Introduction This study aims to explore maternal and perinatal outcomes of migrant women in Iceland. Material and methods This prospective population-based cohort study included women who gave birth to a singleton in Iceland between 1997 and 2018, comprising a total of 92 403 births. Migrant women were defined as women with citizenship other than Icelandic, including refugees and asylum seekers, and categorized into three groups, based on their country of citizenship Human Development Index score. The effect of country of citizenship was estimated. The main outcome measures were onset of labor, augmentation, epidural, perineum support, episiotomy, mode of birth, obstetric anal sphincter injury, postpartum hemorrhage, preterm birth, a 5-minute Apgar <7, neonatal intensive care unit admission and perinatal mortality. Odds ratios (ORs) and 95% confidence intervals (CIs) for maternal and perinatal outcomes were calculated using logistic regression models. Results A total of 8158 migrant women gave birth during the study period: 4401 primiparous and 3757 multiparous. Overall, migrant women had higher adjusted ORs (aORs) for episiotomy (primiparas: aOR 1.43, 95% CI 1.26–1.61; multiparas: 1.39, 95% CI 1.21–1.60) and instrumental births (primiparas: 1.14, 95% CI 1.02–1.27, multiparas: 1.41, 95% CI 1.16–1.72) and lower aORs of induction of labor (primiparas: 0.88, 95% CI 0.79–0.98; multiparas: 0.74, 95% CI 0.66–0.83), compared with Icelandic women. Migrant women from countries with a high Human Development Index score (≥0.900) had similar or better outcomes compared with Icelandic women, whereas migrant women from countries with a lower Human Development Index score than that of Iceland (<0.900) had additionally increased odds of maternal and perinatal complications and interventions, such as emergency cesarean and postpartum hemorrhage. Conclusions Women’s citizenship and country of citizenship Human Development Index scores are significantly associated with a range of maternal and perinatal complications and interventions, such as episiotomy and instrumental birth. The results indicate the need for further exploration of whether Icelandic perinatal healthcare services meet the care needs of migrant women.
Evidence-based insertion and maintenance strategies for neonatal vascular access devices (VAD) exist to reduce the causes of VAD failure and complications in neonates. Peripheral intravenous catheter failure and complications including, infiltration, extravasation, phlebitis, dislodgement with/without removal, and infection are majorly influenced by catheter securement methods.
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Background: Improvement of functional status with physiotherapy is an important goal for patients with postoperative complications and an increased length of hospital stay (LoS) after esophagectomy. Supervised physiotherapy with telerehabilitation instead of conventional face-to-face care could be an alternative to treat these patients in their home environment after hospital discharge (T0), but its feasibility has not yet been investigated in detail. Objective: The aim of this study was to investigate the feasibility of a 12-week supervised postoperative physiotherapy intervention with telerehabilitation for patients with esophageal cancer who underwent esophagectomy and had postoperative complications or who had an increased LoS. The secondary objective was to investigate the preliminary effectiveness of telerehabilitation on functional recovery compared with usual care. Methods: A prospective feasibility study with a matched historical comparison group was performed. Feasibility outcomes included willingness and adherence to participate, refusal rate, treatment duration, occurrence of adverse events, and patient satisfaction. Secondary outcome measures were measurements of musculoskeletal and cardiovascular functions and activities according to the domains of the International Classification of Functioning, Disability and Health. Results: A total of 22 patients with esophageal cancer who underwent esophagectomy and had postoperative complications or an increased LoS were included. The mean age at surgery was 64.55 (SD 6.72) years, and 77% (17/22) of patients were male. Moreover, 15 patients completed the intervention. Patient adherence was 99.8% in the first 6 weeks and dropped to 75.6% in the following 6 weeks, with a mean difference of -24.3% (95% CI 1.3 to 47.2; P=.04). At 3 months post operation, no differences in functional status were found between the intervention group and the matched historical comparison group. Conclusions: This study showed that a postoperative physiotherapeutic intervention with telerehabilitation is feasible for patients with postoperative complications or an increased LoS after esophageal cancer surgery up to 6 weeks after T0.
Lymphedema is one of the most poorly understood, relatively underestimated and least researched complications of cancer, or its treatment. Lymphedema is a chronic condition that causes abnormal build up of fluid under the skin resulting in painful swelling, commonly in the arms and legs. Limpressive Compression Garments have designed and conceptualised an active and smart compression sleeve that integrates pioneering smart materials and sensor technology to be used to treat and evaluate lymphedema. The Limpressive garments can be used as a research tool while replacing existing compression sleeves and pneumatic compression apparatus. There is currently no product on the market that is integrating both the actuator and sensor technology to treat, let alone quantify lymphedema. It is thus imperative that the Limpressive Compression Garments team are allowed the opportunity through funding to investigate the feasibility of the technology and its integration into healthcare, the business structures and processes needed to enter and be successful in the marketplace and the value to both the consumer and to the organisations dedicated to developing a greater understanding of the disease. Limpressive will complete an extensive and detailed business plan and a complete product design by the end of the Take-off Phase. The business plan and complete product design will be complemented by a proof of function prototype.
