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Spiritual intelligence: a scoping review on the gateway to mental health. 精神智能:心理健康之门的范围界定审查。
IF 2.2 3区 医学 Q1 Medicine Pub Date : 2024-12-31 Epub Date: 2024-06-21 DOI: 10.1080/16549716.2024.2362310
Cristina Teixeira Pinto, Lúcia Guedes, Sara Pinto, Rui Nunes

Spiritual Intelligence (SI) is an independent concept from spirituality, a unifying and integrative intelligence that can be trained and developed, allowing people to make use of spirituality to enhance daily interaction and problem solving in a sort of spirituality into action. To comprehensively map and analyze current knowledge on SI and understand its impact on mental health and human interactions, we conducted a scoping review following the Joanna Briggs Institute methodology, searching for 'spiritual intelligence' across PubMedCentral, Scopus, WebOfScience, and PsycInfo. Quantitative studies using validated SI instruments and reproducible methodologies, published up to 1 January 2022, were included. Selected references were independently assessed by two reviewers, with any disagreements resolved by a third reviewer. Data were extracted using a data extraction tool previously developed and piloted. From this search, a total of 69 manuscripts from 67 studies were included. Most studies (n = 48) were conducted in educational (n = 29) and healthcare (n = 19) settings, with the Spiritual Intelligence Self Report Inventory (SISRI-24) emerging as the predominant instrument for assessing SI (n = 39). Analysis revealed several notable correlations with SI: resilience (n = 7), general, mental, and spiritual health (n = 6), emotional intelligence (n = 5), and favorable social behaviors and communication strategies (n = 5). Conversely, negative correlations were observed with burnout and stress (n = 5), as well as depression and anxiety (n = 5). These findings prompt a discussion regarding the integration of the SI concept into a revised definition of health by the World Health Organization and underscore the significance of SI training as a preventative health measure.

灵性智能(SI)是一个独立于灵性的概念,是一种可以训练和发展的统一的综合智能,它可以让人们利用灵性来加强日常互动和解决问题,是一种将灵性付诸行动的智能。为了全面梳理和分析有关灵性智能的现有知识,了解其对心理健康和人际交往的影响,我们按照乔安娜-布里格斯研究所的方法进行了一次范围界定综述,在 PubMedCentral、Scopus、WebOfScience 和 PsycInfo 上搜索 "灵性智能"。研究纳入了截至 2022 年 1 月 1 日发表的、使用经过验证的灵性智能工具和可重复方法的定量研究。所选参考文献由两名审稿人独立评估,如有分歧,由第三名审稿人解决。使用之前开发和试用的数据提取工具提取数据。此次检索共收录了 67 项研究的 69 篇手稿。大多数研究(n = 48)是在教育(n = 29)和医疗保健(n = 19)环境中进行的,精神智能自我报告量表(SISRI-24)成为评估精神智能的主要工具(n = 39)。分析表明,以下几种情况与精神智能有明显的相关性:复原力(7 人),一般、心理和精神健康(6 人),情商(5 人),有利的社会行为和沟通策略(5 人)。相反,倦怠和压力(5 人)以及抑郁和焦虑(5 人)则呈负相关。这些研究结果引发了有关将社会融入概念纳入世界卫生组织修订的健康定义的讨论,并强调了社会融入培训作为一种预防性健康措施的重要性。
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引用次数: 0
Form and functioning: contextualising the start of the global financing facility policy processes in Burkina Faso. 形式与运作:布基纳法索启动全球融资机制政策进程的背景。
IF 2.2 3区 医学 Q1 Medicine Pub Date : 2024-12-31 Epub Date: 2024-06-24 DOI: 10.1080/16549716.2024.2360702
Joël Arthur Kiendrébéogo, Orokia Sory, Issa Kaboré, Yamba Kafando, Meghan Bruce Kumar, Asha S George

Background: Burkina Faso joined the Global Financing Facility for Women, Children and Adolescents (GFF) in 2017 to address persistent gaps in funding for reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N). Few empirical papers deal with how global funding mechanisms, and specifically GFF, support resource mobilisation for health nationally.

Objective: This study describes the policy processes of developing the GFF planning documents (the Investment Case and Project Appraisal Document) in Burkina Faso.

Methods: We conducted an exploratory qualitative policy analysis. Data collection included document review (N = 74) and in-depth semi-structured interviews (N = 23). Data were analysed based on the components of the health policy triangle.

Results: There was strong national political support to RMNCAH-N interventions, and the process of drawing up the investment case (IC) and the project appraisal document was inclusive and multi-sectoral. Despite high-level policy commitments, subsequent implementation of the World Bank project, including the GFF contribution, was perceived by respondents as challenging, even after the project restructuring process occurred. These challenges were due to ongoing policy fragmentation for RMNCAH-N, navigation of differing procedures and perspectives between stakeholders in the setting up of the work, overcoming misunderstandings about the nature of the GFF, and weak institutional anchoring of the IC. Insecurity and political instability also contributed to observed delays and difficulties in implementing the commitments agreed upon. To tackle these issues, transformational and distributive leaderships should be promoted and made effective.

Conclusions: Few studies have examined national policy processes linked to the GFF or other global health initiatives. This kind of research is needed to better understand the range of challenges in aligning donor and national priorities encountered across diverse health systems contexts. This study may stimulate others to ensure that the GFF and other global health initiatives respond to local needs and policy environments for better implementation.

背景:布基纳法索于 2017 年加入全球妇女、儿童和青少年融资机制(GFF),以解决生殖、孕产妇、新生儿、儿童和青少年健康与营养(RMNCAH-N)方面持续存在的资金缺口。很少有经验性论文涉及全球筹资机制,特别是全球森林筹资机制如何在全国范围内支持卫生事业的资源调动:本研究描述了布基纳法索制定全球筹资框架规划文件(投资案例和项目评估文件)的政策过程:我们进行了一项探索性定性政策分析。数据收集包括文件审查(74 份)和深入的半结构化访谈(23 份)。根据卫生政策三角的组成部分对数据进行了分析:结果:国家对 RMNCAH-N 的干预措施给予了强有力的政治支持,投资案例(IC)和项目评估文件的起草过程具有包容性和多部门性。尽管有高层的政策承诺,但受访者认为世界银行项目的后续实施工作,包括全球 信托基金的捐款,具有挑战性,即使在项目重组过程之后也是如此。造成这些挑战的原因包括:RMNCAH-N 的政策仍然支离破碎;在开展工作的过程中,利益相关者之间的程序和观点不尽相同;对全球森林论坛的性质存在误解;以及国际协调机制的机构基础薄弱。不安全和政治不稳定也造成了在履行商定的承诺方面的延误和困难。为解决这些问题,应促进变革型和分配型领导,并使其发挥有效作用:很少有研究探讨与全球森林论坛或其他全球卫生倡议相关的国家政策进程。需要开展此类研究,以便更好地了解在不同的卫生系统背景下,在协调捐助者和国家优先事项方面遇到的各种挑战。这项研究可能会激励其他研究,以确保全球筹资框架和其他全球卫生倡议符合当地需求和政策环境,从而更好地实施。
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引用次数: 0
Maternal betel quid use during pregnancy and child growth: a cohort study from rural Bangladesh. 母亲在怀孕期间服用槟榔与儿童成长:孟加拉国农村地区的一项队列研究。
IF 2.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-31 Epub Date: 2024-07-09 DOI: 10.1080/16549716.2024.2375829
Mohammad Redwanul Islam, Shaki Aktar, Jesmin Pervin, Syed Moshfiqur Rahman, Monjur Rahman, Anisur Rahman, Eva-Charlotte Ekström

Background: Chewing betel quid (BQ) - a preparation commonly containing areca nut and slaked lime wrapped in betel leaf - is entrenched in South Asia. Although BQ consumption during pregnancy has been linked to adverse birth outcomes, its effect on postnatal growth remains largely unexplored.

Objective: We examined the associations of BQ use during pregnancy with children's height-for-age and body mass index-for-age z-scores (HAZ and BAZ, respectively) and fat and fat-free mass along with sex-based differences in association in rural Bangladesh.

Methods: With a prospective cohort design, we assessed BQ use among mothers enrolled in the Preterm and Stillbirth Study, Matlab (n = 3140) with a structured questionnaire around early third trimester. Children born to a subset of 614 women (including 134 daily users) were invited to follow-up between October 2021 and January 2022. HAZ and BAZ were calculated from anthropometric assessment, and fat and fat-free mass were estimated using bioelectric impedance. Overall and sex-specific multiple linear regression models were fitted.

Results: Growth data were available for 501 children (mean age 4.9 years): 43.3% of them were born to non-users, 35.3% to those using prior to or less-than-daily during the survey, and 21.3% to daily users. No statistically significant associations were observed after adjusting for sex, parity, maternal height and education, and household wealth.

Conclusions: There was no effect of BQ use during pregnancy on postnatal growth in this study. Longitudinal studies following up those born to heavy users beyond childhood are warranted for capturing long-term implications of prenatal BQ exposure.

背景:嚼食槟榔(BQ)--一种通常用槟榔叶包裹的含有槟榔和熟石灰的制剂--在南亚地区根深蒂固。尽管怀孕期间食用槟榔与不良出生结果有关,但其对产后生长的影响在很大程度上仍未得到探讨:我们研究了在孟加拉国农村地区,孕期服用槟榔叶与儿童年龄身高和年龄体重指数 z 值(分别为 HAZ 和 BAZ)、脂肪和去脂体重之间的关系,以及这种关系的性别差异:我们采用前瞻性队列设计,在马特拉普早产和死胎研究(Preterm and Stillbirth Study, Matlab)(n = 3140)中,通过结构化问卷调查评估了母亲在怀孕三个月左右使用 BQ 的情况。在 2021 年 10 月至 2022 年 1 月期间,614 名妇女(包括 134 名每日使用者)所生子女受邀接受随访。HAZ和BAZ是通过人体测量评估计算得出的,脂肪和去脂质量是通过生物电阻抗估算得出的。结果表明:501 名儿童的生长数据(501 人)中,有 1 名儿童的生长数据是通过生物电阻抗估算的:共有 501 名儿童(平均年龄为 4.9 岁)的生长数据:其中 43.3% 的儿童为非使用者所生,35.3% 的儿童为调查前使用或调查期间少于每日使用的使用者所生,21.3% 的儿童为每日使用者所生。在对性别、胎次、母亲身高和教育程度以及家庭财富进行调整后,未发现有统计学意义的关联:结论:在这项研究中,怀孕期间使用 BQ 对产后生长没有影响。为了解产前接触溴化昆仑的长期影响,有必要对大量使用溴化昆仑者所生子女的童年期进行纵向跟踪研究。
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引用次数: 0
A 'training of trainers' programme for operational research: increasing capacity remotely. 业务研究 "培训员培训 "计划:远程提高能力。
IF 2.6 3区 医学 Q1 Medicine Pub Date : 2024-12-31 Epub Date: 2024-01-15 DOI: 10.1080/16549716.2023.2297881
Angela Willemsen, Eskinder Wolka, Yibeltal Assefa, Simon Reid

Background: Operational research (OR) is a process to improve health system capacity by evaluating interventions to improve health delivery and outcomes. The World Health Organization (WHO) Structured Operational Research Training Initiative (SORT-IT) programme promotes how OR contributes to improved health care delivery and health outcomes. A partnership project between the International Institute of Primary Health Care (IPHCE) in Ethiopia and The University of Queensland (UQ) in Australia modified the SORT-IT programme to deliver a hybrid Training of Trainers programme and improve OR capacity.

Objective: This study was performed to develop and evaluate the effectiveness of Train-the Trainers approach in building capability to expand the capacity of the IPHCE to deliver the SORT-IT programme.

Methods: Recruitment of participants and training were aligned with the principles of the SORT-IT programme. Training was face-to-face for the first session with subsequent training sessions delivered via Zoom over a 13-week period. Participants were required to complete all activities in line with SORT-IT deliverables. Slide decks supporting the SORT-IT training videos were developed and adapted to the Ethiopian context.

Results: Participants had diverse experience from programme directors to research officers. All training sessions were recorded and available for participants to watch and review when required. All participants completed OR protocols to the draft stage. Course evaluation revealed participants found the content and format of the training useful, pertinent, and interesting.

Conclusion: A hybrid model (face-to-face and video platform) for OR training was implemented. Managing contextual challenges such as information technology were managed easily by programme staff. Translating course requirements at a management level proved challenging with data collection for the protocols but provided insight into potential future challenges. This OR Training of Trainers course demonstrated that sharing of skills and knowledge can occur through a hybrid delivery model and contribute to developing capacity.

背景:运筹学(OR)是一种通过评估干预措施来提高卫生系统能力的方法,以改善医疗服务的提供和结果。世界卫生组织(WHO)的结构化运筹学培训计划(SORT-IT)提倡运筹学如何为改善医疗服务和医疗效果做出贡献。埃塞俄比亚国际初级卫生保健研究所(IPHCE)与澳大利亚昆士兰大学(UQ)之间的合作项目对 SORT-IT 计划进行了修改,以提供混合型培训师培训计划并提高运营研究能力:本研究旨在开发和评估 "培训培训师 "方法在增强 IPHCE 实施 SORT-IT 计划能力方面的有效性:方法:根据 SORT-IT 计划的原则招募参与者并进行培训。第一期培训是面对面培训,随后的培训课程通过 Zoom 提供,为期 13 周。参与者必须按照 SORT-IT 的交付成果完成所有活动。开发了支持 SORT-IT 培训视频的幻灯片,并根据埃塞俄比亚的国情进行了调整:结果:参加培训的人员具有从计划主任到研究官员的不同经验。所有培训课程均已录制,供参与者在需要时观看和复习。所有参与者都完成了 OR 协议的起草阶段。课程评估显示,学员认为培训的内容和形式有用、中肯、有趣:实施了手术室培训的混合模式(面对面和视频平台)。计划人员能够轻松应对信息技术等背景挑战。事实证明,将课程要求转化为管理层面的协议数据收集工作具有挑战性,但也为今后可能面临的挑战提供了启示。这一手术室培训员培训课程表明,可以通过混合授课模式分享技能和知识,并有助于提高能力。
{"title":"A 'training of trainers' programme for operational research: increasing capacity remotely.","authors":"Angela Willemsen, Eskinder Wolka, Yibeltal Assefa, Simon Reid","doi":"10.1080/16549716.2023.2297881","DOIUrl":"10.1080/16549716.2023.2297881","url":null,"abstract":"<p><strong>Background: </strong>Operational research (OR) is a process to improve health system capacity by evaluating interventions to improve health delivery and outcomes. The World Health Organization (WHO) Structured Operational Research Training Initiative (SORT-IT) programme promotes how OR contributes to improved health care delivery and health outcomes. A partnership project between the International Institute of Primary Health Care (IPHCE) in Ethiopia and The University of Queensland (UQ) in Australia modified the SORT-IT programme to deliver a hybrid Training of Trainers programme and improve OR capacity.</p><p><strong>Objective: </strong>This study was performed to develop and evaluate the effectiveness of Train-the Trainers approach in building capability to expand the capacity of the IPHCE to deliver the SORT-IT programme.</p><p><strong>Methods: </strong>Recruitment of participants and training were aligned with the principles of the SORT-IT programme. Training was face-to-face for the first session with subsequent training sessions delivered via Zoom over a 13-week period. Participants were required to complete all activities in line with SORT-IT deliverables. Slide decks supporting the SORT-IT training videos were developed and adapted to the Ethiopian context.</p><p><strong>Results: </strong>Participants had diverse experience from programme directors to research officers. All training sessions were recorded and available for participants to watch and review when required. All participants completed OR protocols to the draft stage. Course evaluation revealed participants found the content and format of the training useful, pertinent, and interesting.</p><p><strong>Conclusion: </strong>A hybrid model (face-to-face and video platform) for OR training was implemented. Managing contextual challenges such as information technology were managed easily by programme staff. Translating course requirements at a management level proved challenging with data collection for the protocols but provided insight into potential future challenges. This OR Training of Trainers course demonstrated that sharing of skills and knowledge can occur through a hybrid delivery model and contribute to developing capacity.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10791116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139467318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How interventions to maintain services during the COVID-19 pandemic strengthened systems for delivery of maternal and child health services: a case-study of Wakiso District, Uganda. 在 COVID-19 大流行期间为维持服务而采取的干预措施如何加强了提供妇幼保健服务的系统:乌干达 Wakiso 地区的案例研究。
IF 2.6 3区 医学 Q1 Medicine Pub Date : 2024-12-31 Epub Date: 2024-02-21 DOI: 10.1080/16549716.2024.2314345
Steven Ndugwa Kabwama, Rhoda K Wanyenze, Neda Razaz, John M Ssenkusu, Tobias Alfvén, Helena Lindgren

Background: Health systems are resilient if they absorb, adapt, and transform in response to shocks. Although absorptive and adaptive capacities have been demonstrated during the COVID-19 response, little has been documented about their transformability and strengthened service delivery systems. We aimed to describe improvements in maternal and child health service delivery as a result of investments during the COVID-19 response.

Methods: This was a descriptive case study conducted in Wakiso District in central Uganda. It included 21 nurses and midwives as key informants and 32 mothers in three focus group discussions. Data were collected using an interview guide following the Systems Engineering Initiative for Patient Safety theoretical framework for service delivery.

Results: Maternal and child health service delivery during the pandemic involved service provision without changes, service delivery with temporary changes and outcomes, and service delivery that resulted into sustained changes and outcomes. Temporary changes included patient schedule adjustments, community service delivery and negative outcomes such as increased workload and stigma against health workers. Sustained changes that strengthened service delivery included new infrastructure and supplies such as ambulances and equipment, new roles involving infection prevention and control, increased role of community health workers and outcomes such as improved workplace safety and teamwork.

Conclusions: In spite of the negative impact the COVID-19 pandemic had on health systems, it created the impetus to invest in system improvements. Investments such as new facility infrastructure and emergency medical services were leveraged to improve maternal and child health services delivery. The inter-departmental collaboration during the response to the COVID-19 pandemic resulted into an improved intra-hospital environment for other service delivery. However, there is a need to evaluate lessons beyond health facilities and whether these learnings are deliberately integrated into service delivery. Future responses should also address the psychological and physical impacts suffered by health workers to maintain service delivery.

背景:如果卫生系统在应对冲击时能够吸收、适应和转变,那么它们就具有复原力。尽管在 COVID-19 灾难应对期间,吸收能力和适应能力得到了证实,但有关其可转化性和强化的服务提供系统的记录却很少。我们的目的是描述 COVID-19 应对行动期间的投资对妇幼保健服务提供的改善情况:这是一项描述性案例研究,在乌干达中部的瓦基索地区进行。主要信息提供者包括 21 名护士和助产士以及参加三次焦点小组讨论的 32 名母亲。收集数据时使用了访谈指南,该指南遵循了 "患者安全系统工程倡议 "的服务提供理论框架:结果:大流行期间提供的妇幼保健服务包括没有变化的服务提供、有临时变化和结果的服务提供以及导致持续变化和结果的服务提供。临时性变化包括病人时间表调整、社区服务提供和负面结果,如工作量增加和对卫生工作者的羞辱。加强服务提供的持续变化包括救护车和设备等新的基础设施和用品、涉及感染预防和控制的新角色、社区卫生工作者作用的增强以及工作场所安全和团队合作的改善等结果:尽管 COVID-19 大流行对卫生系统造成了负面影响,但它为投资改善系统提供了动力。新设施基础设施和紧急医疗服务等投资被用于改善妇幼保健服务的提供。在应对 COVID-19 大流行期间开展的部门间合作改善了医院内部环境,有利于提供其他服务。然而,有必要评估医疗设施以外的经验教训,以及这些经验教训是否被有意识地融入到服务提供中。未来的应对措施还应解决卫生工作者遭受的心理和生理影响,以维持服务的提供。
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引用次数: 0
The Tools for Integrated Management of Childhood Illness (TIMCI) study protocol: a multi-country mixed-method evaluation of pulse oximetry and clinical decision support algorithms. 儿童疾病综合管理工具(TIMCI)研究方案:脉搏血氧仪和临床决策支持算法的多国混合方法评估。
IF 2.6 3区 医学 Q1 Medicine Pub Date : 2024-12-31 Epub Date: 2024-04-29 DOI: 10.1080/16549716.2024.2326253
Fenella Beynon, Hélène Langet, Leah F Bohle, Shally Awasthi, Ousmane Ndiaye, James Machoki M'Imunya, Honorati Masanja, Susan Horton, Maymouna Ba, Silvia Cicconi, Mira Emmanuel-Fabula, Papa Moctar Faye, Tracy R Glass, Kristina Keitel, Divas Kumar, Gaurav Kumar, Gillian A Levine, Lena Matata, Grace Mhalu, Andolo Miheso, Deusdedit Mjungu, Francis Njiri, Elisabeth Reus, Michael Ruffo, Fabian Schär, Kovid Sharma, Helen L Storey, Irene Masanja, Kaspar Wyss, Valérie D'Acremont

Effective and sustainable strategies are needed to address the burden of preventable deaths among children under-five in resource-constrained settings. The Tools for Integrated Management of Childhood Illness (TIMCI) project aims to support healthcare providers to identify and manage severe illness, whilst promoting resource stewardship, by introducing pulse oximetry and clinical decision support algorithms (CDSAs) to primary care facilities in India, Kenya, Senegal and Tanzania. Health impact is assessed through: a pragmatic parallel group, superiority cluster randomised controlled trial (RCT), with primary care facilities randomly allocated (1:1) in India to pulse oximetry or control, and (1:1:1) in Tanzania to pulse oximetry plus CDSA, pulse oximetry, or control; and through a quasi-experimental pre-post study in Kenya and Senegal. Devices are implemented with guidance and training, mentorship, and community engagement. Sociodemographic and clinical data are collected from caregivers and records of enrolled sick children aged 0-59 months at study facilities, with phone follow-up on Day 7 (and Day 28 in the RCT). The primary outcomes assessed for the RCT are severe complications (mortality and secondary hospitalisations) by Day 7 and primary hospitalisations (within 24 hours and with referral); and, for the pre-post study, referrals and antibiotic. Secondary outcomes on other aspects of health status, hypoxaemia, referral, follow-up and antimicrobial prescription are also evaluated. In all countries, embedded mixed-method studies further evaluate the effects of the intervention on care and care processes, implementation, cost and cost-effectiveness. Pilot and baseline studies started mid-2021, RCT and post-intervention mid-2022, with anticipated completion mid-2023 and first results late-2023. Study approval has been granted by all relevant institutional review boards, national and WHO ethical review committees. Findings will be shared with communities, healthcare providers, Ministries of Health and other local, national and international stakeholders to facilitate evidence-based decision-making on scale-up.Study registration: NCT04910750 and NCT05065320.

在资源有限的环境中,需要有效且可持续的战略来解决五岁以下儿童可预防死亡的问题。儿童疾病综合管理工具(TIMCI)项目旨在通过在印度、肯尼亚、塞内加尔和坦桑尼亚的初级医疗机构引入脉搏血氧仪和临床决策支持算法(CDSA),支持医疗服务提供者识别和管理重症疾病,同时促进资源管理。健康影响通过以下方式进行评估:在印度的初级医疗机构随机分配(1:1)给脉搏血氧仪或对照组,在坦桑尼亚随机分配(1:1:1)给脉搏血氧仪加 CDSA、脉搏血氧仪或对照组;在肯尼亚和塞内加尔进行准实验性事后研究。设备的实施需要指导和培训、辅导和社区参与。从护理人员处收集社会人口学和临床数据,并在研究机构收集 0-59 个月入组病童的记录,第 7 天(在 RCT 中为第 28 天)进行电话随访。RCT 评估的主要结果是第 7 天前的严重并发症(死亡率和二次住院)和一次住院(24 小时内和转诊);对于预后研究,则是转诊和抗生素。此外,还对健康状况、低氧血症、转诊、随访和抗菌药物处方等其他方面的次要结果进行了评估。在所有国家,嵌入式混合方法研究将进一步评估干预措施对护理和护理流程、实施、成本和成本效益的影响。试点和基线研究于 2021 年年中开始,RCT 和干预后研究于 2022 年年中开始,预计于 2023 年年中完成,并于 2023 年年底取得初步结果。研究已获得所有相关机构审查委员会、国家和世卫组织伦理审查委员会的批准。研究结果将与社区、医疗服务提供者、卫生部及其他地方、国家和国际利益相关者分享,以促进在推广方面做出循证决策:研究注册:NCT04910750 和 NCT05065320。
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引用次数: 0
Awareness of postpartum depression among midwives and pregnant women in Arkhangelsk, Arctic Russia. 俄罗斯北极阿尔汉格尔斯克助产士和孕妇对产后抑郁症的认识。
IF 2.6 3区 医学 Q1 Medicine Pub Date : 2024-12-31 Epub Date: 2024-06-03 DOI: 10.1080/16549716.2024.2354008
Elena Nechaeva, Olga Kharkova, Vitaly Postoev, Andrej M Grjibovski, Elisabeth Darj, Jon Øyvind Odland

Background: Postpartum depression (PPD) affects approximately 17% of the women worldwide with nearly half of all cases going undetected. More research on maternal mental health, particularly among healthcare professionals and pregnant mothers, could help identify PPD risks and reduce its prevalence.

Objective: Given that awareness of PPD is a crucial preventive factor, we studied PPD awareness among midwives and pregnant women in Arkhangelsk, Arctic Russia.

Methods: A qualitative study was conducted using in-depth semi-structured interviews. Midwives and pregnant women were recruited from the women's clinic of the Arkhangelsk municipal polyclinic. Seven midwives and 12 pregnant mothers were interviewed.

Results: Midwives described limited time for psychological counselling of pregnant women; they reported that their primary focus was on the physiological well-being of women. Pregnant women have expressed a desire for their families to share responsibilities. The participants considered PPD as a mix of psychological and physiological symptoms, and they also highlighted a discrepancy between the expectations of pregnant women and the reality of motherhood. The present study underscored the limited understanding of PPD identification.

Conclusions: The findings suggest that there is a need for increased awareness among midwives and pregnant women regarding PPD. Prevention programs targeting PPD with a specific emphasis on enhancing maternal mental health knowledge are warranted.

背景:全世界约有 17% 的妇女患有产后抑郁症(PPD),其中近一半的病例未被发现。对产妇心理健康进行更多的研究,特别是在医护人员和孕妇中进行研究,有助于识别产后抑郁症的风险并降低其发病率:鉴于对 PPD 的认识是一个重要的预防因素,我们对俄罗斯北极地区阿尔汉格尔斯克的助产士和孕妇对 PPD 的认识进行了研究:方法:我们采用深入的半结构式访谈进行了一项定性研究。助产士和孕妇均来自阿尔汉格尔斯克市综合医院的妇女诊所。对 7 名助产士和 12 名孕妇进行了访谈:助产士表示,她们为孕妇提供心理辅导的时间有限;她们表示,她们主要关注的是孕妇的生理健康。孕妇表示希望家人分担责任。参与者认为 PPD 是心理和生理症状的混合体,她们还强调了孕妇的期望与做母亲的现实之间的差异。本研究强调了对 PPD 识别的有限理解:研究结果表明,有必要提高助产士和孕妇对 PPD 的认识。有必要开展针对 PPD 的预防计划,并特别强调提高孕产妇的心理健康知识。
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引用次数: 0
Fathers' involvement in pregnancy and childbirth in Africa: an integrative systematic review. 非洲父亲参与怀孕和分娩的情况:综合系统综述。
IF 2.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-31 Epub Date: 2024-07-12 DOI: 10.1080/16549716.2024.2372906
Samuel Nambile Cumber, Anna Williams, Helen Elden, Malin Bogren

Background: As notions of masculinity evolve globally, it is important to understand their dimensions within geographic regions and life contexts. African men's involvement in their partners'pregnancy and childbirth has been explored to a limited extent in the peer-reviewed literature. This analysis provides a comprehensive examination of the existing literature on the diverse experiences of fathers across the African continent.

Aim: This study aims to provide an overview of fathers' experience of involvement in their partners' pregnancies andchildbirth in Africa.

Methods: A systematic integrative literature review guided the process. The review comprised problem identification, literature search, data evaluation, data analysis and presentation of results. Systematic searches were conducted in the Cinahl, PubMed and Scopus databases.

Results: The search identified 70 articles of which 31, relating to 11 African countries, were used. Of these, 20 were qualitative, 9 were quantitative and 2 were mixed-methods studies. Men's alienation from health services, and traditional gender norms that discourage fathers' supportive role during pregnancy were prevalent themes. Financial pressures also dominated fathers'experiences. At the same time, in 18 studies fathers expressed motivation to be involved partners and supportive fathers, despite stigma and exclusion from maternity services.

Conclusion: This integrative review shows that fathers' experiences of their involvement in their partners' pregnancy and childbirth across African countries are influenced by multiple factors. While unwelcoming health services, traditional gender norms, and low income are barriers to male involvement, education, younger age, and modern gender norms are associated with greater male involvement.

背景:随着男性概念在全球范围内的发展,了解其在不同地理区域和生活环境中的表现非常重要。在同行评议的文献中,对非洲男性参与其伴侣怀孕和分娩情况的探讨十分有限。本分析报告对现有文献中有关非洲大陆父亲的不同经历进行了全面考察:方法:以系统的综合文献综述为指导。综述包括问题识别、文献检索、数据评估、数据分析和结果陈述。在 Cinahl、PubMed 和 Scopus 数据库中进行了系统检索:搜索结果发现了 70 篇文章,其中 31 篇涉及 11 个非洲国家。其中,20 篇为定性研究,9 篇为定量研究,2 篇为混合方法研究。男性疏远医疗服务和传统的性别规范阻碍了父亲在怀孕期间发挥支持作用,这些都是普遍存在的主题。经济压力也是父亲的主要经历。与此同时,在 18 项研究中,尽管孕产服务机构对父亲有偏见和排斥,但父亲们仍表示愿意成为参与的伴侣和支持的父亲:这项综合研究表明,在非洲国家,父亲参与伴侣怀孕和分娩的经历受到多种因素的影响。不受欢迎的医疗服务、传统性别规范和低收入是男性参与的障碍,而教育、年轻和现代性别规范则与男性的更多参与有关。
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引用次数: 0
Population mobility : spatial spillover effect of government health expenditure in China. 人口流动:中国政府卫生支出的空间溢出效应。
IF 2.6 3区 医学 Q1 Medicine Pub Date : 2024-12-31 Epub Date: 2024-03-11 DOI: 10.1080/16549716.2024.2319952
Simin Wan, Mengying Wang

Background: Since the 20th century, pursuing Universal Health Coverage (UHC) has emerged as an important developmental objective in numerous countries and across the global health community. With the intricate ramifications of population mobility (PM), the government faces a mounting imperative to judiciously deploy health expenditure to realise UHC effectively.

Objective: This study aimed to construct a comprehensive UHC index for China, assess the spatial effects of Government Health Expenditure (GHE) on UHC, and explore the moderating effects of PM on this association.

Method: A Dynamic Spatial Durbin Model (DSDM) was employed to investigate the influence of the GHE on UHC. Therefore, we tested the moderating effect of PM.

Results: In the short-term, the GHE negatively impacted local UHC. However, it enhanced the UHC in neighbouring regions. Over the long term, GHE improved local UHC but decreased UHC in neighbouring regions. In the short-term, when the PM exceeded 1.42, the GHE increased the local UHC. Over the long term, when the PM exceeded 1.107, the GHE impeded local UHC. If the PM exceeded 0.91 in the long term, the GHE promoted UHC in neighbouring regions. The results of this study offer a partial explanation of GHE decisions and behaviours.

Conclusions: To enhance UHC, a viable strategy involves augmenting vertical transfer payments from the central government to local governments. Local governments should institute healthcare systems tailored to the urban scale and developmental stages, with due consideration for PM. Optimising the information disclosure mechanism is also a worthwhile endeavour.

背景:自 20 世纪以来,追求全民健康覆盖(UHC)已成为许多国家和全球卫生界的一项重要发展目标。随着人口流动(PM)带来的复杂影响,政府在合理调配医疗卫生支出以有效实现全民健康覆盖方面面临着日益紧迫的任务:本研究旨在构建中国的全民健康保险综合指数,评估政府卫生支出(GHE)对全民健康保险的空间影响,并探讨人口流动对这一关联的调节作用:方法:我们采用动态空间杜宾模型(DSDM)来研究政府卫生支出对全民健康水平的影响。因此,我们检验了 PM 的调节作用:结果:在短期内,GHE 对当地的 UHC 产生了负面影响。然而,它却提高了邻近地区的全民健康水平。从长期来看,GHE 改善了当地的全民健康水平,但却降低了邻近地区的全民健康水平。在短期内,当 PM 超过 1.42 时,GHE 增加了当地的 UHC。长期来看,当 PM 超过 1.107 时,GHE 会阻碍当地的 UHC。如果 PM 长期超过 0.91,则 GHE 会促进邻近地区的 UHC。这项研究的结果部分解释了 GHE 的决策和行为:为提高全民医保水平,一项可行的战略是增加中央政府对地方政府的纵向转移支付。地方政府应建立适合城市规模和发展阶段的医疗保健体系,并适当考虑 PM。优化信息披露机制也是一项值得努力的工作。
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引用次数: 0
Cash transfer, maternal and child health outcomes: a scoping review in sub-Saharan Africa. 现金转移、孕产妇和儿童健康成果:撒哈拉以南非洲的范围界定审查。
IF 2.6 3区 医学 Q1 Medicine Pub Date : 2024-12-31 Epub Date: 2024-02-09 DOI: 10.1080/16549716.2024.2309726
Emery L Ngamasana, Jessamyn Moxie

Background: Cash Transfer (CT) programmes can improve maternal and child health outcomes in low- and middle-income countries. However, studies assessing the effectiveness of these programmes on maternal and child health outcomes (MCH), beyond nutritional outcomes and service utilisation, remain inconclusive.

Objectives: We synthesized current empirical evidence on the effectiveness of these programmes in improving MCH outcomes and suggested a framework for reporting such outcomes. We focused on sub-Saharan Africa because of substantial operational differences between regions, and the need for MCH advancement in this region.

Methods: This review searched PubMed Central and Google Scholar and supplemented it with a backward citation search for studies conducted in sub-Saharan Africa for the period between 2000 and 2021. Only peer-reviewed studies on CT that reported health outcomes beyond nutritional outcomes and service utilisation among women of reproductive age and children below 18 years old were included.

Results: Twenty-one articles reporting studies conducted in six sub-Saharan African countries were identified. All studies reported health outcome measures, and programmes targeted women of reproductive age and children under 18 years of age. Of the 21 articles, 1 reported measures of mortality, 13 reported measures of functional status; 3 reported subjective measures of well-being, and 4 reported behavioural health outcomes. Across all categories of reported measures, evidence emerges that cash transfer programmes improved some health outcomes (e.g. improved infant and child survival, reduced incidence of illnesses, improved cognitive and motor development, improved general health, delayed sexual debut, lower transactional sex, etc.), while in some of the studies, outcomes such as depression did not show significant improvements.

Conclusion: Cash Transfer programmes are effective and cost-effective, with a real potential to improve maternal and child health outcomes in sub-Saharan African countries. However, further research is needed to address implementation challenges, which include data collection, and programme management.

背景:现金转移(CT)计划可以改善中低收入国家的母婴健康状况。然而,除营养结果和服务利用率外,评估这些计划对母婴健康结果(MCH)的有效性的研究仍未得出结论:我们综合了当前有关这些计划在改善母婴健康成果方面有效性的经验证据,并提出了报告此类成果的框架。我们将重点放在撒哈拉以南非洲地区,因为不同地区之间在操作上存在很大差异,而且该地区需要提高母婴保健水平:本综述检索了 PubMed Central 和 Google Scholar,并对 2000 年至 2021 年期间在撒哈拉以南非洲进行的研究进行了反向引文检索。只纳入了同行评审的关于 CT 的研究,这些研究报告了育龄妇女和 18 岁以下儿童营养结果和服务利用率之外的健康结果:结果:确定了 21 篇报道在 6 个撒哈拉以南非洲国家开展的研究的文章。所有研究都报告了健康结果的衡量标准,计划的目标群体是育龄妇女和 18 岁以下儿童。在这 21 篇文章中,1 篇报告了死亡率测量结果,13 篇报告了功能状态测量结果;3 篇报告了幸福感的主观测量结果,4 篇报告了行为健康结果。在所报告的各类衡量标准中,有证据表明现金转移计划改善了一些健康结果(如提高了婴幼儿存活率、降低了疾病发病率、改善了认知和运动发育、改善了总体健康状况、推迟了初次性行为、减少了性交易等),而在一些研究中,抑郁症等结果并未显示出显著改善:现金转移计划既有效又具有成本效益,确实有可能改善撒哈拉以南非洲国家的母婴健康状况。然而,还需要进一步开展研究,以解决实施过程中遇到的挑战,包括数据收集和计划管理。
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引用次数: 0
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Global Health Action
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