Garenne, Michel; Darkaoui, Nada; Braikat, Mhamed; Azelmat, Mustapha
This study was carried out to evaluate the trends in cause-specific mortality and the impact of child-survival programmes in Morocco. Two national surveys on causes and circumstances of child deaths were conducted in Morocco in 1988 and 1998 (ECCD-1 and ECCD-2 respectively). These surveys were based on a representative sample of deaths of children aged less than five years (432 and 866 respectively). Causes of death were assessed by verbal autopsy and were validated on a subsample of 94 cases...
Dutta, P K
Editorial commentary focused on several Health System Research (HSR) approaches which exemplified some of the key issues for application of HSR for further improvement in Maternal and Child Health (MCH) services in India. The goals of HSR are to delineate health policy which improves the operations of the health care delivery system for sustainability at the district level. HSR is part of a global effort of Health For All by 2000 AD and India's Child Survival and Safe Motherhood (CSSM) program, sponsored by IDA/UNICEF. CSSM aims also to end polio by 2000 AD, eliminate neonatal tetanus by 1995, and prevent deaths and morbidity from measles, diarrheal diseases, and acute respiratory infection. MCH services will be expanded at the village, subcenter, primary health center, and community health center levels in order to reduce maternal mortality to below 2/1000 from the 1990 5/1000 and to reduce mortality of children aged 1-4 years to less than 10/1000 live births from 80/1000 by 2000 AD. States with particularly high levels of child and maternal mortality are Bihar, Uttar Pradesh, Rajasthan, and Madhya Pradesh, which have about 40% of India's population. These states have low marriage ages, low female literacy, and few women in nonagricultural employment. There are about 90 districts in these states with particularly low demographic indicators. India policy directs all CSSM work to be carried out by existing staff; the program emphasis will be training, supervision, and logistics. IEC will need to be directed to attitudinal change in rural areas and urban slums. Research has found that coverage is uneven and quality of MCH services, poor. One study will evaluate the performance over 5 years in Gwalior district in a nutrition and school health program. Another research effort will perform quality assessment of MCH care at the primary health care level and promote community awareness and increased utilization. An ongoing study is evaluating nationally the family welfare
Full Text Available Research question: What proportions of the ASHAs are performing according to the training they have received under the Comprehensive Child Survival Programme (CCSP? Objective: To analyze the ASHAs’ practice with respect to CCSP in related situations. Study design: Cross-sectional study. Study location: Chiraigaon Community Development Block, Varanasi Material and method: 173 out of the total 240 ASHAs (~72% in the selected Chiraigaon Community Development Block of Varanasi were randomly selected and interviewed using a pre-designed and pre-tested questionnaire pertinent to CCSP. Only the first response was recorded. Results: All the ASHAs interviewed claimed that the CCSP training has helped them perform better in the community. Ninety-eight percent of the ASHAs knew that a new born weighing >2.5 kgs at birth is considered to be normal. Only ~ 63% (109 of the ASHAs were found to be home-visiting such newborns as per the CCSP recommendation. The percentage was found to be just 43% for the properly scheduled home visits of LBW newborns. The difference was found to be statistically significant (p<0.001. Almost 80% ASHAs estimated that their average home visit spans for at least 30 minutes. Just about a third of the interviewees suggested that a baby should be bathed only after the first 6 days while one-third said that they advise massaging for the newborn only after the first week. ASHAs rarely used a thermometer to assess the baby’s temperature. Around 56% were confident about using a thermometer. Nearly 90% participants claimed of explaining about Kangaroo Mother Care to the parturient and/or family. Majority of the ASHAs (92% emphasized upon non-discontinuation of breast feeding for the baby during diarrhoeal episodes. However, only 44% revisited such babies. Conclusion: In most cases it is well evident that CCSP training has been taken up well by the ASHAs. The training may be refreshed.
Schellenberg, J R; Abdulla, S; Minja, H; Nathan, R; Mukasa, O; Marchant, T; Mponda, H; Kikumbih, N; Lyimo, E; Manchester, T; Tanner, M; Lengeler, C
We present a large-scale social marketing programme of insecticide-treated nets in 2 rural districts in southwestern Tanzania (population 350,000) and describe how the long-term child health and survival impact will be assessed. Formative and market research were conducted in order to understand community perceptions, knowledge, attitudes and practice with respect to the products to be socially marketed. We identified Zuia Mbu (Kiswahili for 'prevent mosquitoes') as a suitable brand name for both treated nets and single-dose insecticide treatment sachets. A mix of public and private sales outlets is used for distribution. In the first stage of a stepped introduction 31 net agents were appointed and trained in 18 villages: 15 were shop owners, 14 were village leaders, 1 was a parish priest and 1 a health worker. For net treatment 37 young people were appointed in the same villages and trained as agents. Further institutions in both districts such as hospitals, development projects and employers were also involved in distribution. Promotion for both products was intense and used a variety of channels. A total of 22,410 nets and 8072 treatments were sold during the first year: 18 months after launching, 46% of 312 families with children aged under 5 years reported that their children were sleeping under treated nets. A strong evaluation component in over 50,000 people allows assessment of the long-term effects of insecticide-treated nets on child health and survival, anaemia in pregnancy, and the costs of the intervention. This evaluation is based on cross-sectional surveys, and case-control and cohort studies. PMID:10492745
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Full Text Available Objective: We studied child survival in Rakai, Uganda where many children are fostered out or orphaned. Methods: Biological relatedness is measured as the average of the Wright's coefficients between each household member and the child. Instrumental variables for fostering include proportion of adult males in household, age and gender of household head. Control variables include SES, religion, polygyny, household size, child age, child birth size, and child HIV status. Results: Presence of both parents in the household increased the odds of survival by 28%. After controlling for the endogeneity of child placement decisions in a multivariate model we found that lower biological relatedness of a child was associated with statistically significant reductions in child survival. The effects of biological relatedness on child survival tend to be stronger for both HIV- and HIV+ children of HIV+ mothers. Conclusions: Reductions in the numbers of close relatives caring for children of HIV+ mothers reduce child survival.
David Bishai; Heena Brahmbhatt; Ron Gray; Godfrey Kigozi; David Serwadda; Nelson Sewankambo; El Daw Suliman; Fred Wabwire-Mangen; Maria Wawer
Objective: We studied child survival in Rakai, Uganda where many children are fostered out or orphaned. Methods: Biological relatedness is measured as the average of the Wrightâ€™s coefficients between each household member and the child. Instrumental variables for fostering include proportion of adult males in household, age and gender of household head. Control variables include SES, religion, polygyny, household size, child age, child birth size, and child HIV status. Results: Presence of ...
Full Text Available In the last decade, we have witnessed an unimaginable progress of the electronic media. The television takes the first place by its availability, importance and popularity, both with adults and with children. It has become the focal point of family interaction and is progressively taking on a key role in the process of children's socialization. Various research has proven that children begin watching television as babies and that toddlers are already accustomed and constant viewers. During their development, they become increasingly competent to understand and to use the television media, while the differences in the perception of television contents are mainly conditioned by the period of early childhood. The process of preschool child's understanding of media information goes from concrete to abstract and on two levels at the same time: understanding of formal features and understanding of content. Both levels have important role in child's understanding of the world, what could be observed in forming of gender stereotypes, where, as researches show, the television has a special influence.
Sanjay K Mohanty
Full Text Available BACKGROUND: Though the concept of multidimensional poverty has been acknowledged cutting across the disciplines (among economists, public health professionals, development thinkers, social scientists, policy makers and international organizations and included in the development agenda, its measurement and application are still limited. OBJECTIVES AND METHODOLOGY: Using unit data from the National Family and Health Survey 3, India, this paper measures poverty in multidimensional space and examine the linkages of multidimensional poverty with child survival. The multidimensional poverty is measured in the dimension of knowledge, health and wealth and the child survival is measured with respect to infant mortality and under-five mortality. Descriptive statistics, principal component analyses and the life table methods are used in the analyses. RESULTS: The estimates of multidimensional poverty are robust and the inter-state differentials are large. While infant mortality rate and under-five mortality rate are disproportionately higher among the abject poor compared to the non-poor, there are no significant differences in child survival among educationally, economically and health poor at the national level. State pattern in child survival among the education, economical and health poor are mixed. CONCLUSION: Use of multidimensional poverty measures help to identify abject poor who are unlikely to come out of poverty trap. The child survival is significantly lower among abject poor compared to moderate poor and non-poor. We urge to popularize the concept of multiple deprivations in research and program so as to reduce poverty and inequality in the population.
Addresses the problems of child survival and development in developing countries by discussing the biomedical causes and the concomitant social determinants of high infant mortality rates. Describes four intervention strategies recommended by UNICEF: growth monitoring, oral rehydration therapy, breast feeding, and immunization. (HOD)
Sherr, L.; Skar, A-MS; Clucas, C.; von Tetzchner, S.; Hundeide, K.
Background: Many parenting programmes lack proper evaluation, especially under community-wide implementation. Objective: Examining the effectiveness of the eight-week International Child Development Programme (ICDP), implemented as a general programme. Methodology: Non-clinical caregivers attending ICDP (N = 141) and a non-attending community comparison group (N = 79) completed questionnaires on parenting, psychosocial functioning, and child difficulties before and after ICDP course. Analyses...
Michael (et al.) Linnan
Special Series on Child Injury no.4 This paper presents a summary of the findings of the national and sub-national surveys and discusses the implications of the results on child health policy and programmes.The principal finding is that injury has generally been unrecognized as a leading cause of child death. This is largely because the previous estimates of child mortality causality were unable to include injury due to technical issues. The surveys provide convincing evidence that injury is ...
Bobadilla, J L
This work synthesizes the conclusions and recommendations of the 1985 International Workshop on Child Survival held in Teotihuacan, Mexico. Data are presented which document the extent of the problem of child survival in Latin America and the deficiencies of available data. Malnutrition, diseases preventable through vaccination, diarrheal diseases, acute respiratory infections, perinatal disorders, and shortcomings in quality of care are separately discussed following an assessment of their socioeconomic and cultural determining factors. Recent advances in the preventive component of primary health care programs are discussed. In Latin America, 900 of each 1000 live born babies survive to the 5th year of life compared to 980 in developed countries. Although the mortality rate of children under 5 in Latin America declined from 128 in 1950-55 to 63 in 1980-85, there are wide disparities between countries. Most countries of Latin America were classified as having high or very high infant and child mortality. There are serious differences in child survival between geographic regions and social groups of each country. The mortality decline in Costa Rica, Cuba, and Chile demonstrates that other countries could avoid a large proportion of deaths by ensuring that benefits of current programs have broader coverage. The severe economic crisis in Mexico and other countries threatens the progress already achieved in child survival. The recommendations of the conference are based on the premise that recent efforts to improve survival have been insufficient and a more rational use of the available resources and knowledge is required. In the area of health policy, priority should continue to be given to providing care for mothers and small children. Investments should be reoriented toward extending coverage of primary health care. The proportion of mothers attended during delivery by trained paramedical personnel or physicians should be increased, and family planning programs in
This report complements Repositioning Nutrition as Central to Development by looking at environmental health issues that affect child health broadly, while also exploring the links through malnutrition. This report argues that environmental health interventions are preventive measures that are imperative to improve child survival with sustainable results in the long term. Preventive measur...
Jensen, Sarah K G; Bouhouch, Raschida R; Walson, Judd L; Daelmans, Bernadette; Bahl, Rajiv; Darmstadt, Gary L; Dua, Tarun
High rates of child mortality and lost developmental potential in children under 5 years of age remain important challenges and drivers of inequity in the developing world. Substantive progress has been made toward Millennium Development Goal (MDG) 4 to improve child survival, but as we move into the post-2015 sustainable development agenda, much more work is needed to ensure that all children can realize their full and holistic physical, cognitive, psychological, and socio-emotional development potential. This article presents child survival and development as a continuous and multifaceted process and suggests that a life-course perspective of child development should be at the core of future policy making, programming, and research. We suggest that increased attention to child development, beyond child survival, is key to operationalize the sustainable development goals (SDGs), address inequities, build on the demographic dividend, and maximize gains in human potential. An important step toward implementation will be to increase integration of existing interventions for child survival and child development. Integrated interventions have numerous potential benefits, including optimization of resource use, potential additive impacts across multiple domains of health and development, and opportunity to realize a more holistic approach to client-centered care. However, a notable challenge to integration is the continued division between the health sector and other sectors that support child development. Despite these barriers, empirical evidence is available to suggest that successful multisectoral coordination is feasible and leads to improved short- and long-term outcomes in human, social, and economic development. PMID:26234921
Scott, L; C. A. Valdivia
Since the mid-1990s, the UNICEF Multiple Indicators Cluster Survey (MICS) programme has enabled many developing countries to produce statistically sound and internationally comparable estimates of a range of indicators in the areas of health, education and child protection. The current paper draws on MICS datasets to provide a review of child labour in the countries where the survey programme has been implemented. The MICS programme provides information on children’s involvement in child labo...
Atrash, Hani K.
Reduction of child mortality is a global public health priority. Parents can play an important role in reducing child mortality. The inability of one or both parents to care for their children due to death, illness, divorce or separation increases the risk of death of their children. There is increasing evidence that the health, education, and socioeconomic status of mothers and fathers have significant impact on the health and survival of their children. We conducted a literature review to e...
Bhalotra, Sonia; Valente, Christine; Soest, Arthur
The socio-economic status of Indian Muslims is, on average, considerably lower than that of upper caste Hindus. Muslims have higher fertility and shorter birth spacing and are a minority group that, it has been argued, have poorer access to public goods. They nevertheless exhibit substantially higher child survival rates, and have done for decades. This paper documents and analyses this seeming puzzle. The religion gap in survival is much larger than the gender gap but, in contrast to the gen...
Liselore van Ekdom
Full Text Available OBJECTIVE: To cross-validate the global cost of scaling up child survival interventions to achieve the fourth Millennium Development Goal (MDG4 as estimated by the World Health Organization (WHO in 2007 by using the latest country-provided data and new assumptions. METHODS: After the main cost categories for each country were identified, validation questionnaires were sent to 32 countries with high child mortality. Publicly available estimates for disease incidence, intervention coverage, prices and resources for individual-level and programme-level activities were validated against local data. Nine updates to the 2007 WHO model were generated using revised assumptions. Finally, estimates were extrapolated to 75 countries and combined with cost estimates for immunization and malaria programmes and for programmes for the prevention of mother-to-child transmission of the human immunodeficiency virus (HIV. FINDINGS: Twenty-six countries responded. Adjustments were largest for system- and programme-level data and smallest for patient data. Country-level validation caused a 53% increase in original cost estimates (i.e. 9 billion 2004 United States dollars [US$] for 26 countries owing to revised system and programme assumptions, especially surrounding community health worker costs. The additional effect of updated population figures was small; updated epidemiologic figures increased costs by US$ 4 billion (+15%. New unit prices in the 26 countries that provided data increased estimates by US$ 4.3 billion (+16%. Extrapolation to 75 countries increased the original price estimate by US$ 33 billion (+80% for 2010-2015. CONCLUSION: Country-level validation had a significant effect on the cost estimate. Price adaptations and programme-related assumptions contributed substantially. An additional 74 billion US$ 2005 (representing a 12% increase in total health expenditure would be needed between 2010 and 2015. Given resource constraints, countries will need
Health measures promoted by the Campaign for Child Survival include growth monitoring, oral rehydration therapy breastfeeding, and immunization, which together form the cornerstones of the Child Survival Strategy. (CB)
Since an impressive reduction in child mortality in the 1970s to early 1990s improvements have slowed down, and more than 10 million children die annually under the age of 5 years. Most of these deaths occur in relatively few countries, mainly in South Asia and Africa south of the Sahara. Given the causal links between nutrition and mortality in infancy and childhood it is of great importance to assess the role of nutrition in further improvements in global child survival. This study assessed...
Falconer Catherine; Park MinHae; Skow Áine; Black James; Sovio Ulla; Saxena Sonia; Kessel Anthony; Croker Helen; Morris Steve; Viner Russell; Kinra Sanjay
Abstract Background The National Child Measurement Programme was established to measure the height and weight of children at primary school in England and provides parents with feedback about their child’s weight status. In this study we will evaluate the impact of the National Child Measurement Programme feedback on parental risk perceptions of overweight, lifestyle behaviour and health service use. Methods The study will be a prospective cohort study of parents of children enrolled in the N...
Dick D Chamla
Full Text Available Introduction: Integration of HIV into child survival platforms is an evolving territory with multiple connotations. Most literature on integration of HIV into other health services focuses on adults; however promising practices for children are emerging. These include the Double Dividend (DD framework, a new programming approach with dual goal of improving paediatric HIV care and child survival. In this commentary, the authors discuss why integrating HIV testing, treatment and care into child survival platforms is important, as well as its potential to advance progress towards global targets that call for, by 2020, 90% of children living with HIV to know their status, 90% of those diagnosed to be on treatment and 90% of those on treatment to be virally suppressed (90–90–90. Discussion: Integration is critical in improving health outcomes and efficiency gains. In children, integration of HIV in programmes such as immunization and nutrition has been associated with an increased uptake of HIV infant testing. Integration is increasingly recognized as a case-finding strategy for children missed from prevention of mother-to-child transmission programmes and as a platform for diffusing emerging technologies such as point-of-care diagnostics. These support progress towards the 90–90–90 targets by providing a pathway for early identification of HIV-infected children with co-morbidities, prompt initiation of treatment and improved survival. There are various promising practices that have demonstrated HIV outcomes; however, few have documented the benefits of integration on child survival interventions. The DD framework is well positioned to address the bidirectional impacts for both programmes. Conclusions: Integration provides an important programmatic pathway for accelerated progress towards the 90–90–90 targets. Despite this encouraging information, there are still challenges to be addressed in order to maximize the benefits of integration.
Full Text Available Abstract Background The National Child Measurement Programme was established to measure the height and weight of children at primary school in England and provides parents with feedback about their child’s weight status. In this study we will evaluate the impact of the National Child Measurement Programme feedback on parental risk perceptions of overweight, lifestyle behaviour and health service use. Methods The study will be a prospective cohort study of parents of children enrolled in the National Child Measurement Programme and key service providers from 5 primary care trusts (administrative bodies responsible for providing primary and secondary care services. We will conduct baseline questionnaires, followed by provision of weight feedback and 3 follow up questionnaires over the course of a year. Questionnaires will measure change in parental risk perception of overweight, health behaviours and health service use. Qualitative interviews will be used to identify barriers and facilitators to change. This study will produce preliminary data on National Health Service costs associated with weight feedback and determine which feedback approach (letter and letter plus telephone is more effective. Discussion This study will provide the first large scale evaluation of the National Child Measurement Programme feedback. Findings from this evaluation will inform future planning of the National Child Measurement Programme.
As part of the Government of Nigeria's goal of providing universal child immunization, a strategy was developed to strengthen the production capacity of the Nigerian Television Authority (NTA) and to award higher priority to health issues in NTA programming. At the national level, a child survival-oriented training, coordination, and production unit was established to produce "spot messages" on primary health care. In 1985-86, radio and television staff from all Nigerian states attended workshops at which Ministry of Health officials outlined Nigeria's maternal-child health problems and emphasized the potential of the broadcast media in health education. Each station was linked with an officer in the local Ministry of Health to ensure ongoing collaboration on technical problems and health programs in need of promotion. Another set of state-level workshops brought together media producers and radio and television writers to encourage them to integrate primary health care themes into their programs. In addition, a Nigerian nongovernmental organization has organized workshops for electronic media writers and producers aimed at incorporating family planning themes into several popular television programs. In 1986, both NTA and the Federal Radio Corporation of Nigeria signed agreements further committing their networks to the child survival campaign. The Nigerian experience exemplifies the potential for creating and institutionalizing long-term efforts to use the mass media to bring new information to the general population on health-related issues. Needed at this point is more knowledge about specific communication strategies that are most effective in promoting sustainable behavioral change on the family and community levels in a country with much social and cultural diversity. PMID:12343010
Besada, Donela; Kerber, Kate; Leon, Natalie; Sanders, David; Daviaud, Emmanuelle; Rohde, Sarah; Rohde, Jon; van Damme, Wim; Kinney, Mary; Manda, Samuel; Oliphant, Nicholas P; Hachimou, Fatima; Ouedraogo, Adama; Yaroh Ghali, Asma; Doherty, Tanya
Background Household surveys undertaken in Niger since 1998 have revealed steady declines in under-5 mortality which have placed the country ‘on track’ to reach the fourth Millennium Development goal (MDG). This paper explores Niger’s mortality and health coverage data for children under-5 years of age up to 2012 to describe trends in high impact interventions and the resulting impact on childhood deaths averted. The sustainability of these trends are also considered. Methods and Findings Estimates of child mortality using the 2012 Demographic and Health Survey were developed and maternal and child health coverage indicators were calculated over four time periods. Child survival policies and programmes were documented through a review of documents and key informant interviews. The Lives Saved Tool (LiST) was used to estimate the number of child lives saved and identify which interventions had the largest impact on deaths averted. The national mortality rate in children under-5 decreased from 286 child deaths per 1000 live births (95% confidence interval 177 to 394) in the period 1989–1990 to 128 child deaths per 1000 live births in the period 2011–2012 (101 to 155), corresponding to an annual rate of decline of 3.6%, with significant declines taking place after 1998. Improvements in the coverage of maternal and child health interventions between 2006 and 2012 include one and four or more antenatal visits, maternal Fansidar and tetanus toxoid vaccination, measles and DPT3 vaccinations, early and exclusive breastfeeding, oral rehydration salts (ORS) and proportion of children sleeping under an insecticide-treated bed net (ITN). Approximately 26,000 deaths of children under-5 were averted in 2012 due to decreases in stunting rates (27%), increases in ORS (14%), the Hib vaccine (14%), and breastfeeding (11%). Increases in wasting and decreases in vitamin A supplementation negated some of those gains. Care seeking at the community level was responsible for an
Full Text Available Household surveys undertaken in Niger since 1998 have revealed steady declines in under-5 mortality which have placed the country 'on track' to reach the fourth Millennium Development goal (MDG. This paper explores Niger's mortality and health coverage data for children under-5 years of age up to 2012 to describe trends in high impact interventions and the resulting impact on childhood deaths averted. The sustainability of these trends are also considered.Estimates of child mortality using the 2012 Demographic and Health Survey were developed and maternal and child health coverage indicators were calculated over four time periods. Child survival policies and programmes were documented through a review of documents and key informant interviews. The Lives Saved Tool (LiST was used to estimate the number of child lives saved and identify which interventions had the largest impact on deaths averted. The national mortality rate in children under-5 decreased from 286 child deaths per 1000 live births (95% confidence interval 177 to 394 in the period 1989-1990 to 128 child deaths per 1000 live births in the period 2011-2012 (101 to 155, corresponding to an annual rate of decline of 3.6%, with significant declines taking place after 1998. Improvements in the coverage of maternal and child health interventions between 2006 and 2012 include one and four or more antenatal visits, maternal Fansidar and tetanus toxoid vaccination, measles and DPT3 vaccinations, early and exclusive breastfeeding, oral rehydration salts (ORS and proportion of children sleeping under an insecticide-treated bed net (ITN. Approximately 26,000 deaths of children under-5 were averted in 2012 due to decreases in stunting rates (27%, increases in ORS (14%, the Hib vaccine (14%, and breastfeeding (11%. Increases in wasting and decreases in vitamin A supplementation negated some of those gains. Care seeking at the community level was responsible for an estimated 7,800 additional deaths
Habibov, Nazim; Fan, Lida
This study assesses the effects of maternal healthcare on child survival by using nonrandomized data from a cross-sectional survey in Azerbaijan. Using 2SLS and simultaneous equation bivariate probit models, we estimate the effects of delivering in healthcare facility on probability of child survival taking into account self-selection into the treatment. For women who delivered at healthcare facilities, the probability of child survival increases by approximately 18%. Furthermore, if every woman had the opportunity to deliver in healthcare facility, then the probability of child survival in Azerbaijan as a whole would have increased by approximately 16%. PMID:25110673
Full Text Available This study assesses the effects of maternal healthcare on child survival by using nonrandomized data from a cross-sectional survey in Azerbaijan. Using 2SLS and simultaneous equation bivariate probit models, we estimate the effects of delivering in healthcare facility on probability of child survival taking into account self-selection into the treatment. For women who delivered at healthcare facilities, the probability of child survival increases by approximately 18%. Furthermore, if every woman had the opportunity to deliver in healthcare facility, then the probability of child survival in Azerbaijan as a whole would have increased by approximately 16%.
Keslair, Francois; Maurin, Eric; McNally, Sandra
The need for education to help every child rather than focus on average attainment has become a more central part of the policy agenda in the US and the UK. Remedial programmes are often difficult to evaluate because participation is usually based on pupil characteristics that are largely unobservable to the analyst. In this paper we evaluate programmes for children with moderate levels of 'special educational needs' in England. We show that the decentralized design of the policy generates si...
This article discusses theoretical foundation for International Child Development Programme (ICDP) as a resource based communication and mediation approach. A kind relation between a child and caregiver is a critically vital point for psychological development of children. Better relations also contribute to the child’s healthy growth and intellectual, social and emotional development. Fundamental caregiving skills function as particularly important contribution to the quality and effectivene...
Examines the roles and influence of grandmothers with respect to nutrition, breastfeeding, quality of child care and family planning usage; the maternal grandmother is much more involved with grandchildren than the paternal grandmother. Accordingly this category may be a target for programmes and activities to promote child welfare and family planning.
Ruton Hinda; Mugwaneza Placidie; Shema Nadine; Lyambabaje Alexandre; Bizimana Jean de Dieu; Tsague Landry; Nyankesha Elevanie; Wagner Claire M; Mutabazi Vincent; Nyemazi Jean Pierre; Nsanzimana Sabin; Karema Corine; Binagwaho Agnes
Abstract Background Operational effectiveness of large-scale national programmes for the prevention of mother to child transmission (PMTCT) of HIV in sub-Saharan Africa remains limited. We report on HIV-free survival among nine- to 24-month-old children born to HIV-positive mothers in the national PMTCT programme in Rwanda. Methods We conducted a national representative household survey between February and May 2009. Participants were mothers who had attended antenatal care at least once duri...
Skar, Ane-Marthe Solheim; Sherr, Lorraine; Clucas, Claudine; von Tetzchner, Stephen
Parenting programs have been used to good effect in many settings, yet few are systematically introduced and evaluated in developing countries. This study explores the relative long-term effect of participation in the International Child Development Programme (ICDP) in a group of caregivers in Mozambique. A quasi-experimental design was used to…
The problems of maternal malnutrition, low birthweight, and infant mortality and morbidity were investigated in a prospective study (1981-85) involving 7586 pregnant women (3197 from urban areas and 4389 from rural areas) in India. The mothers were followed until their infants were 1 year of age. There were 6879 live births among these women and 208 still births (a rate of 29.3/1000 deliveries). The perinatal, neonatal, and infant mortality rates were 65.3/1000, 57.7/1000, and 94.5/1000, respectively. 90% of these deaths involved infants with a birthweight below 2000 grams. Overall, 39% of infants studied were classified as low birthweight (under 2500 grams). Factors associated with low birthweight included maternal age below 19 years or over 35 years, maternal weight below 40 kg, maternal height below 145 cm, weight gain during pregnancy of under 5 kg, an interpregnancy interval less than 24 months, hemoglobin less than 8 grams%, and maternal illiteracy. Moderate to severe morbidity (neonatalas phyxia) was found in 10% of the births in this series. Breastfeeding was delayed beyond 24 hours in 77% of rural births and 13% of urban births; 30% of infants in both settings were given a bottle within the 1st week of life. 98% of rural mothers and 85% of urban mothers did not utilize available maternal-child health services in the postpartum period. Reducing the incidence of low birthweight births through primary health care interventions such as screening, food supplementation, adequate prenatal care, and correction of maternal nutritional deficiencies is the best strategy for improving infant survival in India. In the interim period, adequate health care must be made available to low birthweight infants and proper feeding practices should be promoted. PMID:3440594
Full Text Available Abstract Background New methods for prevention and health promotion and are constantly evolving; however, positive outcomes will only emerge if these methods are fully adopted and sustainable in practice. To date, limited attention has been given to sustainability of health promotion efforts. This study aimed to explore facilitators, barriers, and requirements for sustainability as experienced by professionals two years after finalizing the development and implementation of a multisectoral child health promotion programme in Sweden (the Salut programme. Initiated in 2005, the programme uses a 'Salutogenesis' approach to support health-promoting activities in health care, social services, and schools. Methods All professionals involved in the Salut Programme's pilot areas were interviewed between May and September 2009, approximately two years after the intervention package was established and implemented. Participants (n = 23 were midwives, child health nurses, dental hygienists/dental nurses, and pre-school teachers. Transcribed data underwent qualitative content analysis to illuminate perceived facilitators, barriers, and requirements for programme sustainability. Results The programme was described as sustainable at most sites, except in child health care. The perception of facilitators, barriers, and requirements were largely shared across sectors. Facilitators included being actively involved in intervention development and small-scale testing, personal values corresponding to programme intentions, regular meetings, working close with collaborators, using manuals and a clear programme branding. Existing or potential barriers included insufficient managerial involvement and support and perceived constraints regarding time and resources. In dental health care, barriers also included conflicting incentives for performance. Many facilitators and barriers identified by participants also reflected their perceptions of more general and forthcoming
Pushkar Maitra; Sarmistha Pal
In view of higher fertility and mortality rates in Pakistan compared to India, this paper examines the two-way relationship between birth interval and child mortality and compares the behaviour of households in the Indian and Pakistani provinces of Punjab. Birth interval and child survival are modelled here as correlated hazard processes to address the bias generated by the simultaneity between spacing and survival. We find evidence of significant mutual dependence between birth interval and ...
Lawson, D. W.; Alvergne, A.; Gibson, M. A.
Evolutionary models of human reproduction argue that variation in fertility can be understood as the local optimization of a life-history trade-off between offspring quantity and 'quality'. Child survival is a fundamental dimension of quality in these models as early-life mortality represents a crucial selective bottleneck in human evolution. This perspective is well-rehearsed, but current literature presents mixed evidence for a trade-off between fertility and child survival, and little empi...
Juan M. Moreno-Manso
Full Text Available This study analyses the effectiveness of a child abuse prevention programme in an educational context. The proposal for action is based on the use of stories as an instrument of primary prevention. The programme aims to improve a child's capacity to face potentially threatening situations and was applied in 10 primary schools of Extremadura (Spain to 317 pupils aged 9 and 10 years old. There were 12 sessions whose aim was for the children to gain an awareness of abuse, identify situations of abuse and learn strategies to face them. This was done through the use of tutorials and by linking the programme to the aims of the pupils' educational stage. The evaluation of the programme shows that the pupils in the experimental group resolved the situations with increasing skill, confidence and determination; and that they could see more clearly where to look for help in terms of protection measures. The tutors evaluated the programme positively, considering the contents useful for prevention.
Full Text Available Malawi is estimated to have achieved its Millennium Development Goal (MDG 4 target. This paper explores factors influencing progress in child survival in Malawi including coverage of interventions and the role of key national policies. We performed a retrospective evaluation of the Catalytic Initiative (CI programme of support (2007–2013. We developed estimates of child mortality using four population household surveys undertaken between 2000 and 2010. We recalculated coverage indicators for high impact child health interventions and documented child health programmes and policies. The Lives Saved Tool (LiST was used to estimate child lives saved in 2013. The mortality rate in children under 5 years decreased rapidly in the 10 CI districts from 219 deaths per 1000 live births (95% confidence interval (CI 189 to 249 in the period 1991–1995 to 119 deaths (95% CI 105 to 132 in the period 2006–2010. Coverage for all indicators except vitamin A supplementation increased in the 10 CI districts across the time period 2000 to 2013. The LiST analysis estimates that there were 10 800 child deaths averted in the 10 CI districts in 2013, primarily attributable to the introduction of the pneumococcal vaccine (24% and increased household coverage of insecticide–treated bednets (19%. These improvements have taken place within a context of investment in child health policies and scale up of integrated community case management of childhood illnesses. Malawi provides a strong example for countries in sub–Saharan Africa of how high impact child health interventions implemented within a decentralised health system with an established community–based delivery platform, can lead to significant reductions in child mortality.
Munro, Lauchian T
In 1992-3 and 1995-6, Zimbabwe used a Child Supplementary Feeding Programme (CSFP) to combat child malnutrition during drought-induced emergencies. Previous evaluations of the CSFP relied on routine administrative data and key informant interviews and made only cursory use of available household survey data. These evaluations concluded that the CSFP was effective in preventing an increase in malnutrition among children under five, especially in 1992-3. The more-detailed analysis of household surveys provided in this article suggests that CSFP coverage was generally patchy and disappointingly low, especially in 1995-6. There is little evidence that children from poor or nutritionally vulnerable households got preferential access to supplementary feeding. The CSFP failed to feed many malnourished and nutritionally vulnerable children even in areas where the programme was operating. Household survey evidence suggests that the CSFP's impact on nutritional status was likely marginal, especially in 1995-6. PMID:12227592
This thesis explores how mothers and children in the UK are affected by domestic violence, resist it, and actively support one another's recoveries. The focus extends beyond 'incidents' of physical violence, into the commonplace, the subtle and the everyday. This thesis shows that supportive mother-child relationships may enhance the well-being and recoveries of both mothers and children. It highlights the need to expand professional supports that repair and strengthen mother-child relationsh...
Mirza, Imran Raza; Kamadjeu, Raoul; Assegid, Kebede; Mulugeta, Abraham
Somalia, one of the most unstable countries in the world, has been without a permanent government for nearly 2 decades. With a health system in total disarray, coverage of basic health interventions remains low and, maternal and child mortality is among the highest in the world. Health partners jointly outlined an integrated package of critical child survival interventions to be delivered through a population-based delivery strategy known as Child Health Days (CHDs), to reduce child mortality. Using this strategy, key child survival interventions are delivered to the community with an objective of reaching children areas, and coverage disparity between the urban and rural areas was reduced from 17% (42% urban and 25% rural) to 10% (50% urban and 60% rural). In addition, infants were reached with a third dose of diphtheria-pertussis-tetanus vaccine, achieving 51% coverage during 2009 and 66% in 2010. This paper summarizes the challenges of scaling up child interventions in the troubled context of Somalia by reviewing the planning, implementation, and achievements of CHDs as well as reflecting on challenges for the future of child survival in Somalia. PMID:22315380
This study is introduced by a literature review of the concept of women's status, and related factors that determine infant and child mortality. Women's status is primarily defined by education, occupation and economic activity, which affect women's decision-making in the home and their independence in larger society. Cluster analysis was used to identify geographical patterns of standardized women's status variables among 20 regencies and 4 municipalities in West Java. Euclidian distances were computed between pairs of regencies across the 13 indicators. Pearson's correlations and multiple regression were used to compare associations between women's status variables and infant and child mortality, after controlling for economic development. Using data from the 1980 census, the study demonstrated large regional variations in women's status in West Java, with higher status in both the household and in society in the south and central highlands than in the north and west. Women's status is closely related to infant and child mortality, independent of the level of development. There was 1 notable exception, the municipality of Bogor, where infant and child mortality were higher than average rates for the cluster of areas with higher women's status. The results suggest that improved education, and increase in age at 1st marriage are key elements for improving the status of women in West Java. PMID:12343263
Siddiqui, K A
The distillation of Zeba Sathar's article on the determinants of fertility decline and child mortality decline is that marriage age and contraceptive surgery could be important factors in bringing about changes in both fertility and child mortality in Pakistan. The concern is that 80 out of 115 million Pakistanis live in rural areas where marriage age is very low and program efforts are limited or nonexistent. The question is raised about how to effectuate changes in attitudes in rural areas to increase marriage age. Another point is made about the simplicity of explanations for fertility and mortality change, when the reality is a complex host of interactive socioeconomic, cultural, social, and program factors that are responsible for fertility at present levels. The suggestion is for development of a more appropriate model of fertility at the micro level which illuminates the interaction of these factors in determining fertility. Sathar is reported to have concluded that the impact of infant and child mortality on fertility was inconclusive. The changing patterns of fertility are likely to bring about a change in the demand for children and a lesser preference for gender; this status change for women will further reduce child mortality and fertility. Large family sizes are postulated to be associated with close spacing and greater concentrations of children under 5 years of age competing for physical resources and having a high risk of infection with inadequate parental attention and care. These conditions occur in families with low income and little parental education. Institutional and community services also affect child mortality. There are also examples of educational opportunity and income equality as factors bringing about demographic change in Sri Lanka and Kerala, India. The author speculates that an outcome of development is increased educational attainment and more equitable distribution of income. Low levels of maternal education are associated with
Chigozie Jesse Uneke
Full Text Available In Nigeria, the government is implementing the Free Maternal and Child Health Care Programme (FMCHCP. The policy is premised on the notion that financial barriers are one of the most important constraints to equitable access and use of skilled maternal and child healthcare. In Ebonyi State, Southeastern Nigeria the FMCHCP is experiencing implementation challenges including: inadequate human resource for health, inadequate funding, out of stock syndrome, inadequate infrastructure, and poor staff remuneration. Furthermore, there is less emphasis on community involvement in the programme implementation. In this policy brief, we recommend policy options that emphasize the implementation of community-based participatory interventions to strengthen the government’s FMCHCP as follows: Option 1: Training community women on prenatal care, life-saving skills in case of emergency, reproductive health, care of the newborn and family planning. Option 2: Sensitizing the community women towards behavioural change, to understand what quality services that respond to their needs are but also to seek and demand for such. Option 3: Implementation packages that provide technical skills to women of childbearing age as well as mothers’ groups, and traditional birth attendants for better home-based maternal and child healthcare. The effectiveness of this approach has been demonstrated in a number of community-based participatory interventions, building on the idea that if community members take part in decision-making and bring local knowledge, experiences and problems to the fore, they are more likely to own and sustain solutions to improve their communities’ health.
Melinder, Annika; Burrell, Lisa; Eriksen, Maria Olaussen; Magnussen, Svein; Wessel, Ellen
The emotional witness effect - the phenomenon whereby people are affected by the emotional manner in which a witness presents testimony - constitutes a possible source of wrongful decisions in legal contexts. One stereotypical view of abused children is that they should be sad when talking about their experiences of maltreatment, whereas children may in fact express a variety of emotional expressions when talking about abusive events. This raises the question as to whether there is an optimal mode in which to present child victim testimony that could reduce the possible influence of displayed emotions. In the present study, mock police interviews were carried out with female child actors, role-playing the victims of physical abuse by their stepfather, telling the same story with four emotional expressions (neutral, sad, angry, or positive). Laypersons (N = 465) were presented with the interviews as transcripts with the emotional reactions of the child witness noted, audio recordings, or videotaped recordings. Participants then rated the credibility of the victim witness. Replicating previous results, the "sad" expression elicited the highest credibility ratings across all modes of presentations. Presentation mode affected ratings of credibility, with the transcript versions resulting in the highest ratings. Copyright © 2016 John Wiley & Sons, Ltd. PMID:26990221
Alyssa B Sharkey
Full Text Available We present the approaches used in and outcomes resulting from integrated community case management (iCCM programmes in Niger and Mozambique with a strong focus on demand generation and social mobilisation. We use a case study approach to describe the programme and contextual elements of the Niger and Mozambique programmes. Awareness and utilisation of iCCM services and key family practices increased following the implementation of the Niger and Mozambique iCCM and child survival programmes, as did care–seeking within 24 hours and care–seeking from appropriate, trained providers in Mozambique. These approaches incorporated interpersonal communication activities and community empowerment/participation for collective change, partnerships and networks among key stakeholder groups within communities, media campaigns and advocacy efforts with local and national leaders. iCCM programmes that train and equip community health workers and successfully engage and empower community members to adopt new behaviours, have appropriate expectations and to trust community health workers’ ability to assess and treat illnesses can lead to improved care–seeking and utilisation, and community ownership for iCCM.
Ryan J Hum
Full Text Available Improvements in life expectancy have been considerable over the past hundred years. Forecasters have taken to applying historical trends under an assumption of continuing improvements in life expectancy in the future. A linear mixed effects model was used to estimate the trends in global and regional rates of improvements in life expectancy, child, adult, and senior survival, in 166 countries between 1950 and 2010. Global improvements in life expectancy, including both child and adult survival rates, decelerated significantly over the study period. Overall life expectancy gains were estimated to have declined from 5.9 to 4.0 months per year for a mean deceleration of -0.07 months/year2; annual child survival gains declined from 4.4 to 1.6 deaths averted per 1000 for a mean deceleration of -0.06 deaths/1000/year2; adult survival gains were estimated to decline from 4.8 to 3.7 deaths averted per 1000 per year for a mean deceleration of -0.08 deaths/1000/year2. Senior survival gains however increased from 2.4 to 4.2 deaths averted per 1000 per year for an acceleration of 0.03 deaths/1000/year2. Regional variation in the four measures was substantial. The rates of global improvements in life expectancy, child survival, and adult survival have declined since 1950 despite an increase in the rate of improvements among seniors. We postulate that low-cost innovation, related to the last half-century progress in health-primarily devoted to children and middle age, is reaping diminishing returns on its investments. Trends are uneven across regions and measures, which may be due in part to the state of epidemiological transition between countries and regions and disparities in the diffusion of innovation, accessible only in high-income countries where life expectancy is already highest.
Heymann, Sally Jody
Models the survival outcomes of children in developing countries born to women infected with human immunodeficiency virus (HIV) who are breast-fed, bottle-fed, and wet-nursed. Uses decision analysis to assess the relative risk of child mortality from HIV transmission and non-HIV causes associated with different methods of feeding. (FMW)
Full Text Available Abstract Background Operational effectiveness of large-scale national programmes for the prevention of mother to child transmission (PMTCT of HIV in sub-Saharan Africa remains limited. We report on HIV-free survival among nine- to 24-month-old children born to HIV-positive mothers in the national PMTCT programme in Rwanda. Methods We conducted a national representative household survey between February and May 2009. Participants were mothers who had attended antenatal care at least once during their most recent pregnancy, and whose children were aged nine to 24 months. A two-stage stratified (geographic location of PMTCT site, maternal HIV status during pregnancy cluster sampling was used to select mother-infant pairs to be interviewed during household visits. Alive children born from HIV-positive mothers (HIV-exposed children were tested for HIV according to routine HIV testing protocol. We calculated HIV-free survival at nine to 24 months. We subsequently determined factors associated with mother to child transmission of HIV, child death and HIV-free survival using logistic regression. Results Out of 1448 HIV-exposed children surveyed, 44 (3.0% were reported dead by nine months of age. Of the 1340 children alive, 53 (4.0% tested HIV positive. HIV-free survival was estimated at 91.9% (95% confidence interval: 90.4-93.3% at nine to 24 months. Adjusting for maternal, child and health system factors, being a member of an association of people living with HIV (adjusted odds ratio: 0.7, 95% CI: 0.1-0.995 improved by 30% HIV-free survival among children, whereas the maternal use of a highly active antiretroviral therapy (HAART regimen for PMTCT (aOR: 0.6, 95% CI: 0.3-1.07 had a borderline effect. Conclusions HIV-free survival among HIV-exposed children aged nine to 24 months is estimated at 91.9% in Rwanda. The national PMTCT programme could achieve greater impact on child survival by ensuring access to HAART for all HIV-positive pregnant women in
Background: While substantial progress has been made globally towards achieving United Nations Millennium Development Goal 4 (MDG 4) on child mortality, the decline is not sufficient to reach the targets set for 2015. The South Asian region, which includes India, was to achieve the MDG 4 target of 39 deaths per 1000 live births by 2015 but was estimated to have reached only 61 by 2011. A part of this under-achievement is due to the gender-differentials in child mortality in South-Asia. The in...
Under-five mortality rate is a key indicator of the level of child health and overall well-being of a given population and is an indicator of the United Nations Millennium Development Goals 4. Of the estimated more than 10 million children that die worldwide each year, 41% of these deaths occur in sub-Saharan Africa. With over one million children dying yearly from preventable diseases in Nigeria, the country may not meet the other Millennium Development Goals by 2015. Child...
Sanghvi, Tina; Haque, Raisul; Roy, Sumitro; Afsana, Kaosar; Seidel, Renata; Islam, Sanjeeda; Jimerson, Ann; Baker, Jean
The Alive & Thrive programme scaled up infant and young child feeding interventions in Bangladesh from 2010 to 2014. In all, 8.5 million mothers benefited. Approaches - including improved counselling by frontline health workers during home visits; community mobilization; mass media campaigns reaching mothers, fathers and opinion leaders; and policy advocacy - led to rapid and significant improvements in key practices related to breastfeeding and complementary feeding. (Evaluation results are forthcoming.) Intervention design was based on extensive formative research and behaviour change theory and principles and was tailored to the local context. The programme focused on small, achievable actions for key audience segments identified through rigorous testing. Promotion strategies took into account underlying behavioural determinants and reached a high per cent of the priority groups through repeated contacts. Community volunteers received monetary incentives for mothers in their areas who practised recommended behaviours. Programme monitoring, midterm surveys and additional small studies to answer questions led to ongoing adjustments. Scale-up was achieved through streamlining of tools and strategies, government branding, phased expansion through BRAC - a local non-governmental implementing partner with an extensive community-based platform - and nationwide mainstreaming through multiple non-governmental organization and government programmes. Key messages Well-designed and well-implemented large-scale interventions that combine interpersonal counselling, community mobilization, advocacy, mass communication and strategic use of data have great potential to improve IYCF practices rapidly. Formative research and ongoing studies are essential to tailor strategies to the local context and to the perspectives of mothers, family members, influential community members and policymakers. Continued use of data to adjust programme elements is also central to the process. Scale
Full Text Available Background: Child abuse is one major threat to children all over the globe. Regardless of the type of child abuse, the result is serious emotional harm affecting the normal growth & development of child. School teachers are in contact with children daily and by reporting suspected child abuse and neglect, teachers can make an important contribution to the early detection and prevention of abuse. Objectives: 1. To assess the knowledge of primary school teachers regarding child abuse and neglect. 2. To assess the effectiveness of planned teaching programme on knowledge of primary school teachers regarding child abuse and neglect. 3. To find out the association between pre-test knowledge scores of primary school teachers with selected demographic variables. Material and Methods: The research approach used for the study was evaluative approach. The study was conducted in 3 primary schools at Karad, Maharashtra, India using one group pre-test post-test design. Non-probability Purposive sampling technique was used for selecting 30 primary school teachers. On the 1st day Structured knowledge questionnaire was used for collecting data and planned teaching programme on child abuse and neglect was conducted and followed by post test on the 7th day. The data collected, tabulated and analyzed in terms of objectives of the study using descriptive and inferential statistics. Results: In pre-test majority 18 (60% teachers had poor and 6 (20% had average and good knowledge regarding child abuse and neglect respectively. Where as in post-test majority 19(63% teachers had average knowledge, 6(20% had good knowledge and 5(17% teachers had poor knowledge regarding knowledge of child abuse and neglect. The mean pre test value is 9.433 and the mean post test value is 16.200 a difference of 6.77.The paired‘t’ value is 5.512, (p 0.05 of Knowledge scores with any other demographic variables. Conclusion: The study showed that the planned teaching programme on child
JAY ROSS; CHUN-MING CHEN; WU HE; GANG FU; YU-YING WANG; ZHEN-YING FU; MING-XIA CHEN
Objective To estimate the benefits of reductions in underweight and Vitamin A deficiency forchild survival in China that might be expected as a result of lowering the prevalence of theseconditions. Methods Profiles, a process of nutrition policy analysis was used to quantify thefunctional consequences of malnutrition in terms of child survival. Results Underweight Theactual reduction in underweight between 1992 and 2001 (from 15.7% to the current 10.1%) resultedin saving of 176 000 child lives. As estimated, without improvements, 612 000 children will die due tounderweight between 2001 and 2010, 281 000 (46%) of them living in western provinces. Reducingunderweight prevalence from 10.1% to 8% could overall save 62 000 lives. The reduction ofunderweight prevalence in the west alone might save 56 000 lives. Vitamin A in China as a whole,vitamin A deficiency accounts, as estimated, for 7.5% of deaths of children 6-59 months old,representing 206 000 deaths over the past ten years. Halving the prevalence over the period wouldsave 49 000 child lives. The higher prevalence and higher mortality rates in western provinces meanthat even with only 28% of the Chinese population, over half of child deaths there are related tovitamin A.
George V. Papatheodoridis; Evangelos Cholongitas; Eleni Dimitriadou; Giota Touloumi; Vassilios Sevastianos; Athanasios J. Archimandritis
AIM: Model of End-stage Liver Disease (MELD) score has recently gained wide acceptance over the old Child-Pugh score in predicting survival in patients with decompensated cirrhosis, although it is more sophisticated. We compared the predictive values of MELD, Child-Pugh and creatinine modified Child-Pugh scores in decompensated cirrhosis. METHODS: A cohort of 102 patients with decompensated cirrhosis followed-up for a median of 6 mo was studied.Two types of modified Child-Pugh scores estimated by adding 0-4 points to the original score using creatinine levels as a sixth categorical variable were evaluated.RESULTS: The areas under the receiver operating characteristic curves did not differ significantly among the four scores, but none had excellent diagnostic accuracy (areas:0.71-0.79). Child-Pugh score appeared to be the worst, while the accuracy of MELD was almost identical with that of modified Child-Pugh in predicting short-term and slightly better in predicting medium-term survival. In Cox regression analysis, all four scores were significantly associated with survival, while MELD and creatinine-modified Child-Pugh scores had better predictive values (c-statistics: 0.73 and 0.69-0.70) than Child-Pugh score (c-statistics: 0.65). Adjustment for gamma-glutamate transpeptidase levels increased the predictive values of all systems (c-statistics: 0.77-0.81). Analysis of the expected and observed survival curves in patients subgroups according to their prognosis showed that all models fit the data reasonably well with MELD probably discriminating better the subgroups with worse prognosis. CONCLUSION: MELD compared to the old Child-Pugh and particularly to creatinine-modified Child-Pugh scores does not appear to offer a clear advantage in predicting survival in patients with decompensated cirrhosis in daily clinical practice.
Gyimah, Stephen Obeng
Using pooled children data from the 1998 and 2003 Ghana Demographic and Health Surveys, this study examines religious differences in child survival in Ghana. Guided by the particularized theology and selectivity theses, a piecewise constant hazard model with gamma-shared frailty is used to explore if there are denominational differences in child mortality, and whether these could be explained through other characteristics. At the bivariate level, children whose mothers identified as Muslim and Traditional were found to have a significantly higher risk of death compared with their counterparts whose mothers identified as Christians. In the multivariate models, however, the religious differences disappeared after the mediating and confounding influence of socioeconomic factors were controlled. The findings provide support for the selectivity hypothesis, which is based on the notion that religious variations mainly reflect differential access to social and human capital rather than religious theology per se. PMID:17359561
Farid Alamdar oglu Suleymanov
Full Text Available Abstract. Kind relation between a child and caregiver (parent, teacher is a critically vital point for psychological development of children. Better relations also contribute to the child’s healthy growth and intellectual, social and emotional development. Fundamental caregiving skills function as particularly important contribution to the quality and effectiveness all caregiving. In order to facilitate full development of a child, it is important that the caregiver have a positive conception of the child. In other words, a caregiver should regard a child as a person with potential for development. From this perspective International Child Development Programme (ICDP functions as a resource-based communication and mediation approach which trains caregiver to develop a positive conception of their children and gain wider and deeper insight and confidence about their responsibilities and roles. Based on the themes of ICDP, the current research studied the quality of positive interaction between teacher assistants (TA and children with special needs (CSN in an inclusive primary education in Azerbaijan. The findings suggest that some elements of ICDP approach exist in teacher-student interaction. However, these interaction patterns are unprofessional and need development through relevant in-service trainings. Methods. In this research a case study design of qualitative research was used to investigate teacher assistants’ (TA understanding of positive attitude and how they establish positive relations with the students with special needs whom they take care of. As for the research method, the case study will adopt triangulation, a multiple methods of data collection which will include interview and observation to extend confidence in its validity and improve the quality of the data and accuracy of the findings. Results. Comparative analyses of triangulation data demonstrate that TAs’ performance within the context of teacher-student positive
A study to assess the effectiveness of planned health teaching programme using child-to –child approach on knowledge of selected first aid measures among school children in selected schools at Dharapuram in Tamil Nadu, India
Full Text Available “All citizens – All health workers” Everyone, even the children also have responsible to involve in health services & act as change agents for health promotion. The study was to assess the effectiveness of teaching programme using child-to-child approach on knowledge of selected first aid measures in children. The aim of the study to assess effectiveness of planned health teaching programme on selected first aid measures among school children using child-to-child approach. Quasi experimental design was adopted. The present study was conducted at Dharapuram in Erode district, Tamil Nadu India. The samples were 200 selected by simple random sampling method. The results showed that (‘Z’ value =1.96 mean pre and post-tests value were 10.26 and 21.55. The study concluded that about 68.5percent of students gained adequate knowledge after teaching programme using child-to-child approach.
Moriarty, Paul; Burke, Christopher; McCrossin, David; Campbell, Robert; Cherian, Sarah; Shahab, Mohammad Shekeeb; Visvesvara, Govinda S; Nourse, Clare
Balamuthia mandrillaris causes granulomatous amoebic encephalitis, which is frequently fatal. There are few reports of survival in children. A 4-year-old child developed severe meningoencephalitis with multiple intracranial ring-enhancing lesions. Empiric therapy was commenced after a biopsy was performed, and the patient had a good clinical response. Molecular testing and indirect immunofluorescence later confirmed the diagnosis of Balamuthia encephalitis. Diagnosis of Balamuthia encephalitis is often delayed. The literature is reviewed with particular reference to reported survival. Prompt tissue diagnosis and initiation of therapy are common features among survivors. In previous reports, miltefosine was not used to treat children, but it was well tolerated in this case and should be considered as a therapeutic option. PMID:26624913
Moramarco, Stefania; Amerio, Giulia; Ciarlantini, Clarice; Chipoma, Jean Kasengele; Simpungwe, Matilda Kakungu; Nielsen-Saines, Karin; Palombi, Leonardo; Buonomo, Ersilia
(1) BACKGROUND: Supplementary feeding programs (SFPs) are effective in the community-based treatment of moderate acute malnutrition (MAM) and prevention of severe acute malnutrition (SAM); (2) METHODS: A retrospective study was conducted on a sample of 1266 Zambian malnourished children assisted from 2012 to 2014 in the Rainbow Project SFPs. Nutritional status was evaluated according to WHO/Unicef methodology. We performed univariate and multivariate Cox proportional risk regression to identify the main predictors of mortality. In addition, a time-to event analysis was performed to identify predictors of failure and time to cure events; (3) RESULTS: The analysis included 858 malnourished children (19 months ± 9.4; 49.9% males). Program outcomes met international standards with a better performance for MAM compared to SAM. Cox regression identified SAM (3.8; 2.1-6.8), HIV infection (3.1; 1.7-5.5), and WAZ death. Time to event showed 80% of children recovered by SAM/MAM at 24 weeks. (4) CONCLUSIONS: Preventing deterioration of malnutrition, coupled to early detection of HIV/AIDS with adequate antiretroviral treatment, and extending the duration of feeding supplementation, could be crucial elements for ensuring full recovery and improve child survival in malnourished Zambian children. PMID:27376317
Moramarco, Stefania; Amerio, Giulia; Ciarlantini, Clarice; Chipoma, Jean Kasengele; Simpungwe, Matilda Kakungu; Nielsen-Saines, Karin; Palombi, Leonardo; Buonomo, Ersilia
(1) Background: Supplementary feeding programs (SFPs) are effective in the community-based treatment of moderate acute malnutrition (MAM) and prevention of severe acute malnutrition (SAM); (2) Methods: A retrospective study was conducted on a sample of 1266 Zambian malnourished children assisted from 2012 to 2014 in the Rainbow Project SFPs. Nutritional status was evaluated according to WHO/Unicef methodology. We performed univariate and multivariate Cox proportional risk regression to identify the main predictors of mortality. In addition, a time-to event analysis was performed to identify predictors of failure and time to cure events; (3) Results: The analysis included 858 malnourished children (19 months ± 9.4; 49.9% males). Program outcomes met international standards with a better performance for MAM compared to SAM. Cox regression identified SAM (3.8; 2.1–6.8), HIV infection (3.1; 1.7–5.5), and WAZ <−3 (3.1; 1.6–5.7) as predictors of death. Time to event showed 80% of children recovered by SAM/MAM at 24 weeks. (4) Conclusions: Preventing deterioration of malnutrition, coupled to early detection of HIV/AIDS with adequate antiretroviral treatment, and extending the duration of feeding supplementation, could be crucial elements for ensuring full recovery and improve child survival in malnourished Zambian children. PMID:27376317
Moucheraud, Corrina; Worku, Alemayehu; Molla, Mitike; Finlay, Jocelyn E; Leaning, Jennifer; Yamin, Alicia Ely
Background: Maternal mortality remains the leading cause of death and disability for reproductive-age women in resource-poor countries. The impact of a mother’s death on child outcomes is likely severe but has not been well quantified. This analysis examines survival outcomes for children whose mothers die during or shortly after childbirth in Butajira, Ethiopia. Methods: This study uses data from the Butajira Health and Demographic Surveillance System (HDSS) site. Child outcomes were assesse...
Adams, Alayne M; Rabbani, Atonu; Ahmed, Shamim; Mahmood, Shehrin Shaila; Al-Sabir, Ahmed; Rashid, Sabina F; Evans, Timothy G
By disaggregating gains in child health in Bangladesh over the past several decades, significant improvements in gender and socioeconomic inequities have been revealed. With the use of a social determinants of health approach, key features of the country's development experience can be identified that help explain its unexpected health trajectory. The systematic equity orientation of health and socioeconomic development in Bangladesh, and the implementation attributes of scale, speed, and selectivity, have been important drivers of health improvement. Despite this impressive pro-equity trajectory, there remain significant residual inequities in survival of girls and lower wealth quintiles as well as a host of new health and development challenges such as urbanisation, chronic disease, and climate change. Further progress in sustaining and enhancing equity-oriented achievements in health hinges on stronger governance and longer-term systems thinking regarding how to effectively promote inclusive and equitable development within and beyond the health system. PMID:24268604
Victora, Cesar G; Requejo, Jennifer Harris; Barros, Aluisio J D; Berman, Peter; Bhutta, Zulfiqar; Boerma, Ties; Chopra, Mickey; de Francisco, Andres; Daelmans, Bernadette; Hazel, Elizabeth; Lawn, Joy; Maliqi, Blerta; Newby, Holly; Bryce, Jennifer
Conceived in 2003 and born in 2005 with the launch of its first report and country profiles, the Countdown to 2015 for Maternal, Newborn, and Child Survival has reached its originally proposed lifespan. Major reductions in the deaths of mothers and children have occurred since Countdown's inception, even though most of the 75 priority countries failed to achieve Millennium Development Goals 4 and 5. The coverage of life-saving interventions tracked in Countdown increased steadily over time, but wide inequalities persist between and within countries. Key drivers of coverage such as financing, human resources, commodities, and conducive health policies also showed important, yet insufficient increases. As a multistakeholder initiative of more than 40 academic, international, bilateral, and civil society institutions, Countdown was successful in monitoring progress and raising the visibility of the health of mothers, newborns, and children. Lessons learned from this initiative have direct bearing on monitoring progress during the Sustainable Development Goals era. PMID:26477328
Sunday A. Adedini
Full Text Available Background: Existing studies indicate that about one in every six children dies before age five in Nigeria. While evidence suggests that improved access to adequate health care holds great potential for improved child survival, previous studies indicate that there are substantial barriers to accessing health care in Nigeria. There has not been a systematic attempt to examine the effects of barriers to health care on under-five mortality in Nigeria. This study is designed to address this knowledge gap. Data and method: Data came from a nationally representative sample of 18,028 women (aged 15–49 who had a total of 28,647 live births within the 5 years preceding the 2008 Nigeria Demographic and Health Survey. The risk of death in children below age five was estimated using Cox proportional hazard models and results are presented as hazards ratios (HR with 95% confidence intervals (CI. Results: Results indicate higher under-five mortality risks for children whose mothers had cultural barriers and children whose mothers had resource-related barriers to health care (HR: 1.44, CI: 1.32–1.57, p<0.001, and those whose mothers had physical barriers (HR: 1.13, CI: 1.04–1.24, p<0.001, relative to children whose mothers reported no barriers. Barriers to health care remained an important predictor of child survival even after adjusting for the effects of possible confounders. Conclusion: Findings of this study stressed the need for improved access to adequate health care in Nigeria through the elimination of barriers to access. This would enable the country to achieve a significant reduction in childhood mortality.
Full Text Available BACKGROUND: As HIV-related deaths increase in a population the usual association between low socioeconomic status and child mortality may change, particularly as death rates from other causes decline. METHODS/PRINCIPAL FINDINGS: As part of a demographic surveillance system in northern Malawi in 2002-6, covering a population of 32,000, information was collected on socio-economic status of the households. Deaths were classified as HIV/AIDS-related or not by verbal autopsy. Poisson regression models were used to assess the association of socio-economic indicators with all-cause mortality, AIDS-mortality and non-AIDS mortality among children. There were 195 deaths in infants, 109 in children aged 1-4 years, and 38 in children aged 5-15. All-cause child mortality in infants and 1-4 year olds was similar in households with higher and lower socio-economic status. In infants 13% of deaths were attributed to AIDS, and there were no clear trends with socio-economic status for AIDS or non-AIDS causes. For 1-4 year olds 27% of deaths were attributed to AIDS. AIDS mortality was higher among those with better built houses, and lowest in those with income from farming and fishing, whereas non-AIDS mortality was higher in those with worse built houses, lowest in those with income from employment, and decreased with increasing household assets. CONCLUSIONS/SIGNIFICANCE: In this population, since HIV infection among adults was initially more common among the less poor, childhood mortality patterns have changed. The usual gap in survival between the poor and the less poor has been lost, but because the less poor have been disproportionately affected by HIV, rather than because of relative improvement in the survival of the poorest.
Stern, C; Núñez, R M; Tolbert, K; Cárdenas, V; Goodwin, M
Conditions of infant and child survival in Mexico have improved considerably over the last 60 years. Infant mortality rates were reduced from more than 250 deaths per 1,000 infants born alive in 1929-1931, to a rate of less than 50 in the period 1982-1987, a figure which still places Mexico among the countries with a high infant mortality rate. Though improvements in the living conditions of the population have undoubtedly played a part in the reduction of infant and child mortality, the early introduction of sanitation campaigns and, more recently of immunization, antibiotics and other modern health techniques have probably been more important. Health services have been extended throughout the country. However, significant portions of the population, especially in the rural areas, but also in the growing urban marginal ones, are to a large extent underserved. As a result, great inequalities in the health status of the population and in their access to health services remain. The problem of providing services to the whole population has become aggravated by the economic and financial crisis which has plagued Mexico since 1982. Reduced revenues for exports and the high cost of servicing the external and the internal debt have significantly decreased government revenues. As a result, public resources directed to health-related services diminished by 50 per cent in real terms between 1982 and 1987. This trend has to be reversed through enforced measures directed to the mobilization of untapped external and internal resources. But improving the conditions of child survival in Mexico requires more than financial resources. It is necessary to integrate and coordinate the fragmented services offered by the government, to give a much higher priority to preventive measures, and to research and to the adequate training of professionals and paraprofessionals in order to re-orient the health system for serving the real needs of the more underprivileged groups of the population
Nowakowski, Andrzej; Cybulski, Marek; Buda, Irmina; Janosz, Iwona; Olszak-Wąsik, Katarzyna; Bodzek, Piotr; Śliwczyński, Andrzej; Teter, Zbigniew; Olejek, Anita; Baranowski, Włodzimierz
A population-based organised cervical cancer screening programme (OCCSP) was introduced in Poland in 2006. In this study we have aimed to analyse whether selected parameters related to invasive cervical cancer (ICC) of patients diagnosed in two distant gynaecological oncology centres changed after the first screening round of the programme run between 2006–2008. We have run a retrospective cross-sectional analysis of 189 women diagnosed with ICC between 2002–2005 (directly before introduction of the programme) and 165 patients diagnosed between 2009–2012 (just after the first screening round of the programme) and compared their age at diagnosis, histology, stage of tumours and overall survival (OS). Mean age of patients diagnosed in years 2002–2005 and 2009–2012 was 52.1 and 52.6 years respectively. Squamous cell carcinomas constituted 90.5% and 86.1% of tumours diagnosed in years 2002–2005 and 2009–2012 respectively and the rest of tumours had glandular and other histologies. 74.5% and 61.0% of women diagnosed in years 2002–2005 and 2009–2012 respectively had early ICC (FIGO—International Federation of Gynaecology and Obstetrics stages I-IIA) and the rest had advanced disease (FIGO IIB-IV). We have noticed no significant differences in mean age of patients, histology of tumours and OS of patients with ICC diagnosed before and after the first screening round of OCSSP in Poland. Advanced stages of ICC were more commonly diagnosed after the introduction of OCSSP. Changes only in some clinical parameters of patients with ICC were noticed before and after the first screening round of OCSSP in Poland but OS of patients remained the same. PMID:27196050
Farid Alamdar oglu Suleymanov
Abstract. Kind relation between a child and caregiver (parent, teacher) is a critically vital point for psychological development of children. Better relations also contribute to the child’s healthy growth and intellectual, social and emotional development. Fundamental caregiving skills function as particularly important contribution to the quality and effectiveness all caregiving. In order to facilitate full development of a child, it is important that the caregiver have a positive conceptio...
Naugle, Danielle A; Hornik, Robert C
Through a systematic review of the literature, this article summarizes and evaluates evidence for the effectiveness of mass media interventions for child survival. To be included, studies had to describe a mass media intervention; address a child survival health topic; present quantitative data from a low- or middle-income country; use an evaluation design that compared outcomes using pre- and postintervention data, treatment versus comparison groups, or postintervention data across levels of exposure; and report a behavioral or health outcome. The 111 campaign evaluations that met the inclusion criteria included 15 diarrheal disease, 8 immunization, 2 malaria, 14 nutrition, 1 preventing mother-to-child transmission of HIV, 4 respiratory disease, and 67 reproductive health interventions. These evaluations were then sorted into weak (n = 33), moderate (n = 32), and stronger evaluations (n = 46) on the basis of the sampling method, the evaluation design, and efforts to address threats to inference of mass media effects. The moderate and stronger evaluations provide evidence that mass media-centric campaigns can positively impact a wide range of child survival health behaviors. PMID:25207453
Falconer, CL; Park, MH; Croker, H.; Skow, Á; Black, J; Saxena, S; Kessel, AS; Karlsen, S.; MORRIS, S.; Viner, RM; Kinra, S.
BACKGROUND Small-scale evaluations suggest that the provision of feedback to parents about their child's weight status may improve recognition of overweight, but the effects on lifestyle behaviour are unclear and there are concerns that informing parents that their child is overweight may have harmful effects. The aims of this study were to describe the benefits and harms of providing weight feedback to parents as part of a national school-based weight-screening programme in England. MET...
This report presents key statistics relating to: (1) child malnutrition in Africa; (2) HIV/AIDS and Malaria in Africa; (3) child marriage, birth registration and Female Genital Mutilation/Cutting (FGM/C); (4) education in Africa; (5) child mortality in Africa; (6) Drinking water and sanitation in Africa; and (7) maternal health in Africa.…
Beatson, Ruth M.; Bayer, Jordana K.; Perry, Alexandra; Mathers, Megan; Hiscock, Harriet; Wake, Melissa; Beesley, Kate; Rapee, Ronald M.
Temperamental inhibition has been identified as a key risk factor for childhood anxiety and internalizing problems. An efficacious early prevention programme for shy/inhibited children has been developed; however, accurate, efficient and acceptable screening is needed to support wider implementation. We explore community screening options in the…
Y. I. Mahraj
Full Text Available Globally, over 300 million people are estimated to be visually impaired. Uncorrected refractive error is the primary cause of almost half of all visual impairment, resulting in the global economy losing $269 billion in productivity annually. There is a definitive level of urgency in the treatment of refractive error in children as uncorrected refractive error results in the failure of normal visual maturation, termed amblyopia, which cannot be corrected in adult life. In South Africa, the lack of appropriatechild eye care strategies has posed a serious problem to the visual health of children. In 2006, the International Centre for Eye Care Education (ICEE conducted a situational analysis of child eye care services in the province of KwaZulu-Natal (KZN. The findings of this analysis indicated a dire need for comprehensive services in the province. Stakeholders (the KwaZulu-Natal Department of Healthand the KwaZulu-Natal Department of Education were advised on the value of a short-term strategy as the underpinning of a long-term sustainable approach. This resulted in the formation of a trialliance to implement the KZN Child Eye Care Programme. Eighty (80 individuals who were previously volunteers for the KZN Department of Health were trained in vision screening. These vi-sion screeners screened 239 606 primary school children from February 2007 to May 2008. Seven percent (15 944 of the children failed the vision screening and were referred for optometric assessments. Of the 15 944 children that failed the vision screening, 10 707 children were examined by optometrists and 1083 were found to have a refractive error and were therefore supplied with spectacles. The study indicates that a short-term programme to address a backlog of services can reach many underserved children. This programme identified many challenges of implementing a vision screening programme such as poor uptake of refractive services by learners in the absence of an appropriate
Burkhalter, B. R.; Abel, E; Aguayo, V.; Diene, S. M.; Parlato, M. B.; Ross, J. S.
Investment in nutritional programmes can contribute to economic growth and is cost-effective in improving child survival and development. In order to communicate this to decision-makers, the PROFILES nutrition advocacy and policy development programme was applied in certain developing countries. Effective advocacy is necessary to generate financial and political support for scaling up from small pilot projects and maintaining successful national programmes. The programme uses scientific knowl...
Bustreo, Flavia; Requejo, Jennifer Harris; Merialdi, Mario; Presern, Carole; Songane, Francisco
The present paper provides an overview of the Safe Motherhood Initiative, Healthy Newborn Partnership, and Child Survival Partnership and their eventual merge into the Partnership for Maternal, Newborn and Child Health (PMNCH) in 2005. The promise and past successes of the PMNCH are highlighted, with a particular focus on the PMNCH's partner-centric approach showing the importance of collaboration for progress. The aims of the strategic framework for 2012-2015 are presented within the context of the Global Strategy for Women's and Children's Health, launched in 2010, and growing political momentum to achieve Millennium Development Goals 4 and 5 (reduce child mortality and improve maternal health, respectively). The next 4 years leading to 2015 are critical, and the global community must continue to work together to ensure all women and children are reached with key interventions proven to reduce mortality. PMID:22883915
Mothers’ literacy skills are emerging as a key determinant of children’s health and survival in low-income contexts, with emphasis on the cognitive and psychological agency that literacy skills provide. This work has clearly established a strong association between mothers’ reading skills—a key subcomponent of broader literacy and language skills—and child mortality. However, this relatively nascent literature has not yet considered how broader social structures condition the process. In Nige...
Løndal, Knut; Greve, Anne
This article explores the nature of teachers' involvement in child-managed play. We approached this didactic issue through analysis of interactional situations in a kindergarten and an after-school programme and by drawing on relational theory and the concept of "pedagogical tact". Qualitative material was gathered from observations and…
Buhendwa, L.; Zachariah, R.; Teck, R; Massaquoi, M; Kazima, J.; Firmenich, Peter; Harries, A. D.
This study shows that cabergoline (single oral-dose) is an acceptable, safe and effective drug for suppressing puerperal lactation. It could be of operational benefit not only for artificial feeding, but also for weaning in those that breast-feed within preventive mother-to-child HIV transmission programmes in resource-limited settings.
Carrera, Carlos; Azrack, Adeline; Begkoyian, Genevieve; Pfaffmann, Jerome; Ribaira, Eric; O'Connell, Thomas; Doughty, Patricia; Aung, Kyaw Myint; Prieto, Lorena; Rasanathan, Kumanan; Sharkey, Alyssa; Chopra, Mickey; Knippenberg, Rudolf
Progress on child mortality and undernutrition has seen widening inequities and a concentration of child deaths and undernutrition in the most deprived communities, threatening the achievement of the Millennium Development Goals. Conversely, a series of recent process and technological innovations have provided effective and efficient options to reach the most deprived populations. These trends raise the possibility that the perceived trade-off between equity and efficiency no longer applies for child health--that prioritising services for the poorest and most marginalised is now more effective and cost effective than mainstream approaches. We tested this hypothesis with a mathematical-modelling approach by comparing the cost-effectiveness in terms of child deaths and stunting events averted between two approaches (from 2011-15 in 14 countries and one province): an equity-focused approach that prioritises the most deprived communities, and a mainstream approach that is representative of current strategies. We combined some existing models, notably the Marginal Budgeting for Bottlenecks Toolkit and the Lives Saved Tool, to do our analysis. We showed that, with the same level of investment, disproportionately higher effects are possible by prioritising the poorest and most marginalised populations, for averting both child mortality and stunting. Our results suggest that an equity-focused approach could result in sharper decreases in child mortality and stunting and higher cost-effectiveness than mainstream approaches, while reducing inequities in effective intervention coverage, health outcomes, and out-of-pocket spending between the most and least deprived groups and geographic areas within countries. Our findings should be interpreted with caution due to uncertainties around some of the model parameters and baseline data. Further research is needed to address some of these gaps in the evidence base. Strategies for improving child nutrition and survival, however
Full Text Available Introduction: Situation analysis of Reproductive and Child Health programme of Government of India in Beed district of Maharashtra state in India indicated lack of achievement of targeted maternal health indicators. Evaluation of the utilization of maternal health services component of Reproductive and Child Health (RCH II programme in Beed district of Maharashtra state in India was undertaken. Material and Methods: A cross sectional survey in the rural area of Beed district using cluster sampling method was conducted. The information about the utilization of maternal health services was collected from mothers who delivered between 1st April and 30th June 2013. A facility survey using pre tested check list was undertaken. Analysis of the data using Epi Info Version 3.5.3 and proportion for selected maternal health care indicators were calculated. Results: Out of the 374 mothers included in the study, 122 (33.0% had registered within first trimester of pregnancy; nearly 50% had received more than three antenatal care (ANC visits and 90% had institutional delivery. Of the 70 mothers, who made phone call for ambulance service, 56 (80% utilized ambulance from their residence to the hospitals. Of the 183 mothers who delivered in Government hospitals, 103 (56.3% utilized it to reach home from hospitals after delivery. Of the eligible women, 96 (76.2% were registered for Janani Suraksha Yojana (JSY scheme of the Government and 67 (69.8% received the benefit. In all 46 (16.4% Auxiliary Nurse Midwives (ANMs were trained as Skilled Birth Attendant (SBA. Of the 22 facilities, 14 (63.6% had delivery kits and in 6 (27.3% facilities maternal health services were monitored by medical officers. Conclusion: The utilization of maternal health care services and knowledge and implementation regarding JSY Scheme and ambulance service utilization among mothers was less than desirable. The coverage of training of ANMs as SBA was low. Provision of antenatal services in
Michele S Youngleson
Full Text Available BACKGROUND: Health systems that deliver prevention of mother to child transmission (PMTCT services in low and middle income countries continue to underperform, resulting in thousands of unnecessary HIV infections of newborns each year. We used a combination of approaches to health systems strengthening to reduce transmission of HIV from mother to infant in a multi-facility public health system in South Africa. METHODOLOGY/PRINCIPAL FINDINGS: All primary care sites and specialized birthing centers in a resource constrained sub-district of Cape Metro District, South Africa, were enrolled in a quality improvement (QI programme. All pregnant women receiving antenatal, intrapartum and postnatal infant care in the sub-district between January 2006 and March 2009 were included in the intervention that had a prototype-innovation phase and a rapid spread phase. System changes were introduced to help frontline healthcare workers to identify and improve performance gaps at each step of the PMTCT pathway. Improvement was facilitated and spread through the use of a Breakthrough Series Collaborative that accelerated learning and the spread of successful changes. Protocol changes and additional resources were introduced by provincial and municipal government. The proportion of HIV-exposed infants testing positive declined from 7.6% to 5%. Key intermediate PMTCT processes improved (antenatal AZT increased from 74% to 86%, PMTCT clients on HAART at the time of labour increased from 10% to 25%, intrapartum AZT increased from 43% to 84%, and postnatal HIV testing from 79% to 95% compared to baseline. CONCLUSIONS/SIGNIFICANCE: System improvement methods, protocol changes and addition/reallocation of resources contributed to improved PMTCT processes and outcomes in a resource constrained setting. The intervention requires a clear design, leadership buy-in, building local capacity to use systems improvement methods, and a reliable data system. A systems improvement
Sureender, S; Prabakaran, B; Khan, A G
Marriage in Indian society is a religious duty. Consanguineous marriage is common, where individuals prefer to marry within their clan (a unilateral kin group based on either matrilineal or patrilineal descent). Keeping in mind that this form of marriage has certain disadvantages for social and biological as well as demographic aspects of individuals and families, the present study examines the influence of mate selection (i.e., close relatives, distant relatives, not related) on female age at marriage, pregnancy wastages, and survival status of the first child. The study was designed based on the information collected on a sample size of 3,948 married women aged 13-49 in Tamil Nadu, India, by the National Family Health Survey (NFHS), 1992. Results suggest that 48 per cent of women in Tamil Nadu marry their relatives. This practice of marrying relatives is high in rural areas, among Hindus, Scheduled Castes/tribes, and illiterate women as compared to urban areas, among non-Hindus, non-SC/ST, and educated women, respectively. The bivariate analysis reveals that women marrying their close relatives had low age at marriage and experienced a higher per cent of pregnancy wastage and child loss (first child) as compared to those women marrying their distant relatives or nonrelatives. The result is found to be consistent even after controlling for selected background variables through multivariate techniques (applied separately for age at marriage, pregnancy wastages, and the survival status of first child). Hence, this study suggests that steps should be taken to inform people about the problems of marrying close relatives through appropriate IEC programs in Tamil Nadu. PMID:10085741
Biswas, R; Ray, S K; Dobe, M; Dasgupta, S; Mandal, A
The major emphasis of Reproductive and Child Health (RCH) programme in India is delivery of client-oriented, demand driven and broader ranges of high quality, safe and effective services for children, adolescents, mothers and reproductive age group population at large. Increased client satisfaction is considered as main determinant for improved acceptance of the services. Thus, well trained and motivated health personnel are necessary to deal with highly sensitive, personal health issues of the clients, like contraception, abortion, infertility services etc. The Indian Public Health Association organized total 10 workshops in several places of India (A total 322 members, composed of Medical Administrators (54.7%), Faculty members of Medical Colleges (24.5%), Sociologist and Nutritionists (13.9%) and also public health personnel (6.9%) participated in the workshop). Learning objectives and lesson plans etc. were formulated. Accordingly the contents were incorporated in a module, validated and pretested. The training sessions were conducted by briefing, discussion, group exercise and VIPP method and were evaluated by semi structured. The pre/post assessment schedule and scored scale of feedback from participantsAE were used for evaluation. The pre-post assessment scores revealed wide variations of mean score among the participants of several places. Significant post workshop improvement of knowledge was quite evident, with few exceptions. The group variants of pre and post score of results was considered to be due to heterogeneous groups of participants. Review of objectivity and quality of the questionnaire were felt as necessary. PMID:12653007
Introduction: The prevention of mother-to-child transmission of HIV (PMTCT) programme has been operational in Uganda since the year 2000, but its performance remains sub-optimal. The objective of this thesis is to increase understanding of the role of the social context in the delivery and utilization of PMTCT services, focusing on how pregnant women experience routine HIV counselling and testing as part of antenatal care, HIV status disclosure to partners and lessons leant by ...
Naregal PM; Mohite VR; Hiremath P; Chendake M; Karale RB; Pawar S
Background: Child abuse is one major threat to children all over the globe. Regardless of the type of child abuse, the result is serious emotional harm affecting the normal growth & development of child. School teachers are in contact with children daily and by reporting suspected child abuse and neglect, teachers can make an important contribution to the early detection and prevention of abuse. Objectives: 1. To assess the knowledge of primary school teachers regarding child abuse and neglec...
Philip Verwimp; Jan Van Bavel
In the 1960s and 1990s, internal strife in Rwanda has caused a mass flow of refugees into neighbouring countries. This paper explores the cumulated fertility of Rwandan refugee women and the survival of their children. To this end, we use a national survey covering 6420 former refugee and non-refugee households conducted between 1999 and 2001. The findings support old-age security theories of reproductive behaviour: refugee women had higher fertility but their children had lower survival chan...
Dorélien, Audrey M.
Birth month is broadly predictive of both under-five mortality rates and stunting throughout most of sub-Saharan Africa (SSA). Observed factors, such as mother's age at birth and educational status, are correlated with birth month but are not the main factors underlying the relationship between birth month and child health. Accounting for maternal selection via a fixed-effects model attenuates the relationship between birth month and health in many SSA countries. In the remaining countries, t...
Requejo, Jennifer Harris; Bhutta, Zulfiqar A
In this article, we draw on available evidence from Countdown to 2015 and other sources to make the case for keeping women and children at the heart of the next development agenda that will replace the Millennium Development Goal (MDG) framework after 2015. We provide a status update on global progress in achieving MDGs 4 and 5, reduce child mortality and improve maternal health, respectively--showing that although considerable mortality reductions have been achieved, many more women's and children's lives can be saved every day through available, cost effective interventions. We describe key underlying determinants of poor maternal and child health outcomes and the need for well-coordinated, comprehensive approaches for addressing them such as introducing a combination of nutrition specific and sensitive interventions to reduce pervasive malnutrition, targeting interventions to the underserved to reduce inequities in access to care, and increasing women's social status through improved access to education and income-earning opportunities. In the wake of population momentum and emergencies such as the recent ebola outbreak and other humanitarian crises, health systems must be strengthened to be able to respond to these pressures. In conclusion, we underscore that the unfinished business of women's and children's health must be prioritized in the days ahead, and that ending preventable maternal and child deaths is not only a moral obligation but is achievable and essential to sustainable development moving forward. PMID:25613979
De Cock, K M; Zadi, F.; Adjorlolo, G; Diallo, M. O.; Sassan-Morokro, M.; Ekpini, E.; Sibailly, T.; Doorly, R.; Batter, V; Brattegaard, K.
OBJECTIVES--To compare the effects of maternal HIV-1 and HIV-2 infections on outcome of pregnancy, infant mortality, and child survival, and to measure serological concordance between mothers and children. DESIGN--Retrospective cohort study with cross sectional study of concordance for HIV antibodies. SETTING--Hospital, tuberculosis clinic, and maternal and child health centre in Abidjan, Côte d'Ivoire, west Africa. SUBJECTS--986 women who had had a total of 2758 pregnancies since 1980. The l...
Balster, Robert L.; Levy, Stephanie; Stammer, Emily
Recognizing the need for evidence to inform public health officials and health care workers in the U.S. government and low- and middle-income country governments on efficient, effective behavior change policies, strategies, and programs for child health and development, the U.S. government convened the Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change. This article summarizes the background and metho...
Effectiveness of a parental training programme in enhancing the parent-child relationship and reducing harsh parenting practices and parental stress in preparing children for their transition to primary school: a randomised controlled trial
Li, Ho Cheung William; Chan, Sophia SC; Mak, Yim Wah; Lam, Tai Hing
Background Entering primary school is an important childhood milestone, marking the beginning of a child’s formal education. Yet the change creates a time of vulnerability for the child, the parents and the parent–child relationship. Failure to adjust to the transition may place the family in a psychologically devastating position. The aims of this study were to test the effectiveness of a parental training programme in enhancing the parent–child relationship and decreasing parental stress by...
Fisker, Ane B; Hornshøj, Linda; Rodrigues, Amabelia;
BACKGROUND: In 2008, the GAVI Alliance funded the introduction of new vaccines (including pentavalent diphtheria-tetanus-pertussis [DTP] plus hepatitis B and Haemophilus influenzae type b antigens) in Guinea-Bissau. The introduction was accompanied by increased vaccination outreach services and a...... more restrictive wastage policy, including only vaccinating children younger than 12 months. We assessed coverage of all vaccines in the Expanded Program on Immunizations before and after the new vaccines' introduction, and the implications on child survival. METHODS: This observational cohort study...... used data from the Bandim Health Project, which has monitored vaccination status and mortality in randomly selected village clusters in Guinea-Bissau since 1990. We assessed the change in vaccination coverage using cohort data from children born in 2007 and 2009; analysed the proportion of children who...
Finlay, Jocelyn E; Moucheraud, Corrina; Goshev, Simo; Levira, Francis; Mrema, Sigilbert; Canning, David; Masanja, Honorati; Yamin, Alicia Ely
The full impact of a maternal death includes consequences faced by orphaned children. This analysis adds evidence to a literature on the magnitude of the association between a woman's death during or shortly after childbirth, and survival outcomes for her children. The Ifakara and Rufiji Health and Demographic Surveillance Sites in rural Tanzania conduct longitudinal, frequent data collection of key demographic events at the household level. Using a subset of the data from these sites (1996-2...
Perry, Henry; Morrow, Melanie; Davis, Thomas; Borger, Sarah; Weiss, Jennifer; DeCoster, Mary; Ricca, Jim; Ernst, Pieter
Care Group projects resulted in high levels of healthy behavior, including use of oral rehydration therapy, bed nets, and health care services. Accordingly, under-5 mortality in Care Group areas declined by an estimated 32% compared with 11% in areas with child survival projects not using Care Groups.
KA Attia; KC Ackoundou-N'guessan; AT N'dri-yoman; AK Mahassadi; E Messou; YF Bathaix; YH Kissi
AIM: To compare the performance of the Child-Pugh-Turcott (CPT) score to that of the model for end-stage liver disease (MELD) score in predicting survival of a retrospective cohort of 172 Black African patients with cirrhosis on a short and mid-term basis.METHODS: Univariate and multivariate (Cox model)analyses were used to identify factors related to mortality. Relationship between the two scores was appreciated by calculating the correlation coefficient.The Kaplan Meier method and the log rank test were used to elaborate and compare survival respectively.The Areas Under the Curves were used to compare the performance between scores at 3, 6 and 12 mo.RESULTS: The study population comprised 172 patients, of which 68.9% were male. The mean age of the patient was 47.5 ± 13 years. Hepatitis B virus infection was the cause of cirrhosis in 70% of the cases.The overall mortality was 31.4% over 11 years of follow up. Independent factors significantly associated with mortality were: CPT score (HR = 3.3, 95% CI [1.7-6.2])(P 1.5 mg/dL versus serum creatine 21 vs MELD < 21). The area under the curves (AUC)that predict survival was 0.72 and 0.75 at 3 mo (P = 0.68),0.64 and 0.62 at 6 mo (P = 0.67), 0.69 and 0.64 at 12 mo (P = 0.38) respectively for the CPT score and the MELD score.CONCLUSION: The CPT score displays the same prognostic significance as does the MELD score in black African patients with cirrhosis. Moreover, its handling appears less cumbersome in clinical practice as compared to the latter.
Vu, Jennifer A.; Hustedt, Jason T.; Pinder, Wendy M.; Han, Myae
Children's early relationships with their caregivers are important for later developmental outcomes, both proximally and distally, and enhanced caregiver-child relationships may promote positive outcomes at both the individual and family levels. In this article, we review six evidence-based caregiver-child interaction interventions that can…
Wiysonge Charles; Ngcobo Nthombenhle J; Jeena Prakash M; Madhi Shabir A; Schoub Barry D; Hawkridge Anthony; Shey Muki S; Hussey Gregory D
Abstract Background The Expanded Programme on Immunisation (EPI) is one of the most powerful and cost-effective public health programmes to improve child survival. We assessed challenges and enablers for the programme in South Africa, as we approach the 2015 deadline for the Millennium Development Goals. Methods Between September 2009 and September 2010 we requested national and provincial EPI managers in South Africa to identify key challenges facing EPI, and to propose appropriate solutions...
Mirkuzie Alemnesh H
Full Text Available Abstract Background In the absence of reliable data, antenatal HIV surveillance has been used to monitor the HIV epidemic since the late 1980s. Currently, routine data from Prevention of Mother-to-child HIV transmission (PMTCT programmes are increasingly available. Evaluating whether the PMTCT programme reports provide comparable HIV prevalence estimates with the antenatal surveillance reports is important. In this study, we compared HIV prevalence estimates from routine PMTCT programme and antenatal surveillance in Addis Ababa with the aim to come up with evidence based recommendation. Methods Summary data were collected from PMTCT programmes and antenatal surveillance reports within the catchment of Addis Ababa. The PMTCT programme data were obtained from routine monthly reports from 2004 to 2009 and from published antenatal HIV surveillance reports from 2003 to 2009. Data were analysed using descriptive statistics. Results In Addis Ababa, PMTCT sites had increased from six in 2004 to 54 in 2009. The site expansion was accompanied by an increased number of women testing. There were marked increases in the rate of HIV testing following the introduction of routine opt-out HIV testing approach. Paralleling these increases, the HIV prevalence showed a steady decline from 10.0% in 2004 to 4.5% in 2009. There were five antenatal surveillance sites from 2003 to 2007 in Addis Ababa and they increased to seven by 2009. Four rounds of surveillance data from five sites showed a declining trend in HIV prevalence over the years. The overall antenatal surveillance data also showed that the HIV prevalence among antenatal attendees had declined from 12.4% in 2003 to 5.5% in 2009. The HIV prevalence estimates from PMTCT programme were 6.2% and 4.5% and from antenatal surveillance 6.1 and 5.5% in 2008 and 2009 respectively. Conclusions There were consistent HIV prevalence estimates from PMTCT programme and from antenatal surveillance reports. Both data sources
Rosamund F Lewis
Full Text Available OBJECTIVE: To guide immunization policy, we determined the public health benefit of introducing Haemophilus influenzae type b (Hib vaccine in Uganda and estimated the vaccine effectiveness. METHODS: Surveillance data for acute bacterial meningitis among children aged 0-59 months were reviewed from three hospital sentinel sites, for July 2001 to June 2007, to determine the incidence of Hib meningitis, the effectiveness of Hib vaccine with a case-control design, and the number of vaccine-preventable cases and deaths of Hib disease in Uganda. FINDINGS: Of the 13 978 children from 17 districts with suspected bacterial meningitis, 269 had confirmed Hib meningitis, declining from 69 patients in the prevaccine year (2001-2002 to three in 2006-2007. Hib meningitis incidence dropped from 88 cases per 100 000 children aged < 5 years in the year before vaccine introduction to 13 within 4 years, and to near zero in the fifth year. Vaccine effectiveness for 2 or more doses was 93% (95% confidence interval, CI: 69-99 against confirmed Hib meningitis and 53% (95% CI: 11-68 against purulent meningitis of unknown cause. In Uganda, Hib vaccine prevents an estimated 28 000 cases of pneumonia and meningitis, 5000 deaths and 1000 severe meningitis sequelae each year. CONCLUSION: Infant immunization with Hib vaccine has virtually eliminated Hib meningitis in Uganda within 5 years. Ensuring long-term benefits of Hib vaccine urgently requires sustainable vaccine financing, high-quality ongoing surveillance, and a health sector able to deliver a robust immunization programme.
Full Text Available ABSTRACT The study was carried out to investigate the perceived impact of the PPTCT programme on the management of parent-to-child HIV and AIDS transmission in Chikuku rural hospital community in Bikita district. A case study was used. A sample of ten expecting couples on Chikuku PPTCT programme and ten expecting mothers who were not on Chikuku PPTCT but attending ANC there participated in the study. Five professional counsellors also participated. Questionnaires and the interviews were used as data collection instruments. The data collected was analysed and interpreted using descriptive statistics and narratives. Tables were used to present the data and each question was analysed. The general findings agree with the reviewed literature as reflected that awareness and knowledge of PPTCT services and knowledge of its benefits was common but there were certain hurdles that need to be overcome in implementing and utilising them effectively. The clarion call is to review and reorganise the existing polices and current approaches in increasing PPTCT service uptake in communities similar to the study area. Recommendations were also made for programme implementers and policy makers in respect of the research findings in order to plan for the future.
Tine T. Hansen
Full Text Available Background: The Nutrition Therapeutic Programme (NTP involves the provision of food supplements at primary health clinics (PHCs to correct nutritional deficiencies in vulnerable groups. Although previous studies have identified problems with implementing the programme at PHCs, assessments of its efficiency have been scarce.Objective: To evaluate implementation of the NTP at PHCs that provide antiretroviral therapy.Methods: A cross-sectional, descriptive study was conducted at 17 PHCs located within 3 districts of Western Cape Province. Two target groups were chosen: 32 staff members working at the sites and 21 women of child-bearing age enrolled in the NTP. Questionnaires were used to obtain data.Results: Only 2 women (10% lived in food-secure households; the rest were either at risk of hunger (29% or classified as hungry (61%. Most of the women knew they had to take the supplements to improve their nutritional status, but the majority only recalled receiving basic nutritional advice, and the information was mainly given verbally. Ten of the women had shared their supplements with others, mostly with their children. The study identified lack of clearly defined NTP responsibilities at the PHCs, causing confusion amongst the staff. Although many staff members expressed problems with the NTP, only 38% of them reported having routine evaluations regarding the programme.Conclusion: Several aspects compromised the effectiveness of the NTP, including socio- economic factors leading to clients’ non-compliance. The strategic organisation and implementation of the NTP varied between different PHCs offering antiretroviral therapy, and staff experienced difficulties with the logistics of the programme.
Full Text Available Abstract Background This cross-sectional study assessed factors affecting access to antiretroviral therapy (ART among HIV-positive women from the prevention of mother to child transmission HIV programme in Chitungwiza, Zimbabwe. Methods Data were collected between June and August 2008. HIV-positive women attending antenatal clinics who had been referred to the national ART programme from January 2006 until December 2007 were surveyed. The questionnaire collected socio-demographic data, treatment-seeking behaviours, and positive or negative factors that affect access to HIV care and treatment. Results Of the 147 HIV-positive women interviewed, 95 (65% had registered with the ART programme. However, documentation of the referral was noted in only 23 (16% of cases. Of the 95 registered women, 35 (37% were receiving ART; 17 (18% had not undergone CD4 testing. Multivariate analysis revealed that participants who understood the referral process were three times more likely to access HIV care and treatment (OR = 3.21, 95% CI 1.89-11.65 and participants enrolled in an HIV support group were twice as likely to access care and treatment (OR = 2.34, 95% CI 1.13-4.88. Those living with a male partner were 60% less likely to access care and treatment (OR = 0.40, 95% CI 0.16-0.99. Participants who accessed HIV care and treatment faced several challenges, including long waiting times (46%, unreliable access to laboratory testing (35% and high transport costs (12%. Of the 147 clients surveyed, 52 (35% women did not access HIV care and treatment. Barriers included perceived long queues (50%, competing life priorities, such as seeking food or shelter (33% and inadequate referral information (15%. Conclusions Despite many challenges, the majority of participants accessed HIV care. Development of referral tools and decentralization of CD4 testing to clinics will improve access to ART. Psychosocial support can be a successful entry point to encourage client referral
Full Text Available Abstract Background Relating Information on causes of deaths to implementation of health interventions provides vital information for program planning and evaluation. This paper from Ballabgarh Health and Demographic Surveillance System (HDSS site in north India looks at temporal trends and gender differentials in the causes of death among under-five children. Methods Data on causes of death for 1972-74, 1982-84, 1992-94, 2002-04 were taken from existing HDSS publications and database. Physicians’ assigned causes of death were based on narratives by lay health worker till 1994 and later by verbal autopsy. Cause Specific Mortality Fractions (CSMF and Cause Specific Mortality Rates (CSMR per 1000 live births were calculated for neonatal ( Results The CSMF of prematurity and sepsis was 32% and 17.6% during neonatal period in 2002-04. The share of infections in all childhood deaths decreased from 55.2% in 1972-74 to 43.6% in 2002-04. All major causes of mortality (malnutrition, diarrhea and acute lower respiratory infection except injuries showed a steep decline among children and seem to have plateued in last decade. Most of disease specific public health interventions were launched in mid eighties. . Girls reported significantly higher mortality rates for prematurity (RR 1.52; 95% CI 1.01-2.29; diarrhea (2.29; 1.59 – 3.29, and malnutrition (3.37; 2.05 – 5.53. Conclusions The findings of the study point out to the need to move away from disease-specific to a comprehensive approach and to address gender inequity in child survival through socio-behavioural approaches.
MacIntyre, Deirdre; Carr, Alan.
Objective. This child abuse prevention study aimed to evaluate the effectiveness of the Stay Safe Programme in training unscreened 7 and 10 year old children in personal safety skills. Subsidiary aims were to evaluate the programme's impact on children's self-esteem and parents' and teachers' knowledge and attitudes of relevance to child abuse and protection. Method. Changes in safety knowledge and skills and self-esteem of 339 children who participated in the Stay Safe Program...
Lalor, Kevin; McElvaney, Rosaleen
Evidence that the sexual abuse of children is universally widespread, and is most frequently perpetrated by family members, neighbours and others known to the child or adolescent is indisputable. Studies have consistently found that victims are vulnerable to subsequent sexual revictimization in adolescence and adulthood. They are also more likely than non-victims to engage in potentially harmful and damaging high-risk sexual behaviours, such as early age at first intercourse, multiple partn...
Freeman, R.; Gibson, B.; Humphris, G.; Leonard, H.; Yuan, S.; Whelton, H.
Objective To use a model of health learning to examine the role of health-learning capacity and the effect of a school-based oral health education intervention (Winning Smiles) on the health outcome, child oral health–related quality of life (COHRQoL). Setting Primary schools, high social deprivation, Ireland/Northern Ireland. Design Cluster randomised controlled trial. Method A total of 383, 7- to 8-year-old children were invited to participate and randomly allocated into intervention and co...
Bhutta, Zulfiqar A
The Millennium Development Goals for improving maternal and child health globally were agreed on in 2000, and several monitoring and evaluation strategies were put in place, including "Countdown to 2015" for monitoring progress and intervention coverage to reach the goals. However, progress in achieving the goals has been slow, with only 13 of the 75 participating Countdown countries on track to reach the targets for reducing child mortality.An overview of child mortality rates in low-income countries is presented, followed by a discussion of evidenced-based interventions that can bridge the equity gaps in global health. Finally, comments are included on the companion article in this issue, "Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care" (page 59), and what is needed for that new project to succeed. PMID:27065474
Ari D Johnson
Full Text Available BACKGROUND: In 2012, 6.6 million children under age five died worldwide, most from diseases with known means of prevention and treatment. A delivery gap persists between well-validated methods for child survival and equitable, timely access to those methods. We measured early child health care access, morbidity, and mortality over the course of a health system strengthening model intervention in Yirimadjo, Mali. The intervention included Community Health Worker active case finding, user fee removal, infrastructure development, community mobilization, and prevention programming. METHODS AND FINDINGS: We conducted four household surveys using a cluster-based, population-weighted sampling methodology at baseline and at 12, 24, and 36 months. We defined our outcomes as the percentage of children initiating an effective antimalarial within 24 hours of symptom onset, the percentage of children reported to be febrile within the previous two weeks, and the under-five child mortality rate. We compared prevalence of febrile illness and treatment using chi-square statistics, and estimated and compared under-five mortality rates using Cox proportional hazard regression. There was a statistically significant difference in under-five mortality between the 2008 and 2011 surveys; in 2011, the hazard of under-five mortality in the intervention area was one tenth that of baseline (HR 0.10, p<0.0001. After three years of the intervention, the prevalence of febrile illness among children under five was significantly lower, from 38.2% at baseline to 23.3% in 2011 (PR = 0.61, p = 0.0009. The percentage of children starting an effective antimalarial within 24 hours of symptom onset was nearly twice that reported at baseline (PR = 1.89, p = 0.0195. CONCLUSIONS: Community-based health systems strengthening may facilitate early access to prevention and care and may provide a means for improving child survival.
Mirkuzie Alemnesh H
Full Text Available Abstract Background Prevention of mother to child HIV transmission (PMTCT programmes have great potential to achieve virtual elimination of perinatal HIV transmission provided that PMTCT recommendations are properly followed. This study assessed mothers and infants adherence to medication regimen for PMTCT and the proportions of exposed infants who were followed up in the PMTCT programme. Methods A prospective cohort study was conducted among 282 HIV-positive mothers attending 15 health facilities in Addis Ababa, Ethiopia. Descriptive statistics, bivariate and mulitivariate logistic regression analyses were done. Results Of 282 mothers enrolled in the cohort, 232 (82%, 95% CI 77-86% initiated medication during pregnancy, 154 (64% initiated combined zidovudine (ZDV prophylaxis regimen while 78 (33% were initiated lifelong antiretroviral treatment (ART. In total, 171 (60%, 95% CI 55-66% mothers ingested medication during labour. Of the 221 live born infants (including two sets of twins, 191 (87%, 95% CI 81-90% ingested ZDV and single-dose nevirapine (sdNVP at birth. Of the 219 live births (twin births were counted once, 148 (68%, 95% CI 61-73% mother-infant pairs ingested their medication at birth. Medication ingested by mother-infant pairs at birth was significantly and independently associated with place of delivery. Mother-infant pairs attended in health facilities at birth were more likely (OR 6.7 95% CI 2.90-21.65 to ingest their medication than those who were attended at home. Overall, 189 (86%, 95% CI 80-90% infants were brought for first pentavalent vaccine and 115 (52%, 95% CI 45-58% for early infant diagnosis at six-weeks postpartum. Among the infants brought for early diagnosis, 71 (32%, 95% CI 26-39% had documented HIV test results and six (8.4% were HIV positive. Conclusions We found a progressive decline in medication adherence across the perinatal period. There is a big gap between mediation initiated during pregnancy and actually
Sibanda Euphemia L
Full Text Available Abstract Background Provider-initiated HIV testing and counselling (PITC is widely recommended to ensure timely treatment of HIV. The Zimbabwe Ministry of Health introduced PITC in 2007. We aimed to evaluate institutional capacity to implement PITC and investigate patient and health care worker (HCW perceptions of the PITC programme. Methods Purposive selection of health care institutions was conducted among those providing PITC. Study procedures included 1 assessment of implementation procedures and institutional capacity using a semi-structured questionnaire; 2 in-depth interviews with patients who had been offered HIV testing to explore perceptions of PITC, 3 Focus group discussions with HCW to explore views on PITC. Qualitative data was analysed according to Framework Analysis. Results Sixteen health care institutions were selected (two central, two provincial, six district hospitals; and six primary care clinics. All institutions at least offered PITC in part. The main challenges which prevented optimum implementation were shortages of staff trained in PITC, HIV rapid testing and counselling; shortages of appropriate counselling space, and, at the time of assessment, shortages of HIV test kits. Both health care workers and patients embraced PITC because they had noticed that it had saved lives through early detection and treatment of HIV. Although health care workers reported an increase in workload as a result of PITC, they felt this was offset by the reduced number of HIV-related admissions and satisfaction of working with healthier clients. Conclusion PITC has been embraced by patients and health care workers as a life-saving intervention. There is need to address shortages in material, human and structural resources to ensure optimum implementation.
High acceptability of voluntary counselling and HIV-testing but unacceptable loss to follow up in a prevention of mother-to-child HIV transmission programme in rural Malawi: scaling-up requires a different way of acting.
Manzi, M; Zachariah, R.; Teck, R; Buhendwa, L.; Kazima, J.; Bakali, E; Firmenich, Peter; Humblet, P
SETTING: Thyolo District Hospital, rural Malawi. OBJECTIVES: In a prevention of mother-to-child HIV transmission (PMTCT) programme, to determine: the acceptability of offering 'opt-out' voluntary counselling and HIV-testing (VCT); the progressive loss to follow up of HIV-positive mothers during the antenatal period, at delivery and to the 6-month postnatal visit; and the proportion of missed deliveries in the district. DESIGN: Cohort study. METHODS: Review of routine antenatal, VCT and PMTCT ...
Awoonor-williams, John Koku; Bawah, Ayaga A; Nyonator, Frank K; Asuru, Rofina; Oduro, Abraham; Ofosu, Anthony; Phillips, James F
Background During the 1990s, researchers at the Navrongo Health Research Centre in northern Ghana developed a highly successful community health program. The keystone of the Navrongo approach was the deployment of nurses termed community health officers to village locations. A trial showed that, compared to areas relying on existing services alone, the approach reduced child mortality by half, maternal mortality by 40%, and fertility by nearly a birth — from a total fertility rate of 5.5 in o...
Full Text Available Targeting of health interventions to poor children at highest risk of mortality are promising approaches for enhancing equity. Methods have emerged to accurately quantify excess risk and identify space-time disparities. This provides useful and detailed information for guiding policy. A spatio-temporal analysis was performed to identify risk factors associated with child (1-4 years mortality in the Agincourt sub-district, South Africa, to assess temporal changes in child mortality patterns within the study site between 1992 and 2007, and to produce all-cause and cause-specific mortality maps to identify high risk areas. Demographic, maternal, paternal and fertility-related factors, household mortality experience, distance to health care facility and socio-economic status were among the examined risk factors. The analysis was carried out by fitting a Bayesian discrete time Bernoulli survival geostatistical model using Markov chain Monte Carlo simulation. Bayesian kriging was used to produce mortality risk maps. Significant temporal increase in child mortality was observed due to the HIV epidemic. A distinct spatial risk pattern was observed with higher risk areas being concentrated in poorer settlements on the eastern part of the study area, largely inhabited by former Mozambican refugees. The major risk factors for childhood mortality, following multivariate adjustment, were mother’s death (especially when due to HIV and tuberculosis, greater number of children under 5 years living in the same household and winter season. This study demonstrates the use of Bayesian geostatistical models for accurately quantifying risk factors and producing maps of child mortality risk in a health and demographic surveillance system. According to the space-time analysis, the southeast and upper central regions of the site appear to have the highest mortality risk. The results inform policies to address health inequalities in the Agincourt sub-district and to
Sartorius, Benn; Kahn, Kathleen; Collinson, Mark A; Vounatsou, Penelope; Tollman, Stephen M
Targeting of health interventions to poor children at highest risk of mortality are promising approaches for enhancing equity. Methods have emerged to accurately quantify excess risk and identify space-time disparities. This provides useful and detailed information for guiding policy. A spatio-temporal analysis was performed to identify risk factors associated with child (1-4 years) mortality in the Agincourt sub-district, South Africa, to assess temporal changes in child mortality patterns within the study site between 1992 and 2007, and to produce all-cause and cause-specific mortality maps to identify high risk areas. Demographic, maternal, paternal and fertility-related factors, household mortality experience, distance to health care facility and socio-economic status were among the examined risk factors. The analysis was carried out by fitting a Bayesian discrete time Bernoulli survival geostatistical model using Markov chain Monte Carlo simulation. Bayesian kriging was used to produce mortality risk maps. Significant temporal increase in child mortality was observed due to the HIV epidemic. A distinct spatial risk pattern was observed with higher risk areas being concentrated in poorer settlements on the eastern part of the study area, largely inhabited by former Mozambican refugees. The major risk factors for childhood mortality, following multivariate adjustment, were mother's death (especially when due to HIV and tuberculosis), greater number of children under 5 years living in the same household and winter season. This study demonstrates the use of Bayesian geostatistical models for accurately quantifying risk factors and producing maps of child mortality risk in a health and demographic surveillance system. According to the space-time analysis, the southeast and upper central regions of the site appear to have the highest mortality risk. The results inform policies to address health inequalities in the Agincourt sub-district and to improve access to
Higgs, Elizabeth S; Goldberg, Allison B; Labrique, Alain B; Cook, Stephanie H; Schmid, Carina; Cole, Charlotte F; Obregón, Rafael A
Given the high morbidity and mortality among children in low- and middle-income countries as a result of preventable causes, the U.S. government and the United Nations Children's Fund convened an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change on June 3-4, 2013, in Washington, D.C. This article summarizes evidence for technological advances associated with population-level behavior changes necessary to advance child survival and healthy development in children under 5 years of age in low- and middle-income countries. After a rigorous evidence selection process, the authors assessed science, technology, and innovation papers that used mHealth, social/transmedia, multiplatform media, health literacy, and devices for behavior changes supporting child survival and development. Because of an insufficient number of studies on health literacy and devices that supported causal attribution of interventions to outcomes, the review focused on mHealth, social/transmedia, and multiplatform media. Overall, this review found that some mHealth interventions have sufficient evidence to make topic-specific recommendations for broader implementation, scaling, and next research steps (e.g., adherence to HIV/AIDS antiretroviral therapy, uptake and demand of maternal health service, and compliance with malaria treatment guidelines). While some media evidence demonstrates effectiveness in changing cognitive abilities, knowledge, and attitudes, evidence is minimal on behavioral endpoints linked to child survival. Population level behavior change is necessary to end preventable child deaths. Donors and low- and middle-income countries are encouraged to implement recommendations for informing practice, policy, and research decisions to fully maximize the impact potential of mHealth and multimedia for child survival and development. PMID:25207452
Full Text Available Single-dose nevirapine (sd-NVP has been the main option for prevention of mother-to-child transmission (PMTCT of HIV-1 in low-resource settings. However, sd-NVP can induce the selection of HIV-1 resistant mutations in mothers and infants. In Mozambique, there are limited data regarding the profile of NVP resistance associated mutations (RAM in the context of PMTCT.To assess the prevalence and the factors associated with NVP RAM among children born to HIV-1 infected mothers enrolled in the PMTCT programme adopted in Mozambique.One hundred and fifty seven children aged 6 to 48 weeks were sequentially included (July 2011 to March 2012 at four centres in Maputo. Genotyping of RAM was performed in samples with HIV-1 RNA≥ 100 copies/μL (Viroseq. Sequencing was performed with ABI 3100 (Applied Biosystems. Logistic regression modelling was undertaken to identify the factors associated with NVP RAM.Seventy-nine children had their samples genotyped. Their median age was 7.0 (3-12 months and 92.4% received prophylaxis with sd-NVP at birth plus daily NVP. 35.4% of mothers received antiretrovirals (ARVs for PMTCT. ARV RAM were detected in 43 (54.4% of the children. 45.6% of these children had at least one NVP RAM. The most common mutations associated with NVP resistance were K103N (n = 16 and Y181C (n = 15. NVP RAM was significantly associated with mother exposure to PMTCT (crude odds ratio [OR] 30.3, 95% CI 4.93-186.34 and with mother's CD4 count < 350 cells/mm3 (crude OR 3.08, 95% CI 1.02-9.32. In the multivariable analysis the mother's exposure to PMTCT was the only variable significantly associated with NVP RAM (adjusted OR 48.65, 95% CI 9.33-253.66.We found a high prevalence of NVP RAM among children who were exposed to the drug regimen for PMTCT in Mozambique. The mothers' exposure to PMTCT significantly increased the risk of NVP RAM.
Murray, Joanna; Remes, Pieter; Ilboudo, Rita; Belem, Mireille; Salouka, Souleymane; Snell, Will; Wood, Cathryn; Lavoie, Matthew; Deboise, Laurent; Head, Roy
A 35-month cluster randomized controlled trial was conducted in Burkina Faso to test whether a radio campaign focused on child health, broadcast between March 2012 and January 2015, could reduce under-5 mortality. This paper describes the design and implementation of the mass media intervention in detail, including the Saturation+ principles that underpinned the approach, the creative process, the lessons learned, and recommendations for implementing this intervention at scale. The Saturation+ approach focuses on the 3 core principles of saturation (ensuring high exposure to campaign messages), science (basing campaign design on data and modeling), and stories (focusing the dramatic climax on the target behavior) to maximize the impact of behavior change campaigns. In Burkina Faso, creative partnerships with local radio stations helped us obtain free airtime in exchange for training and investing in alternative energy supplies to solve frequent energy problems faced by the stations. The campaign used both short spots and longer drama formats, but we consider the short spots as a higher priority to retain during scale-up, as they are more cost-effective than longer formats and have the potential to ensure higher exposure of the population to the messages. The implementation research synthesized in this paper is designed to enable the effective adoption and integration of evidence-based behavior change communication interventions into health care policy and practice. PMID:26681703
United Nations Children's Fund, Paris (France).
This digest examines the problem of child labor and education in India and other Southeast Asian countries. It offers novel insights into the extent of child labor and the shortcomings and inertia of educational systems in adapting to the needs of working children. Also, the digest describes a series of promising educational innovations meant to…
Charles, Joanna M; Bywater, Tracey J; Edwards, Rhiannon Tudor; Hutchings, Judy; Zou, Lu
Background There is co-morbidity between parental depression and childhood conduct disorder. The Incredible Years (IY) parenting programmes reduce both conduct disorder in children and depression in their parents. Recent U.K. and Ireland trials of the effectiveness and cost-effectiveness of IY parenting programmes have assessed children’s health and social care service use, but little is known about the programme’s impact on parental service use. This paper explores whether an above clinical ...
Nomafrench Mbombo; Million Bimerew
South Africa (SA) has the highest number of women infected with HIV and AIDS during pregnancy, which results in more than 70 000 infected babies being born each year AIDS is the major contributor to maternal and child morbidities and mortalities in the country. To combat this, the SA government has developed a national policy to prevent mother-to-child HIV transmission (PMTCT). However, for effective implementation of this policy, there is a dire need for a competent, skilled health worker to...
Sylvain Dessy; Stéphane Pallage
In this paper, we highlight the economic effects of the existence of child trafficking. We show that the risk of child trafficking on the labor market acts as a deterrent to supply child labor, unless household survival is at stake. An imperfectly enforceable legislation aiming at fighting child trafficking, by raising the expected gains parents derive from sending their children to work, will cause a rise in the number of child laborers. We show that it can even cause the incidence of child ...
Ladner, Joël; Besson, Marie-Hélène; Rodrigues, Mariana; Sams, Kelley; Audureau, Etienne; Saba, Joseph
Background Transmission of HIV from mother-to-child during pregnancy, labor, or breastfeeding is the primary cause of pediatric HIV infection in sub-Saharan Africa. A regimen of single-dose nevirapine administered to both HIV-positive pregnant women and their infants has been shown to lower the risk of mother-to-child transmission (MTCT) of HIV. In an effort to facilitate scale-up of PMTCT programs in low-income countries, Boehringer Ingelheim, the manufacturer of Viramune (branded nevirapine...
Joshua O. Akinyemi
Full Text Available Under-five mortality in Nigeria has been reported to be on the decline, but the dynamics are yet to receiveadequate attention. Thus the main objective of this study was to assess these factors and quantify their relativecontributions to under-five mortality between 1990 and 2008. The Nigeria Demographic and HealthSurvey data for 1990, 2003 and 2008 were re-analysed to assess the trends in determinants of under-fivemortality.Cox Regression model was applied to determine the relative contributions of each factor to theunder-five mortality risk.The results showed there were improvements in maternal education (8.6%, childhoodvaccination (17.7%, use of oral rehydration therapy (13.9% and medical treatment of childhood illnesses(17.5% over the 19-year period. There were declines in proportions with birth interval less than 24months (3.9%, access to improved sources of drinking water (24.2%, improved toilet facilities (9.0%antenatal care (4.5%, skilled delivery (3.0% while maternal age at childbirth remained unchanged. Thesefactors increased the death hazards by 4.6% between 1990-2003 but decreased them by 12% between2003 and 2008. It was concluded that Nigeria has recorded very minimal improvements in birth spacing andantenatal/delivery care. Poor access to potable drinking water and sewage disposal, and short birth intervals,are among the factors fuelling childhood mortality risks. Further improvements in these environmental andhealth practices as well as other factors are recommended as strategies for promoting child survival inNigeria.
Mirzoev, T; Etiaba, E; Ebenso, B; Uzochukwu, B; Manzano, A.; Onwujekwe, O; Huss, R; Ezumah, N; Hicks, JC; Newell, J; Ensor, T.
Background Achievement of improved maternal and child health (MCH) outcomes continues to be an issue of international priority, particularly for sub-Saharan African countries such as Nigeria. Evidence suggests that the use of Community Health Workers (CHWs) can be effective in broadening access to, and coverage of, health services and improving MCH outcomes in such countries. Methods/design In this paper, we report the methodology for a 5-year study which aims to evaluate the context, process...
In many instances, child labor is a way to exploit the cheap labor a child has to offer. Although in many situations, the exploitation of child labor is not normally the case, such as families living in a developing country. What individuals raised in Western cultures fail to realize is that in some nations and for some families, child labor is a necessary resource to survive, children act as an exceptional resource in these situations. Without the extra income a child could make working in t...
Sartorius, Benn; Kahn, Kathleen; Mark A Collinson; Vounatsou, Penelope; Tollman, Stephen M.
Targeting of health interventions to poor children at highest risk of mortality are promising approaches for promoting equity. Methods have emerged to accurately quantify excess risk and identify space-time disparities. This provides useful and detailed information for guiding policy. A spatial-temporal analysis was performed to identify risk factors associated with child (1-4 years) mortality in rural South Africa (the Agincourt sub-district), to assess temporal changes in child mortality pa...
Benn Sartorius; Kathleen Kahn; Mark A Collinson; Penelope Vounatsou; Tollman, Stephen M.
Targeting of health interventions to poor children at highest risk of mortality are promising approaches for enhancing equity. Methods have emerged to accurately quantify excess risk and identify space-time disparities. This provides useful and detailed information for guiding policy. A spatio-temporal analysis was performed to identify risk factors associated with child (1-4 years) mortality in the Agincourt sub-district, South Africa, to assess temporal changes in child mortality patterns w...
... Public Awareness Sustainability Policy Issues Understanding Child Traumatic Stress Page Contents: Responding to Danger When Danger Turns ... malevolence, and human accountability. Back to Top Posttraumatic Stress Responses For reasons that are basic to survival, ...
Juraci A. Cesar
Full Text Available This study aimed to evaluate knowledge on child survival among mothers of children under five years of age living in nine municipalities in North and Northeast Brazil. A standardized questionnaire was used for home interviews of mothers visited by volunteers from the Pastorate of the Child and mothers not visited by the program (control areas. The association between independent variables and the outcome (visited versus not visited by the Pastorate of the Child was evaluated using the chi-square test. Among the 752 mothers studied, 386 were visited by Pastorate of the Child volunteers and 366 were not visited. Mothers visited by the Pastorate of the Child, although poorer, showed better knowledge on monitoring child growth and identifying child development difficulties as compared to mothers from the control areas. Despite the better performance of mothers visited by the Pastorate of the Child volunteers, maternal knowledge on child survival in both groups was less than desirable. This hinders the identification of more serious cases, delays seeking medical care, and reduces the impact on child morbidity and mortality.Este estudo teve por objetivo avaliar o conhecimento em sobrevivência infantil entre mães de menores de cinco anos residentes em nove municípios das regiões Norte e Nordeste do Brasil. Aplicou-se questionário padronizado no domicílio para mães acompanhadas pelos líderes da Pastoral da Criança e não acompanhadas (áreas-controle. A associação entre as variáveis independentes e o desfecho (receber ou não visita dos líderes da Pastoral da Criança foi avaliada pelo teste do qui-quadrado. Dentre as 752 mães estudadas, 386 eram visitadas pelos líderes da Pastoral da Criança e 366 não eram visitadas. Mães visitadas pelos líderes da Pastoral da Criança, apesar de mais pobres, apresentaram melhor conhecimento sobre monitoração do crescimento infantil, identificação de pneumonia e dificuldade no desenvolvimento em
Full Text Available La infancia es considerada como una etapa trascendental en el proceso evolutivo del hombre, caracterizada por dos fenómenos: crecimiento y desarrollo, para lo cual es fundamental una adecuada nutrición. Los estragos que provoca la desnutrición que se padece en la infancia son los más lamentados por una sociedad, ya que en esta etapa el mayor impacto lo sufre el cerebro del niño, en el que se producirían alteraciones metabólicas y estructurales irreversibles, sin embargo, la desnutrición infantil no es sólo un problema de falta de alimentos, es un conflicto social más profundo, que debe ser tenido en cuenta a la hora de brindar soluciones. La Corporación para la Nutrición Infantil (CONIN, creada en Chile en 1975, tiene por finalidad recuperar a los niños de 0 a 3 años que presentan desnutrición primaria o secundaria. Desde 1993, este proyecto se extendió a la provincia de Mendoza, Argentina, como Fundación CONIN (Cooperadora para la Nutrición Infantil,donde se completó esta experiencia creando Centros de Prevención de Desnutrición. Actualmente este proyecto se desarrolla en distintas provincias del país, en Paraguay y próximamente en Perú, sustentando su trabajo en tres pilares: docencia, asistencia e investigación. CONIN desarrolla una estrategia de intervención de gran impacto sanitario sobre la población de bajos recursos de su área de influencia, con una elevada repercusión social ya que potencia la familia y su entorno como base del correcto desarrollo físico e intelectual del niño, unido a un aporte adecuado de nutrientes, que le permiten al niño desarrollar su potencial genético.Childood is considered a transcendental stage in the evolutionary process of man, characterized by two phenomenon: growth and development, for which a suitable nutrition is fundamental. The damage that causes undernourishment that is suffered in childhood is greatly lamented by society, since in this stage it is the child"s brain
Full Text Available South Africa (SA has the highest number of women infected with HIV and AIDS during pregnancy, which results in more than 70 000 infected babies being born each year AIDS is the major contributor to maternal and child morbidities and mortalities in the country. To combat this, the SA government has developed a national policy to prevent mother-to-child HIV transmission (PMTCT. However, for effective implementation of this policy, there is a dire need for a competent, skilled health worker to render the service. In response to this, the School of Nursing at the University of the Western Cape has integrated PMTCT competencies into the undergraduate Bachelor of Nursing Science curriculum. In this paper, we described teaching and learning approaches used to integrate PMTCT competencies, including the skills laboratory methodology and case-based learning, as well as a portfolio of evidence assessment tool. A quantitative descriptive design was used to analyse data collected from students in regard to assessment of PMTCT competencies achieved. The study used the conceptual framework of Lenburg’s competency outcomes and performance assessment model, which focuses on competency development and assessment in a clinical environment. HIV competencies, including PMTCT, should be integrated both theoretically and at service delivery into other nursing and midwifery competencies, including assessment strategies. Provincial policies in provision of antiretrovirals by nurses and midwives become barriers to successful implementation of PMTCT, resulting in limited learning opportunities for students to practice PMTCT competencies. Further research is required to assess an attribute, affect, which is another prong for competencies.
Full Text Available South Africa (SA has the highest number of women infected with HIV and AIDS during pregnancy, which results in more than 70 000 infected babies being born each year AIDS is the major contributor to maternal and child morbidities and mortalities in the country. To combat this, the SA government has developed a national policy to prevent mother-to-child HIV transmission (PMTCT. However, for effective implementation of this policy, there is a dire need for a competent, skilled health worker to render the service. In response to this, the School of Nursing at the University of the Western Cape has integrated PMTCT competencies into the undergraduate Bachelor of Nursing Science curriculum. In this paper, we describedteaching and learning approaches used to integrate PMTCT competencies, including the skills laboratory methodology and case-based learning, as well as a portfolio of evidence assessment tool. A quantitative descriptive design was used to analyse data collected from students in regard to assessment of PMTCT competencies achieved. The study used the conceptual framework of Lenburg’s competency outcomes and performance assessment model, which focuses on competency development and assessment in a clinical environment. HIV competencies, including PMTCT, should be integrated both theoretically and at service delivery into other nursing and midwifery competencies, including assessment strategies. Provincial policies in provision of antiretrovirals by nurses and midwives become barriers to successful implementation of PMTCT, resulting in limited learning opportunities for students to practice PMTCT competencies. Further research is required to assess an attribute, affect, which is another prong for competencies.
Gordon E Schutze
Full Text Available Introduction: Loss to follow-up is a major challenge in the prevention of mother to child transmission of HIV (PMTCT programme in Malawi with reported loss to follow-up of greater than 70%. Tingathe-PMTCT is a pilot intervention that utilizes dedicated community health workers (CHWs to create a complete continuum of care within the PMTCT cascade, improving service utilization and retention of mothers and infants. We describe the impact of the intervention on longitudinal care starting with diagnosis of the mother at antenatal care (ANC through final diagnosis of the infant. Methods: PMTCT service utilization, programme retention and outcomes were evaluated for pregnant women living with HIV and their exposed infants enrolled in the Tingathe-PMTCT programme between March 2009 and March 2011. Multivariate logistic regression was done to evaluate maternal factors associated with failure to complete the cascade. Results: Over 24 months, 1688 pregnant women living with HIV were enrolled. Median maternal age was 27 years (IQR, 23.8 to 30.8; 333 (19.7% were already on ART. Among the remaining women, 1328/1355 (98% received a CD4 test, with 1243/1328 (93.6% receiving results. Of the 499 eligible for ART, 363 (72.8% were successfully initiated. Prior to, delivery there were 93 (5.7% maternal/foetal deaths, 137 (8.1% women transferred/moved, 51 (3.0% were lost and 58 (3.4% refused ongoing PMTCT services. Of the 1318 live births to date, 1264 (95.9% of the mothers and 1285 (97.5% of the infants received ARV prophylaxis; 1064 (80.7% infants were tested for HIV by PCR and started on cotrimoxazole. Median age at PCR was 1.7 months (IQR, 1.5 to 2.5. Overall transmission at first PCR was 43/1047 (4.1%. Of the 43 infants with positive PCR results, 36 (83.7% were enrolled in ART clinic and 33 (76.7% were initiated on ART. Conclusions: Case management and support by dedicated CHWs can create a continuum of longitudinal care in the PMTCT cascade and result in
Malnutrition stunts physical growth and/or limits mental development in one child out of three in developing countries and is a factor in one-third of the 13 million child deaths which occur annually in developing countries. The Department of Technical Co-operation is sponsoring a programme, with technical support from the Human Health Division, to evaluate the effectiveness of a Government food supplement intervention to combat malnutrition in Peru. (IAEA)
peer-reviewed This article describes a community support programme which implicitly challenges the assumption that the existence of a partner and local kin obviates the need to support women when they come home from hospital with a new baby. Implicit in the programme is the idea that support by mothers, of mothers, validates the activity of child care and is one way of facilitating the child's development. This programme was successful in terms of its perceived impact on both the providers...
Musafili, Aimable; Essén, Birgitta; Baribwira, Cyprien; Binagwaho, Agnes; Persson, Lars-Åke; Selling, Katarina Ekholm
Background: Rwanda has embarked on ambitious programmes to provide equitable health services and reduce mortality in childhood. Evidence from other countries indicates that advances in child survival often have come at the expense of increasing inequity. Our aims were to analyse trends and social differentials in mortality before the age of 5 years in Rwanda from 1990 to 2010. Methods: We performed secondary analyses of data from three Demographic and Health Surveys conducted in 2000, 2005 an...
Brinda, Ethel Mary; Rajkumar, Anto P; Enemark, Ulrika
Background Gender inequality weakens maternal health and harms children through many direct and indirect pathways. Allied biological disadvantage and psychosocial adversities challenge the survival of children of both genders. United Nations Development Programme (UNDP) has recently developed a Gender Inequality Index to measure the multidimensional nature of gender inequality. The global impact of Gender Inequality Index on the child mortality rates remains uncertain. Methods We employed an ...
Zembe-Mkabile, Wanga; Ramokolo, Vundli; Sanders, David; Jackson, Debra; Doherty, Tanya
Objective Cash transfer programmes targeting children are considered an effective strategy for addressing child poverty and for improving child health outcomes in developing countries. In South Africa, the Child Support Grant (CSG) is the largest cash transfer programme targeting children from poor households. The present paper investigates the association of the duration of CSG receipt with child growth at 2 years in three diverse areas of South Africa. Design The study analysed data on CSG ...
Her Majesty's Inspectorate of Pollution's 1992 report on its programme of monitoring radioactive substances is presented. Site operators' returns are verified and the report provides independent data on the environmental impact of authorized disposal of radioactive wastes. Radiation doses which may have been received by members of the public, fall well below the International Commission for Radiological Protection's (ICRP) recommended annual doses. (UK)
Full Text Available Abstract Background Guinea-Bissau is a small country in West Africa with a population of 1.7 million. The WHO and UNICEF reported an under-five child mortality of 203 per 1000, the 10th highest amongst 192 countries. The aim of the trial is to assess whether an intervention package that includes community health promotion campaign and education through health clubs, intensive training and mentoring of village health workers to diagnose and provide first-line treatment for children's diseases within the community, and improved outreach services can generate a rapid and cost-effective reduction in under-five child mortality in rural regions of Guinea-Bissau. Effective Intervention plans to expand the project to a much larger region if there is good evidence after two and a half years that the project is generating a cost-effective, sustainable reduction in child mortality. Methods/design This trial is a cluster-randomised controlled trial involving 146 clusters. The trial will run for 2.5 years. The interventions will be introduced in two stages: seventy-three clusters will receive the interventions at the start of the project, and seventy-three control clusters will receive the interventions 2.5 years after the first clusters have received all interventions if the research shows that the interventions are effective. The impact of the interventions and cost-effectiveness will be measured during the first stage. The package of interventions includes a community health promotion campaign and education through health clubs, and intensive training and mentoring of village health workers to diagnose and provide first-line treatment for common children's diseases within the community. It also includes improved outreach services to encourage provision of antenatal and post natal care and provide ongoing monitoring for village health workers. The primary outcome of the trial will be the proportion of children that die under 5 years of age during the trial
Full Text Available Background: To eliminate new pediatric HIV infections, interventions that facilitate adherence, including those that minimize stigma, enhance social support, and mitigate the influence of poverty, will likely be required in addition to combination antiretroviral therapy (ART. We examined the relationship between partner testing and infant outcome in a prevention of parent-to-child transmission of HIV program, which included a family-centered case management approach and a supportive environment for partner disclosure and testing. Design: We analyzed routinely collected data for women and infants who enrolled in the parent-to-child transmission of HIV program at Goroka Family Clinic, Eastern Highlands Provincial Hospital, Papua New Guinea, from 2007 through 2011. Results: Two hundred and sixty five women were included for analysis. Of these, 226 (85% had a partner, 127 (56% of whom had a documented HIV test. Of the 102 HIV-infected partners, 81 (79% had been linked to care. In adjusted analyses, we found a significantly higher risk of infant death, infant HIV infection, or loss to follow-up among mother–infant pairs in which the mother reported having no partner or a partner who was not tested or had an unknown testing status. In a second multivariable analysis, infants born to women with more time on ART or who enrolled in the program in later years experienced greater HIV-free survival. Conclusions: In a program with a patient-oriented and family-centered approach to prevent vertical HIV transmission, the majority of women's partners had a documented HIV test and, if positive, linkage to care. Having a tested partner was associated with program retention and HIV-free survival for infants. Programs aiming to facilitate diagnosis disclosure, partner testing, and linkage to care may contribute importantly to the elimination of pediatric HIV.
李丹; 刘明翔; 彭夏碧; 樊荣; 刘祁钰
Objective To explore influencing factors of the disabled child parents' state anxiety and survival quality. Methods Disabled child parents filled out state anxiety .quality of life questionnaire in Xi,an. Results Different education level of parents had significant difference in state anxiety level (t = -2. 12,P=0. 039),Sex and self-rated influence severity were not statistically significant for parents' state anxiety(t=0. 48,P = 0. &01;t = 2. 305,P = 0. 107);②Sex and education level were not statistically significant for parents' live quality(t = -0. 997,0. 338;P>0. 05) ,self-rated influence severity had significant differences in the environment, social relation field,psychological field (t = 13. 13,8. 048,7. 006,7. 242;P=0001). Conclusion Disabled child parents' overall state anxiety level is high,their quality of life level is low,self-rated influence severity is an important influencing factor of their state anxiety and survival quality.%目的 研究残疾孩子家长状态焦虑与生存质量的影响因素.方法 对西安市残疾孩子家长进行状态焦虑与生存质量问卷调查.结果 ①教育程度不同的家长在状态焦虑水平方面的差异性显著(F=-2.12,P=0.039),性别、自评影响程度差异对孩子家长的状态焦虑无统计学意义(F=0.48,P=0.601)；②性别、受教育程度对孩子家长的生存质量无统计学意义,自评影响程度在环境领域、社会关系领域、心理领域、生理领域差异显著(F=13.13,P=0；F=8.048,P=0.001；F=7.006,P=0.002；F=7.242,P=0.001).结论 残疾孩子家长整体的状态焦虑水平较高,生存质量水平较低且自评影响程度是残疾孩子家长状态焦虑、生存质量水平的一个重要影响因素.
This thesis assesses the effectiveness of the National Prevention of Mother to Child Transmission of HIV (PMTCT) programme in 3 sites in South Africa, and the quality of infant feeding counselling across four countries, Botswana, Kenya, Malawi and Uganda . Implementation and outcome of PMTCT services were very different across the 3 sites. The Paarl site is achieving results comparable to clinical trial studies with a HIV-free survival rate of 85% at 36 weeks, while Umlazi is somewhat lower...
The technology activities carried out by the Euratom-ENEA Association in the framework of the European Fusion Development Agreement concern the Next Step (International Thermonuclear Experimental Reactor - ITER), the Long-Term Programme (breeder blanket, materials, International Fusion Materials Irradiation Facility - IFMIF), Power Plant Conceptual Studies and Socio-Economic Studies. The Underlying Technology Programme was set up to complement the fusion activities as well to develop technologies with a wider range of interest. The Technology Programme mainly involves staff from the Frascati laboratories of the Fusion Technical and Scientific Unit and from the Brasimone laboratories of the Advanced Physics Technologies Unit. Other ENEA units also provide valuable contributions to the programme. ENEA is heavily engaged in component development/testing and in design and safety activities for the European Fusion Technology Programme. Although the work documented in the following covers a large range of topics that differ considerably because they concern the development of extremely complex systems, the high level of integration and coordination ensures the capability to cover the fusion system as a whole. In 2004 the most significant testing activities concerned the ITER primary beryllium-coated first wall. In the field of high-heat-flux components, an important achievement was the qualification of the process for depositing a copper liner on carbon fibre composite (CFC) hollow tiles. This new process, pre-brazed casting (PBC), allows the hot radial pressing (HRP) joining procedure to be used also for CFC-based armour monoblock divertor components. The PBC and HRP processes are candidates for the construction of the ITER divertor. In the materials field an important milestone was the commissioning of a new facility for chemical vapour infiltration/deposition, used for optimising silicon carbide composite (SiCf/SiC) components. Eight patents were deposited during 2004
Batistoni, Paola; De Marco, Francesco; Pieroni, Leonardo (ed.)
The technology activities carried out by the Euratom-ENEA Association in the framework of the European Fusion Development Agreement concern the Next Step (International Thermonuclear Experimental Reactor - ITER), the Long-Term Programme (breeder blanket, materials, International Fusion Materials Irradiation Facility - IFMIF), Power Plant Conceptual Studies and Socio-Economic Studies. The Underlying Technology Programme was set up to complement the fusion activities as well to develop technologies with a wider range of interest. The Technology Programme mainly involves staff from the Frascati laboratories of the Fusion Technical and Scientific Unit and from the Brasimone laboratories of the Advanced Physics Technologies Unit. Other ENEA units also provide valuable contributions to the programme. ENEA is heavily engaged in component development/testing and in design and safety activities for the European Fusion Technology Programme. Although the work documented in the following covers a large range of topics that differ considerably because they concern the development of extremely complex systems, the high level of integration and coordination ensures the capability to cover the fusion system as a whole. In 2004 the most significant testing activities concerned the ITER primary beryllium-coated first wall. In the field of high-heat-flux components, an important achievement was the qualification of the process for depositing a copper liner on carbon fibre composite (CFC) hollow tiles. This new process, pre-brazed casting (PBC), allows the hot radial pressing (HRP) joining procedure to be used also for CFC-based armour monoblock divertor components. The PBC and HRP processes are candidates for the construction of the ITER divertor. In the materials field an important milestone was the commissioning of a new facility for chemical vapour infiltration/deposition, used for optimising silicon carbide composite (SiCf/SiC) components. Eight patents were deposited during 2004
de las políticas de salud pública junto con el reforzamiento de la infraestructura institucional también contribuyen a explicar la reducción en las tasas de mortalidad en menores de cinco años.Public health interventions aimed at children in Mexico have placed the country among the seven countries on track to achieve the goal of child mortality reduction by 2015. We analysed census data, mortality registries, the nominal registry of children, national nutrition surveys, and explored temporal association and biological plausibility to explain the reduction of child, infant, and neonatal mortality rates. During the past 25 years, child mortality rates declined from 64 to 23 per 1000 livebirths. A dramatic decline in diarrhoea mortality rates was recorded. Polio, diphtheria, and measles were eliminated. Nutritional status of children improved significantly for wasting, stunting, and underweight. A selection of highly cost-effective interventions bridging clinics and homes, what we called the diagonal approach, were central to this progress. Although a causal link to the reduction of child mortality was not possible to establish, we saw evidence of temporal association and biological plausibility to the high level of coverage of public health interventions, as well as significant association to the investments in women education, social protection, water, and sanitation. Leadership and continuity of public health policies, along with investments on institutions and human resources strengthening, were also among the reasons for these achievements.
Jung, Youngok; Zuniga, Stephen; Howes, Carollee; Jeon, Hyun-Joo; Parrish, Deborah; Quick, Heather; Manship, Karen; Hauser, Alison
Noting the lack of research on how early childhood education (ECE) programmes within family literacy programmes influence Latino children's early language and literacy development, this study examined key features of ECE programmes, specifically teacher-child interactions and child engagement in language and literacy activities and how these…
Fedosseev, V; Lynch, K M; Grob, L K; Herfurth, F; Scheidenberger, C; Geppert, C; Gorges, C; Ratajczyk, T; Vogel, S; Munch, M K; Nieminen, P; Pakarinen, J J A; Lecesne, N; Bouzomita, H; Grinyer, J; Marques moreno, F M; Parlog, M; Blank, B A; Pedroza, J; Ghetta, V; Guillemaud mueller, D S; Cottereau, E; Cheikh mhamed, M; Tusseau nenez, S; Tungate, G; Walker, P M; Smith, A G; Fitzpatrick, C; Dominik, W M; Karny, M; Ciemny, A A; Nyman, G H; Thies, R M A; Lindberg, S K G; Langouche, G F; Delaure, B J P; Mayet, P; Ory, G T; Kesteloot, N J K; Papuga, J; Dehairs, M H R; Callens, M; Domnanich, K A; Richter, D; Lutter, R J; Wiehr, S; Tengblad, O; Nacher gonzalez, E; Jungclaus, A; Ribeiro jimenez, G; Marroquin alonso, I; Cal gonzalez, J; Paziy, V; Salsac, M; Murphy, C; Podolyak, Z F; Bajoga, A D; Butler, P; Pritchard, A; Steer, A N; Fox, S P; Wadsworth, B A; Truesdale, V L; Al monthery, M; Hass, M; Guttormsen, M S; Badea, M N; Calinescu, S; Cederkall, J A; Zemlyanoy, S; Golovkov, M; Wu, C; Harrichunder, S; Ncube, M; Gerten, R F; Lehnert, J; Gladnishki, K A; Pospisil, S; Datta pramanik, U; Benzoni, G; Fedorov, D; Molkanov, P; Pfeiffer, B; Griesel, T; Wehner, L W; Mikkelsen, M; Recchia, F; Smith, J F; Kelly, C M; De melo bandeira tavares, P M; Vieira, J M; Martins da silva, M A; Lima lopes, A M; Mader, J; Kessler, P; Schweikhard, L C; Marx, G H; Kulczycka, E; Komorowska, M; Da silva, M F; Goncalves marques, C P; Baptista peres, M A; Welander, J E; Coeck, S; Ryssens, W A M; Knoops, G; Vanbuel, J; Reiter, P; Miller, C; Martin sanchez-cano, D; Wiens, A; Blazhev, A A; Braun, N; Cappellazzo, M V; Birkenbach, B; Gerst, R; Dannhoff, M F; Sithole, M J; Bilgier, B; Nardelli, S; Vetter, U; Araujo mendes, C M; Valencia marin, E; Pantea, E; Hessberger, F P; Leduc, A J; Mitsuoka, S; Carbonari, A W; Buchegger, F J; Garzon camacho, A; Stachura, M K; Stora, T; Marsh, B A; Thiboud, J A; Antalic, S; Stahl, C; Bauer, C; Thurauf, M; Maass, B; Sturm, S; Boehm, C; Wolf, N R; Ways, M; Riisager, K; Ruotsalainen, P A; Bastin, B; Duval, F T; Penessot, G; Flechard, X D; Desrues, P; Giovinazzo, J; Kurtukian nieto, T; Ascher, P E L; Roccia, S; Matea, I; Croizet, H A G; Bonnin, C M; Morfouace, P; Smith, A J; Guin, R; Banerjee, D; Ohtsubo, T; Zhukov, M V; Tengborn, E A; Dessagne, P; Juscamaita vivanco, Y; De rydt, M A E; Vermaelen, P; Monten, R; Yang, X; De coster, A; Kruecken, R; Muecher, D; Nowak, A K; Cano ott, D; Murphy, A S J; Shand, C M; Regan, P H; Jones, G D; Herzberg, R; Ikin, P; Davies, P J; Napoli, D R; Scarel, G; Larsen, A; Tornyi, T G; Pascu, S G; Stroe, L; Toma, S; Jansson, K; Dronjak fahlander, M; Krupko, S; Hurst, A M; Veskovic, M; Nikolov, J; Sibanda, W N; Rocchini, M; Deicher, M; Wichert, T; Wolf, E; Kronenberg, J; Helmke, A; Meliani, Z; Ivanov, V S; Kuti, I; Halasz, Z; Henry, M O; Bras de sequeira amaral, V; Espirito santo, F; Carvalho teixeira, R C; Rosendahl, S; Speidel, K; Agarwal, I; Faul, T; Kownacki, J M; Martins correia, J G; Lorenz, K; Costa miranda, S M; Granadeiro costa, A R; Keupers, M; Stukken, R; Wursten, E J; Kotthaus, T; Pfeiffer, M; Stegemann, S T; Gironi, L; Cakirli, R B; Jensen, A; Romstedt, F; Constantino silva furtado, I; Heredia cardona, J A; Jordan martin, M D; Montaner piza, A; Plewinski, F; Mesli, A; Pichard, A; Fallis starhunter, J P; Voulot, D; Mrazek, J; Ugryumov, V; Savreux, R P; Kojouharov, I M; Stegmann, R; Fitting, J; Lauer, M; Kirsebom, O S; Jensen, K L; Jokinen, A; Rahkila, P J; Hager, U D K; Dubois, M; Orr, N A; Fabian, X; Huikari, J E; Goigoux, T; Magron, C; Zakari, A A; Maietta, M; Bachelet, C E M; Roussiere, B; Li, R; Mertzimekis, T; Gislason, H P; Shayestehaminzadeh, S; Qi, B; Mukai, M; Watanabe, Y; Willmann, L; Kurcewicz, W; Wimmer, K; Meisel, Z P; Lievens, P; Neyens, G; Darby, I G; Descamps, B O; Bunka, M; Vermeulen, C; Podadera aliseda, I; Alcorta moreno, M; Pesudo fortes, V; Algora, A; Zielinska, M; Korten, W; Wang, C H; Lotay, G J; Mason, P; Rice, S J; Willenegger, L M; Judson, D S; Revill, J P; Andreev, A; Yavuzkanat, N; Kumar, V; Zamfir, N - V; Deleanu, D; Golubev, P I; Jeppesen, H B; Pain, S D; Stracener, D W; Matousek, V; Venhart, M; Birova, M; Li, X; Stuchbery, A E; Lellep, G M; Poves paredes, A; Chakraborty, S; Leoni, S; Chupp, T; Yilmaz, C; Severin, G; Garcia ramos, J E; Hadinia, B; Mc glynn, E; Monteiro de sena silvares de carvalho, I; Friedag, P; Koos, V; Meot, V H; Pauwels, D B; Jancso, A; Srebrny, J; Alves, E J; David bosne, E; Dexters, W M M; Velten, P; Kalkuehler, M; Albers, M; Bharuth-ram, K; Akkus, B; Hemmingsen, L B S; Pedersen, J T; Dos santos redondo, L M; Rubio barroso, B; Kozlov, V; Mokhles gerami, A; Bernardo da silva, E; Unzueta solozabal, I; Schell, J; Szybowicz, M; Lassen, J; Johnston, K; Miyazaki, A; Macko, M; Coquard, L; Bloch, T P; Bonig, E S; Ignatov, A
The experiments aim at a broad exploration of the properties of atomic nuclei far away from the region of beta stability. Furthermore, the unique radioactive beams of over 60~elements produced at the on-line isotope separators ISOLDE-2 and ISOLDE-3 are used in a wide programme of atomic, solid state and surface physics. Around 300 scientists are involved in the project, coming from about 70 laboratories. \\\\ \\\\ The electromagnetic isotope separators are connected on-line with their production targets in the extracted 600 MeV proton or 910~MeV Helium-3 beam of the Synchro-Cyclotron. Secondary beams of radioactive isotopes are available at the facility in intensities of 10$^1
... puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse. Most abused children suffer greater emotional than physical ...
Reviews the evidence on the prevalence of child poverty in Britain including: (1) how child poverty has changed over the last 20 years; (2) how child poverty in Britain compares with that in other countries; (3) characteristics of poor children; (4) impact of poverty on child well-being; and (5) government attempts to abolish child poverty. (SD)
Morawska, Alina; Dyah Ramadewi, Mikha; Sanders, Matthew R.
Evidence-based parent-training programmes aim to reduce child behaviour problems; however, the effects of these programmes are often limited by poor participation rates. This study proposes a model of parent, child and family factors related to parental participation in parenting interventions. A computer-assisted telephone interview was used to…
Dessy, Sylvain E.; Ste´phane Pallage
In this note, we highlight some economic effects of the existence of child trafficking. We show that the risk of child trafficking on the labor market acts as a deterrent to supply child labor, unless household survival is at stake. Better law enforcement against child trafficking, by raising the expected gains parents derive from sending their children to work, might have the undesirable effect of causing a rise in the number of child laborers and possibly in the incidence of child trafficki...
It has been claimed that there are universal goals of child-rearing, such as survival of the child or the promotion of their capacity to contribute to economic and social reproduction. Yet in certain circumstances parents appear to pursue child-rearing practices that actively harm children, threaten their survival and inhibit their ability to grow…
Human Resources Division
27 March 2001 from 2.00 p.m. to 5.30 p.m. 28 March 2001 from 2.00 p.m. to 5.30 p.m. 29 March 2001 from 2.00 p.m. to 5.30 p.m. 30 March 2001 from 2.00 p.m. to 4.45 p.m. Auditorium (Main Building) After the success of the preparation seminars held in recent years, it has been decided that the programme should continue. The forthcoming seminar has been prepared in close collaboration with the CERN Pensioners' Association. The programme will be organised over several half-day sessions. Once again this year, a special session will be devoted to the 10th revision of the Swiss state pension scheme, the 'AVS' (Assurance-Vieillesse et Survivants), and the consequences for international civil servants. A talk will be given by Mrs Danièle Siebold, Director of the Caisse Cantonale Genevoise de Compensation, aimed mainly at those residing in or intending to move to Switzerland, or who worked in Switzerland before joining CERN. To enable Mrs Siebold to respond to your concerns as effectively as possible, please ...
The technology activities carried out by the EURATOM-ENEA Association concern the continuation of the European Fusion Development Agreement (EFDA) as well as the ITER activities coordinated by the ITER International Office and Fusion for Energy. Also included in the activities are design and RD under the Broader Approach Agreement between the EU and Japan. In order to better contribute to the programme a number of consortium agreements among the Associations are being signed. Collaboration with industries in view of their participation in the construction of ITER was further strengthened, mainly in the field of magnet and divertor components. The new European Test Blanket Facility at ENEA Brasimone was completed; the design of the ITER radial neutron camera was optimised and the performance achievable with the in-vessel viewing system was further assessed by experimental trials. Design activities for the JT-60SA magnet and power supply system as well as the design and experimental activities related to the target of the International Fusion Materials Irradiation Facility were continued. Significant work was done to define quality assurance for neutronics analyses. Mockups of the ITER pre-compression ring made in glass fibre epoxy were tested. The activities and results documented in the following illustrate ENEA's efforts to support fusion development
Jérôme Ballet; Augendra BHUKUTH; Felana Rakotonirinjanahary; Miantra Rakotonirinjanahary
Child beggars form a specific category of child workers. They are generally associated with street-living children, as defined by UNICEF. Analysis of begging thus generally focuses on children?s survival strategies. Using data from an exploratory survey conducted in Antananarivo in autumn 2009, this research paper shows that in the Madagascan capital, the vast majority of child beggars are in fact exploited by their family and do not live on the streets. It proposes a typology of child beggar...
The paper makes an analysis of the situation of child labour in India-focuses on the causes of child labour and also outlines the remedial measures so far taken-exhaustively discusses the trend report of different laws enacted in the country-finally briefly concludes that immediate implementation of anti-poverty programmes in the country is highly necessary to eradicate child labour.
This paper investigates whether the income from child wage work is necessary to the survival of rural households in Pakistan. It is by no means obvious that it is. For instance, children may work because the returns to work exceed the returns to school, or because parents are selfish or short-sighted. It is argued here that, if child work is necessary, then the income effect of a wage change will dominate the substitution effect and the labour supply curve will be "forward falling" or negativ...
Peace Corps, Washington, DC. Information Collection and Exchange Div.
This publication is designed for use by managers of community-based nutrition programs. The training modules included in this manual were produced and field-tested by the Centre for Development and Population Activities (CEDPA) as a special project providing focused technical assistance and project support to CEDPA training graduates. CEDPA…
O'Connor, Peter; O'Connor, Briar; Welsh-Morris, Marlane
This article examines a national applied theatre programme coordinated through the Department of Child, Youth and Family in New Zealand. The programme uses dramatic processes to create opportunities for communities to discuss and find their own answers to the issues of child abuse and family violence. The programme utilises a sophisticated in-role…
Ahmed, Zoya; Kamal, Asifa; Kamal, Asma
Child mortality is a composite indicator reflecting economic, social, environmental, healthcare services, and their delivery situation in a country. Globally, Pakistan has the third highest burden of fetal, maternal, and child mortality. Factors affecting child mortality in Pakistan are investigated by using Binary Logistic Regression Analysis. Region, education of mother, birth order, preceding birth interval (the period between the previous child birth and the index child birth), size of child at birth, and breastfeeding and family size were found to be significantly important with child mortality in Pakistan. Child mortality decreased as level of mother's education, preceding birth interval, size of child at birth, and family size increased. Child mortality was found to be significantly higher in Balochistan as compared to other regions. Child mortality was low for low birth orders. Child survival was significantly higher for children who were breastfed as compared to those who were not. PMID:27354000
... his or her health status, when diagnosed with cancer may have an effect on their survival and recovery. Older adults are more likely to have other health conditions such as diabetes and heart disease. Managing these conditions can complicate ...
Bradshaw, J. (Jonathan)
Child support is a private transfer, which for many people is mediated by the government, and which mainly benefits lone parents. Children in lone parent families represented 42 per cent of all poor children in 2003/4. Therefore child support might play an important part in reducing child poverty. Although this was not an aspiration of the 1991 Child Support Act it was certainly the main aspiration of the Child Support, Pensions and Social Security Act 2000. This paper is a review of the pote...
The Paper gives the purpose of Ghana's Nuclear Programme and describes some specific research activities and peaceful applications of atomic energy in agriculture, medicine and industry. A discussion of some of the problem facing the programme concludes the Paper. (author)
@@ The Olympic Partner Programme (TOP) is an international Olympic marketing programme created by the International Olympic Committee (IOC),which includes the Organising Committees of the Games,the National Olympic Committees and the TOP Partners.
van Wassenaer-Leemhuis, Aleid G; Jeukens-Visser, Martine; van Hus, Janeline W P; Meijssen, Dominique; Wolf, Marie-Jeanne; Kok, Joke H; Nollet, Frans; Koldewijn, Karen
Post-discharge preventive intervention programmes with involvement of the parent may support the resilience and developmental outcomes of infants born very preterm. Randomized controlled trials of home-based family-centred intervention programmes in very preterm infants that aimed to improve cognitive outcome, at least at age two, were selected and updated on the basis of a recent systematic review to compare their content and effect over time to form the basis of a narrative review. Six programmes were included in this narrative review. Four of the six programmes led to improved child cognitive and/or motor development. Two programmes, which focused primarily on responsive parenting and development, demonstrated improved cognitive outcome up till 5 years after completion of the programme. The programmes that also focused on maternal anxiety remediation led to improved maternal mental well-being, along with improved child behaviour, in one study - even at 3 years after completion of the programme. The magnitude of the effects was modest. Family-centred preventive intervention programmes that aim at improvement of child development should be continued after discharge home to improve the preterm child's resilience. Programmes may be most effective when they support the evolvement of a responsive parent-infant relationship over time, as well as the parent's well-being. PMID:27027610
The programme, which is written in the Fortran language, solves the Carlson discrete Sn approximation to the Boltzmann transport equation in cylindrical geometry. This report describes the input and output facilities of the WINFRITH DSN programme and the associated editing programme WED. (author)
Congenital hypothyroidism is a condition that, if left untreated, can cause lifelong human suffering as a result of severe mental retardation and deficiency of growth. With the involvement of the IAEA, screening programmes to detect congenital hypothyroidism in newborn infants have been introduced successfully in a large number of countries. The cornerstone of these programmes is accurate and reliable screening methods involving isotope techniques and simple medical treatment. The suffering - and heavy social and economic burden - caused by congenital hypothyroidism prompted many countries to institute a formalized screening programme directed at newborns, just as a vaccination programme has become an integral part of child health care. In many other countries however, this type of formalized service has not yet been established. For these countries, the implementation of a neonatal screening programme will bring about a considerable improvement in child health care. It is hoped that the guidance in this publication will be especially useful to the signatories of the United Nations Convention on the Rights of the Child. Several factors that prevail in a country - the climate, political environment, economic development, level of health care and the transportation system - have an influence on the overall operational systems, design and implementation of a screening programme. As such, the design of such a programme will differ greatly from country to country. Nevertheless, neonatal screening programmes have many elements in common. This book draws on the IAEA's experience in this area over more than a decade, and on the results of a regional technical cooperation programme on neonatal screening for congenital hypothyroidism in East Asia (IAEA Project RAS6032). This publication provides guidance aimed specifically at implementing and sustaining programmes for the screening of newborn infants
Miller, Rupert G
A concise summary of the statistical methods used in the analysis of survival data with censoring. Emphasizes recently developed nonparametric techniques. Outlines methods in detail and illustrates them with actual data. Discusses the theory behind each method. Includes numerous worked problems and numerical exercises.
This article presents the continued effects of a home-based intervention programme on child development outcomes and parenting practices in Bahrain. The intervention is the "Mother-Child Home Education Programme" (MOCEP) which was implemented in Arabic in the Kingdom of Bahrain beginning in 2001. One hundred and sixty-seven poor, disadvantaged…
Lim, Cynthia; Lim, Sirene May-Yin
While there has been extensive research exploring the quality of caregiver-child interactions in programmes for preschool children, comparatively less international research has explored the nature of caregiver-child interactions in centre-based infant-care programmes. Nine caregivers in six Singapore infant-care settings were observed and…
Cryopreservation and distribution of radiation-attenuated helminth larvae and the use of radioisotopes to monitor their survival. Coordinated programme on preparation of irradiated vaccines against some human diseases
Techniques for the cryopreservation of schistosomula are described, from the methanol/two-step cooling technique, through a technique which uses 40% methanol and rapid cooling to the current technique which employs a two-step addition of ethanediol and rapid cooling. Levels of survival with these techniques have improved from 0.3% to 5.9% and now to 47% of control values. The 40% methanol/rapid cooling technique is described in detail as this forms the basis for understanding the role of cryoprotective additives and cooling and warming rates in the cryopreservation of schistosomula. The toxicity of 12 different potentially cryoprotective compounds is described. Cryopreservation of S.japonicum and S.bovis is described. The effect of the age of the schistosomula and their cryopreservability is related to the development of water sensitivity and the permeation and damage produced by glycerol and it is postulated that morphological changes occurring in the tegument during transformation from a cercaria to schistosomulum may account for these observations. Studies with 14C-ethanediol are described which attempt to provide an understanding of permeability of cryoprtectants to schistosomula of different ages and at different temperatures. Vaccination studies with cryopreserved and radiation-attenuated schistosomula are also reported. Radiation-attenuated schistosomula are also reported. Radiation-attenuated cercariae and schistosomula produced high (64% to 89%) levels of protection in baboons, and cryopreserved schistosomula produced comparable levels of protection in vaccinated mice to normal schistosomula. Cryopreserved radiation-attenuated schistosomula produced a significant level of protection (49% reduction) in sheep although the numbers of normally motile organisms injected was low (1,000 per dose, 2 doses). It is concluded that normally-motile cryopreserved radiation-attenuated schistosomula are as immunogenic as fresh organisms
Mekonnen, Alemu; Tefera, Bekele; Woldehanna, Tassew; Jones, Nicola; Seager, John; Alemu, Tekie; Asgedom, Getachew
Ethiopia is one the world’s poorest countries with one of the highest rates of child malnutrition. The poor nutritional status of Ethiopian children is well documented, but the causes and relative importance of various determinants of malnutrition are not well understood. Ethiopia thus lacks an integrated cross-sectoral policy to guide nutrition programmes and interventions. While the literature on child malnutrition suggests gender- and location-related differences in malnutrition rates, thi...
The applicability of Webster-Stratton Parenting Programmes to deaf children with emotional and behavioural problems, and autism, and their families: annotation and case report of a child with autistic spectrum disorder.
Garcia, Ruth; Turk, Jeremy
This article describes a pilot project whose objective was to explore whether the Webster-Stratton Parenting Programme may be effective for hearing parents and their deaf children who present with conduct disorders and other emotional, behavioural and developmental problems. Outcome measures aimed at overall impact in decreasing behavioural problems and improving overall family function were used. Participants were hearing parents of deaf children referred to our specialist service whose assessment had recommended a parenting skills group as treatment of choice. The children had been diagnosed with behavioural problems with or without additional comorbidity. This pilot phase focused deliberately on one participant, in order to explore whether the approach justified further, more comprehensive evaluative research. Outcome was positive, suggesting that modified Webster-Stratton approaches may well be of use in deaf children of hearing parents. PMID:17375814
Bjarnason Skifte, Turid
Objectives: New vaccines in the child healthcare programme are regularly considered. When considering the introduction of the Hepatitis-B vaccine into the programme, it was asked to what extent children in Greenland were actually covered by the existing immunization series. Would introducing new vaccines make any sense if the percentage of children immunized was shown to be low? A telephone enquiry conducted in 2000 showed a tendency of very high percentage of full coverage per child (98-99 %...
Denne note er en introduktion til programmering. Formålet er at give dig et indblik i hvad programmering egentlig er for noget. Jeg vil vise at programmering kan foregå på forskellige måder, og at der er mange forskellige udfordringer forbundet med at programmere. Noten vil ikke knytte sig til et...... bestemt programmeringssprog. Noten vil kunne supplere et egentlig undervisningsmateriale, der støtter dig i en bestemt form for programmering i et udvalgt programmeringssprog....
Asplund, D. [VTT Energy, Jyvaeskylae (Finland)
Finland is a leading country in the use of biofuels and has excellent opportunities to increase the use of biofuels by up to 25-30 %. The Finnish Government has set an objective for the promotion of bioenergy. The aim is to increase the use of bioenergy by about 25 % from the present level by 2005, and the increment corresponds to 1.5 million tonnes of oil equivalent (toe) per year. The R and D work has been considered as an important factor to achieve this ambitious goal. Energy research was organised into a series of research programmes in 1988 in accordance with the proposal of Finnish Energy Research Committee. The object of the research programmes is to enhance research activities and to bundle individual projects together into larger research packages. The common target of the Finnish energy research programmes is to proceed from basic and applied research to product development and pilot operation, and after that to the first commercial applications, e.g. demonstrations. As the organisation of energy research to programmes has led to good results, the Finnish Ministry of Trade and Industry decided to go on with this practice by launching new six-year programmes in 1993-1998. One of these programmes is the Bioenergy Research Programme and the co-ordination of this programme is carried out by VTT Energy. Besides VTT Energy the Finnish Forest Research Institute, Work Efficiency Institute, Metsaeteho and University of Joensuu are participating in the programme 7 refs.
Hagen Anne; Tretli Steinar; Mæhle Lovise; Apold Jaran; Vedå Nina; Møller Pål
Abstract Several studies of survival in women with BRCA1 mutations have shown either reduced survival or no difference compared to controls. Programmes for early detection and treatment of inherited breast cancer, have failed to demonstrate a significant improvement in survival in BRCA1 mutation carriers. One hundred and sixty-seven women with disease-associated germline BRCA1 mutations and breast cancer from 1980 to 2001 were identified. Tumour characteristics, treatment given and survival w...
The weak economy is challenging the child care program budget. Fluctuations in enrollment come up against rising costs making every penny count. So for many reasons a federal program that helps defray the costs of snacks and meals in child care programs is particularly important and timely. In this article, the author pushes for the…
Brownlee, J.; Boulton-Lewis, G.; Berthelsen, D.
Background: The quality of child care is of social and economic significance worldwide. The beliefs that child care workers hold about knowing and knowledge (epistemological beliefs) influence the quality of their professional work. However, attention to epistemological beliefs is rarely a focus in vocational education programmes. Aim: The aim of…
Benjamin H Chi
Full Text Available Objective To evaluate if a pilot programme to prevent mother-to-child transmission (PMTCT of the human immunodeficiency virus (HIV was associated with changes in early childhood survival at the population level in rural Zambia. Methods Combination antiretroviral regimens were offered to pregnant and breastfeeding, HIV-infected women, irrespective of immunological status, at four rural health facilities. Twenty-four-month HIV-free survival among children born to HIV-infected mothers was determined before and after PMTCT programme implementation using community surveys. Households were randomly selected and women who had given birth in the previous 24 months were asked to participate. Mothers were tested for HIV antibodies and children born to HIV-infected mothers were tested for viral deoxyribonucleic acid. Multivariable models were used to determine factors associated with child HIV infection or death. Findings In the first survey (2008–2009, 335 of 1778 women (18.8% tested positive for HIV. In the second (2011, 390 of 2386 (16.3% tested positive. The 24-month HIV-free survival in HIV-exposed children was 0.66 (95% confidence interval, CI: 0.63–0.76 in the first survey and 0.89 (95% CI: 0.83–0.94 in the second. Combination antiretroviral regimen use was associated with a lower risk of HIV infection or death in children (adjusted hazard ratio: 0.33, 95% CI: 0.15–0.73. Maternal knowledge of HIV status, use of HIV tests and use of combination regimens during pregnancy increased between the surveys. Conclusion The PMTCT programme was associated with an increased HIV-free survival in children born to HIV-infected mothers. Maternal utilization of HIV testing and treatment in the community also increased.
CERN audiovisual service
The SET-Routes programme, launched in 2007 with the goal of attracting girls and young women to careers in science, came to an end in April this year. The result of a collaboration between EMBL, EMBO and CERN, the programme established a network of "ambassadors", women scientists who went out to talk about their careers in science at schools and universities across Europe.
Liebovich, Betty J.; Matoba Adler, Susan
Teacher education programmes in the United States and in England with early childhood certification usually include courses with topics such as early childhood theory and curriculum, child development, model programs, and history of early childhood education but less often include courses with content focused specifically on advocacy. This article…
Marsh, Lesley J.
This article discusses the potential benefits of the Massage in Schools Programme (MISP), a programme originating in Scandinavia, which has been introduced into schools in the United Kingdom (UK) since 2001. Meeting four out of five outcomes of the Every Child Matters agenda, the review of the literature aims to separate anecdotal and media…
Vijaykumar R. Londhe; B. Yuvakumar Reddy
Worldwide, more than 200 million children aged under five do not reach their full developmental potential due to the absence of early childhood care programmes. Education is the mainstay of a development of a human being. Childhood education lays foundation of the child leading to awareness of child rights and empowerment. The awareness about child rights is even more necessary in lieu of various crimes being committed against children. Qualitative school education should not m...
Matsaganis, Manos; O’Donoghue, Cathal; Levy, Horacio; Coromaldi, Manuela; Mercader-Prats, Magda; Rodrigues, Carlos Farinha; Toso, Stefano; Tsakloglou, Panos
The drive to reduce child poverty is of particular interest in southern Europe, where the subsidiary role of the State in matters of family policy has implied that programmes of public assistance to poor families with children are often meagre or not available at all. The paper examines the effect of family transfers (used broadly to include contributory family allowances, non-contributory child benefits and tax credits or allowances) on child poverty in Greece, Italy, Spain and Portugal. Usi...
KfK participates to the Fusion Technology Programme of the European Community. Most of the work in progress addresses the Next European Torus (NET) and the long term technology aspects as defined in the 82/86 programme. A minor part serves to preparation of future contributions and to design studies on fusion concepts in a wider perspective. The Fusion Technology Programme of Euratom covers mainly aspects of nuclear engineering. Plasma engineering, heating, refueling and vacuum technology are at present part of the Physics Programme. In view of NET, integration of the different areas of work will be mandatory. KfK is therefore prepared to address technical aspects beyond the actual scope of the physics experiments. The technology tasks are reported project wise under title and code of the Euratom programme. Most of the projects described here are shared with other European fusion laboratories as indicated in the table annexed to this report. (orig./GG)
... of their parents' rules and of their own self-control. Sometimes, however, these conflicts are more than occasional ... a timeout until he calms down and regains self-control. When your child is obedient and respectful, compliment ...
Ottova, Veronika; Alexander, Denise; Rigby, Michael; Staines, Anthony; Hjern, Anders; Leonardi, Matilde; Blair, Mitch; Tamburlini, Giorgio; Gaspar de Matos, Margarida; Bourek, Ales; Köhler, Lennart; Gunnlaugsson, Geir; Tomé, Gina; Ramiro, Lucia; Santos, Teresa
RICHE was the response to a call under HEALTH-2009-3.3-5, with the title of 'European child health research platform'. The call text asked us to “address the diversity and fragmentation in child health research in Europe in an inclusive multidisciplinary way, identifying existing research programmes in Member States, recent advances and identification of gaps to explore road maps for the future of child health research in Europe”. Project structure A consortium, with a final total of 23...
The European Fusion Programme is coordinated by Euratom and represents a long term cooperative project of Member States of the European Communities in the field of fusion, designed to lead to the joint construction of prototypes. The main lines of the programme proposed for 1982 to 1986 are: (1) the continuation of a strong effort on tokamaks with emphasis on JET construction, operation and upgrading, (2) conceptual design of NET and development of the related technology, and (3) further work on two alternative magnetic confinement systems. The current status and future plans for this programme are discussed in the paper. (author)
Maximising engagement, motivation and long term change in a Structured Intensive Education Programme in Diabetes for children, young people and their families: Child and Adolescent Structured Competencies Approach to Diabetes Education (CASCADE
Full Text Available Abstract Background This trial aims to evaluate effective delivery and cost effectiveness of an innovative structured psycho-educational programme (CASCADE for young people and their families living with diabetes. The increase in numbers of people being diagnosed with diabetes is posing a challenge for both the UK and the rest of the world. The peak age for diagnosis is between 10 and 14 years of age. There is clear evidence that improved diabetes control from diagnosis in childhood can reduce the incidence and progression of long-term complications. However, despite the development of improved insulin regimens and delivery methods, the overall metabolic control in children and adolescents has improved little in the UK in the past decade. Therefore there is a need for novel interventions and health delivery mechanisms aimed at young people and their families to help improve control and reduce complications, illness burden and costs to the NHS. Methods/Design The CASCADE trial is a multi-centre randomised control trial with 26 clinics randomised to control or intervention groups, with 572 children and young people involved in the study. The intervention will be delivered in 4 group sessions, over a 4 month period. A developmentally appropriate curriculum will be delivered to groups of 3 - 4 families, focusing on achievement of increasing competency in self-management of diabetes. The control group will receive standard care from their clinical team, usually consisting of regular 3-monthly clinic visits and telephone contact as required with the clinical nurse specialist and consultant. The primary outcomes of the trial will be change in HbA1c between baseline and 12 months and 24 months post recruitment. Secondary outcomes will include measures related to the economic evaluation, psychosocial outcomes, outcomes related to management of diabetes outcomes, and adherence to the intervention. Discussion The trial will be run by independent research
Musafili, Aimable; Essén, Birgitta; Baribwira, Cyprien; Binagwaho, Agnes; Persson, Lars-Åke; Selling, Katarina Ekholm
Background Rwanda has embarked on ambitious programmes to provide equitable health services and reduce mortality in childhood. Evidence from other countries indicates that advances in child survival often have come at the expense of increasing inequity. Our aims were to analyse trends and social differentials in mortality before the age of 5 years in Rwanda from 1990 to 2010. Methods We performed secondary analyses of data from three Demographic and Health Surveys conducted in 2000, 2005 and 2010 in Rwanda. These surveys included 34 790 children born between 1990 and 2010 to women aged 15–49 years. The main outcome measures were neonatal mortality rates (NMR) and under-5 mortality rates (U5MR) over time, and in relation to mother's educational level, urban or rural residence and household wealth. Generalised linear mixed effects models and a mixed effects Cox model (frailty model) were used, with adjustments for confounders and cluster sampling method. Results Mortality rates in Rwanda peaked in 1994 at the time of the genocide (NMR 60/1000 live births, 95% CI 51 to 65; U5MR 238/1000 live births, 95% CI 226 to 251). The 1990s and the first half of the 2000s were characterised by a marked rural/urban divide and inequity in child survival between maternal groups with different levels of education. Towards the end of the study period (2005–2010) NMR had been reduced to 26/1000 (95% CI 23 to 29) and U5MR to 65/1000 (95% CI 61 to 70), with little or no difference between urban and rural areas, and household wealth groups, while children of women with no education still had significantly higher U5MR. Conclusions Recent reductions in child mortality in Rwanda have concurred with improved social equity in child survival. Current challenges include the prevention of newborn deaths. PMID:25870163
Colle, Didier; Jooris, Bart; Gurzi, Pasquale; Pickavet, Mario; Demeester, Piet
We present network virtualization (building virtual or logical networks over a physical infrastructure) and network programmability (allowing the network operator to at least control the network but more fundamentally to define its behavior) concepts.
Erasmus+ programm liidab senised koostööprogrammid „Euroopa elukestva õppe programm“, „Euroopa Noored“ ning Euroopa komisjoni rahvusvahelised kõrgharidusprogrammid. Elukestva õppe programmi 2013 kokkuvõte
The present document reviews the CERN Fellows, Associates and Students Programmes emphasizing the developments since 2000, when the previous review was presented to the Scientific Policy Committee, Finance Committee and Council (CERN/2325), and makes proposals for the coming five years. In summary, it is proposed to â?¢ Simplify the payment scheme for the Paid Scientific Associates Programme, which will no longer depend on candidateâ??s home support and age; â?¢ Broaden the scope of the Fellowship Programme, in order to facilitate the recruitment of young graduates in computing and engineering. Age-related eligibility conditions and payment levels will be replaced with experience-based criteria; â?¢ Modify subsistence rates for the Doctoral and Technical Student Programme in order to harmonize CERNâ??s payment levels with those offered by other research establishments. This document is presented for discussion and recommendation by the Scientific Policy Committee and approval by the Council. Additiona...
The 3rd edition of this year's Greek Teachers Programme was co-organized by CERN Education Group and the Hellenic Physical Society and took place from 8 to 12 November 2015. The programme targets physics high-school teachers from all over Greece. It aims to help teachers inspire the next generation of scientists and engineers by motivating their students to understand and appreciate how science works at the world's largest physics laboratory, whereby increasing their interest in pursuing studies in STEM fields in secondary and post-secondary education. 33 teachers took part in this programme which comprised lectures by Greek members of the CERN scientific community, with visits to experimental facilities, hands-on activities and dedicated sessions on effective and creative ways through which participants may bring physics, particle physics and CERN closer to their school classroom. In 2015, more than 100 teachers took part in the three editions of the Greek Teachers Programme.
Neumann, Tim; Rasmussen, Mette; Ghith, Nermin;
To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates.......To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates....
George Korir; Manu Prakash
Small volume fluid handling in single and multiphase microfluidics provides a promising strategy for efficient bio-chemical assays, low-cost point-of-care diagnostics and new approaches to scientific discoveries. However multiple barriers exist towards low-cost field deployment of programmable microfluidics. Incorporating multiple pumps, mixers and discrete valve based control of nanoliter fluids and droplets in an integrated, programmable manner without additional required external component...
... call the police . Crisis and support contacts For Child Abuse Reporting Numbers in your State please visit: Child ... suspected child abuse and neglect. Parent Resources Prevent Child Abuse America (800) CHILDREN A resource for tips, referrals, ...
In recent years, there has been an astonishing proliferation of empirical work on child labor. An Econlit search of keywords "child lab*r" reveals a total of 6 peer reviewed journal articles between 1980 and 1990, 65 between 1990 and 2000, and 143 in the first five years of the present decade. The purpose of this essay is to provide a detailed overview of the state of the recent empirical literature on why and how children work as well as the consequences of that work. Section 1 defines terms...
Child abuse is common in most, if not all, Western nations; it probably occurs worldwide. It may be a major factor in the increase in violence throughout much of the world. Radiologists who treat children should think of the possibilitys of abuse whenever they diagnose a fracture, intracranial bleed, ar visceral injury, especially when the history is not compatible with their findings. Metaphyseal 'corner' fractures in infants usually are caused by abuse. Less than 20% of abused children, however, present injuries that can be recognized by radiologic techniques. Consequently normal roentgenograms, nuclear medicine scans, ultrasound studies, and computed tomograms do not exclude child abuse. (orig.)
Human Resources Division
HR Division wishes to clarify to members of the personnel that the allowance for a dependent child continues to be paid during all training courses ('stages'), apprenticeships, 'contrats de qualification', sandwich courses or other courses of similar nature. Any payment received for these training courses, including apprenticeships, is however deducted from the amount reimbursable as school fees. HR Division would also like to draw the attention of members of the personnel to the fact that any contract of employment will lead to the suppression of the child allowance and of the right to reimbursement of school fees.
Gyampoh, Sandra; Otoo, Gloria Ethel; Aryeetey, Richmond Nii Okai
Background Child undernutrition and poor feeding practices remain a concern in Ghana. The Growth Monitoring and Promotion (GMP) programme seeks to empower mothers to provide appropriate child care. Although the program has been implemented in Ghana for over four decades, little is known about its impact on child feeding outcomes. The current study assessed the association between GMP exposure and mothers' child feeding knowledge and practices in the Accra Metropolitan Area (AMA), Ghana. Metho...
Rasheda Khanam; Mohammad Mafizur Rahman
This paper examines the role of education, poverty and birth order with regard to child labour in developing countries. The higher the cost of education is, compared to benefit, the higher is the likelihood of a child being sent to work. Poor school facilities and poor quality of education ensure higher incidence of child labour. However, easy access to credit market, income transfer programmes to households and law of compulsory schooling affect child labour negatively. The link between pove...
Studies related to nuclear reactors and radioactive waste started at the French National Centre for Scientific research, CNRS, as a result of the French law on radioactive waste that was published in 1991. They were initially organized around the programme PACE (Physique pour l’Aval du Cycle Electronucléaire = physics of the back end of the nuclear fuel cycle), which became PACEN (Physique pour l’Aval du Cycle et production d’Energie Nucléaire = Physics of the back end of the nuclear fuel cycle and production of nuclear energy) in 2006. Research on accelerator driven systems was from the beginning part of this programme. This research is mainly funded by the National Institute for Nuclear end Particle Physics (IN2P3) of CNRS and within the EURATOM European programmes (FP5, 6 and 7). The programme took place in several stages, and covered various scientific fields, benefitting from expertise of CNRS in the field. More specifically, it aimed and still aims to: – Test and verify the feasibility and design of the ADS concept, in terms of neutronics, physics of materials, design of the accelerator and tests of its prototypical components that have been built (or are at present under construction); – Measure and-or improve nuclear data related to radioactive waste transmutation. Today, most of the activities in support to ADS development carried out by CNRS focus on accelerator developments, GUINEVERE (Generator of Uninterrupted Intense NEutron at the lead VEnus REactor) experiment, ADS core studies, deployment scenarios and nuclear data measurements. The CEA R&D programmes on ADS are mainly focused on the European project EUROTRANS of the 6th Framework programme (2005–2010) and continued in the FREYA project of the 7th Framework Programme
Sharma, A; Gupta, S
In 1924, the League of Nations adopted the 1st international law recognizing that children have inalienable rights and are not the property of their father. The UN Declaration on the Rights of the Child emerged in 1959. 1979 was the International Year of the Child. In 1990 there was the World Summit on Children and the UN General Assembly adopted the Global Convention on the Rights of the Child. The convention included civil, economic, social, cultural, and political rights of children all of which covered survival, development, protection, and participation. At the end of 1990, 60 countries had ratified the convention, thus including it into their national legislation. Even though India had not yet endorsed the Convention by the end of 1991, it expressed its support during the 1st workshop on the Rights of the Child which focused on girls. India has a history of supporting children as evidenced by 250 central and state laws on their welfare such as child labor and child marriage laws. In 1974, India adopted the National Policy for Children followed by the establishment of the National Children's Board in 1975. The Board's activities resulted in the Integrated Child Development Services Program which continues to include nutrition, immunization, health care, preschool education, maternal education, family planning, and referral services. Despite these laws and actions, however, the Indian government has not been able to improve the status of children. For example, between 1947-88, infant mortality fell only from 100/1000 to 93/1000 live births and child mortality remained high at 33.3 in 1988 compared with 51.9 in 1971. Population growth poses the biggest problem to improving their welfare. Poverty also exacerbates their already low status. PMID:12317284
The global population growth rate has been 1.7% since 1975, while for developing countries it is 2.1%. UN projections are for population to grow from 5.5 billion in 1992 to 10 billion by 2050. Sustainable development is only possible when population growth is balanced with available resources. UN medium population projections of 7.8 billion by 2050 can be reached with 187 million more couples practicing family planning (FP) by the year 2000. Within the past 20 years, 1 billion people, mostly from developed countries, have enjoyed economic growth, but have contributed polluting technologies, excessive waste, and environmentally dangerous economic practices. The generations to come will be affected by the continuance of these practices by the 1 billion affluent population. The bottom billion are mired in poverty and high population growth and survival, needs that hinder their country's economic development, upset fragile ecosystems, and destroy the balance between human beings and the environment. International migration on a large scale could be the by-product of population growth. Progress has been made since the 1974 UN Conference on Population in Bucharest. There are still, however, vulnerable populations, the poorest households, the landless and small-holder families, urban squatters and slum dwellers, those living in low lying deltas and along coasts, and women. Women control family resources and their micro environment. Sustainable development is not possible without the elimination of prejudice against women. Reproductive freedom for women must be a priority. High quality, readily available FP services are also needed for those desiring this. The difficulty is in providing FP services that conform to a woman's social and cultural background and personal needs; success is dependent on involving women in the process and holding men more responsible for FP. Development means allowing for the legitimate aspirations of the majority not just the specialized
Sharmila Kurukulasuriya; Solrun Engilbertsdottir
There is a growing consensus that children experience poverty in ways that are different from adults; and looking at child poverty through an income-consumption lens only is inadequate. The 2005 State of the World’s Children presented the following definition of child poverty: “Children living in poverty experience deprivation of the material, spiritual and emotional resources needed to survive, develop and thrive, leaving them unable to enjoy their rights, achieve their full potential or par...
Human trafficking is the third biggest beneficial industry on the planet. Child trafficking unlike many other issues is found in both developed and developing nations. NGOs evaluate that 12,000 - 50,000 ladies and kids are trafficked into the nation every year from neighboring states for the sex exchange.
Humlum, Maria Knoth
I investigate the effects of the timing of family income on child achievement production. Detailed administrative data augmented with Programme for International Student Assessment test scores at age 15 are used to analyze the effects of the timing of family income on child achievement. Contrary to...... many earlier studies, the results suggest that the timing of income does not matter for long-term child outcomes. This is a reasonable result given the setting in a Scandinavian welfare state with generous child and education subsidies. Actually, later family income (age 12–15) is a more important...
The German R&D programme for ADS development is related to the partitioning and transmutation of spent fuel. This programme is implemented mainly by the three national research centres belonging to the Helmholtz Association, i.e. Karlsruhe Institute of Technology (KIT), Forschungszentrum Jülich (FZJ) in cooperation with the Technical University of Aachen (RWTH Aachen) and the Helmholtz Zentrum Dresden Rossendorf (HZDR). The main purpose of this R&D programme is the prospect to manage the high level radioactive waste such as to reduce the burden on a final repository. P&T does not eliminate the need for a final repository whatever the strategy, but it allows the reduction of the radio-toxicity associated with radioactive waste, the increase of the repository capacity as a consequence of the reduction of masses to be stored and their associated residual heat load. Different fuel cycle scenarios to implement P&T can be envisaged. These scenarios have been evaluated to identify the impact of P&T on the characteristics, number and deployment pace of the installations of the fuel cycle (reprocessing, fuel fabrication, storage etc). Almost all activities conducted in the R&D programme are embedded in European and international projects and initiatives. In the following more details on the relevant components of the R&D programme are summarized
Nolas, Sevasti-Melissa; Neville, Lucy; Sanders-McDonagh, Erin
The report presents findings from the evaluation of the Community Group Programme (CGP). The CGP is a 12-week psycho-educational, group work programme for children and young people who have experienced domestic violence. The Programme was developed in Canada and is being rolled out in England for the first time across 32 London boroughs. The programme is unique in working with children and their mothers concurrently and in a child-focused way. The study takes a theory-driven approach to evalu...
After nearly twenty years since it was first launched, the Brazilian Ethanol Programme to data remains the largest commercial application of biomass for energy production and use in the world. It succeeded in demonstrating the technical feasibility of large scale ethanol production from sugar cane and its use to fuel car engines. On social and economic grounds, however, its evaluation is less positive. The purpose of this study is to provide an updated overview of the perspectives for the Ethanol Programme under the light of increasingly important local and global environmental concerns. Major results show that after oil prices supported upon the basis of its contribution to curb the increase of air pollution in Brazilian cities and of the greenhouse effect. It is concluded that the very survival of the Ethanol Programme, depends upon adequate economic compensation considering its global environmental benefits. These are appraised with two scenarios based on the use of a Markal-like model to define the range and costs of curbing greenhouse gases with a policy aiming at extending the Ethanol Programme
Small volume fluid handling in single and multiphase microfluidics provides a promising strategy for efficient bio-chemical assays, low-cost point-of-care diagnostics and new approaches to scientific discoveries. However multiple barriers exist towards low-cost field deployment of programmable microfluidics. Incorporating multiple pumps, mixers and discrete valve based control of nanoliter fluids and droplets in an integrated, programmable manner without additional required external components has remained elusive. Combining the idea of punch card programming with arbitrary fluid control, here we describe a self-contained, hand-crank powered, multiplex and robust programmable microfluidic platform. A paper tape encodes information as a series of punched holes. A mechanical reader/actuator reads these paper tapes and correspondingly executes a series of operations onto a microfluidic chip coupled to the platform in a plug-and-play fashion. Enabled by the complexity of codes that can be represented by a series ...
Every year, a significant number of highly-skilled staff members leave the Organization and offer their talents on the European job market. CERN is launching a programme aiming to help staff members to whom the Organization cannot offer an indefinite contract in the transition towards their next employment. The programme, which is based on the establishment of a number of partnerships with potential employers in the private sector, will run on a voluntary basis. Staff members who have received confirmation that they will not be offered an indefinite contract and who are interested in availing themselves of the opportunities offered by the programme, are invited to enrol by following the procedure described at: https://ert.cern.ch/browse_intranet/wd_pds?p_web_page_id=5841 Applications will be processed in the strictest confidence by the Human Resources Department and eligible profiles will then be made available to partner companies for recruitment purposes. Any subsequent ...
EDF has long been interested in the use of nuclear energy for thermal power generation. After a period of apprenticeship and experiments, EDF launched a major PWR plant programme so as to reduce France's energy dependence and master generation costs. This programme, based on standardization, has achieved the desired results. It must now be adapted to suit the needs of the 21st century. For this programme, all those involved (Governmental authorities, EDF, manufacturers) were mobilized to an unprecedented extent and rigorous working methods were imposed. Experience feedback has been used to make improvements both to the installations themselves and to procedures. Results have proved satisfactory as regards nuclear safety but vigilance must be maintained. Public opinion on nuclear power is reserved we are sentenced to achieving a 'fault-free' track record, all the while mastering costs, so as to ensure the continuing use of nuclear energy. (author)
Trenden inom systemutveckling och programutveckling går mot ett mer användande av multi programmeringsparadigmer. Funktionell programmering har fått mer uppmärksamhet på senare tid och utvecklingen tycks över lag gå än mer åt det deklarativa hållet där programmeraren fokuserar mer på vad som skall utföras och inte lika mycket på hur. Under en tid har det objektorienterade paradigmet varit dominerande, kommer det vara så i framtiden? Funktionell programmering skiljer sig från imperativ program...
A Programmer's Geometry provides a guide in programming geometric shapes. The book presents formulas and examples of computer representation and coding of geometry. Each of the nine chapters of the text deals with the representation and solution of a specific geometrical problem, such as areas, vectors, and volumes. The last chapter provides a brief discussion on generating image through a computer. The codes presented in the book are written in FORTRAN 77. The text will be of great use to programmers who are working on projects that involve geometric calculations.
Abney, Darrell H; Sibrel, Donald W
Computer Mathematics for Programmers presents the Mathematics that is essential to the computer programmer.The book is comprised of 10 chapters. The first chapter introduces several computer number systems. Chapter 2 shows how to perform arithmetic operations using the number systems introduced in Chapter 1. The third chapter covers the way numbers are stored in computers, how the computer performs arithmetic on real numbers and integers, and how round-off errors are generated in computer programs. Chapter 4 details the use of algorithms and flowcharting as problem-solving tools for computer p
Full Text Available Cancer survival estimation is an important part of assessing the overall strength of cancer care in a region. Generally, the death of a patient is taken as the end point in estimation of overall survival. When calculating the overall survival, the cause of death is not taken into account. With increasing demand for better survival of cancer patients it is important for clinicians and researchers to know about survival statistics due to disease of interest, i.e. net survival. It is also important to choose the best method for estimating net survival. Increase in the use of computer programmes has made it possible to carry out statistical analysis without guidance from a bio-statistician. This is of prime importance in third- world countries as there are a few trained bio-statisticians to guide clinicians and researchers. The present communication describes current methods used to estimate net survival such as cause-specific survival and relative survival. The limitation of estimation of cause-specific survival particularly in India and the usefulness of relative survival are discussed. The various sources for estimating cancer survival are also discussed. As survival-estimates are to be projected on to the population at large, it becomes important to measure the variation of the estimates, and thus confidence intervals are used. Rothman′s confidence interval gives the most satisfactory result for survival estimate.
Pavlović, Zoran S.; Petković, Nikola; Matijašević Obradović, Jelena
The abuse of children for pornographic purposes is a serious sociological, criminological and victimological problem of today which, despite all preventive and restrictive activities on an international level, shows a tendency of global expansion. The fact that the Republic of Serbia has only recently actively joined the fight against child pornography on the Internet indicates the need for critical analysis of the existing national, penal, and legal solutions and their harmonization with the...
This film tells the story of the fight against and final extinction of the Mediterranean fruit-fly (Ceratitis capitata) in Mexico. By producing billions of high quality sterile flies in the Medfly reproduction and sterilization laboratory in the province of Chiapas and releasing them over infested areas, the Moscamed Programme succeeded in eradicating this pest from Mexico in 1982
"Das Programm einer kulturalistischen Unternehmensethik wird vorgestellt. Es gründet auf einem philosophischen Ansatz, der sich als instrumentalistisch, kontextualistisch, transsubjektivistisch und individualistisch charakterisieren lässt. Hinsichtlich der ethischen Grundlagen werden starke Thesen durch den Rekurs auf eine kontextualistisch-normative Anthropologie vermieden." (Autorenreferat)
Kemp, K.; Palmgren, F.
The Danish Air Quality Monitoring Programme (LMP IV) has been revised in accordance with the Framework Directive and the first three daughter directives of SO2, NOx/NO2, PM10, lead, benzene, CO and ozone. PM10 samplers are under installation and the installation will be completed during 2002...
Christensen, Henrik Bærbak
Dette undervisningsmateriale beskriver en model for, hvordan programmer er opbygget. Materialet er skrevet til brug i det gymnasiale forsøgsfag Informationsteknologi. Seneste version af dette undervisningsmateriale kan findes på http:// www.imhotep.dk. Tak til Elisabeth Husum for en kritisk...
Marietta Schupp, EMBL Photolab
Dr Sabine Hentze, specialist in human genetics, giving an Insight Lecture entitled "Human Genetics – Diagnostics, Indications and Ethical Issues" on 23 September 2008 at EMBL Heidelberg. Activities in a achool in Budapest during a visit of Angela Bekesi, Ambassadors for the SET-Routes programme.
A. Remzi Sezgin
In August 1997, the Government of Turkey greatly increased its efforts to implement eight-year obligatory education, through parliamentary approval of Law No. 4306 for Basic Education. The law mobilises significant resources for a major investment in school facilities through earmarked taxes, establishes a timetable for the Basic Education Programme and streamlines procedures to allow for swift action and implementation.
This progress report summarises the fast reactor research carried out at the Netherlands Energy Research Centre during the year 1981. The neutron and fission product cross sections of various isotopes have been evaluated. In the fuel performance programme, some preliminary results are given and irradiation facilities described. Creep experiments on various stainless steel components are reported
KfK is involved in the European Fusion Programme predominantly in the NET and Fusion Technology part. The following fields of activity are covered: Studies for NET, alternative confinement concepts, and needs and issues of integral testing. Research on structural materials. Development of superconducting magnets. Gyrotron development (part of the Physics Programme). Nuclear technology (breeding materials, blanket design, tritium technology, safety and environmental aspects of fusion, remote maintenance). Reported here are status and results of work under contracts with the CEC within the NET and Technology Programme. The aim of the major part of this R and D work is the support of NET, some areas (e.g. materials, safety and environmental impact, blanket design) have a wider scope and address problems of a demonstration reactor. In the current working period, several new proposals have been elaborated to be implemented into the 85/89 Euratom Fusion Programme. New KfK contributions relate to materials research (dual beam and fast reactor irradiations, ferritic steels), to blanket engineering (MHD-effects) and to safety studies (e.g. magnet safety). (orig./GG)
Anyone who develops software for a living needs a proven way to produce it better, faster, and cheaper. The Productive Programmer offers critical timesaving and productivity tools that you can adopt right away, no matter what platform you use. Master developer Neal Ford details ten valuable practices that will help you elude common traps, improve your code, and become more valuable to your team.
Larson, Anne; Bergman, E.; Ehlers, S.;
The publication is a result of a cooperation between organisations in six European countries with the aim to develop a common European education for programme managers. It contains of a description of the different elements of the education together with a number of case-studies from the counties...... involved in the cooperation (Finland, Denmark, Portugal, Iceland, United Kingdom and Austria)....
Vipin chandran, K.P; Mrs. P. Sandhya
The most neglected form of human deprivation is malnutrition particularly among preschool children. Millions of Indian children are equally deprived of the rights to survival, health, nutrition, education and safe drinking water. Interventions for preschool children (Early Childhood Care and Development) in India must be broadly addressed in three dimensions: child health, child development/education and child nutrition. The specific objectives of the study are to examine the current picture ...
Charmian M. Bennett; Sharon Friel
This paper addresses an often overlooked aspect of climate change impacts on child health: the amplification of existing child health inequities by climate change. Although the effects of climate change on child health will likely be negative, the distribution of these impacts across populations will be uneven. The burden of climate change-related ill-health will fall heavily on the world’s poorest and socially-disadvantaged children, who already have poor survival rates and low life expect...
In China the conceptual study of an ADS concept which lasted for about five years ended in 1999. As one project of the National Basic Research Programme of China (973 Programme) in energy domain, which is sponsored by the China Ministry of Science and Technology (MOST), a five year programme of fundamental research of ADS physics and related technology was launched in 2000 and passed national review at the end of 2005. From 2007, another five year 973 Programme Key Technology Research of Accelerator Driven Subcritical System for Nuclear waste Transmutation started. The research activities were focused on HPPA physics and technology, reactor physics of external source driven subcritical assembly, nuclear data base and material study. For HPPA, a high current injector consisting of an ECR ion source, LEBT and an RFQ accelerating structure of 3.5 MeV has been built and were being improved. In reactor physics study, a series of neutron multiplication experimental study has been carrying out. The VENUS I facility has been constructed as the basic experimental platform for neutronics study in ADS blanket. VENUS I a zero power subcritical neutron multiplying assembly driven by external neutron produced by a pulsed neutron generator or 252Cf neutron source. The theoretical, experimental and simulation studies on nuclear data, material properties and nuclear fuel circulation related to ADS are carried out in order to provide the database for ADS system analysis. China Institute of Atomic Energy (CIAE), Institute of High Energy Physics (IHEP) and other Chinese institutes carried out the MOST project together. Besides CIAE, China Academy of Science (CAS) pays more and more attention to Advanced Nuclear Fuel Cycles (ANFC). A large programme of ANFC, including ADS and Th based nuclear fuel cycle, has been launched by CAS
Thirty years after Alma-Ata: a systematic review of the impact of community health workers delivering curative interventions against malaria, pneumonia and diarrhoea on child mortality and morbidity in sub-Saharan Africa
potentially achieve large gains in child survival in sub-Saharan Africa if these programmes were implemented at scale. Large-scale rigorous studies, including RCTs, are urgently needed to provide policymakers with more evidence on the effects of CHWs delivering these interventions.
Davis, Deborah J; Ringsted, Charlotte; Bonde, Mie;
CONTEXT: Learning during residency in child and adolescent psychiatry (CAP) is primarily work-based and has traditionally been opportunistic. There are increasing demands from both postgraduate trainees and medical organisations for structured programmes with defined learning outcomes. OBJECTIVES...
In 1989, USAID awarded the Philippines a 5-year, US $50 million Child Survival Program targeting improvement in immunization coverage of children, prenatal care coverage for pregnant women, and contraceptive prevalence. Upon successful completion of performance benchmarks at the end of each year, USAID released monies to fund child survival activities for the following year. This program accomplished a major program goal, which was decentralization of health planning. The Philippine Department of Health soon incorporated provincial health planning. The Philippine Department of Health soon incorporated provincial health planning in its determination of allocation of resources. Social marketing activities contributed greatly to success in achieving the goal of boosting the immunization coverage rate for the 6 antigens listed under the Expanded Program for Immunization (51%-85% of infants, 1986-1991). In fact, rural health officers in Tarlac Province in Central Luzon went from household to household to talk to mothers about the benefits of immunizing a 1-year-old child, thereby contributing greatly to their achieving a 95% full immunization coverage rate by December 1991. Social marketing techniques included modern marketing strategies and multimedia channels. They first proved successful in metro Manila which, at the beginning of the campaign, had the lowest immunization rate of all 14 regions. Every Wednesday was designated immunization day and was when rural health centers vaccinated the children. Social marketing also successfully publicized oral rehydration therapy (ORT), breast feeding, and tuberculosis control. Another contributing factor to program success in child survival activities was private sector involvement. For example, the Philippine Pediatric Society helped to promote ORT as the preferred treatment for acute diarrhea. Further, the commercial sector distributed packets of oral rehydration salts and even advertised its own ORT product. At the end of 2
Giordano, Livia; von Karsa, Lawrence; Tomatis, Mariano; Majek, Ondrej; de Wolf, Chris; Lancucki, Lesz; Hofvind, Solveig; Nyström, Lennarth; Segnan, Nereo; Ponti, Antonio; Van Hal, G; Martens, P; Májek, O; Danes, J; von Euler-Chelpin, My Catarina; Aasmaa, A; Anttila, A; Becker, N; Péntek, Z; Budai, A; Mádai, S; Fitzpatrick, P; Mooney, T; Zappa, M; Ventura, L; Scharpantgen, A; Hofvind, S; Seroczynski, P; Morais, A; Rodrigues, V; Bento, M J; Gomes de Carvalho, J; Natal, C; Prieto, M; Sánchez-Contador Escudero, C; Zubizarreta Alberti, R; Fernández Llanes, S B; Ascunce, N; Ederra Sanza, M; Sarriugarte Irigoien, G; Salas Trejo, D; Ibáñez Cabanell, J; Wiege, M; Ohlsson, G; Törnberg, S; Korzeniewska, M; de Wolf, C; Fracheboud, J; Patnick J, J; Lancucki, L; Ducarroz, S; Suonio, E
To summarize participation and coverage rates in population mammographic screening programmes for breast cancer in Europe.......To summarize participation and coverage rates in population mammographic screening programmes for breast cancer in Europe....
AIDS by mother-to-child transmission: survival analysis of cases followed from 1983 to 2002 in different regions of Brazil AIDS por transmissão vertical: análise de sobrevivência dos casos acompanhados entre 1983 e 2002 nas diferentes regiões do Brasil
Luiza Harunari Matida
Full Text Available Antiretroviral therapy contributes to decreasing morbidity and mortality, and ultimately to increasing survival. In Brazil, there are regional differences in HIV epidemiology regarding pregnant women and children with HIV/AIDS. This study evaluates survival time after AIDS diagnosis in 914 children infected by mother-to-child transmission, reported between 1983 and 1998 and followed until 2002, in Brazil's five regions. Time between birth and HIV diagnosis decreased over the years, mainly in the South and Southeast Regions. There was a significant improvement in survival; more than 75% of cases were still living four years after diagnosis in the 1997-1998 group. This Brazilian study demonstrates that even with regional inequalities in health care infrastructure it is possible for a developing country to establish an effective system of universal and free access to antiretroviral therapy that produces a significant increase in survival for children with AIDS.A terapia anti-retroviral contribui para a diminuição da morbidade e da mortalidade, com conseqüente aumento da sobrevida. No Brasil, há diferenças regionais relativas à dinâmica da epidemia do HIV e ao seu enfrentamento no grupo das gestantes e das crianças com HIV/AIDS. Este estudo verifica o tempo de sobrevida após o diagnóstico de AIDS em 914 crianças infectadas por transmissão vertical, entre os anos de 1983 e 1998, e acompanhadas até 2002, nas cinco regiões brasileiras. O tempo do nascimento ao diagnóstico de infecção pelo HIV, ao longo dos anos, apresenta uma diminuição, principalmente nos estados das regiões Sul e Sudeste. Houve melhora significativa da sobrevivência, mais de 75% dos casos ainda estavam vivendo quatro anos após o diagnóstico, no grupo de 1997 e 1998. Esta análise brasileira mostra ser possível para um país em desenvolvimento estabelecer um sistema efetivo de acesso gratuito e universal à terapia anti-retroviral, mesmo com dificuldades
The transplantation of organs and tissues from one human to another human has become an essential and well established form of therapy for many types of organ and tissue failure. In Malaysia, kidney, cornea and bone marrow transplantation are well established. Recently, liver, bone and heart transplanation have been performed. Unfortunately, because of the lack of cadaveric organ donation, only a limited number of solid organ transplantation have been performed. The cadaveric organ donor rate in Malaysia is low at less than one per million population. The first tissue transplanted in Malaysia was the cornea which was performed in the early 1970s. At that time and even now the majority of corneas came from Sri Lanka. The first kidney transplant was performed in 1975 from a live related donor. The majority of the 629 kidney transplants done at Hospital Kuala Lumpur to date have been from live related donors. Only 35 were from cadaver donors. Similarly, the liver transplantation programme which started in 1995 are from live related donors. A more concerted effort has been made recently to increase the awareness of the public and the health professionals on organ and tissue donation. This national effort to promote organ and tissue donation seems to have gathered momentum in 1997 with the first heart transplant successfully performed at the National Heart Institute. The rate of cadaveric donors has also increased from a previous average of I to 2 per year to 6 per year in the last one year. These developments are most encouraging and may signal the coming of age of our transplantati on programme. The Ministry of Health in conjunction with various institutions, organizations and professional groups, have taken a number of proactive measures to facilitate the development of the cadaveric organ donation programme. Efforts to increase public awareness and to overcome the negative cultural attitude towards organ donation have been intensified. Equally important are efforts
Winkler, C.; Gehrels, N.; Lund, Niels; Schonfelder, V.; Ubertini, P.
The Core Programme of the INTEGRAL mission is defined as the portion of the scientific programme covering the guaranteed time observations for the INTEGRAL Science Working Team. This paper describes the current status of the Core Programme preparations and summarizes the key elements of the...
The KfK-Association has continued work on 17 R and D contracts of the Fusion Technology Programme. An effort of 94 manyears per year is at present contributed by 10 KfK departments, covering all aereas defined in the Fusion Technology Programme. The dominant part of the work is directed towards the need of the NET design or supporting experiments. Some additional effort addresses long term technological issues and system studies relevant to DEMO or confinement schemes alternative to tokamaks. Direct contribution to the NET team has increased by augmentation of NET study contracts and delegation of personnel, three KfK delegates being at present members of the NET team. In reverse, specifications and design guidelines worked out by NET have started to have an impact on the current R and D-work in the laboratory. (orig./GG)
The main objectives of Finland`s Bioenergia Research Programme are (1) To develop new methods of producing biofuels which can compete with imported fuels, demonstrating the most promising production methods through pilot schemes, (2) To develop and demonstrate 3 - 4 new pieces of equipment or methods connected with handling and using bioenergy, (3) To produce basic information on conversion techniques and evaluate the quality, usability and environmental impacts of the products as well as the overall economy of the entire production chain and to create 2-3 conversion methods for follow-up development by industry. The principle research areas are (1) Development of production technology for wood-derived fuels, (2) Peat production, (3) The use of bioenergy and (4) Biomass conversion. This conference paper discusses the results obtained so far and reviews in some detail the activities of the programme. 3 figs., 3 tabs.
The main objectives of Finland's Bioenergia Research Programme are (1) To develop new methods of producing biofuels which can compete with imported fuels, demonstrating the most promising production methods through pilot schemes, (2) To develop and demonstrate 3 - 4 new pieces of equipment or methods connected with handling and using bioenergy, (3) To produce basic information on conversion techniques and evaluate the quality, usability and environmental impacts of the products as well as the overall economy of the entire production chain and to create 2-3 conversion methods for follow-up development by industry. The principle research areas are (1) Development of production technology for wood-derived fuels, (2) Peat production, (3) The use of bioenergy and (4) Biomass conversion. This conference paper discusses the results obtained so far and reviews in some detail the activities of the programme. 3 figs., 3 tabs
Full Text Available The monitoring and reporting of adverse drug reactions (ADRs through pharmacovigilance is vital to patient safety and rational prescribing. In India, Central Drugs Standard Control Organization (CDSCO initiated Pharmacovigilance Programme of India (PvPI to report ADRs through ADRs monitoring centres in India. Indian Pharmacopoeia Commission (IPC is functioning as National Coordination Centre (NCC for PvPI. The ADRs are reported to NCC through VigiFlow by various centres are evaluated and committed to Uppsala Monitoring Centre, Sweden. The potential benefit of the PvPI is aimed to reducing or eliminating a harm of medicine. Continuous efforts of the healthcare professionals and the patients are expected to make this as one of the most successful and effective programmes. The present article updates the status and future plan of PvPI.
There are 11 main fields of KfK R + D activities which are connected with one or more of the research goals of a) assurance of nuclear fuel supply, b) nuclear waste management, c) safety of nuclear facilities, d) basic research and research on new technologies. The scientific and technical tasks connected with these goals in 1981 and on a medium-term basis as well as the financial requirements are presented in the programme budget. (orig.)