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52, 95% CI=0.18 to 1.50, P=0.23), and macrosomia (OR=0.81, 95% CI=0.41 to 1.57, P=0.53). No significant increase was observed in terms of 5-minute Apgar (SMD=0.16, 95% CI=-0.06 to 0.39, P=0.15, I2=0%), birth weight (SMD=-0.18, 95% CI=-0.43 to 0.06, P=0.13, I2=0%), and gestational age (SMD=0.13, 95% CI=-0.11 to 0.37, P=0.28, I2=0%). Conclusion Probiotic or synbiotic supplements are not associated with significant effects on pregnancy outcomes in GDM. However, due to the limited number of studies in this regard and heterogeneity between studies, future high-quality RCTs are recommended.Introduction The period of transition from nursing student to professional nurse is demanding. Most often the challenges among the novice nurses are attributed to the number of patients with complex illness and co-morbidities, inaccessible mentors, performance anxiety, communication difficulties, and blame/complaint culture. Transitional challenges could result in work dissatisfaction forcing novice nursing graduates to quit their jobs that result in a high turnover rate. The study aimed to identify the transitional challenges among new nursing graduates and the role of preceptor in various transitional challenges. Methods The study adopted descriptive correlational design. The data were collected from 314 participants working in six different tertiary level public hospitals situated in six states of India. Casey-Fink graduate nurse experience survey-revised was used to collect the data and methods of this study were in line with the guidelines of Strengthening the Reporting of Observational studies in Epidemiology (STROBE). Descriptive and Inferential statistics were calculated using SPSS software version 16. Results The study found that new nursing graduates are uncomfortable in performing numerous procedures independently and in accordance with them increased support would help them feel more supported or integrated into the unit. The study also found positive relationship between preceptor support and organizing and prioritizing, communication/leadership, professional satisfaction, and job satisfaction. Conclusion New nursing graduates experience various challenges during their transition period in the areas of role expectation, confidence, workload, orientation, and fears. The preceptors and the nursing administrators needs to bring forth significant strategies to address these challenges.Introduction Preconception care is defined as a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to a woman's health or pregnancy outcome through risk assessment, health promotion, and medical and psychosocial interventions. This study aimed to review the status, policies, and programs of preconception risk assessment in Iran. Methods We searched scientific databases including Medline, PubMed, Web of Science, Scopus, CINAHL, Magiran, Iran Medex, SID, Iran Doc, Science Direct, and Google Scholar using key words such as "preconception care", "pre-pregnancy care", "instruction", "guideline", "risk assessment", "program", "policy", "Iran" and their combinations. No time limit was considered in searching the databases and all studies were published until February 1, 2020. Our search strategy resulted in the retrieval of 66 articles and guidelines, of which nine articles met the inclusion criteria and entered the study. Results Multiple guidelines have been designed to assess the general health of women and men of childbearing age, with pay little attention to the reproductive health assessment in Iran. Assessment of reproductive health is specific to the integrated maternal health care program, which the reproductive health risk assessment from pre-pregnancy to postpartum period. The preconception care is a component of integrated maternal health care program that is faced in its content and faces challenges in implementation. Conclusion Several strategies have been developed in the field of risk assessment for general health in Iran, but risk assessment in pre-pregnancy period is only exclusive to preconception care program that is moderate in performance.Introduction The COVID-19 outbreak is a health emergency, in which health care personnel (HCP) face psychological consequences, working as frontline workers. Therefore, we conducted this study to find out associated psychological impacts among HCP during COVID-19 pandemic. Methods This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. The reviewed studies were searched from PubMed, MEDLINE, CINAHL and Google scholar electronic database using the Medical Subject Heading (MeSH) terms. Results We searched through 2676 articles, 19 of which were finally included, most of them were cross-sectional and descriptive studies with 12910 participants. HCP were found to be exposed to a variety of psychological problems; anxiety symptoms were reported in 33% (3081 of 9269), depression 28% (2681 of 9487), post-traumatic stress disorder (PTSD) 41% (2933 of 7167), sleep problems 26% (903 of 3442), stress 13% (487 of 3496) and fear 67.3% (392 of 582). The severity of impacts was often mild to moderate. The nurses were twice as likely to develop these symptoms. The factors associated with psychological impacts were fear of infection to self and family members, lack of resources and facilities at workplace, demanding work conditions, working closely with COVID-19 clients in intensive care unit and pre-existing medical and psychological problems. Conclusion Psychological impacts was mild to moderate among majority of HCP during COVID-19 pandemic. The outcome of this review is to provide some utilitarian information for making supportive policies and strategies to improve the psychological wellbeing of frontline HCP during this pandemic.Introduction Women's physical and mental health and their mortality at reproductive age depend on fertility behaviors, delivery, and its complications. Unintended pregnancy is a risk to the life of women at reproductive age. The present study aimed to compare maternal and neonatal attachment in intended and unintended pregnancies after the mother and baby skin-to-skin contact immediately after delivery (first hour) and 24 hours after that. Methods This analytical case-control study was performed on 140 women who gave birth in the hospitals affiliated to Shiraz University of Medical Sciences, Iran. The subjects were categorized into groups of intended and unintended pregnancy. Skin-to-skin contact of the mother and baby was done for 15 minutes in the recovery room at the first hour and 24 hours after birth. Then, the Avant's questionnaire of mother-infant attachment behaviors was completed. Data were analyzed using SPSS ver.13. Results The mean (SD) attachment score in the first hours in intended pregnancy was 84.22 (12.59), which was higher than that in unintended pregnancy 74.28 (15.81), indicating a significant difference. find more However, after 24 hours of delivery, there was no significant difference between the two groups. During the first hours after delivery, there was a significant difference in the total score of the emotional behaviors and care between the two groups. Conclusion Maternal and infant skin contact during lactation increased attachment after 24 hours in unintended pregnancy, while in the first hours after delivery, attachment decreased in these pregnancies.Introduction Given that children in pediatric intensive care units (PICUs) are more vulnerable to safety risks, health care officials are required to identify the weaknesses and strengths of care and ensure the safety of these children. In this study, the safety status in PICUs of selected educational children's hospitals in Tehran, Iran, was examined and compared with standards proposed by the World Health Organization (WHO). Methods In this descriptive study, the performance of nurses with a bachelor's degree or higher and minimum work experience of six months in the PICU was examined. The study environment included four selected educational hospitals located in Tehran, Iran. Data collection tools were eight safety observation checklists based on the safety standards of WHO. Data collection took five months and the nurses' performance was categorized into three groups of undesirable, relatively desirable, and desirable. The data were analyzed using SPSS software version 13, descriptive statistics, and regression analysis. Results Consistency of nursing care for the safety of hospitalized children was found undesirable in hand hygiene in accordance with the WHO standards. Nurses' performance was relatively desirable in the fields of being more cautious about drugs with similar names or spelling to avoid medication errors, communication during patient hand-over, and performance of correct procedure at correct body site. Regarding other fields, the consistency was at a desirable level. Conclusion Children's safety in the PICUs is not desirable in terms of observing health codes and there is a long way to go to meet the international standards.This study is based on the system resilience framework, which outlines the aspects of community behavior, employees, the environment, history, and corporate social responsibility. We used a partial least squares structural equation model to evaluate a sample of 300 Vietnamese SMEs and travel agencies. We discovered that SMEs' strategies positively influence performance and are co-created with corporate social responsibility. The dependability of internal integrity was then determined. The empirical results showed that the overall confidence index for all facilities ranged from 0.70 to 0.95, with values ranging from 0.809 to 0.931. Furthermore, the A and Cronbach's alpha reliability values ranged from 0.70 to 0.90. As a result, the reliability of internal consistency was established. The convergence validity of the configurations was assessed by comparing the extracted mean values of variance (AVE), which, for all configurations, exceeded the limit of 0.50. This approach emphasizes the impact of corporate social responsibility practices on communities, the environment, and heritage.
Vascular calcification is a hallmark of atherosclerotic burden and can predict the cardiovascular outcome. Vitamin K antagonists (VKA) are widely used anticoagulant drugs to treat patients at risk of arterial and venous thrombosis but are also associated with increase vascular calcification progression. We aim to unravel the paradox that VKA suppresses plasma coagulation but promotes vascular calcification and subsequent atherosclerosis-dependent coagulability of the vessel wall.
mice were placed on western-type diet enriched with the VKA warfarin for 18 weeks to measure atherosclerotic plaque burden, calcification, and coagulation. Patients (
= 54) displaying paroxysmal atrial fibrillation with a low cardiovascular risk, who were treated with VKA were included to measure pre-thrombotic state. Finally, primary vascular smooth muscle cells (VSMC) derived from human tissue explants were used for
experiments. In
mice, VKA increases both atherosclerotic plaque size and calcification. Higher plaould thereby potentially positively affect atherothrombosis.
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