RESUMO
The challenges observed in health service psychology (HSP) training during COVID-19 revealed systemic and philosophical issues that preexisted the pandemic, but became more visible during the global health crisis. In a position paper written by 23 trainees across different sites and training specializations, the authors use lessons learned from COVID-19 as a touchstone for a call to action in HSP training. Historically, trainee voices have been conspicuously absent from literature about clinical training. We describe longstanding dilemmas in HSP training that were exacerbated by the pandemic and will continue to require resolution after the pandemic has subsided. The authors make recommendations for systems-level changes that would advance equity and sustainability in HSP training. This article advances the conversation about HSP training by including the perspective of trainees as essential stakeholders.
RESUMO
At one high-risk perinatal centre over a 9-year period, 83.1% (103/124) sets of liveborn twins with gestational ages less than 33 weeks were delivered vaginally. Mortality in vaginal births was 26.7% (55/206), almost double that of Caesarean births of 14.3% (6/42), a non-significant difference. When gestational age discrepancies were corrected, however, the trend favouring survival of Caesarean births disappeared. Furthermore, there were no significant associations between mode of delivery and the condition of the infants at birth, or the presence of respiratory distress in the nursery. Because Caesarean section carries substantial risks for the mother our practice of predominantly vaginal deliveries for preterm twins should continue.
