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Background: Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy, and it can lead to complications for the mother and the infant/fetus. This was especially evident during the COVID-19 pandemic. Therefore, the present systematic review aimed to describe the changes in screening, diagnosis, management, and outcomes of gestational diabetes during the COVID-19 pandemic.

Methods: The systematic review was conducted from December 2019 until January 1, 2022. To find articles related to the purpose of the study, PubMed, Scopus, Web of Science, and WHO were searched using relevant and validated keywords using MeSH/Emtree.

Results: In total, 675 entries were ascertained from the database inquiry, and 17 scholarly works were deemed suitable for inclusion in the final review. The salient conclusions derived from this review were as follows: (a) During the COVID-19 pandemic, there was a significant decrease in the use of OGTTs and a rise in the use of HbA1c assays for both GDM screening and diagnosing. (b) A predominant number of physicians incorporated some variation of telemedicine to remotely supervise and conduct follow-up evaluations of patients with GDM. Various strategies are presented for the provision of prenatal care to women afflicted with GDM, such as concentrating on high-risk demographics, the initiation of lifestyle modifications at early stages, and the implementation of remote patient monitoring techniques. The ’single test procedure’ is identified as the most suitable for the preliminary screening of GDM. The OGTT should be assigned clinical precedence in patients at high risk during the ongoing COVID-19 pandemic. Additionally, Medical Nutrition Therapy (MNT) was established as the primary management strategy, and the most influential determinant of the transition from dietary adjustments to pharmacotherapy was the Fasting Blood Glucose (FBG) levels during the second trimester.

Conclusion: Suggested strategies for GDM screening and management during the pandemic integrated into routine antenatal care, emphasized the importance of remote diabetes education and technology utilization during health emergencies. 

BACKGROUND: Pilates has captured interest due to its possible advantages during pregnancy and childbirth. Although research indicates that Pilates may reduce labor duration, alleviate pain, and improve satisfaction with the childbirth experience, consensus on these outcomes remains elusive, underscoring the necessity for additional studies.

AIM: This systematic review and meta-analysis aimed to assess the impact of Pilates exercises on labor duration among pregnant women.

METHODS: The online database was searched to yield the literature using the terms of 'Pilates', 'childbirth', and 'labor duration', and similar terms including PubMed, Clinical Key, Scopus, Web of Science, Embase, and Cochrane Database of Systematic Reviews up to June 25, 2023. Studies were considered eligible if they were randomized or clinical controlled trials (RCTs/CCTs) published in English, focusing on healthy pregnant women without exercise contraindications. The studies needed to include interventions involving Pilates or exercise movement techniques, a comparison group with no exercise, and outcomes related to labor duration, the period of the active phase, and the second stage of delivery.

RESULTS: Eleven studies, totalling 1239 participants, were included in the analysis. These studies provided high-quality evidence from exercise only RCTs/CCTs. The findings indicated a significant reduction in the active phase of labor (8 RCTs, n = 1195; Mean Difference [MD] = -56.35, 95% Confidence Interval [CI] [-89.46 to -23.25]) and overall labor duration (8 RCTs, n = 898; MD = -93.93, 95% CI [-138.34 to -49.51]) in pregnant women who engaged in Pilates exercises compared to those who did not but doesn't affect on the duration of the second stage of labor (7 RCTs, n = 1135; MD = -0.11, 95% CI [-7.21 to 6.99]).

CONCLUSIONS: While this review primarily addresses the effects of Pilates on healthy and low-risk pregnant women, the findings suggest a potential role for Pilates in shortening labor duration. Therefore, engaging in Pilates or similar physical activities is recommended for pregnant women to potentially facilitate a more efficient labor process.

Introduction: Little is known about the impact of the coronavirus on sexual behavior, function, and satisfaction.

Aim: The aim of the present study was to systematically review people’s sexual function and behaviors and their changes in sexual activities during the COVID-19 pandemic.

Methods: Comprehensive searches in PubMed, Web of Science, and Scopus were conducted with keywords in accordance with MeSH terms: COVID-19, SARS-CoV-2, coronavirus, sexual health, sexual function, sexual dysfunctions, sexuality, sexual orientation, sexual activities, and premarital sex. Two reviewers independently assessed full-text articles according to predefined criteria: original design, English studies, and investigating either the general population or sexual minorities.

Results: Risk of bias in the studies was assessed by the Newcastle-Ottawa Scale, and data were pooled via random effects meta-analyses. We utilized the standardized mean difference to evaluate the effects of the COVID-19 pandemic on sexual activity, functioning, and satisfaction. We included 19 studies in the analysis and 11 studies in the meta-analysis, with a sample size of 12 350. To investigate sexual activity changes, a sample size of 8838 was entered into the subgroup analysis, which showed a significant decrease in both genders (5821 women, P < .033; 3017 men, P < .008). A subgroup meta-analysis showed that the sexual function of men and women during the COVID-19 pandemic significantly declined (3974 women, P < .001; 1427 men, P < .001). Sexual desire and arousal decreased in both genders, though mainly in women. In investigating sexual satisfaction changes during the COVID-19 pandemic, a meta-analysis with a sample size of 2711 showed a significant decrease (P < .001). The most indicative changes in sexual behaviors during the pandemic were the increase in masturbating and usage of sex toys. Greater COVID-19 knowledge was associated with lower masturbation, oral sex, and vaginal sex. The more protective behaviors were associated with less hugging, kissing, cuddling, genital touching, watching porn with a partner, and vaginal sex.

Conclusion: The COVID-19 pandemic led to increased challenges and changes for individuals’ sexual behaviors. Efforts for preventive strategies should therefore be concentrated between pandemics, while ensuring that there is information available to the population during a pandemic for help in times of psychological distress or crisis.

Background

The principle of human dignity is woven into the ethical principles of the midwifery profession, noted as both an obligation and a human right.

Research Objectives

The aim of this study is to explore the experiences of midwifery students regarding threats to women's dignity during childbirth.

Research Design

This is a qualitative study with explorative design. Participants and Research Context: The research was carried out in 2022 at Kermanshah University of Medical Sciences, involving 32 midwifery students in individual interviews that lasted between 30 and 90 minutes. These participants aged 21 to 28 years, with an average age of 23.5 years, provided their perspectives on the matter.

Results

Four key themes described the threats to women?s dignity during childbirth: 1) professional incompetence, 2) abuse of power imbalance, 3) caring only for physical and not mental health, and 4) structural issues within the healthcare system. Professional incompetence was characterized by outdated practices and lack of adherence to evidence-based medicine. Abuse of power imbalance was demonstrated in instances where the authoritative position of healthcare providers was misused, thereby disrupting the respectful care that women are entitled to receive. The disproportionate emphasis on physical health over mental health was evidenced by the disregard for mothers' psychological well-being during childbirth. Lastly, systemic structural issues emerged as significant impediments, revealing the need for system-wide changes. Ethical considerations: This study was approved by the Ethics Committee of the Research Deputy at Kermanshah University. Participation was voluntary and the confidentiality were maintained.

Conclusion

The findings underscore the role that unprofessional behavior, ethical lapses in medical practices, and systemic challenges play in undermining maternal dignity during childbirth. These threats necessitate urgent attention and must be adequately addressed in policy development and program implementation to safeguard the dignity of mothers during childbirth.

Ever more people are in paid work following the age of state pension availability, andyet the experience of working in this phase of the late career has been little studied.We interviewed a purposive sample of 25 Swedish people in their mid- to late sixtiesand early seventies, many of whom were or had recently been working while claimingan old-age pension. The data were analysed with constant comparative analysis inwhich we described and refined categories through the writing of analytic memos and diagramming.We observed that paid work took place within a particular material, normativeand emotional landscape: a stable and secure pension income decommodifying theseworkers from the labour market, a social norm of a retired lifestyle and a loomingsense of contraction of the future. This landscape made paid work in these yearsdistinctive: characterised by immediate intrinsic rewards and processes of containingand reaffirming commitments to jobs. The oldest workers were able to craft assertivelythe temporal flexibility of their jobs in order to protect the autonomy and freedom thatretirement represented and retain favoured job characteristics. Employed on short-term(hourly) contracts or self-employed, participants continually reassessed their decision towork. Participation in paid work in the retirement years is a distinctive second stage inthe late career which blends the second and third ages.

Background: Obstetric violence (OV) is a widespread post antenatal phenomenon all around the globe and threatens the provision of respectful, dignified and autonomy-based childbirth for women. Previous research indicates that the consequence of OV is devastating for women’s human right, health, and childbirth experiences. Furthermore, previous studies have also highlighted the increased numbers of elective cesarean section because of fear to exposed to OV during childbirth. The aim of this study is to illuminate the risk factors associated with obstetric violence in the private and public financed hospital and the need of ethical aspects.  

Methods: Systematic reviews were performed and a comprehensive data extraction from 1996 to 2022 were conducted in databases PubMed, CINAHL and Web of science. Mesh terms and Cinahl headings used to identify the relevant literature based on the concept obstetric violence. In total 330 scientific articles were analyzed, condensed, and generated the results.

Discussion/Conclusion: Preliminary results shows that risk factors that is associated with the prevalence of obstetric violence is more likely to appear in the public financed hospital compare with private. This includes the lack of resources, staff/shortage/work overload, organizational and medical hierarchy (culture of abuse), women’s socioeconomical backgrounds and education, social status and family support, age, physical appearance, patients’ advocacy, lack of legal protection and patient organization, lack of ethical guidelines and principles. The result also indicates a great need for ethical reflection groups among healthcare providers in both private and public financed hospital delivery unit. 

Consequences: Women who are exposed to OV are more likely to develop postnatal depression and anxiety. This could have a huge impact on women’s’ lactation and care for the infant (difficulty bonding). Distrust to the healthcare system (ethical and legal aspects) could lead to choices such as home birth which means higher risks and complications for women’s health in terms of infections, hypertension, bleeding, newborn injuries, or death.

 Future studies need to focus on the hypothesis: 

- Obstetric violence could have negative impact on pro-natalist society with lower      childbirth rate consequently.

- Postpartum depression could enhance the risk for trigger a shaken baby syndrome.

This qualitative paper focuses on individuals who work after pensionable age, a distinctive period in the late career when workers are supported by the known and reliable income of a pension. Using constant comparative analysis, we analyzed interviews from a purposive sample of 25 Swedish people in their late sixties and early seventies. We examined conditions for being in paid work in terms of enabling factors (self-employment, shift work, shortage occupation), improvisation, and the role of chance. The interviews revealed that post-retirement workers took charge of the aspects of work that mattered most to them, evading the disciplinary aspects of work by controlling scheduling and limiting the duration of their commitment. These constrained commitments had knock-on effects of improving psychosocial working conditions. Women and immigrants—groups facing low pensions—experienced the greatest financial consequences of being unable to work in their retirement years in order to supplement their pension income.