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This study aims to examine the relationship between medication for opioid use disorder (MOUD) among pregnant individuals, referral source, mental health, political affiliation and substance use policies in all 50 states in the USA.

This study describes MOUD receipt among pregnant people with an opioid use disorder (OUD) in 2018. The authors explored sociodemographic differences in MOUD receipt, referrals and co-occurring mental health disorders. The authors included a comparison of MOUD receipt among states that have varying substance use policies and examined the impact of these policies and the political affiliation on MOUD. The authors used multilevel binary logistic regression to examine effects of individual and state-level characteristics on MOUD.

Among 8,790 pregnant admissions with OUD, the majority who received MOUD occurred in the Northeast region (71.52%), and 14.99% were referred by the criminal justice system (n = 1,318). Of those who were self-referred, 66.39% received MOUD, while only 30.8% of referrals from the criminal justice system received MOUD. Those referred from the criminal justice system or who had a co-occurring mental health disorder were least likely to receive MOUD. The multilevel model showed that while policies were not a significant predictor, a state’s political affiliation was a significant predictor of MOUD.

The study has some methodological limitations; a state-level analysis, even when considering the individual factors, may not provide sufficient description of community-level or other social factors that may influence MOUD receipt. This study adds to the growing literature on the ineffectiveness of prenatal substance use policies designed specifically to increase the use of MOUD. If such policies are consistently assessed as not contributing to substantial increase in MOUD among pregnant women over time, it is imperative to investigate potential mechanisms in these policies that may not facilitate MOUD access the way they are intended to.

Findings from this study aid in understanding the impact that a political affiliation may have on treatment access; states that leaned more Democratic were more likely to have higher rates of MOUD, and this finding can lead to research that focuses on how and why this contributes to greater treatment utilization. This study provides estimates of underutilization at a state level and the mechanisms that act as barriers, which is a stronger assessment of how state-specific policies and practices are performing in addressing prenatal substance use and a necessary step in implementing changes that can improve the links between pregnant women and MOUD.

To the best of the authors’ knowledge, this is the first study to explore individual-level factors that include mental health and referral sources to treatment that lead to MOUD use in the context of state-level policy and political environments. Most studies estimate national-level rates of treatment use only, which can be useful, but what is necessary is to understand what mechanisms are at work that vary by state. This study also found that while substance use policies were designed to increase MOUD for pregnant women, this was not as prominent a predictor as other factors, like mental health, being referred from the criminal justice system, and living in a state with more Democratic-leaning affiliations.

This study aims to determine the prevalence and predictors of postpartum depression (PPD) among nursing mothers in Nsukka, Nigeria.

This study was a descriptive cross-sectional survey among nursing mothers in three hospitals in Nsukka, Nigeria. Data was collected using a self-administered Edinburgh Postpartum Depression Scale (EPDS) and sociodemographic form. The data obtained were analyzed using descriptive statistics, chi-square test and binary logistic regression.

A total of 270 nursing mothers participated in this survey, giving a response rate of 94.4%. The prevalence of PPD among the study group was 20.0%. However, women who did not have complications during childbirth were about two times (AOR = 0.417, 95% CI = 0.204, 0.852, P = 0.016) less likely to develop symptoms of PPD than women who experienced birth complications. In addition, women who had poor relationships with their partners have approximately seven times (AOR = 6.994, 95% CI = 1.110, 44.059, P = 0.038) higher odds of developing PPD compared with those women who had excellent relationships with their partners.

The sample size was small, hence, might limit the generalizability of its findings beyond the study group. Health-care practitioners should provide appropriate interventions to women at a higher risk of developing PPD on the need to maintain a healthy and supportive relationship with their partners.

This study provides unique insight into PPD among nursing mothers and its determinants from a different regional, socioeconomic, societal expectations, social support system, access to health care and cultural context.

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

Policing requires atypical work hours. The present study examined associations between shiftwork and pregnancy loss among female police officers.

Participants were 91 female officers with a prior history of at least one pregnancy. Shiftwork information was assessed using daily electronic payroll work records. Any prior pregnancy loss (due to miscarriage) was self-reported. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for main associations.

On average, the officers were 42 years old, had 14 years of service, and 56% reported a prior pregnancy loss. Officers who worked dominantly on the afternoon or night shift during their career had 96% greater odds of pregnancy loss compared to those on day shift (OR = 1.96, 95% CI:0.71–5.42), but the result was not statistically significant. A 25% increase in percent of hours worked on night shift was associated with 87% increased odds of pregnancy loss (OR = 1.87, 95% CI:1.01–3.47). Associations were adjusted for demographic and lifestyle factors. Objective assessment of shiftwork via electronic records strengthened the study. Limitations include small sample size, cross-sectional design and lack of details on pregnancy loss or the timing of pregnancy loss with regard to shiftwork.

The present study is preliminary and cross-sectional.

With considerable further inquiry and findings into this topic, results may have an impact on police policy affecting shift work and pregnant police officers.

Implication on the health and welfare of police officers.

To our knowledge, there are no empirical studies which associate shiftwork and pregnancy loss among police officers. This preliminary study suggested an association between shiftwork and increased odds of pregnancy loss and points out the need for further study.