METHODS: Cross-sectional baseline evaluation of EVOLVE: an international, multicenter, non-interventional study investigating the safety of injectable glucose-lowering drugs in pregnant women with pre-existing type 1 (T1D) or type 2 diabetes (T2D). Data were collected at enrollment visit interviews before gestational week 16.
RESULTS: In total, 2383 women from 17 mainly European countries were enrolled in the study: 2122 with T1D and 261 with T2D; mean age was 31 and 33 years, and duration of diabetes was 15 and 6 years, respectively. For women with T1D or T2D, 63% and 75%, respectively, received basal and rapid-acting insulin, 36% and 3% rapid-acting insulin only, 0.7% and 14.0% basal insulin only, 0.2% and 5.4% premix insulin, 0.0% and 1.2% injectable glucagon-like peptide-1 receptor agonist treatment without insulin. In women with T1D or T2D, respectively, during early pregnancy, 59% and 62% had HbA1c <7.0% (53 mmol/mol); 16% and 36% reported not taking folic acid before or during early pregnancy. Overall, >40% of women had ≥1 chronic concomitant condition (predominantly thyroid disease or hypertension). Retinopathy was the most commonly reported diabetic complication. The most commonly reported previous pregnancy complication was miscarriage.
CONCLUSIONS: Baseline data from this large multinational population of women with pre-existing diabetes indicate that sub-optimal glycemic control, poor pregnancy planning, and chronic concomitant conditions were common in early pregnancy.
Methods: A purposive design in combination with a convenience sampling approach was used to recruit 24 women ages 26 to 55 of Malay, Indian, and Chinese descent across 15 university departments in Kuala Lumpur, Malaysia. Audio recordings of the individual semi-structured interviews were transcribed and analyzed using grounded theory.
Results: Women identified two important life transitions, getting married and having children, as particularly influential in changing eating behavior. Women reported a desire to eat healthier that was in tension with pressures to cater to the taste preferences of their household members and to accommodate their work schedules. Persistent social norms of eating in group settings and difficulty in accessing foods perceived as nutritious were reported as barriers to changing individual eating behavior. Regardless of education level and marital status, women agreed that the act of eating was closely connected with cultural values and embodied important meanings that took precedence over eating as a health-promoting behavior. While all participants expressed a desire to eat healthier, many reported limited confidence in their ability to consistently give up familiar and tasty foods for healthier alternatives. Shifts in eating behavior such as trying new healthy recipes and adopting a more restrictive diet were reported as most feasible and personally applicable after learning about a family member's declining health.
Conclusions: In this urban, multiethnic population, increasing the accessibility of nutritious foods and changing cultural perceptions of the relationship between food and nutrition may be important for enabling healthy eating behaviors.
Funding Sources: Yale Sustainable Food Program, Yale School of Public Health.
METHODS: A total of 399 women in their second and third trimester of pregnancy were recruited from government maternal and child health clinics in Kuala Lumpur and Putrajaya and completed a self-administered online questionnaire. Content validity was conducted with an expert panel consisting of 4 members. Confirmatory factor analysis (CFA) using maximum likelihood was conducted to determine the construct validity. Internal consistency was determined by Cronbach's alpha coefficient (CAC), while the test-retest reliability was conducted using intraclass correlation coefficient (ICC).
RESULTS: The questionnaire had an appropriate content validity index of 0.91. The CPQ-P consists of 22 items, measuring 5 constructs, including morning chrono-habits, sleeping habits, evening eating, temporal eating, and pregnancy symptoms. The factor model showed good fit with χ2/df = 2.486, GFI = 0.893, CFI = 0.912, and RMSEA = 0.065. The 22 items in CPQ-P showed fair to excellent test-retest reliability (ICC: 0.42 to 0.98). The 5 constructs in CPQ-P were found to have a good to excellent internal consistency (α = 0.612-0.963).
CONCLUSIONS: The CPQ-P is a valid and reliable tool for assessing lifestyle habits during pregnancy. The questionnaire can be used to identify areas where pregnant women may need additional support or intervention to adopt healthy behaviours and reduce the risk of adverse maternal and foetal outcomes.
TRIAL REGISTRATION: NCT05700136 (clinicaltrials.gov). Trial registration date: 26/01/2023.
METHODS AND ANALYSIS: A total of 294 eligible participants will be recruited and allocated into 3 groups comprising of mHealth intervention alone, mHealth intervention integrated with personal medical nutrition therapy and a control group. Pretested structured questionnaires are used to obtain the respondents' personal information, anthropometry data, prenatal knowledge, physical activity, psychosocial well-being, dietary intake, quality of life, sleep quality and GWG. There will be at least three time points of data collection, with all participants recruited during their first or second trimester will be followed up prospectively (after 3 months or/and after 6 months) until delivery. Generalised linear mixed models will be used to compare the mean changes of outcome measures over the entire study period between the three groups.
ETHICS AND DISSEMINATION: Ethical approvals were obtained from the ethics committee of human subjects research of Universiti Putra Malaysia (JKEUPM-2022-072) and medical research & ethics committee, Ministry of Health Malaysia: NMRR ID-22-00622-EPU(IIR). The results will be disseminated through journals and conferences targeting stakeholders involved in nutrition research.
TRIAL REGISTRATION NUMBER: Clinicaltrial.gov ID: NCT05377151.
METHOD: This cross-sectional study used a questionnaire to survey final-year medical students at one school in 1999. It tested students' patient-centeredness, "patient-care" values, and degree of comfort in performing certain intimate physical examinations.
RESULTS: Women students were more patient-centered than were men students. Both genders were more attuned to the concerns of patients of their own gender, were more comfortable with personal rather than sexual issues, and were more uncomfortable with performing more intimate examinations upon the opposite gender. Using comparable case studies, it was also shown that the female student-female patient dyad had significantly greater "patient-care" values than did the male student-male patient dyad.
CONCLUSION: Medical students did not behave in a gender-neutral way in the consultation. There is a powerful interaction between a student's gender and a patient's gender. This warrants further investigation in the real clinical situation because it has implications on the outcomes of the consultation.
METHODS: The quasi-experimental study was conducted in Tharparker and Umerkot districts, Sindh, Pakistan, in 2013-14, and comprised pregnant women in their earlier weeks of pregnancy. The enrolment and follow-up phase entailed 3 visits to each subject. Areas covered by lady health workers were designated as intervention areas, and those with non-LHW population were labelled as non-intervention areas.
RESULTS: Of the 1204 subjects, 600(49.8%) were in the intervention group and 604(50.2%) were in the nonintervention group. By the end of the follow-up phase, significantly more women had increased number of meals in the intervention group compared to the non-intervention group (p<0.001). There was a significantly higher increase in mean haemoglobin levels and body mass index of women in the intervention arm after 3 and 6 months of interventions (p<0.05). Significantly higher mean birth weight was recorded in intervention areas compared to nonintervention areas (p<0.05).
CONCLUSIONS: Community-based provision of multiple micronutrients to women along with deworming, health education and dietary counselling significantly reduced the prevalence of anaemia and reduced the incidence of low birth weight.
Methods: A quasi-experimental design was conducted. The intervention and control groups consisted of 66 nurses randomly selected from the Tumpat and Pasir Mas districts, respectively, in Kelantan. The intervention group received an antenatal-exercise counseling module, and the control group performed counseling based on self-reading. Knowledge and self-efficacy were assessed at the baseline and at week 4. Analysis of variance and repeated measure analysis of covariance were performed using SPSS.
Results: There was a significant difference in the knowledge scores [estimated marginal mean (95% confidence interval, CI): 33.9 (33.29, 34.53) versus 27.4 (26.52, 28.29); P < 0.001)] and the self-efficacy scores [estimated marginal mean (95% CI): 31.3 (30.55, 32.03) versus 27.4 (26.03, 28.74); P = 0.005)] between intervention and control groups at week 4 after adjusting for duration of practice and formal training.
Conclusion: The antenatal-exercise counseling module is recommended for use in routine counseling in health centers to promote healthy lifestyles among pregnant women.