Background:

Every woman giving birth has expectations. Identifying women’s expectations, wishes, needs and fears enable the health care provider(s) to work toward a common goal of safe and positive childbirth experience.

Aim:

The aim was to determine women’s preferences and needs during labor.

Design:

Analytic- cross sectional study.

Setting:

El Kasr- Aini, - Cairo- University Maternity Hospitals.

Sample:

A random sample of 400 women were recruited in the present study with the following criteria; age ranged between 20-30 years old, can read and write, primigravida, nulliparous woman with singleton low risk pregnancies, in the third trimester, up to 37 weeks of gestational age, no previous abortion and free from any medical complains.

Procedure:

Data collection took place in the antenatal clinic, each interview administrated questionnaire took a time between 10-15 minutes. Mothers completed the questionnaire in the antenatal clinics during their waiting for medical examination.

Results:

Twenty two need requirements emerged from the women's perspective. The highest ranked needs for parturient women during labor are; maintaining privacy through all procedures of 86.5%, accessibility of nurses demonstrate empathy of 67.5%, availability to ventilate and expressing fear and anxiety of 57.5%, quick response to request of 67.5%, frequent monitoring of 52.8%, accessibility of caring medical staff of 47.2% and short delivery of 52.8%.

Conclusion:

Despite good general coverage of labor care among women, there were clear variations in the type of management given to them or needed by them. This study confirms that different factors predict the multidimensionality of childbirth satisfaction.

This article elucidates Somali women's experiences of cooking and meals after immigration to Sweden. Six Somali women participated in repeated focus group interviews. Content analysis of the interviews resulted in four themes: change in routines and content of the daily meals, changed experiences related to cooking and shopping for groceries, the social dimensions in food-related occupations, and change of identity and roles. According to the women, variety of factors related to their life in Sweden had led to changes in their food occupations and meals: environmental changes, societal factors and the fact that the women secured employment. Although their new focus on employment led to altered responsibility and time for the cooking, food-related occupations remained important for the creation of identity and the maintenance of the family. This study may inform the development of strategies to restrict the negative impacts of immigration on Somali women's health. Future research will increase understandings of the relationships between food-related occupations and women's roles, identity and health.

OBJECTIVE: to explore Sudanese midwives' motives for and perceptions and experiences of re-infibulation after birth and to elucidate its context and determinants.

DESIGN: triangulation of methods, using observational techniques and open-ended interviews.

SETTING AND PARTICIPANTS: two government hospitals in Khartoum/Omdurman, Sudan, for the observations and in-depth interviews with 17 midwives.

FINDINGS: midwives are among the major stakeholders in the performance of primary female genital cutting (FGC) as well as re-infibulation. Focusing on re-infibulation after birth, midwives were trying to satisfy differing, and sometimes contradictory, perspectives. The practice of re-infibulation (El Adel) represented a considerable source of income for the midwives. The midwives integrated the practice of re-infibulation into a greater whole of doing well for the woman, through an endeavour to increase her value by helping her to maintain her marriage as well as striving for beautification and completion. They were also trying to meet socio-cultural requests, dealing with pressure from the family while balancing on the edge of the law.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the findings confirm that midwives are important stakeholders in perpetuating re-infibulation, and indicate that the motives are more complex than being only economic. The constant balancing between demands from others puts the midwives in a difficult position. Midwives' potential role to influence views in the preventative work against FGC and re-infibulation should be acknowledged in further abolition efforts.

The purpose of the study was to explore the encounters with the health care system in Sweden of women from Somalia, Eritrea, and Sudan who have been genitally cut. A qualitative study was performed through interviews with 22 women originally from Somalia, Sudan, and Eritrea who were living in Sweden. The women experienced being different and vulnerable, suffering from being abandoned and mutilated, and they felt exposed in the encounter with the Swedish health care personnel and tried to adapt to a new cultural context. The results of this study indicate a need for more individualized, culturally adjusted care and support and a need for systematic education about female genital cutting for Swedish health care workers.

Objective. To investigate the risk for anal sphincter tears (AST) in infibulated women. Design. Population-based cohort study. Setting. Nationwide study in Sweden. Population. The study population included 250 491 primiparous women with a vaginal singleton birth at 37–41 completed gestational weeks during 1999–2008. We only included women born in Sweden and in Africa. The African women were categorized into three groups; a Somalian-group, n = 929, where over 95% are infibulated; the Eritrea-Ethiopia-Sudan-group, n = 955, where the majority is infibulated, compared to other African countries, n = 1035, where few individuals are infibulated, but had otherwise similar anthropometric characteristics. These women were compared to 247 572 Swedish-born women. Methods. Register study with data from the National Medical Birth Registry. Main outcome measures. AST in non-instrumental and instrumental vaginal delivery. Results. Compared to Swedish-born women, women from Somalia had the highest odds ratio for AST in all vaginal deliveries: 2.72 (95% CI 2.08–3.54), followed by women from Eritrea-Ethiophia-Sudan 1.80 (1.41–2.32) and other African countries 1.23 (0.89–1.53) after adjustment for major risk factors. Mediolateral episiotomy was associated with a reduced risk of AST in instrumental deliveries. Conclusion. Delivering African women from countries where infibulation is common have an increased risk of AST compared with Swedish-born women, despite delivering in a highly technical quality healthcare setting. AST can cause anal incontinence and it is important to investigate risk factors for this and try to improve clinical routines during delivery to reduce the incidence of this complication.

Female Genital Mutilation (FGM) or the more value neutral term, Female Genital Cutting (FGC) is widely practised in northern Sudan, where around 90% of women undergo the most extensive form of FGC, infibulation. One new approach to combating FGC in Sudan is to acknowledge the previously hidden form of FGC, reinfibulation (RI) after delivery, when the woman is sewn back so much as to mimic virginity. Based on a qualitative study in Khartoum State, this article explores Sudanese women's and men's perceptions and experiences of FGC with emphasis on RI after delivery. The results showed that both genders blame each other for the continuation of the practices, and the comprehensive understanding of the perceptions and experiences was that both the women and the men in this study were victims of th e consequences of FGC and RI. The female narratives could be understood in the three categories: viewing oneself as being "normal" in having undergone FGC and RI; being caught between different perspectives; and having limited influence on the practices of FGC and RI. The male narratives could be understood in the three categories: suffering from the consequences of FGC and RI, trying to counterbalance the negative sexual effects of FGC and striving in vain to change female traditions. The results indicate that the complexity of the persistence of FGC and RI goes far beyond being explained by subconscious patriarchal and maternalistic actions, related to socially constructed concepts of normality, female identity,tradition and religion a"silent" culture betweenmen and women.

Background:

Undernutrition is a problem in institutional care, where 20–46% of all inpatients are classified as being “at nutritional risk”. This study explores the prevalence of undernutrition risk and overweight/obesity and the targeting of nutritional care in relation to undernutrition risk among inpatients in southwestern Saudi Arabia.

Methods:

A cross-sectional, point prevalence study was carried out in a Central hospital in southwestern Saudi Arabia. The subjects were inpatients, over the age of 18 who had their nutritional status assessed. Moderate/high undernutrition risk was defined as the occurrence of at least two of: weight loss, low BMI, and/or eating difficulties. Overweight/obesity was graded by using Caucasian and Asian cut-offs for BMI.

Results:

Out of 219 patients 166 (76%) agreed to participate (106 men and 60 women) with a significantly higher drop-out among women (n=35, 37% vs. men n=18, 14%). There was no significant difference in the prevalence of moderate/high undernutrition risk between men and women (40% vs. 38%) but more women (29% or 40%, depending on cut-off) than men (10% or 23%) were obese. Among patients at moderate/high undernutrition risk, more women (61%) than men (31%) were served small portions.

Conclusions:

There is a need to increase awareness about nutrition among nurses, to implement nutritional guidelines and to do more research regarding overweight/obesity among the female population. Motivational strategie  need to be developed to focus on increasing the Saudi female participation in research.

Rationale: Body-shape preference is an important determinant of obesity and underweight, but studies on body image among females in the Arab region are, at most, scanty. The aim of this study was to describe the prevalence of underweight and overweight/obesity among Saudi Arabian female university students, and to investigate discrepancies between their actual, perceived and ideal body shape.

Methods: This cross sectional study included 663  female students in a university centre in Saudi Arabia. Anthropometric measurements including weight, height, BMI and body image scale (9-figures silhouette) were used. A cross-tabulation was made between “warped self-image” against “subjective goal image”. Regression analysis was used to predict variables related to body image perception.

Results: The participants had a mean age of 20.4 years (SD 1.5), 16% were underweight and 25% were over- weight/obese.Discrepancy in subjective goal image: 44% wished they were slimmer and 20% that they were heavier than what they perceived themselves. Thus, 36% were happy with their current body shape.Warped self-image: It was 16% that thought they were slimmer and 18% that they were heavier than what they actually were. Thus, in 61% of cases the perceived body image was in agreement with their actual body shape. Cross-tabulation showed that only 23% had an agreemen tbetween their actual, perceived and ideal body shape. Of all variables entered into the regression analysis, only BMI was able to predict how the subject perceives herself in the body image scale (R square = 0.676; p < 0.000). None of the variables entered was significant enough to predict how the subject wishes to look like.

Conclusion: Discrepancies between actual, perceived and ideal body image is common among the Saudi Arabian female students and can possibly lead to eating disorders and increased  prevalence of underweight oroverweight/obesity.

Male partners' involvement in women's sexual and reproductive health has been increasingly emphasised in international health. A qualitative approach with open-ended qualitative interviews was used to explore young, married men's first time experiences of early childbearing, their sexual and reproductive decision making and the meanings they make of their role as husbands and fathers. The results offer a nuanced picture of the men's vulnerability in becoming young fathers and having to assume their role as family decision-makers, while still being inexperienced in matters related to the health of their wives and newborn child. Constraints to gender equality and traditional norms and values continue to pose barriers to both young men and women making independent decisions in relation to marriage and childbearing. Men's involvement is necessary in healthcare programmes designed to improve women's sexual and reproductive health and the health of the newborn. Young, first-time fathers, in particular, need support and empowerment.

Aim: To determine the frequency of occupational exposure to human immunodeficiency virus (HIV), the circumstances and predisposing factors, the high-risk groups, the extent to which exposures are reported and the post-exposure prophylaxis (PEP) utilized by health-care workers (HCWs) and students in a Ugandan hospital. Background: Occupational exposure to HIV is a low but potential risk of HIV infection to health workers. Method: Self-administered questionnaire was given to 224 participants (including 98 HCWs and 126 students) in Mbarara Hospital, Uganda. Data were analysed with descriptive statistics using the Statistical Package for the Social Sciences version 15.0 (SPSS Inc, Chicago, IL, USA). Findings: Of the 224 participants surveyed, 19.2% reported having sustained injection needle stick injuries in the previous year, of which 4.46% occurred with HIV-infected blood. Other reported injuries were cannula needle stick injury (0.89%), suture needle stick injuries (3.13%), scalpel cut injuries (0.45%) and muco-cutaneous contamination (10.27%). The most affected groups were nurses-midwives for scalpel injuries and students for stick injuries. The predisposing factors reported included lack of protective devices and recapping of needles. Exposures were under-reported. Uptake of PEP was also low. Conclusion: Occupational exposure to HIV presents a conflict situation for HCWs. It remains a frequent occurrence particularly among student nurses-midwives, despite being avoidable. Its prophylactic treatment is hampered by poor reporting and investigation of exposures, and poor access to PEP. Strict adherence to universal precaution and proper handling of occupational exposure to HIV should be encouraged.

Findings from international research as well as fromSwedenshow that breastfeeding is important for infant health. Further there are still needs to continuously invest on the society level to promote the breastfeeding. Working together in international research collaborations can empower all partners involved.

The project have  two aims: both to describe the successful factors of  Swedish and Norwegian breastfeeding interventions programs on national level, and to elucidate the present situation and background of the present low rates of  breastfeeding.

Data will be collected by individual interviews with obstetricians, midwifes, district nurses, paediatricians and voluntary breastfeeding advisers in both countries.

The findings will be used to promote breastfeeding and inspire other countries spatially high-income countries to focus on the benefits and importance of the breastfeeding to infant’s health.

Findings from international research as well as from Sweden show that breastfeeding is important for infant health. Further there are still needs to continuously invest on the society level to promote the breastfeeding. Working together in international research collaborations can empower all partners involved.

The projects’ aims are to describe the successful factors of Swedish and Norwegian breastfeeding interventions programs on national level, and to elucidate the present situation and background of the present low rates of breastfeeding. Further the aim is to develop the Nordic breastfeeding model.  

Data will be collected between September and December 2013 by individual and focus group interviews with obstetricians, midwifes, district nurses, paediatricians and voluntary breastfeeding advisers in both countries. Further the outcomes from the interviews will be used to creation of the questionnaire that will be tested and power analysis performed during the spring at 2014.

The findings will be used to promote breastfeeding and inspire other countries spatially high-income countries to focus on the benefits and importance of the breastfeeding to infant’s health.

There is an urgent need to facilitate the development of more effective breastfeeding support strategies. The desired research will focus on knowledge-based service innovation that include intervention in form of computer-based training program aimed for training of health and care professionals involved in breastfeeding support. The intervention in the proposed study will contribute to more effective adoption of new knowledge in healthcare organisations. Further, the proposed project will be organised as an interdisciplinary and crosswise sectorial collaboration and will be customized at a national and international level, by involving decision-makers, researchers, health care professionals and care users. Ambition with this project is to contribute to increased breastfeeding frequency by increasing competence in professional support in related healthcare services and midwife education program. There is also an urgent need for evidence based technical solutions as a professional support for the professionals to more effectively implement new research in practice. This project will contribute health care with high quality and resource use. The overall aim for the project is to implement and evaluate new innovative solutions in order to improve long-term strategies for professional support and quality of care, related to knowledge-based breastfeeding support. The design method for the project is longitudinal randomized controlled intervention trial. The intervention will be computer-based training education program developed in collaboration with decision-makers, professionals and researchers. Data will be gained before and after intervention by using: Breastfeeding attitudes among counselling health professionals (An instrument based on WHO standards was developed to measure breastfeeding attitudes), Mother-to-infant Relation and Feelings (MIRF) scale and Mother-Perceived-Professional-Professional support (MoPPS) scale. For successful intervention, it is important that decision-makers are involved in the research process, so that suggested changes can be possible if they actively participate and encourage the project as well as the adoption of research results in practice. Involvement of stakeholders in the research demand facilitation of the research process. This can enable cooperation by using project management techniques as co-counselling and clinical reflection. The outcome of the project will be multiple may be placed in a regional, national, international or global context. Firstly, the project will contribute to development of knowledge-based professionals’ competence with focus on to support breastfeeding from first breastfeeding time, to minimise usage of infant formula during first week of life, longer exclusive- and predominant breastfeeding and stronger connection between mother and child. This topic will fit with theme Nutrition and Lactation.

The purpose of the study was to describe the experiences of elderly people, living at home who receive hot meals that are distributed by their municipality. Qualitative content analysis was used to analyse the (n=13) interviews. The results showed that feelings of dependency, loneliness and gratitude were expressed by the participants in the study related to their meals being delivered home. Dependency was expressed as not having influence over the food products the meals were made from. Loneliness was expressed as being isolated and being confined at home alone due to difficulties getting out of the house, which was associated with the costs of taxis transportation. Gratitude was expressed by the sincere thanks for the possibility of receiving traditional meals delivered daily.

The major conclusion of the study was the indication that greater attention should be paid to meet both the practical and psychological needs of elderly people.