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A child's good morning book
As the sun rises, birds, horses, rabbits, flowers, bugs, and finally children get up to start their day.
Book
Assessing community pharmacists’ responses to pregnancy-related nausea and vomiting: A national simulated patient study in Jordan
Nausea and vomiting of pregnancy (NVP) is the most common medical condition of gestation, affecting up to 90% of women and significantly impacting their quality of life. Community pharmacists (CPs) are often the first point of contact for these women, yet there is a lack of objective data on their practice quality in Jordan. This study aimed to conduct the first national, simulated patient study to assess objectively the assessment, management, counseling, satisfaction and predictors of appropriate practice among Jordanian community CPs when managing NVP.
A national, cross-sectional study using a simulated patient methodology was conducted in 380 community pharmacies, selected via proportionate stratified random sampling. Two validated scenarios (mild NVP and severe NVP with red flags) were used. A validated structured data collection form documented CPs ' assessment, management, counseling, and patient satisfaction. Multivariable logistic regression was used to identify independent predictors of \"Appropriate Practice.\" All data were analysed using SPSS (V28.0).
A significant gap between guideline-recommended care and actual practice was evident, particularly in high-risk situations. While most CPs (84.2%) initiated symptom inquiry, crucial assessment of red flags in the severe NVP scenario was dangerously low (e.g., inquiry about dehydration, 21.1%). This assessment failure translated directly to practice: only 56.8% of CPs correctly referred the high-risk patient, while 43.2% inappropriately sold an over-the-counter medication, delaying necessary medical care. Counseling on medication safety was consistently poor, with only 29.9% of CPs discussing potential side effects. Despite these clinical deficiencies, the overall patient satisfaction was high, appearing to be driven more by interpersonal skills than clinical accuracy. Multivariable analysis revealed that appropriate practice was independently predicted by prior maternal health training (aOR = 3.48, p < 0.001) and being a female pharmacist (aOR = 2.01, p = 0.009). Conversely, a high pharmacy workload was a significant independent barrier, reducing the odds of providing appropriate care by 50% (aOR = 0.50, p = 0.018).
Jordanian community CPs are a critical but currently underperforming resource in maternal care. The prevalent gaps in clinical assessment and referral for severe NVP represent a significant patient safety risk. A one-size-fits-all approach to quality improvement is unlikely to succeed. Instead, a dual-pronged strategy is essential: (1) national professional pharmacy bodies must mandate targeted continuing professional development in maternal health, focusing on risk assessment and referral protocols; and (2) health policymakers and community pharmacy owners must address systemic barriers, particularly the detrimental impact of high workload on the delivery of safe and effective patient care.
Journal Article
Getting ready for school
\"Whether wearing a uniform or picking out their own clothes, its not always easy for children to get up and get ready in the morning. In this book, early readers learn about this essential part of everyday life, learning how they can help their own families get the day started.\"--Amazon.com.
Book
Morning–Afternoon Asymmetry in Correlations Between the Equatorial Electrojet and Sq Westward Currents on Polar‐Side of the Focus
Equatorial electrojet (EEJ) and solar quiet (Sq) currents with one vortex each in either hemisphere are key components of the ionospheric dynamo currents, driving geomagnetic diurnal variations observed at Earth's surface. However, the physical coupling between EEJ and Sq westward currents on the polar side of the vortex focus remains poorly understood. Here, we present observational evidence that there are significant correlations between EEJ variability and Sq westward currents variability in both morning and afternoon sectors, with correlation coefficients of −0.87 during March in the afternoon and −0.67 during May in the morning, respectively. The seasonal variations of the correlations exhibit a morning‐afternoon asymmetry. Specifically, the correlations in the afternoon are stronger during the hemispheric summer season, whereas in the morning correlations show a slightly semiannual variation that are stronger approximately during the equinoxes. The results are helpful for understanding of current closure and global ionospheric electrodynamics.
Journal Article
Bonjour Camille
It is a Sunday morning, and Camille has so many things to do that she can hardly wait for the day to begin.
Book
Self-medication practice and contributing factors among pregnant women
The practice of self-medication during pregnancy is a global challenge that necessitates high attention as it poses a potential threat to the pregnant mother and fetus. However, little is known regarding self-medication practice and its contributors among pregnant women in our setting.
The main aim of this study was to investigate the practice of self-medication and its contributing factors among pregnant women.
A cross sectional study was conducted among pregnant women at antenatal care follow-up of Ayder comprehensive specialized hospital, Tigray, Ethiopia. Written informed consent was obtained from each participant before interview. Simple random sampling technique was employed to recruit participants in to the study. Data were collected by interviewing participants using the structured questionnaire. Binary logistic regressions analysis was performed to determine the contributing factors of self-medication practice during pregnancy. A p value of less than 0.05 was considered as significant.
A total of 250 pregnant women were included in the study. Of the total, 40.8% practiced self-medication during the current pregnancy. Morning sickness (39.2%), headache (34.3%), and upper respiratory tract infections (29.4%) were the leading indications for self-medication. According to participant report, ease of access to medicines (25.5%), feelings that the disease is minor (21.6%) and timesaving (19.6%) were the most commonly reported reasons for self-medication practice. Absence of health insurance (AOR: 2.75, 95%CI: 1.29-5.89) and being on first trimester of pregnancy (AOR: 2.44, 95%CI: 1.02-5.86) were significant contributors of self-medication practice among pregnant women.
In our study, high prevalence of self-medication was reported among pregnant women. Self-medication practice during pregnancy was higher among pregnant women on first trimester and those who were not having health insurance. Therefore, intervention programs should be designed to minimize the practice of self-medication during pregnancy.
Journal Article
The paperboy
A paperboy and his dog enjoy the quiet of the early morning as they go about their rounds.
Book
The burden of nausea and vomiting during pregnancy: severe impacts on quality of life, daily life functioning and willingness to become pregnant again – results from a cross-sectional study
Background
Though nausea and vomiting is very common during pregnancy, no studies have investigated the impact of this condition on the women’s daily lives in a Scandinavian population. The aim of this study was to describe the burden of nausea and vomiting during pregnancy (NVP) on global quality of life, daily life functioning and willingness to become pregnant again according to the severity of NVP symptoms.
Methods
This study is a cross-sectional population-based study conducted in Norway. Pregnant women and mothers with children <1 year of age with current or prior NVP were eligible to participate. Data were collected through an anonymous on-line questionnaire accessible from November 10
th
, 2014 to January 31
st
, 2015. Severity of NVP was measured using the 24-h Pregnancy Unique Quantification of Emesis Scale (PUQE). Associations between severity of NVP, daily life functioning and willingness to become pregnant again were tested using chi-square tests. Associations with global quality of life measured in terms of the Quality of Life Scale (QOLS) were estimated using generalized linear models and reported as unstandardized regression coefficients (β) with 95% confidence intervals (CI).
Results
712 women with NVP were included in the study. NVP was significantly associated with several characteristics, including daily life functioning, quality of life and willingness to become pregnant again. The negative impact was greater the more severe the symptoms were, although considerable adverse effects were also seen among women with mild and moderate NVP symptoms. Over one fourth of the women with severe NVP considered terminating the pregnancy due to NVP, and three in four considered not to get pregnant again. Severity of NVP remained significantly associated with reduced global quality of life when adjusting for maternal characteristics and illnesses with
β
(95% CI) = −10.9 (−16.9, −4.9) for severe versus mild NVP.
Conclusions
NVP as measured by PUQE had a major impact on various aspects of the women’s lives, including global quality of life and willingness to become pregnant again.
Journal Article
Daddy cuddle
\"Young bunny rises early and is eager to start the day, but will Daddy ever wake up?\"-- Provided by publisher.
Book
The health and quality of life of Thalidomide survivors as they age – Evidence from a UK survey
In the late 1950s and early 1960s the drug Thalidomide was marketed across the world as a non-addictive tranquilizer. Despite being given to pregnant women as a safe treatment for morning sickness, Thalidomide caused serious damage to the unborn child. Much has been written about the drug and the birth defects it caused but evidence about the health of Thalidomide survivors as they age is limited.
The aim of this study was to: explore the health and wellbeing UK Thalidomide survivors; document the health problems experienced by them as they reach their mid-50s; and examine the impacts on their health-related quality of life and employment.
A health and wellbeing survey of 351 UK Thalidomide survivors, which gathered information about home and employment circumstances, recent health problems, and health related quality of life (using SF12 Health Survey). Overall analysis focused on descriptive statistics; the association between respondents' health related quality of life and original impairment was examined using Pearson Correlation; and a three step Hierarchical Regression was used to explore the influence of five factors which narrative responses suggested might be important.
As Thalidomide survivors reach their mid-50's they are experiencing a wide range of secondary health problems, in particular musculoskeletal problems, and depression and anxiety, with multimorbidity a growing issue. These health problems are having a negative impact on their employment (two fifths are unable to work) and their physical health related quality of life, which is significantly poorer than the general population.
Having lived relatively independent lives, many Thalidomide survivors are now having to adjust to growing disability. The study provides further evidence of the accumulative impact of disability over peoples' lifetimes and highlights the value of a life course perspective in understanding the complex experience of growing older with a disability.
Journal Article