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This article investigates how domestic violence and abuse (DVA), its underreporting and its links with alcohol consumption, manifest in and impact the outcome of help-seeking telephone calls to U.K.-based police services. Conversation analysis of call-takers' questions about alcohol found that they either (a) focused only on the perpetrator's drinking, and occurred after informing callers that help was being dispatched, or (b) targeted both victims' and perpetrators' drinking and complicated the decisions to dispatch police assistance. The article helps specify the communicative practices that may constitute victims' negative experiences of disclosing DVA to the police.
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BACKGROUND: Timely goals-of-care (GOC) discussions are essential for end-of-life planning, particularly during acute hospital admissions, where ambiguity often persists. Frailty, prevalent in the ageing population and linked to adverse outcomes, underscores the need to align treatment strategies with quality of life. Recognising frailty as a trigger for GOC discussions during rapid response calls (RRCs) is critical for efficient resource management and improving patient outcomes. METHODS: This single-centre retrospective cohort study included all hospitalised patients aged ≥65 years admitted between September 2021 and June 2023 who experienced an RRC. Frailty was assessed using the Clinical Frailty Scale (CFS) during the RRC. The primary outcome was to investigate whether frailty, specifically assessed by the CFS as screened during an RRC, could be a suitable clinical trigger for initiating GOC discussions. We also aimed to identify the proportion of patients with frailty (CFS score: ≥5) and predictors at the time of RRC, resulting in recommendations for GOC discussions. RESULTS: Among 4954 patients, 1685 (34.0%) were classified as frail (CFS score: ≥5). Recommendations increased with frailty levels (nonfrail [CFS score: 1-4]: 6.6%, mildly frail [CFS score: 5]: 19.3%, moderate-to-severely frail [CFS score: 6-9]: 32.2%; p < 0.001). Frailty independently increased the probability of GOC recommendations during an RRC (area under the receiver operating characteristic curve = 0.71). The CFS cut-off point for GOC recommendations was ≥5. The presence of frailty was associated with higher odds of receiving GOC recommendations for mildly frail (CFS score: 5; odds ratio [OR] = 2.53; 95% confidence interval: 1.96-3.27) and moderate-to-severely frail (CFS score: 6-9; OR = 4.69; 95% confidence interval: 3.81-5.78) compared to nonfrail patients. CONCLUSION: Frailty, identified during an RRC, served as a robust trigger for GOC recommendations, highlighting the importance of tailored proactive discussions before episodes of deterioration. Higher levels of frailty (CFS score: ≥5) demonstrate practical markers for aiding clinicians with proactive GOC discussions.
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Species worldwide are experiencing anthropogenic environmental change, and the long-term impacts on animal cultural traditions such as vocal dialects are often unknown. Our prior studies of the yellow-naped amazon (Amazona auropalliata) revealed stable vocal dialects over an 11-year period (1994-2005), with modest shifts in geographic boundaries and acoustic structure of contact calls. Here, we examined whether yellow-naped amazons maintained stable dialects over the subsequent 11-year time span from 2005 to 2016, culminating in 22 years of study. Over this same period, this species suffered a dramatic decrease in population size that prompted two successive uplists in IUCN status, from vulnerable to critically endangered. In this most recent 11-year time span, we found evidence of geographic shifts in call types, manifesting in more bilingual sites and introgression across the formerly distinct North-South acoustic boundary. We also found greater evidence of acoustic drift, in the form of new emerging call types and greater acoustic variation overall. These results suggest cultural traditions such as dialects may change in response to demographic and environmental conditions, with broad implications for threatened species.
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Amazona , Vocalização Animal , Animais , Amazona/fisiologia , Espécies em Perigo de Extinção , Densidade Demográfica , Conservação dos Recursos NaturaisRESUMO
BACKGROUND: The management of blood supply depends, among other factors, on the effective remobilization of first-time donors (FTDs). This study investigates the efficacy of telephone calls to increase second donation rates. STUDY DESIGN AND METHODS: A randomized controlled trial was conducted on 418 first-time blood donors. In the telephone group (TG, n = 206), men were contacted 9-10 and women 13-14 weeks after their first donation. They were asked about satisfaction and intention to return, and offered an appointment. The primary outcome was the return rate within 6 months after the first donation. RESULTS: The mean age was 28.8 ± 10.0 years and 59.9% of FTDs were female. In the TG, 89.3% were reached. Approximately 50% of each group had donated a second time by 24.2 weeks for the control group (CG) and 14.8 weeks for the TG. The six-month return rate was 65.0% in the TG and 54.3% in the CG (95%-CI [0.9%; 20.6%]; p = .033). The restricted mean time to return within 6 months was 19.4 weeks in the CG compared to 17.2 weeks in the TG (95%-CI [0.7; 3.7]; p = .004). The intervention effect tended to be larger in men than in women. DISCUSSION: Contacting FTDs by phone after their first donation increases the six-month return rate and reduces the interval to a second donation. Male donors appear to be more receptive to this intervention. Whether the effect of the intervention helps to establish a donor identity in the long term should be the subject of further studies.
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BACKGROUND: The primary objective of this study was to investigate whether using a novel text messaging system improves patient overall satisfaction compared to standard care. Secondary objectives included assessing the impact of the text messaging system on decreasing narcotic usage, the number of emergency department visits, the range of flexion and extension, and number of telephone calls to the surgeon's office. METHODS: We enrolled 217 patients to either receive informative text messages (text messaging group, n = 86) or no additional text messages (conventional group, n = 131). Patients self-reported results on a questionnaire at the 6-week follow-up regarding the primary and secondary objectives. The active range of motion of total knee arthroplasty patients was recorded by the surgeon or treating physiotherapist. RESULTS: There was no significant difference in overall satisfaction (P = 0.644), narcotic cessation (P = 0.185), range of motion (Flexion P = 0.521; Extension P = 0.515), and emergency department visits (P = 0.650) between the two groups. There was a statistically significant decrease in surgeon office calls favoring the text messaging group (P = 0.029). A subgroup analysis revealed that the statistical difference was mainly in the TKA group (P = 0.046). CONCLUSIONS: A novel text messaging system may help reduce the work burden by decreasing telephone calls to the surgeon's office. While satisfaction, narcotic usage, emergency department visits, and range of motion did not significantly differ, patients endorsed the system for friends/family.
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Background: Falls amongst the elderly represent a global public health challenge because of their potential to cause illness, death, and reduce the autonomy of this group. They also impact the emotional, family, social and economic well-being of those involved. Various strategies to prevent falls have been reported in the literature, focusing mainly on addressing individual risk factors, and on the continuous assessment of the risk of falls in older people. Objective: This study evaluated user satisfaction and acceptability of a comprehensive model, implemented in the community, to prevent falls amongst independent older adults aged 65 years and above. It sought to capture both the perceptions of the individuals who received the intervention and of the interventionists who implemented it. The study protocol was registered at ClinicalTrials.gov in November 2020 (ID: NCT04313062). Design: Qualitative, exploratory study using a case study design. The evaluation of the intervention followed the recommendations proposed by the Medical Research Council for complex interventions. Methods and participants: In the period between April 2021 to April 2022, 11 semi-structured interviews were conducted with independent older adults between 65 and 80 years of age who participated in the implementation of the comprehensive model in Santiago, Chile. Data were also collected with eight interventionists through: three semi-structured interviews at the beginning of the intervention; and two focus groups with seven interventionists at the end of the implementation of the model. The team members undertook a content analysis of the data collected. Results: Three themes emerged to account for the satisfaction and acceptability of the intervention with the model on the part of the participants and interventionists: (1) Previous experience of older persons and interventionists; (2) The older person-interventionist encounter and its context; and (3) Identification of facilitators, strengths and challenges for the implementation of the model. The results show a positive assessment of the model, highlighting the value of the social contact derived from the intervention by both participants and interventionists. Although the model involved an individual intervention, the participants' accounts indicate that it reached out to others, including family members and other elderly acquaintances. Moreover, the interventionists helped identify challenges in implementation and made recommendations to strengthen the model. Conclusion: The evaluation of satisfaction and feasibility of implementing the model showed positive results that will nurture the next phase of development of this model, which involves scaling up the intervention.
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INTRODUCTION: 'Teachable moments', such as inpatient treatment periods, can be turned into opportunities for smokers to acquire healthy living behaviors. This study was conducted to evaluate the outcomes of smoking cessation interventions in an inpatient hospital setting. METHODS: Data were collected for this single-arm prospective intervention cohort study between October 2021 and March 2022 from hospitalized patients at Recep Tayyip Erdogan University Training and Research Hospital in Türkiye. Smoker patients received smoking cessation counseling and brief smoking cessation interventions during their hospitalization and were informed about how to apply to our hospital's smoking cessation outpatient clinic after discharge. They were followed via phone on the 3rd, 5th, and 7th day and the 1st, 3rd, 6th, and 12th month after their discharge, regarding their quit status as well as admissions to smoking cessation clinics. Quitters were confirmed by exhaled air carbon monoxide testing. Logistic regression analysis was performed to evaluate the presence of admission to the emergency department and family physicians at follow-up at 1st year. The model was adjusted in terms of age, sex, presence of malignancy, and education level. RESULTS: Of the 183 patients included in the study, 163 participants completed periodic follow-up during one year, with quit rate of 47.2%. The rate of anxiety was higher among non-quitters compared to quitters (9.4% vs 1.2%) (p=0.024). Non-quitters were 19 times more likely to have emergency department admissions (AOR=19.64; 95% CI: 8.08-47.68) and eight times more likely to have family doctor visits (AOR=8.43; 95% CI: 4.05-17.53) than quitters. CONCLUSIONS: This cessation program evaluated the quit rates of hospitalized patients in the first year and revealed that the rate of anxiety was higher in non-quitters compared to quitters. It would be an important approach to include psychiatric support in this practice.
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Background: In a previous study, we identified eight types of potential barriers to bystander cardiopulmonary resuscitation (CPR) initiation and continuation until the arrival of emergency medical services (EMS) on scene, in the context of emergency calls for out-of-hospital cardiac arrest (OHCA). Many cases had multiple barriers. In this study, we aimed to estimate the independent effects of these barriers after adjusting for case characteristics. Methods: We used data for the 295 non-trauma OHCAs from the St John Western Australian (SJ-WA) OHCA Database. Excluded cases were: EMS-witnessed OHCA, callers not with/close to the patient, OHCA not recognised during the emergency call, bystander CPR in progress prior to the call and calls coded as obvious death by SJ-WA. We conducted two multivariable logistic regression models including the eight barriers (callers: 1) perceived inappropriateness of CPR, 2) emotional distress, 3) reluctance to perform CPR, 4) physical limitations, 5) access to the patient, 6) leaving the scene, 7) communication failure, and 8) on-scene distractions) and case characteristics. Results: The callers perceiving CPR as inappropriate (adjusted odds ratio [AOR] = 0.20, 0.11-0.37) and witnessed arrest (AOR = 2.88, 95% CI 1.48-5.60) were independently associated with CPR initiation. Caller distractions such as performing other tasks or relaying information to other bystanders were negatively significantly associated with callers continuing CPR to EMS arrival (AOR = 0.27, 0.10-0.73). Conclusions: Perceptions of inappropriateness and caller distractions were independent risk factors for the delivery of bystander CPR. Further research around how call-takers navigate these barriers and encourage callers should be performed.
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Short-term exposure to air pollution has previously been studied in relation to certain neurological disorders, but there is still a lack of convincing data linking air pollution to epileptic seizures. The study's goal was to investigate how exposure to ambient nitrogen dioxide (NO2) affected the number of patients seeking assistance at the Wuhan Emergency Medical Center due to epileptic seizures. We gathered data on medical emergency calls (MECs), daily ambient air pollution concentrations (SO2, NO2, PM2.5, PM10, CO, and O3), and meteorological variables in Wuhan, China, spanning from January 1, 2017, to November 30, 2019. To investigate the potential influence of ambient nitrogen dioxide on MECs for epileptic seizures, we carried out a time-series investigation using the general additive model (GAM). Additionally, analyses stratified by season, age, and gender were performed. A total of 8989 records of MECs for epileptic seizures were enrolled in our study during the period. Statistical analysis indicates that a rise of 10 µg/m3 in NO2 concentration is linked to a 0.17% increase in daily MECs for epileptic seizures (95% confidence interval [CI]: 0.02%, 0.32%). Furthermore, people aged 14-59 years were more susceptible(2.25%, P < 0.05). The short-term effects of NO2 exposure on daily MECs for epileptic seizures were stronger in warm seasons than in cool seasons (0.55% vs. -0.10%, P < 0.0001). Our findings suggests that short-term exposure to ambient NO2 was positively correlated with daily MECs for epileptic seizures in Wuhan, China. Additionally, we observed that these associations were stronger in patients aged above 14 but under 60 years and the warmer seasons (from April to September).
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With the growth in maritime traffic comes an increased need for precise modelling, analysis, and visualisation to enhance the monitoring capabilities of maritime authorities. To address this need, a range of sensing technologies have been developed to track vessel movements worldwide. Among these, the Automatic Identification System (AIS) is particularly significant, offering high-frequency transmission of both location and identification data. This makes AIS an invaluable tool in the intricate process of modelling maritime traffic that we use in this study. Our study presents a comprehensive dataset for the Caribbean in 2019, including port calls, quay geometries, vessel trajectories, daily locations, a seven-class vessel classification, port statistics, and United Nations reference data for comparison. Beneficial for geomatics, geography, and economics, the dataset provides a versatile tool for visualising data, assessing maritime impact on coastal areas, and enhancing maritime trade analysis. The methodology extracts 1.5 million port calls from 642 million AIS messages, offering detailed data tables and reusable processes. Its granularity down to the single quay allows for flexible data analysis, facilitating in-depth understanding of port and inter-port maritime activities.
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The acoustic communication system (ACS) in bark beetles has been studied mainly in species of the genera Dendroctonus, Ips and Polygraphus. Specifically, ACS of the roundheaded pine beetle, Dendroctonus adjunctus, has been little studied. In this study, we described the stridulatory apparatus of this beetle using optical and scanning electron microscopy and recorded the call types produced by males in three behavioral contexts: stress, female-male-, and male-male interactions. From the spectrograms and waveforms, call types, as well as temporal (tooth strike, tooth strike rate, and intertooth strike interval) and spectral features (minimum, maximum and dominant frequency), were determined. Males have a functional elytro-tergal stridulatory apparatus-females do not-consisting of a file for the pars stridens and two lobes for the plectrum. Most of spectro-temporal features were statistically different between single- and multi-noted calls and across the three behavioral contexts. In the male-male interaction, a new type of call named "withdrawal" was produced by the male withdrawing or fleeing. Our results suggest that the spectro-temporal features of single- and multiple-noted calls in the three behavioral conditions are specific and different from each other. Yet, the combination of single and multiple calls determines an overall calling pattern characteristic of the tested behaviors and, therefore, is species-specific.
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BACKGROUND: The purpose of this study was to understand how transplant infectious disease (TID) physicians assess a potential donor with known or suspected infection and describe posttransplant management. METHODS: We designed a survey of 10 organ offer scenarios and asked questions pertaining to organ acceptability for transplantation and management posttransplant. The survey was distributed to TID clinicians via transplant society listservs and email. Responses were recorded in REDCap, and descriptive statistics were employed. RESULTS: One hundred thirteen infectious disease physicians responded to the survey, of whom 85 completed all cases. Respondents were generally in agreement regarding organ acceptability, although some divergence was seen when evaluating lungs from donors with influenza, tuberculosis, or multidrug-resistant Acinetobacter infection. Posttransplant management showed more variation. Areas of optimization were identified: (1) Further understanding of where risk-mitigation strategies within the donor offer process may improve donor acceptability and therefore organ utilization; (2) importance of recipient considerations in assessing degree of infectious risk; and (3) gaps in evidenced-based data regarding optimal posttransplant management of recipients. CONCLUSION: Evaluation of donor offers by TID clinicians is a complex process. Although the survey does not itself serve to make recommendations regarding best practices, it highlights areas where generation of data to inform acceptance and management practices may allow for improved organ utilization and recipient management.
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Promptly calling for assistance in an anaesthetic emergency is important. However, emergency call systems are not present in all locations where anaesthesia is administered, and in those that do have an emergency call system, the call button is often obscured by other equipment or in an unfamiliar location. Placing a red stripe from the ceiling, down the wall, to the emergency call button significantly reduces delays in activating an emergency call, demonstrating a simple but effective system change to the layout of operating theatres.
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Anestesia , Salas Cirúrgicas , Humanos , Anestesia/métodos , Sistemas de Comunicação entre Serviços de Emergência , Fatores de Tempo , Serviços Médicos de Emergência/métodosRESUMO
The reaction of birds to the nest parasite, the European cuckoo Cuculus canorus, has been the subject of extensive testing in various aspects. However, while the cuckoo is a long-distance migrant, some of its hosts are sedentary species. In this study, we aimed to investigate whether species, primarily hosts, react to the presence of the cuckoo also in the winter season. This behaviour may involve an attempt to drive the parasite away from locations that will subsequently become their breeding sites. During playback experiments conducted in the winter of 2021/2022 in Poland, we demonstrated that numerous bird species react to the male cuckoo calls in winter. These calls may be perceived as a source of danger, particularly by cuckoo hosts, who responded to this call more frequently than non-hosts and the control species (pigeon). Nonetheless, the birds' reactions were not strong, as they did not approach the source of the call. However, our results are constrained by the limited number of cuckoo host species wintering in Poland. To better evaluate the intensity of bird responses to the male cuckoo's call during the non-breeding season, further studies should be conducted in regions where a greater variety of species, especially those most susceptible to parasitism, overwinter.
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Passeriformes , Estações do Ano , Animais , Masculino , Passeriformes/fisiologia , Passeriformes/parasitologia , Polônia , Vocalização Animal/fisiologia , Comportamento de Nidação/fisiologia , Migração Animal/fisiologiaRESUMO
Objective: The aim of this study was to conduct a comprehensive spatio-temporal analysis of suicide-related emergency calls in the city of Valencia (Spain) over a six-year period. To this end we first examined age and gender patterns and, second, the influence of neighborhood characteristics on general and gender-specific spatio-temporal patterns of suicide-related emergency calls. Method: Geocoded data on suicide-related emergency calls between 2017 and 2022 (N = 10,030) were collected from the 112 emergency service in Valencia. Data were aggregated at the census block group level, used as a proxy for neighborhoods, and trimesters were considered as the temporal unit. Two set of analyses were performed: (1) demographic (age and gender) and temporal descriptive analyses and (2) general and gender-specific Bayesian spatio-temporal autoregressive models. Results: Descriptive analyses revealed a higher incidence of suicide-related emergency calls among females and an increase in calls among the 18-23 age group from 2020 onwards. The general spatio-temporal model showed higher levels of suicide-related emergency calls in neighborhoods characterized by lower education levels and population density, and higher residential mobility, aging population, and immigrant concentration. Relevant gender differences were also observed. A seasonal effect was noted, with a peak in calls during spring for females and summer for males. Conclusions: These findings highlight the need for comprehensive mental health targeted interventions and preventive strategies that account for gender-specific disparities, age-related vulnerabilities, and the specific characteristics of neighborhoods.
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Características de Residência , Análise Espaço-Temporal , Suicídio , Humanos , Masculino , Feminino , Adulto , Espanha/epidemiologia , Pessoa de Meia-Idade , Características de Residência/estatística & dados numéricos , Adulto Jovem , Adolescente , Suicídio/estatística & dados numéricos , Fatores Sexuais , Idoso , Fatores Etários , Teorema de BayesRESUMO
The challenge of developing an Android malware detection framework that can identify malware in real-world apps is difficult for academicians and researchers. The vulnerability lies in the permission model of Android. Therefore, it has attracted the attention of various researchers to develop an Android malware detection model using permission or a set of permissions. Academicians and researchers have used all extracted features in previous studies, resulting in overburdening while creating malware detection models. But, the effectiveness of the machine learning model depends on the relevant features, which help in reducing the value of misclassification errors and have excellent discriminative power. A feature selection framework is proposed in this research paper that helps in selecting the relevant features. In the first stage of the proposed framework, t-test, and univariate logistic regression are implemented on our collected feature data set to classify their capacity for detecting malware. Multivariate linear regression stepwise forward selection and correlation analysis are implemented in the second stage to evaluate the correctness of the features selected in the first stage. Furthermore, the resulting features are used as input in the development of malware detection models using three ensemble methods and a neural network with six different machine-learning algorithms. The developed models' performance is compared using two performance parameters: F-measure and Accuracy. The experiment is performed by using half a million different Android apps. The empirical findings reveal that malware detection model developed using features selected by implementing proposed feature selection framework achieved higher detection rate as compared to the model developed using all extracted features data set. Further, when compared to previously developed frameworks or methodologies, the experimental results indicates that model developed in this study achieved an accuracy of 98.8%.
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Theoretical work suggests that having many informed individuals within social groups can promote efficient resource location. However, it may also give rise to group fragmentation if members fail to reach consensus on their direction of movement. In this study, we investigate whether the number of informed individuals, exemplified by bats emitting calls from different roosts, influences group cohesion in Spix's disk-winged bats (Thyroptera tricolor). Additionally, we explore the role of signal reliability, quantified through signalling rates, in group consensus on where to roost. These bats use contact calls to announce the location of a roost site and recruit conspecifics. The groups they form exhibit high levels of cohesion and consist of both vocal and non-vocal bats, with vocal behaviour being consistent over time. Our findings revealed that an increase in the number of roosts broadcasting calls is strongly associated with the likelihood of groups fragmenting among multiple roosts. Additionally, we found that a majority of group members enter the roost with higher calling rates. This phenomenon can mitigate the risk of group fragmentation, as bats emitting more calls may contribute to greater group consensus on roosting locations, thereby reducing the likelihood of individuals separating and enhancing overall group cohesion. Our results highlight the potential costs of having too many information producers for group coordination, despite their established role in finding critical resources. This article is part of the theme issue 'The power of sound: unravelling how acoustic communication shapes group dynamics'.
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Quirópteros , Tomada de Decisões , Comportamento Social , Vocalização Animal , Animais , Quirópteros/fisiologia , Tomada de Decisões/fisiologia , MasculinoRESUMO
OBJECTIVES: COVID-19-related stay-at-home orders (SAHOs) created an immediate physical barrier between children and professionals such as pediatricians and teachers, who are often first to identify and report signs of child maltreatment. Our objective was to determine how the SAHO in a southern state was associated with reports of child maltreatment and whether this association was modified by sociodemographic characteristics. METHODS: We linked data on reports of child maltreatment from a southern state in the United States from October 1, 2018, through September 30, 2020, to data from the US Census Bureau to obtain data on county-level socioeconomic characteristics. We fit a segmented regression model to evaluate changes in reports before and after the SAHO, March 20, 2020. We evaluated potential disparities by child age, case and allegation severity, and socioeconomic characteristics. RESULTS: Of 374 885 hotline calls, 276 878 (73.9%) were made before the SAHO and 98 007 (26.1%) after it. Although an immediate decrease in reports of child maltreatment occurred on the day of the SAHO, the rates of reporting within socioeconomic groups started increasing thereafter. While we found no significant change in the overall rate of change in hotline calls after versus before the SAHO (0.23; 95% CI, -0.11 to 0.58), stratified analyses indicate that the rates at which reporting increased varied by education level, health insurance coverage, median annual household income, and unemployment. CONCLUSIONS: Evaluating these trends is important for policy makers and practitioners to understand how policies enforced during the pandemic influence child maltreatment reporting and how these policies may affect reporting differently across socioeconomic groups.
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BACKGROUND: In an increasingly strained maternity care system with a shortage of midwives and great demands for service, pregnant women in their early labour are at risk of receiving insufficient support. Women make calls and visit the labour ward on multiple occasions before being admitted. A video call with a labour ward midwife during early labour is an unknown practice but could support pregnant women and their partners during this uncertain period. AIM: The study aimed to describe women's experiences of remote video calls with a labour ward midwife during early labour. METHODS: A qualitative study comprising nine semi-structured interviews followed by an inductive thematic analysis was conducted. RESULTS: The results revealed that video calls prepared women and their partners by means of practical support. They received an assessment of early labour and the interaction with labour ward midwives prepared them for the impending birth. The participants reported feeling secure and strengthened by being met at their current stage of labour. Furthermore, they found the service accessible, easy to use and emphasised the need for increased availability and continuity. CONCLUSION: This study highlights the positive impact of video calls in early labour when conducted by competent labour ward midwives. The perceived accessibility and ease of use e-health system underscore a demand for extended availability. These findings indicate the potential benefits of integrating video calls in labour care to enhance support, security, accessibility and overall satisfaction for pregnant women and their partners.