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Stanton ME, Hanson L, Klima C, Low LK. Joyce Roberts: Midwifery Scholar, Educator, Legend, and Friend. J Midwifery Womens Health 2022; 67:687-688. [PMID: 36471490 DOI: 10.1111/jmwh.13443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/21/2022] [Indexed: 12/12/2022]
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Farah E, Barger MK, Klima C, Rossman B, Hershberger P. Impaired Lactation: Review of Delayed Lactogenesis and Insufficient Lactation. J Midwifery Womens Health 2021; 66:631-640. [PMID: 34596953 DOI: 10.1111/jmwh.13274] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 05/08/2021] [Accepted: 06/04/2021] [Indexed: 12/29/2022]
Abstract
It is estimated that as many as 1 in 20 women worldwide are unable to successfully breastfeed or provide adequate nutrition for their infants through their breast milk alone. Compromised nutrition in the early stages of life places the infant at risk for insufficient growth as well as serious and potentially disabling or life-threatening complications. This review summarizes risk factors associated with impaired lactation that may result in either delayed lactogenesis or insufficient lactation. The risk factors for insufficient lactation are categorized into preglandular, glandular, and postglandular causes. Impaired lactation can occur despite maternal motivation, knowledge, support, and appropriate breastfeeding technique. Although there is no clear way to predict who will experience impaired lactation, knowledge about the risk factors can enable health care professionals to better identify at-risk mother-infant dyads. Early intervention may help prevent infant complications associated with inadequate nutritional intake.
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Affiliation(s)
- Erin Farah
- Department of Human Development Nursing Science, University of Illinois at Chicago, Chicago, Illinois
| | - Mary K Barger
- Hahn School of Nursing and Health Sciences, University of San Diego, San Diego, California
| | - Carrie Klima
- Department of Human Development Nursing Science, University of Illinois at Chicago, Chicago, Illinois
| | - Beverly Rossman
- Department of Women, Children, and Family Nursing, Rush University Medical Center, Chicago, Illinois
| | - Patricia Hershberger
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, Illinois
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Grenier L, Lori JR, Darney BG, Noguchi LM, Maru S, Klima C, Lundeen T, Walker D, Patil CL, Suhowatsky S, Musange S. Building a Global Evidence Base to Guide Policy and Implementation for Group Antenatal Care in Low- and Middle-Income Countries: Key Principles and Research Framework Recommendations from the Global Group Antenatal Care Collaborative. J Midwifery Womens Health 2020; 65:694-699. [PMID: 33010115 PMCID: PMC9022023 DOI: 10.1111/jmwh.13143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 02/13/2020] [Accepted: 03/03/2020] [Indexed: 11/28/2022]
Abstract
Evidence from high‐income countries suggests that group antenatal care, an alternative service delivery model, may be an effective strategy for improving both the provision and experience of care. Until recently, published research about group antenatal care did not represent findings from low‐ and middle‐income countries, which have health priorities, system challenges, and opportunities that are different than those in high‐income countries. Because high‐quality evidence is limited, the World Health Organization recommends group antenatal care be implemented only in the context of rigorous research. In 2016 the Global Group Antenatal Care Collaborative was formed as a platform for group antenatal care researchers working in low‐ and middle‐income countries to share experiences and shape future research to accelerate development of a robust global evidence base reflecting implementation and outcomes specific to low‐ and middle‐income countries. This article presents a brief history of the Collaborative's work to date, proposes a common definition and key principles for group antenatal care, and recommends an evaluation and reporting framework for group antenatal care research.
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Affiliation(s)
| | - Jody R Lori
- Department of Health Behavior and Biological Science, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Blair G Darney
- Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon.,National Institute of Public Health, Center for Population Health Research, Cuernavaca, Mexico
| | | | - Sheela Maru
- Department of Health Systems Design and Global Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Carrie Klima
- Department of Women, Children, and Family Health Sciences, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Tiffany Lundeen
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California
| | - Dilys Walker
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California.,Department of Obstetrics, Gynecology, and Reproductive Health Sciences and Institute for Global Health Sciences, University of California San Francisco, San Francisco, California
| | - Crystal L Patil
- Department of Women, Children, and Family Health Sciences, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | | | - Sabine Musange
- University of Rwanda, School of Public Health, Kigali, Rwanda
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Meagher BT, Campos MR, Thornton P, Klima C, Peters TA, Hallberg J, Ulfhager E, O'Brien WD, McFarlin BL. Reasons Why Pregnant Women Participate in Ultrasound Research Involving Transvaginal Scans. J Ultrasound Med 2020; 39:1581-1587. [PMID: 32073680 PMCID: PMC8059443 DOI: 10.1002/jum.15248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/24/2020] [Accepted: 01/30/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES The aim of this study was to explore the motivations of pregnant women in participating in an ultrasound study and the acceptability of vaginal ultrasound examinations. METHODS A prospective sample of 270 women were asked one question: "Can you tell me what motivated you to participate in the study?" The data were then analyzed through a qualitative thematic analysis with an inductive approach. In addition to the thematic analysis, quantification of the data was performed to enhance the qualitative result. RESULTS Through the thematic analysis, 5 themes emerged from the responses of the participants: altruism, research, personal experience, personal benefit, and finding out. All responses were relatively short, and some responses included more than one theme. CONCLUSIONS Vaginal ultrasound examinations were acceptable to the participants, and pregnant women had many motivations to participate. Regardless of race, ethnicity, or insurance status, the women in our study were altruistic and curious about our research.
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Affiliation(s)
- Barbara T Meagher
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Marissa R Campos
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Patrick Thornton
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Carrie Klima
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Tara A Peters
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Josefin Hallberg
- Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institute, Stockholm, Sweden
| | - Emma Ulfhager
- Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institute, Stockholm, Sweden
| | - William D O'Brien
- Department of Computer and Electrical Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Barbara L McFarlin
- Department of Women, Children, and Family Health Science, University of Illinois at Chicago, Chicago, Illinois, USA
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Javed MA, Klima C, Cameron AA, Alexander TW, Zaheer R, Munns K, McAllister TA. 0495 Genomic approaches to characterizing and reducing antimicrobial resistance in beef cattle production systems. J Anim Sci 2016. [DOI: 10.2527/jam2016-0495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Klima C, Patil C, Norr K, Leshabari S, Kaponda C, Rising S. Exporting Centering Pregnancy May Contribute to Improving Antenatal Care and Improving Maternal and Child Health in Sub‐Saharan Africa. J Midwifery Womens Health 2016. [DOI: 10.1111/jmwh.12560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Patil CL, Abrams ET, Klima C, Kaponda CP, Leshabari SC, Vonderheid SC, Kamaga M, Norr KF. CenteringPregnancy-Africa: a pilot of group antenatal care to address Millennium Development Goals. Midwifery 2013; 29:1190-8. [PMID: 23871278 PMCID: PMC3786019 DOI: 10.1016/j.midw.2013.05.008] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 05/21/2013] [Accepted: 05/23/2013] [Indexed: 11/22/2022]
Abstract
BACKGROUND severe health worker shortages and resource limitations negatively affect quality of antenatal care (ANC) throughout sub-Saharan Africa. Group ANC, specifically CenteringPregnancy (CP), may offer an innovative approach to enable midwives to offer higher quality ANC. OBJECTIVE our overarching goal was to prepare to conduct a clinical trial of CenteringPregnancy-Africa (CP-Africa) in Malawi and Tanzania. In Phase 1, our goal was to determine the acceptability of CP as a model for ANC in both countries. In Phase 2, our objective was to develop CP-Africa session content consistent with the Essential Elements of CP model and with national standards in both Malawi and Tanzania. In Phase 3, our objective was to pilot CP-Africa in Malawi to determine whether sessions could be conducted with fidelity to the Centering process. SETTING Phases 1 and 2 took place in Malawi and Tanzania. Phase 3, the piloting of two sessions of CP-Africa, occurred at two sites in Malawi: a district hospital and a small clinic. DESIGN we used an Action Research approach to promote partnerships among university researchers, the Centering Healthcare Institute, health care administrators, health professionals and women attending ANC to develop CP-Africa session content and pilot this model of group ANC. PARTICIPANTS for Phases 1 and 2, members of the Ministries of Health, health professionals and pregnant women in Malawi and Tanzania were introduced to and interviewed about CP. In Phase 2, we finalised CP-Africa content and trained 13 health professionals in the Centering Healthcare model. In Phase 3, we conducted a small pilot with 24 pregnant women (12 at each site). MEASUREMENTS AND FINDINGS participants enthusiastically embraced CP-Africa as an acceptable model of ANC health care delivery. The CP-Africa content met both CP and national standards. The pilot established that the CP model could be implemented with process fidelity to the 13 Essential Elements. Several implementation challenges and strategies to address these challenges were identified. KEY CONCLUSIONS preliminary data suggest that CP-Africa is feasible in resource-constrained, low-literacy, high-HIV settings in sub-Saharan Africa. By improving the quality of ANC delivery, midwives have an opportunity to make a contribution towards Millennium Development Goals (MDG) targeting improvements in child, maternal and HIV-related health outcomes (MDGs 4, 5 and 6). A clinical trial is needed to establish efficacy. IMPLICATIONS FOR PRACTICE CP-Africa also has the potential to reduce job-related stress and enhance job satisfaction for midwives in low income countries. If CP can be transferred with fidelity to process in sub-Saharan Africa and retain similar results to those reported in clinical trials, it has the potential to benefit pregnant women and their infants and could make a positive contribution to MGDs 4, 5 and 6.
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Affiliation(s)
- Crystal L. Patil
- University of Illinois at Chicago, Department of Anthropology, 1007 W. Harrison St (MC 027), Chicago, IL 60607, USA, Phone: (312) 413-3570, Fax: (312) 413-3573,
| | - Elizabeth T. Abrams
- Independent Researcher and Consultant, 2243 Midvale Avenue, Los Angeles, CA 90064, (310) 595-5324,
| | - Carrie Klima
- UIC College of Nursing, 845 South Damen Avenue (MC 802), Chicago, IL 60612-7350, Phone: (312) 996-1863, Fax: (312) 996-8871,
| | | | - Sebalda C. Leshabari
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, P. O. Box 65001, Dar es Salaam, Tanzania, , (255) 784-287-062
| | - Susan C. Vonderheid
- UIC College of Nursing, 845 South Damen Avenue (MC 802), Chicago, IL 60612-7350, Phone: (312) 996-7982, Fax: (312) 996-8871,
| | - Martha Kamaga
- UIC College of Nursing, 845 South Damen Avenue (MC 802), Chicago, IL 60612-7350, Phone: (312) 996-7940, Fax: (312) 996-8871,
| | - Kathleen F. Norr
- UIC College of Nursing, 845 South Damen Avenue (MC 802), Chicago, IL 60612-7350, Phone: (312) 996-7940, Fax: (312) 996-8871,
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Hanson L, Klima C, Lori J, Levi A. Abstracts from Research Forums Presented at the American College of Nurse-Midwives' 58th Annual Meeting. J Midwifery Womens Health 2013. [DOI: 10.1111/jmwh.12115_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Carrie Klima
- Chair, Research Dissemination Section, Division of Research
| | | | - Amy Levi
- Chair, Research Section, Division of Global Health
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Klima C, Norr K, Vonderheid S, Handler A. Introduction of CenteringPregnancy in a public health clinic. J Midwifery Womens Health 2009; 54:27-34. [PMID: 19114236 DOI: 10.1016/j.jmwh.2008.05.008] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2007] [Revised: 05/26/2008] [Accepted: 05/26/2008] [Indexed: 10/21/2022]
Abstract
CenteringPregnancy is a promising group visit prenatal care innovation that provides substantial health promotion content. Elements unique to group care include peer support and self-management training and activities. CenteringPregnancy was introduced at a large public health clinic serving predominantly low-income African American pregnant women. All prenatal care at this clinic was provided by certified nurse-midwives, and all providers were trained in the CenteringPregnancy model. One hundred and ten women received prenatal care in CenteringPregnancy groups. Focus groups of pregnant women, providers, and health center staff reported that the program benefited women despite implementation challenges such as scheduling changes. Compared to women in individual care, women in CenteringPregnancy had significantly more prenatal visits, increased weight gain, increased breast feeding rates, and higher overall satisfaction. This pilot project demonstrated that CenteringPregnancy can be implemented in a busy public health clinic serving predominantly low-income pregnant women and is associated with positive health outcomes.
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Affiliation(s)
- Carrie Klima
- University of Illinois at Chicago, Centering Pregnancy and Parenting Board of Directors, USA.
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Geibel A, Zehender M, Kasper W, Olschewski M, Klima C, Konstantinides SV. Prognostic value of the ECG on admission in patients with acute major pulmonary embolism. Eur Respir J 2005; 25:843-8. [PMID: 15863641 DOI: 10.1183/09031936.05.00119704] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A number of ECG abnormalities can be observed in the acute phase of pulmonary embolism (PE). Their prognostic value has not yet been systematically studied in large patient populations. In 508 patients with acute major PE derived from a large prospective registry, the current authors assessed, on admission, the impact of specific pathological ECG findings on early (30-day) mortality. Atrial arrhythmias, complete right bundle branch block, peripheral low voltage, pseudoinfarction pattern (Q waves) in leads III and aVF, and ST segment changes (elevation or depression) over the left precordial leads, were all significantly more frequent in patients with a fatal outcome. Overall, 29% of the patients who exhibited at least one of these abnormalities on admission did not survive to hospital discharge, as opposed to only 11% of the patients without a pathological 12-lead ECG. Multivariate analysis revealed that the presence of at least one of the above ECG findings was, besides haemodynamic instability, syncope and pre-existing chronic pulmonary disease, a significant independent predictor of outcome. In conclusion, ECG may be a useful, simple, non-costly tool for initial risk stratification of patients with acute major pulmonary embolism.
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Affiliation(s)
- A Geibel
- Georg August University of Goettingen, Dept of Cardiology and Pulmonary Medicine, Robert Koch Strasse 40, Goettingen D-37085, Germany
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Ickovics JR, Kershaw TS, Westdahl C, Rising SS, Klima C, Reynolds H, Magriples U. Group prenatal care and preterm birth weight: results from a matched cohort study at public clinics. Obstet Gynecol 2004; 102:1051-7. [PMID: 14672486 DOI: 10.1016/s0029-7844(03)00765-8] [Citation(s) in RCA: 90] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine the impact of group versus individual prenatal care on birth weight and gestational age. METHODS This prospective, matched cohort study included pregnant women (N = 458) entering prenatal care at 24 or less weeks' gestation; one half received group prenatal care with women of the same gestational age. Women were matched by clinic, age, race, parity, and infant birth date. Women were predominantly black and Hispanic of low socioeconomic status, served by one of three public clinics in Atlanta, Georgia or New Haven, Connecticut. RESULTS Birth weight was greater for infants of women in group versus individual prenatal care (P < .01). Among those born preterm, infants of group patients were significantly larger than infants of individual-care patients (mean, 2398 versus 1990 g, P < .05). Although not statistically significant, infants of group patients were less likely than those of individual-care patients to be low birth weight (less than 2500 g; 16 versus 23 infants); very low birth weight (less than 1500 g; three versus six infants); early preterm (less than 33 weeks; two versus seven infants); or to experience neonatal loss (none versus three infants). There were no differences in number of prenatal visits or other risk characteristics (patient age, race, prior preterm birth). CONCLUSIONS Group prenatal care results in higher birth weight, especially for infants delivered preterm. Group prenatal care provides a structural innovation, permitting more time for provider-patient interaction and therefore the opportunity to address clinical as well as psychological, social, and behavioral factors to promote healthy pregnancy. Results have implications for design of sustainable prenatal services that might contribute to reduction of racial disparities in adverse perinatal outcomes.
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Affiliation(s)
- Jeannette R Ickovics
- Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut 06520-8034, USA.
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Abstract
Teenage pregnancy has reached epidemic proportions in the United States with I million pregnancies and more than 500,000 live births occurring each year among women under the age of 20. The safety and efficacy of postcoital administration of oral contraceptives, commonly called "emergency contraception" (EC), have been well documented. However, EC is dramatically underused in the United States. Because low use of EC may be attributable, in part, to both lack of knowledge, as well as misinformation on the part of health care providers, further research in this area is warranted. Because midwives play a significant role in the provision of reproductive health care to adolescents, their attitudes about the use of EC among teens may impact the availability of emergency contraception options to these clients. This article presents results of a survey of certified nurse-midwives with respect to their attitudes, practices, and policies related to EC and provides recommendations specific to this provider population.
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Abstract
During several volunteer experiences in the Corozal District in Northern Belize, the authors worked with and interviewed traditional midwives, midwife educators, administrators, and professional midwives, who practice in public health clinics, rural health outposts, and a government hospital. One interview with a traditional midwife from a rural Mayan village, garnered interesting information about her 63-year practice, which is compared with the practice of professional midwives. Issues important to midwifery and health care in Belize are discussed. The interviews and the authors' own experiences reveal changing birthing practices, as well as the continued importance of midwives in the care of childbearing women in Northern Belize.
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Affiliation(s)
- D B Boyer
- Women's Health Nurse Practitioner Program at Loyola University, Chicago, USA
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Orbanic SD, Levi A, Hawkins JW, Driscoll JW, Biley FC, Kendall J, Griffin JK, Daisy C, Clemmens D, Klima C, Glass N, Matteson PS. The complexity of obesity. Image J Nurs Sch 2000; 31:315. [PMID: 10628092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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