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Introduction: Breast cancer may have a significant impact on the psychosocial well-being, not only of the women diagnosed, but also on their family members. Aim: The purpose of this review and narrative synthesis is to investigate the affect of breast cancer on women and their family. Methods: The electronic databases Scopus, Psycinfo, Science Direct and Pubmed were searched during the period 2010-2020. We followed the PRISMA guidelines and the PICO framework with Boolean operators. Of the 1126 articles identified, only 35 were used in the final configuration of the systematic review, based on the inclusion and exclusion criteria that were set. Results: The 35 articles that were finally included in this review focused mainly on the relationship of women with breast cancer with their family. More specifically, family seems to play a significant role for women with breast cancer. Dynamics and roles among the family members are affected and burdened because of the disease. Family caregivers provide support to women with breast cancer, and patients receiving family care seem to respond more effectively to their treatment and manage to cope with their illness. Both breast cancer patients and family caregivers seek psychosocial support. Breast cancer can also have a detrimental effect on their family caregivers, their partners and the extended family. Conclusion: A supportive family may a have a positive impact on patients’ psychosocial wellbeing. Providing psychosocial support to both patients and family members may significantly improve the quality of life for the whole family.

IntroductionInadequate understanding of medical terminology, poor communication and lack of information affect women's ability to receive adequate care and to establish a relationship with the care provider.MethodsThe sample consists of five immigrants and refugees who lived in a shelter and participated in the ORAMMA program during their pregnancy, in March 2018. In-person interviews were conducted with the participation of an intercultural mediator with an open-ended exploratory questionnaire.ResultsThe women who received care under the ORAMMA program were very satisfied with the provision of prenatal care, they felt very comfortable with the providers talking, communicating, and building a relationship, asking clarifying questions and understanding the reason for their care. Women also felt intimacy, respect, friendship, empathy and confidence to share problems and feelings. Finally, empowering them to familiarize themselves with the health care system has proven to be useful enough for women to be able to care for themselves.ConclusionsThe provision of prenatal and perinatal care to refugee and migrant women offers significant benefits to pregnancy. Therefore, the provision of the ORAMMA program to migrant and refugee women is vital.

Οι μητέρες κατά τη διάρκεια της γαλουχίας μπορεί να αντιμετωπίσουν εμπόδια όπως η έναρξη φαρμακευτικής αγωγής λόγω χρόνιου νοσήματος ή οξείας ασθένειας με επιπτώσεις που αφορούν κυρίως στη διάρκεια του θηλασμού. Σε αυτές τις περιπτώσεις, προκύπτει το ζήτημα της συμβατότητας των χορηγούμενων φαρμάκων με το θηλασμό και η απόφαση που λαμβάνει η μητέρα εξαρτάται από την πληροφόρηση που θα λάβει από τον εξειδικευμένο επαγγελματία υγείας. Η παροχή επιστημονικά έγκυρων πληροφοριών σχετικά με τα οφέλη του θηλασμού και τον κίνδυνο έκθεσης του νεογνού/βρέφους στα φάρμακα μέσω του μητρικού γάλακτος, αποτελεί χρέος των επαγγελματιών υγείας. Υπάρχουν ποικίλες αξιόπιστες πηγές για τη συμβατότητα των φαρμάκων με το θηλασμό, παρόλα ταύτα οι μεταξύ τους πληροφορίες είναι αντικρουόμενες ή και ανεπαρκείς, με αποτέλεσμα να δυσχεραίνεται το έργο των επαγγελματιών υγείας στην άσκηση συμβουλευτικής. Με σκοπό να καταστεί η χρήση των φαρμάκων ασφαλής κατά τη διάρκεια του θηλασμού, και δεδομένου ότι οι θηλάζουσες μητέρες εξαιρούνται των κλινικών μελετών διότι θεωρούνται ευάλωτος πληθυσμός, η επιστημονική κοινότητα στράφηκε σε εναλλακτικές μεθόδους που βασίζονται στην φαρμακοκινητική μοντελοποίηση του πληθυσμού. Επιπλέον, μέσω της επιστήμης της φαρμακοεπαγρύπνησης, οι βάσεις δεδομένων που σχετίζονται με τη συμβατότητα των φαρμάκων με το θηλασμό μπορούν να εμπλουτιστούν με καινούργια στοιχεία. Αδιαμφισβήτητα, η συμβολή των μαιών και των λοιπών επαγγελματιών υγείας που σχετίζονται με το μητρικό θηλασμό παίζει καθοριστικό ρόλο στο έργο της φαρμακοεπαγρύπνησης μέσω της παρατήρησης και αναφοράς των ανεπιθύμητων ενεργειών των φαρμάκων που χορηγούνται στις θηλάζουσες. Απώτερος στόχος είναι η υποστήριξη και συνέχιση του μητρικού θηλασμού με γνώσεις που βασίζονται στην τεκμηρίωση.

Midwives' burnout affects their effectiveness and the quality of the services they provide to pregnant women as well as the quality of the collaboration with medical staff. The burnout depends on a number of factors that can exhibit high variability over time. This creates the necessity of introducing intelligent approaches that assess changes in behavior, environmental factors, working conditions, and to make decisions to optimize the physical and mental health of midwives. The aim of this study was to employ fuzzy logic to design a Fuzzy Intelligent or Inference System (FIS) that assesses midwives' burnout level by emulating the reasoning of human experts.The proposed FIS addresses the assessment of midwives' burnout comprehensively since it incorporates findings following a thorough analysis of the relevant literature, as well as assimilates experts' knowledge elicited through semi-structured interviews. Additionally, fuzzy rules are more intuitive and thus easier to understand and modify by human users than dealing and translating numerical results. The FIS performance is compared and evaluated against experienced midwives.Findings confirm the ability of the proposed FIS to produce judgments that are closer to experts' consensus, as expressed by their aggregated assessment.The proposed FIS is evaluated by comparing its results with judgments made by experts, suggesting that fuzzy logic allows precise and personalized assessment of midwives' burnout levels. The proposed FIS can be used to evaluate burnout, support organizations to develop burnout policies as well as used as a research instrument to investigate interrelationships of burnout factors.

INTRODUCTION Migration is a growing phenomenon affecting many European countries,\ud with many migrants being of childbearing age. Depending on the country of origin, poorer\ud pregnancy and birth outcomes amongst migrant women have been reported. Providing\ud appropriate culturally sensitive perinatal services is of paramount importance.\ud METHODS The Operational Refugee And Migrant Mothers Approach (ORAMMA) was\ud a three-site multidisciplinary collaborative research project, designed to develop and\ud test implementation of a high-quality maternity care model including peer supporters\ud for migrant women who have recently arrived in European countries. Community-based\ud activities were undertaken to ensure ongoing local impact for maintaining supportive\ud interactions amongst peer supporters and recently arrived migrant women in the UK.\ud RESULTS The women who volunteered to become maternity peer supporters were\ud motivated by their own experiences of being newly arrived migrants in the past or a sense\ud of altruism. Forging links with multiple local community groups enabled the continuation\ud of the support provided by maternity peer supporters, including during the COVID-19\ud pandemic.\ud CONCLUSIONS Engagement of maternity peer supporters in supporting newly arrived\ud mothers has multiple advantages of addressing social isolation and marginalisation of\ud migrant communities, with potential benefits of improving access and enhancing health\ud literacy and health outcomes amongst recently arrived migrant women as well as creating\ud a self-supporting network for peer supporters themselves.

Cesarean sections have become the most commonly performed operations around the world. The World Health Organization recommended the use of the Robson classification system as a universal standard to establish a joint control system in healthcare facilities. The aim of this study was to implement the Robson classification for the first time in Greece to identify trends in cesarean births and examine the groups of women who are the main contributors to the increasing rates. Moreover, the indicators for cesarean sections will be evaluated as per the Robson classification. In the sample analysis, we included the records of 8572 women giving birth in one private health facility in Greece. A total of 8572 women gave birth during the study period, of which 5224 (60.9%) were cesarean section births and 3348 (39.1%) were vaginal births. In our study, according to the Robson classification, the largest contributors to the overall CS rate were as follows: (a) nulliparous women with a single cephalic term pregnancy, who were either labor induced or delivered by cesarean section before labor—Group 2 (34.6%); (b) multiparous women with a single cephalic term pregnancy and at least one previous cesarean section—Group 5 (30.7%); (c) women with a single cephalic preterm pregnancy—Group 10 (11.7%); (d) women with multiple pregnancies—Group 8 (7.0%). Our study is expected to assist policymakers in Greece in planning further interventions for each subgroup of women in order to reduce the overall CS rate and unnecessary CSs.

INTRODUCTION Machine learning is increasingly utilized over recent years in order to develop models that represent and solve problems in a variety of domains, including those of obstetrics and midwifery. The aim of this systematic review was to analyze research studies on machine learning and intelligent systems applications in midwifery and obstetrics. METHODS A thorough literature review was performed in four electronic databases (PubMed, APA PsycINFO, SCOPUS, ScienceDirect). Only articles that discussed machine learning and intelligent systems applications in midwifery and obstetrics, were considered in this review. Selected articles were critically evaluated as for their relevance and a contextual synthesis was conducted. RESULTS Thirty-two articles were included in this systematic review as they met the inclusion and methodological criteria specified in this study. The results suggest that machine learning and intelligent systems have produced successful models and systems in a broad list of midwifery and obstetrics topics, such as diagnosis, pregnancy risk assessment, fetal monitoring, bladder tumor, etc. CONCLUSIONS This systematic review suggests that machine learning represents a very promising area of artificial intelligence for the development of practical and highly effective applications that can support human experts, as well the investigation of a wide range of exciting opportunities for further research.

Worldwide there is an alarming increase in the caesarean delivery rate which has become a controversial topic. However, the reasons for this tendency are not clear. For example, in Greece alone, rates increased by almost 50% from 1983 to 1996. In order to better understand the causes of this phenomenon, we need to examine closely what groups of women undergo caesarean section (CS). To achieve this, it is essential to use a system that will enable us to monitor and compare caesarean delivery rates. Such a classification system should be easily adopted by obstetricians, midwives, and public health services.A review search of electronic databases concerning medical care was held from December 2020 to January 2021 in order to find systematic reviews which describe either theoretical or practical CS classification systems.The most common classification systems fall into three main categories based on indication, urgency and maternal-based characteristics. According to users the highest rated classification system was women-based classifications in general. In particular the Robson Ten Group Classification System was considered to be the most valid to meet current local and international standards. The Robson classification system is praised for its robustness, simplicity, flexibility, and reproducibility.The right implementation of the Robson Ten Group Classification System can facilitate an in-depth analysis of the main groups that increase CS rates and can be used to both review and monitor delivery practices both in Greece and abroad.

The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is an important measurement instrument for assessing the health-related quality of life (HRQOL) among heart failure patients. The purpose of this study was to translate and validate the MLHFQ in the Greek language.Three hundred forty-four consecutive adult patients from three General Hospitals, two in Athens and one in another part of the country, who were diagnosed with chronic heart failure, and 347 healthy controls were enrolled in the study from March 2009 to March 2010. The questionnaire instrument was translated from English, back-translated, and reviewed by a committee of experts. The psychometric measurements that were performed included reliability coefficients and Explanatory Factor Analysis (EFA), using a Varimax rotation and Principal Components Method. In a further step, confirmatory analysis (CFA)--known as structural equation modeling--of the principal components was conducted.The internal consistency of the Greek MLHFQ version was found to be 0.97, using Cronbach's alpha coefficient. An exploratory factor analysis identified two domains that accounted for 72.5% of the variance of MLHFQ items; the area under the ROC curve was calculated at 0.942 and the logistic estimate for the threshold score of 24.50 provided the model with 95.1% sensitivity and 99.8% specificity. Additionally, the CFA demonstrated that the two-factor model offered a very good fit to our data.Our data indicate that the Greek MLHFQ is a reliable and valid tool for assessing HRQOL among patients with heart failure. Health professionals can use it in their clinical practice to improve their evaluation of these patients.

Recent findings suggest a significant association between the antioxidant status of pregnant women and of their children during the first years of life and the development of allergic disease during childhood. The aim of this review was to identify all studies that estimated the effect of intake of antioxidants in pregnant women and their children on the development of allergic disease during early childhood. A systematic review was conducted of epidemiological studies featuring original peer-reviewed data on the association between dietary antioxidant status and allergic disease during childhood. A systematic search was performed following the Meta-analysis of Observational Studies in Epidemiology Guidelines. A comprehensive search of the literature yielded 225 studies, 18 of which were selected for the extraction of results and were related to antioxidant status and allergic disease. The systematic review included five prospective cohort studies, four cross-sectional studies, and nine case-control studies. Eight studies reported an important association between antioxidant status and asthma onset during childhood. Similarly, wheezing and eczema were studied as an outcome in six and in five studies, respectively. Recent observational studies suggest that a higher intake of antioxidant vitamins, zinc, and selenium during pregnancy and childhood reduces the likelihood of childhood asthma, wheezing, and eczema.

Socrates can, to some extent, be credited with an original conception of what is now seen as 20th century phenomenology 'invented' by Heidegger. With phenomenology becoming more recognised as important in understanding health care and all its complexities, this article by Victoria Vivilaki and Martin Johnson provides a theoretical evaluation of some of the terminology and the underpinning philosophy used in recent phenomenological studies.

Cervical screening programs have been introduced in many countries and are generally regarded as the most appropriate and effective method currently available for preventing cervical cancer. Although action has been undertaken by some rural practitioners, especially by district midwives, there are still few published data on the effectiveness of community-oriented cervical screening programs in Greece.To explore an innovative approach in a primary-care setting in rural Crete. This study reports on the effectiveness of a health education meeting in recruiting women for a cervical screening program.At a centre for the elderly, 16 women participated in an educational discussion meeting organised to promote cervical screening. The women who participated in the discussion meeting were invited to organise a group visit to a rural primary healthcare centre, in order to be screened as a team during the following 15 days. The theoretical model underpinning the development of this intervention was based on the 'social learning theory'. Emphasis was placed up individual and social responsibility regarding cervical cancer.A total number of 48 women (average age 62 years) including all those who participated in the educational discussion meeting, visited the Spili Health Center, Crete, 15 days after the discussion meeting. The main finding was the high compliance rate of the women who participated in the educational discussion meeting, resulting in recruiting all the initial participants. Moreover, the lay women who participated in the small group discussion meeting, in the capacity of key messengers convinced an additional 32 women to participate in a screening program for cervical cancer as members of a team, rather than individually. The majority (52.1%, n = 25 out of 48) of the women had not been previously screened for cervical cancer.Health education is an important factor in the process of health promotion, and health professionals should consider the dynamics of a specific group in order to carry out their work effectively. Awareness of the special characteristics of an individual as a member of a defined group can contribute to increasing the motivation for participation in health programs as a member of that group. It is suggested that more educational programs take place in rural Crete in order to augment the compliance rate of women in cervical screening programs.