childbirth take place in completely novel and unusual conditions for people. Therefore, we aimed to determine the opportunities, threats, and needs of pregnant women during a crisis. METHODS: The present qualitative study was conducted among women who had a history of pregnancy and childbirth during the COVID-19 pandemic period in 2022. The data were collected by conducting face-to-face, semi-structured and in-depth interviews with 20 purposefully selected participants. Interviews continued until data saturation was attained. Data were analyzed through conventional qualitative content analysis based on the Graneheim and Lundman approach. RESULTS: The data were categorized under three main themes: 1("Opportunities for safe motherhood in crisis"(2 Sub­themes), 2) "Threats to safe motherhood in crisis"(2 Sub­themes), and 3) "Needs for safe motherhood in crisis" (3 Sub­themes). CONCLUSIONS: Crisis is not always a threat. By developing an awareness of the opportunities, threats, and needs that safe motherhood faced during the COVID-19 crisis, policy makers can identify the existing gaps affecting the health of mothers and take the necessary measures to improve their conditions, experiences, and health in further crises.

Explaining Iranian midwives' experiences of providing healthcare services during the COVID-19 pandemic: a qualitative study.

BACKGROUND: COVID-19 has changed and challenged the way health and maternity care is provided. Midwives are among the first and most influential maternity care providers during the COVID-19 pandemic; however, there is inadequate information about their experiences in providing healthcare services, particularly in Iran. The present study was conducted to explain the midwives' experiences of providing healthcare services during the COVID-19 pandemic in Gorgan. METHODS: The present study was conducted qualitatively through the inductive content analysis method in 2022. Data were collected through semi-structured interviews. A total of 21 individuals were selected as participants using a purposeful method and the maximum diversity strategy. RESULTS: Data analysis led to the emergence of 377 codes, 12 subcategories, and 3 main categories, including, the laborious occupational challenges for midwives during the pandemic, identifying and creating new opportunities for the development of the midwifery profession, and the lack of perceived organizational and social support. CONCLUSIONS: During the COVID-19 pandemic, midwives experienced various challenges in providing healthcare services, yet sacrificed themselves to perform their duties and provide quality care incessantly. The COVID-19 pandemic was a combination of laborious occupational challenges and individual and professional growth opportunities for midwives in Iran. Strong and managed organizational support is essential to overcome the crisis, maintain the workforce, and empower them to deal with future crises.

Comparison of nine heart rate-based models to predict work metabolism of Forest workers.

Predicted work metabolism (WM) from 9 heart rate (HR)-based models were compared to measured WM obtained during work in 39 forest workers. Using measured (i.e. raw) HR in these models can overestimate actual WM since the HR increase associated with body heat accumulation is non-metabolic. Hence, accuracy of WM prediction was assessed on all possible combinations of models using raw HR and corrected HR (thermal component removed) and with five different estimates of maximum work capacity (MWC) for the models that require it as an input. The 50 model combinations produced a wide range of WM estimates. Three models using individual calibration produced the lowest RMSE and narrowest LoA with corrected HR (rRMSE ≤13%; LoA [rBias <5% ± 25%]). One of the models that requires neither determination of the thermal component nor individual calibration performed very well (rRMSE = 18%; LoA [rBias = 1% ± 36%]). Practitioner Summary: These results provide a better understanding of the accuracy of various HR-based work metabolism (WM) estimation models. This information should prove particularly useful to ergonomics professionals wishing to select a method that provides accurate estimation of WM from HR measurements during work in varied thermal environments. Abbreviations: BMI: body mass index; HR: heart rate (beats per min); HR99: HR value exceeded during 99% of the duration of the HR recording period; HRcorr: heart rate without thermal pulses; HRraw: measured heart rate; HRres: heart rate reserve; HRrest: heart rate at rest; LoA: limits of agreement; Mrest: resting metabolism; MWC: maximum work capacity; RMSE: root mean square error; VO2: oxygen consumption; VO2 max: maximum oxygen consumption; WM: work metabolism.

"Konkoor Giant", a narrative of high school female students from Gorgan, Iran.

Background The university entrance exam or Konkoor is a determining event for the Iranian adolescents and their families. It is considered as the most important opportunity for adolescents for creating their ideal futures. Hence, regarding the importance of this exam and its accompanying pressures during the critical and stressful adolescence period, this study describes adolescents' perspective about what make them worried about the university entrance exam. Methods This study is based on responses of 500 high school female students to an open-ended question completed in their class. In total 482 adolescents wrote down their answers. Using quantitative content analysis, these statements were analyzed. Results The findings showed that three categories including "individual" category (87.90%) with three subcategories; Konkoor's outcome, readiness for Konkoor, self-blame, and "family" category (7.12%) with three subcategories; consequences of failure, family expectations, family conflicts, and "religious- socioeconomic" category (4.98%) with three subcategories; religion, financial status, educational policies as the main adolescents concern sources about the university entrance exam. Conclusion Considering the high concerns of female adolescents about the university entrance exam and the pressures that they receive from their families, society, and even themselves, modifying the educational policies, applying some measures to promote knowledge, and gaining required skills to deal with different aspects of such concerns are necessary for adolescents and their parents.

A longitudinal prospective study of bleeding diathesis in Egyptian pediatric patients: single-center experience.

Keeping an updated registry of bleeding disorders is crucial for planning care and documenting prevalence. We aimed to assess the prevalence of various bleeding disorders including rare inherited coagulation and platelet disorders concerning their clinico-epidemiological, diagnostic data and bleeding manifestations severity. Patients suffering from manifestations of bleeding or coagulation disorders presented to Hematology Clinic during 16 years were included and prospectively followed up. Demographics, clinical characteristics, complete blood count, bleeding, prothrombin and activated partial thromboplastin times, platelet aggregation tests and bone marrow aspiration were recorded. Overall 687 patients with bleeding disorders from total 2949 patients were identified. Inherited coagulation defects were found in 27.2%; hemophilia A (70.6%), hemophilia B (13.9%), factor I deficiency (2.3%), factor V deficiency (1.6%), factor X deficiency (4.2%), factor VII deficiency (2.6%), factor XIII deficiency (1.1%), combined factor deficiency (2.1%) and unclassified coagulation disorders in 1.6% of studied patients. Overall 72.7% had diagnosed with platelet disorders; immune thrombocytopenia was the commonest (74.8%), and inherited conditions represent (25.2%) in the following order: Glanzman's thrombasthenia (11.2%), von Willebrand disease (6.6%), Bernard-Soulier syndrome (1%) and Chediak Higashi in 0.4% and unclassified in 6%. Median age of diagnosis of coagulation and platelet disorders were 33 and 72 months. Presenting symptoms of coagulation disorders were: 25.1% post circumcision bleeding, 22.5% ecchymosis, 20.9% hemoarthrosis and 15% epistaxis. Symptoms of rare coagulation disorders were postcircumcision bleeding (20%), bleeding umbilical stump (20%), epistaxis (12%), hemoarthrosis (8%) and hematomas (4%). Presenting symptoms in rare inherited platelet disorders were purpura, ecchymosis, epistaxis and bleeding gums, respectively. Analysis of the clinico-epidemiological data of patients with bleeding disorders is a useful tool for monitoring and improving their quality of care.