Search results for: maternal feminism

Authors: Khitam Ibrahem Shlash Mohammad

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Background: Postnatal depression is a focus of considerable research attention, but little is known about the pattern of stress across this period. Objective: to investigate the prevalence of stress after childbirth for Jordanian women and identify associated risk factors. Method: Design: A descriptive cross-sectional study. Participants were recruited six to eight weeks postpartum, provided personal, social and obstetric information, and completed the stress subscale of Depression Anxiety and Stress Scale (DASS-S), the Maternity Social Support Scale (MSSS), and Perceived Self-Efficacy Scale (PSES). Setting: maternal and child health care clinics in four health care centres in Maan city in Southern Jordan. Participants: Arabic speaking women (n = 324) between the ages of 18 and 45 years, six to eight weeks postpartum, primiparous or multiparous at low risk for obstetric complications. Data collection took place between October 2015 and January 2016. Ethical clearance was obtained prior to data collection. Results: The prevalence of postpartum stress among Jordanian women was 39.8 %. A regression analysis revealed that occupation, low social support, financial problems, difficult marital relationships, difficult relationship with family-in-law, giving birth to a female baby, difficult childbirth, and low self-efficacy were associated with postpartum stress. Conclusions and implications for practice: Jordanian women need support during pregnancy, during and after childbirth. Postpartum emotional support and assessment of symptoms of stress need to be incorporated into routine practice. The opportunity for open discussion along with increased awareness and clarification of common misconceptions about postpartum stress is necessary.

Keywords: prevalence, postpartum, stress, Jordanian women

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Authors: Cangir Uyarlar, E. Eren Gultepe, I. Sadi Cetingul, Ismail Bayram

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This study was conducted to investigate the effect of humic acid (Potassium Humate) at different levels on rations on the effects of both maternal and offspring health, metabolic parameters and immunity levels in transition dairy cows. For this purpose, 50 Holstein dairy cows divided 5 trial groups. Experimental groups were designed as follows: A) Control (0% Humas); B) 0.5 Humas (0,5% in concentrated diet); C) 1 Humas (1% in concentrated diet), D) 1,5 Humas (1,5% in concentrated diet), E) 2 Humas (2% in concentrated diet), respectively. The study lasted from the first day of the dry period to postpartum 30th day. Diets were prepared as isocaloric and isonitrogenic. In the experiment, the day on which the animals gave birth was accepted as ‘0 (zero)’ and blood was taken from tail vein (v. coccygea) at -60, -53, -46, -39, -32, -25, -18, -11, -4, 0, ; Colostrum samples were taken on days 0, 1 and 2; Blood samples were taken on days 0, 1, 2, 15 and 30 from the juguler vein (v. jugularis) of the new born calves. Total blood leukocyte, Lymphocyte, Monocyte, granulocytes, Hemoglobin, Hematocrit, MCV, MCH, MWC, RDW, PLT, MPV, PDW, PCT, NEFA, BHBA, Glucose, Total Cholesterol , Triglyceride, LDL, HDL, VLDL, ALT, AST, ALP, GGT and Total IgG levels and colostrum IgG levels were determined in this experiment. The results suggest that although the supplementation of humic acid at 2% level adversely affected to production parameters, the addition of humic acid (potassium humate) to the concentrate mix during the dry period (particularly 0.5 and 1% levels) may provide an increasing on mother and the offspring immunity, some improving on serum metabolism parameters and enhancing the milk production.

Keywords: humic acid, dairy cow, calf, immunity

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Authors: O. S. Asaolu, A. Bolorunduro

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Background: Unwanted, mistimed and unintended pregnancy is an important public health issue and the most common cause of maternal mortality in developing countries. Unintended pregnancy is a potential hazard for every sexually active woman as it most times ends in unsafe abortion. The study aimed at assessing the pre-conception contraceptive use, prevalence of unintended pregnancies and the non-contraceptive factors associated with unintended pregnancy amongst currently married women in Osun state. Methodology: A descriptive cross-sectional study among randomly selected 341 currently married pregnant women attending antenatal clinics in Ilesa town of Osun state was conducted in 5 health facilities. A random selection of 5 of the 22 health facilities in the state was done. Data was collected through a self-administered questionnaire and all completed questionnaires were analyzed with SPSS. Result: About two-fifth of the currently pregnant women (40%) who has never used an FP method reported that their current pregnancy was unintended. The results indicate that age of women, age at first sex, substance use, total children ever born of children, religion, and extramarital affairs were key predictors of unintended pregnancy. Women who have higher parity are more likely to experience unintended pregnancy compared to women with lower parity (odds ratio, 0.25). Furthermore, those women who don’t engage in extra marital affairs were less likely to experience unintended pregnancy (odds ratio, 0.3) compared to those who do not. Contribution to knowledge: The predicted probability, using logistic regression, has shown that women who engage in extramarital affairs and women with high parity are more likely to have unintended pregnancy. Conclusion: Behaviour change programs should aim to reduce unintended pregnancy by focusing mostly on identified factors so that the need for abortion is decreased and the overall well-being of the family is maintained and enhanced.

Keywords: unintended pregnancy, factors, pregnant women, Nigeria

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Authors: Haatembo Mooya

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Cross-culturally, exclusive maternal care of infants is an exception, rather than a rule. In most traditional non-Western societies, child care is shared within the family while in most middle class Western societies parents tend to rely more on ‘hired hands’ for support. In both contexts however, a common caregiver is the sibling. Despite this, the phenomenon of sib-care has remained relatively understudied. Cultural and gender differences in sib-care and attachment were explored using a retrospective survey instrument comparing Zambian and Dutch college students. The total study sample (N = 394) comprised of 200 Zambian students from the University of Zambia and 194 Dutch students from Leiden University, the Netherlands. We tested four main hypotheses. Firstly, we hypothesized that the Zambian subjects performed more sib-care than Dutch subjects. Secondly we hypothesized that female participants performed more sib-care than males participants, both among the Zambian and Dutch subjects, especially when parents are not at home. Thirdly, we hypothesized that larger family size was associated with more sib-care. Finally, we hypothesized that securely attached participants performed more sib-care than their less securely attached peers. Results indicated that sib-care was prevalent in both Zambian and Dutch samples. Zambian subjects performed more sib-care than Dutch subjects, with females performing more sib-care than males, both when parents were at home (F(2, 244) = 62.09, p < .01) and when parents were not at home (F(2, 237) = 51.28, p < .01). We also found that family size and attachment related avoidance and anxiety were not significant predictors of sib-care. It is concluded that sib-care is understudied, not only in Africa but also in Western societies and that females perform more sib-care than males, especially when the parents are not at home. In addition, attachment related avoidance and anxiety appear to be more related to the quality than the quantity of sib-care provided.

Keywords: sibling, sib-care, attachment, Africa, Zambia, the Netherlands

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Authors: Ghadeer M Alkusayer, Adelicia Yu, Pamela Orr

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Study objective: To report a case of postpartum pulmonary cryptococcal infection (CCI) in an otherwise healthy 35-year-old woman. Additionally, the cases of pulmonary cryptococcal infections either in the antepartum or the postpartum period with pregnancy outcomes, were systematically reviwed. Methods: A systematic search of Cochrane Library, MEDLINE, and EMBASE was conducted for peer-reviewed studies without date restrictions, published in English and relating to CCI during pregnancy or postpartum period. Conference press, editorials, opinion pieces and letters were excluded. Two authors independently screened citations and full-text articles, extracted data and assessed study quality. Given the heterogeneity of study designs, a narrative synthesis was conducted. Results: The search identified 128 references, of which 22 case reports and series met the inclusion criteria. This is a total of 29 women (including the current case) . The mean age of the women was 28.3 ± 12.3 years. Nine (31.03%) presented and were diagnosed in the postpartum period. Two (6.90%) of the patients were reported as immunocompromised with HIV. Four maternal deaths (13.79%) were found in this case series with one (4.3%) patient with severe neurological deficits. Four (17.4%) infant deaths were reported. Women primary presentation varied with chest pain 13 (44.82%), headache 10 (35.70%), dyspnea 19 (65.51%), or fever 12 (41.38%). Three studies reported placental pathology positive for C. neoformans. Conclusion: This case of pulmonary cryptococcal infection in the postpartum period is an important addition to the literature of this rare infection in pregnancy. The patient is not immunocompromised. The patient was successfully treated with 4 months of Fluconazole 400 mg and continued to breastfeed the healthy baby.

Keywords: pulmonary cryptococcus, pregnancy, cryptococci , postpartum

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Authors: Fares Mahdi

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Background: Infection control is an important concern for all health care professionals, especially nurses. Nurses have a higher risk for both self-acquiring and transmitting infections to other patients. Aim of this study: to assess nurses' knowledge regarding infection control for wound care. Methodology: a descriptive research design was used in the study. The total number studied sample was 200 nurses, were conducting in Amran Public Hospitals in Amran City- Yemen. The study covered sample nurses in the hospital according to the study population; a standard closed-ended questionnaire was used to collect the data. Results: The results showed less than half (37.5 %) of nurses were from 22 May Hospital, also followed by (62.5%) of them were from Maternal and Child Hospital. Also according to the department name. Most (22.5%) of nurses worked in an intensive care unit, followed by (20%) of them were working in the pediatric world, also about (19%) of them were working in the surgical department. While in finally, only about (8.5%) of them worked from another department. According to course training, The results showed about (21%) of nurses had course training in wound care management. At the same time, others (79%) of them have not had course training in wound care management. According to the total nurse's knowledge of infection control for wound care, that find more than two-thirds (68%) of nurses had fair knowledge according to total all of nurse's knowledge of infection control wound care. Conclusion:The results showed that more than two-thirds (68%) of nurses had fair knowledge according to total all of the nurse's knowledge of infection control for wound care. Recommendations: There should be providing training program about infection control masseurs and it's important for new employees of nurses. Providing continuing refreshment training courses about infection control programs and about evidence-based practice in infection control for all health care teams.

Keywords: assessment, knowledge, infection control, wound care, nurses, amran hospitals

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Authors: Kaltrina Kusari

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Displaced populations have received increasing attention, yet the experiences of return migrants remain largely hidden within social sciences. Existing research, albeit limited, suggests that policies which impact return migrants, especially those forced to return to their home countries, do not reflect their voices. Specifically, the United Nations Hight Commissioner for Refugees has adopted repatriation as a preferred policy solution, despite research which substantiates that returning to one’s home country is neither durable nor the end of the migration cycle; as many of 80% of returnees decide to remigrate. This one-size-fits-all approach to forced displacement does not recognize the impact of intersecting identity categories on return migration, thus failing to consider how ethnicity, gender, and class, among others, shape repatriation. To address this, this qualitative study examined the repatriation experiences of return migrant women from Kosovo and the role of social workers in facilitating return. In 2015, Kosovars constituted the fourth largest group of asylum seekers in the European Union, yet 96% of them were rejected. Additionally, since 1999 Kosovo has ranked among the top 10 countries of origin for return migrants. Considering that return migration trends are impacted by global power dynamics, this study relied on a postcolonial and transnational feminist framework to contextualize the mobility of displaced peoples in terms of globalization and conceptualize migration as a gendered process. Postcolonial and feminist theories suggest that power is partly operationalized through language, thus, Critical Discourse Analysis was used as a research methodology. CDA is concerned with examining how power, language, and discourses shape social processes and relationships of dominance. Data collection included interviews with 15 return migrant women (eight ethnic minorities and seven Albanian) and 18 service providers in Kosovo. The main findings illustrate that both returnee women and service providers rely on discourses which 1) challenge the voluntariness and sustainability of repatriation; 2) construct Kosovo as inferior to EU countries; and 3) highlight the impact of patriarchy and ethnic racism on return migration. A postcolonial transnational feminist analysis demonstrates that despite Kosovars’ challenges with repatriation, European Union countries use their power to impose repatriation as a preferred solution for Kosovo’s government. These findings add to the body of existing repatriation literature and provide important implications for how return migration might be carried out, not only in Kosovo but other countries as well.

Keywords: migration, gender, repatriation, transnational feminism

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Authors: Behnaz Farahani, Razieh Sotoudeh, Ali Vahdani, Hamed Abdi

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Individual differences in eating behavior can cause underweight or overweight and obesity. Thus influencing factors on children’s eating behavior such as mothers’ feeding practices are needed to be more investigated. The goals of this survey are to evaluate the association of (i) parental pressure and children’s food avoidant tendency, (ii) parental restriction and children’s food approach tendency, (iii) modeling of healthy eating in front of children and their children’s eating behavior. 760 mothers of children aged 7-10 from schools in Isfahan were asked to complete questionnaires including Child Feeding Questionnaire, Children’s Eating Behavior Questionnaire, Modeling Questionnaire, and self-administered demographic questionnaire in which mothers reported their children’s height and weight as well. Of those mothers, 745 completed the questionnaires for the children’s index (mean age: 8.513±1.112) during the 2011-2012 school year. The results of this quantitative, descriptive, cross-sectional analysis indicated that “parental restriction” was positively associated with child food responsiveness (P,0.000) and food enjoyment (P,0.000) and surprisingly, it was positively associated with Food Fussiness(0.000) .Parental pressure to eat was positively associated with child satiety responsiveness (P,0.000), slowness (P,0.000), and fussiness (P,0.00) and negatively associated with Food responsiveness(p,0.000)and Enjoyment of food (p,0.002), modeling of healthy eating were positively associated with Enjoyment of food / q (p,0.000) and negatively with food fussiness (P,0.000). The results of this survey will improve interventions and maternal guidance on their feeding practices and their association with children’s eating behavior and weight.

Keywords: feeding practices, eating behavior, pressure to eat, restriction, modeling, satiety responsiveness, slowness in eating, food fussiness, food responsiveness, enjoyment of food

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Authors: Ovidiu Anemtoaicei

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This paper offers a possible answer to the question of what it means to think about men and masculinities through the philosophy of sexual difference as developed by Luce Irigaray, employing Gilles Deleuze’s concept of 'critique' and arguing, at the same time, for a concept of 'becoming-man' as an expression of this answer. First, while examining the nature of the role of male bodies underlying the theorizing of men and masculinities in the field of the Critical Studies of Men and Masculinities, the paper argues for a turn to sexual difference theory as an answer to the 'gap' between the representations on male bodies and their participation in thought and masculine subjective production. Secondly, sharing Luce Irigaray’s critique of Western thought, the paper explores alternative morphological bodily 'locations' for rethinking male imaginary in relation to male embodiments, on the one hand, and in relation to the maternal and the feminine, on the other hand. Thirdly, the paper develops the idea that a phenomenologically-influenced approach towards male bodies might be productive, especially when thought through Irigaray’s sexual difference as a relational and experiential ontology. Finally, while showing that Irigaray and Deleuze share a similar critique of Western philosophical thought and of the masculine historical subject, it proposes a rethinking of the concept of 'becoming-man' as an assemblage meeting between Irigaray’s theory of sexual difference and Deleuze and Guattari’s nomadologic project, as a possibility of thinking change in men’s masculine subjective constitution in relation to both women and other men. As far as the ethical implications of such rethinking are concerned, the paper urges for the cultivation of a masculine culture of stepping back and its constitutive political, social and cultural practices so as to make possible the construction of new spaces that would allow for the becoming of at least two subjects based on the respect for their differences.

Keywords: feminist philosophy, male bodies, masculinities, phenomenology, sexual difference

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Authors: Mona Alyedreessy

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This study, which is based on a qualitative study sample of thirty-four British converts from different ages, ethnicities, social classes, areas and religious backgrounds in London, investigates the common challenges, problems and abuse in the name of Islam that many British female Muslim converts experienced during their time as Muslims, which caused them to leave the faith. It is an important study, as it creates an awareness of the weaknesses found in western Muslim societies and in various Islamic educational programs that causes people to leave Islam and contribute towards its negative reputation in the media. The women in this study shared common problems regarding gender and racial discrimination, identity development, feminism, marriage, parenting, Muslim culture, isolation, extremism, belonging and practising Islam in both Muslim and non-Muslim societies with differing sacrifices and consequences that caused them to de-convert. The study argues that many of the personal, religious and social problems female Muslim converts experience are due to a lack of knowledge about Islam and their rights as Muslim women, which often results in them being vulnerable and influenced by the opinions, attitudes and actions of uneducated, abusive, non-practising and extremist Muslims. For example, it was found that young female converts in particular were often taken advantage of and manipulated into believing that many negative actions displayed by patriarchal Muslim husbands were a part of Islam. This created much confusion, especially when their husbands used specific Quran texts and Hadiths to justify their abuse, authority and attitudes that made them miserable. As a result and based on the positive experiences of some converts, the study found that obtaining a broad Islamic education that started with an intimate study of the Prophet Muhammad’s biography alongside being guided by the teachings of western Muslim scholars contributed greatly towards a more enjoyable conversion journey, as women were able to identify and avoid problematic Muslims and abuse in the name of Islam. This in turn helped to create a healthier family unit and Muslim society. Those who enjoyed being Muslims were able to create a balanced western Muslim identity by negotiating and applying their own morals and western values to their understanding of The Prophet’s biography and The Quran and integrated Islamic values into their own secular western environments that were free from foreign cultural practices. The outcomes of the study also highlight some effective modern approaches to da’wah based on the teachings of The Prophet Mohammad and other prophets for young Arab and Asian Muslims who marry, study and live among non-Muslims and converts.

Keywords: abuse, apostasy, converts, Muslims

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Authors: Majeda Hammoud

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Background: Anemia during pregnancy increases the risk of delivery by cesarean section, low birth weight, preterm birth, perinatal mortality, stillbirth, and maternal mortality. In this study, we aimed to assess the prevalence of anemia in pregnant women and its associated factors in the Kuwait birth cohort study. Methods: The Kuwait birth cohort (N=1108) was a prospective cohort study in which pregnant women were recruited in the third trimester. Data were collected through personal interviews with mothers who attend antenatal care visits, including data on socio-economic status and lifestyle factors. Blood samples were taken after the recruitment to measure multiple laboratory indicators. Clinical data were extracted from the medical records by a clinician including data on comorbidities. Anemia was defined as having Hemoglobin (Hb) <110 g/L with further classification as mild (100-109 g/L), moderate (70-99 g/L), or severe (<70 g/L). Predictors of anemia were classified as underlying or direct factors, and logistic regression was used to investigate their association with anemia. Results: The mean Hb level in the study group was 115.21 g/L (95%CI: 114.56- 115.87 g/L), with significant differences between age groups (p=0.034). The prevalence of anemia was 28.16% (95%CI: 25.53-30.91%), with no significant difference by age group (p=0.164). Of all 1108 pregnant women, 8.75% had moderate anemia, and 19.40% had mild anemia, but no pregnant women had severe anemia. In multivariable analysis, getting pregnant while using contraception, adjusted odds ratio (AOR) 1.73(95%CI:1.01-2.96); p=0.046 and current use of supplements, AOR 0.50 (95%CI: 0.26-0.95); p=0.035 were significantly associated with anemia (underlying factors). From the direct factors group, only iron and ferritin levels were significantly associated with anemia (P<0.001). Conclusion: Although the severe form of anemia is low among pregnant women in Kuwait, mild and moderate anemia remains a significant health problem despite free access to antenatal care.

Keywords: anemia, pregnancy, hemoglobin, ferritin

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Authors: Lilian A. Okeke, I. Okeke, N. Waziri, S. Balogun, P. Nguku, O. Fawole

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Background: Access to ante-natal care services promotes safe motherhood and delivery with improved maternal and neonatal outcome. We conducted this study to identify factors influencing the utilization of antenatal care (ANC) and health delivery services. Methods: We conducted a cross sectional study. Households were numbered and a one in three sample was selected using a systematic sampling method. One hundred and ninety eight women who were either pregnant or had previous deliveries were interviewed using pretested structured questionnaires to obtain information on their socio-demographic characteristics, and reasons for non-utilization of ANC and health delivery services. We performed univariate and bivariate analysis using Epi info version 3.5.3. Results: The age of respondents ranged from (17-55 years) with a median age of 29 years. One hundred and ninety two (97%) utilized antenatal care services. Ninety three (47.9%) attended ANC at second trimester. More than half (58.6%) had ≥ 4 visits to ANC. One hundred and thirty one (66.2%) had their last delivery at home by a traditional birth attendant. Factors associated with ANC and health facility delivery services utilization were: age group 45-55 (OR 0.01; 95% CI: 0.00-0.16) and > 55 years (OR 0.03; 95% CI: 0.00-0.60), wife’s educational status (OR 3.17; 95% CI: 1.66-8.30), husband’s permission (OR 11.8; 95% CI 2.19-63.62), and distance ≥ 5km (OR 0.33; 95% CI: 0.16-0.60). Conclusion: ANC services were well utilized. Most women did not book early and had their last delivery at home. Predictors of ANC use and health facility delivery were age, wife’s educational status, husband's permission and long distance from health facility. A one-day health sensitization of the benefits of ANC utilization and the dangers of delivering at home was implemented.

Keywords: ante natal care, health facility, delivery services, rural area, Plateau state

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Authors: Nuruddeen Abubakar Adamu

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Background: Global health nursing describes health-related work across borders and focuses more on the differences between the nurses’ role between countries and identified why nursing care in particular country differs from another. It also helps in analyzing the health issues and concerns that transcend national borders class, race, ethnicity and culture. The primary objective of this study is to introduce the concept of global health nursing. And the article also argues for the need for global health nursing. Methods This review assesses available evidence, both published and unpublished, on issues relating to the global health nursing and the nurse's role in global health. The review is qualitative based. Results: Globalization, modern technologies, travel, migration and changes in diseases trend globally has made the nursing role to become more diverse and less traditional. These issues change the nurse’s role in the healthcare industry to become enormous and very challenging. This article considers response to issues of emerging global health nursing concept, challenges, purposes, global health nursing activities in both developed and developing countries and the nurse's role globally in maternal-newborn health; preparedness for advocacy in global health within a framework of social justice, equity; and health system strengthening globally. Conclusion: Global health nursing goes beyond the intervention to care for a patient with a particular health problem but, however health is interconnected to political, economic and social context and therefore this explains the need of a multi-professional and multi-sectoral approach to achieve the goal of global health and the need for global health nursing. Global health equity can be promoted and if the profile of nursing and nurses will be raised and enable nurses to be aware of global health issues so as to enable them to work to their full maximum potential, to attain greater health outcome and wellness.

Keywords: global health nursing, double burden of diseases, globalization, health equity

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Authors: Rahul Kumar

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Background: Under-FiveMortality Rate(U5MR)ofanationiswidelyacceptedandlong-standing indicators of well-beingofherchildren.They measuredtheprobability of dying before theageoffive(expressedper1000livebirths).TheU5MRisanappropriate indicator of the cumulative exposure totheriskofdeathduringthefirstfiveyearsoflife, and accepted globalindicator ofthehealthandsocioeconomicstatusofagiven population.Itisalsousefulforassessing theimpactofvariousintervention programmes aimed at improving child survival.Under-fivemortalitytrendsconstitutealeadingindicatorofthelevel ofchildhealthandoveralldevelopmentincountries. Objectives: The first aim of our research is to study the level, trends, and Pattern of Under-five mortality using different sources of data. The second objective is to examine the survival pattern of Under-five mortality by different background characteristics. Data Source and Methodology: SRS and NFHS data have been used forobservingthelevelandtrendofUnder-Five mortality rate. Kaplan Meier Estimate has been used to understand the survival Pattern of Under-five mortality. Result: WefindthatallmostallthestatesmadesomeprogressbyreducingU5MRin recent decades.During1992-93highestU5MR(per thousand live birth) was observed in Assam(142)followed by up(141),Odisha(131),MP(130),andBihar(127.5).While the least U5MR(perthousandlive birth)wasobservedinRajasthan(102). The highestU5MR(per thousandlive birth)isobservedinUP(78.1), followed by MP(64.9)and Chhattisgarh(63.7)which are far away from the national level(50). Among them, Uttarakhand(46.7)hadleastU5MR(perthousandlivebirth), followed by Odisha(48.6). TheU5MR(perthousandlivebirth)ofcombinedhighfocusstateis63.7whichisfar away fromthenationallevel(50). Weidentified thatthesurvivalprobability ofunder-fivechildrenfromadolescentmotherislessin comparisontootherchildrenbornby differentagegroupofmothers. thatduringneonatalperiodusually male mortality exceedsthefemale mortality butthisdifferentialreversedinthepostneonatalperiod. Astheirageincreasesand approachingtofiveyears,weidentifiedthatthesurvivalprobability ofbothsexdecreasesbut female’s survival probabilitydecrement is more than male as their ageincreases. The poorer children’s survival probability is minimum. Children using improved toilet facility has more survival probability throughout thefiveyearsthan who uses unimproved. The survival probability of children under five who got Full ANCis more than the survival probability of children under five who doesn’t get any ANC. Conclusions: Improvement of maternal education is an urgent need to improve their health seeking behavior and thus the health of their children. Awareness on reproductive health and environmental sanitation should be strengthened.

Keywords: under-five mortality, survival pattern, ANC, trend

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Authors: Leona Ondrejikova, Martin Hill, Antonin Parizek

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The incidence of gestational diabetes mellitus (GDM) is higher in women predisposed to developing intrahepatic cholestasis of pregnancy (ICP). Both diseases are associated with altered steroidogenesis when compared with none-ICP controls. However, the effect of GDM on circulating steroids in ICP patients remains unclear. The question remains, whether the levels of circulating steroids differ between ICP patients with and without GDM. In total 10 ICP patients without GDM (ICP+GDM-), 7 ICP patients with GDM (ICP+GDM+), and 15 controls (ICP-GDM-) were monitored during late gestation, at labor, and during three periods postpartum (day 5, week 3, and week 6 postpartum) (Šimják et al., 2018). The relationships between steroid profiles and patients’ status were evaluated using the ANOVA model consisting of subject factor, between-subject factors Group (ICP+GDM+, ICP+GDM-, ICP-GDM-), gestational age at the diagnosis of ICP and gestational age at labor, and within-subject factor Stage and ICP × Stage interaction. The levels of the C21 and C19 Δ5 steroids and 5α/β-reduced C19 steroids were highest in ICP+GDM+, while those for the ICP-GDM-, and ICP+GDM- groups were lower. In the C21 Δ4 steroids and their 5α/β-reduced metabolites, the steroid levels were highest in the ICP+GDM-, intermediate in the ICP-GDM- and lowest in the ICP+GDM+ group. This higher concentration in ICP+GDM- group may be of importance as the 5α-pregnane-3α,20α-diol disulfate, is considered as the substance inducing ICP. In general, these data show that the comorbidity with GDM substantially changes the steroidome in ICP patients towards the higher activity of steroid CYP17A1 lyase step in adrenal zona reticularis reduced CYP17A1 hydroxylase step in zona fasciculata. This is consistent with our previously published hypothesis about the critical role of maternal zona reticularis in the pathophysiology of ICP. Our present data also indicate that the comorbidity with GDM might moderate the gravity of the ICP in this way.

Keywords: CYP17A1, GC-MS, gestational diabetes mellitus, intrahepatic cholestasis of pregnancy

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Authors: Getnet Gedefaw, Fentanesh Endalew, Bitewush Azmeraw, Bethelhem Walelign, Eyob Shitie

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Introduction: The issue of menstrual hygiene is often overlooked and has not been sufficiently addressed in the fields of reproductive health in low and middle-income countries. Inadequate menstrual hygiene practices can increase the risk of various infectious and chronic obstetric and gynaecological complications for girls and adolescents. Hence, this study seeks to investigate the knowledge, attitudes, and practices related to menstrual hygiene, along with the factors influencing them, among high school students. Methods: A facility based cross-sectional study was conducted involving a total of 423 study subjects. A systematic random sampling technique was utilized. Data was entered and analyzed through Epi data 3.1 and SPSS 22, respectively. Both univariable and multivariable logistic regression models were employed. A p-value of less than 0.05 was considered statistically significant. Results: This study revealed that 365(89.2%), 200(48.9%) and 196(47.9%) of the study participants have good knowledge, good practice, and good attitudes about menstrual hygiene, respectively. Being higher grade students (grade 10) [AOR=3.96, 95% CI =2.0-7.8] and having good practice of menstrual hygiene (AOR=2.52, 95% CI= 1.26-5) had a positive association with menstrual hygiene knowledge. Whereas maternal education level (AOR=1.86, 95% CI=1.18-2.9) and being a grade 10 student (AOR=2.3, 95% CI=1.48-3.56) were associated factors for practising menstrual hygiene. Additionally, being higher grade students (AOR=1.9, 95% CI=1.2-2.8), age ≥18 years (AOR=1.67, 95% CI=1.09-2.55) were statistically and positively associated with the attitude of menstrual hygiene. Conclusion: The study findings indicated that the knowledge of the study participants regarding menstrual hygiene was high, while their attitudes and practices towards menstrual hygiene were low. It is suggested that raising awareness among reproductive health groups and educating their families and parents could potentially lead to a positive change in their poor practices and attitudes towards menstrual hygiene.

Keywords: menstrual hygiene, menstruation, students, reproductive health

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Authors: Anna Jesionek, Aleksandra Szreniawa-Sztajnert, Zbigniew Jaremicz, Adam Kokotkiewicz, Natalia Filipowicz, Renata Ochocka, Bozena Zabiegala, Maria Luczkiewicz

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Rhododendron tomentosum (formerly Ledum palustre), an evergreen shrub grows in peaty soils in northern Europe, Asia and North America. In Poland, it is classified as an endangered species not only due to the drainage of wetlands, but also to the excessive collection of this repellent plant by human. The other valuable biological properties of R. tomentosum, used for years in folk medicine, include anti-inflammatory, analgesic and anti-microbial activity, conditioned by the essential oil content. Taking into account the importance of biodiversity and the potential therapeutic application, it was decided to establish, for the first time, the micropropagation protocol for R. tomentosum, for ex-situ conservation of this endangered species as well as to obtain the continuous source of in vivo and in-vitro plant material for further studies. This object was achieved by the selection of the explant and the media, which were modified within the scope of mineral composition, sugar content, pH and the growth regulators. As a result, the four-stage micropropagation protocol for R. tomentosum was specified, including shoot multiplication, elongation, rooting and ex-vitro adaptation. The genetic identification of the examined species and the compatibility of progeny plants with maternal ones was tested with molecular biology methods. Moreover, during the research process, the chemical composition of initial and regenerated plant and in vitro shoots was controlled in terms of volatile fraction by phytochemical analysis (GC and TLC methods). The correctness of the micropropagation procedure was confirmed by both types of studies.

Keywords: ex situ conservation, Ledum palustre, micropropagation, Rhododendron tomentosum

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Authors: Edit Xhajanka, Gresa Baboci, Irene Malagnino, Mimoza Canga, Vito Antonio Malagnino

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Purpose: This study aimed at identifying dental caries increment or reduction, based on factors such as smoking, the scaling of teeth, BMI before and during pregnancy, carbohydrates consumption in relation to childbirth. Material and method: In this observational study, the sample included a total of 98 pregnant women and their age class was 18-45 years old, with a median age of 31.5 years. The setting of the participants resides in Vlora –Albania. Moreover, 64.4% were from the city and 35.6% were from the nearby villages. The study was conducted in the time period January 2018 –June 2021. Body mass index (BMI) was calculated using the standard formula (kg/m²). Maternal pre, during and post-pregnancy BMI was collected by using a validated questionnaire. Statistical analysis was performed using IBM SPSS Statistics 23.0. The significance level (α) was set at 0.05, whereas P-value and analysis of variance (ANOVA) were used to analyze the data. Results: Based on the data analysis, 44.4% of the sample declared that they did smoke before pregnancy and 55.6% not smoked during their pregnancy. As a result, no association was found between smoking and length of pregnancy P=0.95. There is also a strong relation (P=0.000) between the number of teeth with caries before pregnancy and the number of teeth with caries during pregnancy. There is a significant relationship between the scaling of teeth and childbirth, P=0.05. BMI before and during pregnancy in relation to carbohydrates consumption have a significant correlation P=0.004 and P=0.002. The values of BMI before and during pregnancy in relation to childbirth have a strong correlation: P=0.043 and P=0.040, respectively. As a result, obesity was associated with preterm birth. The percentage of children born during 34-36 weeks of pregnancy was 69%, and children born during 32-34 weeks of pregnancy were 31%. CONCLUSION: There was a positive association between dental caries experience, BMI and carbohydrates consumption. Obesity in pregnancy is increasing worldwide; that is why this study suggests the importance of an appropriate weight before and during pregnancy.

Keywords: BMI, dental caries, pregnancy, scaling, smoking

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Authors: Alfiah Hasanah, Silvia Mendolia, Oleg Yerokhin

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This paper explores the impacts of adult child migration on the health of elderly parents left behind. The maternal and children health are a priority of health-related policy in most low and middle-income country, and so there is lack of evidence on the health of older population particularly in Indonesia. With increasing life expectancy and limited access to social security and social services for the elderly in this country, the consequences of increasing number of out-migration of adult children to parent health are important to investigate. This study use Indonesia Family Life Survey (IFLS), the only large-scale continuing longitudinal socioeconomic and health survey that based on a sample of households representing about 83 percent of the Indonesian population in its first wave. Using four waves of IFLS including the recent wave of 2014, several indicators of the self-rated health status, interviewer-rated health status and days of illness are used to estimate the impact of labour out-migration of adult children on parent health status. Incorporate both individual fixed effects to control for unobservable factors in migrant and non-migrant households and the ordered response of self-rated health, this study apply the ordered logit of “Blow-up and Cluster” (BUC ) estimator. The result shows that labour out-migration of adult children significantly improves the self-rated health status of the elderly parent left behind. Findings of this study are consistent with the view that migration increases family resources and contribute to better health care and nutrition of the family left behind.

Keywords: aging, migration, panel data, self-rated health

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Authors: Remi Szauer

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Introductory, Background, and Importance of the Study: For many years, religiosity in Poland remained at a stable level of religious practice. When the symptoms of secularization and privatization processes appeared in Poland, it was not clearly felt but rather related to the decline in compulsory practices carried out in public, the growing distance of respondents to catholic ethic, and the lack of acceptance regarding the intervention of the Church in legislation and policy. The basic indicators observed over the years kept the picture: more religious women - less religious men. By carrying out own research in the field of religious and moral attitudes in 2019-2021, it was noticed that a reversal of the trend preserved over the years could be observed. The data showed that women under 40 are radically different in their responses than women older than them - especially those over 50: in terms of practices or ties with the Church and many more specific aspects. This became the basis for a careful examination of the responses in the under 40 age cohorts among women. This study is significant because it shows completely new perspectives of women's perception of religiosity and allows us to notice clearly the aspects of social changes mapped in the minds of the surveyed women. Research Methodology: The original survey was carried out using the quantitative method among 2,346 respondents in northern Poland, 1,349 of whom were women. The findings from these observations led to deepening the topic of beliefs of women under 40 compared to other age cohorts of women. Hence, studies were carried out on the general population of women in Poland, which constituted a comparative sample. These were panel studies. The selection of the sample among women was random, respecting the age amounts so that the two statistical groups could be compared. The designated research parameters included: declarations of religious faith, declarations of religious practice, bond with the Church, acceptance of Mariological dogmas, attitude towards the image of women in the Church, and acceptance of selected issues in Catholic ethics. Main Research Findings: Among women under 40, the decline in declarations not only concerning compulsory public practices but also private practices and declarations of religious faith is more pronounced. Not only is the range of indifferent religious attitudes increasing, but also attitudes directly declaring religious disbelief, for which there are important justifications. Women under 40 years of age strongly distance themselves from the institutions of the Church and from accepting Mariological dogmas. Moreover, they note that the image of a woman is marked by stereotyping, favoring the intensification of violence against women, as well as disregarding her potential and agency. Concluding Statement: By analyzing the answers of the female respondents and the data obtained in the research, it can be observed a reevaluation of women's beliefs, which opens the perspective of analyzing the role of religion and the Church in Poland as well as religious socialization.

Keywords: religiosity, morality, gender, feminism, social change

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Authors: Dagem Alemayehu, Samson Gebersilassie, Jan Frank

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Climate change is impacting nutrition through reducing food quantity and access, limiting dietary diversity, and decreased nutritional food content as well as strongly affecting seasonal rainfall in Ethiopia. Nevertheless, only a few data is available on the impacts of seasonality in Infant, and Young Child Feeding (IYCF) practices undernutrition among 6-23 months old children in different agro-ecological zones of poor resource settings of Ethiopia. Methods: Socio-demographic, anthropometry, and IYCF indicators were assessed in the harvest and lean seasons among children aged 6–23 months of age randomly selected from rural villages of lowland and midland agro-ecological zones. Results: Child stunting and underweight increased from prevalence of 32.8 % and 23.9 % (lowland &midland respectively) in the lean season to 36.1% and 33.8 % harvest seasons, respectively. The biggest increase in the prevalence of stunting and underweight between harvest and lean seasons was noted in the lowland zone. Wasting decreased from 11.6% lean to 8.5% harvest, with the biggest decline recorded in the midland zone. Minimum meal frequency, minimum acceptable diet, and poor dietary diversity increased considerably in harvest compared to a lean season in the lowland zone. Feeding practices and maternal age were predictors of wasting, while women's dietary diversity and children's age was a predictor of child dietary diversity in both seasons. Conclusion: There is seasonal variation in undernutrition and IYCF practices among children 6-23 months of age with more pronounced effect lowland agro-ecological zone.

Keywords: agroecology, seasonality, stunting, wasting

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Authors: Umme Habiba Jasmine, Mzikazi Nduna

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Due to the dearth of exploratory research in Bangladesh on parenting practices and transmission thereof, there is a lack of information on culture-sensitive methodology in studying this topic. This paper aims to share some methodological reflections from the research field, which will address this knowledge gap. Eleven dyads of biological mothers and maternal grandmothers of school-going children constituted the sample, and a female fieldworker conducted one-to-one, semi-structured, in-depth interviews with them. The participants were recruited through purposive sampling through a representative of a cooperative society in Mirpur area in Bangladesh. Four dyads of the sample outside that eleven dyads were discarded because of the unavailability of the other participant of the dyads or unsuitability for an in-depth interview. The sample recruitment strategy of approaching mothers without their known reference body had to be discarded because of existing social insecurity in Dhaka city. To meet the cultural demand of the research field the researcher had to change in the research plan and comply with the cultural tradition of mutual entertainment with food while conducting interviews which helped in engaging in positive interaction. Also, the researcher had to compromise the strict confidentiality to a collectivistic sense of confidentiality of the in-depth interview sessions. This study suggests future researchers to investigate Bangladeshi traditional practices and accommodate the applicable ones in their research plan for qualitative studies, especially the Bengali tradition of hospitality and shared confidentiality for building rapport and for proper access to the targeted information and research participants. Sample recruitment should always accompany a well-accepted reference person in the targeted research field.

Keywords: confidentiality, culture-sensitive, ethics, parenting practices, sampling

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Authors: Rachel Dolan

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Background: Over two thirds of women in prison in England are mothers, and estimates suggest between 100 and 200 women per year give birth during imprisonment. There are currently six mother and baby units (MBUs) in prisons in England which admit women and babies up to the age of 18 months. Although there are only 65 places available, and despite positive impacts, they are rarely full. Mental illness may influence the number of admissions, as may interpretation of admission criteria. They are the only current alternative to separation for imprisoned mothers and their babies. Aims: To identify the factors that affect the decision to apply for/be offered a place in a prison MBU; to measure the impact of a placement upon maternal mental health and wellbeing; To measure the Initial outcomes for mother and child. Methods: A mixed methods approach - 100 pregnant women in English prisons are currently being recruited from prisons in England. Quantitative measures will establish the prevalence of mental disorder, personality disorder, substance misuse and quality of life. Qualitative interviews will document the experiences of pregnancy and motherhood in prison. Results: Preliminary quantitative findings suggest the most prevalent mental disorders are anxiety and depression and approximately half the participants meet the criteria for one or more personality disorders. The majority of participants to date have been offered a place in a prison MBU, and those in a prison with an MBU prior to applying are more likely to be admitted. Those with a previous history of childcare issues, who are known to social services are less likely to be offered a place. Qualitative findings suggest that many women are often hungry and uncomfortable during pregnancy, many have feelings of guilt about having a child in prison and that feelings of anxiety and worry are exacerbated by lack of information.

Keywords: mothers, prison, mother and baby units, mental health

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Authors: Asma Inge-Hanif, Ayyub Ansari Hanif

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The impact of conflicts, the subsequent refugee migration to America and their attempted use of societal resources implicate the lack of further humanitarian aid as a consequence of the abrupt decrease in services and policy changes stemming from new governmental mandates and Executive Orders. Statistical research data indicates a substantial decline in access to standardized health services by refugee women creating a significant alteration in the management of their maternal health care in America, previously shown to result in decreased mortality and morbidity. Studying nursing at Howard University in Washington, D.C., observed doctors were not always sensitive to the needs and modesty concerns of immigrant Muslim women - often unintentionally. Among health care professionals, the prevailing belief should be that every man, woman and child has the right to quality care in a dignified manner and the achievement of optimal health and well-being, regardless of race, creed, socio-economic level or status. In 1987 Muslimat Al Nisaa Health and Social Services Center was established to care for underserved and uninsured women and children. This Center, plus the subsequent shelter, provided direct access to those homeless, refugees, human trafficking and women victims of domestic violence was established and provides the data for this study. Understanding specific culture, social, economic and religious nuances respects their diversity and addressing their basic human needs that they achieve optimal success. The ultimate goal being to facilitate the rescue and housing of those whom escaped from a country/communities where girls are devalued, brought, sold and abused.

Keywords: women, refugee, domestic violence, health care

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Authors: Tope Olubodun

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Background: Family planning practices help individuals and couples avoid unwanted pregnancies, regulate intervals between pregnancies, and determine the number of children in the family. Family planning is an effective intervention for promoting maternal health, but its acceptability and utilization are impeded by many factors in Southwest Nigeria. Aim: This study was conducted to assess women’s knowledge and practice of family planning in two rural communities in Ogun State, Southwest Nigeria, and to determine factors associated with the utilization of family planning among these women. Methods: This was a cross-sectional study conducted among 561 women of reproductive age selected by multistage sampling. The data collection was done using interviewer-administered questionnaires. Data obtained were analyzed using IBM SPSS Statistics version 20. Frequencies were generated, and chi-square test was used to explore associations. The level of significance was set at 0.05. Result: The majority of the respondents were aware of family planning 410 (73.1%). The method most commonly known was male condom 348 (62.0%), then pills 276 (49.2%) and injectables 231(41.3%). The commonest sources of information on family planning were health workers 158 (26.8%), outreaches 162 (27.5%) and TV/radio 136 (23.1%). Respondents that had used family planning, however, only constituted forty–five percent. The methods commonly used were injectables 104 (39.2%) and pills 85 (32.1%). Reasons for choosing not to use family planning include the desire for more children 78 (26.3%), because spouse does not support family planning 56 (18.9%), fear of unbearable side effects 44 (14.9%), and poor knowledge of the methods of family planning as well as where the services can be obtained 39 (13.2%). There is a statistically significant association between age, ethnicity, education, occupation, average monthly income, and use of family planning. Conclusion: Campaigns that promote male involvement in family planning, use of family planning for child spacing, and dispelling of fears is recommended to improve the practice of family planning among such a group of women.

Keywords: family planning, rural, knowledge, practice

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Authors: Habtamu Fufa, Yemane Berhane

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Child under nutrition has long-term consequences for intellectual ability, economic productivity, reproductive performance and susceptibility to metabolic and cardiovascular disease. The unacceptably high prevalence of malnutrition in young children of the region has not changed much over the last decades, which could make the achievement of the corresponding Millennium Development Goals very unlikely. Despite the well-documented problems of child malnutrition in Sub-Saharan Africa, there is few systematic review of evidences on determinants of child malnutrition in the region. The current available evidence on determinants of child under nutrition in Sub-Saharan Africa is systematically reviewed. The method used in searching relevant literature was using bio medical databases PUBMED, Google scholar and the website of the World Health Organization on nutrition using the following key words: "Determinants “, "Child Malnutrition", and "Sub- Saharan Africa". The search was limited to articles published in and after 1995 up to date. In all the reviewed articles, the data were analyzed using multivariate regression analysis and or odds ratios for significance of determinants in child malnutrition. Synthesis of 40 published articles from various countries of the region is done and noted that household economic status, maternal education, disease, breastfeeding practices, age and sex of a child, birth interval and residential areas were found to be determinants of child under nutrition. Poverty remains the main factor of malnutrition in Sub-Saharan Africa and poor education of parents aggravates the malnutrition through perpetuation of poor nutrition practices. Male children under five years are the most affected ones. Understanding of these determinants of poor nutritional attainment would provide insights in designing interventions for reducing the high levels of child malnutrition in this region. Large-scale multi-sectoral community-based interventions are urgently needed for a sustainable improvement of child nutritional & health status in Sub-Saharan Africa.

Keywords: child malnutrition, determinants, Sub-Saharan Africa, health status

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Authors: Clesse C., Lighezzolo-Alnot J., De Lavergne S.

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Considered as the most common surgical procedure worldwide, episiotomy can be defined as an incision around the vulva performed to enlarge it, in the aim of preventing the traumatic rupture of the perineum during childbirth. Rather mediatized, this practice raises many questions in the field of mental health, relayed by different users and health professionals. Today, is topicality is moderately hectic since many queries about the prophylactic exercise of episiotomy are subject to a relative consensus, particularly since WHO advocated in 1996 that only 10% of childbirths should involve an episiotomy. This indicator appeared after the publication of numerous results from randomized clinical trials. Unfortunately, these papers seem mostly centered about somatic impacts of episiotomy. From the side of psychological studies, they mostly integrate a major clinical methodological bias, especially considering that every primiparous woman is identical to the others face to the experience of parturition. In the aim to fill this lack of knowledge, we developed a longitudinal research starting in the 7th month of pregnancy and ending one year after delivery. We are studying in a comparative way different possible psychological consequences inherent to the use of episiotomy. To do this, we use a standardized methodology which combines semi-structured clinical interviews (IRMAG, IRMAN ...), free clinical interviews, a projective test (Rorschach) and five questionnaires (QIC, EPDS, CPQ WOMBLSQ4, SF36). Therefore, we can comprehend with shrewdness the question of psychic impacts of episiotomy in a qualitative and quantitative way by comparing it to other obstetric interventions. In this paper, we will present the first results obtained about a population of twenty-two primiparous women by focusing on body image, sexuality, quality of life, depressive affects, post-traumatic stress disorder and investment of the maternal role. Finally, we will consider the different implications and perspectives of this research which could improve the public health policies in the field of perinatal care.

Keywords: assessment, episiotomy, mental health, psychical impacts

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Authors: Jesus D. Cortes Gil, Fernanda Ewerling, Leonardo Ferreira, Aluisio J. D. Barros

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Background: The sustainable development goals call for inclusive, equitable, and quality learning opportunities for all. This is especially important for children, to ensure they all develop to their full potential. We studied the prevalence and inequalities of suspected delay in child development in 63 low- and middle-income countries. Methods and Findings: We used the early child development module from national health surveys, which covers four developmental domains (physical, social-emotional, learning, literacy-numeracy) and provides a combined indicator (early child development index, ECDI) of whether children are on track. We calculated the age-adjusted prevalence of suspected delay at the country level and stratifying by wealth, urban/rural residence, sex of the child, and maternal education. We also calculated measures of absolute and relative inequality. We studied 330.613 children from 63 countries. The prevalence of suspected delay for the ECDI ranged from 3% in Barbados to 67% in Chad. For all countries together, 25% of the children were suspected of developmental delay. At regional level, the prevalence of delay ranged from 10% in Europe and Central Asia to 42% in West and Central Africa. The literacy-numeracy domain was by far the most challenging, with the highest proportions of delay. We observed very large inequalities, and most markedly for the literacy-numeracy domain. Conclusions: To date, our study presents the most comprehensive analysis of child development using an instrument especially developed for national health surveys. With a quarter of the children globally suspected of developmental delay, we face an immense challenge. The multifactorial aspect of early child development and the large gaps we found only add to the challenge of not leaving these children behind.

Keywords: child development, inequalities, global health, equity

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Authors: Josie West

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This paper focuses on the conflicts and utility of Marxist Feminist frames for sex work research, drawing on findings uncovered through in-depth interviews with online sex workers, alongside critical discourse analysis of media and political commentary. It brings the critical perspective of women into digital workerism and gig economy dialogue who, despite their significant presence within online work, have been overlooked. The autonomist Marxist concept of class composition is adopted to unpack the social, technical and political composition of this often-invisible segment of the service sector. Autonomism makes visible the perspective of workers engaged in processes of mobilization and demobilizaiton. This allows researchers to find everyday forms of resistance which occur within and outside trade unions. On the other hand, Marxist feminist arguments about invisibility politics can generate unhelpful allegories about sex work as domestic labour within the reproductive sphere. Nick Srnicek’s development of Marx’s notion of infrastructure rents helps theorize experiences of unpaid labour within online sex work. Moreover, debates about anti-work politics can cause conflict among sex workers fighting for the labour movement and those rejecting the capitalist work ethic. This illuminates’ tensions caused by white privilege and differing experiences of sex work. The monopolistic and competitive nature of sex work platforms within platform capitalism, and the vulnerable position of marginalised workers within stigmatized/criminalised markets, complicates anti-work politics further. This paper is situated within the feminist sex wars and the intensely divisive question of whether sex workers are victims of the patriarchy or symbols of feminist resistance. Camgirls are shown to engage in radical tactics of resistance against their technical composition on popular sex work platforms. They also engage in creative acts of resistance through performance art, in an attempt to draw attention to stigma and anti-criminalization politics. This sector offers a fascinating window onto grassroots class-action, alongside education about ‘whorephobia.’ A case study of resistance against Only Fans, and a small workers co-operative which emerged during the pandemic, showcases how workers engage in socialist and political acts without the aid of unions. Workers are victims of neoliberalism and simultaneous adopters of neoliberal strategies of survival. The complex dynamics within unions are explored, including tensions with grass-roots resistance, financial pressures and intersecting complications of class, gender and race.

Keywords: autonomist marxism, digital labor, feminism, neoliberalism, sex work, platform capitalism

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Authors: Shannon Rappe, Elizabeth Morse, David Phillippi

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Postpartum women with an opioid use disorder (OUD) are at high risk for treatment disengagement, leaving them vulnerable to overdose and death between seven and twelve months postpartum. Intensive case management programs have been proposed as an effective strategy to reduce barriers and increase treatment engagement among postpartum women. The purpose of this project is to determine the effects of early engagement in an intensive case management program on postpartum engagement and infant health outcomes among postpartum women with opioid use. This retrospective review of secondary data was collected on 225 infants, and 221 postpartum women enrolled in an intensive case management program in Tennessee between May 1, 2019, and May 5, 2020. Chi-squares were computed to examine the timing of engagement during pregnancy, maternal treatment outcomes, and infant health outcomes, including neonatal abstinence syndrome (NAS), birth weight, gestational age, and length of stay. The mean prenatal program engagement was 109 days (SD = 67.6); 16.7% (n = 37) enrolled during the first trimester, 37.6% (n = 83) in the second trimester, and 45.7% (n = 101) in the third trimester. Of the 221 women engaged, 45.2% (n = 100) remained engaged in the case of management at the time of data collection, and 40% (n = 89) remained engaged in MAT at the time of data collection. Twenty- five percent (n = 25) of mothers who graduated sustained engagement in MAT. Of 225 infants 28.9% (n = 65) had a positive NAS status, mean birth weight was 6.5 lbs. (SD = 19.3); mean gestational age was 38.3 weeks (SD = 19.3) and mean length of stay was 8.19 days (SD = 9.8). This study's findings identified that engaging mothers during pregnancy in a program designed to meet their unique challenges positively impacts both the mother and infant outcomes, regardless of their timing.

Keywords: intensive case management, neonatal abstinence syndrome, opioid addiction, opioid crisis, opioid use in pregnant women, postpartum addiction

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