RESUMO
BACKGROUND: The number of international migrants continues to increase worldwide. Depending on their country of origin and migration experience, migrants may be at greater risk of maternal and neonatal morbidity and mortality. Having compassionate and culturally competent healthcare providers is essential to optimise perinatal care. The "Operational Refugee and Migrant Maternal Approach" (ORAMMA) project developed cultural competence training for health professionals to aid with providing perinatal care for migrant women. This presents an evaluation of ORAMMA training and explores midwives' experiences of the training and providing care within the ORAMMA project. METHODS: Cultural competence was assessed before and after midwives (n = 35) received ORAMMA compassionate and culturally sensitive maternity care training in three different European countries. Semi-structured interviews (n = 12) explored midwives' experiences of the training and of caring for migrant women within the ORAMMA project. RESULTS: A significant improvement of the median score pre to post-test was observed for midwives' knowledge (17 to 20, p < 0.001), skills (5 to 6, p = 0.002) and self-perceived cultural competence (27 to 29, p = 0.010). Exploration of midwives' experiences of the training revealed themes of "appropriate and applicable", "made a difference" and "training gaps" and data from ORAMMA project experiences identified three further themes; "supportive care", "working alongside peer supporters" and "challenges faced". CONCLUSIONS: The training improved midwives' knowledge and self-perceived cultural competence in three European countries with differing contexts and workforce provision. A positive experience of ORAMMA care model was expressed by midwives, however clearer expectations of peer supporters' roles and more time within appointments to assess the psychosocial needs of migrant women were desired. Future large-scale research is required to assess the long-term impact of the ORAMMA model and training on practice and clinical perinatal outcomes.
Assuntos
Competência Cultural/educação , Assistência à Saúde Culturalmente Competente/normas , Serviços de Saúde Materna/normas , Enfermeiros Obstétricos/psicologia , Migrantes , Adulto , Assistência à Saúde Culturalmente Competente/organização & administração , Europa (Continente) , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Entrevistas como Assunto , Serviços de Saúde Materna/organização & administração , Pessoa de Meia-Idade , Enfermeiros Obstétricos/educação , Pesquisa Qualitativa , Adulto JovemRESUMO
AIM: Meningiomas are one of the most common benign intracranial tumors, making up nearly one third of all primary intracranial tumors. The majority of meningiomas have benign histological features and total resection is associated with favourable prognosis. Atypical and malignant meningiomas are associated with increased risk of recurrence. In the present study we set out to investigate the role of nestin mRNA levels and miR-21 in meningiomas. MATERIAL AND METHODS: We studied 17 patients with meningiomas that were treated surgically in our institute. Clinical variables that were analyzed were age, sex and histology. The expression of stem cell marker nestin mRNA levels and miR-21 was investigated in tissue samples by qRT-PCR. RESULTS: Considerable levels of both miR-21 and nestin mRNA were found. Atypical and anaplastic meningiomas had higher expression of both miR-21 and nestin compared to benign tumors. Furthermore, a trend towards a positive correlation between miR-21 and nestin mRNA levels was also found. CONCLUSION: Increased miR-21 and nestin mRNA levels were found in anaplastic meningiomas, in which recurrence is common, and the role of miR-21 and Nestin in meningiomas therefore warrants further investigation.