bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi-Disaster Hazard Analysis, The Case of Elazığ Province
Authors: Canpolat Fethi Ahmet
Published: July 2024

In this study, a comprehensive assessment of disaster hazards in Elazığ province, where the Eastern Anatolian Fault Zone passes through, was conducted. Hazard maps for earthquakes, floods, landslides, rockfalls, avalanches, desertification, and erosion were integrated to create a multi-hazard map. Various methods, such as the Analytic Hierarchy Process (AHP) and machine learning models, including the Random Forest algorithm, were employed to assess the severity and probability of exposure for each hazard type. Independent variables, including VS30, liquefaction potential, Digital Elevation Model (DEM)-derived data, and climatic data, were selected based on relevant literature and the study area. For earthquake and erosion hazards, intuitive models were used due to the absence of a single dependent variable. The desertification map was obtained from the Ministry of Environment, Urban Planning, and Climate Change. The Random Forest model was used for other disaster hazard maps. All hazard maps were combined using a hierarchical approach with the Weighted Overlay tool. The study generated a spatial synthesis and database intended to offer proactive insights into disaster preparedness, optimizing resource allocation, and expediting recovery efforts post-disaster within the Elazığ Province. Its primary objective is to provide assistance to local authorities and emergency response teams. In the province, a significant portion of urban settlements and the majority of rural areas face high earthquake hazards. Floods pose a considerable risk, particularly in low-lying areas downstream of numerous dams scattered across the province, as well as at the confluence points of seasonal riverbeds. The hazard of landslides is high in the rugged areas along the EAF and in steep terrains eroded by rivers. Moreover, rock falls occur more frequently in mountainous areas along the Hazarbaba-Akdağ axis due to erosion and physical dissolution. Erosion and desertification represent significant slow-moving hazards, with erosion intensifying on steep slopes and barren lands, while desertification notably affects Baskil and its surrounding low-lying areas in the western part of the province. Considering multiple hazards, areas with concentrated settlements and economic activities such as Elazığ, Baskil, Kovancılar, Karakoçan, and Behrimaz plains are categorized as very high and high-risk zones.
Bartın İlinin İklim Sınıflarının Belirlenmesi ve CBS Tabanlı İklim Sınır Haritalarının Oluşturulması
Authors: Keskin Çıtıroğlu Hülya , Arca Deniz
Published: July 2024

İklim, bir bölge için uzun bir süre boyunca gözlemlenen meteorolojik olayların ortalamasını ve hava koşullarını ifade etmektedir. İklim konusunda uzman pek çok araştırmacı tarafından çeşitli sınıflandırmalar yapılmıştır. Bu sınıflandırmalarda temel hedef iklim türlerini tespit ederek araştırılan ortamların benzerliklerini belirlemektir. İklim özelliklerinin tespiti, iklim sınırlarının bilinmesine; bu durum da o yöredeki kaynakların sürdürülebilirliğine ve arazi kullanım planlarının hazırlanmasına katkı sağlamaktadır. Sürdürülebilir bölgesel kaynaklar ve doğrudan arazi kullanım planlarının sağlanması için farklı iklim türlerinin sınırlarının belirlenmesi esastır. Bu çalışmada, iklim kaynaklı sorunların önlenebilmesi amacıyla iklim sınırlarının belirlenmesi hedeflenmiştir. Bu amaçla bu çalışmada, ileride yapılacak planlamalara altlık olması ve planlamalarda yararlanılabilmesi amaçlarıyla, Bartın ili (Amasra, Kurucaşile, Merkez İlçe ve Ulus) iklim sınır haritalarının oluşturulması esas alınmıştır. Bu nedenlerle Bartın ilinin ilçelerinde bulunan dört adet meteorolojik istasyona ait son otuz yıllık döneme ait ölçüm verileri ile Thornthwaite iklim sınıflama yöntemi kullanılarak her bir ilçe istasyonunun su bilançosu hesaplanmış, Thornthwaite, Trewartha, Erinç, De Martonne, Köppen ve Trewartha iklim sınıflama yöntemleri kullanılarak da iklim tipleri tespit edilmiştir. Daha sonra konumla ilişkilendirilen veriler, Kriging enterpolasyon metodu uygulanarak Coğrafi Bilgi Sistemi (CBS) tabanlı iklim sınır haritaları üretilmiştir.
Blood-derived products can moderate the activity of neutrophils isolated after biomaterial implantation in a sheep model
Authors: NGOC DOMINIKA NGUYEN , DRZEWIECKA BEATA , JUNKUSZEW ANDRZEJ , PATKOWSKI KRZYSZTOF , SZPONDER TOMASZ , SZYMCZAK BARTŁOMIEJ , NOWAKIEWICZ ANETA , PODWYSOCKA SANDRA , WESSELY-SZPONDER JOANNA
Published: July 2024

Neutrophils play a pivotal role in both the inflammatory phase and subsequent repair processes, making their activity crucial after contact with biomaterials. Excessive neutrophil activation can lead to complications, including implant rejection, highlighting the importance of modulating their activity. This study investigates the long-term interaction of circulating ovine neutrophils with titanium (Ti) and silicon-doped layer (Si-DLC) coated implants. Additionally, the effects of platelet-rich plasma (PRP), platelet-poor plasma (PPP), and antimicrobial neutrophil crude extract (ANE) on neutrophil activity were assessed. Twelve female sheep were divided into Ti, Si-DLC implant and a control group. Neutrophils were stimulated with PRP, PPP, ovine ANE (oANE), or rabbit ANE (rANE), and their enzymatic activity and reactive oxygen and nitrogen species (RONS) generation were evaluated. Hematological parameters were also analyzed. Results showed no adverse effects at implant sites, and all hematological parameters remained within reference values. Ti and Si-DLC implants did not alter neutrophil activity. PRP significantly increased neutrophil activity and RONS production, while PPP decreased activity. oANE reduced enzymatic activity and RONS generation, indicating potential antiinflammatory effects. rANE showed varied effects on neutrophil function. Both ANEs lacked antimicrobial activity against tested pathogens. This study demonstrates the hemocompatibility of Ti and Si-DLC implants and highlights the potential of blood-derived products in modulating the inflammatory response to implants.
The interaction between teachers' efficacy and students' attitudes toward effective learning in state universities and colleges of the Philippines
Authors: Lazo Kristian Paul M. ,   College of Education, Isabela State University Echague Campus, Isabela State University, Isabela, Philippines
Published: July 2024

The role of classroom teachers significantly influences student learning and is essential for the success or failure of an educational system. This study assessed how teacher characteristics, self-confidence in teaching, and student attitudes toward learning relate to each other in State Universities and Colleges (SUCs) in Region 02. Teacher effectiveness is seen as a crucial element in education that can positively affect student academic achievement. The research included 348 faculty members and 646 students from four universities, collecting data through a modified questionnaire via online and face-to-face surveys. It found notable differences in how faculty members viewed their own teaching confidence based on their characteristics, which included their abilities in teaching, motivation, managing the classroom, handling behavior, teaching methods, and motivational techniques. The study also noted significant variations in student attitudes towards learning, classified by their learning nature, openness, expectations, and anxiety about learning. It was observed that teaching methods that highlight understanding rather than memorization directly link to positive student attitudes toward learning, suggesting that learning is not just about innate ability. This indicates a need for teachers to enhance their teaching methods using various approaches and platforms.
The Portrayal of Cesarean Section on Instagram: Mixed Methods Social Media Analysis
Authors: Zahroh Rana Islamiah , Cheong Marc , Hazfiarini Alya , Vazquez Corona Martha , Ekawati Fitriana Murriya , Emilia Ova , Homer Caroline SE , Betrán Ana Pilar , Bohren Meghan A
Published: July 2024

Background

Cesarean section (CS) rates in Indonesia are rapidly increasing for both sociocultural and medical reasons. However, there is limited understanding of the role that social media plays in influencing preferences regarding mode of birth (vaginal or CS). Social media provides a platform for users to seek and exchange information, including information on the mode of birth, which may help unpack social influences on health behavior.

Objective

This study aims to explore how CS is portrayed on Instagram in Indonesia.

Methods

We downloaded public Instagram posts from Indonesia containing CS hashtags and extracted their attributes (image, caption, hashtags, and objects and texts within images). Posts were divided into 2 periods—before COVID-19 and during COVID-19—to examine changes in CS portrayal during the pandemic. We used a mixed methods approach to analysis using text mining, descriptive statistics, and qualitative content analysis.

Results

A total of 9978 posts were analyzed quantitatively, and 720 (7.22%) posts were sampled and analyzed qualitatively. The use of text (527/5913, 8.91% vs 242/4065, 5.95%; P<.001) and advertisement materials (411/5913, 6.95% vs 83/4065, 2.04%; P<.001) increased during the COVID-19 pandemic compared to before the pandemic, indicating growth of information sharing on CS over time. Posts with CS hashtags primarily promoted herbal medicine for faster recovery and services for choosing auspicious childbirth dates, encouraging elective CS. Some private health facilities offered discounts on CS for special events such as Mother’s Day and promoted techniques such as enhanced recovery after CS for comfortable, painless birth, and faster recovery after CS. Hashtags related to comfortable or painless birth (2358/5913, 39.88% vs 278/4065, 6.84%; P<.001), enhanced recovery after CS (124/5913, 2.1% vs 0%; P<.001), feng shui services (110/5913, 1.86% vs 56/4065, 1.38%; P=.03), names of health care providers (2974/5913, 50.3% vs 304/4065, 7.48%; P<.001), and names of hospitals (1460/5913, 24.69% vs 917/4065, 22.56%; P=.007) were more prominent during compared to before the pandemic.

Conclusions

This study highlights the necessity of enforcing advertisement regulations regarding birth-related medical services in the commercial and private sectors. Enhanced health promotion efforts are crucial to ensure that women receive accurate, balanced, and appropriate information about birth options. Continuous and proactive health information dissemination from government organizations is essential to counteract biases favoring CS over vaginal birth.
Bridging Language Barriers in COVID-19 Research: Descriptive Study of AccesoCovid.com’s Reach and User Engagement
Authors: Abascal Miguel Lucía , Forster Maeve , Gallalee Sarah , Carson Mariam , Fieldhouse Jane K , Keir Alexandra , Maya Sigal , Rahman Sabahat , Reid Michael J A , Vasilopoulos Hariclea , Lima Sanchez Dania Nimbe
Published: July 2024

Background

The COVID-19 pandemic underscored the challenge of swiftly disseminating research findings to a global audience. Language barriers further exacerbated disparities in access to timely scientific information, particularly for non-English speaking communities. The majority of COVID-19 research was published in English, limiting accessibility for Spanish-speaking populations.

Objective

This paper aims to assess the reach and effectiveness of AccesoCovid.com, a platform designed to disseminate up-to-date COVID-19 research in both English and Spanish, addressing the language gap in scientific communication.

Methods

AccesoCovid.com was developed through a partnership between the University of California, San Francisco (UCSF) and Universidad Nacional Autónoma de México (UNAM). The website’s performance and user engagement were evaluated using Google Analytics over a span of 2 years. Key metrics included user language preference, geographical distribution, and site traffic. The website summarized and translated 1032 articles on various COVID-19 topics, such as “Pharmaceutical Interventions and Vaccines.”

Results

From February 2021 to February 2023, the platform attracted 57,000 users. Of the 43,000 unique new visitors, 84.2% (n=36,219) hailed from Spanish-speaking regions. The majority accessed the site organically through search engines, with 88.4% (n=38,000) of users arriving this way, while 5000 (11.6%) users accessed the site directly. Most users (n=30,894, 72.1%) preferred the Spanish version of the site. The website’s most accessed category was “Pharmaceutical Interventions and Vaccines,” followed by “Clinical Presentation and Management” and “Mental Health.” Regarding language distribution, 72.1% (n=30,894) of users primarily used Spanish; 21.4% (n=9215) used English; and 6.7% (n=2891) spoke other languages, including Portuguese, Chinese, and German. Geographically, the website attracted visitors from 179 countries, with the highest visitor counts from Mexico (n=12,342, 28.7%), Spain (n=6405, 14.9%), the United States (n=4416, 10.3%), and Peru (n=3821, 8.9%).

Conclusions

AccesoCovid.com successfully bridged a critical language gap in the dissemination of COVID-19 research. Its success underscores the pressing need for multilingual scientific resources. The platform demonstrated significant user engagement and reach, particularly in Spanish-speaking countries. This highlights the potential for similar platforms to ensure equitable access to scientific knowledge across diverse linguistic communities. Future efforts should focus on expanding to other languages and conducting formal evaluations to enhance user satisfaction and impact.
Insights From the Development of a Dynamic Consent Platform for the Australians Together Health Initiative (ATHENA) Program: Interview and Survey Study
Authors: Xiong Eddy , Bonner Carissa , King Amanda , Bourne Zoltan Maxwell , Morgan Mark , Tolosa Ximena , Stanton Tony , Greaves Kim
Published: July 2024

Background

Dynamic consent has the potential to address many of the issues facing traditional paper-based or electronic consent, including enrolling informed and engaged participants in the decision-making process. The Australians Together Health Initiative (ATHENA) program aims to connect participants across Queensland, Australia, with new research opportunities. At its core is dynamic consent, an interactive and participant-centric digital platform that enables users to view ongoing research activities, update consent preferences, and have ongoing engagement with researchers.

Objective

This study aimed to describe the development of the ATHENA dynamic consent platform within the framework of the ATHENA program, including how the platform was designed, its utilization by participants, and the insights gained.

Methods

One-on-one interviews were undertaken with consumers, followed by a workshop with health care staff to gain insights into the dynamic consent concept. Five problem statements were developed, and solutions were posed, from which a dynamic consent platform was constructed, tested, and used for implementation in a clinical trial. Potential users were randomly recruited from a pre-existing pool of 615 participants in the ATHENA program. Feedback on user platform experience was gained from a survey hosted on the platform.

Results

In the 13 consumer interviews undertaken, participants were positive about dynamic consent, valuing privacy, ease of use, and adequate communication. Motivators for registration were feedback on data usage and its broader community benefits. Problem statements were security, trust and governance, ease of use, communication, control, and need for a scalable platform. Using the newly constructed dynamic consent platform, 99 potential participants were selected, of whom 67 (68%) were successfully recontacted. Of these, 59 (88%) agreed to be sent the platform, 44 (74%) logged on (indicating use), and 22 (57%) registered for the clinical trial. Survey feedback was favorable, with an average positive rating of 78% across all questions, reflecting satisfaction with the clarity, brevity, and flexibility of the platform. Barriers to implementation included technological and health literacy.

Conclusions

This study describes the successful development and testing of a dynamic consent platform that was well-accepted, with users recognizing its advantages over traditional methods of consent regarding flexibility, ease of communication, and participant satisfaction. This information may be useful to other researchers who plan to use dynamic consent in health care research.
Thyroid Disease Classification Using Machine Learning Algorithms
Authors: Krishnaveni S. , Poojitha E , Reddy M Anthara , Harshith G
Published: July 2024

Abstract: The thyroid is very important because it helps our body function properly. It does this by secreting special hormones into our bloodstream that control how our body uses energy. Sometimes there may be problems with the thyroid gland secreting too much or too little hormone. This is because not having enough iodine, swelling of the tumor, or the body's immune system attacking the tumor. Doctors can diagnose these problems with blood tests, but sometimes the results may be confusing. Using special technology, doctors can make information easier to understand and detect how a person may have thyroid problems. This analysis includes analysis of the distribution pattern of thyroid disease and data based on the UCI Machine Learning Repository. Detection of thyroid diseases involves machine learning, which plays an vital role in detecting thyroid disease. Using this technique,doctors can better understand and treat thyroid problems.
Haptic Feedback: Definition and Applications
Authors: Dutta Rohan
Published: July 2024

Abstract: Haptic feedback refers to the use of touch and vibrations to communicate sensations or feelings to a user. Here in this paper we are going to dive deep into what is haptic feedback and how this technology is being implemented in VR systems.
Experimental Investigation on Concrete with Zeolite Powder, Silica Fume and Cashew Nut Shell Ash
Authors: Chaitanya J. Sree Naga , Sahera Sk. , Chandramouli Dr. K. , Srikanth B.N L
Published: July 2024

Abstract: This experimental investigation explores the impact of incorporating zeolite powder as a partial replacement for fine aggregate, along with silica fume and cashew nut shell ash (CNSA) as partial replacements for cement in concrete. Zeolite, a natural aluminosilicate mineral, is known for its pozzolanic properties, which can enhance the mechanical and durability characteristics of concrete. Silica fume, a byproduct of silicon and ferrosilicon alloy production, is renowned for its high silica content and fineness, contributing to the strength and density of concrete. Cashew nut shell ash, an agricultural waste product, offers a sustainable alternative to traditional cementitious materials, potentially reducing the environmental footprint of concrete production. This experimental study investigated the effects of partially replacing fine aggregate with zeolite powder (5%,10% and 15%) and cement with silica fume (3%,6%,9%,12% and 15%) and cashew nut shell ash (5%,7.5%,10%,12.5%,15% and 17.5%) on the properties of concrete. This study underscores the viability of using zeolite powder, silica fume, and CNSA in sustainable concrete production, contributing to the development of more environmentally friendly construction materials. Further research is recommended to explore the long-term performance and environmental benefits of these alternative materials in concrete applications.
Investigation of Coaches' Attitudes Towards Teaching Students with Disabilities
Authors: Bacı Abdullah , Çakır Zekai
Published: July 2024

This study aims to determine the attitudes of the trainers while teaching disabled students. Two hundred eighty-two people randomly selected among the trainers working under the Ministry of Youth and Sports in the Black Sea region participated in the research. The participants are 79 female and 203 male trainers working in the youth sports provincial and district directorates of the youth sports ministry. The descriptive method was used in the research. The descriptive method is a situation determination that indicates the current situation. Only one scale was used as a measurement tool. The scale of teachers' attitudes towards teaching disabled students consists of personal information and 22 items. In addition, the scale consists of four sub-dimensions. Attitudes are evaluated in terms of dimensions and overall attitude totals. Scale dimensions are behavioural purpose, subjective norms, perceived behavioural control, attitudes towards behaviour, and general attitude total. Since the data were normally distributed in the analysis of quantitative data, t-tests and ANOVA tests from parametric tests were used. As a result of the research, when the General Attitude Scale score is examined, it is seen that while the trainers' attitudes towards teaching disabled students are positive, some variables that predict these positive attitudes influence the attitudes, while others are not. Although it is seen that the special norm sub-dimension is effective in the effect of the trainers' attitudes, their general attitudes are positive
Vaginal Birth After Cesarean Section: Outcomes of Women Receiving Midwifery Care in Ontario
Authors: Darling Elizabeth K.
Published: July 2024

Providing care to women with a history of cesarean section is within the scope of practice of Canadian midwives, and midwifery care may be of benefit to women who plan a vaginal birth after cesarean section. This retrospective cohort study describes the birth outcomes of women with a history of cesarean section cared for by a midwife in Ontario between April 1, 2003 and March 31, 2008 (n= 3262). The primary outcome was cesarean section, and the secondary outcome was perinatal mortality. The overall rate of cesarean section in this cohort was 46.1%, but among women who laboured the rate of cesarean section was 28.8%. There was not a statistically significant difference in perinatal mortality (excluding congenital anomalies and stillbirth prior to labour) when women with a history of cesarean section (0.18%) were compared to those without (0.20%), p=0.99. This study demonstrates positive outcomes for both mothers and babies when midwives are primary care providers during the intrapartum period for women with a history of cesarean section. There is a need to explore the factors contributing to the high rate of planned repeat cesarean section in this cohort.
Midwives' Belief in Normal Birth: The Canadian Survey of Maternity Care Providers’ Attitudes Toward Labour and Birth
Authors: McNiven Patricia , Klein Michael C. , Baradaran Nazli , Tomkinson Jocelyn , Hearps Stephen J. C. , Saxell Lee
Published: July 2024

Background: Midwifery has been integrated into the health care systems of over half of Canadian provinces and territories. While there are differences in legislation and payment mechanisms, the model of midwifery is fairly similar across the country. This study examined the similarities and differences among midwives' attitudestowardlabourandbirth. Inaddition,wecompareditemswhichrelatedtobeliefsaboutnormal birth between midwives and other care providers.Methods: A national cross-sectional survey was conducted comparing maternity care providers’ beliefs aboutchildbirthandintra-professionalvariationsinmidwives'attitudestowardsbirth. Therewere400 (54%) midwife respondents: 218 from Ontario, 75 from B.C, 53 from Quebec, 48 from the remaining regulated or pre-regulated provinces (six missed information for this field).Results: All midwives were critical of the routine use of interventions such as episiotomy, epidural analgesia andelectronicfetalmonitoring(EFM). Therewasstrongagreementaboutthesafetyofhomebirth,outof hospital birth centres and the importance of women's autonomy and decision-making in pregnancy and birth. However, some regional variations were identified. Quebec midwives were more opposed to epidural analgesia than BC and Ontario (p<.001), and were more likely to believe that cesarean birth is more costly than vaginal birth (p=.005). Ontario midwives were most likely to believe that cesarean birth protects against urinary incontinence (p=.001), and sexual dysfunction (p=.002). Qualitative comments of midwives indicated a strong desire to reduce unnecessary medical intervention and to lower cesarean section rates.Conclusion: Canadian midwives share similar beliefs regarding place of birth, the routine use of episiotomy, EFM, and epidurals, but reported significant attitudinal differences for other issues. Regional differences may be related to midwives' primary practice settings, the historical development of midwifery in their region and the number of new midwives with less than 5 years of clinical experience. A set of core midwifery values was identified that demonstrate a strong belief in normal birth.
Why Do Midwives Stay? A Descriptive Study of Retention in Ontario Midwives
Authors: Versaevel Nicole
Published: July 2024

This descriptive, exploratory study was designed to examine why Ontario midwives stay in clinical practice. AllregisteredmidwivesintheprovincewereinvitedtocompleteaWebbasedsurveyanda response rate of 37% was ascertained. Descriptive statistics were used to analyze quantitative data while inductive content analysis was employed to analyze qualitative data. Midwives enjoy their work and are highly committed to the profession. Relationships with clients and making a difference through  their work are key factors in retention. Midwives report that autonomy in their work is another mediator of job satisfaction. Important support mechanisms for midwives include: relationships with their partner,colleagues and family. Barriers faced in clinical practice include: the need for greater flexibility in working patterns, as well as, conflict with hospitals with midwifery and/or non-midwifery colleagues. These findings are discussed and recommendations for future research are offered.
A Qualitative Study Exploring Women's Experiences of Unplanned Cesarean Surgery and Their Suggestions for Improving Care
Authors: Robb Karen
Published: July 2024

The rate of unplanned cesarean birth is increasing and there is a growing body of evidence regarding the associated psychosocial harms. A phenomenological study exploring eight women's lived experiences of intrapartum cesarean birth in Nova Scotia was undertaken. Two groups of women were recruited, three receiving care from a midwife with transfer from a planned home birth and five women under the care of a physician. Semi-structured interviews were tape-recorded and transcribed. These data, combined with participantdiariesande-mails,wereanalyzedusingColazzi'smethod. Threemajorthemesemerged:1) Immediate and lingering emotional reactions, which were wide ranging, the majority negative, particularly fear, disappointment and self-doubt, 2) Mediating factors, most significantly, continuous contact with the baby and provider support, especially from midwives, and 3) Participant suggestions for improving care which included prenatal operating room (OR) tours, family-friendly OR policies, postnatal medical review with extended follow-up and peer support. This study adds to the already substantial evidence of associated psychosocial harms which can be mediated by concurrently reducing unnecessary cesarean surgery and implementing measures to improve the quality of cesarean care.
An Analysis of the Healthcare Brain Drain and its Effect on Maternal and Neonatal Health in Developing Countries
Authors: Mennie Jenna
Published: July 2024

Student Article.
Evolution of the Midwifery Education Program in Response to Legislative Amendments to the Midwifery Drug Regulation in Ontario
Authors: Beites Crestina L.
Published: July 2024

Recent new amendments to the Midwifery Drug Regulation in Ontario have given registered midwives in the province the much anticipated and much needed authority to independently prescribe from an extended list of drugs. These legislative changes have steered and focused the pharmacotherapeutics and science curriculum of the Midwifery Education Progam (MEP) in Ontario. The aspects of the curriculum that have evolved with the goal of delivering a solid foundation in the concepts of pharmacotherapeutics in pregnancy and a good understanding in the principles of prescribing in pregnancy are discussed. Perspectives for continuing professional development and competency in pregnancy pharmacotherapeutics are also provided.
Favoriser la santé sexuelle postnatale des couples lors d'un suivi avec sage-femme
Authors: Beauséjour Danielle , Lafrance Josée
Published: July 2024

Un nombre important de nouveaux parents se séparent au cours des premières années suivant la naissance de leur enfant. Les bouleversements rencontrés dans la transition vers la parentalité représentent de réels défis d'adaptation pour les couples et menacent parfois la qualité de l'intimité entre les partenaires. Aborder le sujet de la sexualité avec les couples pendant le suivi de grossesse, les aider à anticiper les difficultés sexuelles associées au postpartum et à l'allaitement et les inviter à prendre soin de leur santé sexuelle à travers toute la période périnatale pourrait être bénéfique pour la stabilité des familles. Dans le contexte d'un suivi périnatal avec sage-femme, quelques outils d'information et de réflexion sont proposés ici pour favoriser la santé sexuelle postnatale.
Using Simple Simulation to Teach Midwifery Skills
Authors: Van Wagner Vicki , Chu Hedrey
Published: July 2024

Simulation has become a vital part of health care education. Growing evidence supports its use to assist students in learning both basic and emergency skills. Expensive simulation models exist and some offer midwifery students excellent learning opportunities. However, many simulations can be highly effective and much more accessible to both students and instructors when handmade from ordinary household objects. Based on experience using simulation as part of the Ryerson Midwifery Education Program curriculum, we describe how to create simple models that can be used in the classroom, with preceptors in the clinical setting or by midwifery students independently. We also explain how we use household objects to augment commercial teaching models to make simulations more realistic.
Student Attrition in the Ontario Midwifery Education Program: A Qualitative Analysis - 1. Personal Issues
Authors: Wilson Rhea , Neiterman Elena , Lobb Derek K.
Published: July 2024

This study identifies some of the factors associated with student withdrawal from the Ontario Midwifery Education Program (OMEP). An Internet-based survey was used to collect data and written comments. Participation was requested from senior-level students, graduates of the program, and students who withdrew prior to graduation. In this qualitative study, we found that commuting and relocation, support and guidance, and the stress of one-on-one preceptor mentorships are areas in which the OMEP could develop interventions to improve student retention.
Who’s the Mother? Midwifery Care in Adoption and ‘Surrogacy’
Authors: Katz Rothman Barbara
Published: July 2024

Article.
Chronic Pain Management in Pregnancy: A Review of the Literature
Authors: Jankiewicz April , Fielder Andrea , Warland Jane
Published: July 2024

Objective: This review summarizes current literature and explores issues involved in the management of pregnant women with chronic pain conditions.
Methods: Articles in this review were selected through searches of Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Library, and MEDLINE databases. “Grey” literature such as cross-references from identified articles, clinical recommendations, professional consensus, bibliographies from review articles, and book chapters were also examined for appropriate material.
Results: The search yielded 18,401 results in total; however, the majority related to management of labour pain, physiological pain in pregnancy, chronic pain in the nonpregnant population, and opioid maintenance in pregnancy for substance- dependent women. These results were therefore excluded. Sixteen relevant articles were included. A lack of high-quality research in the area, a potential for increased maternal and fetal complications, and the need for multidisciplinary input were identified as issues.
Discussion: This is one of the first literature reviews to assess the management of women with chronic pain conditions who become pregnant. Poorly managed chronic pain can have adverse effects on the mother and lead to premature induction of labour and birth of the infant. Despite the apparent risks, there remains an absence of research in this field.
Conclusion: It is imperative that research and clinical education are continued in this field. This will enable health care clinicians to provide women with appropriate, evidence-based options for their prenatal care, as well as effective, ongoing management of chronic pain conditions during pregnancy.

This article has been peer reviewed.
Giving Birth Outside the Health Care System in New Brunswick: A Qualitative Investigation
Authors: LeBlanc Kate , Kornelsen Jude
Published: July 2024

Introduction: There is limited research data on unassisted childbirth (a planned out-of-hospital birth without the attendance of a regulated care provider) in Canada; this means that there is a lack of understanding of its prevalence and of the childbearing women’s motivations. This study aimed to uncover women’s reasons for planning to give birth in the absence of an attendant licensed to practice in New Brunswick, in order to create insight into mainstream maternity care practices through those who have rejected them.
Methods: In-depth qualitative interviewing with women who have had planned home births in New Brunswick in the past 10 years.
Results: Participants had a variety of motivations and influences that played in their decision to have an unassisted home birth, including deeply held beliefs about childbirth and the need to manifest these beliefs in their experiences of birth. Participants expressed their desire to be the locus of control in their childbirth experience and believed they could best accomplish this outside of the hospital setting. Influences included ideological stance toward birth, the attitudes of their families and friends, and birth stories they had heard.
Conclusion: This study demonstrates that when women’s needs are not met by mainstream health services, some will choose to give birth in the absence of a skilled provider or independent attendant. This gives rise to the need for discussion between all care providers and parturient women to better understand unmet needs and unaddressed fears around hospital birth.

This article has been peer reviewed.
A Qualitative Assessment of Factors in the Uptake of Midwifery Among Diverse Populations in Thunder Bay, Ontario
Authors: Møller Helle , Dowsley Martha , Wakewich Pamela , Bishop Lisa , Burnett Kristin , Churchill Mackenzie
Published: July 2024

Introduction: Although the uptake of midwifery in Thunder Bay, Ontario, is above the provincial average, it is well below the World Health Organization–suggested level. Midwifery is especially underutilized by Indigenous women and by recent immigrant, refugee, and asylum-seeking women.
Objective: To explore factors shaping birth-attendant choices and decisions of diverse women in northwestern Ontario.
Methods: Drawing on data from a larger pilot study, this paper discusses factors in choosing midwifery for Indigenous, Euro-Canadian, and visible-minority (VM) women in Thunder Bay. Using in-depth interviews, we explored where the women obtained information regarding birth-attendant options, how and why they chose their caregiver, and their perceptions of the quality of their maternal care experiences.
Results: Participating women’s birth-attendant choices and experiences were influenced by (1) health care provider and/or social network awareness of (and attitudes towards) midwifery; (2) personal knowledge; (3) access to midwifery; and (4) understanding of the pregnancy as being on a medical risk continuum or as a normal, healthy process. Additional influences for VM women include a lack of formally educated midwives and social status gained through having a physician in their country of origin. Additional influences for Indigenous women were the effects of colonization, discrimination, and racism.
Conclusion: Women (particularly VM and Indigenous women), their families, and health care providers in northwestern Ontario need more and easier access to midwives and to knowledge about their services and scope of practice. Also, increased focus on antiracist and culturally safe practice in health care provider curricula would help improve care for Indigenous women.

This article has been peer reviewed.
The Legacy of Midwifery and the Women’s Health Movement in Contemporary Discourses of Patient Choice and Empowerment
Authors: MacDonald Margaret E.
Published: July 2024

This commentary traces the roots of the notion of patient empowerment and patient-centred care to the radical beginnings of the women’s health movement and the feminist critiques of medicalized childbirth. I pay particular attention to the emergence of the concept of informed choice in community midwifery as one of the women’s health movement’s key strategies to combine medical science with women’s own experience to effect the empowerment of women in health care. I also reflect on the limitations of the notions of empowerment and choice as they have been taken up by mainstream health institutions and the health care marketplace-often without acknowledging the contributions of midwifery and the women’s health movement-noting the diminished promise and potentially problematic effects of taking these notions out of their political contexts.

This article has been peer reviewed.
After the Unexpected: Ontario Midwifery Clients’ Experiences of Postpartum Hemorrhage
Authors: Robertson Jenna , Kehler Sophia , Meuser Anna , MacDonald Tasha , Gilbert Jenny , Bennett Suzannah
Published: July 2024

Background: The incidence of postpartum hemorrhage (PPH) varies worldwide. While there is abundant research to guide midwifery practice regarding the acute clinical management of PPH, there is less known about the psychological needs of clients and families following significant blood loss during birth, and no relevant research conducted in a Canadian setting.
Methods: Analysis of qualitative data was conducted based on data from two focus groups and two online surveys with participants who had received midwifery care during at least one pregnancy and had experienced at least one PPH.
Objective: The goal of this research was to describe the experiences of midwifery clients in Ontario who had suffered a PPH and to compare those findings to what is documented in existing literature.
Findings: This study found a range of physical and emotional responses to the experience of PPH, ranging from no effect to short- or longer-term psychological trauma, which is consistent with a small but growing body of international studies. While the risk of delayed lactogenesis increases with PPH, most participants in this study reported no breastfeeding concerns. This study is unique in reporting on creative strategies families developed to cope with PPH.

This article has been peer reviewed.
How I Learned to Love Midwifery and Stop Worrying About Episiotomy
Authors: Klein Michael C.
Published: July 2024

Commentary.
Apple Tree Maternity: A Qualitative Exploration of the Development of a Rural Collaborative Interprofessional Maternity Care Service
Authors: Butt Emma J. , Kornelsen Jude
Published: July 2024

Introduction: There is currently a maternity care crisis in Canada, with many of the obstetricians and family physicians reaching retirement age in the next 10 years. Primary midwifery care services may offer solutions. However, due to the many constraints and difficulties faced by midwives practicing in rural settings, there is an emerging interest in exploring interprofessional collaborative models of maternity care as a possible solution to the crisis. This study documents the process and experiences of care providers in establishing and providing collaborative interprofessional maternity care in rural British Columbia.
Methods: Semistructured interviews were conducted with key stakeholders (primary care providers and allied health professionals) working at Apple Tree Maternity. Interviewees spoke to both the process of establishing a new collaborative interprofessional model of care and the experience of working and providing care within the model.
Findings: Four main themes emerged through the dialogue with the stakeholders: motivation for collaboration; challenges and barriers to collaborative care; attributes and benefits of collaborative care; and core qualities and recommendations for successful interprofessional collaboration. Based on their experience of establishing and working within a new model of collaborative, interprofessional, rural maternity care, the study participants identified core qualities and recommendations for successful interprofessional collaboration in a rural community to be mutual trust and respect; common philosophy of care, mutual commitment, and genuine desire to collaborate; clear and effective communication; ensuring the collaborative model is responsive to the unique needs of specific communities; community support; supportive institutional culture; and alternative payment plans and billing structures.

Conclusion and implications for practice: This study revealed a number of attributes to collaboration that mirror those identified by others. In addition, study participants identified particular challenges unique to the rural context. Further research documenting the care provider experiences of interprofessional collaboration in other rural settings is warranted. In addition, there is also a need to explore and document the experiences of collaborative practice, in both rural and urban settings, from the client perspective. It is only when this is achieved that significant policy change suggestions should be made that will facilitate both collaborative practice and an improvement in care to women in rural settings. The need for this research is vital given the maternity care crisis in British Columbia and the need for supporting sustainable rural maternity care models.

This article has been peer reviewed.
Prison Nurseries: A Review of Maternal and Infant Rooming in Outcomes for Incarcerated Mothers
Authors: Dowling Amanda , Fulton Colleen
Published: July 2024

Women are the fastest growing prison population in Canada, and at incarceration, 4-10 percent of women are pregnant. These women, their correctional facilities, and Canadian health care services are increasingly forced to address the issues of motherhood and reproductive health care during incarceration. Most incarcerated women are separated from their infants soon after birth. The authors claim that prison nurseries, as a harm reduction strategy, are a positive alternative to this separation. Midwives could play a valuable role in these health care units.
Methods: This paper is a literature review examining the outcomes of mother-infant dyads who have access to prison nurseries. The search strategy included 15 health research databases, applying similar search terms to all databases.

This article has been peer reviewed.
The Use of Poke Root in the Treatment of Lactational Mastitis: Practice Patterns among Midwives in British Columbia
Authors: Hodgson Zoë G. , Latka Patrice , Fulford Rachelle , Campbell Allison
Published: July 2024

Introduction: The prevalence of mastitis has been reported as high as 33%. Effective milk removal, pain medication, and antibiotics are the mainstays of treatment. Midwives support the use of complementary and alternative medicines, but few studies have examined their use. This paper explores practice patterns of midwives in British Columbia with respect to the use of poke root, Phytolacca decandra, in the treatment of mastitis.
Methodology: A questionnaire was distributed to all registered midwives in British Columbia asking about their familiarity with poke root, whether they recommend it for treatment of mastitis, how they recommend that it be used, and whether they perceive it as effective in treating mastitis.
Results: A total of 106 questionnaires were returned. Fifty midwives (47.2%) reported using poke root. Over sixty-nine percent of respondents used it as a tincture, 22.4% used it as a homeopathic, and 8.2% used it topically. The dose, route, timing, and duration of use varied; however, there were few perceived side effects, and the satisfaction among midwives was high.
Conclusion: The questionnaire responses demonstrate that a large number of midwives in British Columbia perceive poke root to be effective in treating lactational mastitis. Reported rates of satisfaction with the therapy among midwives were high. The tremendous variability in administration and the lack of known side effects highlight the need for a future study that will examine the effectiveness of poke root to facilitate informed choice discussion.

This article has been peer reviewed.
Are Ontario Midwives Prepared to Respond to Their Clients’ Sexual Concerns? A Survey of Attitudes, Perceived Training, Knowledge, and Comfort
Authors: McCallum Ali , Byers-Heinlein Alyssa , Byers E. Sandra , Pukall Caroline
Published: July 2024

Objective: Sexual health and well-being are vital components of overall health, quality of life, and relationship satisfaction and stability. Midwives have the potential to play an important role in addressing their clients’ sexual health concerns and promoting their sexual health. The goal of this study was to assess the attitudes, perceptions of training, knowledge, and comfort of midwives registered in Ontario with respect to addressing their clients’ sexual concerns.
Methods: We used a cross-sectional online survey (45 mins) of registered midwives in Ontario. An email containing information about the study and a link to the survey was sent to all midwives registered in Ontario in 2016 and members of the Association of Ontario Midwives (AOM) as part of the weekly “Midwife Memo” from the AOM, and was posted on a Canadian midwifery Facebook group. Participants were asked about their training and practice, attitudes toward their role in addressing their clients’ sexual concerns, perception of quality of sexual health training, and sexual knowledge and comfort.
Results: Of the 740 midwives registered in Ontario at the time of the study, 100 submitted responses yielding a response rate of 14%. Results indicated that participants felt strongly that midwives have an important role to play in addressing their clients’ sexual concerns and most participants reported that they would feel very or extremely comfortable addressing each of the 10 sexual health topics. Participants who rated themselves as more knowledgeable and comfortable addressing sexual topics had more positive attitudes toward doing so. However, the results also suggested that some midwives currently are not adequately prepared to take on this role. Many participants perceived gaps in how knowledgeable they would feel in addressing the sexual health topics. The topics that participants were most likely to feel knowledgeable about were postpartum issues, changes in sexuality over the lifespan, sexual health, sexual practices, and biological aspects of sexuality, whereas participants felt least knowledgeable about sex and disability, sexual problems/concerns/dysfunction, and experiences of sexual violence. Moreover, participants felt significantly less knowledgeable than comfortable talking about sexual issues.
Conclusion: These results suggest that midwives would benefit from training that provides them with information about sexual topics, translating this knowledge into practice, and strategies on how to be proactive on these topics in a way that is acceptable to their clients. Such training is likely to also increase midwives’ comfort discussing sexual issues.
Peer-reviewed article.