In 2011, representatives from the Multnomah County Health Departments and several Native-serving organizations came together to address substance-exposed pregnancies among urban Native Americans in Portland, Oregon. From these partnerships, the Future Generations Collaborative was formed representing a significant shift toward community-led maternal child health research and planning. Additionally, the Future Generations Collaborative adopted a historical trauma-informed community based participatory research and planning process. This is particularly significant considering government agencies' role in colonization within Native communities. The purpose of this case study is to explore partnerships between government agencies and the Portland Native community within the Future Generations Collaborative. Given the profound influence of historical trauma in Native communities, this paper addresses how the partnerships between government agencies and the Portland Native community pose distinct opportunities, challenges, and implications. Drawing from FGC members' lived experiences and an interdisciplinary body of research, I develop a theoretical model for explaining the government's role in creating and sustaining historical trauma within Native communities. This analysis provides critical context for examining the impact of historical trauma on the relationships between government agencies and the Portland Native community within the FGC. By entering methodological discussions of Native-specific community-based participatory research, this study also addresses how the use of a trauma-informed research and planning model affects the relationships between government agencies and the Portland Native community within the FGC.

Objetivo: Describir las características clínico-epidemiológicas de gestantes con COVID-19 y sus recién nacidos, atendidos en un hospital de EsSalud - Chiclayo. Marzo 2020 – junio 2021. Materiales y Métodos: Se realizó un estudio descriptivo, retrospectivo y transversal. Se revisó las historias clínicas virtuales de las gestantes con COVID-19 y sus recién nacidos atendidos en el servicio de Gineco-Obstetricia del Hospital II Luis Heysen Inchaustegui. Resultados: La población fue de 152 gestantes, de las cuales el 34.2% tuvieron igual o mayor a 35 años. Los meses de marzo y abril del 2021 fueron los de mayor incidencia con 24 y 21 casos reportados, respectivamente. Tos (68.4%), malestar general (63.1%) y disnea (47.3%) fueron los síntomas más comunes. La prueba diagnóstica más utilizada fue la serológica IGM/G (48.7%). El 98% presentó infección a partir de las 29 semanas de gestación, las complicaciones obstétricas más frecuente fueron RPM con un 14.5%, seguida de preeclampsia con 8.6% y el 46.7% tuvo anemia. Respecto a los recién nacidos, el 55.3% fueron del sexo masculino, con un peso entre 2500-4000 gramos (91.4%). Se evidenció que el 18.4% presentó dificultad respiratoria, el 6.6% fiebre y el 59.2% tuvo una estancia hospitalaria mayor a las 36 horas. Conclusiones: El rango de edad de las mujeres gestantes con COVID- 19 estuvo entre los 28 y 36 años. Tos y malestar general fueron los síntomas más frecuentes; y las complicaciones obstétricas fueron RPM y Preeclampsia. En relación a los recién nacidos, el 99.3% tuvo un Apgar mayor a 7 puntos a los 5 minutos de vida, con un peso normal en el 91.4%. Los síntomas que presentaron fueron dificultad respiratoria y fiebre. / Aim: To describe epidemiological and clinical characteristics of pregnant women with COVID19 and their newborns, treated at a Hospital in Chiclayo from March 2020 through June 2021. Methods: This is a descriptive, retrospective and cross-sectional study that reviewed the medical records of pregnant women with COVID-19 and their newborns treated in the Gynecology and Obstetrics department of II Luis Heysen Inchaustegui Hospital. Results: The population was 152 pregnant women, of which 34.2% were 35 years old or older. The months of March and April 2021 were the months with the highest incidence with 24 and 21 cases reported, respectively. Cough (68.4%), general malaise (63.1%) and dyspnea (47.3%) were the most common symptoms. The most used diagnostic test was the IGM/G serological test (48.7%). 98% presented infection after 29 weeks of gestation, the most frequent obstetric complications were PPROM with 14.5%, followed by preeclampsia with 8.6% and 46.7% had hemoglobin less than 11g/dl. Regarding the newborns, 55.3% were male, weighing between 2500-4000 grams (91.4%). It was evident that 18.4% had respiratory difficulty, 6.6% had fever and 59.2% had a hospital stay of more than 36 hours. Conclusions: The age range of pregnant women with COVID-19 was between 28 and 36 years. Cough and general malaise were the most frequent symptoms; and obstetric complications were PPROM and Preeclampsia. In relation to newborns, 99.3% had an Apgar score greater than 7 points at 5 minutes of life, with a normal weight in 91.4%. The symptoms they presented were respiratory distress and fever.

Thesis (PhD)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Pregnancy is a vulnerable time in settings such as sub-Saharan Africa, and is associated with exposure to a multitude of physiological, social and psychological risks. High HIV prevalence, and the fact that many women will test for HIV for the first time during their pregnancy, has raised concern about women‘s psychological health during pregnancy. Depression during the antenatal period is of public health concern as it has been shown to be associated with poorer foetal and delivery outcomes, risky behaviours, and poorer uptake of antenatal care. Antenatal depression is a predictor of postnatal depression, and postnatal depression has been associated with poor maternal sensitivity and attachment in mothers which is known to result in increased behavioural and developmental difficulties in children. The aim of this research was to provide a clear, in depth and culturally sensitive understanding of the manifestation of depression in pregnant women in a rural area with high HIV prevalence in South Africa. The research method included a diagnostic assessment of depression in 109 women in their third trimester of pregnancy, and an in-depth qualitative examination of the contextual framework within which HIV testing and depression are experienced with a sub-sample of 56 women. The quantitative results demonstrated that the prevalence of antenatal depression was high (46.7%), with close to half of the women being diagnosed with depression. Presentations of depression most frequently included disturbances in mood, loss of interest and suicide ideation. Symptoms which overlap with common side effects of pregnancy such as loss of energy and weight change did not result in an overestimation of depression. Likewise, very little evidence of the somatisation of depression, or particular cultural barriers to the diagnosis of depression based on DSM-IV criteria was found. Rates of suicide ideation were high and equally common among HIV positive as HIV negative women. Factors significantly associated with depression included living within a family homestead, access to a regular source of income and practical support from a partner. Both income and partner support had a negative association with depression. Living away from a family or parental home had a positive association with depression. The results showed that the Edinburgh Postnatal Depression Scale (EPDS) was effective in identifying depression and that a shorter three item version was as effective as longer versions. A positive score for depressed mood on the EPDS was significantly associated with HIV, suggesting that the EPDS is a good screening tool for elevated psychological risks among HIV positive women post HIV testing. Qualitative results showed that having an unsupportive partner and the occurrence of relationship or familial conflict played an important role in the development of emotional distress during pregnancy and resulted in a high number of unwanted pregnancies. Partner and familial conflict was intertwined with cultural practices which govern the acceptability of childbearing among unmarried women and the social recognition of partnerships and paternal responsibilities. Testing for HIV was considered a stressful life event for all women regardless of their HIV status and was a particularly negative life event for women who tested HIV positive or for women who had concerns over partner infidelity. Disclosure among HIV positive women frequently lead to increased partnership conflict. Qualitative findings suggested that depression and emotional distress after HIV testing did interfere with women‘s ability to engage with prevention messages. Women who were coping well with learning their HIV positive status had high levels of family disclosure and subsequent family support in common. The implication of this research is that it is important that public health programmes screen for depression among childbearing women. These data suggests that a shorter three item version of the EPDS along with screening for partner and family support or conflict would effectively detect most women at high risk for depression. Likewise, public health interventions for women with depression which are implemented in primary health care facilities and in isolation of the partnership and familial context within which depression occurs are not likely to be effective. Further research is needed to establish the precise prevalence of antenatal and postnatal depression in women at high risk for HIV; to validate the effectiveness of a shorter screening tool in resource limited settings; and to establish risk and protective factors, and trimester specific risks which could inform the design of cost effective interventions in poorly resourced settings. / AFRIKAANSE OPSOMMING: Swangerskap in Afrika, suid van die Sahara, is ʼn kwesbare tydperk met blootstelling aan ʼn menigte fisiologiese, sosiale en sielkundige risiko‘s. Die hoë voorkoms van HIV en die feit dat baie vrouens gedurende swangerskap vir die eerste keer vir HIV wil toets, het ‗n besorgdheid oor vrouens se sielkundige gesondheid gedurende swangerskap laat ontstaan. Depressie gedurende die voorgeboortelike periode is van belang vir publieke gesondheid, want daar is bewyse wat dui op ‗n verband tussen depressie en swakker fetale en geboorte resultate, riskante gedrag en verminderde gebruik van voorgeboortelike sorg . Voorgeboortelike depressie is ʼn indikasie van moontlike nageboortelike depressie en nageboortelike depressie word geassosieer met swak moederlike sensitiwiteit en die gebrekkige vorming van ‗n band tussen moeder en kind; wat reeds bewys is om te lei tot verhoogde gedrags- en ontwikkelingsprobleme in kinders. Die doel van hierdie navorsing was om ʼn duidelike, indiepte en kulturele-sensitiewe begrip van die manifestasie van depressie in swanger vroue in ʼn landelike omgewing met hoë HIV voorkoms in Suid Afrika te verkry. Die navorsingsmetode sluit in ʼn simptomatiese beraming van depressie by 109 vroue in hul derde trimester van swangerskap en ʼn indiepte kwalitatiewe ondersoek na die kontekstuele raamwerk waarbinne HIV toetse en depressie ondervind word met ʼn sub-steekproef van 56 vrouens. Die bevinding was dat die voorkoms van voorgeboortelike depressie hoog was, 46.7 %, met feitlik die helfte van die vrouens wat met depressie gediagnoseer is. In die meeste gevalle het die voorkoms van depressie gepaard gegaan met ʼn verandering in gemoedstoestand, ʼn verlies aan belangstelling en selfmoordgedagtes. Simptome wat ooreenstem met algemene newe-effekte van swangerskap, soos verlies aan energie en verandering in gewig, het nie bygedra tot ʼn oorberekening van depressie nie. Soortgelyk is baie min bewyse gevind dat somatosasie van depressie, of spesifieke kulturele grense, tot die diagnose van depressie gebaseer op DSM-IVkriteria bydra. Die oorweging van selfmoord was hoog en algemeen tussen beide HIV-positiewe en HIV-negatiewe vouens. Faktore wat aansienlik met depressie geassosieer word, sluit in om in ʼn familiegroep te bly, toegang tot ʼn vaste bron van inkomste en die praktiese ondersteuning van ʼn lewensmaat. Beide inkomste en die ondersteuning van ʼn lewensmaat het ʼn negatiewe verbintenis met depressive. Om nie by familie of in ʼn ouerhuis te bly nie het ʼn positiewe assosiasie met depressive. Alhoewel HIV-status verband hou met depressie, was dit nie uitermate die geval nie, alhoewel daar ʼn gebrek aan statistiese kragdoeltreffendheid was om die effek van HIV vas te stel, gegee die beperkte grootte van die steekproef. Die resultate het getoon dat die EPDS graderingsinstrument effektief was om depressie te identifiseer en dat ʼn korter driepunt weergawe daarvan net so effektief was soos die langer weergawe. ʼn Positiewe telling vir ʼn depressiewe gemoedstoestand op die EPDS het ʼn betekenisvolle assosiasie met HIV en dui daarop dat die EPDS ʼn goeie graderingsinstrument is vir verhoogde sielkundige risiko by HIV-positiewe vrouens, selfs al is HIV-positiewe vrouens in dié steekproef statistieksgewys nie meer geneig tot depressie as HIV-negatiewe vrouens nie. Kwalitatiewe resultate toon dat ʼn lewensmaat wat nie ondersteunend is nie en die voorkoms van verhoudings- of familiekonflik ʼn belangrike rol speel in die ontwikkeling van emosionele angs gedurende swangerskap en dit het gelei tot ʼn groot aantal ongewenste swangerskappe. Konflik met ʼn lewensmaat en met familie was verweefd met kulturele gebruike wat die aanvaarbaarheid van geboortes onder ongetroude vrouens beheer en die sosiale erkenning van verhoudings en die vader se verantwoordelikhede. ʼn HIV-toets is as ʼn stresvolle lewensgebeurtenis beskou deur alle vroue, ongeag van hulle HIV-status en was ʼn besondere negatiewe lewensgebeurtenis vir vroue wat HIV-positief getoets het of vir vroue wat bekommerd was oor hulle lewensmaats se getrouheid. Onthulling van die HIV-status van positiewe vrouens het gereeld tot verhoogde konflik in verhoudings gelei. Kwalitatiewe bevindings dui daarop dat depressie en emosionele angs na ʼn HIV-toets inmeng met ʼn vrou se vermoë om ag te slaan op voorkomingsboodskappe. Vroue wat die kennis van hulle HIV-positiewe status goed hanteer het, het hoë vlakke van bekendmaking van hulle status en die ondersteuning van hulle familie in gemeen. Die implikasie van die navorsing is dat dit belangrik is vir publieke gesondheidsorgprogramme om te toets vir depressie onder swanger vroue. Die resultate dui daarop dat ʼn korter driepunt weergawe van die EPDS, saam met ʼn ondersoek na die ondersteuning van of konflik met ʼn lewensmaat en familie, effektief kan wees om vroue met ʼn hoë risiko vir depressie te identifiseer. Soortgelyk, publieke gesondheidsingryping in primêre gesondheidsorg fasiliteite vir vroue met depressie wat in isolasie van die lewensmaat en familie konteks, waar depressie voorkom geadministreer word, is onwaarskynlik om te slaag. Bevindings onderskryf die belangrikheid van ondersteuning vir die familie om effektief te kan reageer en herstel van stresvolle faktore soos onbeplande swangerskappe en HIV-diagnose, in ʼn konteks wat swaar deur HIV geaffekteer word, aangesien dit ʼn voorkomende effek op depressie kan hê. Verdere navorsing is nodig om die presiese voorkoms van voorgeboortelike en nageboortelike depressie in vrouens met ʼn hoë blootstelling aan HIV vas te stel; om die sukses van ʼn korter graderingsinstrument in arm omgewings te staaf; en om die risiko en beskermende faktore vas te stel en trimester spesifieke risiko‘s wat die ontwerp van ʼn koste-effektiewe ingryping in gebiede met ontoereikende hulpbronne kan beïnvloed.

Background: Malaria continues to pose a complex public health problem amongst pregnant women in Africa (Schantz-Dunn & Nour 2009; Antwi 2010), accounting for over 90% of the global malaria burden (WHO 2002; Morel et al. 2005; Schantz-Dunn & Nour 2009). However, little is known about the impact of information, education and communication (IEC) strategies in malaria prevention and control among pregnant women in Africa. Aims and Objectives: The study sought to identify: evidence of impact of IEC strategies; feasibility, appropriateness, meaningfulness and effectiveness of the IEC strategies; challenges; best practices and key lessons to inform governments, policymakers, health partners, the academic community, directors, managers of health, frontline health professionals and health educators at institutional and community levels. Moreover, the study aimed to develop a theoretical framework to enhance the understanding of issues related to implementation of IEC strategies. Methods: A mixed method approach was adopted. This consisted of a systematic review of evidence within the African context and an evaluation methodology involving a contextually based survey of Ethiopia, Ghana, Nigeria and Tanzania. The systematic review involved a structured search of relevant databases and websites, and hand search strategies. Three sets of evidence were identified and aggregated using a narrative synthesis approach. A survey questionnaire reflecting the outcomes of the review was sent to health professionals and lay persons in the countries under study. Primary data were analysed using SPSS Version 15.0. Non-parametric tests and sensitivity analyses were conducted to assess the nature of opinions among respondents within and across countries. Findings: 3,440 studies were identified during the systematic review. Out of this number, 57 met the inclusion criteria. Following critical appraisal, 50 studies met the criteria for methodological quality. Ten IEC strategies were identified. These were: Staff training and orientation Advocacy Community mass education campaigns House-to-house sensitisation Health education in health units Visiting places of worship Women’s group meetings Integrated health education campaigns Symbolism versus message delivery Audience segmentation versus information delivery. The survey reveals a high level of awareness of IEC strategies among respondents in the African countries studied. The evidence of impact reported by respondents supported the findings of the systematic review. However, there were some differences, and some concerns still remain regarding the extent of impact. The study suggests that using an IEC strategy implementation equation could enhance the understanding of issues related to implementation of IEC strategies. Implications of the findings are outlined, including implications for professional practice in relation to IEC programme implementation, most especially among nurses and midwives. IEC roles and responsibilities of key actors are also proposed. Conclusions: Despite the challenges of adopting a mixed method approach, the study highlights an important relationship between evidence and practice. This approach also helped to ensure that a comprehensive multiperspective view of IEC strategies was achieved. In designing and implementing IEC programmes, clients must be involved in order to encourage community ownership and programme sustainability. Attitudinal change and commitment is required by all stakeholders in order to achieve and maintain impact on malaria in pregnancy. Finally, while recognising the essence of feasibility, appropriateness and meaningfulness of a given strategy, it is worth noting that the key message from this study is that no one single strategy on its own appears ideal. Therefore, there is the need to pay equal attention to both institutional and community-based strategies. Doing one thing alone will not work; more evidence of impact is required to know what works and in what context.

Darbo tikslas – įvertinti šachtinių šulinių geriamojo vandens kokybę ir jo gerinimo galimybes Pakruojo rajone. Uždaviniai: 1. Įvertinti šachtinių šulinių geriamojo vandens kokybės rodiklius. 2. Nustatyti nėščių moterų ir moterų, kurios augina kūdikius iki 6 mėn. amžiaus, požiūrį į naudojamo vandens kokybę ir tyrimo rodiklius. 3. Įvertinti šachtinių šulinių geriamojo vandens kokybės gerinimo galimybes. Tyrimo metodika. Anketinė nėščių moterų ir kūdikius iki 6 mėn. amžiaus auginančių moterų (n=167, atsako dažnis 100 proc.) apklausa. Šachtinių šulinių geriamojo vandens kokybės rodiklių tyrimo protokolų analizė (n = 270) ir visuomenės sveikatos centro ir biuro specialistų, rajono ekologo (n=3, atsako dažnis 100 proc.) interviu. Apklausos duomenys analizuoti „SPSS 15.0 for Windows“ programa. Hipotezės tikrintos, taikant χ² testą, nustatčius reikšmingumo lygį p<0,05. Rezultatai. Tyrimo metu buvo nustatyta, kad respondentės, naudojančios užterštų šachtinių šulinių vandenį, dažniausiai gyvena kaimo vietovėse, turi mažas metines pajamas, yra bedarbės. 95,8 % respondenčių gavo informaciją apie šachtinių šulinių vandens kokybę ir patarimus, kaip apsaugoti save ir kūdikius. Moterys, turinčios žemesnį išsilavinimą, informavus apie vandens tyrimo rezultatus bei riziką sveikatai, vartoja užterštą geriamąjį vandenį nitratais ir nesiima jokių veiksmų jo kokybei gerinti. Netinkamai tvarkoma šulinio aplinka, kuri gali sąlygoti užteršimą: apie šulinį auginami augalai, kurie yra tręšiami... [toliau žr. visą tekstą] / The Aim of the study: to asses the quality of the possibilities of improving it in Pakruojis district. Objectives : 1. Estimate the quality of the dug wells for drinking water. 2. Evaluate the standpoint of pregnant women and the women growing up babies sunder the age of six (6) months to the dug wells water quality indicators. 3. Estimate the opportunities of improvements for the quality of drinking water. Research methods. Questions for pregnant women and the women raising infants under six months Cn =167, response rate was 100 percent survey. The analysis of the dug wells for drinking water quality indicators (n=270) made by the public health center, the office professionals the region ecologist (n=3, response rate 100 percent) interview. Survey data, was analysed at “SPSS15.0 for Windows” program. The Hypothesis is verified by using the test χ2. According to it the significance level is p<0,05. Results. The study found out that the respondents using contaminated water from dug wells, are unemployed. 95.8 % of them have received the right information about the quality of the water in their dug wells. They also have get the advices how to protect themselves and their children. The women with lower education were informed about the test results of their water, about health risks using the water, they still consumpt contaminated by nitrates drinking water and don’t take any actions to improve its quality. Improperly handled wells, their environment which may lead to... [to full text]

Studies have shown that pregnant women do understand and value information of their unborn child. However, those providing health promotion services often focus on medical procedures and health education messages, ignoring the cultural, socio-economic and psychological dimensions that impact on women's health. This research aimed to look at a specific component of health promotion, i.e. health promotion messages shared with pregnant women attending Stellenbosch and Klapmuts Community Health Centre Antenatal Health Promotion Programme and their perceptions of how they apply messages in their daily lives.

This thesis is a subset of a larger “parent” project under the direction of my supervisor, Dr. Cecilia Benoit. The purpose of the larger project is to seize an unique research opportunity that has emerged with the development and implementation of the HerWay Home (HWH) program, a community-based initiative for pregnant and early parenting women who face substance use and other challenges in the Greater Victoria Area. My research has capitalized on the pre-implementation phase of the HWH program between 2010-2011. Thirteen in-person semi-structured interviews were conducted with women who would likely be clients for the HWH program, based on their pregnancy experiences, substance use concerns and other life challenges. The goal of this research has been to explore these women’s pregnancy and postpartum narratives and investigate what, in their view, should be crucial components of the HWH intervention in the short and longterm. My findings indicate that, consistent with the literature on pregnant and early parenting women facing substance use and other life challenges, a range of complex, intertwined disadvantages exist in their lives that translate into multiple barriers to accessing continuous health and social care during their pregnancy and after the birth of their child. An adapted model of the Health Lifestyle Theory is used to frame the analysis of the data collected from this research. The results from this research support the argument that the life choices of the participants are constrained by structural life chances and socially determined inequities that systematically disadvantage and disempower them. The findings also reveal an implicit sense of agency in the women’s narratives, as well as key specifics about what they view as the main gaps in care and their desired program services. The findings will be relayed to HWH organizers, and used to inform the development and implementation of the program’s services. / Graduate

Self-determination Theory postulates that there are innate psychological needs for autonomy, competence, and relatedness, and that satisfaction of these needs fosters the development of autonomous motivation. Research suggests that autonomous forms of motivation are important for behavior change and maintenance. With increasing research on Self-determination Theory and its possible applications, there is a demand for research that develops and tests behavioral interventions. This study seeks to apply Self-determination Theory to a prenatal care intervention for low-income pregnant women in the Los Angeles area. The Self-determination Theory based and the non-Self-determination Theory based prenatal care interventions will be compared. Perceived autonomy, competence, relatedness, and autonomous motivation will be measured as well as health care behaviors (healthy behavior habits, prenatal care return rates, and adherence to doctor’s regimen). Perceived autonomy competence, relatedness, autonomous motivation, and healthy behavior will be measured before and after the intervention. Return rate and adherence to doctor’s regimen will be measured post-intervention. The Self-determination Theory based intervention group is expected to report higher levels of autonomous motivation, perceived autonomy, competence, relatedness, and healthy behavior, higher return rates, and better adherence to doctor’s orders than the control group. The findings may help shape prenatal care interventions for low-income pregnant women resulting in healthier pregnancies and reduced risk factors for infant disease and mortality.

The purpose of this study was to assess college students' attitudes toward pregnancy and women in the work force following the passage of the Family Medical Leave Act of 1993. Data were obtained from 347 students at a university in North Texas during the spring semester of 1997. Gender, age, employment status, parental status, and citizenship were independent variables hypothesized to influence attitudes toward pregnant working women. Gender was significant for the following factors: pregnant women as employees (p<.001), emotional stereotypes (p<.001), choosing family or career (p<.001), and physical limitations (p<.001). Those students 17-19-years-old had a more negative attitude toward pregnant women choosing work over family (p<.001) than did the older students.

Social security of women during pregnancy and maternity The purpose of thesis is to analyse social security of women during pregnancy and maternity in the current legislation. The thesis is composed of introduction, main part and conclusion. The main part is divided into six chapters. Chapter one describes historical development of social security of women during pregnancy and maternity in the Czech republic. Folowing two chapters focuse on social security of pregnat women and parents of small children in connection with membership of the Czech republic in international organisations and the European union. Chapter four characterises system of sickness insurance and benefits that are provided in case of maternity (maternity benefits, pregnancy and maternity compensation benefits, sick pay, care benefits). Chapter five analyzes system of state social support with benefits provided to pregnant women and parents (parental allowance, birth grant, child allowance). Last - sixth chapter complements the subject of the thesis with protection of pregnant women and parents with small children in labour-law. Conclusion summs up social security of women during pregnancy and maternity. Social benefits are above standarts and system is functional. Drawback is seen in wrong understanding of system by some parents...