Sample records for antenatal leve controversias
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Epistemología, controversias y pragmática
Directory of Open Access Journals (Sweden)
Dascal, Marcelo
1995-10-01
Full Text Available Not available.
En este artículo quiero presentar y defender la tesis de que el impasse en que se encuentran la epistemología y la historia de la ciencia desde hace un par de décadas se debe en gran parte, o bien a la total ignorancia. o bien al tratamiento equivocado del rol jugado por las controversias científicas en la evolución de la ciencia.
Para hacerlo, tendré que empezar por una aclaración preliminar del impasse a que me refiero (sección 1. Luego, explicaré por qué veo en el estudio de las controversias científicas una pieza fundamental para solucionarlo (sección 2, identificaré la posición de díchas controversias en el seno del conjunto de los fenómenos empíricos del tipo 'discurso polémico' (sección 3 e indicaré las propiedades de tales controversias que explican su rol potencial para solventar el impasse (sección 4. Pasaré enseguida a mostrar el modo en que las opciones epistemológicas existentes son incapaces de tratar las controversias de manera satisfactoria, lo que explica su incapacidad para resolver el impasse (sección S. Más adelante expondré un desideratum esencial para resolver ese impasse (sección 6, e indicaré de qué manera cabe satisfacerlo empleando la pragmática como instrumento y como modelo (sección 7.
Lo que se me antojó, en un principio, un artículo relativamente corto, se ha ido transformando progresivamente en un texto complejo y extenso, más digno de un ensayo. He tratado de acortarlo, reduciéndolo a lo esencial. De ahí que algunas afirmaciones puedan parecer dogmáticas e insuficientemente fundamentadas. Espero cumplir con el onus probando que me compete llevar a cabo en el prometido ensayo. Pero no quise dejar de publicar su esbozo en estas reflexiones, para poder - cuando menos así lo espero- beneficiarme de la crítica. -
Carter, N. T.
2017-12-01
The nation's flood risk is increasing. The condition of U.S. dams and levees contributes to that risk. Dams and levee owners are responsible for the safety, maintenance, and rehabilitation of their facilities. Dams-Of the more than 90,000 dams in the United States, about 4% are federally owned and operated; 96% are owned by state and local governments, public utilities, or private companies. States regulate dams that are not federally owned. The number of high-hazard dams (i.e., dams whose failure would likely result in the loss of human life) has increased in the past decade. Roughly 1,780 state-regulated, high-hazard facilities with structural ratings of poor or unsatisfactory need rehabilitation. Levees-There are approximately 100,000 miles of levees in the nation; most levees are owned and maintained by municipalities and agricultural districts. Few states have levee safety programs. The U.S. Army Corps of Engineers (Corps) inspects 15,000 miles of levees, including levees that it owns and local levees participating in a federal program to assist with certain post-flood repairs. Information is limited on how regularly other levees are inspected. The consequence of a breach or failure is another aspect of risk. State and local governments have significant authority over land use and development, which can shape the social and economic impacts of a breach or failure; they also lead on emergency planning and related outreach. To date, federal dam and levee safety efforts have consisted primarily of (1) support for state dam safety standards and programs, (2) investments at federally owned dams and levees, and (3) since 2007, creation of a national levee database and enhanced efforts and procedures for Corps levee inspections and assessments. In Public Law 113-121, enacted in 2014, Congress (1) directed the Corps to develop voluntary guidelines for levee safety and an associated hazard potential classification system for levees, and (2) authorized support for the
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Directory of Open Access Journals (Sweden)
Durand Eduard
2016-01-01
Full Text Available Along the river Loire, in order to have a homogenous method to do specific risk assessment studies, a new model named CARDigues (for Levee Breach Hazard Calculation was developed in a partnership with DREAL Centre-Val de Loire (owner of levees, Cerema and Irstea. This model enables to approach the probability of failure on every levee sections and to integrate and cross different “stability” parameters such topography and included structures, geology and material geotechnical characteristics, hydraulic loads… and observations of visual inspections or instrumentation results considered as disorders (seepage, burrowing animals, vegetation, pipes, etc.. This model and integrated tool CARDigues enables to check for each levee section, the probability of appearance and rupture of five breaching scenarios initiated by: overflowing, internal erosion, slope instability, external erosion and uplift. It has been recently updated and has been applied on several levee systems by different contractors. The article presents the CARDigues model principles and its recent developments (version V28.00 with examples on river Loire and how it is currently used for a relevant and global levee system diagnosis and assessment. Levee reinforcement or improvement management is also a perspective of applications for this model CARDigues.
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National Levee Database, series information for the current inventory of the Nation's levees.
Federal Geographic Data Committee — The National Levee Database is authoritative database that describes the location and condition of the Nationâs levees. The database contains 21 feature classes...
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Levee Health Monitoring With Radar Remote Sensing
Jones, C. E.; Bawden, G. W.; Deverel, S. J.; Dudas, J.; Hensley, S.; Yun, S.
2012-12-01
Remote sensing offers the potential to augment current levee monitoring programs by providing rapid and consistent data collection over large areas irrespective of the ground accessibility of the sites of interest, at repeat intervals that are difficult or costly to maintain with ground-based surveys, and in rapid response to emergency situations. While synthetic aperture radar (SAR) has long been used for subsidence measurements over large areas, applying this technique directly to regional levee monitoring is a new endeavor, mainly because it requires both a wide imaging swath and fine spatial resolution to resolve individual levees within the scene, a combination that has not historically been available. Application of SAR remote sensing directly to levee monitoring has only been attempted in a few pilot studies. Here we describe how SAR remote sensing can be used to assess levee conditions, such as seepage, drawing from the results of two levee studies: one of the Sacramento-San Joaquin Delta levees in California that has been ongoing since July 2009 and a second that covered the levees near Vicksburg, Mississippi, during the spring 2011 floods. These studies have both used data acquired with NASA's UAVSAR L-band synthetic aperture radar, which has the spatial resolution needed for this application (1.7 m single-look), sufficiently wide imaging swath (22 km), and the longer wavelength (L-band, 0.238 m) required to maintain phase coherence between repeat collections over levees, an essential requirement for applying differential interferometry (DInSAR) to a time series of repeated collections for levee deformation measurement. We report the development and demonstration of new techniques that employ SAR polarimetry and differential interferometry to successfully assess levee health through the quantitative measurement of deformation on and near levees and through detection of areas experiencing seepage. The Sacramento-San Joaquin Delta levee study, which covers
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Transient Seepage for Levee Engineering Analyses
Tracy, F. T.
2017-12-01
Historically, steady-state seepage analyses have been a key tool for designing levees by practicing engineers. However, with the advances in computer modeling, transient seepage analysis has become a potentially viable tool. A complication is that the levees usually have partially saturated flow, and this is significantly more complicated in transient flow. This poster illustrates four elements of our research in partially saturated flow relating to the use of transient seepage for levee design: (1) a comparison of results from SEEP2D, SEEP/W, and SLIDE for a generic levee cross section common to the southeastern United States; (2) the results of a sensitivity study of varying saturated hydraulic conductivity, the volumetric water content function (as represented by van Genuchten), and volumetric compressibility; (3) a comparison of when soils do and do not exhibit hysteresis, and (4) a description of proper and improper use of transient seepage in levee design. The variables considered for the sensitivity and hysteresis studies are pore pressure beneath the confining layer at the toe, the flow rate through the levee system, and a levee saturation coefficient varying between 0 and 1. Getting results for SEEP2D, SEEP/W, and SLIDE to match proved more difficult than expected. After some effort, the results matched reasonably well. Differences in results were caused by various factors, including bugs, different finite element meshes, different numerical formulations of the system of nonlinear equations to be solved, and differences in convergence criteria. Varying volumetric compressibility affected the above test variables the most. The levee saturation coefficient was most affected by the use of hysteresis. The improper use of pore pressures from a transient finite element seepage solution imported into a slope stability computation was found to be the most grievous mistake in using transient seepage in the design of levees.
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Hydrodynamic and sedimentological controls governing formation of fluvial levees
Johnston, G. H.; Edmonds, D. A.; David, S. R.; Czuba, J. A.
2017-12-01
Fluvial levees are familiar features found on the margins of river channels, yet we know little about what controls their presence, height, and shape. These attributes of levees are important because they control sediment transfer from channel to floodplain and flooding patterns along a river system. Despite the familiarity and importance of levees, there is a surprising lack of basic geomorphic data on fluvial levees. Because of this we seek to understand: 1) where along rivers do levees tend to occur?; 2) what geomorphic and hydrodynamic variables control cross-sectional shape of levees? We address these questions by extracting levee shape from LiDAR data and by collecting hydrodynamic and sedimentological data from reaches of the Tippecanoe River, the White River, and the Muscatatuck River, Indiana, USA. Fluvial levees are extracted from a 1.5-m resolution LiDAR bare surface model and compared to hydrological, sedimentological, and geomorphological data from USGS stream gages. We digitized banklines and extracted levee cross-sections to calculate levee slope, taper, height, e-folding length, and e-folding width. To answer the research questions, we performed a multivariable regression between the independent variables—channel geometry, sediment grain size and concentration, flooding conditions, and slope—and the dependent levee variables. We find considerable variation in levee presence and shape in our field data. On the Muscatatuck River levees occur on 30% of the banks compared to 10% on the White River. Moreover, levees on the Muscatatuck are on average 3 times wider than the White River. This is consistent with the observation that the Muscatatuck is finer-grained compared to the White River and points to sedimentology being an important control on levee geomorphology. Future work includes building a morphodynamic model to understand how different hydrodynamic and geomorphic conditions control levee geometry.
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Erosion of Earthen Levees by Wave Action
Ozeren, Y.; Wren, D. G.; Reba, M. L.
2016-02-01
Earthen levees of aquaculture and irrigation reservoirs in the United States often experience significant erosion due to wind-generated waves. Typically constructed using local soils, unprotected levees are subjected to rapid erosion and retreat due to wind generated waves and surface runoff. Only a limited amount of published work addresses the erosion rates for unprotected levees, and producers who rely on irrigation reservoirs need an economic basis for selecting a protection method for vulnerable levees. This, in turn, means that a relationship between wave energy and erosion of cohesive soils is needed. In this study, laboratory experiments were carried out in order to quantify wave induced levee erosion and retreat. A model erodible bank was packed using a soil consisting of approximately 14% sand, 73% silt, and 13% clay in a 20.6 m long 0.7 m wide and 1.2 m deep wave tank at the USDA-ARS, National Sedimentation Laboratory in Oxford MS. The geometry of the levee face was monitored by digital camera and the waves were measured by means of 6 capacitance wave staffs. Relationships were established between levee erosion, edge and retreat rates, and incident wave energy.
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Applying Mechanistic Dam Breach Models to Historic Levee Breaches
Risher Paul; Gibson Stanford
2016-01-01
Hurricane Katrina elevated levee risk in the US national consciousness, motivating agencies to assess and improve their levee risk assessment methodology. Accurate computation of the flood flow magnitude and timing associated with a levee breach remains one of the most difficult and uncertain components of levee risk analysis. Contemporary methods are largely empirical and approximate, introducing substantial uncertainty to the damage and life loss models. Levee breach progressions are often ...
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Protection of Levees against Beavers
Kozłowski, Wojciech; Balawejder, Adam
2017-10-01
Beavers are a protected species, so the levees must be properly protected so as not to harm the beavers and protect the levees from the destruction caused by these animals. This protection requires the use of bentonite mats as shaft seals, and wire mesh. Recently, such new protection structures began to be used successfully.
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Numerical Hydrodynamic Study of Hypothetical Levee Setback Scenarios
2018-01-01
has recorded peak flows up to 9,919 cms (350,000 cfs) before the construction of flow control dams. The New Savannah Bluff Lock and Dam (NSBLD...of the levee setback alternatives at the observation point downstream of the levee setbacks are nearly identical as the WSE of the base condition...the levee setback, respectively. The WSE of the levee setback alternatives at the observation point downstream are nearly identical as the WSE of the
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Inversiones y solución de controversias en el MERCOSUR
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Natasha Suñé
2013-08-01
Full Text Available En los primeros años del MERCOSUR, los cuatro países miembros buscaban claramente atraer financiamiento externo tanto de capital extrazona como intrazona. Los protocolos firmados en 1993 y 1994 tornan evidente la relevancia del tema por aquellos años. A partir del año 2000 cambia el panorama normativo regional y los avances en la reglamentación de las inversiones fueron poco consistentes. A pesar de ello, existe un continuo crecimiento en el volumen de recursos directos aplicados por empresas locales en el espacio extraregional, como en la recepción de inversiones en la región. Ante este contexto regional alentador, el sistema de solución de controversias del MERCOSUR debería ser mejor aprovechado y abarcar las inversiones para que los diferendos en la materia puedan resueltos en el seno de la región. El Tribunal Permanente de Revisión debería tener en su competencia de actuación las controversias surgidas en materia de inversiones entre Estados miembros, asociados e, incluso, inversores.
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Climate and floods still govern California levee breaks
Florsheim, J.L.; Dettinger, M.D.
2007-01-01
Even in heavily engineered river systems, climate still governs flood variability and thus still drives many levee breaks and geomorphic changes. We assemble a 155-year record of levee breaks for a major California river system to find that breaks occurred in 25% of years during the 20th Century. A relation between levee breaks and river discharge is present that sets a discharge threshold above which most levee breaks occurred. That threshold corresponds to small floods with recurrence intervals of ???2-3 years. Statistical analysis illustrates that levee breaks and peak discharges cycle (broadly) on a 12-15 year time scale, in time with warm-wet storm patterns in California, but more slowly or more quickly than ENSO and PDO climate phenomena, respectively. Notably, these variations and thresholds persist through the 20th Century, suggesting that historical flood-control effects have not reduced the occurrence or frequency of levee breaks. Copyright 2007 by the American Geophysical Union.
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Lidar-based mapping of flood control levees in south Louisiana
Thatcher, Cindy A.; Lim, Samsung; Palaseanu-Lovejoy, Monica; Danielson, Jeffrey J.; Kimbrow, Dustin R.
2016-01-01
Flood protection in south Louisiana is largely dependent on earthen levees, and in the aftermath of Hurricane Katrina the state’s levee system has received intense scrutiny. Accurate elevation data along the levees are critical to local levee district managers responsible for monitoring and maintaining the extensive system of non-federal levees in coastal Louisiana. In 2012, high resolution airborne lidar data were acquired over levees in Lafourche Parish, Louisiana, and a mobile terrestrial lidar survey was conducted for selected levee segments using a terrestrial lidar scanner mounted on a truck. The mobile terrestrial lidar data were collected to test the feasibility of using this relatively new technology to map flood control levees and to compare the accuracy of the terrestrial and airborne lidar. Metrics assessing levee geometry derived from the two lidar surveys are also presented as an efficient, comprehensive method to quantify levee height and stability. The vertical root mean square error values of the terrestrial lidar and airborne lidar digital-derived digital terrain models were 0.038 m and 0.055 m, respectively. The comparison of levee metrics derived from the airborne and terrestrial lidar-based digital terrain models showed that both types of lidar yielded similar results, indicating that either or both surveying techniques could be used to monitor geomorphic change over time. Because airborne lidar is costly, many parts of the USA and other countries have never been mapped with airborne lidar, and repeat surveys are often not available for change detection studies. Terrestrial lidar provides a practical option for conducting repeat surveys of levees and other terrain features that cover a relatively small area, such as eroding cliffs or stream banks, and dunes.
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National Levee Database: monitoring, vulnerability assessment and management in Italy
Barbetta, Silvia; Camici, Stefania; Maccioni, Pamela; Moramarco, Tommaso
2015-04-01
A properly designed and constructed levees system can often be an effective device for repelling floodwaters and provide barriers against inundation to protect urbanized and industrial areas. However, the delineation of flooding-prone areas and the related hydraulic hazard mapping taking account of uncertainty (Apel et al., 2008) are usually developed with a scarce consideration of the possible occurrence of levee failures along river channels (Mazzoleni et al., 2014). Indeed, it is well known that flooding is frequently the result of levee failures that can be triggered by several factors, as: (1) overtopping, (2) scouring of the foundation, (3) seepage/piping of levee body/foundation, and (4) sliding of the foundation. Among these failure mechanisms that are influenced by the levee's geometrical configuration, hydraulic conditions (e.g. river level and seepage), and material properties (e.g. permeability, cohesion, porosity, compaction), the piping caused by seepage (ICOLD, http://www.icold-cigb.org) is considered one of the most dominant levee failure mechanisms (Colleselli F., 1994; Wallingford H. R., 2003). The difficulty of estimating the hydraulic parameters to properly describe the seepage line within the body and foundation of the levee implies that the study of the critical flood wave routing is typically carried out by assuming that the levee system is undamaged during the flood event. In this context, implementing and making operational a National Levee Database (NLD), effectively structured and continuously updated, becomes fundamental to have a searchable inventory of information about levees available as a key resource supporting decisions and actions affecting levee safety. The ItaliaN LEvee Database (INLED) has been recently developed by the Research Institute for Geo-Hydrological Protection (IRPI) for the Civil Protection Department of the Presidency of Council of Ministers. INLED has the main focus of collecting comprehensive information about
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Game theory and risk-based leveed river system planning with noncooperation
Hui, Rui; Lund, Jay R.; Madani, Kaveh
2016-01-01
Optimal risk-based levee designs are usually developed for economic efficiency. However, in river systems with multiple levees, the planning and maintenance of different levees are controlled by different agencies or groups. For example, along many rivers, levees on opposite riverbanks constitute a simple leveed river system with each levee designed and controlled separately. Collaborative planning of the two levees can be economically optimal for the whole system. Independent and self-interested landholders on opposite riversides often are willing to separately determine their individual optimal levee plans, resulting in a less efficient leveed river system from an overall society-wide perspective (the tragedy of commons). We apply game theory to simple leveed river system planning where landholders on each riverside independently determine their optimal risk-based levee plans. Outcomes from noncooperative games are analyzed and compared with the overall economically optimal outcome, which minimizes net flood cost system-wide. The system-wide economically optimal solution generally transfers residual flood risk to the lower-valued side of the river, but is often impractical without compensating for flood risk transfer to improve outcomes for all individuals involved. Such compensation can be determined and implemented with landholders' agreements on collaboration to develop an economically optimal plan. By examining iterative multiple-shot noncooperative games with reversible and irreversible decisions, the costs of myopia for the future in making levee planning decisions show the significance of considering the externalities and evolution path of dynamic water resource problems to improve decision-making.
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Evaluation of levee setbacks for flood-loss reduction, Middle Mississippi River, USA
Dierauer, Jennifer; Pinter, Nicholas; Remo, Jonathan W. F.
2012-07-01
SummaryOne-dimensional hydraulic modeling and flood-loss modeling were used to test the effectiveness of levee setbacks for flood-loss reduction along the Middle Mississippi River (MMR). Four levee scenarios were assessed: (1) the present-day levee configuration, (2) a 1000 m levee setback, (3) a 1500 m levee setback, and (4) an optimized setback configuration. Flood losses were estimated using FEMA's Hazus-MH (Hazards US Multi-Hazard) loss-estimation software on a structure-by-structure basis for a range of floods from the 2- to the 500-year events. These flood-loss estimates were combined with a levee-reliability model to calculate probability-weighted damage estimates. In the simplest case, the levee setback scenarios tested here reduced flood losses compared to current conditions for large, infrequent flooding events but increased flood losses for smaller, more frequent flood events. These increases occurred because levee protection was removed for some of the existing structures. When combined with buyouts of unprotected structures, levee setbacks reduced flood losses for all recurrence intervals. The "optimized" levee setback scenario, involving a levee configuration manually planned to protect existing high-value infrastructure, reduced damages with or without buyouts. This research shows that levee setbacks in combination with buyouts are an economically viable approach for flood-risk reduction along the study reach and likely elsewhere where levees are widely employed for flood control. Designing a levee setback around existing high-value infrastructure can maximize the benefit of the setback while simultaneously minimizing the costs. The optimized levee setback scenario analyzed here produced payback periods (costs divided by benefits) of less than 12 years. With many aging levees failing current inspections across the US, and flood losses spiraling up over time, levee setbacks are a viable solution for reducing flood exposure and flood levels.
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Using Levee Setbacks to Increase Floodplain Connectivity and Reduce Flood Risk
Dahl, T. A.; Echevarria-Doyle, W.
2017-12-01
Levees typically constrain flood flows to within the main channel, isolating the river from its natural floodplain. Levees limit the areal and temporal extents of flooding, but can increase flood peaks, alter ecosystems, and cause scour. In order to mitigate these effects, some groups have begun moving portions of levees further away from the main channel, creating setback levees. Here we describe a series of levee setback scenarios for a hypothetical river that were modeled with the unsteady, 2D-hydraulic model AdH. In our scenarios, the water surface elevations were reduced both at the location of the levee setback and for some distance upstream. The models also show that the floodplain roughness can have a greater effect on the reduction in water surface elevation than the size of the levee setback. Groups planning levee setbacks can use these results to help guide their designs.
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Game Theory and Risk-Based Levee System Design
Hui, R.; Lund, J. R.; Madani, K.
2014-12-01
Risk-based analysis has been developed for optimal levee design for economic efficiency. Along many rivers, two levees on opposite riverbanks act as a simple levee system. Being rational and self-interested, land owners on each river bank would tend to independently optimize their levees with risk-based analysis, resulting in a Pareto-inefficient levee system design from the social planner's perspective. Game theory is applied in this study to analyze decision making process in a simple levee system in which the land owners on each river bank develop their design strategies using risk-based economic optimization. For each land owner, the annual expected total cost includes expected annual damage cost and annualized construction cost. The non-cooperative Nash equilibrium is identified and compared to the social planner's optimal distribution of flood risk and damage cost throughout the system which results in the minimum total flood cost for the system. The social planner's optimal solution is not feasible without appropriate level of compensation for the transferred flood risk to guarantee and improve conditions for all parties. Therefore, cooperative game theory is then employed to develop an economically optimal design that can be implemented in practice. By examining the game in the reversible and irreversible decision making modes, the cost of decision making myopia is calculated to underline the significance of considering the externalities and evolution path of dynamic water resource problems for optimal decision making.
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Directory of Open Access Journals (Sweden)
Lisset García-Fernández
2013-06-01
Full Text Available La vacunación es una de las medidas de mayor impacto en la salud pública para la reducción de la morbimortalidad infantil. El timerosal es un compuesto orgánico del mercurio utilizado como preservante de los frascos multidosis. Eventualmente, en el Perú, surgen olas de controversia acerca de la seguridad de estas vacunas, asociándolas especialmente con el autismo. Como resultado de estas controversias, se han propuesto, incluso, leyes que prohíben este tipo de vacunas, lo que tendría un importante impacto en los costos y en los aspectos logísticos de la estrategia nacional de vacunación. En este artículo se revisa la literatura sobre las principales controversias acerca de las vacunas que contienen timerosal y su supuesta asociación con el autismo. Se realiza una aproximación histórica sobre estas controversias, se hace una actualización de la evidencia científica disponible al momento, y se revisa la posición de los organismos internacionales más importantes con respecto a este tema. Se concluye que la evidencia científica no apoya la noción que exista una asociación entre el uso del timerosal en las vacunas con los trastornos del espectro autista en niños.
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Traumatismo craneoencefálico leve
Ortega Zufiría, José Manuel; Prieto, Noemí Lomillos; Cuba, Bernardino Choque; Degenhardt, Martin Tamarit; Núñez, Pedro Poveda; López Serrano, María Remedios; López Raigada, Azahara Belén
2018-01-01
Resumen Introducción y objetivo: El TCE leve representa un problema sanitario de enorme interés debido a que un número significativo de enfermos con trauma leve desarrollará complicaciones potencialmente mortales. El objetivo de este estudio ha sido describir una serie amplia de pacientes adultos, mayores de 14 años, que sufren TCE leve, atendidos en el Hospital Universitario de Getafe, entre los años 2010 y 2015 (n = 2480), estudiar el perfil epidemiológico y analizar el diagnóstico y el tratamiento efectuados, así como establecer los principales factores pronósticos que influyen en el resultado final. Método: Se ha realizado un estudio retrospectivo, de revisión de historias clínicas, analizando los resultados con estudio estadístico bivariable y multivariable. Resultados: El TCE leve es más frecuente en varones, y el mecanismo causante más común en nuestro medio es el accidente de tráfico. Se propone un modelo de clasificación de pacientes según grupos de riesgo, que los subdivide en riesgo bajo, intermedio o alto, que se correlaciona bien con la probabilidad de desarrollar complicación intracraneal, y, consecuentemente, con el resultado final. Se discute la indicación de la radiografía simple de cráneo y de la Tomografía Computarizada (TC), así como del ingreso hospitalario para observación neurológica. Conclusiones: En este estudio, la presencia de focalidad neurológica en la exploración clínica, la edad, las alteraciones de la coagulación y la existencia de fractura en la radiografía simple se relacionan con mayor posibilidad de desarrollar lesiones traumáticas intracraneales y con peor pronóstico final. La escala de Glasgow para el Coma es deficitaria en la determinación del resultado final del paciente que sufre TCE, porque no considera variables tales como la amnesia o la pérdida de conocimiento, muy frecuentes en el traumatismo craneoencefálico leve. PMID:29430327
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La teledetección directa por satélites y la solución de controversias
Directory of Open Access Journals (Sweden)
Luis Castillo Argañarás
2014-04-01
Full Text Available Una de las actividades comerciales espaciales es la teledetección satelital, en este ámbito actúan frecuentemente Estados, organizaciones internacionales y empresas privadas. En 1986, la Asamblea General de la ONU adoptó la Resolución Principios Relativos ala Teleobservación, mientras que en el año 2011, la Corte Permanente de Arbitraje de La Haya adoptó las “Reglas Opcionales para Arbitraje de Controversias, relativas con las actividades del espacio ultraterrestre”. Fundamentos que soportan el desarrollo del presente ensayo cuyo objetivo permite analizar si la Resolución de 1986 regula de manera adecuada las controversias que se plantean y aproximarnos brevemente a las Reglas Opcionales para Arbitraje adoptadas en el año 2011.
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A Bivariate return period for levee failure monitoring
Isola, M.; Caporali, E.
2017-12-01
Levee breaches are strongly linked with the interaction processes among water, soil and structure, thus many are the factors that affect the breach development. One of the main is the hydraulic load, characterized by intensity and duration, i.e. by the flood event hydrograph. On the magnitude of the hydraulic load is based the levee design, generally without considering the fatigue failure due to the load duration. Moreover, many are the cases in which the levee breach are characterized by flood of magnitude lower than the design one. In order to implement the strategies of flood risk management, we built here a procedure based on a multivariate statistical analysis of flood peak and volume together with the analysis of the past levee failure events. Particularly, in order to define the probability of occurrence of the hydraulic load on a levee, a bivariate copula model is used to obtain the bivariate joint distribution of flood peak and volume. Flood peak is the expression of the load magnitude, while the volume is the expression of the stress over time. We consider the annual flood peak and the relative volume. The volume is given by the hydrograph area between the beginning and the end of event. The beginning of the event is identified as an abrupt rise of the discharge by more than 20%. The end is identified as the point from which the receding limb is characterized by the baseflow, using a nonlinear reservoir algorithm as baseflow separation technique. By this, with the aim to define warning thresholds we consider the past levee failure events and the relative bivariate return period (BTr) compared with the estimation of a traditional univariate model. The discharge data of 30 hydrometric stations of Arno River in Tuscany, Italy, in the period 1995-2016 are analysed. The database of levee failure events, considering for each event the location as well as the failure mode, is also created. The events were registered in the period 2000-2014 by EEA
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McGee Creek Drainage and Levee District, Illinois.
1973-04-01
J COUNTY MC GEE REEK DRAINAGE BLEVEE DISTRICT N~ i, 0. ~ I I LEGEND Co ,. 3 ~ . -~------~----EXISTING LEVEE _____________PROPOSED LEVEE...Development, Conservation, Environmental Protection Agency, Health, Institute for Environmental Quality, Mines and Minerals. Pollution Control Board...Protection Agency, Health, Institute for Environmental Quality, Mines and Minerals, Pollution Control Board, Registration and Education, Transportation
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Lisset García-Fernández; Adrián V Hernández; Víctor Suárez Moreno; Fabián Fiestas
2013-01-01
La vacunación es una de las medidas de mayor impacto en la salud pública para la reducción de la morbimortalidad infantil. El timerosal es un compuesto orgánico del mercurio utilizado como preservante de los frascos multidosis. Eventualmente, en el Perú, surgen olas de controversia acerca de la seguridad de estas vacunas, asociándolas especialmente con el autismo. Como resultado de estas controversias, se han propuesto, incluso, leyes que prohíben este tipo de vacunas, lo que tendría un impor...
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Efeitos do treinamento auditivo em idosos com Comprometimento Cognitivo Leve
Renata Rezende de Almeida Ávila; Cristina Ferraz Borges Murphy; Eliane Schochat
2014-01-01
INTRODUÇÃO: Pesquisas demonstram a existência do Transtorno do Processamento Auditivo em indivíduos com Comprometimento Cognitivo Leve. OBJETIVO: Verificar os efeitos de um treinamento auditivo, em indivíduos com comprometimento cognitivo leve. MÉTODOS: Participaram 25 indivíduos, com idades entre 69 e 91 anos e diagnóstico de Comprometimento Cognitivo Leve, sendo que, 10 receberam treinamento auditivo (grupo estudo), 10 receberam treinamento visual (grupo alternativo) e cinco não re...
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Aggradation of Leveed Channels and Their Flood Plains in Arroyo Bottoms
Vincent, K. R.
2005-12-01
Many arroyos that formed by incision more than a century ago in the southwestern United States are currently filling with sediment. This reversal of processes is important because it causes changes in riparian ecology, erosion hazards, ground water recharge, and sediment supply to downstream. Along the Rio Puerco and Chaco Wash in New Mexico, we examined the geometry and facies of channel and floodplain stratigraphy exposed in trenches, used high-resolution dating of the sedimentary beds, and used photographs and other historical evidence to investigate the processes of aggradation in naturally leveed channels within arroyos. Prior to the onset of aggradation, the streambeds were composed of sand and had low relief, and arroyo walls retreated rapidly due to stream undermining. Aggradation began with the formation of sand levees at the margins of the streambeds, followed by formation of newer levees increasingly closer to the thalweg. These levees coincide with rows of woody shrubs (tamarisk and willow), plants that germinated in moist sand along the high-water marks of moderate flows, and survived because subsequent periods lacked flows large enough to remove them. Flow entering a row of woody shrubs decelerates, promoting deposition of suspended sand. Stream flows in this setting are always turbid but do not have the rheology of debris flows. The rows of shrubs probably are a requirement for initial formation of sand levees on low relief streambeds in this setting. As new levees formed closer to the thalweg the channel effectively narrowed, and smaller discharges overtopped the levees adjacent to the channel. Those closer levees accumulated sand most rapidly, leaving the suspended sand concentration depleted by the time water reached more distant ones. All levees aggraded vertically. As the main channel narrowed it acquired a roughly trapezoidal-shape (Top Width/Depth ~ 9 to 5) with banks inclined close to the angle of repose. In addition, sediment deposited on
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Su, Huaizhi; Li, Hao; Kang, Yeyuan; Wen, Zhiping
2018-02-01
Seepage is one of key factors which affect the levee engineering safety. The seepage danger without timely detection and rapid response may likely lead to severe accidents such as seepage failure, slope instability, and even levee break. More than 90 percent of levee break events are caused by the seepage. It is very important for seepage behavior identification to determine accurately saturation line in levee engineering. Furthermore, the location of saturation line has a major impact on slope stability in levee engineering. Considering the structure characteristics and service condition of levee engineering, the distributed optical fiber sensing technology is introduced to implement the real-time observation of saturation line in levee engineering. The distributed optical fiber temperature sensor system (DTS)-based monitoring principle of saturation line in levee engineering is investigated. An experimental platform, which consists of DTS, heating system, water-supply system, auxiliary analysis system and levee model, is designed and constructed. The monitoring experiment of saturation line in levee model is implemented on this platform. According to the experimental results, the numerical relationship between moisture content and thermal conductivity in porous medium is identified. A line heat source-based distributed optical fiber method obtaining the thermal conductivity in porous medium is developed. A DTS-based approach is proposed to monitor the saturation line in levee engineering. The embedment pattern of optical fiber for monitoring saturation line is presented.
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Morphology of fluvial levee series along a river under human influence, Maros River, Hungary
Kiss, Tímea; Balogh, Márton; Fiala, Károly; Sipos, György
2018-02-01
The development and morphometry of fluvial levees reflect the connection between channel and overbank processes, which can be altered by various human activities. The aims of this study are to investigate the morphology and spatial characteristics of fluvial levees and evaluate the role of some local- and catchment-scale human activities on their medium-term (150 years) development. This study applies LiDAR data along a 53-km-long reach of the Maros River in Hungary. Six fluvial levee types are identified based on the beginning and end of their evolution. These levee types were generated by local nineteenth century channel regulation works (cutoffs) and mid-twentieth century channel narrowing, which was caused by gravel mining and water impoundment in the upstream sections. However, other human activities also influenced the development of active fluvial levees because their horizontal evolution could have been limited by embanked flood-protection levees or the widening of low-lying floodplain benches that were generated by channel narrowing. Additionally, revetment constructions influenced their vertical parameters as higher fluvial levees developed along the fixed banks. Generally, the older active fluvial levees are wider, while the younger active levees are narrower with steeper slopes but not always lower. On the low-lying floodplain levels (benches), the youngest fluvial levees evolved quite rapidly and consist of coarser material. Currently, only 9.8- to 38-year return-period floods could cover the fluvial levees, contributing to their evolution. This fact and the development of fluvial levee series with two-three members reflect a gradual decoupling of the channel from the floodplain.
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Levee Vertical Land Motion Changes in the Sacramento-San Joaquin Delta
Telling, J. W.; Brooks, B. A.; Glennie, C. L.; Ericksen, T. L.; Knowles, N.
2017-12-01
The Sacramento-San Joaquin Delta is home to numerous islands that provide economically and agriculturally important land. However, the island interiors are sinking and most sit below sea level, making the levee roads that surround the islands vital for their continued health and productivity. Airborne LiDAR (Light Detection and Ranging) data over the islands was collected in 2007 by the California Department of Water Resources and mobile LiDAR data was collected along the levee roads on Bacon, Bouldin, Jersey, and Brannan-Andrus Islands in 2015 and 2016 by the USGS. These datasets provide high resolution topographic models with 8 year separation that can be used to examine topographic change along the levees. A cross-section of each dataset was output along the approximate centerline of the levee road, so that profiles of the 2007 and 2015/2016 LiDAR observations could be compared. Regions of levee road subsidence and of levee road construction and reinforcement on the order of 0-3 centimeters per year were evident in locations around the islands. There is a high degree of spatial variability of these rates even for individual islands. These results were compared to the levee road maps published by the CA Delta Stewardship Council and it was found that the regions of reinforcement and subsidence did not always align between the published maps and the LiDAR data. Additionally, the levee road heights and rates of change, in regions of road subsidence, were compared to sea level rise projections to evaluate the risk that rising sea level may pose to the islands in the future.
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Directory of Open Access Journals (Sweden)
Manlio F. Márquez
2015-10-01
Full Text Available El artículo que presentan en este número de la revista CorSalud los doctores Dorantes y Trung, constituye una excelente revisión de un tema que, como bien ellos señalan, es todavía motivo de gran controversia. Vale la pena hacer un pequeño comentario histórico para situar apropiadamente al lector en esta controversia.
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Application of GPR Method for Detection of Loose Zones in Flood Levee
Gołębiowski, Tomisław; Małysa, Tomasz
2018-02-01
In the paper the results of non-invasive georadar (GPR) surveys carried out for detection of loose zones located in the flood levee was presented. Terrain measurements were performed on the Vistula river flood levee in the village of Wawrzeńczyce near Cracow. In the investigation site, during the flood in 2010, leakages of levee were observed, so detection of inner water filtration paths was an important matter taking into account the stability of the levee during the next flood. GPR surveys had reconnaissance character, so they were carried out with the use of short-offset reflection profiling (SORP) technique and radargrams were subjected to standard signal processing. The results of surveys allowed to outline main loose zone in the levee which were the reason of leakages in 2010. Additionally gravel interbeddings in sand were detected which had an important influence, due to higher porosity of such zones, to water filtration inside of the levee. In the paper three solutions which allow to increase quality and resolution of radargrams were presented, i.e. changeable-polarisation surveys, advanced signal processing and DHA procedure.
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menopausia: tendencias y controversias
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Georgina Sánchez-Ramírez
2008-01-01
Full Text Available Con la finalidad de contribuir a una actualización del estado del arte y bajo una perspectiva crítica, se realizó una revisión bibliográfica sobre las indicaciones terapéuticas de la Terapia de Reemplazo Hormonal, así como las diferentes controversias, usos y beneficios durante la pre y la posmenopausia. Los beneficios demostrados hasta el momento de la THR, son la corrección de la atrofia urogenital y/o vaginal y la disminución de las molestias de los síntomas vasomotores (los sofocos o bochornos, los vértigos, las sensaciones de hormigueo en las extremidades y palpitaciones y el aumento de la DMO que puede prevenir las fracturas de cadera y vértebras. Las dosis recomendadas para la administración de THR han variado con el tiempo, cobrando fuerza últimamente la corriente clínica que recomienda dosis menores que las utilizadas en años anteriores, ya que se están demostrando los mismos beneficios, disminuyendo los riesgos asociados a su uso, lo cual requiere una actualización en la información que manejan tanto los médicos como las usuarias. Existe además la necesidad de ampliar las investigaciones sobre el uso de otro tipo de terapias para aliviar la sintomatología climatérica diferente a la THR
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Transient Flow through an Unsaturated Levee Embankment during the 2011 Mississippi River Flood
Jafari, N.; Stark, T.; Vahedifard, F.; Cadigan, J.
2017-12-01
The Mississippi River and corresponding tributaries drain approximately 3.23 million km2 (1.25 million mi2) or the equivalent of 41% of the contiguous United States. Approximately 2,600 km ( 1,600 miles) of earthen levees presently protect major urban cities and agricultural land against the periodic Mississippi River floods within the Lower Mississippi River Valley. The 2011 flood also severely stressed the levees and highlighted the need to evaluate the behavior of levee embankments during high water levels. The performance of earthen levees is complex because of the uncertainties in construction materials, antecedent moisture contents, hydraulic properties, and lack of field monitoring. In particular, calibration of unsaturated and saturated soil properties of levee embankment and foundation layers along with the evaluation of phreatic surface during high river stage is lacking. Due to the formation of sand boils at the Duncan Point Levee in Baton Rouge, LA during the 2011 flood event, a reconnaissance survey was conducted to collect pore-water pressures in the sand foundation using piezometers and identifying the phreatic surface at the peak river level. Transient seepage analyses were performed to calibrate the foundation and levee embankment material properties using field data collected. With this calibrated levee model, numerical experiments were conducted to characterize the effects of rainfall intensity and duration, progression of phreatic surface, and seasonal climate variability prior to floods on the performance of the levee embankment. For example, elevated phreatic surface from river floods are maintained for several months and can be compounded with rainfall to lead to slope instability.
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Numerical simulation of pore pressure changes in levee under flood conditions
Stanisz, Jacek; Borecka, Aleksandra; Pilecki, Zenon; Kaczmarczyk, Robert
2017-11-01
The article discusses the potential for using numerical simulation to assess the development of deformation and pore pressure changes in a levee as a result of the increase and decrease of the flood wave. The simulation made in FLAC 2D did not take into account the filter-erosion deformation associated with seepage in the levee. The simulations were carried out for a field experimental storage consisting of two combined levees, which was constructed with the help of homogeneous cohesive materials with different filtration coefficients. Calculated and measured pore pressure changes were analysed at 4 monitoring points. The water level was increased to 4 m in 96 hours and decreased in 120 hours. The characteristics of the calculated and measured pore pressure changes over time were similar. The maximum values of the calculated and measured pore pressure were almost identical. The only differences were the greater delay of the experimental levee response to changes in water level increase compared to the response of the numerical model. These differences were probably related to filtering-erosion effects during seepage in the levee.
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Spatial relationships of levees and wetland systems within floodplains of the Wabash Basin, USA
Bray, E. N.; Morrison, R. R.; Nardi, F.; Annis, A.; Dong, Q.
2017-12-01
Given the unique biogeochemical, physical, and hydrologic services provided by floodplain wetlands, proper management of river systems should include an understanding of how floodplain modifications influences wetland ecosystems. The construction of levees can reduce river-floodplain connectivity, yet it is unclear how levees affect wetlands within a river system, let alone the cumulative impacts within an entire watershed. This paper explores spatial relationships between levee and floodplain wetland systems in the Wabash basin, United States. We used a hydrogeomorphic floodplain delineation technique to map floodplain extents and identify wetlands that may be hydrologically connected to river networks. We then spatially examined the relationship between levee presence, wetland area, and other river network attributes within discrete HUC-12 sub-basins. Our results show that cumulative wetland area is relatively constant in sub-basins that contain levees, regardless of maximum stream order within the sub-basin. In sub-basins that do not contain levees, cumulative wetland area increases with maximum stream order. However, we found that wetland distributions around levees can be complex, and further studies on the influence of levees on wetland habitat may need to be evaluated at finer-resolution spatial scales.
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Levee Seepage Detection in the Sacramento-San Joaquin Delta Using Polarimetric SAR
An, K.; Jones, C. E.; Bekaert, D. P.
2017-12-01
The Sacramento-San Joaquin Delta's extensive levee system protects over 2,800 km2 of reclaimed lands and serves as the main irrigation and domestic water supply for the state of California. However, ongoing subsidence and disaster threats from floods and earthquakes make the Delta levee system highly vulnerable, endangering water supplies for 23 million California residents and 2.5 million acres of agricultural land. Levee failure in the Delta can cause saltwater intrusion from San Francisco Bay, reducing water quality and curtailing water exports to residents, commercial users, and farmers. To protect the Delta levee system, it is essential to search for signs of seepage in which water is piping through or beneath levees, which can be associated with deformation of the levees themselves. Until now, in-situ monitoring has largely been applied, however, this is a time-consuming and expensive approach. We use data acquired with NASA's UAVSAR (Uninhabited Aerial Vehicle Synthetic Aperture Radar) airborne radar instrument to identify and characterize levee seepages and associated land subsidence through advanced remote sensing technologies. The high spatial resolution of UAVSAR can help to direct surveys to areas that are likely to be experiencing damage. UAVSAR is an L-band airborne sensor with high signal-to-noise ratio, repeat flight track accuracy, and spatial resolution of 7x7 m2 (for multi-looked products) that is necessary for detailed levee monitoring. The adaptability of radar instruments in their ability to see through smoke, haze, and clouds during the day or night, is especially relevant during disaster events, when cloud cover or lack of solar illumination inhibits traditional visual surveys of damage. We demonstrate the advantages of combining polarimetric radar imagery with geographic information systems (GIS) datasets in locating seepage features along critical levee infrastructure in the Delta for 2009-2016. The ability to efficiently locate potential
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Levee Presence and Wetland Areas within the 100-Year Floodplain of the Wabash Basin
Morrison, R. R.; Dong, Q.; Nardi, F.; Grantham, T.; Annis, A.
2016-12-01
Wetlands have declined over the past century due to land use changes and water management activities in the United States. Levees have been extensively built to provide protection against flooding events, and can fundamentally alter the water distribution and hydrologic dynamics within floodplains. Although levees can reduce wetlands in many places, it is unclear how much wetland areas are impacted at a basin-scale. This study explores the relationship between wetlands, levee presence, and other important hydrologic metrics within a 100-year floodplain. We estimated total wetland area, levee length, floodplain area and other variables, in discrete 12-digit hydrologic units (HUC-12) of the Wabash Basin (n=854) and examined the relationship between these variables using non-parametric statistical tests. We found greater areas of wetland habitat in HUC12 units that contain levees compared to those without levees when we aggregated the results across the entire basin. Factors such as stream order, mean annual flow, and HUC12 area are not correlated with the wetland area in HUC-12 units that contain levees. In addition, median wetland area in HUC12 units with levees is surprisingly consistent regardless of maximum stream order. Visual observations of wetland distributions indicate that wetland presence may be dependent on its location relative to levees. These results indicate that refined geospatial analyses may be necessary to explore the complex influence of levees on wetland habitat, and that additional basins should be explored to develop more generalized trends. This information is preliminary and subject to revision.
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An assessment of two methods for identifying undocumented levees using remotely sensed data
Czuba, Christiana R.; Williams, Byron K.; Westman, Jack; LeClaire, Keith
2015-01-01
Many undocumented and commonly unmaintained levees exist in the landscape complicating flood forecasting, risk management, and emergency response. This report describes a pilot study completed by the U.S. Geological Survey in cooperation with the U.S. Army Corps of Engineers to assess two methods to identify undocumented levees by using remotely sensed, high-resolution topographic data. For the first method, the U.S. Army Corps of Engineers examined hillshades computed from a digital elevation model that was derived from light detection and ranging (lidar) to visually identify potential levees and then used detailed site visits to assess the validity of the identifications. For the second method, the U.S. Geological Survey applied a wavelet transform to a lidar-derived digital elevation model to identify potential levees. The hillshade method was applied to Delano, Minnesota, and the wavelet-transform method was applied to Delano and Springfield, Minnesota. Both methods were successful in identifying levees but also identified other features that required interpretation to differentiate from levees such as constructed barriers, high banks, and bluffs. Both methods are complementary to each other, and a potential conjunctive method for testing in the future includes (1) use of the wavelet-transform method to rapidly identify slope-break features in high-resolution topographic data, (2) further examination of topographic data using hillshades and aerial photographs to classify features and map potential levees, and (3) a verification check of each identified potential levee with local officials and field visits.
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Afzal, Muhammad; Khan, Ejaz A; Khan, Wisal A; Anwar, Viqas; Yaqoob, Asma; Rafiq, Shahid; Azam, Shaheena
2014-05-01
Antenatal Bartter syndrome is characterized by severe polyhydramnios in mother leading to premature delivery. Antenatal treatment has proven effective to prevent these problems. Postnatally newborns suffer from recurrent episodes of severe dehydration and electrolyte imbalance which can lead to fatal outcome. These manifestations are likely to be overlooked and missed under the umbrella of diagnosis of prematurity. This premature newborn with antenatal polyhydramnios had severe manifestations of polyuria, recurrent dehydration, electrolyte derangements and metabolic alkalosis. She was managed accordingly but unfortunately could not survive beyond 4 weeks.
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Study of Movement and Seepage Along Levees Using DINSAR and the Airborne UAVSAR Instrument
Jones, Cathleen E.; Bawden, Gerald; Deverel, Steven; Dudas, Joel; Hensley, Scott
2012-01-01
We have studied the utility of high resolution SAR (synthetic aperture radar) for levee monitoring using UAVSAR (Uninhabited Aerial Vehicle Synthetic Aperture Radar) data collected along the dikes and levees in California's Sacramento-San Joaquin Delta and along the lower Mississippi River. Our study has focused on detecting and tracking changes that are indicative of potential problem spots, namely deformation of the levees, subsidence along the levee toe, and seepage through the levees, making use of polarimetric and interferometric SAR techniques. Here was present some results of those studies, which show that high resolution, low noise SAR imaging could supplement more traditional ground-based monitoring methods by providing early indicators of seepage and deformation.
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Complicaciones neurológicas de la endocarditis infecciosa: controversias
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Federico A. Silva, MD., MSc
2011-07-01
Full Text Available En la endocarditis infecciosa aguda se describen complicaciones neurológicas entre 20% y 40% de los casos, lo cual representa un importante factor que predice morbimortalidad, secuelas y discapacidad. Esta entidad se caracteriza por un amplio espectro clínico debido a su compleja fisiopatología, que involucra entre otros, fenómenos inflamatorios, inmunes, infecciosos y embólicos. A pesar de la notable frecuencia de las complicaciones neurológicas en la endocarditis infecciosa, dadas especialmente por enfermedad cerebrovascular y neuroinfecciones, aun existen controversias acerca de algunos aspectos diagnósticos y terapéuticos, en parte por la poca evidencia disponible, las cuales se discuten a continuación, a partir de una serie de casos atendidos en la Fundación Cardiovascular de Colombia.
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Environment - Borrow Area for Temporary Levee
Army Corps of Engineers, Department of the Army, Department of Defense — This data represents the location of a borrow site for construction materials used in temporary levee building during flood events. The footprint of these areas have...
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Directory of Open Access Journals (Sweden)
Lalitha Dabbiru
2017-03-01
Full Text Available This article reviews the use of synthetic aperture radar remote sensing data for earthen levee mapping with an emphasis on finding the slump slides on the levees. Earthen levees built on the natural levees parallel to the river channel are designed to protect large areas of populated and cultivated land in the Unites States from flooding. One of the signs of potential impending levee failure is the appearance of slump slides. On-site inspection of levees is expensive and time-consuming; therefore, a need to develop efficient techniques based on remote sensing technologies is mandatory to prevent failures under flood loading. Analysis of multi-polarized radar data is one of the viable tools for detecting the problem areas on the levees. In this study, we develop methods to detect anomalies on the levee, such as slump slides and give levee managers new tools to prioritize their tasks. This paper presents results of applying the National Aeronautics and Space Administration (NASA Jet Propulsion Lab (JPL’s Uninhabited Aerial Vehicle Synthetic Aperture Radar (UAVSAR quad-polarized L-band data to detect slump slides on earthen levees. The study area encompasses a portion of levees of the lower Mississippi River in the United States. In this paper, we investigate the performance of polarimetric and texture features for efficient levee classification. Texture features derived from the gray level co-occurrence (GLCM matrix and discrete wavelet transform were computed and analyzed for efficient levee classification. The pixel-based polarimetric decomposition features, such as entropy, anisotropy, and scattering angle were also computed and applied to the support vector machine classifier to characterize the radar imagery and compared the results with texture-based classification. Our experimental results showed that inclusion of textural features derived from the SAR data using the discrete wavelet transform (DWT features and GLCM features provided
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Directory of Open Access Journals (Sweden)
Kessy Flora
2011-05-01
Full Text Available Abstract Background The potential of antenatal care for reducing maternal morbidity and improving newborn survival and health is widely acknowledged. Yet there are worrying gaps in knowledge of the quality of antenatal care provided in Tanzania. In particular, determinants of health workers' performance have not yet been fully understood. This paper uses ethnographic methods to document health workers' antenatal care practices with reference to the national Focused Antenatal Care guidelines and identifies factors influencing health workers' performance. Potential implications for improving antenatal care provision in Tanzania are discussed. Methods Combining different qualitative techniques, we studied health workers' antenatal care practices in four public antenatal care clinics in the Kilombero Valley, south-eastern Tanzania. A total of 36 antenatal care consultations were observed and compared with the Focused Antenatal Care guidelines. Participant observation, informal discussions and in-depth interviews with the staff helped to identify and explain health workers' practices and contextual factors influencing antenatal care provision. Results The delivery of antenatal care services to pregnant women at the selected antenatal care clinics varied widely. Some services that are recommended by the Focused Antenatal Care guidelines were given to all women while other services were not delivered at all. Factors influencing health workers' practices were poor implementation of the Focused Antenatal Care guidelines, lack of trained staff and absenteeism, supply shortages and use of working tools that are not consistent with the Focused Antenatal Care guidelines. Health workers react to difficult working conditions by developing informal practices as coping strategies or "street-level bureaucracy". Conclusions Efforts to improve antenatal care should address shortages of trained staff through expanding training opportunities, including health worker
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Gee, Hugo K.W.; King, Sammy L.; Keim, Richard F.
2014-01-01
Flooding is a defining disturbance in floodplain forests affecting seed germination, seedling establishment, and tree growth. Globally, flood control, including artificial levees, dams, and channelization has altered flood regimes in floodplains. However, a paucity of data are available in regards to the long-term effects of levees on stand establishment and tree growth in floodplain forests. In this study, we used dendrochronological techniques to reconstruct tree recruitment and tree growth over a 90-year period at three stands within a ring levee in the Mississippi River Alluvial Valley (MAV) and to evaluate whether recruitment patterns and tree growth changed following levee construction. We hypothesized that: (1) sugarberry is increasing in dominance and overcup oak (Quercus lyrata) is becoming less dominant since the levee, and that changes in hydrology are playing a greater role than canopy disturbance in these changes in species dominance; and (2) that overcup oak growth has declined following construction of the levee and cessation of overbank flooding whereas that of sugarberry has increased. Recruitment patterns shifted from flood-tolerant overcup oak to flood-intolerant sugarberry (Celtis laevigata) after levee construction. None of the 122 sugarberry trees cored in this study established prior to the levee, but it was the most common species established after the levee. The mechanisms behind the compositional change are unknown, however, the cosmopolitan distribution of overcup oak during the pre-levee period and sugarberry during the post-levee period, the lack of sugarberry establishment in the pre-levee period, and the confinement of overcup oak regeneration to the lowest areas in each stand after harvest in the post-levee period indicate that species-specific responses to flooding and light availability are forcing recruitment patterns. Overcup oak growth was also affected by levee construction, but in contrast to our hypothesis, growth actually
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ON LAND SLIDE DETECTION USING TERRASAR-X OVER EARTHEN LEVEES
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M. Mahrooghy
2012-08-01
Full Text Available Earthen levees have an important role to protect large areas of inhabited and cultivated land in the US from flooding. Failure of the levees can threaten the loss of life and property. One of the problems which can lead to a complete failure during a high water event is a slough slide. In this research, we are trying to detect such slides using X-band SAR data. Our methodology consists of the following four steps: 1 segmentation of the levee area from background; 2 extracting features including backscatter features and texture features; 3 training a back propagation neural network classifier using ground-truth data; and 4 testing the area of interest and validation of the results using ground truth data. A dual-polarimetric X-band image is acquired from the German TerraSAR-X satellite. Ground-truth data include the slides and healthy area. The study area is an approximately 1 km stretch of levee along the lower Mississippi River in the United States. The output classification shows the two classes of healthy and slide areas. The results show classification accuracies of approximately 67% for detecting the slide pixels.
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Levee reliability analyses for various flood return periods - a case study in southern Taiwan
Huang, W.-C.; Yu, H.-W.; Weng, M.-C.
2015-04-01
In recent years, heavy rainfall conditions have caused disasters around the world. To prevent losses by floods, levees have often been constructed in inundation-prone areas. This study performed reliability analyses for the Chiuliao First Levee in southern Taiwan. The failure-related parameters were the water level, the scouring depth, and the in situ friction angle. Three major failure mechanisms were considered: the slope sliding failure of the levee and the sliding and overturning failures of the retaining wall. When the variability of the in situ friction angle and the scouring depth are considered for various flood return periods, the variations of the factor of safety for the different failure mechanisms show that the retaining wall sliding and overturning failures are more sensitive to the change of the friction angle. When the flood return period is greater than 2 years, the levee could fail with slope sliding for all values of the water level difference. The results of levee stability analysis considering the variability of different parameters could aid engineers in designing the levee cross sections, especially with potential failure mechanisms in mind.
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El confesor regio Fray Luis Aliaga y la controversia Inmaculista
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Callado Estela, Emilio
2016-06-01
Full Text Available The present article analyses the participation of the aragonese dominican monk Luis Aliaga (Zaragoza, 1565-† Zaragoza, 1626, last confessor of Philip III and Inquiring general of the Hispanic Monarchy from 1619, in one of the most white hot theological controversies along the 17th century: the Immaculate Conception of the Virgin MaryEl presente artículo analiza la participación del dominico aragonés fray Luis Aliaga (Zaragoza, 1565-† Zaragoza, 1626 , último confesor de Felipe III e Inquisidor general de la Monarquía Hispánica desde 1619, en una de las controversias teológicas más candentes a lo largo del siglo XVII: la Inmaculada Concepción de la Virgen María.
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Posiciones y debates en torno a los mecanismos de solución de controversias inversor – Estado
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Magdalena Bas Vilizzio
2017-05-01
Full Text Available Los mecanismos de solución de controversias inversor - Estado previstos en más de 3000 tratados bilaterales de inversión y otros instrumentos jurídicos han sido centro de numerosas críticas en los últimos años. En esta línea, en primer lugar, se analizarán los riesgos que entraña el sistema arbitral del Centro de Arreglo de Diferencias relativas a Inversiones (CIADI o la Corte Permanente de Arbitraje (CPA, entre otros, y que han sido identificados desde el ámbito académico, social y gubernamental. Este trabajo analizará específicamente la conformación de los tribunales arbitrales, la ausencia de una instancia de apelación, la inclusión de una amplia diversidad de temas dentro del concepto de inversión protegida y el factor social en el arbitraje de inversiones, especialmente en relación al género y nacionalidad de los árbitros. Asimismo, se examinarán los diferentes caminos hacia la reforma o intentos de mejoramiento parcial del sistema en base a ejemplos concretos. Tal es el caso de la eliminación de ciertas áreas de la solución de controversias inversor - Estado, como las políticas de control del tabaco del Acuerdo de Asociación Transpacífico; la creación de un sistema de Cortes de Inversiones como propone la Unión Europea en los acuerdos que está negociando con terceros Estados; o la exclusión de los mecanismos de solución de controversias de los acuerdos de protección de inversiones, como en el nuevo modelo de Acuerdo de cooperación y facilitación de inversiones de Brasil.
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Carbonate Channel-Levee Systems Influenced by Mass-Transport Deposition, Browse Basin, Australia
Dunlap, D.; Janson, X.; Sanchez-Phelps, C.; Covault, J. A.
2017-12-01
Submarine channels are primary conduits for clastic sediment transport to deep-water basins, thereby controlling the location of marine depocenters and sediment bypass. The evolution and depositional character of submarine channels have broad implications to sediment dispersal, sediment quality, and hydrocarbon exploration potential. Siliciclastic channel systems have been extensively studied in modern environments, seismic and outcrop; however, carbonate channel-levee deposits have only recently been explored. Here we utilize newly released high-resolution (90 Hz) seismic-reflection data from the Australian Browse Basin to document the influence of mass-transport complex (MTC) deposition on the stratigraphic architecture of carbonate channel-levee systems. The 2014 vintage seismic survey is 2500 km2 and hosts numerous large Miocene-age carbonate channel-levee complexes basinward of the shelf edge. Regional horizons and individual channel forms were mapped. Channels range from 200-300 m wide and are bounded by high-relief levee-overbank wedges (>100 ms TWTT). These channels extend across the survey area >70 km. The leveed-channels were sourced from middle and late Miocene slope gullies linked to platform carbonates. Slope-attached and locally derived MTC's are evident throughout the Miocene section likely related to periods of basin inversion and shelf-edge gully incision. We interpret that regionally extensive (>1000 km2) slope-attached MTC's can shut down a channel-levee system and trigger the initiation of a new system, whereas more locally derived (wasting and turbidity currents, which informs depositional models of carbonate slope systems and calls for re-evaluation of the controls on stratigraphic patterns in mixed siliciclastic-carbonate deep-water basins.
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Marcio Luiz Figueredo Balthazar
2008-01-01
Resumo: A organização cerebral da memória léxico-semântica, assim como suas alterações em pacientes com doença de Alzheimer (DA) leve e Comprometimento Cognitivo Leve amnéstico (CCLa) não são completamente conhecidas. Neste estudo, avaliamos o desempenho de pacientes com DA leve, CCLa e idosos normais em testes léxico-semânticos como o Teste de Nomeação de Boston (TNB), Teste de Similaridades do CAMCOG e Fluência Verbal (FV) para categoria animais, além de outros domínios cognitivos. Aprofund...
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Sustentabilidad y economía: la controversia de la valoración ambiental
Alma Angelina Haro-Martínez; Isabel Cristina Taddei-Bringas
2014-01-01
En el tema del desarrollo sustentable una controversia fundamental es la asignación de valor a bienes y servicios ambientales. La economía lo aborda desde dos perspectivas: el enfoque tradicional neoclásico (economía ambiental) y otra, más integral, donde confluyen distintas ciencias (economía ecológica). Este trabajo ofrece una revisión crítica de la teoría económica convencional asociada al desarrollo sustentable, asimismo, destaca la necesidad de asignar valores a los servicios ambientales...
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An Approach for Real-time Levee Health Monitoring Using Signal Processing Methods
Pyayt, A.L.; Kozionov, A.P.; Mokhov, I.I.; Lang, B.; Krzhizhanovskaya, V.V.; Sloot, P.M.A.
2013-01-01
We developed a levee health monitoring system within the UrbanFlood project funded under the EU 7th Framework Programme. A novel real-time levee health assessment Artificial Intelligence system is developed using data-driven methods. The system is implemented in the UrbanFlood early warning system.
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Collins, Brian D.; Kayen, Robert; Minasian, Diane L.; Reiss, Thomas
2009-01-01
Hurricane Katrina made landfall with the northern Gulf Coast on August 29, 2005, as one of the strongest hurricanes on record. The storm damage incurred in Louisiana included a number of levee failures that led to the inundation of approximately 85 percent of the metropolitan New Orleans area. Whereas extreme levels of storm damage were expected from such an event, the catastrophic failure of the New Orleans levees prompted a quick mobilization of engineering experts to assess why and how particular levees failed. As part of this mobilization, civil engineering members of the United States Geological Survey (USGS) performed terrestrial lidar topographic surveys at major levee failures in the New Orleans area. The focus of the terrestrial lidar effort was to obtain precise measurements of the ground surface to map soil displacements at each levee site, the nonuniformity of levee height freeboard, depth of erosion where scour occurred, and distress in structures at incipient failure. In total, we investigated eight sites in the New Orleans region, including both earth and concrete floodwall levee breaks. The datasets extend from the 17th Street Canal in the Orleans East Bank area to the intersection of the Gulf Intracoastal Waterway (GIWW) with the Mississippi River Gulf Outlet (MRGO) in the New Orleans East area. The lidar scan data consists of electronic files containing millions of surveyed points. These points characterize the topography of each levee's postfailure or incipient condition and are available for download through online hyperlinks. The data serve as a permanent archive of the catastrophic damage of Hurricane Katrina on the levee systems of New Orleans. Complete details of the data collection, processing, and georeferencing methodologies are provided in this report to assist in the visualization and analysis of the data by future users.
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2017-06-30
ER D C/ EL S R- 17 -3 Levee Setbacks: An Innovative , Cost-Effective, and Sustainable Solution for Improved Flood Risk Management En vi...EL SR-17-3 June 2017 Levee Setbacks: An Innovative , Cost-Effective, and Sustainable Solution for Improved Flood Risk Management David L. Smith...alternative view point is necessary. ERDC/EL SR-17-3 4 Levee setbacks are a relatively recent innovation in Corps flood risk management practice
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REVIEW OF FOCUSSED ANTENATAL CARE
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Sreelatha
2015-09-01
Full Text Available INTRODUCTION: Antenatal care is a comprehensive antepartum programme which involves a coordinated approach to medical care , continuous risk assessment , and psychological support that optimally begins before conception and extends throughout the postpartum period and int erconceptional period . [1] One of major responsibility of obstetrician providing antenatal care is to identify high risk factors based on past history, examination and investigation results. The objective of antenatal care therefore is to assure that every wanted pregnancy results in the delivery of a healthy baby without impairing the mothers health . [2] In a 1914 study by Williams antenatal care reduced fetal mortality by 40%
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Grain-size segregation and levee formation in geophysical mass flows
Johnson, C.G.; Kokelaar, B.P.; Iverson, Richard M.; Logan, M.; LaHusen, R.G.; Gray, J.M.N.T.
2012-01-01
Data from large-scale debris-flow experiments are combined with modeling of particle-size segregation to explain the formation of lateral levees enriched in coarse grains. The experimental flows consisted of 10 m3 of water-saturated sand and gravel, which traveled ∼80 m down a steeply inclined flume before forming an elongated leveed deposit 10 m long on a nearly horizontal runout surface. We measured the surface velocity field and observed the sequence of deposition by seeding tracers onto the flow surface and tracking them in video footage. Levees formed by progressive downslope accretion approximately 3.5 m behind the flow front, which advanced steadily at ∼2 m s−1during most of the runout. Segregation was measured by placing ∼600 coarse tracer pebbles on the bed, which, when entrained into the flow, segregated upwards at ∼6–7.5 cm s−1. When excavated from the deposit these were distributed in a horseshoe-shaped pattern that became increasingly elevated closer to the deposit termination. Although there was clear evidence for inverse grading during the flow, transect sampling revealed that the resulting leveed deposit was strongly graded laterally, with only weak vertical grading. We construct an empirical, three-dimensional velocity field resembling the experimental observations, and use this with a particle-size segregation model to predict the segregation and transport of material through the flow. We infer that coarse material segregates to the flow surface and is transported to the flow front by shear. Within the flow head, coarse material is overridden, then recirculates in spiral trajectories due to size-segregation, before being advected to the flow edges and deposited to form coarse-particle-enriched levees.
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¿«Sin loteo no hay esquí» o «Sí al esquí, no al loteo»? Análisis de una controversia ambiental
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Carina Llosa
2016-01-01
Full Text Available En este artículo se exponen los principales resultados del análisis de una controversia ambiental en El Bolsón, Río Negro, Argentina. Como no existe una teoría general para analizar controversias ambientales, se recurrió a una triangulación teórica en el marco del campo de la ciencia, la tecnología y la sociedad. La empresa a cargo de la concesión de las pistas de esquí, asevera que necesita de un negocio inmobiliario para garantizar las mejoras que debe realizar. Propone una urbanización que considera sustentable y es apoyada por un sector de la población, pero la escala de dicho proyecto y las tecnologías involucradas, forjaron una resistencia en otro sector de la población, que no la considera sustentable. Se investigaron las prácticas y representaciones de las partes en la construcción de la controversia y su proceso de cambio, por medio del análisis de fuentes y entrevistas en profundidad a informantes clave.
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Sawyer, D. E.; Flemings, P. B.; Nikolinakou, M. A.
2011-12-01
Late Pleistocene channel levees on the Mississippi Fan failed repeatedly along deep-seated listric faults. These growth faults begin at the top of the levee, as much as a kilometer away from the channel axis. They plunge 150-200 meters downward reaching their deepest point halfway towards the channel axis (0.5 km) along the base of a regional sand unit. They then rise toward the channel axis where they emerge. The erosion of toe-thrust material coupled with levee growth, promoted a dynamic equilibrium: turbidity currents flushed the channel axis and deposited new levee on the margins, which induced further displacement into the channel. With a geomechanical model we show that deep-seated failure occurred by undrained loading of an underlying low permeability mudstone. Excess pore pressure formed a low-strength layer that localized the detachment at the base of a regional sand. Our results show that deep-seated failure is expected when levee systems form above regional sand bodies that were deposited rapidly above low permeability mudstone. Furthermore, the presence of this failure style in channel-levee systems is a strong indicator that overpressures and low effective stresses were present during formation and thus record paleo-pressures. Understanding these systems is critical for the design of safe well penetrations, predicting hydraulic connectivity of deepwater channel sands, and the growth of submarine channel-levee systems. This study illuminates the linkages between sedimentation, erosion, and the mechanical stability of levees in submarine channel systems.
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Efeitos do treinamento auditivo em idosos com Comprometimento Cognitivo Leve
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Renata Rezende de Almeida Ávila
2014-01-01
Full Text Available INTRODUÇÃO: Pesquisas demonstram a existência do Transtorno do Processamento Auditivo em indivíduos com Comprometimento Cognitivo Leve. OBJETIVO: Verificar os efeitos de um treinamento auditivo, em indivíduos com comprometimento cognitivo leve. MÉTODOS: Participaram 25 indivíduos, com idades entre 69 e 91 anos e diagnóstico de Comprometimento Cognitivo Leve, sendo que, 10 receberam treinamento auditivo (grupo estudo, 10 receberam treinamento visual (grupo alternativo e cinco não receberam intervenção (grupo controle. Testes cognitivos e de processamento auditivo foram aplicados antes e após os treinamentos. RESULTADOS: Apenas o grupo estudo apresentou melhora significante para todas as habilidades auditivas testadas, mas com piora do desempenho para as habilidades cognitivas. CONCLUSÃO: O treinamento auditivo foi efetivo em relação às habilidades auditivas, mas não em relação às habilidades cognitivas.
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Using ground penetrating radar in levee assessment to detect small scale animal burrows
Chlaib, Hussein K.; Mahdi, Hanan; Al-Shukri, Haydar; Su, Mehmet M.; Catakli, Aycan; Abd, Najah
2014-04-01
Levees are civil engineering structures built to protect human lives, property, and agricultural lands during flood events. To keep these important structures in a safe condition, continuous monitoring must be performed regularly and thoroughly. Small rodent burrows are one of the major defects within levees; however, their early detection and repair helps in protecting levees during flooding events. A set of laboratory experiments was conducted to analyze the polarity change in GPR signals in the presence of subsurface voids and water-filled cavities. Ground Penetrating Radar (GPR) surveys using multi frequency antennas (400 MHz and 900 MHz) were conducted along an 875 meter section of the Lollie Levee near Conway, Arkansas, USA, to assess the levee's structural integrity. Many subsurface animal burrows, water-filled cavities, clay clasts, and metallic objects were investigated and identified. These anomalies were located at different depths and have different sizes. To ground truth the observations, hand dug trenches were excavated to confirm several anomalies. Results show an excellent match between GPR interpreted anomalies and the observed features. In-situ dielectric constant measurements were used to calculate the feature depths. The results of this research show that the 900 MHz antenna has more advantages over the 400 MHz antenna.
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Ramakalavathi Marapareddy
2017-10-01
Full Text Available This paper analyzes the use of a synthetic aperture radar (SAR imagery to support levee condition assessment by detecting potential slide areas in an efficient and cost-effective manner. Levees are prone to a failure in the form of internal erosion within the earthen structure and landslides (also called slough or slump slides. If not repaired, slough slides may lead to levee failures. In this paper, we compare the accuracy of the supervised classification methods minimum distance (MD using Euclidean and Mahalanobis distance, support vector machine (SVM, and maximum likelihood (ML, using SAR technology to detect slough slides on earthen levees. In this work, the effectiveness of the algorithms was demonstrated using quad-polarimetric L-band SAR imagery from the NASA Jet Propulsion Laboratory’s (JPL’s uninhabited aerial vehicle synthetic aperture radar (UAVSAR. The study area is a section of the lower Mississippi River valley in the Southern USA, where earthen flood control levees are maintained by the US Army Corps of Engineers.
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Directory of Open Access Journals (Sweden)
Luis Felipe Zapata
2008-01-01
Full Text Available La Demencia Tipo Alzheimer (DTA representa un 70% del total de demencias que afectan a las personas de edad avanzada. Es una enfermedad neurodegenerativa que ocasiona un significativo deterioro cognitivo en los pacientes e implica una incapacidad progresiva para el adecuado funcionamiento en la vida diaria. Los estudios han tenido como eje el deterioro cognitivo, principalmente los procesos de memoria que son los más dramáticos. Sólo en años recientes se ha empezado a investigar el deterioro que puede causar la enfermedad a otros niveles como en el reconocimiento de las expresiones faciales emocionales. El objetivo de la presente investigación es analizar el reconocimiento de la expresión facial emocional en pacientes con DTA frente a personas sanas y determinar si se presentan alteraciones en este tipo de reconocimiento en los pacientes con dicha demencia. PACIENTES Y MÉTODOS: se conformaron dos grupos. Uno de 22 pacientes con DTA leves y moderados y otro grupo de 22 personas sin demencia. Se aplicó el MMSE para el diagnóstico del grado de severidad de la demencia y la prueba de rostros Pofa Kit de Paul Ekman para la evaluación del reconocimiento de la expresión facial emocional. RESULTADOS: se encontraron diferencias significativas en el reconocimiento global entre el grupo control y el grupo de pacientes. La única emoción que permaneció reconocida fue la de felicidad aún en estados moderados de la enfermedad. La rabia y tristeza se vieron afectadas desde los estados leves y el reconocimiento de la expresión de miedo se alteró solo en los estados moderados de la enfermedad
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Babalola, Stella
2014-02-01
Many pregnant women in Africa who access professional antenatal care do not receive all the WHO-recommended components of care. Using Demographic and Health Survey (DHS) data from Kenya, Malawi and Nigeria, this study assesses the relationship of education level with the quality of antenatal care received and highlights how the number of antenatal visits mediates this relationship. The results show that a large proportion of the effect of education level on quality of care is direct, while only a small portion is mediated through the number of antenatal visits. Efforts to improve pregnancy outcomes for under-privileged women should focus on removing structural barriers to access, strengthening the technical and interpersonal skills of providers, and addressing providers' biases and discriminatory practices towards these women. Such efforts should also seek to empower underprivileged women to insist on quality antenatal care by explaining what to expect during an antenatal visit.
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Overview of Levee Setback Projects and Benefits
2017-07-31
other life-history stages of fish and other aquatic organisms . Levees can also increase the frequency of common floods in the floodplain where they...projects is the use of flood- borne sediments to supplement fertilizers in flooded farm fields. Historically, floodwaters were a significant source of
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Mount St. Helens Project. Cowlitz River Levee Systems, 2009 Level of Flood Protection Update Summary
2010-02-04
of Flood Protection Update Summary Draft December 2009 Page F-5 soil in unsaturated region. So those equipotential lines above phreatic surface are...Lexington levee where a 50 percent probability of failure is assumed when the water surface is at the top of the levee and a 100 percent chance of failure...is assumed when the water surface is above the top of the levee. Additionally, for cases where the SWL is determined to be the same elevation as
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National Research Council Canada - National Science Library
Dunbar, Joseph B; Llopis, Jose L; Sills, George L; Smith, Eric W; Miller, Rick D; Ivanov, Julian; Corwin, Robert F
2007-01-01
In November 2004, a team from the U.S. Army Engineer Research and Development Center conducted a ponding test on a reach of the Retamal levee in the Lower Rio Grande Valley to simulate performance of the levee during a flood event...
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Dwornik Maciej
2016-01-01
Full Text Available The numerical modelling of coupled mechanical, thermal and hydrogeological processes for a soil levee is presented in the paper. The modelling was performed for a real levee that was built in Poland as a part of the ISMOP project. Only four parameters were changed to build different flood waves: the water level, period of water increase, period of water decrease, and period of low water level after the experiment. Results of numerical modelling shows that it is possible and advisable to calculate simultaneously changes of thermal and hydro-mechanical fields. The presented results show that it is also possible to use thermal sensors in place of more expensive pore pressure sensors, with some limitations. The results of stability analysis show that the levee is less stable when the water level decreases, after which factor of safety decreases significantly. For all flooding wave parameters described in the paper, the levee is very stable and factor of safety variations for any particular stage were not very large.
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A. A. Freixo
2002-06-01
Full Text Available Este trabalho teve como objetivo estudar a natureza química das frações leves-livres (FLL e leves intra-agregado (FLI da matéria orgânica do solo, obtidas pelo fracionamento físico do solo por densidade, por meio da espectroscopia na região do infravermelho, para verificar se tais frações constituem compartimentos distintos da matéria orgânica do solo. Foram analisadas amostras de Latossolos de dois estados do Brasil (RS e GO, submetidos a plantio direto e preparo convencional, em distintos sistemas de rotação de culturas. A análise por infravermelho revelou diferenças contrastantes entre os compartimentos orgânicos estudados. Os espectros de IV da fração leve-livre apresentaram configuração semelhante aos dos resíduos vegetais, indicando que ela se encontra em estádios iniciais de transformação. Não foram observadas diferenças estruturais na FLL entre os distintos sistemas de preparo e rotação de culturas. Os espectros de IV da FLI apresentaram bandas de absorção N-H e C-O de polissacarídeos menos intensas e em maior conjugação, em relação aos espectros da FLL, características de material mais humificado. Foi observada ainda uma maior transformação estrutural da fração leve intra-agregado em solos sob preparo convencional, quando comparada à FLI de solo sob vegetação natural e plantio direto. Os índices de hidrofobicidade (IH e de condensação (IC, determinados a partir de relações entre as bandas de absorção de grupamentos - CH3 alifáticos, C-O de polissacarídeos e C=O conjugados, permitiram identificar as diferenças na recalcitrância e condensação das frações leves. Constatou-se que ambos os índices foram significativamente maiores para a matéria orgânica intra-agregado, por conseqüência de seu maior grau de humificação.
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Antenatal corticosteroids: an assessment of anticipated benefits and potential risks.
Jobe, Alan H; Goldenberg, Robert L
2018-04-07
Antenatal corticosteroids are standard of care for pregnancies at risk of preterm delivery between 24-34 weeks' gestational age. Recent trials demonstrate modest benefits from antenatal corticosteroids for late preterm and elective cesarean deliveries, and antenatal corticosteroids for periviable deliveries should be considered with family discussion. However, many women with threatened preterm deliveries receive antenatal corticosteroids but do not deliver until >34 weeks or at term. The net effect is that a substantial fraction of the delivery population will be exposed to antenatal corticosteroids. There are gaps in accurate assessments of benefits of antenatal corticosteroids because the randomized controlled trials were performed prior to about 1990 in pregnancies generally >28 weeks. The care practices for the mother and infant survival were different than today. The randomized controlled trial data also do not strongly support the optimal interval from antenatal corticosteroid treatment to delivery of 1-7 days. Epidemiology-based studies using large cohorts with >85% of at-risk pregnancies treated with antenatal corticosteroids probably overestimate the benefits of antenatal corticosteroids. Although most of the prematurity-associated mortality is in low-resource environments, the efficacy and safety of antenatal corticosteroids in those environments remain to be evaluated. The short-term benefits of antenatal corticosteroids for high-risk pregnancies in high-resource environments certainly justify antenatal corticosteroids as few risks have been identified over many years. However, cardiovascular and metabolic abnormalities have been identified in large animal models and cohorts of children exposed to antenatal corticosteroids that are consistent with fetal programming for adult diseases. These late effects of antenatal corticosteroids suggest caution for the expanded use of antenatal corticosteroids beyond at-risk pregnancies at 24-34 weeks. A way forward
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Laboratory Modeling of Self-Formed Leveed Channels From Sediment-Laden Flows Entering Still Water
Rowland, J. C.; Dietrich, W. E.
2004-12-01
Self-formed leveed channels constructed by deposition of suspended sediment from sediment-laden flows entering still water are common features in nature. Such channels drive delta progradation, develop at tidal inlets and occur where mainstem river flows empty into oxbows and blocked valley lakes. Presently there is no theory for the formation of such channels. This lack of theory is partly due to a lack of field or laboratory studies that provide insight about the mechanism controlling these self-formed, propagating channels. The creation of such features in the laboratory, have proved illusive to date. Our ongoing experiments aimed at modeling the formation of floodplain tie channels provide insight into the necessary conditions for levee formation and channel growth. Under conditions of steady water discharge, constant sediment feed rate, unimodal sediment distribution and invariant basin stage we are able to create subaqueous lateral bars (submerged levees) along the margins of a sediment laden jet. Our results highlight the sensitivity of channel formation to issues of scaling and experimental design. In the laboratory, levee formation has only been possible with the use of plastic particles (specific gravity ~1.5); complete bed alluviation and dune formation results from the use of particles with specific gravities of ~ 2.65 across a range grain diameters and shapes. We hypothesize this effect is related to high entrainment thresholds relative to suspension thresholds of small (< 100 mm) natural particles under conditions of reduced turbulence in laboratory scaled flows. Additionally, both the width to depth ratio and the form of the outlet channel introducing the sediment laden flow into the experimental basin exert a strong control on sedimentation pattern and levee growth. Continuing experiments are focused on generating emergent channel levees and a basin ward propagation of the channel by adjusting the form of the feed channel, varying basin stage, and
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SIRS Digues 2.0: A Cooperative Software For Levees Management
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Moins Isabelle
2016-01-01
Full Text Available SIRS Digues is a computing tool that makes informations on levees more durable and accessible in order to enhance their management. The first version of the software, which was IRSTEA’s initiative, was deployed in 2004. The second version was released in 2015. This article aims at pointing out the innovative aspects of this last version. They concern thematic and functionalities, computing technics and architecture, and last but not least, the business model chosen in order to build a long lasting software. The software’s kernel is sketched to propose a general description of levees: it focuses on description of the levees and linked objects, on disorders that affects them, on works... Most of these topics were already broached by the first version. The kernel of the version 2 may be extended using optional thematic modules. These modules concern: vegetation monitoring, reporting (in coherence with current French regulatory requirements, riverbanks, riverbed... Main functionnalities perfomed by SIRS Digues V1 and V2 are : data structuring and centralisation, quick access to relevant data, reporting and mapping, etc. SIRS Digues 2.0 updates and improves already existing functionalities of the first version. SIRS Digues V2 relies on an documentoriented NoSQL database, CouchDB, and on geospatial libraries, Geotoolkit and Apache-SIS. SIRS Digues V2 was released with a copyleft license. Copyrights belong to the French levees managers’ society, “France Digues”, which acts as a cooperative. Members put their heads together in order to gather their financial capacities and fund software development. France Digues has got the technical and thematic expertise and supply various services to the members. This business model aims to ensure accessibility, durability and adaptability of the software.
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Directory of Open Access Journals (Sweden)
Magdalena Bas Vilizzio
2015-03-01
Full Text Available Este trabajo analiza las características particulares del sistema legal internacional de solución de controversias inversor-Estado, con especial foco en los tratados bilaterales de inversión (TBI en vigor en América del Sur, salvo excepciones. En este marco, aplicando la teoría de los regímenes internacionales (Krasner, 1983, se examinan las tres posiciones de los Estados de la región en torno al tema: 1 no ratificar TBI ni ser miembro del Centro Internacional de Arreglo de Diferencias relativas a Inversiones (CIADI (Brasil; 2 denunciar los TBI en vigor y abandonar el CIADI (Bolivia, Ecuador y Venezuela; 3 mantener los TBI en vigor y permanecer en los foros de solución de controversias actuales (Argentina, Chile, Colombia, Guyana, Paraguay, Perú, Surinam y Uruguay.
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Antenatal education for childbirth-epidural analgesia.
Cutajar, Lisa; Cyna, Allan M
2018-05-07
The language structures used by antenatal educators have not been previously researched in the context of antenatal childbirth classes. Epidural analgesia for labour is a common, and a frequently asked about, component of antenatal education for parents in hospitals providing maternity care. We aimed to identify the way information is described and presented by childbirth educators to assess content and determine which language structures such as metaphor, suggestion, information and storytelling are utilized. This observational study of antenatal education was conducted at a single tertiary referral center for maternity care in Western Sydney, Australia. All three childbirth educators agreed to be video recorded whilst providing information to parents during antenatal classes. Audio data was subsequently transcribed and then analysed by two researchers, independently categorising the various language structures and types of information provided. For the purposes of the current study, data concerning a single topic was used for the analysis-'epidural analgesia for labour'. Language structures used were highly variable between educators, as was the content and time taken for the information being provided. Our findings represent a first attempt to identify baseline information used in the clinical setting of antenatal education in order to categories communication structures used. This study has identified areas for further improvements and consistency in the way educators provide information to parents and has important implications for future midwifery practice, education and research. Copyright © 2018 Elsevier Ltd. All rights reserved.
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Directory of Open Access Journals (Sweden)
Ruby Angeline Pricilla
2017-01-01
Full Text Available Background:India contributes to 19% of the global maternal deaths. Good quality antenatal care can prevent maternal deaths by early detection of complications and maintaining maternal health. There are few studies documenting quality of antenatal care in India. This study aimed to document the antenatal services provided by nurse midwives to low-risk pregnant mothers from an urban population. Aims: The primary objective was to describe the quality of the antenatal care provided by nurse midwives of an urban health centre with regard to low-risk mothers. The secondary objective was to document the maternal and early neonatal outcomes of the enrolled mothers during the period of study. Methods: This prospective cohort study was done on 200 pregnant women who had antenatal care by nurse midwives between April 2014 and November 2014. The quality of care was assessed by a checklist adapted from World Health Organization (WHO. Results: We report that the quality of antenatal care for all domains was above 90% except for the health education domain, which was poor with regard to breastfeeding and family planning in the enrolled 200 pregnant women. Conclusion: Our study concluded that trained nurse midwives when regularly monitored, audited and linked with reliable referral facilities can deliver good quality antenatal care.
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Natural levee evolution in the Rhine-Meuse delta, the Netherlands, during the first millennium CE
Pierik, H.J.; Stouthamer, E.; Cohen, K.M.
2017-01-01
This paper presents reconstructions on natural levee development in the Rhine-Meuse delta, the Netherlands, during the first millennium CE, covering the full delta plain. It is the first study that performs this on a delta scale, which allows seeing the delta-wide trends on levee-forming controls
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Prevalence and factors associated with late antenatal care visit ...
African Journals Online (AJOL)
Flora
Background: Adequate utilization of antenatal health care services is associated ... access to antenatal care services including provision of ANC services that are free of charge (Gross ... Information about demographic characteristics, antenatal.
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EL TRASTORNO LÍMITE DE LA PERSONALIDAD: CONTROVERSIAS ACTUALES
Directory of Open Access Journals (Sweden)
Vicente E. Caballo
2000-01-01
Full Text Available Los trastornos de personalidad representan hoy día una de las áreas de mayor desafío para la psicología científica. Aunque los principales sistemas de clasificación de la psicopatología (DSM-IV y CIE-10 les dedican un considerable espacio, son, quizás, unos de los grupos de síndromes más desconocidos a todos los niveles: epidemiología, etiología, evaluación, tratamiento, etc. En el breve trabajo que aquí presentamos intentamos describir brevemente diversos aspectos de uno de los trastornos de personalidad más representativos actualmente: el trastorno límite de la personalidad (TLP. A pesar de que este síndrome comparte con el resto de los trastornos de personalidad una escasez de conocimiento, es, probablemente, uno de los más investigados y sobre el que se han desarrollado una variedad de terapias cognitivo-conductuales. A lo largo de este trabajo planteamos también algunas de las controversias actuales más candentes y resaltamos la necesidad de una mayor y más sistematizada investigación sobre el TLP.
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An assessment of antenatal care among Syrian refugees in Lebanon.
Benage, Matthew; Greenough, P Gregg; Vinck, Patrick; Omeira, Nada; Pham, Phuong
2015-01-01
After more than three years of violence in Syria, Lebanon hosts over one million Syrian refugees creating significant public health concerns. Antenatal care delivery to tens of thousands of pregnant Syrian refugee women is critical to preventing maternal and fetal mortality but is not well characterized given the multiple factors obtaining health data in a displaced population. This study describes antenatal care access, the scope of existing antenatal care, and antenatal and family planning behaviors and practice among pregnant Syrian refugees in various living conditions and multiple geographic areas of Lebanon. A field-based survey was conducted between July and October 2013 in 14 main geographic sites of refugee concentration. The assessment evaluated antenatal services among a non-randomized sample of 420 self-identified pregnant Syrian refugee women that included demographics, gestational age, living accommodation, antenatal care coverage, antenatal care content, antenatal health behaviors, antenatal health literacy, and family planning perception and practices. In total, 420 pregnant Syrian refugees living in Lebanon completed the survey. Of these, 82.9% (348) received some antenatal care. Of those with at least one antenatal visit, 222 (63.8%) received care attended by a skilled professional three or more times, 111 (31.9%) 1-2 times, and 15 (4.3%) had never received skilled antenatal care. We assessed antenatal care content defined by blood pressure measurement, and urine and blood sample analyses. Of those who had received any antenatal care, only 31.2% received all three interventions, 18.2% received two out of three, 32.1% received one out of three, and 18.5% received no interventions. Only (41.2%) had an adequate diet of vitamins, minerals, and folic acid. Access, content and health behaviors varied by gestational age, type of accommodation and location in Lebanon. Standards of antenatal care are not being met for pregnant Syrian refugee women in
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Case Study: Zutphen : Estimates of levee system reliability
Roscoe, K.; Kothuis, Baukje; Kok, Matthijs
2017-01-01
Estimates of levee system reliability can conflict with experience and intuition. For example, a very high failure probability may be computed while no evidence of failure has been observed, or a very low failure probability when signs of failure have been detected.
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Mobile phones improve antenatal care attendance in Zanzibar
DEFF Research Database (Denmark)
Lund, Stine; Nielsen, Birgitte B; Hemed, Maryam
2014-01-01
BACKGROUND: Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns' survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality...... of care is declining. We evaluated the association between a mobile phone intervention and antenatal care in a resource-limited setting. We aimed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during...... included at their first antenatal care visit and followed until 42 days after delivery. 24 primary health care facilities in six districts were randomized to either mobile phone intervention or standard care. The intervention consisted of a mobile phone text-message and voucher component. Primary outcome...
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Antenatal imaging of cutis verticis gyrata
International Nuclear Information System (INIS)
Kennedy, Ana; Perry, David; Battin, Malcolm
2008-01-01
Cutis verticis gyrata (CVG) is a skin condition characterized by thick folds and deep furrows, resembling a cortical gyral pattern. There is a recognized but rare association with Noonan syndrome. We report the antenatal imaging, including three-dimensional surface-rendered sonography and MRI, of a fetus with CVG who was subsequently diagnosed with Noonan syndrome. The case illustrates the antenatal appearances of congenital CVG and the potential yield of antenatal imaging in excluding a major central nervous system anomaly. This is important because without prior knowledge of this condition and its imaging characteristics, it is possible to get a false impression of an underlying skull defect on mid-trimester imaging. (orig.)
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Antenatal imaging of cutis verticis gyrata
Energy Technology Data Exchange (ETDEWEB)
Kennedy, Ana [Starship Hospital, Department of Paediatric Cardiology, Auckland (New Zealand); Perry, David [Starship Children' s Hospital, Radiology Department, Auckland (New Zealand); Battin, Malcolm [Auckland City Hospital, Newborn Services, National Women' s Health, Auckland (New Zealand); University of Auckland, Department of Paediatrics, Auckland (New Zealand)
2008-05-15
Cutis verticis gyrata (CVG) is a skin condition characterized by thick folds and deep furrows, resembling a cortical gyral pattern. There is a recognized but rare association with Noonan syndrome. We report the antenatal imaging, including three-dimensional surface-rendered sonography and MRI, of a fetus with CVG who was subsequently diagnosed with Noonan syndrome. The case illustrates the antenatal appearances of congenital CVG and the potential yield of antenatal imaging in excluding a major central nervous system anomaly. This is important because without prior knowledge of this condition and its imaging characteristics, it is possible to get a false impression of an underlying skull defect on mid-trimester imaging. (orig.)
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Antenatal services for Aboriginal women: the relevance of cultural competence.
Reibel, Tracy; Walker, Roz
2010-01-01
Due to persistent significantly poorer Aboriginal perinatal outcomes, the Women's and Newborns' Health Network, Western Australian Department of Health, required a comprehensive appraisal of antenatal services available to Aboriginal women as a starting point for future service delivery modelling. A services audit was conducted to ascertain the usage frequency and characteristics of antenatal services used by Aboriginal women in Western Australia (WA). Telephone interviews were undertaken with eligible antenatal services utilising a purpose specific service audit tool comprising questions in five categories: 1) general characteristics; 2) risk assessment; 3) treatment, risk reduction and education; 4) access; and 5) quality of care. Data were analysed according to routine antenatal care (e.g. risk assessment, treatment and risk reduction), service status (Aboriginal specific or non-specific) and application of cultural responsiveness. Significant gaps in appropriate antenatal services for Aboriginal women in metropolitan, rural and remote regions in WA were evident. Approximately 75% of antenatal services used by Aboriginal women have not achieved a model of service delivery consistent with the principles of culturally responsive care, with few services incorporating Aboriginal specific antenatal protocols/programme, maintaining access or employing Aboriginal Health Workers (AHWs). Of 42 audited services, 18 Aboriginal specific and 24 general antenatal services reported utilisation by Aboriginal women. Of these, nine were identified as providing culturally responsive service delivery, incorporating key indicators of cultural security combined with highly consistent delivery of routine antenatal care. One service was located in the metropolitan area and eight in rural or remote locations. The audit of antenatal services in WA represents a significant step towards a detailed understanding of which services are most highly utilised and their defining characteristics
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Diagnosis of antenatal Bartter syndrome.
Narayan, R; Peres, M; Kesby, G
2016-01-01
Bartter syndrome is a rare heterogeneous group of autosomal-recessive salt-losing renal tubular disorders that can present in fetal life (antenatal Bartter syndrome; ABS) as "unexplained" early-onset polyhydramnios, often associated with growth restriction. Prenatal diagnosis of the condition involves assessment of amniotic fluid biochemistry in a setting of polyuric polyhydramnios; with elevated chloride levels considered a consistent and diagnostic finding. Other amniotic fluid biochemical markers have been described, notably increased aldosterone levels, and low total protein levels. NOVEL INSIGHT: Antenatal Bartter syndrome is a heterogeneous group of renal disorders. While certain biochemical features in amniotic fluid might heighten suspicion, final diagnosis can only be made in the postnatal setting. In the setting of unexplained severe polyhydramnios, clinicians should continue to entertain the diagnosis of antenatal Bartter Syndrome and maintain neonatal surveillance, even if amniotic fluid markers do not support the diagnosis.
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Kommunen er død - længe leve den digitale disruption
DEFF Research Database (Denmark)
Andersen, Kim Normann
2017-01-01
"New Public Management is Dead. Long Live the Digital Era." Sådan proklamerede Patrick Donleavy digitaliseringens muligheder i en banebrydende artikel fra 2005. Med en omskrivning af dette citat til "Kommunen er død, længe leve den digitale disruption", er ballet åbnet for denne artikel......."New Public Management is Dead. Long Live the Digital Era." Sådan proklamerede Patrick Donleavy digitaliseringens muligheder i en banebrydende artikel fra 2005. Med en omskrivning af dette citat til "Kommunen er død, længe leve den digitale disruption", er ballet åbnet for denne artikel....
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Sustentabilidad y economía: la controversia de la valoración ambiental
Directory of Open Access Journals (Sweden)
Alma Angelina Haro-Martínez
2014-01-01
Full Text Available En el tema del desarrollo sustentable una controversia fundamental es la asignación de valor a bienes y servicios ambientales. La economía lo aborda desde dos perspectivas: el enfoque tradicional neoclásico (economía ambiental y otra, más integral, donde confluyen distintas ciencias (economía ecológica. Este trabajo ofrece una revisión crítica de la teoría económica convencional asociada al desarrollo sustentable, asimismo, destaca la necesidad de asignar valores a los servicios ambientales para una mejor toma de decisiones, en la que se consideren las preferencias individuales y las sociales, con lo que avanzaría hacia las metas centrales del desarrollo sustentable: eficiencia económica, justicia social y sustentabilidad ecológica.
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2012-02-17
... revetments, sand dunes, and barrier islands. b. New federally authorized cost-shared levee projects shall be..., the landside slope, and within 15 feet of the landside toe (subject to preexisting real estate... appropriate depth but not less than 20 feet below the levee toe. The determination and documentation of site...
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Health care providers' knowledge and practice of focused antenatal ...
African Journals Online (AJOL)
... observational checklist were the instruments for data collection. Findings revealed poor knowledge of concept, components, timing of visits on focused antenatal care and non compliance with the guidelines for the practice of focused antenatal care, because of health workers lack of knowledge on focused antenatal care.
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Internet: a new concept of antenatal education.
Nikolova, Gergana
2015-02-01
Historically antenatal education has been seen as an important part of antenatal care and a mechanism to provide women with close to realistic interpretations of childbirth and motherhood. Through the years, the main themes and emphases of parenting education have changed, sometimes to reflect the new socio-economic structure and sometimes forced by the women themselves seeking specific information and knowledge. Yet again, this time the invasion of online information and social media is about to change the perception and the philosophy of antenatal education from an informative opportunity to a powerful and effective intervention.
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Gianetta, Ivan; Schwarz, Massimiliano; Glenz, Christian; Lammeranner, Walter
2013-04-01
In recent years the effects of roots on river banks and levees have been the subject of major discussions. The main issue about the presence of woody vegetation on levees is related to the possibility that roots increase internal erosion processes and the superimposed load of large trees compromise the integrity of these structures. However, ecologists and landscape managers argue that eliminating the natural vegetation from the riverbanks also means eliminating biotopes, strengthening anthropisation of the landscape, as well as limiting recreations areas. In the context of the third correction of the Rhone in Switzerland, the discussion on new levee geometries and the implementation of woody vegetation on them, lead to a detailed analysis of this issue for this specific case. The objective of this study was to describe quantitatively the processes and factors that influence the root distribution on levees and test modeling approaches for the simulation of vertical root distribution with laboratory and field data. An extension of an eco-hydrological analytic model that considers climatic and pedological condition for the quantification of vertical root distribution was validated with data provided by the University of Vienna (BOKU) of willows' roots (Salix purpurea) grown under controlled conditions. Furthermore, root distribution data of four transversal sections of a levee near Visp (canton Wallis, Switzerland) was used to validate the model. The positions of the levee's sections were chosen based on the species and dimensions of the woody vegetation. The dominant species present in the sections were birch (Betula pendula) and poplar (Populus nigra). For each section a grid of 50x50 cm was created to count and measure the roots. The results show that vertical distribution of root density under controlled growing conditions has an exponential form, decreasing with increasing soil depth, and can be well described by the eco-hydrological model. Vice versa, field
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Contraceptive‑seeking Behavior of Women Attending Antenatal ...
African Journals Online (AJOL)
Department of Community Medicine, Abia State University Teaching Hospital, Aba, 1Department of Public ... cross‑sectional study of 430 antenatal women using structured self‑administered ... KEY WORDS: Antenatal, contraception, population control Nigeria ... hence, the need to study the contraceptive-seeking behavior.
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Antenatal care and pregnancy outcome in Ghana, the importance of ...
African Journals Online (AJOL)
Antenatal care and pregnancy outcome in Ghana, the importance of women\\'s ... The antenatal characteristics of 503 pregnant women attending maternal and child ... Higher educational level associated with early antenatal care attendance.
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Psychoprophylaxis - Antenatal preparation and actual use during labour
Bergström, Malin
2010-01-01
The aim of this thesis was to study the effects of a model of antenatal education, focusing on natural childbirth preparation by including psychoprophylaxis, breathing and relaxation techniques to cope with labour pain, and the actual use of psychoprophylaxis during labour. Satisfaction with antenatal education and experiences of a subgroup of men with antenatal fear of childbirth were also explored. The principal design was a randomised controlled trial where the new mo...
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Duval, Rodolphe; Fauchard, Cyrille; Antoine, Raphael
2014-05-01
We study the influence of the topography of a levee on the electric and magnetic signals obtained with the Radio-Magnetotelluric method (RMT) and the Slingram method, respectively. For the RMT method, field measurements have been modelled with a finite element commercial software (AC/DC and Radio-Frequency modules of Comsol Multiphysics). A levee situated in Orléans (France) along the Loire river has been considered in order to design a model taking into account the skin depth and the incident wavelength. The effect of the incident electromagnetic field direction has been assessed with two different incident wave directions: BBC 5 from Salford (UK) and France-Inter from Allouis (France). The simulations highlight the tri-dimensional effects of the topography in the apparent resistivity, observed on the crest of the levee, depending on the incident field direction and topography. For the Slingram method, the magnetic field has been simulated using the AC/DC module of Comsol. The ratio of the primary magnetic field on the secondary one, received in a loop is determined above a straight levee. The study aims to show the various responses obtained in function of both vertical and horizontal coil configurations. We show that the signal also depends on the topography and the right configuration of the coils alignment with respect to the levee stretch direction. In this study, a buried gas pipe is also characterized by the two methods. Numerical modelling of 3D electromagnetic effects on geophysical signals helps to interpret the field measurements and offers to the stakeholder an optimized methodology for geophysical surveys on levees.
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Determinants of Antenatal Care Use in Ghana
Overbosch, G.B.; Nsowah-Nuamah, N.N.N.; van den Boom, G.J.M.; Damnyag, L.
2004-01-01
The paper investigates the determinants of antenatal care use in Ghana. In particular, we study how economic factors affect the demand for antenatal care and the probability that the number of visits falls below the recommended number of four. Estimation results from a nested three-level multinomial
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44 CFR 65.10 - Mapping of areas protected by levee systems.
2010-10-01
..., compressibility of embankment soils, compressibility of foundation soils, age of the levee system, and... described in the COE manual, “Soil Mechanics Design—Settlement Analysis” (EM 1100-2-1904) must be submitted...
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Dedicated IT infrastructure for Smart Levee Monitoring and Flood Decision Support
Directory of Open Access Journals (Sweden)
Balis Bartosz
2016-01-01
Full Text Available Smart levees are being increasingly investigated as a flood protection technology. However, in large-scale emergency situations, a flood decision support system may need to collect and process data from hundreds of kilometers of smart levees; such a scenario requires a resilient and scalable IT infrastructure, capable of providing urgent computing services in order to perform frequent data analyses required in decision making, and deliver their results in a timely fashion. We present the ISMOP IT infrastructure for smart levee monitoring, designed to support decision making in large-scale emergency situations. Most existing approaches to urgent computing services in decision support systems dealing with natural disasters focus on delivering quality of service for individual, isolated subsystems of the IT infrastructure (such as computing, storage, or data transmission. We propose a holistic approach to dynamic system management during both urgent (emergency and normal (non-emergency operation. In this approach, we introduce a Holistic Computing Controller which calculates and deploys a globally optimal configuration for the entire IT infrastructure, based on cost-of-operation and quality-of-service (QoS requirements of individual IT subsystems, expressed in the form of Service Level Agreements (SLAs. Our approach leads to improved configuration settings and, consequently, better fulfilment of the system’s cost and QoS requirements than would have otherwise been possible had the configuration of all subsystems been managed in isolation.
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Technical Note: Stability of a Levee Made of Bottom Sediments From a Dam Reservoir
Directory of Open Access Journals (Sweden)
Koś Karolina
2015-02-01
Full Text Available Stability analysis of a levee made of the bottom sediments from Czorsztyn-Niedzica Reservoir is presented in the paper. These sediments were classified as silty sands and, based on the authors' own research, their geotechnical parameters were beneficial, so the possibility of using this material for the hydraulic embankments was considered. Stability and filtration calculations were carried out for a levee that had the same top width - 3 m, slope inclinations 1:2 and different heights: 4, 6 and 8 m. Two methods were used: analytical and numerical. Calculations were carried out without and with a steady and unsteady seepage filtration. Based on the analysis carried out it was stated that the levee made of the bottom sediments is stable even at the height of 8.0 m, although because of the seepage on the downstream side it is recommended to use a drainage at the toe of the slope.
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New Orleans Levees and Floodwalls: Hurricane Damage Protection
National Research Council Canada - National Science Library
Carter, Nicole T
2005-01-01
.... The breaches occurred at the Lake Pontchartrain and Vicinity Project being constructed by the U.S. Army Corps of Engineers and maintained by local levee districts. Those observers questioning why infrastructure providing a greater level of hurricane protection was not available are countered by those arguing that structural protections carry their own risks. This report will be updated as needed to track significant developments.
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Risk factors for antenatal depression, postnatal depression and parenting stress
Directory of Open Access Journals (Sweden)
Milgrom Jeannette
2008-04-01
Full Text Available Abstract Background Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Methods Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26–32 weeks gestation. A subsample of these women (N = 161 also completed questionnaires at 10–12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI. Results Regression analyses identified significant risk factors for the three outcome measures. (1. Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2. Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3. Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator
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Risk factors for antenatal depression, postnatal depression and parenting stress.
Leigh, Bronwyn; Milgrom, Jeannette
2008-04-16
Given that the prevalence of antenatal and postnatal depression is high, with estimates around 13%, and the consequences serious, efforts have been made to identify risk factors to assist in prevention, identification and treatment. Most risk factors associated with postnatal depression have been well researched, whereas predictors of antenatal depression have been less researched. Risk factors associated with early parenting stress have not been widely researched, despite the strong link with depression. The aim of this study was to further elucidate which of some previously identified risk factors are most predictive of three outcome measures: antenatal depression, postnatal depression and parenting stress and to examine the relationship between them. Primipara and multiparae women were recruited antenatally from two major hoitals as part of the beyondblue National Postnatal Depression Program 1. In this subsidiary study, 367 women completed an additional large battery of validated questionnaires to identify risk factors in the antenatal period at 26-32 weeks gestation. A subsample of these women (N = 161) also completed questionnaires at 10-12 weeks postnatally. Depression level was measured by the Beck Depression Inventory (BDI). Regression analyses identified significant risk factors for the three outcome measures. (1). Significant predictors for antenatal depression: low self-esteem, antenatal anxiety, low social support, negative cognitive style, major life events, low income and history of abuse. (2). Significant predictors for postnatal depression: antenatal depression and a history of depression while also controlling for concurrent parenting stress, which was a significant variable. Antenatal depression was identified as a mediator between seven of the risk factors and postnatal depression. (3). Postnatal depression was the only significant predictor for parenting stress and also acted as a mediator for other risk factors. Risk factor profiles for
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Currie, Sinéad; Gray, Cindy; Shepherd, Ashley; McInnes, Rhona J
2016-07-22
Regular physical activity (PA) can be beneficial to pregnant women, however, many women do not adhere to current PA guidelines during the antenatal period. Patient and public involvement is essential when designing antenatal PA interventions in order to uncover the reasons for non-adherence and non-engagement with the behaviour, as well as determining what type of intervention would be acceptable. The aim of this research was to explore women's experiences of PA during a recent pregnancy, understand the barriers and determinants of antenatal PA and explore the acceptability of antenatal walking groups for further development. Seven focus groups were undertaken with women who had given birth within the past five years. Focus groups were transcribed and analysed using a grounded theory approach. Relevant and related behaviour change techniques (BCTs), which could be applied to future interventions, were identified using the BCT taxonomy. Women's opinions and experiences of PA during pregnancy were categorised into biological/physical (including tiredness and morning sickness), psychological (fear of harm to baby and self-confidence) and social/environmental issues (including access to facilities). Although antenatal walking groups did not appear popular, women identified some factors which could encourage attendance (e.g. childcare provision) and some which could discourage attendance (e.g. walking being boring). It was clear that the personality of the walk leader would be extremely important in encouraging women to join a walking group and keep attending. Behaviour change technique categories identified as potential intervention components included social support and comparison of outcomes (e.g. considering pros and cons of behaviour). Women's experiences and views provided a range of considerations for future intervention development, including provision of childcare, involvement of a fun and engaging leader and a range of activities rather than just walking
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Behaviour of levee on softsoil caused by rapid drawdown
Upomo, Togani Cahyadi; Effendi, Mahmud Kori; Kusumawardani, Rini
2018-03-01
Rapid Drawdown is a condition where the water elevation that has reached the peak suddenly drops. As the water level reaches the peak, hydrostatic pressure helps in the stability of the slope. When water elevation decreases there will be two effects. First, reduced hydrostatic pressure and second, modification of pore water pressure. Rapid draw down usually comon in hydraulic structure such as dam and levee. This study will discuss behaviour of levee on softsoil caused by rapid drawdown. The analysis based on method which developed by US Army Corps Engineer and modified method which developed by Duncan, Wright, dan Wong. Results of analysis show that in drawdown condition, at 1 m drop of water, safety factor obtained based on US Army Corps Engineer method was 1.16 and 0.976 while based on Duncan, Wright, and Wong methods were 1.244 and 1.117. At 0.5 m water level, safety factor based on US Army Corps Engineer method was 1.287 and 1.09 while Duncan, Wright, and Wong were 1.357 and 1.194.
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EL ACCESO A LA SOLUCIÓN DE CONTROVERSIAS EN LA OMC: OBSTÁCULOS PARA LOS PAÍSES EN DESARROLLO
Directory of Open Access Journals (Sweden)
Germán Burgos
2011-11-01
Full Text Available Este artículo identifica los aportes centrales de la literatura especializada sobre cuáles son y cómo se presentan los obstáculos más importantes para el acceso de los Estados en desarrollo al Sistema de Solución de Controversias de la OMC. Establece, para el caso colombiano, cómo se dan tales barreras teniendo en cuenta que hasta la fecha este país no ha tramitado exitosamente ningún caso ante esta instancia internacional.
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An, K.; Jones, C. E.; Bekaert, D. P.; Dudas, J.
2016-12-01
Radar remote sensing of the Sacramento-San Joaquin Delta, the largest estuary in the western U.S. (over 2500 km2), and its levee system provides an opportunity for NASA Applied Science to aid the CA Department of Water Resources (CA-DWR) in monitoring and emergency response. The delta contains over 1,500 km of earthen levees, supports about 2.5 million acres of agricultural land, and serves as a main water supply for 23 million California residents. Many of the reclaimed islands are 10-25 feet below sea level, sit atop compressible peat and organic clay soils, and are surrounded by levees only 1 foot above the once in a century flood elevation threshold. Land subsidence in the delta can be attributed to a variety of factors, including: aerobic oxidation of soils, soil compaction from drainage, wind erosion, anaerobic decomposition, dissolved carbon fluxes, floods, seismic events, and even rodent burrowing. Interferometric Synthetic Aperture Radar (InSAR) is an established technique to measure surface displacements and has been used to map large-scale subsidence. The demonstration of earthen levee monitoring is a recent development that has been greatly furthered by the emergence of new instruments such as NASA's Uninhabited Aerial Vehicle Synthetic Aperture Radar (UAVSAR). UAVSAR is an L-band airborne sensor with high signal-to-noise ratio, repeat flight track accuracy, and has a high spatial resolution (7 x 7 m) that is necessary for detailed levee monitoring. The adaptability of radar instruments in their ability to see through smoke, haze, and clouds during the day or night, is especially relevant during disaster events, when cloud cover or lack of solar illumination inhibits traditional visual surveys of damage. We demonstrate the advantages of combining InSAR with geographic information systems (GIS) datasets in locating subsidence features along critical levee infrastructure in the Delta for 2009-2016. The ability to efficiently locate potential areas of
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Hvordan er det å leve med CRPS?
Hovind, Thomas
2014-01-01
Hensikten med denne studien er å se på hvordan pasienter med komplekst regionalt smertesyndrom (CRPS) opplever å leve med tilstanden og hvordan disse pasientene har opplevd å bli møtt i helsevesenet. CRPS er en langvarig tilstand med sterke smerter som kan medføre økt smerterespons, redusert funksjon og nedsatt livskvalitet hos pasientene. Studien er en kvalitativ undersøkelse basert på dybdeintervju av fire pasienter med CRPS. Pasientene ble rekruttert fra en smerteavdeling i Nord-Norge og u...
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1991-12-10
Presented by Earl E. Eiker) Headquarters, U.S. Army Corps of Engineers ...................... 5 LEVEE FREEBOARD DEJA VU ALL OVER AGAIN (Paper 2) Brad...0~e a) . Plate PAPE 0 12 LEVEE FREEBOARD DEJA VU ALL OVER AGAIN by Brad Fowler 1 presented by Robert M. Daniel2 1. Introduction. It’s been now nearly... Deja Vu All Over Again (Bob Daniel, HQUSACE) 10:00 - 10:15 am Break 10:15 - 11:00 am Paper 3 FEMA Levee Accreditation Procedures (John Matticks, Asst
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Antenatal hypnosis training and childbirth experience
DEFF Research Database (Denmark)
Werner, Anette; Uldbjerg, Niels; Zachariae, Robert
2013-01-01
Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience.......Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience....
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The Prevalence of Osteoporosis among Antenatal Clinic Attendees ...
African Journals Online (AJOL)
Introduction: Osteoporosis is a global public health problem characterized by reduction of bone mineral density (BMD). This study aimed to assess the prevalence of osteoporosis among antenatal clinic attendees in a rural Southeastern hospital. Material and Methods: This was a cross‑sectional study of booking. Antenatal ...
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Influence of multiple antenatal counselling sessions on modern contraceptive uptake in Nigeria.
Adanikin, Abiodun I; Onwudiegwu, Uche; Loto, Olabisi M
2013-10-01
To determine the influence of multiple contraceptive counselling sessions during antenatal care on use of modern postpartum contraception. A total of 216 eligible pregnant women were randomised into antenatal and postnatal counselling groups. The 'Antenatal group' received one-to-one antenatal contraceptive counselling on several occasions while the 'Postnatal group' received a single one-to-one contraceptive counselling session at the sixth week postnatal check, as is routinely practised. All participants were contacted six months postpartum by telephone or personal visit, and questioned about their contraceptive use, if any. More women who had multiple antenatal contraceptive counselling sessions used modern contraceptive methods than those who had a single postnatal counselling session (57% vs. 35%; p = 0.002). There was also a significantly more frequent use of contraception among previously undecided patients in the Antenatal group (p = 0.014). Multiple antenatal contraceptive counselling sessions improve the use of modern postpartum contraception.
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California Levee Risk, Now and in the Future:Identifying Research and Tool Development Needs
Energy Technology Data Exchange (ETDEWEB)
Newmark, R L; Hanemann, M; Farber, D
2006-11-28
The Center for Catastrophic Risk Management (CCRM) and the California Center for Environmental Law and Policy (CCELP) at UC Berkeley and the Lawrence Livermore National Laboratory (LLNL) joined together to cosponsor a workshop to define research requirements to mitigate the hazards facing the Sacramento-San Joaquin Delta Levee system. The Workshop was intended to provide a forum to (1) Report assessments of current vulnerabilities facing the levees, such as structural failure, seismic loading, flooding, terrorism; (2) Consider longer term challenges such as climate change, sea level rise; and (3) Define research requirements to fill gaps in knowledge and reduce uncertainties in hazard assessments.
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Palozzi, Jason; Pantopoulos, George; Maravelis, Angelos G.; Nordsvan, Adam; Zelilidis, Avraam
2018-02-01
This investigation presents an outcrop-based integrated study of internal division analysis and statistical treatment of turbidite bed thickness applied to a Carboniferous deep-water channel-levee complex in the Myall Trough, southeast Australia. Turbidite beds of the studied succession are characterized by a range of sedimentary structures grouped into two main associations, a thick-bedded and a thin-bedded one, that reflect channel-fill and overbank/levee deposits, respectively. Three vertically stacked channel-levee cycles have been identified. Results of statistical analysis of bed thickness, grain-size and internal division patterns applied on the studied channel-levee succession, indicate that turbidite bed thickness data seem to be well characterized by a bimodal lognormal distribution, which is possibly reflecting the difference between deposition from lower-density flows (in a levee/overbank setting) and very high-density flows (in a channel fill setting). Power law and exponential distributions were observed to hold only for the thick-bedded parts of the succession and cannot characterize the whole bed thickness range of the studied sediments. The succession also exhibits non-random clustering of bed thickness and grain-size measurements. The studied sediments are also characterized by the presence of statistically detected fining-upward sandstone packets. A novel quantitative approach (change-point analysis) is proposed for the detection of those packets. Markov permutation statistics also revealed the existence of order in the alternation of internal divisions in the succession expressed by an optimal internal division cycle reflecting two main types of gravity flow events deposited within both thick-bedded conglomeratic and thin-bedded sandstone associations. The analytical methods presented in this study can be used as additional tools for quantitative analysis and recognition of depositional environments in hydrocarbon-bearing research of ancient
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Game-based online antenatal breastfeeding education: A pilot.
Grassley, Jane S; Connor, Kelley C; Bond, Laura
2017-02-01
The aim of this study was to evaluate the effect of the Healthy Moms intervention on antenatal breastfeeding self-efficacy and intention and to determine the feasibility of using an online game-based learning platform to deliver antenatal breastfeeding education. The Internet has potential for improving breastfeeding rates through improving women's access to antenatal breastfeeding education. Twelve computer-based breastfeeding education modules were developed using an online learning platform. Changes in participants' breastfeeding self-efficacy and intention pre- and post-intervention were measured using descriptive statistics and a one-way ANOVA. Of the 25 women submitting the pretest, four completed zero quests; seven, orientation only; eight, one to six breastfeeding quests; and six, 10 to 12 breastfeeding quests. No significant differences in breastfeeding self-efficacy and intention were found among the groups. Online antenatal breastfeeding education is feasible; however, further research is warranted to determine if it can affect breastfeeding outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.
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Antenatal care services utilization among women of reproductive ...
African Journals Online (AJOL)
Methods: A cross-sectional study was carried out between September and October 2013 among 425 women of reproductive age using a multi-stage sampling technique. Results: Almost all the respondents (93.9%) were aware of antenatal care services. A good proportion of the mothers (90.1%) used antenatal services, ...
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Variables influencing delay in antenatal clinic attendance among ...
African Journals Online (AJOL)
A delay in deciding to seek antenatal care is predominant among pregnant teenagers in Lesotho. This subsequently leads to delay in reaching treatment and in receiving adequate treatment. Early antenatal care attendance plays a major role in detecting and treating complications of pregnancy and forms a good basis for ...
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Pattern and Determinants of Antenatal Booking at Abakaliki ...
African Journals Online (AJOL)
for pregnant women to enable them attain and maintain a state of good health throughout pregnancy and to improve ... subsidization of cost of medical services will help in reversing the trend of late antenatal booking. Keywords: Abakaliki, Antenatal booking, .... Artisan/fashion/ design. 10 (2.9). 3 (30). 7 (70). Civil servant.
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Risk factors for major antenatal depression among low-income African American women.
Luke, Sabrina; Salihu, Hamisu M; Alio, Amina P; Mbah, Alfred K; Jeffers, Dee; Berry, Estrellita Lo; Mishkit, Vanessa R
2009-11-01
Data on risk factors for major antenatal depression among African American women are scant. In this study, we seek to determine the prevalence and risk factors for major antenatal depression among low-income African American women receiving prenatal services through the Central Hillsborough Healthy Start (CHHS). Women were screened using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff of > or =13 as positive for risk of major antenatal depression. In total, 546 African American women were included in the analysis. We used logistic regression to identify risk factors for major antenatal depression. The prevalence of depressive symptomatology consistent with major antenatal depression was 25%. Maternal age was identified as the main risk factor for major antenatal depression. The association between maternal age and risk for major antenatal depression was biphasic, with a linear trend component lasting until age 30, at which point the slope changed markedly tracing a more pronounced likelihood for major depression with advancing age. Women aged > or =30 were about 5 times as likely to suffer from symptoms of major antenatal depression as teen mothers (OR = 4.62, 95% CI 2.23-9.95). The risk for major antenatal depression increases about 5-fold among low-income African American women from age 30 as compared to teen mothers. The results are consistent with the weathering effect resulting from years of cumulative stress burden due to socioeconomic marginalization and discrimination. Older African American mothers may benefit from routine antenatal depression screening for early diagnosis and intervention.
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Effects of Antenatal Betamethasone and Dexamethasone in Preterm Neonates
Directory of Open Access Journals (Sweden)
Chen-Yu Chen
2005-09-01
Conclusion: In our study, no significant differences between antenatal betamethasone and dexamethasone were found in complications of preterm neonates. Incomplete courses of antenatal corticosteroids were associated with an increased incidence of RDS compared with complete courses.
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S-wave velocity measurements along levees in New Orleans using passive surface wave methods
Hayashi, K.; Lorenzo, J. M.; Craig, M. S.; Gostic, A.
2017-12-01
In order to develop non-invasive methods for levee inspection, geophysical investigations were carried out at four sites along levees in the New Orleans area: 17th Street Canal, London Avenue Canal, Marrero Levee, and Industrial Canal. Three of the four sites sustained damage from Hurricane Katrina in 2005 and have since been rebuilt. The geophysical methods used include active and passive surface wave methods, and capacitively coupled resistivity. This paper summarizes the acquisition and analysis of the 1D and 2D passive surface wave data. Twelve wireless seismic data acquisition units with 2 Hz vertical component geophones were used to record data. Each unit includes a GPS receiver so that all units can be synchronized over any distance without cables. The 1D passive method used L shaped arrays of three different sizes with geophone spacing ranging from 5 to 340 m. Ten minutes to one hour of ambient noise was recorded with each array, and total data acquisition took approximately two hours at each site. The 2D method used a linear array with a geophone spacing of 5m. Four geophones were moved forward every 10 minutes along 400 1000 m length lines. Data acquisition took several hours for each line. Recorded ambient noise was processed using the spatial autocorrelation method and clear dispersion curves were obtained at all sites (Figure 1a). Minimum frequencies ranged from 0.4 to 0.7 Hz and maximum frequencies ranged from 10 to 30 Hz depending on the site. Non-linear inversion was performed and 1D and 2D S-wave velocity models were obtained. The 1D method penetrated to depths ranging from 200 to 500 m depending on the site (Figure 1b). The 2D method penetrated to a depth of 40 60 m and provided 400 1000 m cross sections along the levees (Figure 2). The interpretation focused on identifying zones beneath the levees or canal walls having low S-wave velocities corresponding to saturated, unconsolidated sands, or low-rigidity clays. Resultant S-wave velocity profiles
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Directory of Open Access Journals (Sweden)
Flávia Raquel Rossi
2005-06-01
Full Text Available O estudo teve por objetivo identificar a utilização das tecnologias leves nos processos gerenciais do enfermeiro e a sua interferência na produção do cuidado. Constituiu-se em um estudo de caso de abordagem qualitativa, cujos sujeitos da pesquisa foram enfermeiros de um setor de internação de um hospital geral localizado em um município do interior do Rio Grande do Sul. Os dados foram coletados através da observação livre do trabalho do enfermeiro. Nos processos gerenciais do enfermeiro identificou-se a utilização de tecnologias leves, entre elas o acolhimento, assim como alguns fatores que o configuram, sendo possível afirmar que ao utilizar essa tecnologia o enfermeiro produz e promove a humanização do cuidado.El objetivo de este estudio fué la utilización de tecnologías leves en los procesos gerenciales del enfermería e su interferencia al producir lo cuidado. Se constituye en un estudio de caso de abordaje cualitativa e los sujetos de investigación eran enfermeros de un sector de internación de un hospital general localizado en una ciudad del Río Grande do Sul. Los datos fueron colectados a través de la libre observación de sus trabajos. En los procesos gerenciales del enfermero, se identifico el uso de tecnologías leves, entre ellas, el acogimiento, así como algunos factores que lo configuran, siendo posible afirmar que al utilizar esa tecnología, el enfermero produce e promociona la humanización del cuidado.This study aimed the identification of the use of soft technologies in nursing management processes and their interference in care production. It was constituted in a case study case of quality feature and the research subjects were nurses of a public hospital located in a city of Rio Grande do Sul. Data were collected by means of free observation of the nurses' job. In their managing processes, it was identified the use of soft technologies, among them the welcoming, as well as some factors that present it
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Prevalence of antenatal depressive symptoms among women in Sabah, Malaysia.
Mohamad Yusuff, Aza Sherin; Tang, Li; Binns, Colin W; Lee, Andy H
2016-01-01
To investigate the prevalence of antenatal depression and to assess whether the common risk factors identified in previous studies were applicable to women in Sabah, Malaysia. A prospective cohort study of 2072 women was conducted in Sabah during 2009-2010. Participants were recruited at 36-38 weeks of gestation to complete a self-administered questionnaire regarding their demographic, socioeconomic and health characteristics. The presence of depression was assessed using the validated Malay version of the Edinburgh Postnatal Depression Scale. The prevalence of antenatal depression was 13.8% [95% confidence interval (CI) 12.3%, 15.3%]. Women who were happy with the pregnancy [odds ratio (OR) 0.43, 95% CI 0.21, 0.89] and those with a planned pregnancy (OR 0.45, 95% CI 0.33, 0.60) were less likely to suffer from antenatal depression. Pregnant mothers who were taking oral contraceptives before pregnancy (OR 1.63, 95% CI 1.20, 2.22) and women who experienced antenatal anxiety (OR 3.17, 95% CI 2.35, 4.26) appeared to have an increased risk of antenatal depression. A substantial proportion of women suffered from antenatal depression in Sabah, Malaysia. Screening and culturally tailored intervention programs targeting vulnerable subgroups of women in the early stage of pregnancy are recommended to deal with the problem.
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Audit of antenatal care at a community health centre in Tshwane ...
African Journals Online (AJOL)
Objective: Few studies document the level of compliance with antenatal care protocols in primary health care in South Africa. The aim of this study was to conduct an audit of antenatal care at a community health centre in Tshwane North subdistrict in order to measure the level of compliance of maternity staff with antenatal ...
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Using level-I PRA for enhanced safety of the advanced neutron source reactor
International Nuclear Information System (INIS)
Ramsey, C.T.; Linn, M.A.
1995-01-01
The phase-1, level-I probabilistic risk assessment (PRA) of the Advanced Neutron Source (ANS) reactor has been completed as part of the conceptual design phase of this proposed research facility. Since project inception, PRA and reliability concepts have been an integral part of the design evolutions contributing to many of the safety features in the current design. The level-I PRA has been used to evaluate the internal events core damage frequency against project goals and to identify systems important to safety and availability, and it will continue to guide and provide support to accident analysis, both severe and nonsevere. The results also reflect the risk value of defense-in-depth safety features in reducing the likelihood of core damage
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Antenatal education in the transition to motherhood
Burley, Suzanne Elizabeth
2003-01-01
This thesis explores the relationship between antenatal education and the transition to motherhood, focusing on the pre-natal expectations and postnatal experiences of a small sample of first-time mothers in Plymouth. The aims of the study were 1) to investigate the style and content of statutory and voluntary sector antenatal classes in the Plymouth area. 2) To investigate factors affecting non-attendance, including non-attenders' perceptions of them. 3) To examine the role of...
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Bawden, Gerald W.; Howle, James; Bond, Sandra; Shriro, Michelle; Buck, Peter
2014-01-01
A full scale field seepage test was conducted on a north-south trending levee segment of a now bypassed old meander belt on Twitchell Island, California, to understand the effects of live and decaying root systems on levee seepage and slope stability. The field test in May 2012 was centered on a north-south trench with two segments: a shorter control segment and a longer seepage test segment. The complete length of the trench area measured 40.4 meters (m) near the levee centerline with mature trees located on the waterside and landside of the levee flanks. The levee was instrumented with piezometers and tensiometers to measure positive and negative porewater pressures across the levee after the trench was flooded with water and held at a constant hydraulic head during the seepage test—the results from this component of the experiment are not discussed in this report. We collected more than one billion three-dimensional light detection and ranging (lidar) data points before, during, and after the centerline seepage test to assess centimeter-scale stability of the two trees and the levee crown. During the seepage test, the waterside tree toppled (rotated 20.7 degrees) into the water. The landside tree rotated away from the levee by 5 centimeters (cm) at a height of 2 m on the tree. The paved surface of the levee crown had three regions that showed subsidence on the waterside of the trench—discussed as the northern, central, and southern features. The northern feature is an elongate region that subsided 2.1 cm over an area with an average width of 1.35 m that extends 15.8 m parallel to the trench from the northern end of the trench to just north of the trench midpoint, and is associated with a crack 1 cm in height that formed during the seepage test on the trench wall. The central subsidence feature is a semicircular region on the waterside of the trench that subsided by as much as 6.2 cm over an area 3.4 m wide and 11.2 m long. The southern feature is an elongate
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Utilisation of Antenatal Services at the Provincial Hospital, Mongomo ...
African Journals Online (AJOL)
Utilisation of Antenatal Services at the Provincial Hospital, Mongomo, Guinea Equatoria. AAG Jimoh. Abstract. This prospective study was carried out to evaluate the utilisation of antenatal care at the Provincial Specialist Hospital, Mongomo, Guinea Equatoria, paying close attention to the confounding factors affecting ...
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Developments in Levee Reliability and Flood Risk Analysis in the Netherlands
Jonkman, S.N.; Schweckendiek, T.
2015-01-01
This paper presents and overview of advances in flood risk and levee reliability analysis in the Netherlands. It is described how new safety standards – in the form of a target failure probability – have been derived on the basis of nationwide flood risk assessments which taken into account both
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Awareness of family planning amongst antenatal patients in a ...
African Journals Online (AJOL)
Aim: This study aimed at determining the awareness about family planning amongst pregnant women presenting to the antenatal clinic of Federal Medical Centre, Owo, Ondo State, Nigeria. Methodology: The study was conducted between December, 2007 and February, 2008 at the antenatal clinic of the hospital. Ethical ...
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Mobile phones improve antenatal care attendance in Zanzibar: a cluster randomized controlled trial
2014-01-01
Background Applying mobile phones in healthcare is increasingly prioritized to strengthen healthcare systems. Antenatal care has the potential to reduce maternal morbidity and improve newborns’ survival but this benefit may not be realized in sub-Saharan Africa where the attendance and quality of care is declining. We evaluated the association between a mobile phone intervention and antenatal care in a resource-limited setting. We aimed to assess antenatal care in a comprehensive way taking into consideration utilisation of antenatal care as well as content and timing of interventions during pregnancy. Methods This study was an open label pragmatic cluster-randomised controlled trial with primary healthcare facilities in Zanzibar as the unit of randomisation. 2550 pregnant women (1311 interventions and 1239 controls) who attended antenatal care at selected primary healthcare facilities were included at their first antenatal care visit and followed until 42 days after delivery. 24 primary health care facilities in six districts were randomized to either mobile phone intervention or standard care. The intervention consisted of a mobile phone text-message and voucher component. Primary outcome measure was four or more antenatal care visits during pregnancy. Secondary outcome measures were tetanus vaccination, preventive treatment for malaria, gestational age at last antenatal care visit, and antepartum referral. Results The mobile phone intervention was associated with an increase in antenatal care attendance. In the intervention group 44% of the women received four or more antenatal care visits versus 31% in the control group (OR, 2.39; 95% CI, 1.03-5.55). There was a trend towards improved timing and quality of antenatal care services across all secondary outcome measures although not statistically significant. Conclusions The wired mothers’ mobile phone intervention significantly increased the proportion of women receiving the recommended four antenatal care
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River Activism, “Levees-Only” and the Great Mississippi Flood of 1927
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Ned Randolph
2018-02-01
Full Text Available This article investigates media coverage of 19th and early 20th century river activism and its effect on federal policy to control the Mississippi River. The U.S. Army Corps of Engineers’ “levees-only” policy—which joined disparate navigation and flood control interests—is largely blamed for the Great Flood of 1927, called the largest peacetime disaster in American history. River activists organized annual conventions, and later, professional lobbies organized media campaigns up and down the Mississippi River to sway public opinion and pressure Congress to fund flood control and river navigation projects. Annual river conventions drew thousands of delegates such as plantation owners, shippers, bankers, chambers of commerce, governors, congressmen, mayors and cabinet members with interests on the Mississippi River. Public pressure on Congress successfully captured millions of federal dollars to protect property, drain swamps for development, subsidize local levee districts and influence river policy.
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The Impact of Antenatal Depression on Perinatal Outcomes in Australian Women.
Directory of Open Access Journals (Sweden)
John Eastwood
Full Text Available In Australia, there is limited evidence on the impact of antenatal depression on perinatal outcomes. This study investigates the association between maternal depressive symptoms during pregnancy and key perinatal outcomes, including birth weight, gestational age at birth, breastfeeding indicators and postnatal depressive symptoms.A retrospective cohort of mothers (N = 17,564 of all infants born in public health facilities within South Western Sydney Local Health District and Sydney Local Health District in 2014, in the state of New South Wales (NSW, Australia, was enumerated from routinely collected antenatal data to investigate the risk of adverse perinatal outcomes associated with maternal depressive symptoms during pregnancy. Antenatal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS. Logistic regression models that adjusted for confounders were conducted to determine associations between antenatal depressive symptoms and low birth weight, early gestational age at birth (<37 weeks, breast feeding indicators and postnatal depressive symptoms.The prevalence of maternal depressive symptoms during pregnancy was 7.0% in the cohort, and was significantly associated with postnatal depressive symptoms [Adjusted Odd Ratios (AOR = 6.4, 95% CI: 4.8-8.7, P<0.001]. Antenatal depressive symptoms was associated with a higher odds of low birth weight [AOR = 1.7, 95% CI: 1.2-2.3, P = 0.003] and a gestational age at birth of <37 weeks [AOR = 1.3, 95% CI: 1.1-1.7, P = 0.018] compared to women who reported lower EPDS scores in antenatal period. Antenatal depressive symptoms were not strongly associated with non-exclusive breast feeding in the early postnatal period.Maternal depressive symptoms in the antenatal period are strongly associated with postnatal depressive symptoms and adverse perinatal outcomes in Australian infants. Early identification of antenatal and postnatal depressive symptoms, and referral for appropriate
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Antenatal calcium intake in Malaysia.
Mahdy, Zaleha Abdullah; Basri, Hashimah; Md Isa, Zaleha; Ahmad, Shuhaila; Shamsuddin, Khadijah; Mohd Amin, Rahmah
2014-04-01
To determine the adequacy of antenatal calcium intake in Malaysia, and the influencing factors. A cross-sectional study was conducted among postnatal women who delivered in two tertiary hospitals. Data were collected from antenatal cards, hospital documents and diet recall on daily milk and calcium intake during pregnancy. SPSS version 19.0 was used for statistical analyses. A total of 150 women were studied. The total daily calcium intake was 834 ± 43 mg (mean ± standard error of the mean), but the calcium intake distribution curve was skewed to the right with a median intake of 725 mg daily. When calcium intake from milk and calcium supplements was excluded, the daily dietary calcium intake was only 478 ± 25 mg. Even with inclusion of milk and calcium supplements, more than a third (n=55 or 36.7%) of the women consumed less than 600 mg calcium in their daily diet. The adequacy of daily calcium intake was not influenced by maternal age, ethnicity, income or maternal job or educational status as well as parity. The daily dietary calcium intake of the Malaysian antenatal population is far from adequate without the addition of calcium supplements and milk. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.
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Influence of pregnancy perceptions on patterns of seeking antenatal ...
African Journals Online (AJOL)
To the women with a positive orientation towards antenatal care, pregnancy provides joy, happiness, pride, promotes their social status and safe-guards their marriage. Pregnancy is rewarding with care, love, support and gifts. Women who shun antenatal care perceive pregnancy to be a source of misery, sadness, pain and ...
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Factors associated with late antenatal care attendance in selected ...
African Journals Online (AJOL)
Background: Despite antenatal care services being provided free of charge or sometimes at a minimal cost in Zambia, only 19% of women attend antenatal care by their fourth month of pregnancy, as recommended by World Health Organization (WHO). An estimated 21% of pregnant women in urban and 18% in rural ...
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Antenatal Care and Skilled Birth Attendance in Three Communities ...
African Journals Online (AJOL)
Antenatal Care and Skilled Birth Attendance in Three Communities in Kaduna State, Nigeria. ... Most importantly, safer delivery options that would be acceptable in communities where women traditionally birth at home need to be explored (Afr. J. Reprod. Health 2010; 14[3]: 89-96). Key words: Antenatal care, skilled birth ...
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Sakata, Yasuyo
The survey of interview, resource acquisition, photographic operation, and questionnaire were carried out in the “n” Community in the “y” District in Hakusan City in Ishikawa Prefecture to investigate the actual condition of paddy field levee maintenance in the area where land-renting market was proceeding, large-scale farming was dominant, and the problems of geographically scattered farm-land existed. In the study zone, 1) an agricultural production legal person rent-cultivated some of the paddy fields and maintained the levees, 2) another agricultural production legal person rent-cultivated some of the soy bean fields for crop changeover and land owners maintained the levees. The results indicated that sufficient maintenance was executed on the levees of the paddy fields cultivated by the agricultural production legal person, the soy bean fields for crop changeover, and the paddy fields cultivated by the land owners. Each reason is considered to be the managerial strategy, the economic incentive, the mutual monitoring and cross-regulatory mechanism, etc.
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Zwart, A.P.
2003-01-01
This article gives a short summary of my PhD thesis Queueing Systems with Heavy-tails, winner of the Gijs De Leve prize for the best Dutch thesis in operations research in the period 2000-2002. Apart from the Gijs de Leve prize, this thesis also received the ASML prize, for best thesis in Ihe
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2005 United States Army Corps of Engineers (USACE) Post-Hurricane Katrina Levee Surveys
National Oceanic and Atmospheric Administration, Department of Commerce — These topographic data were collected for the U.S. Army Corps of Engineers by a helicopter-mounted LiDAR sensor over the New Orleans Hurricane Protection Levee...
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Measuring the adequacy of antenatal health care: a national cross-sectional study in Mexico.
Heredia-Pi, Ileana; Servan-Mori, Edson; Darney, Blair G; Reyes-Morales, Hortensia; Lozano, Rafael
2016-06-01
To propose an antenatal care classification for measuring the continuum of health care based on the concept of adequacy: timeliness of entry into antenatal care, number of antenatal care visits and key processes of care. In a cross-sectional, retrospective study we used data from the Mexican National Health and Nutrition Survey (ENSANUT) in 2012. This contained self-reported information about antenatal care use by 6494 women during their last pregnancy ending in live birth. Antenatal care was considered to be adequate if a woman attended her first visit during the first trimester of pregnancy, made a minimum of four antenatal care visits and underwent at least seven of the eight recommended procedures during visits. We used multivariate ordinal logistic regression to identify correlates of adequate antenatal care and predicted coverage. Based on a population-weighted sample of 9 052 044, 98.4% of women received antenatal care during their last pregnancy, but only 71.5% (95% confidence interval, CI: 69.7 to 73.2) received maternal health care classified as adequate. Significant geographic differences in coverage of care were identified among states. The probability of receiving adequate antenatal care was higher among women of higher socioeconomic status, with more years of schooling and with health insurance. While basic antenatal care coverage is high in Mexico, adequate care remains low. Efforts by health systems, governments and researchers to measure and improve antenatal care should adopt a more rigorous definition of care to include important elements of quality such as continuity and processes of care.
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Marcadores de estrés oxidativo en hipertensión leve
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Raquel Oré
2007-12-01
Full Text Available Introducción: La hipertensión es un factor de riesgo cardiovascular y en 90% de los casos se desconoce el mecanismo que la inicia. Recientemente, se considera que la hipertensión es un síndrome de anormalidades metabólicas y estructurales, en el que las especies reactivas derivadas del oxígeno (EROs juegan un papel fisiopatológico preponderante en su desarrollo. Objetivo: Determinar los niveles séricos de zinc, selenio y magnesio en personas normotensas e hipertensas. Asimismo, valorar la actividad de la enzima superóxido dismutasa (SOD y los niveles de sustancias reactivas al ácido tiobarbitúrico (TBARS en ambos grupos de estudio. Diseño: Estudio analítico observacional, tipo casos y controles. Lugar: Centro de Investigación de Bioquímica y Nutrición, Universidad Nacional Mayor de San Marcos. Material biológico: Sangre de pacientes normotensos y con hipertensión leve. Intervenciones: Se obtuvo las muestras de sangre de 20 pacientes normotensos y 20 con hipertensión leve, con edades entre 50 y 60 años, después de un ayuno de 12 horas, realizándose el estudio en suero y sangre total. Principales medidas de resultados: Variación de niveles de TBARS, oligoelementos (Se, Zn y Mg, medición de actividad de SOD eritrocitario. Resultados: En el grupo de hipertensos, se obtuvo incremento significativo de magnesio y TBARS y disminución significativa de zinc y de la actividad de SOD. Conclusiones: Se demuestra el compromiso del estrés oxidativo en pacientes con hipertensión leve. La hipermagnesemia podría explicarse por el daño a los elementos formes de la sangre.
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Antenatal care service utilization and associated factors in Metekel ...
African Journals Online (AJOL)
socioeconomic and some obstetric factors have been stated by few studies in other areas, the factors associated with low utilization of Antenatal care in Metekel Zone are not well assed before. Therefore, the objective of this study was to assess the status of Antenatal care service utilization and associated factors among ...
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An inverse method to estimate the flow through a levee breach
D'Oria, Marco; Mignosa, Paolo; Tanda, Maria Giovanna
2015-08-01
We propose a procedure to estimate the flow through a levee breach based on water levels recorded in river stations downstream and/or upstream of the failure site. The inverse problem is solved using a Bayesian approach and requires the execution of several forward unsteady flow simulations. For this purpose, we have used the well-known 1-D HEC-RAS model, but any unsteady flow model could be adopted in the same way. The procedure has been tested using four synthetic examples. Levee breaches with different characteristics (free flow, flow with tailwater effects, etc.) have been simulated to collect the synthetic level data used at a later stage in the inverse procedure. The method was able to accurately reproduce the flow through the breach in all cases. The practicability of the procedure was then confirmed applying it to the inundation of the Polesine Region (Northern Italy) which occurred in 1951 and was caused by three contiguous and almost simultaneous breaches on the left embankment of the Po River.
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Perception of prenatal services by antenatal clinic attendees in a ...
African Journals Online (AJOL)
DR ADDAH A.O
2015-09-30
Sep 30, 2015 ... also been recognised that most women who registered for antenatal care in a particular health ..... is not yet appropriate to embrace focused antenatal care.9 There are still gaps in the continued use of ... higher wages.
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Crevasse Splays Versus Avulsions: A Recipe for Land Building With Levee Breaches
Nienhuis, Jaap H.; Törnqvist, Torbjörn E.; Esposito, Christopher R.
2018-05-01
Natural-levee breaches can not only initiate an avulsion but also, under the right circumstances, lead to crevasse splay formation and overbank sedimentation. The formative conditions for crevasse splays are not well understood, yet such river sediment diversions form an integral part of billion-dollar coastal restoration projects. Here we use Delft3D to investigate the influence of vegetation and soil consolidation on the evolution of a natural-levee breach. Model simulations show that crevasse splays heal because floodplain aggradation reduces the water surface slope, decreasing water discharge into the flood basin. Easily erodible and unvegetated floodplains increase the likelihood for channel avulsions. Denser vegetation and less potential for soil consolidation result in small crevasse splays that are not only efficient sediment traps but also short-lived. Successful crevasse splays that generate the largest land area gain for the imported sediment require a delicate balance between water and sediment discharge, vegetation root strength, and soil consolidation.
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Kane, I. A.; Hodgson, D.
2009-12-01
Thinning upwards of the turbidite beds that form deepmarine channel levees is a common motif reported from modern and recent levees on the seafloor, from subsurface examples, and from outcropping ancient examples. Because levees are thought to be built by deposition from turbidity currents superelevated over their channel form, the volume and style of overbank deposition are controlled primarily by the relationship between levee height (i.e., thalweg to crest) and flow thickness, determining the amount of overspill. Thus stratigraphic variability of turbidite thickness is explained by some change in either or both of those factors, which may arise autocyclicly or allocyclicly. Variation in the ratio of intra-channel and extra-channel deposition can be an autocyclic stratigraphic response, e.g., in bypass dominated systems, thalweg aggradation may be retarded with respect to levee aggradation, hence as levee relief increases, flows become more confined and, given a relatively narrow range of flow sizes, the volume of overbank flow and deposit thickness decrease with stratigraphic height. However, the same stratigraphic response of the levee may occur due to allocyclic flow magnitude variation, i.e., through decreasing flow magnitude. In both the autocyclic and allocyclic case the stratigraphic response of the levee may be one of thinning upwards, even if the overall system response may be one of progradation (autocyclic bypassing case) or retrogradation (allocyclic decreasing flow magnitude case), with entirely different connotations for sequence stratigraphic interpretation. Here we report examples of different scales of bed thickness cyclicity (both thickening and thinning upward cycles superimposed by smaller scale cycles) within levees of the Rosario Formation, Baja California, Mexico, and from the Laingsburg Formation, Karoo, South Africa, and, together with published examples, discuss criteria for the recognition, and drivers of, autocyclic and allocyclic bed
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The effect of antenatal education in small classes on obstetric and psycho-social outcomes
DEFF Research Database (Denmark)
Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Andersen, Stig Krøger
2014-01-01
The aims of antenatal education contain both outcomes related to pregnancy, birth and parenthood. Both content and methods of antenatal education have changed over time without evidence of effects on relevant outcomes. The effect of antenatal education in groups, with participation of a small num......-analysis aims to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes....
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Social capital and antenatal depression among Chinese primiparas: A cross-sectional survey.
Zhou, Chi; Ogihara, Atsushi; Chen, Hao; Wang, Weijue; Huang, Liu; Zhang, Baodan; Zhang, Xueni; Xu, Liangwen; Yang, Lei
2017-11-01
The aim of this study is to investigate the associations between social capital and antenatal depression among Chinese primiparas. A cross-sectional design was used and a questionnaire survey was conducted with 1471 participants using the intercept method at the provincial hospital in Zhejiang in 2016. Antenatal depression was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) and social capital was assessed by the Chinese version of Social Capital Assessment Questionnaire (C-SCAQ). The prevalence of antenatal depression was assessed among Chinese primiparas in their third trimesters. The antenatal depression prevalence among sub-groups with lower social trust (ST), social reciprocity (SR), social network (SN), and social participation (SP) were significantly higher than those among higher score sub-groups. In the fully adjusted model, primiparas' antenatal depression was significantly associated with ST, SR, SN, and SP. Compared to the structural social capital, the cognitive social capital was a more crucial dimension to the prevalence of antenatal depression. For future community pregnancy health care management programs in China, it might be beneficial to add more social capital related intervention. Copyright © 2017 Elsevier B.V. All rights reserved.
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On-site screening for maternal syphilis in an antenatal clinic
African Journals Online (AJOL)
Abstract Study objective. To determine the sensitivity, specificity, negative predictive value and positive predictive value of the rapid plasma reagin (RPR) test as performed on site in an antenatal clinic to facilitate immediate diagnosis and treatment of maternal syphilis. Design. Open, descriptive study. Setting. Antenatal ...
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On-site screening for maternal syphilis in an antenatal clinic ...
African Journals Online (AJOL)
Study objective. To determine the sensitivity, specificity, negative predictive value and positive predictive value of the rapid plasma reagin (RPR) test as performed on site in an antenatal clinic to facilitate immediate diagnosis and treatment of maternal syphilis. Design. Open, descriptive study. Setting. Antenatal clinic ...
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Uso del tratamiento acupuntural en pacientes con episodio depresivo leve
Directory of Open Access Journals (Sweden)
Roberto Anselmo Ramos Valverde
2014-08-01
Full Text Available Se realizó un estudio experimental en el Centro Comunitario Provincial de Salud Mental de Las Tunas, con el objetivo de determinar la efectividad del empleo de la acupuntura en pacientes portadores de episodio depresivo leve. El universo estuvo constituido por todos los pacientes diagnosticados clínicamente con la enfermedad, que acudieron a la consulta de Medicina Natural y Tradicional de esta entidad entre marzo de 2011 a marzo de 2013. La muestra quedó constituida por 60 pacientes que cumplieron los criterios diagnósticos y de inclusión establecidos para la investigación, se aplicó un muestreo aleatorio simple que permitió conformar dos grupos, uno de estudio, al que se le aplicó tratamiento acupuntural, y uno control, que recibió tratamiento con amitriptilina. Los resultados mostraron que el insomnio fue el síntoma asociado más frecuente. Al terminar el tratamiento se obtuvo que la depresión se eliminó en la totalidad de los pacientes, pero fue más inmediato el efecto antidepresivo en los pacientes del grupo estudio, los síntomas asociados desaparecieron en casi la totalidad de ellos. Se concluye que el tratamiento tradicional acupuntural constituye una terapia efectiva en los pacientes con episodio depresivo leve
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Prognostic accuracy of antenatal neonatology consultation.
Kukora, S; Gollehon, N; Weiner, G; Laventhal, N
2017-01-01
Neonatologists provide antenatal counseling to support shared decision-making for complicated pregnancies. Poor or ambiguous prognostication can lead to inappropriate treatment and parental distress. We sought to evaluate the accuracy of antenatal prognosticaltion. A retrospective cohort was assembled from a prospectively populated database of all outpatient neonatology consultations. On the basis of the written consultation, fetuses were characterized by diagnosis groups (multiple anomalies or genetic disorders, single major anomaly and obstetric complications), assigned to five prognostic categories (I=survivable, IIA=uncertain but likely survivable, II=uncertain, IIB=uncertain but likely non-survivable, III non-survivable) and two final outcome categories (fetal demise/in-hospital neonatal death or survival to hospital discharge). When possible, status at last follow-up was recorded for those discharged from the hospital. Prognostic accuracy was assessed using unweighted, multi-level likelihood ratios (LRs). The final cohort included 143 fetuses/infants distributed nearly evenly among the three diagnosis groups. Over half (64%) were assigned an uncertain prognosis, but most of these could be divided into 'likely survivable' or 'likely non-survivable' subgroups. Overall survival for the entire cohort was 62% (89/143). All but one of the fetuses assigned a non-survivable prognosis suffered fetal demise or died before hospital discharge. The neonatologist's antenatal prognosis accurately predicted the probability of survival by prognosis group (LR I=4.56, LR IIA=10.53, LR II=4.71, LR IIB=0.099, LR III=0.040). The LRs clearly differentiated between fetuses with high and low probability of survival. Eleven fetuses (7.7%) had misalignment between the predicted prognosis and outcome. Five died before discharge despite being given category I or IIA prognoses, whereas six infants with category IIB or III prognoses survived to discharge, though some of these were
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Influence of Antenatal Care on the Haematocrit Value of Pregnant ...
African Journals Online (AJOL)
Context: Antenatal care is generally believed to influence the outcome of any pregnancy. Haematocrit values are important in the assessment of anaemia in pregnancy. A good antenatal care is expected to be associated with good haematocrit values, prevent anaemia in pregnancy, and result in an overall good pregnancy ...
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Antenatal mother–infant bonding scores are related to maternal reports of infant crying behaviour
Kommers, D.R.; Truijens, S.E.M.; Oei, S.G.; Bambang Oetomo, S.; Pop, V.J.M.
2017-01-01
Objective: To assess the relation between antenatal mother–infant bonding scores and maternal reports of infant crying behaviour. Background: Crying is normal behaviour and it is important for parent–infant bonding. Even though bonding starts antenatally, the relation between antenatal bonding
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Pattern of Family Planning Methods used by Antenatal Patients in ...
African Journals Online (AJOL)
This study aimed at assessing the pattern of family planning methods used by antenatal patients at Federal Medical Centre, Owo, Ondo State, Nigeria. The study was conducted between December,2007 and February,2008 at the antenatal clinic of the hospital. Ethical clearance was obtained from the Ethical committee of ...
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HIV testing and treatment in the antenatal care setting.
LENUS (Irish Health Repository)
Coulter-Smith, S
2010-01-01
Routine linked HIV antenatal screening, with "opt-out", was introduced at the Rotunda in January 1998. This paper reviews the screening and subsequent pregnancy management and outcome in HIV positive women from 1998 to 2006. During this time 225 women (280 pregnancies) were HIV positive and 194 women subsequently delivered at the Rotunda, representing 233 liveborn infants. Overall anti-HIV prevalence was 0.42%, increasing from 0.06% in 1998 to 0.57% in 2006. Of 233 livebirths, 111 (48%) were delivered by spontaneous vaginal delivery (SVD). HIV treatment was started pre-pregnancy in 14 (6%) pregnancies and antenatally in 208 (90%). The vertical transmission rate in mothers receiving >4 weeks of treatment was 0%. We conclude that routine antenatal HIV screening is effective and significantly benefits the health of mother and child.
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HIV testing and treatment in the antenatal care setting.
LENUS (Irish Health Repository)
Coulter-Smith, S
2012-02-01
Routine linked HIV antenatal screening, with "opt-out", was introduced at the Rotunda in January 1998. This paper reviews the screening and subsequent pregnancy management and outcome in HIV positive women from 1998 to 2006. During this time 225 women (280 pregnancies) were HIV positive and 194 women subsequently delivered at the Rotunda, representing 233 liveborn infants. Overall anti-HIV prevalence was 0.42%, increasing from 0.06% in 1998 to 0.57% in 2006. Of 233 livebirths, 111 (48%) were delivered by spontaneous vaginal delivery (SVD). HIV treatment was started pre-pregnancy in 14 (6%) pregnancies and antenatally in 208 (90%). The vertical transmission rate in mothers receiving >4 weeks of treatment was 0%. We conclude that routine antenatal HIV screening is effective and significantly benefits the health of mother and child.
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Yang, Xiuhao; Henderson, Gregg; Mao, Lixin; Evans, Ahmad
2009-08-01
A ground penetrating radar (GPR) technique was used to detect Formosan subterranean termite (Coptotermes formosanus) and red imported fire ant (Solenopsis invicta) hazards and risks (targets) in a soil levee at the London Avenue Canal in New Orleans, LA. To make this assessment, GPR signal scans were examined for features produced by termite or ant activities and potential sources of food and shelter such as nests, tree roots, and voids (tunnels). The total scanned length of the soil levee was 4,125 m. The average velocity and effective depth of the radar penetration was 0.080 m/ns and 0.61 m, respectively. Four hundred twenty-seven targets were identified. Tree roots (38), voids (31), fire ant nests (209), and metal objects (149) were detected, but no Formosan termite carton nests were identified. The lack of identified termite nests may be related to drowning events at the time to the flood. Based on the target density (TD), the two new floodwall and levee sections that were rebuilt or reinforced after they were destroyed by Hurricane Katrina in 2005 were determined to be at low potential risk from termites and ants. A merging target density (MTD) method indicated a high potential risk near one of the breached sections still remains. Foraging and nesting activity of Formosan subterranean termites and red imported fire ants may be a contributory factor to the levee failure at the London Avenue Canal.
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Antenatal care visits and pregnancy outcomes at a Kenyan rural ...
African Journals Online (AJOL)
Background: The goal of antenatal care (ANC) is to improve maternal and neonatal outcomes. Fewer ANC visits in focused antenatal care (FANC) model can affect maternal and perinatal outcomes in low income settings where the number ANC visits are often low. Objective: To determine the number of ANC visits and their ...
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Directory of Open Access Journals (Sweden)
Jordi Domènech-Casal
2017-01-01
Full Text Available Aprender ciencia en contexto implica aprender a transferir modelos a situaciones reales y tomar decisiones. En la enseñanza de las ciencias, este enfoque tiene su exponente en el trabajo con controversias socio-científicas (CSC, una metodología didáctica que se revela compleja en su aplicación y evaluación. Se propone un marco metodológico para estandarizar el trabajo y evaluación de actividades de controversia socio-científica, en el marco de dinámicas de comunicación de distintos tipos (lectura, comunicación oral y escritura. El marco propuesto ofrece distintos andamios didácticos como apoyo para el desarrollo y evaluación de habilidades científicas del alumnado, como el uso de datos, la transferencia de modelos a contextos relevantes, o la argumentación, o el léxico partiendo de un dilema. Se han desarrollado y aplicado dos actividades para testar el marco metodológico. Los resultados indican que el uso del marco propuesto permite promover y evaluar habilidades de razonamiento científico en el marco de las CSC.
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Prevalence of Novel MAGED2 Mutations in Antenatal Bartter Syndrome.
Legrand, Anne; Treard, Cyrielle; Roncelin, Isabelle; Dreux, Sophie; Bertholet-Thomas, Aurélia; Broux, Françoise; Bruno, Daniele; Decramer, Stéphane; Deschenes, Georges; Djeddi, Djamal; Guigonis, Vincent; Jay, Nadine; Khalifeh, Tackwa; Llanas, Brigitte; Morin, Denis; Morin, Gilles; Nobili, François; Pietrement, Christine; Ryckewaert, Amélie; Salomon, Rémi; Vrillon, Isabelle; Blanchard, Anne; Vargas-Poussou, Rosa
2018-02-07
Mutations in the MAGED2 gene, located on the X chromosome, have been recently detected in males with a transient form of antenatal Bartter syndrome or with idiopathic polyhydramnios. The aim of this study is to analyze the proportion of the population with mutations in this gene in a French cohort of patients with antenatal Bartter syndrome. The French cohort of patients with antenatal Bartter syndrome encompasses 171 families. Mutations in genes responsible for types 1-4 have been detected in 75% of cases. In patients without identified genetic cause ( n =42), transient antenatal Bartter syndrome was reported in 12 cases. We analyzed the MAGED2 gene in the entire cohort of negative cases by Sanger sequencing and retrospectively collected clinical data regarding pregnancy as well as the postnatal outcome for positive cases. We detected mutations in MAGED2 in 17 patients, including the 12 with transient antenatal Bartter syndrome, from 16 families. Fifteen different mutations were detected (one whole deletion, three frameshift, three splicing, three nonsense, two inframe deletions, and three missense); 13 of these mutations had not been previously described. Interestingly, two patients are females; in one of these patients our data are consistent with selective inactivation of chromosome X explaining the severity. The phenotypic presentation in our patients was variable and less severe than that of the originally described cases. MAGED2 mutations explained 9% of cases of antenatal Bartter syndrome in a French cohort, and accounted for 38% of patients without other characterized mutations and for 44% of male probands of negative cases. Our study confirmed previously published data and showed that females can be affected. As a result, this gene must be included in the screening of the most severe clinical form of Bartter syndrome. Copyright © 2018 by the American Society of Nephrology.
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Fuentes, Sergio Edgardo
2002-01-01
Los países con economías desarrolladas y con predominio en el comercio internacional tanto de bienes como de servicios, utilizan el arbitraje comercial internacional, prácticamente en forma excluyente para dirimir las controversias surgidas en el ámbito de los negocios internacionales. Y ello, por dos situaciones que se señalan en este artículo, a saber: 1.- Menores costos que los demandados en procesos judiciales. 2.- Seguridad jurídica para las partes intervinientes en los negocios ...
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Antenatal breastfeeding education for increasing breastfeeding duration
Lumbiganon, Pisake; Martis, Ruth; Laopaiboon, Malinee; Festin, Mario R; Ho, Jacqueline J; Hakimi, Mohammad
2014-01-01
Background Breastfeeding (BF) is well recognised as the best food for infants. The impact of antenatal BF education on the duration of BF has not been evaluated. Objectives To evaluate the effectiveness of antenatal BF education for increasing BF initiation and duration. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (21 April 2010), CENTRAL (The Cochrane Library 2010, Issue 2), MEDLINE (1966 to April 2010) and SCOPUS (January 1985 to April 2010). We contacted experts and searched reference lists of retrieved articles. We updated the search of the Pregnancy and Childbirth Group’s Trials Register on 28 September 2011 and added the results to the awaiting classification section of the review. Selection criteria All identified published, unpublished and ongoing randomised controlled trials (RCTs) assessing the effect of formal antenatal BF education or comparing two different methods of formal antenatal BF education, on duration of BF. We excluded RCTs that also included intrapartum or postpartum BF education. Data collection and analysis We assessed all potential studies identified as a result of the search strategy. Two review authors extracted data from each included study using the agreed form and assessed risk of bias. We resolved discrepancies through discussion. Main results We included 17 studies with 7131 women in the review and 14 studies involving 6932 women contributed data to the analyses. We did not do any meta-analysis because there was only one study for each comparison. Five studies compared a single method of BF education with routine care. Peer counselling significantly increased BF initiation. Three studies compared one form of BF education versus another. No intervention was significantly more effective than another intervention in increasing initiation or duration of BF. Seven studies compared multiple methods versus a single method of BF education. Combined BF educational interventions were not
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The effect of antenatal education in small classes on obstetric and psycho-social outcomes
DEFF Research Database (Denmark)
Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Lauemøller, Stine Glenstrup
2015-01-01
of small group antenatal education on obstetric and psycho-social outcomes. CONCLUSIONS: Insufficient evidence exists as to whether antenatal education in small classes is effective in regard to obstetric and psycho-social outcomes. We recommend updating this review following the emergence of well......, with participation of a small number of participants, may differ from the effect of other forms of antenatal education due to, for example, group dynamic. The objective of this systematic review is to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes. METHODS...
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(HIV) infection among pregnant women in an antenatal clinic in Port
African Journals Online (AJOL)
Women attending ante-natal clinic in Nigeria are routinely screened for HIV/AIDS. A retrospective study was conducted between 2000 and 2004 to investigate the prevalence of the human immunodeficiency virus (HIV) infection among pregnant women attending ante-natal clinic in Braithwalte Memorial Hospital (BMH), Port ...
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Directory of Open Access Journals (Sweden)
Ana Paula Grotti Clemente
2012-01-01
Full Text Available FUNDAMENTO: Estudos têm demonstrado que a desnutrição pré/pós-natal leva a um maior risco de doenças não transmissíveis, como diabetes, hipertensão e obesidade na idade adulta. OBJETIVO: Determinar se os adolescentes com sobrepeso e desnutrição leve [escores-Z altura/idade (HAZ na faixa de -2] têm pressão arterial mais elevada do que os indivíduos com sobrepeso e com estatura normal (HAZ > -1. MÉTODOS: Os participantes foram classificados como de baixa estatura leve ou de estatura normal, e estratificados de acordo com os percentis de massa corporal para a idade, como sobrepeso, peso normal ou abaixo do peso. As pressões arteriais sistólica (PAS e diastólica (PAD foram determinadas de acordo com as diretrizes e a gordura abdominal foi analisada por absorciometria de dupla emissão de raios-X. RESULTADOS: Indivíduos com baixa estatura leve e sobrepeso apresentaram valores mais elevados da PAD (p = 0,001 do que suas contrapartes de baixo peso (69,75 ± 12,03 e 54,46 ± 11,24 mmHg, respectivamente, mas semelhantes àqueles com IMC normal. Não foram encontradas diferenças nos valores de PAD em indivíduos normais, indivíduos com sobrepeso e com baixo peso entre os grupos de estatura normal. Foi encontrado um aumento na PAS (p = 0,01 entre os indivíduos com baixa estatura leve quando comparados os indivíduos com sobrepreso com suas contrapartes de baixo peso e IMC normal (114,70 ± 15,46, 97,38 ± 10,87 e 104,72 ± 12,24 mmHg, respectivamente. Embora não tenham sido observadas diferenças nas médias de PAS entre os grupos de baixa estatura leve e estatura normal, foi encontrado um intercepto significativo (p = 0,01, revelando maior PAS entre os indivíduos com baixa estatura leve. Houve correlação entre PAS e gordura abdominal (r = 0,42, ρ = 0,02 no grupo com baixa estatura leve. CONCLUSÃO: Indivíduos de baixa estatura leve com sobrepeso apresentaram maior PAS do que os de estatura normal e sobrepeso. Esses achados
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Diabetes tipo 2 y obesidad leve: tratamiento quirúrgico
Lanzaren S,Enrique
2013-01-01
Introducción: En la actualidad la diabetes mellitus tipo 2 (DM2) y la obesidad representan un serio problema de salud, comportándose como enfermedades epidémicas. Existe un gran interés en explorar distintas opciones de tratamiento de la DM2 en pacientes que no tienen obesidad mórbida. Objetivo: Reportar los parámetros de control glicémico en pacientes con DM2 y obesidad leve sometidos a bypass gástrico (BPG) a 3 años de seguimiento. Metodología: Estudio clínico prospectivo que incluye pacien...
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Concreto leve com pérolas de EPS: estudo de dosagens e de características mecânicas
Bianca Pereira Moreira Ozório
2016-01-01
Este trabalho teve como objetivo analisar o comportamento do concreto leve com pérolas de poliestireno expandido (expanded polystyrene – EPS), para posterior utilização em estruturas pré-moldadas constituídas, por exemplo, por painéis de paredes e lajes sujeitas a ações mecânicas. Também foram considerados parâmetros de durabilidade e mecanismos de redução da porosidade. Dentre um universo de solicitações a que as estruturas de concreto leve podem estar submetidas, analisaram-se, para d...
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Dickson, Kwamena Sekyi; Darteh, Eugene Kofuor Maafo; Kumi-Kyereme, Akwasi
2017-03-14
Antenatal care is one of the three most essential care - antenatal, delivery and post-natal, given to women during pregnancy and has the potential to contribute towards the achievement of the Sustainable Development Goal (SDG) target 3.1- reducing the global maternal mortality ratio to less than 70 per 100,000 and target 3.8 - achieve universal health coverage. The main objective is to examine the contribution of the various providers of antenatal care services in Ghana from 1988 to 2014. The study uses data from all the six rounds of the Ghana Demographic and Health Survey (GDHS). Binary logistic regression models were applied to examine the association between background characteristics of respondents and providers of antenatal care services. The results show that majority of antenatal care services were provided by nurses over the period under review. The proportion of women who received antenatal care services from nurses improved over the period from 55% in 1988 to 89.5% in 2014. Moreover, there was a decline in antenatal care services provided by traditional birth attendants and women who did not receive antenatal care services from any service provider over the years under review. It was observed that women from rural areas were more likely to utilise antenatal care services provided by traditional birth attendants, whilst those from urban areas were more likely to utilise antenatal care from doctors and nurses. To further improve access to and utilisation of antenatal care services provided by nurses and doctors it is recommended that the Ghana Health Service and the Ministry of Health should put in place systems aimed at improving on the quality of care given such as regular training workshops for health personnel and assessment of patient's satisfaction with services provided. Also, they should encourage women in rural areas especially those from the savannah zone to utilise antenatal care services from skilled providers through social and behaviour
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Remo, Jonathan W.F.; Ickes, Brian; Ryherd, Julia K.; Guida, Ross J.; Therrell, Matthew D.
2018-01-01
The impacts of dams and levees on the long-term (>130 years) discharge record was assessed along a ~1200 km segment of the Mississippi River between St. Louis, Missouri, and Vicksburg, Mississippi. To aid in our evaluation of dam impacts, we used data from the U.S. National Inventory of Dams to calculate the rate of reservoir expansion at five long-term hydrologic monitoring stations along the study segment. We divided the hydrologic record at each station into three periods: (1) a pre-rapid reservoir expansion period; (2) a rapid reservoir expansion period; and (3) a post-rapid reservoir expansion period. We then used three approaches to assess changes in the hydrologic record at each station. Indicators of hydrologic alteration (IHA) and flow duration hydrographs were used to quantify changes in flow conditions between the pre- and post-rapid reservoir expansion periods. Auto-regressive interrupted time series analysis (ARITS) was used to assess trends in maximum annual discharge, mean annual discharge, minimum annual discharge, and standard deviation of daily discharges within a given water year. A one-dimensional HEC-RAS hydraulic model was used to assess the impact of levees on flood flows. Our results revealed that minimum annual discharges and low-flow IHA parameters showed the most significant changes. Additionally, increasing trends in minimum annual discharge during the rapid reservoir expansion period were found at three out of the five hydrologic monitoring stations. These IHA and ARITS results support previous findings consistent with the observation that reservoirs generally have the greatest impacts on low-flow conditions. River segment scale hydraulic modeling revealed levees can modestly increase peak flood discharges, while basin-scale hydrologic modeling assessments by the U.S. Army Corps of Engineers showed that tributary reservoirs reduced peak discharges by a similar magnitude (2 to 30%). This finding suggests that the effects of dams and
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Quality and uptake of antenatal and postnatal care in Haiti.
Mirkovic, Kelsey R; Lathrop, Eva; Hulland, Erin N; Jean-Louis, Reginald; Lauture, Daniel; D'Alexis, Ghislaine Desinor; Handzel, Endang; Grand-Pierre, Reynold
2017-02-02
Despite improvement, maternal mortality in Haiti remains high at 359/100,000 live births. Improving access to high quality antenatal and postnatal care has been shown to reduce maternal mortality and improve newborn outcomes. Little is known regarding the quality and uptake of antenatal and postnatal care among Haitian women. Exit interviews were conducted with all pregnant and postpartum women seeking care from large health facilities (n = 10) in the Nord and Nord-Est department and communes of St. Marc, Verrettes, and Petite Rivière in Haiti over the study period (March-April 2015; 3-4 days/facility). Standard questions related to demographics, previous pregnancies, current pregnancy, and services/satisfaction during the visit were asked. Total number of antenatal visits were abstracted from charts of recently delivered women (n = 1141). Provider knowledge assessments were completed by antenatal and postnatal care providers (n = 39). Frequencies were calculated for descriptive variables and multivariable logistic regression was used to explore predictors of receiving 5 out of 10 counseling messages among pregnant women. Among 894 pregnant women seeking antenatal care, most reported receiving standard clinical service components during their visit (97% were weighed, 80% had fetal heart tones checked), however fewer reported receiving recommended counseling messages (44% counselled on danger signs, 33% on postpartum family planning). Far fewer women were seeking postnatal care (n = 63) and similar service patterns were reported. Forty-three percent of pregnant women report receiving at least 5 out of 10 counseling messages. Pregnant women on a repeat visit and women with greater educational attainment had greater odds of reporting having received 5 out of 10 counseling messages (2 nd visit: adjusted odds ratio [aOR] =1.70, 95% confidence interval [CI]: 1.09-2.66; 5+ visit: aOR = 5.44, 95% CI: 2.91-10.16; elementary school certificate: a
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Antenatal Bartter's syndrome with sensorineural deafness
Bhamkar, R. P.; Gajendragadkar, A.
2009-01-01
Bartter's syndrome is a group of inherited, salt-losing tubulopathies presenting as metabolic alkalosis with normotensive hyperreninemia and hyperaldosteronism. We report here the first case of a neonate with bilateral, sensorineural deafness, a variant of antenatal Bartter's syndrome from an Indian community.
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The adequacy of antenatal care services among slum residents in Addis Ababa, Ethiopia.
Bayou, Yibeltal T; Mashalla, Yohana S; Thupayagale-Tshweneagae, Gloria
2016-06-15
There are recent efforts made to eliminate inequalities in the utilisation of basic health care services. More emphasis is given for improvement of health in developing countries including maternal and child health. However, disparities for the fast-growing population of urban poor are masked by the urban averages. The aim of this paper is to report on the findings of antenatal care adequacy among slum residents in Addis Ababa, Ethiopia. This was a quantitative and cross-sectional community based study design which employed a stratified two-stage cluster sampling technique to determine the sample. Data was collected using structured questionnaire administered to 870 women aged 15-49 years. Weighted 'backward selection' logistic regression models were employed to identify predictors of adequacy of antenatal care. Majority of slum residents did not have adequate antenatal care services with only 50.3, 20.2 and 11.0 % of the slum resident women initiated antenatal care early, received adequate antenatal care service contents and had overall adequate antenatal care services respectively. Educational status and place of ANC visits were important determinant factors for adequacy of ANC in the study area. Women with secondary and above educational status were 2.7 times more likely to receive overall adequate care compared to those with no formal education. Similarly, clients of private healthcare facilities were 2.2 times respectively more likely to receive overall adequate antenatal care compared to those clients of public healthcare facilities. In order to improve ANC adequacy in the study area, the policy-making, planning, and implementation processes should address the poor adequacy of ANC among the disadvantaged groups in particular and the slum residents in general.
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Impact of antenatal glucocorticosteroids on whole-genome expression in preterm babies.
Saugstad, Ola Didrik; Kwinta, Przemko; Wollen, Embjørg Julianne; Bik-Multanowski, Mirosław; Madetko-Talowska, Anna; Jagła, Mateusz; Tomasik, Tomasz; Pietrzyk, Jacek Józef
2013-04-01
To study the impact that using antenatal steroid to treat threatened preterm delivery has on whole-genome expression. A prospective whole-genome expression study was carried out on 50 newborn infants, delivered before 32 weeks gestation, who had been exposed to antenatal steroids, including 40 who had received a full antenatal steroid course. Seventy infants not exposed to antenatal steroids formed the control group. Microarray analyses were performed five and 28 days after delivery, and the results were validated by real-time PCR. The study was conducted between September 2008 and November 2010. Twenty thousand six hundred and ninety-three genes were studied in the infants' leucocytes. Thirteen were differentially expressed 5 days after delivery, but there were no differences at day 28. Four genes related to cancer or inflammation were up-regulated. Nine genes were down-regulated: six were Y-linked and associated with malignancies, graft-versus-host disease, male infertility and cell differentiation and three were associated with pre-eclampsia, oxidative stress and chloride/bicarbonate exchange. Seven gene pathways were up-regulated at day five and only one at day 28. These were associated with cell growth, cell cycle regulation, metabolism and apoptosis. Antenatal steroid therapy affects a limited number of genes and gene pathways in leucocytes in preterm babies at day five of life. The effect is short-lived, but long-term effects cannot be ruled out. ©2013 The Author(s)/Acta Paediatrica ©2013 Foundation Acta Paediatrica.
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Sociodemographic factors associated with anaemia in pregnancy at booking for antenatal care.
Adanikin, A I; Awoleke, J O
2016-01-01
Late patronage of antenatal care by women in low-resource areas makes timely intervention at correcting anaemia difficult. This study aimed to identify modifiable sociodemographic factors that predict anaemia before commencing antenatal care and make appropriate recommendation. A survey of sociodemographic features and haemoglobin concentrations of 232 women booking for antenatal care was conducted. Anaemia was diagnosed in 119 (51.3%), of which 87 (37.5%) had mild anaemia and 32 (13.8%) were moderately anaemic. There was no severe anaemia. Anaemia was highest among respondents who were 35 years of age, Muslims, of Igbo ethnicity (64.3%), single (55.0%), student/unemployed (58.8%), nulliparous (57.3%) and those who registered at 21 weeks' gestation (54.2%). Only occupation of the woman showed association with anaemia before antenatal care (p 0.007). A personal source of income may reduce anaemia in pregnancy; and it is advisable to have a social welfare package for unemployed pregnant women.
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Wealth and antenatal care use: implications for maternal health care utilisation in Ghana.
Arthur, Eric
2012-08-06
The study investigates the effect of wealth on maternal health care utilization in Ghana via its effect on Antenatal care use. Antenatal care serves as the initial point of contact of expectant mothers to maternal health care providers before delivery. The study is pivoted on the introduction of the free maternal health care policy in April 2005 in Ghana with the aim of reducing the financial barrier to the use of maternal health care services, to help reduce the high rate of maternal deaths. Prior to the introduction of the policy, studies found wealth to have a positive and significant influence on the use of Antenatal care. It is thus expected that with the policy, wealth should not influence the use of maternal health care significantly. Using secondary data from the 2008 Ghana Demographic and Health survey, the results have revealed that wealth still has a significant influence on adequate use of Antenatal care. Education, age, number of living children, transportation and health insurance are other factors that were found to influence the use of Antenatal care in Ghana. There also exist considerable variations in the use of Antenatal care in the geographical regions and between the rural and urban dwellers. It is recommended that to improve the use of Antenatal care and hence maternal health care utilization, some means of support is provided especially to women within the lowest wealth quintiles, like the provision and availability of recommended medication at the health center; secondly, women should be encouraged to pursue education to at least the secondary level since this improves their use of maternal health services. Policy should also target mothers who have had the experience of child birth on the need to use adequate Antenatal care for each pregnancy, since these mothers tend to use less antenatal care for subsequent pregnancies. The regional disparities found may be due to inaccessibility and unavailability of health facilities and services in the
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Postnatal Imaging of Antenatal Hydronephrosis
Kitchens, David M.; Herndon, C. D. Anthony
2009-01-01
Radiologic imaging of the newborn detected prenatally with hydronephrosis should follow a systematic approach. Upper and lower urinary tract imaging should be performed in most cases in order to determine the etiology and gauge the use of future imaging. An overview of renal ultrasound, voiding cystourethrography, renal scintigraphy, and magnetic resonance urography in the setting of antenatal hydronephrosis are discussed. PMID:19484160
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Postnatal Imaging of Antenatal Hydronephrosis
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David M. Kitchens
2009-01-01
Full Text Available Radiologic imaging of the newborn detected prenatally with hydronephrosis should follow a systematic approach. Upper and lower urinary tract imaging should be performed in most cases in order to determine the etiology and gauge the use of future imaging. An overview of renal ultrasound, voiding cystourethrography, renal scintigraphy, and magnetic resonance urography in the setting of antenatal hydronephrosis are discussed.
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Socioeconomic Determinants of the Utilization of Antenatal Care and Child Vaccination in India.
Zuhair, Mohd; Roy, Ram Babu
2017-11-01
Antenatal care and child vaccination services are adopted worldwide to reduce the risk of child mortality, maternal mortality, and burden of infectious diseases. This article examines the effect of socioeconomic factors on the utilization of antenatal care and child vaccination services in India. The generalized linear model has been used along with the Indian National Family Health Survey data for the period 2005-2006. The analysis shows that the health insurance plan has a significant effect on the use of antenatal care but not in the child vaccination. Furthermore, there is inequality in the utilization of antenatal care as well as child vaccination services and it is positively related to the wealth. The study suggests that there is a need to improve the socioeconomic status of the financially weaker section of the society for improving the use of child and maternal care services.
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Maternal Antenatal Depression and Infant Disorganized Attachment at 12 months
Hayes, Lisa J.; Goodman, Sherryl H.; Carlson, Elizabeth
2012-01-01
Although high rates of attachment disorganization have been observed in infants of depressed mothers, little is known about the role of antenatal depression as a precursor to infant attachment disorganization. The primary aim of this study was to examine associations between maternal antenatal depression and infant disorganization at 12 months in a sample of women (N = 79) at risk for perinatal depression. A secondary aim was to test the roles of maternal postpartum depression and maternal pa...
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Understanding delayed access to antenatal care: a qualitative interview study
2014-01-01
Background Delayed access to antenatal care ('late booking’) has been linked to increased maternal and fetal mortality and morbidity. The aim of this qualitative study was to understand why some women are late to access antenatal care. Methods 27 women presenting after 19 completed weeks gestation for their first hospital booking appointment were interviewed, using a semi-structured format, in community and maternity hospital settings in South Yorkshire, United Kingdom. Interviews were transcribed verbatim and entered onto NVivo 8 software. An interdisciplinary, iterative, thematic analysis was undertaken. Results The late booking women were diverse in terms of: age (15–37 years); parity (0–4); socioeconomic status; educational attainment and ethnicity. Three key themes relating to late booking were identified from our data: 1) 'not knowing’: realisation (absence of classic symptoms, misinterpretation); belief (age, subfertility, using contraception, lay hindrance); 2) 'knowing’: avoidance (ambivalence, fear, self-care); postponement (fear, location, not valuing care, self-care); and 3) 'delayed’ (professional and system failures, knowledge/empowerment issues). Conclusions Whilst vulnerable groups are strongly represented in this study, women do not always fit a socio-cultural stereotype of a 'late booker’. We report a new taxonomy of more complex reasons for late antenatal booking than the prevalent concepts of denial, concealment and disadvantage. Explanatory sub-themes are also discussed, which relate to psychological, empowerment and socio-cultural factors. These include poor reproductive health knowledge and delayed recognition of pregnancy, the influence of a pregnancy 'mindset’ and previous pregnancy experience, and the perceived value of antenatal care. The study also highlights deficiencies in early pregnancy diagnosis and service organisation. These issues should be considered by practitioners and service commissioners in order to promote
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Directory of Open Access Journals (Sweden)
Breno Satler Diniz
2008-12-01
Full Text Available OBJECTIVE: To describe the neuropsychological profile of mild cognitive impairment subtypes (amnestic, non-amnestic and multiple-domain of a clinical sample. We further address the diagnostic properties of the Mini-Mental State Examination and the Cambridge Cognitive Examination for the identification of the different mild cognitive impairment subtypes in clinical practice. METHOD: Cross-sectional clinical and neuropsychological evaluation of 249 elderly patients attending a memory clinic at a university hospital in Sao Paulo, Brazil. RESULTS: The performance of patients with mild cognitive impairment was heterogeneous across the different subtests of the neuropsychological battery, with a trend towards an overall worse performance for amnestic (particularly multiple domain mild cognitive impairment as compared to non-amnestic subtypes. Screening tests for dementia (Mini-Mental State Examination and Cambridge Cognitive Examination adequately discriminated cases of mild Alzheimer's disease from controls, but they were not accurate to discriminate patients with mild cognitive impairment (all subtypes from control subjects. CONCLUSIONS: The discrimination of mild cognitive impairment subtypes was possible only with the aid of a comprehensive neuropsychological assessment. It is necessary to develop new strategies for mild cognitive impairment screening in clinical practice.OBJETIVO: Descrever o perfil neuropsicológico dos subtipos de comprometimento cognitivo leve, amnéstico, não-amnéstico e múltiplos domínios, de uma amostra clínica. Além disto, avaliou-se as propriedades diagnósticas do Mini-exame do Estado Mental e do Cambridge Cognitive Examination na identificação dos diferentes subtipos de comprometimento cognitivo leve na prática clínica. MÉTODO: Avaliação clínica e neuropsicológica transversal de 249 idosos em uma clínica de memória de um hospital universitário em São Paulo, Brasil. RESULTADOS: Testes de rastreio para
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Parents' experiences and perceptions of group-based antenatal care in four clinics in Sweden.
Andersson, Ewa; Christensson, Kyllike; Hildingsson, Ingegerd
2012-08-01
group-based antenatal care consists of six to nine two-hour sessions in which information is shared and discussed during the first hour and individual examinations are conducted during the second hour. Groups generally consist of six to eight pregnant women. Parent education is built into the programme, which originated in the United States and was introduced in Sweden at the beginning of the year of 2000. to investigate parents' experiences of group antenatal care in four different clinics in Sweden. a qualitative study was conducted using content analysis five group interviews and eleven individual interviews with parents who experienced group-based antenatal care. An interview guide was used. the study was set in four antenatal clinics that had offered group-based antenatal care for at least one year. The clinics were located in three different areas of Sweden. the participants were women and their partners who had experienced group-based antenatal care during pregnancy. Other criteria for participation were mastery of the Swedish language and having followed the care programme. three themes emerged, 'The care-combining individual physical needs with preparation for parenthood, refers to the context, organisation, and content of care'. Group antenatal care with inbuilt parent education was appreciated, but respondents reported that they felt unprepared for the first few weeks after birth. Their medical needs (for physical assessment and screening) were, however, fulfilled. The theme, 'The group-a composed recipient of care', showed the participants role and experience. The role could be passive or active in groups or described as sharers. Groups helped parents normalise their symptoms. The theme, 'The midwife-a controlling professional', showed midwives are ignorant of gender issues but, for their medical knowledge, viewed as respectable professionals. in the four clinics studied, group-based antenatal care appeared to meet parents' needs for physical assessment
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Directory of Open Access Journals (Sweden)
Ikeoluwapo O. Ajayi
2013-08-01
Full Text Available A cross sectional study was conducted in Primary Health Centers among pregnant women to elucidate adequacy of antenatal care across different socio demographic variables. Four hundred respondents were proportionately selected from 18 primary health centers using simple random sampling. Exit interviews were conducted using the adapted antenatal care exit interview form of the Safe Motherhood Needs Assessment package. Data was analyzed using descriptive statistics and Chi square test. Adequacy of antenatal care in this study was measured by the single adequacy indicators which are duration of pregnancy at entry into antenatal care and number of antenatal visits; which are particularly suitable for developing countries. Age of respondents, means of transportation to the PHCs, occupation, location and level of education of the respondents were found to be determinants of whether the pregnant women attended their first antenatal visit in the first trimester, similarly, age of the respondents was a predictor of whether the women made up to four antenatal visits by their third trimester. Occupation and level of education were determinants of whether or not the pregnant women made their first antenatal visits at the first trimester. More respondents who were not working and those who were unskilled workers made their first antenatal visit at the first trimester compared to those who were skilled workers; work place policies and the fact that antenatal booking are made on weekdays and at work hours may hinder or be discouraging to the working class mothers.
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Antenatal exposure following the Chernobyl accident: neuropsychiatric aspects
International Nuclear Information System (INIS)
Igumnov, S.A.; Drozdovitch, V.V.
2004-01-01
Ten years follow-up investigation of intellectual development of 250 persons from Belarus exposed in utero following the Chernobyl accident and a control group of 250 persons from non- and slightly contaminated regions has been conducted. Neuropsychiatry and psychological examinations were performed among persons of both groups at the age of 6-7, 0-12, and 15-16 years. Mean antenatal external dose among persons of exposed group is 10 ± 13 mGy, maximal dose - 91 mGy. No statistically significant correlation was found in exposed group between individual thyroid dose as well as individual antenatal external dose and IQ at the age of 6-7 years, 10-12 years, and 15-16 years
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Taylor, Steve M; Madanitsa, Mwayiwawo; Thwai, Kyaw-Lay; Khairallah, Carole; Kalilani-Phiri, Linda; vanEijk, Anna; Mwapasa, Victor; terKuile, Feiko; Meshnick, Steven R
2017-01-01
Antenatal malaria screening with a rapid diagnostic test (RDT) and treatment only of RDT-positive women may potentially prevent low birthweight resulting from malaria. The consequences of subpatent antenatal infections below the detection limit of RDTs are incompletely understood. In Malawi, pregnant women of any gravidity were tested at each antenatal visit for P. falciparum using RDT and PCR and followed until delivery. Associations between antenatal infections and delivery outcomes were as...
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Focusing on relationships, not information, respects autonomy during antenatal consultations.
Gaucher, Nathalie; Payot, Antoine
2017-01-01
Policy statements regarding antenatal consultations for preterm labour are guided by physicians' concerns for upholding the legal doctrine of informed consent, through the provision of standardised homogeneous medical information. This approach, led by classical in-control conceptions of patient autonomy, conceives moral agents as rational, independent, self-sufficient decision-makers. Recent studies on these antenatal consultations have explored patients' perspectives, and these differ from guidelines' suggestions. Relational autonomy - which understands moral agents as rational, emotional, creative and interdependent - resonates impressively with these new data. A model for antenatal consultations is proposed. This approach encourages clinicians to explore individual patients' lived experiences and engage in trusting empowering relationships. Moreover, it calls on physicians to enhance patients' relational autonomy by becoming advocates for their patients within healthcare institutions and professional organisations, while calling for broadscale policy changes to encourage further funding and support in investigations of the patient's voice. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
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Sawyer, Taylor; Fu, Belinda; Gray, Megan; Umoren, Rachel
2017-08-01
Neonatologists must be skilled at providing antenatal counseling to expectant parents of premature infants at the limits of viability. We conducted a medical improvisation workshop with the objective of enhancing antenatal counseling skills. Pre- and postworkshop questionnaires were collected to examine the impact of the training. A follow-up survey was distributed 3 months after the workshop to examine the impact of the training on antenatal counseling skills. Nine neonatologists and three neonatal fellows participated in the workshop. Participants reported the skills learned in the workshop could enhance the quality of antenatal counseling. On follow-up survey, 90% of subjects reported improvements in the quality of their antenatal counseling. Participation in a medical improvisation workshop resulted in enhancements of self-perceived antenatal counseling skills. Medical improvisation training may provide a feasible and effective method of communication training for neonatologists. Further research into this innovative method are needed.
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Determinação da exigência nutricional de treonina para poedeiras leves e semipesadas
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Valerio Sandra Roselí
2000-01-01
Full Text Available Desenvolveu-se este experimento com o objetivo de determinar a exigência nutricional de treonina para poedeiras leves e semipesadas no período de 21 a 36 semanas. Foram utilizadas 576 aves, 288 poedeiras leves e 288 semipesadas, durante quatro períodos experimentais de 28 dias cada. O delineamento experimental foi inteiramente casualizado em esquema fatorial 6 x 2 (níveis x marcas, com seis repetições e oito aves por unidade experimental. Os tratamentos consistiram em uma ração basal contendo 14,2% de proteína bruta, suplementada com cinco níveis de L-treonina (0,025; 0,050; 0,075; 0,100; e 0,125%, resultando em um total de 0,510; 0,535; 0,560; 0,585; 0,610; e 0,635% de treonina. O desempenho produtivo e a qualidade interna dos ovos foram avaliados. Consumo de ração, produção de ovos massa de ovos e o ganho de peso foram superiores para as poedeiras semipesadas. A produção e qualidade interna dos ovos, a conversão alimentar e o ganho de peso não foram influenciados pelos níveis de treonina utilizados. O nível de 0,510% de treonina, que corresponde a 515 mg/ave/dia (0,423% de treonina digestível e 535 mg/ave/dia (0,440% de treonina digestível, foi suficiente para atender, satisfatoriamente, o desempenho e a qualidade interna dos ovos das poedeiras leves e semipesadas, respectivamente, para as características avaliadas.
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Rustagi, N; Prasuna, J G; Vibha, M D
2011-06-01
The burden of antenatal morbidities and health care services utilization during antenatal period serve an important role in defining service needs and to assess reproductive health status of women. To evaluate the burden of antenatal morbidities in women and to assess the health care utilization by study subjects during antenatal period. A community based follow up study was carried out in an urban resettlement colony of Delhi. All pregnant women in the study area were enrolled and followed for two more visits to collect information about morbidities suffered and health care services utilized during pregnancy. Appropriate tests of significance were applied. Of 358 women enrolled, three hundred could be followed for two more visits. Majority of women (80.3%) suffered one or more morbidities during their current pregnancy but overall care sought for illness during pregnancy was poor. Visits for routine preventive check up was made by most of women (95% and above) but recommended three antenatal visits was significantly low among women of age more than thirty (OR=16.6; 2.2-125.9), of lower middle socio economic status (OR=2.84; 1.16-6.93) and parity three or more (OR=4.37; 1.07-17.83). Women with education status of high school and above had significantly lower odd ratio (OR=0.33; 0.11-0.99) for having less than three antenatal visits. Care sought for antenatal morbidities is still poor among women of urban resettlement colonies and age, parity and education of women has a significant bearing on antenatal visits.
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Rahman, Md Mizanur; Ngadan, Deburra Peak; Arif, Mohammad Taha
2016-01-01
High levels of satisfaction among women with the antenatal care services will increase the compliance of antenatal visits during pregnancy. Thus, this study was done to assess the level of satisfaction among women on the quality of antenatal care received and the factors influencing thereof. This was a cross-sectional study conducted in the three zones of Sarawak. Women aged 18 years and above, irrespective of ethnic groups, having children aged 3 years and below were included in the study. Data was collected by face-to-face interview using interview schedule. A validated Patient Satisfaction Questionnaire (PSQ-18) was used to assess the satisfaction with antenatal care. A total of 1236 data was analysed using IBM SPSS version 22.0. A p value <0.05 was considered as statistically significant. A multinomial logistic regression analysis revealed that Bidayuh 17.4 % was less likely to be highly satisfied with antenatal care. Similarly, respondents with secondary level of education 29.9 % were less likely to be highly satisfied, whereas, respondents having primary level of education, 1.6 % were less likely to be highly satisfied. However, those who did not spend any money as out of pocket expenses were 1.935 times more likely to be highly satisfied with antenatal care. Overall the studied women were satisfied with the antenatal care services. Ethnicity, level of education and out of pocket expenses appeared to be important predictors of satisfaction with antenatal care. The finding recommends the community-based and language-specific interventions should be implemented to sustain the satisfaction of maternal care.
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Antenatal education in small classes may increase childbirth self-efficacy
DEFF Research Database (Denmark)
Brixval, Carina S; Axelsen, Solveig F; Thygesen, Lau C
2016-01-01
Antenatal education in small classes may increase childbirth self-efficacy. In this randomised trial we assessed the effect of a structured antenatal programme versus auditorium-based lectures on childbirth self-efficacy measured by three single items. We found that women in the intervention group...... reported statistically significant higher levels of confidence in their ability to cope at home during labour compared to the control group. Likewise, the intervention had a positive effect on the women's confidence in own ability to handle the birth process....
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Impact of antenatal steroids on intraventricular hemorrhage in very-low-birth weight infants.
Wei, J C; Catalano, R; Profit, J; Gould, J B; Lee, H C
2016-05-01
To determine the association between antenatal steroids administration and intraventricular hemorrhage rates. We used cross-sectional data from the California Perinatal Quality Care Collaborative during 2007 to 2013 for infants ⩽32 weeks gestational age. Using multivariable logistic regression, we evaluated the effect of antenatal steroids on intraventricular hemorrhage, stratified by gestational age. In 25 979 very-low-birth weight infants, antenatal steroid use was associated with a reduction in incidence of any grade of intraventricular hemorrhage (odds ratio=0.68, 95% confidence interval: 0.62, 0.75) and a reduction in incidence of severe intraventricular hemorrhage (odds ratio=0.51, 95% confidence interval: 0.45, 0.58). This association was seen across gestational ages ranging from 22 to 29 weeks. Although current guidelines recommend coverage for preterm birth at 24 to 34 weeks gestation, our results suggest that treatment with antenatal steroids may be beneficial even before 24 weeks of gestational age.
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Impact of Antenatal Steroids on Intraventricular Hemorrhage in Very Low Birth Weight Infants
Wei, Julia C.; Catalano, Ralph; Profit, Jochen; Gould, Jeffrey B.; Lee, Henry C.
2016-01-01
Objective To determine the association between antenatal steroids administration and intraventricular hemorrhage rates. Methods We used cross-sectional data from the California Perinatal Quality Care Collaborative during 2007-2013 for infants ≤ 32 weeks gestational age. Using multivariable logistic regression, we evaluated the effect of antenatal steroids on intraventricular hemorrhage, stratified by gestational age. Results In 25,979 very low birth weight infants, antenatal steroid use was associated with a reduction in incidence of any grade of intraventricular hemorrhage (odds ratio = 0.51, 95% confidence interval: 0.45, 0.58) and a reduction in incidence of severe intraventricular hemorrhage (odds ratio = 0.62, 95% confidence interval: 0.57, 0.67). This association was seen across gestational ages ranging from 22 to 29 weeks. Conclusions While current guidelines recommend coverage for preterm birth at 24 to 34 weeks gestation, our results suggest that treatment with antenatal steroids may be beneficial even before 24 weeks of gestational age. PMID:27010109
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Antenatal hydronephrosis: Negative predictive value of normal postnatal ultrasound - a 5-year study
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Moorthy, I.; Joshi, N.; Cook, J.V. E-mail: jcook@epsom-sthelier.nhs.uk; Warren, M
2003-12-01
AIM: To determine whether normal postnatal ultrasound, as part of a strict screening protocol for the detection and follow-up of antenatal hydronephrosis, effectively excludes the majority of babies with congenital urinary tract abnormalities that would otherwise present with a urinary tract infection. MATERIALS AND METHODS: We retrospectively reviewed all babies who had postnatal follow-up of antenatally detected hydronephrosis over a 5-year period at our institution, a district general Trust with a specialist paediatric unit. We then studied all babies presenting with urinary tract infection before their first birthday to our institution over the same period. By cross-referencing these two study groups we were able to determine which babies developed a urinary tract infection having been previously discharged after normal postnatal ultrasound. RESULTS: Four hundred and twenty-five babies had postnatal follow-up of antenatal hydronephrosis. Of these, 284 were investigated with ultrasound alone. In the same 5-year period, 230 babies presented with urinary tract infection before their first birthday. Only three of these babies had been previously discharged after normal postnatal ultrasound. The negative predictive value of a normal postnatal ultrasound was therefore 98.9% (281/284) for babies who subsequently presented with a urinary tract infection before their first birthday. CONCLUSION: Careful antenatal and postnatal ultrasound with strict protocols is effective in detecting congenital renal tract abnormalities. Infants discharged after normal postnatal ultrasound are highly unlikely to still have an undetected urinary tract abnormality. We suggest that all babies with antenatal hydronephrosis are started on prophylactic antibiotics at birth, pending further investigation. All babies without features of severe obstruction antenatally should have their postnatal ultrasound delayed for a month. We recommend selective use of micturating cystourethrogram (MCUG
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Antenatal hydronephrosis: Negative predictive value of normal postnatal ultrasound - a 5-year study
International Nuclear Information System (INIS)
Moorthy, I.; Joshi, N.; Cook, J.V.; Warren, M.
2003-01-01
AIM: To determine whether normal postnatal ultrasound, as part of a strict screening protocol for the detection and follow-up of antenatal hydronephrosis, effectively excludes the majority of babies with congenital urinary tract abnormalities that would otherwise present with a urinary tract infection. MATERIALS AND METHODS: We retrospectively reviewed all babies who had postnatal follow-up of antenatally detected hydronephrosis over a 5-year period at our institution, a district general Trust with a specialist paediatric unit. We then studied all babies presenting with urinary tract infection before their first birthday to our institution over the same period. By cross-referencing these two study groups we were able to determine which babies developed a urinary tract infection having been previously discharged after normal postnatal ultrasound. RESULTS: Four hundred and twenty-five babies had postnatal follow-up of antenatal hydronephrosis. Of these, 284 were investigated with ultrasound alone. In the same 5-year period, 230 babies presented with urinary tract infection before their first birthday. Only three of these babies had been previously discharged after normal postnatal ultrasound. The negative predictive value of a normal postnatal ultrasound was therefore 98.9% (281/284) for babies who subsequently presented with a urinary tract infection before their first birthday. CONCLUSION: Careful antenatal and postnatal ultrasound with strict protocols is effective in detecting congenital renal tract abnormalities. Infants discharged after normal postnatal ultrasound are highly unlikely to still have an undetected urinary tract abnormality. We suggest that all babies with antenatal hydronephrosis are started on prophylactic antibiotics at birth, pending further investigation. All babies without features of severe obstruction antenatally should have their postnatal ultrasound delayed for a month. We recommend selective use of micturating cystourethrogram (MCUG
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"Determinação cromatografica quantitativa de gases leves em hidrogenio"
Newton Pimenta Neves Jr
1995-01-01
Resumo: O hidrogênio ultrapurificado tem sido utilizado em ritmo crescente em diversos processos de alta tecnologia, com destaque para a indústria de micro-eletrônica, onde a presença de impurezas no gás influi decisivamente nos resultados obtidos. Neste trabalho foram desenvolvidos aspectos relacionados à determinação cromatográfica quantitativa de gases leves em hidrogênio. Inicialmente foram desenvolvidas técnicas de amostragem e análise que possibilitam determinar concentrações de até 1mm...
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Rana Pratap; Ahmad Nadeem Aslami; Manjushri; Narayan Prasad Sahu
2016-01-01
Background: Toxoplasmosis seroprevalence in antenatal women has remained a contentious issue in Indian subcontinent. Bad obstetric history (BOH) is specific to women of childbearing age and can be caused by infection with Toxoplama gondii. In Jharkhand, scarce data exist for the roles of toxoplasmosis in the aetiology of adverse pregnancy outcome. Aim: To study the sero-epidemiology of Toxoplasmosis and associated risk factors among antenatal women attending antenatal clinic of a tertiary car...
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Seroprevalence of toxoplasmosis in antenatal women with bad obstetric history.
Chintapalli, Suryamani; Padmaja, I Jyothi
2013-01-01
The occurrence of fetal death is one of the tragedies that confront the physician providing obstetric care. Among the various agents associated with infections of pregnancy, viruses are the most important followed by bacteria and protozoa. Among protozoal infections in pregnancy, toxoplasmosis is reported to have a high incidence, sometimes causing fetal death. The study was intended to observe the seroprevalence of Toxoplasmosis in pregnant women presenting with bad obstetric history (BOH). A total of 92 antenatal women were included in the study (80 in the study group and 12 in control group). The study group comprised of antenatal women with BOH in the age group of 20-35 years. Antenatal women with Rh incompatibility, pregnancy induced hypertension, diabetes mellitus, renal disorders and syphilis were not included in the study. The control group included women in reproductive age group without BOH. All the samples were screened by enzyme linked immuno sorbent assay (ELISA) for Toxoplasma specific Immunoglobulin M (IgM) and Immunoglobulin G (IgG) antibodies. Of the 80 antenatal women in the study group, 36 (45%) were seropositive for Toxoplasma specific IgG antibodies (P habits, illiteracy, socio-economic status and residential status were also studied. We conclude that toxoplasmosis during pregnancy causes congenital fetal infection with possible fetal loss. ELISA was found to be a sensitive serological test for diagnosis of Toxoplasmosis in pregnant women with BOH. Major cause of fetal loss in BOH cases in the study group was abortion.
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Risk factors for incident HIV infection among antenatal mothers in rural Eastern Cape, South Africa
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Charles Bitamazire Businge
2016-01-01
Full Text Available Background: The prevalence of HIV among antenatal clients in South Africa has remained at a very high rate of about 29% despite substantial decline in several sub-Saharan countries. There is a paucity of data on risk factors for incident HIV infection among antenatal mothers and women within the reproductive age bracket in local settings in the Eastern Cape, South Africa. Objective: To establish the risk factors for incident HIV infection among antenatal clients aged 18–49 years attending public antenatal clinics in rural Eastern Cape, South Africa. Design: This was an unmatched case–control study carried out in public health antenatal clinics of King Sabata District Municipality between January and March 2014. The cases comprised 100 clients with recent HIV infection; the controls were 200 HIV-negative antenatal clients. Socio-demographic, sexual, and behavioral data were collected using interviewer-administered questionnaires adapted from the standard DHS5 women's questionnaire. Multivariate logistic regression models were used to identify the independent risk factors for HIV infection. A p<0.05 was considered statistically significant. Results: The independent risk factors for incident HIV infection were economic dependence on the partner, having older male partners especially among women aged ≤20 years, and sex under the influence of alcohol. Conclusions: Therefore, effective prevention of HIV among antenatal mothers in KSDM must target the improvement of the economic status of women, thereby reducing economic dependence on their sexual partners; address the prevalent phenomenon of cross-generation sex among women aged <20 years; and regulate the brewing, marketing, and consumption of alcohol.
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Directory of Open Access Journals (Sweden)
Marcio L.F. Balthazar
2007-09-01
Full Text Available OBJECTIVE: To study lexical semantic memory in patients with amnestic mild cognitive impairment (aMCI, mild Alzheimer's disease (AD and normal controls. METHOD: Fifteen mild AD, 15 aMCI, and 15 normal control subjects were included. Diagnosis of AD was based on DSM-IV and NINCDS-ADRDA criteria, and that of aMCI, on the criteria of the International Working Group on Mild Cognitive Impairment, using CDR 0.5 for aMCI and CDR 1 for mild AD. All subjects underwent semantic memory tests (Boston Naming-BNT, CAMCOG Similarities item, Rey Auditory Verbal Learning Test (RAVLT, Mini-Mental Status Examination (MMSE, neuropsychological tests (counterproofs, and Cornell Scale for Depression in Dementia. Data analysis used Mann-Whitney test for intergroup comparisons and Pearson's coefficient for correlations between memory tests and counterproofs (statistical significance level was pOBJETIVO: Estudar a memória léxico-semântica no comprometimento cognitivo leve amnéstico (aCCL, doença de Alzheimer (DA leve e controles normais. MÉTODO: Incluímos 15 pacientes com DA leve, 15 com aCCL e 15 controles normais, usando os critérios DSM-IV, NINCDS-ADRDA e CDR 1 para DA, e os do International Working Group on Mild Cognitive Impairment, e CDR 0,5 para aCCL. Todos os sujeitos passaram por testes de memória semântica (Teste de nomeação de Boston - TNB, item de Similaridades do CAMCOG, teste de aprendizado auditivo-verbal de Rey (TAAVR, Mini-Exame do Estado Mental (MEEM, testes neuropsicológicos (contraprovas e Escala Cornell para Depressão em Demência. A análise dos dados usou o teste de Mann-Whitney para comparações entre os grupos e o coeficiente de Pearson para correlação entre testes e contraprovas (nível de significância p<0,05. RESULTADOS: Os pacientes com aCCL foram semelhantes aos controles no TNB e Similaridades, mas inferiores no MEEM e TAAVR. Pacientes com DA leve tiveram performance inferior à de sujeitos com aCCL e controles em todos os
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National Research Council Canada - National Science Library
Dunbar, Joseph
1999-01-01
.... The data examined during research on the causes of levee failure included geologic setting, historic bank migration and previous bank lines, thalweg profiles, width/depth ratios, scour pool movement, and river profiles...
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Antenatal corticosteroids beyond 34 weeks gestation: What do we do now?
Kamath-Rayne, Beena D; Rozance, Paul J; Goldenberg, Robert L; Jobe, Alan H
2016-10-01
The practice of antenatal corticosteroid administration in pregnancies of 24-34 weeks of gestation that are at risk of preterm delivery was adopted over 20 years after the first randomized clinical trial in humans. It is biologically plausible that antenatal corticosteroid in pregnancies beyond 34 weeks of gestation would reduce rates of respiratory morbidity and neonatal intensive care admission. Mostly guided by the results of a large multicenter randomized trial of antenatal corticosteroid in late preterm infants, the Antenatal Late Preterm Steroids Trial, the American Congress of Obstetricians and Gynecologists has released a practice advisory that the "administration of betamethasone may be considered in women with a singleton pregnancy between 34 0/7 and 36 6/7 weeks of gestation at imminent risk of preterm birth within 7 days." However, many unanswered questions about the risks and benefits of antenatal corticosteroids in this population remain and should be considered with the adoption of this treatment recommendation. This review of the literature indicates that the greatest effect is in the reduction of transient tachypnea of the newborn infant, which is a mostly self-limited condition. This benefit must be weighed against unanticipated outcomes, such as neonatal hypoglycemia, and unknowns about long-term neurodevelopmental follow up and metabolic risks. Amelioration of respiratory morbidity in late preterm infants does not preclude these infants from having other complications that are related to prematurity that require intensive care. Other possible morbidities of prematurity may be magnified if these babies no longer have respiratory symptoms. Conversely, if these late preterm babies no longer exhibit respiratory symptoms and "look good," they may be discharged before other morbidities of prematurity have resolved and be at risk for readmission. Furthermore, it is also important to ensure that unintended consequences are avoided to achieve a minor
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Directory of Open Access Journals (Sweden)
Fatimah Fatimah
2015-11-01
Full Text Available Anemia is one of the problems in Indonesia that important to examine, especially for pregnant women. This research used quantitative with explanatory design. Population were 44 pregnant women in 3 trimester selected by the total sampling technique. The independent variable were implementation of the antenatal care by midwives and dependent variable is anemia in 3 trimester of pregnancy at Puskesmas Sedayu I Yogyakarta. Data was collected using questionnaire. The analysis used was chi-square. The results of study showed that there was 33 (75% of antenatal care in good category, with no anemia were 32 (72.7% respondents, and there was a significant relationship between antenatal care and anemia in the third trimester of pregnancy with p-value=0.004. In conclusion, there was a significant relationship between antenatal care and anemia in the third trimester of pregnancy. Suggestions were needed to maintain and improve the care of midwives in antenatal care to improve the health of pregnant women, especially anemia in pregnancy.
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Contraceptive‑seeking Behavior of Women Attending Antenatal ...
African Journals Online (AJOL)
Contraceptive‑seeking Behavior of Women Attending Antenatal Care in a Developing Country: A Veritable Tool for Slowing Population Growth. ... Background: The use of modern contraceptives has been embraced by developed nations as a means of achieving controlled growth rate. Nigeria, Africa's most populous nation ...
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van der Veer, C.G.; Groven, M.; Higler, L.
2011-01-01
Leve de Variatie! Een onderzoek naar de beleving van en de publiciteit rondom Oktober Kennismaand 2010 The until 2007 yearly organized Science Week aimed at the enhancement of the knowledge of scientific and technological developments by the public has from 2008 on developed into a month of
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Gudayu, Temesgen Worku; Woldeyohannes, Solomon Meseret; Abdo, Abdella Amano
2014-08-25
Antenatal care service which is among strategies to maintain maternal and fetal wellbeing is strongly recommended to be initiated early during pregnancy. To developing world where there is uncommon practice of pre-pregnancy care and support, timely commencement is crucial in getting potential benefits from some of the elements of the care. Therefore, we sought to assess timing and factors associated with the first antenatal care booking among pregnant mothers attending antenatal care clinics in Gondar town health facilities; North West Ethiopia. Health institution based cross-sectional study was conducted among pregnant mothers from April to June 2012 in Gondar town. A total of 407 pregnant mothers were interviewed at exit from antenatal clinic by using structured and pre-tested questionnaire. Bivariate and multivariate data analysis was performed using SPSS for Windows version 16.0. The study indicated that 35.4% of mothers started antenatal care timely (in the first trimester of pregnancy). The mean time was 4.5 months (17.7 weeks) of pregnancy. Multivariate logistic regression analysis showed that: [(AOR (95% CI)) maternal age ≤ 25 (1.85 (1.10, 3.09)), age at marriage ≥20 years (2.21 (1.33, 3.68)), pregnancy recognition by urine test (2.29 (1.42, 3.71)), mothers who perceived the right time to start antenatal care within first trimester (3.93 (2.29, 6.75)) and having decision power to use antenatal care (2.43 (1.18, 4.99))] were significantly associated with timely commencement to antenatal care. Timely entry to antenatal care was low in the study area. In order to improve the situation, it is important to provide community based information, education and communication on antenatal care and its right time of commencement. In addition, empowering women and implementing the proclamation designed for the age at marriage is mandatory up to the local level.
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Cherniak, William; Anguyo, Geoffrey; Meaney, Christopher; Yuan Kong, Ling; Malhame, Isabelle; Pace, Romina; Sodhi, Sumeet; Silverman, Michael
2017-01-01
In rural Uganda pregnant women often lack access to health services, do not attend antenatal care, and tend to utilize traditional healers/birth attendants. We hypothesized that receiving a message advertising that "you will be able to see your baby by ultrasound" would motivate rural Ugandan women who otherwise might use a traditional birth attendant to attend antenatal care, and that those women would subsequently be more satisfied with care. A cluster randomized trial was conducted across eight rural sub-counties in southwestern Uganda. Sub-counties were randomized to a control arm, with advertisement of antenatal care with no mention of portable obstetric ultrasound (four communities, n = 59), or an intervention arm, with advertisement of portable obstetric ultrasound. Advertisement of portable obstetric ultrasound was further divided into intervention A) word of mouth advertisement of portable obstetric ultrasound and antenatal care (one communitity, n = 16), B) radio advertisement of only antenatal care and word of mouth advertisement of antenatal care and portable obstetric ultrasound (one community, n = 7), or C) word of mouth + radio advertisement of both antenatal care and portable obstetric ultrasound (two communities, n = 75). The primary outcome was attendance to antenatal care. 159 women presented to antenatal care across eight sub-counties. The rate of attendance was 65.1 (per 1000 pregnant women, 95% CI 38.3-110.4) where portable obstetric ultrasound was advertised by radio and word of mouth, as compared to a rate of 11.1 (95% CI 6.1-20.1) in control communities (rate ratio 5.9, 95% CI 2.6-13.0, padvertising antenatal care and portable obstetric ultrasound by radio attendance was significantly improved. This study suggests that women can be motivated to attend antenatal care when offered the concrete incentive of seeing their baby.
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Antenatal breastfeeding education for increasing breastfeeding duration.
Lumbiganon, Pisake; Martis, Ruth; Laopaiboon, Malinee; Festin, Mario R; Ho, Jacqueline J; Hakimi, Mohammad
2016-12-06
Breast milk is well recognised as the best food source for infants. The impact of antenatal breastfeeding (BF) education on the duration of BF has not been evaluated. To assess the effectiveness of antenatal breastfeeding (BF) education for increasing BF initiation and duration. We searched Cochrane Pregnancy and Childbirth's Trials Register on 1 March 2016, CENTRAL (The Cochrane Library, 2016, Issue 3), MEDLINE (1966 to 1 March 2016) and Scopus (January 1985 to 1 March 2016). We contacted experts and searched reference lists of retrieved articles. All identified published, unpublished and ongoing randomised controlled trials (RCTs) assessing the effect of formal antenatal BF education or comparing two different methods of formal antenatal BF education, on the duration of BF. We included RCTs that only included antenatal interventions and excluded those that combined antenatal and intrapartum or postpartum BF education components. Cluster-randomised trials were included in this review. Quasi-randomised trials were not eligible for inclusion. We assessed all potential studies identified as a result of the search strategy. Two review authors extracted data from each included study using the agreed form and assessed risk of bias. We resolved discrepancies through discussion. We assessed the quality of the evidence using the GRADE approach. This review update includes 24 studies (10,056 women). Twenty studies (9789 women) contribute data to analyses. Most studies took place in high-income countries such as the USA, UK, Canada and Australia. In the first five comparisons, we display the included trials according to type of intervention without pooling data. For the 'Summary of findings' we pooled data for a summary effect.Five included studies were cluster-randomised trials: all of these adjusted data and reported adjustments as odds ratios (OR). We have analysed the data using the generic inverse variance method and presented results as odds ratios, because we were
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Quality of antenatal care in Zambia: a national assessment
2012-01-01
Background Antenatal care (ANC) is one of the recommended interventions to reduce maternal and neonatal mortality. Yet in most Sub-Saharan African countries, high rates of ANC coverage coexist with high maternal and neonatal mortality. This disconnect has fueled calls to focus on the quality of ANC services. However, little conceptual or empirical work exists on the measurement of ANC quality at health facilities in low-income countries. We developed a classification tool and assessed the level of ANC service provision at health facilities in Zambia on a national scale and compared this to the quality of ANC received by expectant mothers. Methods We analysed two national datasets with detailed antenatal provider and user information, the 2005 Zambia Health Facility Census and the 2007 Zambia Demographic and Health Survey (DHS), to describe the level of ANC service provision at 1,299 antenatal facilities in 2005 and the quality of ANC received by 4,148 mothers between 2002 and 2007. Results We found that only 45 antenatal facilities (3%) fulfilled our developed criteria for optimum ANC service, while 47% of facilities provided adequate service, and the remaining 50% offered inadequate service. Although 94% of mothers reported at least one ANC visit with a skilled health worker and 60% attended at least four visits, only 29% of mothers received good quality ANC, and only 8% of mothers received good quality ANC and attended in the first trimester. Conclusions DHS data can be used to monitor “effective ANC coverage” which can be far below ANC coverage as estimated by current indicators. This “quality gap” indicates missed opportunities at ANC for delivering effective interventions. Evaluating the level of ANC provision at health facilities is an efficient way to detect where deficiencies are located in the system and could serve as a monitoring tool to evaluate country progress. PMID:23237601
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DEFF Research Database (Denmark)
Koushede, Vibeke; Brixval, Carina Sjöberg; Thygesen, Lau Caspar
2017-01-01
Prospective parents widely use education to gain information about, e.g., labour and parenting skills. It is unknown if antenatal education in small classes is more beneficial for parenting stress and parenting alliance compared with other types of antenatal education. In the present randomised t...
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Study of compliance with a new, targeted antenatal D immunization prevention programme in Denmark
DEFF Research Database (Denmark)
Damkjaer, M B; Perslev, A; Clausen, F B
2012-01-01
A targeted routine antenatal anti-D prophylaxis programme was implemented in Denmark where anti-D immunoglobulin is given based on the result from noninvasive antenatal screening for fetal RHD. Our objective was to evaluate compliance with this new programme right after its initiation. Materials and...
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Outcomes of Isolated Antenatal Hydronephrosis at First Year of Life
Orabi, Mutaz; Abozaid, Sameh; Sallout, Bahauddin; Abu Shaheen, Amani; Heena, Humariya; Al Matary, Abdulrahman
2018-01-01
Objectives To compare the grade of hydronephrosis between the antenatal and first postnatal ultrasound (US) and their clinical outcomes. Methods This retrospective study included all cases of isolated hydronephrosis detected by antenatal US from August 2005 to February 2011. Hydronephrosis was classified based on the standard criteria into mild, moderate, or severe. Cases associated with other major congenital anomalies were excluded. All patients were followed-up postnatally and outcomes available were analyzed at one year of age. Results A total of 105 cases were included out of which 83 (79.0%) were males and 22 (20.9%) were females with a median gestational age of 38 weeks. First postnatal US of 105 cases showed that 20 (19.0%) were free of hydronephrosis, 39 (37.1%) had mild, 29 (27.6%) moderate, and 17 (16.1%) had severe hydronephrosis. Half (50.4%) of hydronephrosis cases improved in their clinical presentation while 13.3% showed deterioration and 36.3% remained the same. Almost half of all cases (52 cases) were diagnosed by US at the end of first year without any effect on renal function. Conclusions Antenatal and postnatal US are sensitive tools for detecting hydronephrosis as well as for postnatal counseling. Fetal anatomy US is usually done at 18 weeks gestation and if this reveals any evidence of hydronephrosis, the patient is followed according to the severity. Postnatal US is not done routinely for cases where hydronephrosis resolves completely during pregnancy. Although newborns with antenatal hydronephrosis due to secondary causes are at greater risk for renal impairment, surgical intervention reserves renal function. PMID:29657681
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Determinants of Home Delivery among Women attending Antenatal ...
African Journals Online (AJOL)
USER
Abstract. Unskilled home delivery is a threat to maternal and child health. ... home delivery after attending antenatal services, this study employed a cross-sectional design and a non-probability purposive ... deaths occur in sub-Saharan Africa.
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Antenatal Deworming and Materno-Perinatal Outcomes in Calabar, Nigeria
Directory of Open Access Journals (Sweden)
Ubong Bassey Akpan
2018-05-01
CONCLUSION: Presumptive deworming during the antenatal period can significantly reduce the incidence of peripartum anaemia. However, more studies may be needed to prove any positive perinatal outcome.
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Antenatal and postnatal corticosteroid and resuscitation induced lung injury in preterm sheep
Directory of Open Access Journals (Sweden)
Kallapur Suhas G
2009-12-01
Full Text Available Abstract Background Initiation of ventilation using high tidal volumes in preterm lambs causes lung injury and inflammation. Antenatal corticosteroids mature the lungs of preterm infants and postnatal corticosteroids are used to treat bronchopulmonary dysplasia. Objective To test if antenatal or postnatal corticosteroids would decrease resuscitation induced lung injury. Methods 129 d gestational age lambs (n = 5-8/gp; term = 150 d were operatively delivered and ventilated after exposure to either 1 no medication, 2 antenatal maternal IM Betamethasone 0.5 mg/kg 24 h prior to delivery, 3 0.5 mg/kg Dexamethasone IV at delivery or 4 Cortisol 2 mg/kg IV at delivery. Lambs then were ventilated with no PEEP and escalating tidal volumes (VT to 15 mL/kg for 15 min and then given surfactant. The lambs were ventilated with VT 8 mL/kg and PEEP 5 cmH20 for 2 h 45 min. Results High VT ventilation caused a deterioration of lung physiology, lung inflammation and injury. Antenatal betamethasone improved ventilation, decreased inflammatory cytokine mRNA expression and alveolar protein leak, but did not prevent neutrophil influx. Postnatal dexamethasone decreased pro-inflammatory cytokine expression, but had no beneficial effect on ventilation, and postnatal cortisol had no effect. Ventilation increased liver serum amyloid mRNA expression, which was unaffected by corticosteroids. Conclusions Antenatal betamethasone decreased lung injury without decreasing lung inflammatory cells or systemic acute phase responses. Postnatal dexamethasone or cortisol, at the doses tested, did not have important effects on lung function or injury, suggesting that corticosteroids given at birth will not decrease resuscitation mediated injury.
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Vitamin D nutritional status and antenatal depressive symptoms in African American women.
Cassidy-Bushrow, Andrea E; Peters, Rosalind M; Johnson, Dayna A; Li, Jia; Rao, D Sudhaker
2012-11-01
Vitamin D deficiency is associated with depression; however, no studies have examined the relationship of vitamin D and antenatal depression. Antenatal depression increases the risk of adverse birth outcomes and poorer postpartum maternal and infant health. African American women are at increased risk for vitamin D deficiency and antenatal depression. Thus, we examined if early pregnancy vitamin D nutrition (VDN) was associated with antenatal depressive symptoms among African American women in the second trimester of pregnancy. Women (n=178) were recruited from obstetrics clinics of a large health system. VDN was assessed by serum 25-hydroxyvitamin D (25-OHD). Depression symptoms were measured with the Center for Epidemiological Studies Depression (CES-D) scale; CES-D≥16 equates with criteria for clinical depression. Logistic regression was used to examine the association of log-transformed 25-OHD and elevated depression symptoms (CES-D≥16). Mean 25-OHD was 13.4±8.4 ng/mL; most women (82.6%, n=147) were vitamin D inadequate or deficient (25-OHD<20 ng/mL). Mean CES-D was 15.2±10.7, and 74 (41.6%) women had a CES-D≥16, suggestive of clinical depression. A significant inverse relationship was found between log (25-OHD) and CES-D≥16 (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.29-0.99, p=0.046). For every 1-unit increase in log (25-OHD) (corresponding to ~2.72 ng/mL increase in 25-OHD), the odds of CES-D≥16 decreased by 46%. African American women with lower VDN exhibit increased depressive symptoms. Research on vitamin D supplementation for reducing antenatal depressive symptoms is needed.
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Hypnosis Antenatal Training for Childbirth (HATCh: a randomised controlled trial [NCT00282204
Directory of Open Access Journals (Sweden)
Baghurst Peter
2006-03-01
Full Text Available Abstract Background Although medical interventions play an important role in preserving lives and maternal comfort they have become increasingly routine in normal childbirth. This may increase the risk of associated complications and a less satisfactory birth experience. Antenatal hypnosis is associated with a reduced need for pharmacological interventions during childbirth. This trial seeks to determine the efficacy or otherwise of antenatal group hypnosis preparation for childbirth in late pregnancy. Methods/design A single centre, randomised controlled trial using a 3 arm parallel group design in the largest tertiary maternity unit in South Australia. Group 1 participants receive antenatal hypnosis training in preparation for childbirth administered by a qualified hypnotherapist with the use of an audio compact disc on hypnosis for re-enforcement; Group 2 consists of antenatal hypnosis training in preparation for childbirth using an audio compact disc on hypnosis administered by a nurse with no training in hypnotherapy; Group 3 participants continue with their usual preparation for childbirth with no additional intervention. Women > 34 and Discussion If effective, hypnosis would be a simple, inexpensive way to improve the childbirth experience, reduce complications associated with pharmacological interventions, yield cost savings in maternity care, and this trial will provide evidence to guide clinical practice.
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Antenatal Hydronephrosis: Differential Diagnosis, Evaluation, and Treatment Options
Herndon, C.D. Anthony
2006-01-01
The diagnosis, evaluation and management of antenatal hydronephrosis has undergone a two stage paradigm shift since the advent of prenatal ultrasonography in the early 1980s. Initially the identification of a large number of asymptomatic infants appeared to afford the surgeon the opportunity for preemptive intervention. However, it has now become apparent that antenatal hydronephrosis (AH) is far more difficult to interpret thanoriginally perceived. The initial enthusiasm for surgery has now been replaced by a much more conservative approach to ureteropelvic junction(UPJ) obstruction, multi-cystic dysplastic kidney(MCDK), vesicoureteral reflux and the non-refluxing megaureter. This review will highlight the postnatal evaluation of AH and include an overview of the Society for Fetal Urology grading system for hydronephrosis. The differential diagnosis and treatment options for UPJ obstruction, vesicoureteral reflux, MCDK, duplication anomalies, megaureter, and posterior urethral valves will be discussed. PMID:17619702
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Teenage pregnancy antenatal and perinatal morbidity: results from a tertiary centre in Greece.
Pergialiotis, V; Vlachos, D-E G; Gkioka, E; Tsotra, K; Papantoniou, N; Vlachos, G D
2015-01-01
We present the experience of a tertiary referral hospital in Greece, evaluating obstetric and perinatal outcomes among teenage and average maternal age (AMA) women. We retrospectively assessed all singleton pregnancies during a twelve-month period (January-December 2012). A total of 1,704 cases were reviewed and divided into two groups: one of AMA mothers (20-34 years old) (1,460 women) and the other of teenage mothers (12-19 years old) (244 women). We observed significantly higher incidence rates of preterm births (p teenage mothers. Antenatal surveillance was decreased among teenage mothers (p Teenage pregnancy is accompanied by significant antenatal and perinatal complications that need specific obstetrical attention. Obstetricians should be aware of these complications in order to ameliorate the antenatal outcome of childbearing teenagers.
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Cristiano Armando Diniz Guerra Silvestre; Flávia de Ávila
2016-01-01
Resumo: O crescimento da atenção internacional acerca da temática relacionada a armas leves tem gerado várias ações que evidenciam esta preocupação no âmbito internacional. Diversas organizações multilaterais – como a ONU com seu Programa de Ação da ONU para Prevenir, Combater e Suprimir o Comércio Ilícito de Armas Pequenas e Armamentos Leves em Todos seus Aspectos – e não-governamentais – tendo a Caritas por exemplo, seguem registrando seu uso em diversas zonas de conflito do mundo. Entretan...
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The Readiness of Students to Learn Interprofessional Teamwork in Antenatal Care
Directory of Open Access Journals (Sweden)
Dina Zakiyyatul Fuadah
2016-09-01
Full Text Available Introduction: Indonesia as a developing country have a higher Maternal Mortality Rate (MMR. The prevention efforts is developing interprofessional collaborative practice (IPCP in the level of health care. Collaboration attitudes should start from education level through interprofessional education training and simulation for student. The objective of this study was to analyze the effect of interprofessional education training toward the readiness of students to learn interprofessional teamwork in antenatal care. Methods: Quasi-experimental design (pre test and post test without control with Time-Series Design. Participants used in this study were students of five semester in STIKes Karya Husada Kediri year of 2011/2012 and the number of samples are 60 students. Technique sampling using simple random. The data collected by used questionnaires Readiness Interprofessional Learning Scale (RIPLS and checklist observations using Teamwork Score (TWS. Anova, Friedman test, and Kruskal Wallis was used to statistically analyzed the data. Results: Readiness to learn interprofessional teamwork indicates the value of p = 0.001 thats means there are significant differences between the readiness before and after training IPE. Delta test showed that p value > 0.05 so there is no difference between the three programs study on readiness to learn interprofessional teamwork in antenatal care. Discussion: Interprofessional education training using simulation methods can affect the readiness of nursing, midwifery and nutritionist students for learning interprofessional teamwork in antenatal care. Keywords: interprofessional education, readiness, training and simulations, pre clinics students, antenatal care.
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Amoakoh-Coleman, Mary; Agyepong, Irene Akua; Kayode, Gbenga A; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin; Ansah, Evelyn K
2016-09-21
Lack of resources has been identified as a reason for non-adherence to clinical guidelines. Our aim was to describe public health facility resource availability in relation to provider adherence to first antenatal visit guidelines. A cross-sectional analysis of the baseline data of a prospective cohort study on adherence to first antenatal care visit guidelines was carried out in 11 facilities in the Greater Accra Region of Ghana. Provider adherence was studied in relation to health facility resource availability such as antenatal workload for clinical staffs, routine antenatal drugs, laboratory testing, protocols, ambulance and equipment. Eleven facilities comprising 6 hospitals (54.5 %), 4 polyclinics (36.4 %) and 1 health center were randomly sampled. Complete provider adherence to first antenatal guidelines for all the 946 participants was 48.1 % (95 % CI: 41.8-54.2 %), varying significantly amongst the types of facilities, with highest rate in the polyclinics. Average antenatal workload per month per clinical staff member was higher in polyclinics compared to the hospitals. All facility laboratories were able to conduct routine antenatal tests. Most routine antenatal drugs were available in all facilities except magnesium sulphate and sulphadoxine-pyrimethamine which were lacking in some. Antenatal service protocols and equipment were also available in all facilities. Although antenatal workload varies across different facility types in the Greater Accra region, other health facility resources that support implementation of first antenatal care guidelines are equally available in all the facilities. These factors therefore do not adequately account for the low and varying proportions of complete adherence to guidelines across facility types. Providers should be continually engaged for a better understanding of the barriers to their adherence to these guidelines.
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Shidhaye, Pallavi; Shidhaye, Rahul; Phalke, Vaishali
2017-06-01
Maternal depression is a major public health problem in low- and middle-income countries including India. Very few studies have assessed association of various risk factors with antenatal depression in rural Indian women, especially the effect of marital conflict, gender disadvantage and gender preference on antenatal depression. This paper describes the prevalence of probable antenatal depression in rural Maharashtra, a state in the western part of India and specifically assesses the association of marital and gender disadvantage factors and gender preference for a male child with antenatal depression. Primary Health Centre-based cross-sectional survey of antenatal women in rural Maharashtra was carried out. The outcome of interest was a probable diagnosis of depression in antenatal women which was measured using the Edinburgh postnatal depression scale (EPDS). Data were analyzed using simple and multiple logistic regression. 302 women in their antenatal period were included in this study. The outcome of antenatal depression (EPDS > 12) was found in 51 women (16.9%, 95% CI 12.6-21.1%). Feeling pressurized to deliver a male child was strongly associated with the outcome of antenatal depression (adjusted odds ratio (OR): 3.0; 95% CI 1.4-6.5). Unsatisfactory reaction of in-laws to dowry (adjusted OR 11.2; 95% CI 2.4-52.9) and difficult relationship with in-laws (adjusted OR 5.3; 95% CI 2.4-11.6) were also significantly associated with antenatal depression. Our findings demonstrate that antenatal depression in rural women of Western Maharashtra is associated with gender disadvantage factors, especially related to preference for a male child. The agenda to improve maternal mental health should be ultimately linked to address the broader social development goals and gender empowerment.
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Outcomes of Isolated Antenatal Hydronephrosis at First Year of Life
Directory of Open Access Journals (Sweden)
Mutaz Orabi
2018-03-01
Full Text Available Objectives: To compare the grade of hydronephrosis between the antenatal and first postnatal ultrasound (US and their clinical outcomes. Methods: This retrospective study included all cases of isolated hydronephrosis detected by antenatal US from August 2005 to February 2011. Hydronephrosis was classified based on the standard criteria into mild, moderate, or severe. Cases associated with other major congenital anomalies were excluded. All patients were followed-up postnatally and outcomes available were analyzed at one year of age. Results: A total of 105 cases were included out of which 83 (79.0% were males and 22 (20.9% were females with a median gestational age of 38 weeks. First postnatal US of 105 cases showed that 20 (19.0% were free of hydronephrosis, 39 (37.1% had mild, 29 (27.6% moderate, and 17 (16.1% had severe hydronephrosis. Half (50.4% of hydronephrosis cases improved in their clinical presentation while 13.3% showed deterioration and 36.3% remained the same. Almost half of all cases (52 cases were diagnosed by US at the end of first year without any effect on renal function. Conclusions: Antenatal and postnatal US are sensitive tools for detecting hydronephrosis as well as for postnatal counseling. Fetal anatomy US is usually done at 18 weeks gestation and if this reveals any evidence of hydronephrosis, the patient is followed according to the severity. Postnatal US is not done routinely for cases where hydronephrosis resolves completely during pregnancy. Although newborns with antenatal hydronephrosis due to secondary causes are at greater risk for renal impairment, surgical intervention reserves renal function.
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Red River of the North Walsh and Pembina Countries, North Dakota Farmstead Ring Levees.
1983-12-01
services during the event; and postflood reoccupation and recovery. Practically, for rural areas, a plan should be developed and implemented on a county...trends for the area can be seen in the OBERS projections in table 4. Farm employment is projected to continue decreasing while the nonfarm sectors ...report provides the public the initial information needed to assess the potential for Federal involvement in developing ring levees for the
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Weiniger, Carolyn F; Einav, Sharon; Elchalal, Uriel; Ozerski, Vladislav; Shatalin, Daniel; Ioscovich, Alexander; Ginosar, Yehuda
2018-03-19
Care of pregnant women with concurrent medical conditions can be optimized by multidisciplinary antenatal management. In the current study we describe women with concurrent medical conditions who attended our antenatal anesthesia clinic over a 14-year period, 2002-2015 and, based on the findings, we suggest new policies, strategies and practices to improve antenatal care. In 2002, an antenatal anesthesia clinic was established in Hadassah Medical Center. Each consultation focused on the concurrent medical condition. A written anesthesia strategy according to the medical condition and its anesthesia considerations was discussed and given to the patient. Data regarding clinic visits were recorded. A total of 451 clinic women attended the antenatal anesthesia clinic. Maternal age was 31.7 ± 6.0 years (mean ± SD), with gestational age of pregnancy 33.0 ± 5.4 weeks at the clinic visit. Musculoskeletal conditions (23% of all the women seen) were the most frequent concurrent conditions, followed by anesthesia related concerns 20%, neurologic conditions 19%, and cardiac conditions 15%. Women were provided plans that were deliberated carefully rather than being concocted during labor. A wide range of concurrent medical conditions was seen in the antenatal anesthesia clinic, however fewer women attended the clinic than expected according to known population frequencies of concurrent medical conditions. Women with concurrent medical conditions should have labor and anesthesia plans considered during the nine months of pregnancy, prior to delivery, and hospitals should have a means of obtaining this information in a timely manner. Finally, there is a need to develop additional antenatal anesthesia clinics.
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The quality of free antenatal and delivery services in Northern Sierra Leone.
Koroma, Manso M; Kamara, Samuel S; Bangura, Evelyn A; Kamara, Mohamed A; Lokossou, Virgil; Keita, Namoudou
2017-07-12
The number of maternal deaths in sub-Saharan Africa continues to be overwhelmingly high. In West Africa, Sierra Leone leads the list, with the highest maternal mortality ratio. In 2010, financial barriers were removed as an incentive for more women to use available antenatal, delivery and postnatal services. Few published studies have examined the quality of free antenatal services and access to emergency obstetric care in Sierra Leone. A cross-sectional survey was conducted in 2014 in all 97 peripheral health facilities and three hospitals in Bombali District, Northern Region. One hundred antenatal care providers were interviewed, 276 observations were made and 486 pregnant women were interviewed. We assessed the adequacy of antenatal and delivery services provided using national standards. The distance was calculated between each facility providing delivery services and the nearest comprehensive emergency obstetric care (CEOC) facility, and the proportion of facilities in a chiefdom within 15 km of each CEOC facility was also calculated. A thematic map was developed to show inequities. The quality of services was poor. Based on national standards, only 27% of women were examined, 2% were screened on their first antenatal visit and 47% received interventions as recommended. Although 94% of facilities provided delivery services, a minority had delivery rooms (40%), delivery kits (42%) or portable water (46%). Skilled attendants supervised 35% of deliveries, and in only 35% of these were processes adequately documented. None of the five basic emergency obstetric care facilities were fully compliant with national standards, and the central and northernmost parts of the district had the least access to comprehensive emergency obstetric care. The health sector needs to monitor the quality of antenatal interventions in addition to measuring coverage. The quality of delivery services is compromised by poor infrastructure, inadequate skilled staff, stock-outs of
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determinants of first antenatal care visit by pregnant women
African Journals Online (AJOL)
2014-09-01
Sep 1, 2014 ... Subjects: Four hundred and seventeen (417) pregnant women attending antenatal care ... convenience of opening hours at ANC facility, commuting distance from home to ... identifying maternal education, employment, age,.
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Do antenatal education classes decrease use of epidural analgesia during labour? – a Danish RCT
DEFF Research Database (Denmark)
Brixval, Carina Sjöberg; Thygesen, Lau Caspar; Axelsen, Solveig Forberg
Background: Epidural analgesia is widely used as pain relief during labour but has negative side effects, such as prolonged labour and increased risk of obstetric interventions. Antenatal education in small groups may increase trust in own ability to cope at home in the early stages of labour...... of an antenatal education program in small classes on use of epidural analgesia. Methods: Data from the NEWBORN trial were used. A total of 1766 women from the Copenhagen area, Denmark were randomized to participate in either antenatal education in small groups or standard care. Data were analysed according...... on whether to implement the NEWBORN program in a clinical setting also depend upon the trial effect on psycho-social outcomes which will be analysed in near future. Main messages (max 200 anslag): 1. No effect of antenatal education in small groups on use of epidural analgesia as pain relief during labour...
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The effects of antenatal depression and antidepressant treatment on placental gene expression
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Jocelien DA Olivier
2015-01-01
Full Text Available The effects of antenatal depression and antidepressant treatment during pregnancy on both mother and child are vigorously studied, but the underlying biology for these effects is largely unknown. The placenta plays a crucial role in the growth and development of the fetus. We performed a gene expression study on the fetal side of the placenta to investigate gene expression patterns in mothers with antenatal depression and in mothers using antidepressant treatment during pregnancy.Placental samples from mothers with normal pregnancies, from mothers with antenatal depression, and from mothers using antidepressants were collected. We performed a pilot microarray study to investigate alterations in the gene expression and selected several genes from the microarray for biological validation with qPCR in a larger sample.In mothers with antenatal depression 108 genes were differentially expressed, whereas 109 genes were differentially expressed in those using antidepressants. Validation of the microarray revealed more robust gene expression differences in the seven genes picked for confirmation in antidepressant-treated women than in depressed women. Among the genes that were validated ROCK2 and C12orf39 were differentially expressed in both depressed and antidepressant-treated women, whereas ROCK1, GCC2, KTN1, and DNM1L were only differentially expressed in the antidepressant-treated women. In conclusion, antenatal depression and antidepressant exposure during pregnancy are associated with altered gene expression in the placenta. Findings on those genes picked for validation were more robust among antidepressant-treated women than in depressed women, possibly due to the fact that depression is a multifactorial condition with varying degrees of endocrine disruption. It remains to be established whether the alterations found in the gene expression of the placenta are found in the fetus as well.
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Directory of Open Access Journals (Sweden)
Estrella Israel Garzón
2013-10-01
Full Text Available Las imágenes periodísticas son objeto de debates y controversias. Desde la niña de Trang Bang hasta las imágenes de niñas y mujeres en el terremoto y la epidemia de cólera de Haití en 2010, los comentarios se suceden sobre el valor simbólico y comunicativo de lo representado. Las imágenes de prensa reconocidas como “Foto del año” por la World Press Photo en el periodo comprendido entre los años 2000 y 2011 representan conflictos y catástrofes internacionales en las que los protagonistas son principalmente mujeres, niños y niñas; se trata de imágenes cargadas de drama y pathos. Los ejes de la discusión son la jerarquización en portada frente al derecho a la intimidad, la visibilidad de las personas enfermas y víctimas de catástrofes y la respuesta social ante las imágenes a través de la red.
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What is the impact of antenatal diagnosis on long-term outlook?
Energy Technology Data Exchange (ETDEWEB)
Garel, Laurent [CHU Ste-Justine, Department of Medical Imaging, Montreal (Canada)
2008-06-15
Congential malformations result in very significant consequences in paediatrics; more than 20% of infant mortality, more than 30% of paediatric ICU admissions, and one-third of overall admissions in the paediatric age group are linked to congential malformations. Health economics and antenatal diagnosis. Key issues yet to be addressed include: 1. Clarification of the objectives for screening for birth defects: Is it to detect cases or to prevent the birth of affected fetuses? 2. The establishment of the trade-of between resources allocated to screening and those allocated to help families and disabled children. 3. The value of a child born with structural or chromosomal defects compared with miscarriage of a normal fetus following amniocentesis. Apart from the ethical debates related to prenatal screening (variable expertise, rationing of resources, eugenics), the economic evaluations of antenatal diagnosis espouse the hypothesis and value judgment of the health commissioners. Indeed, prenatal screening and antenatal diagnosis carry high political and social stakes that make evidence-based evaluation of their impact more difficult than in any field in medicine. (orig.)
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Recurrent urinary tract infections in an infant with antenatal Bartter syndrome.
Tasic, Velibor; Pota, Liljana; Gucev, Zoran
2011-02-01
antenatal variant of Bartter syndrome is characterized by a history of polyhydramnios, premature birth, metabolic alkalosis, hypokalemia, polyuria and renal salt wasting. In this report we present a premature female baby with antenatal Barter syndrome who had three episodes of urinary tract infection (UTI), without evidence for congenital anomaly of the kidneys or urinary tract. antenatal Bartter syndrome was diagnosed according to the standard criteria. Ultrasound scan and voiding cystourethrography were performed to exclude congenital anomaly of the kidneys and urinary tract. the baby presented with early hyperkalemia and acidosis. The typical biochemical features of the Bartter syndrome were observed in the second month. Despite appropriate treatment she had persistent hypercalciuria. The clinical course was complicated with recurrent episodes of febrile UTIs. Urinary tract system imaging did not demonstrate congenital anomalies. She finally died of severe dehydration, acidosis and renal failure. since no congenital anomaly of the kidneys or urinary tract was demonstrated in our patient, we believe that severe, persistent hypercalciuria is the most important risk factor for development of recurrent UTIs.
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Homeyard, Claire; Montgomery, Elsa; Chinn, Deborah; Patelarou, Evridiki
2016-01-01
changing attitudes, alongside integration, more independent living and recognition of rights to family life have meant a steady rise in women with intellectual disabilities becoming pregnant. However, existing evidence shows that women with intellectual disabilities are less likely to seek or attend for regular antenatal care. This population experiences poorer maternal wellbeing and worse pregnancy outcomes compared to the general population, including preterm and low-birthweight babies. to identify and review the existing evidence on the provision of antenatal care among women with intellectual disabilities. a systematic search strategy was formulated using key Medical Sub-Headings terms and related text words for pregnancy, antenatal care and intellectual disability. Comprehensive searches dating back to 1980 using pre-determined criteria followed by a hand search of reference lists and citations were undertaken. Data were extracted using a data extraction form and methodological quality assessed using the framework developed by Caldwell et al. (2011). A three stage textual narrative synthesis was used to integrate the findings from the included studies. searches identified 16 papers that met the inclusion criteria. A majority of the papers focused on women's experience of pregnancy and antenatal care with a paucity of papers identified on midwives knowledge and experience. The four broad themes of the analysis and synthesis performed included: In the Family Way ('I've a baby inside. I've got a life inside of me.׳); Knowledge and advocacy ('...everyone was looking at one another and no one was talking to me...'); Midwives educational needs ('...helpful to have guidance...') and Midwives Attitudes ('...women with [intellectual disabilities]...should not be pregnant'). significant gaps in the evidence base were apparent, however evidence was identified which showed that intellectually disabled pregnant women struggle to understand antenatal information
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Directory of Open Access Journals (Sweden)
Saurabh RamBihariLal Shrivastava
2013-04-01
Full Text Available BACKGROUND: This study aimed to assess the utilization of antenatal & intra-natal services by antenatal women and the socio-demographic factors affecting the utilization. METHODS: A cross sectional descriptive study was conducted in urban slum from July to September 2011. Study population comprised of women who had delivered in last one year preceding study, irrespective of place and outcome of delivery. Only women who were residing at current address for at least 1 year were included. Women not consenting and pregnant women were excluded. All such women were interviewed face to face after obtaining their informed consent using pre tested semi-structured questionnaire which included details of their antenatal care (ANC and intra-natal services availed. Hospital Management Information System (HMIS and Systems, Applications and Products (SAP software were used for obtaining information regarding antenatal and intra-natal care. RESULTS: Antenatal services were utilized by 158(77.8% of study participants. 161(79.3% subjects had institutional delivery and 42(20.7% home delivery, out of which, only 3(7.1% subjects had an assisted home delivery. Low education status and poor socio-economic class had a significant association (P < 0.05 with utilization of ANC services. CONCLUSION: Public sector was the major source of utilization of antenatal care services and intra natal services in 62.7% subjects and 78% subjects respectively. It is suggested that low-income, uneducated women should be targeted for promotion of utilization of antenatal and intra-natal services. [TAF Prev Med Bull 2013; 12(2.000: 157-164
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Directory of Open Access Journals (Sweden)
William Cherniak
Full Text Available In rural Uganda pregnant women often lack access to health services, do not attend antenatal care, and tend to utilize traditional healers/birth attendants. We hypothesized that receiving a message advertising that "you will be able to see your baby by ultrasound" would motivate rural Ugandan women who otherwise might use a traditional birth attendant to attend antenatal care, and that those women would subsequently be more satisfied with care. A cluster randomized trial was conducted across eight rural sub-counties in southwestern Uganda. Sub-counties were randomized to a control arm, with advertisement of antenatal care with no mention of portable obstetric ultrasound (four communities, n = 59, or an intervention arm, with advertisement of portable obstetric ultrasound. Advertisement of portable obstetric ultrasound was further divided into intervention A word of mouth advertisement of portable obstetric ultrasound and antenatal care (one communitity, n = 16, B radio advertisement of only antenatal care and word of mouth advertisement of antenatal care and portable obstetric ultrasound (one community, n = 7, or C word of mouth + radio advertisement of both antenatal care and portable obstetric ultrasound (two communities, n = 75. The primary outcome was attendance to antenatal care. 159 women presented to antenatal care across eight sub-counties. The rate of attendance was 65.1 (per 1000 pregnant women, 95% CI 38.3-110.4 where portable obstetric ultrasound was advertised by radio and word of mouth, as compared to a rate of 11.1 (95% CI 6.1-20.1 in control communities (rate ratio 5.9, 95% CI 2.6-13.0, p<0.0001. Attendance was also improved in women who had previously seen a traditional healer (13.0, 95% CI 5.4-31.2 compared to control (1.5, 95% CI 0.5-5.0, rate ratio 8.7, 95% CI 2.0-38.1, p = 0.004. By advertising antenatal care and portable obstetric ultrasound by radio attendance was significantly improved. This study suggests that women can
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Placenta accreta: MRI antenatal diagnosis and surgical correlation.
Ha, T P; Li, K C
1998-01-01
We describe a case of a placenta previa accreta that was diagnosed antenatally by MRI with subsequent surgical confirmation. We show the advantages of ultrafast MRI single shot (SS) fast spin echo (FSE) techniques for accurate diagnosis with minimal scan time and fetal motion artifacts.
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Toxoplasmosis among pregnant women attending antenatal clinic in ...
African Journals Online (AJOL)
Toxoplasmosis is a neglected tropical protozoan disease of public health importance. This study estimated the seroprevalence of toxoplasmosis and the associated risk factors among pregnant women attending the antenatal clinic in the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. Two hundred and ...
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Martin, L.; Hutton, E.K.; Spelten, E.R.; Gitsels-van der Wal, J.T.; Dulmen, S. van
2014-01-01
Objective: this study aims to provide insight into: (a) midwives' views on appropriate antenatal counselling for congenital anomaly tests, and (b) whether these views match clients' preferences regarding antenatal counselling. Design: a comparative (midwives versus clients) questionnaire survey.
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Dixon, Jenna; Tenkorang, Eric Y; Luginaah, Isaac N; Kuuire, Vincent Z; Boateng, Godfred O
2014-01-01
The objective of this study was to examine whether enrolment in the National Health Insurance Scheme (NHIS) affects the likelihood and timing of utilising antenatal care among women in Ghana. Data were drawn from the Ghana Demographic and Health Survey, a nationally representative survey collected in 2008. The study used a cross-sectional design to examine the independent effects of NHIS enrolment on two dependent variables (frequency and timing of antenatal visits) among 1610 Ghanaian women. Negative binomial and logit models were fitted given that count and categorical variables were employed as outcome measures, respectively. Regardless of socio-economic and demographic factors, women enrolled in the NHIS make more antenatal visits compared with those not enrolled; however, there was no statistical association with the timing of the crucial first visit. Women who are educated, living in urban areas and are wealthy were more likely to attend antenatal care than those living in rural areas, uneducated and from poorer households. The NHIS should be strengthened and resourced as it may act as an important tool for increasing antenatal care attendance among women in Ghana. © 2013 John Wiley & Sons Ltd.
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Rwakarema, Mechtilda; Premji, Shahirose S; Nyanza, Elias Charles; Riziki, Ponsiano; Palacios-Derflingher, Luz
2015-09-02
Psychosocial health problems, specifically depression during pregnancy, can have negative impact on birth outcomes, postnatal mental health of the mother, and infant health. Antenatal depression is more prevalent among women in low- and middle-income countries than among women in high-income countries. Risk factors for antenatal depression reported in the literature relate to pregnant women in South Asia. Consequently, this study assessed depression in pregnancy and related psychosocial risk factors among select pregnant women residing in Mwanza region, Northern Tanzania. We analysed data from 397 pregnant women recruited from three antenatal clinics for the period June-August 2013 for this cross-sectional study. Women provided data at one time point during their pregnancy by completing the Edinburgh Postnatal Depression Scale and a structured questionnaire assessing psychosocial, demographic, and behavioural risk factors related to antenatal depression. Multiple logistic regression analysis was performed to determine the relationship between risk factors examined and antenatal depression. Overall, 33.8 % (n = 134) of pregnant women had antenatal depression. Pregnancy-related anxiety was associated with antenatal depression (odds ratio (OR) 1.36, 95 % confidence interval (CI) 1.23 to 1.5). Pregnant women with poor relationship with partner and low/moderate socio-economic status had the highest OR for antenatal depression (82.34, 95 % CI 4.47, 1516.60) after adjusting for other covariates. Pregnant women with poor relationship with partner and high socio-economic status had an OR of 13.48 (95 % CI 1.71, 106.31) for antenatal depression. "Reference" pregnant women were those with very good relationship with partner and high socio-economic status. High proportion of self-reported depression among select pregnant women attending antenatal clinics in Mwanza, Tanzania merit integrating depression assessment into existing antenatal care services. Health care providers
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Dibaba, Yohannes; Fantahun, Mesganaw; Hindin, Michelle J
2013-09-16
There has been considerable debate in the reproductive health literature as to whether unintended pregnancy influences use of maternal health services, particularly antenatal care. Despite the wealth of studies examining the association between pregnancy intention and antenatal care, findings remain mixed and inconclusive. The objective of this study is to systematically review and meta-analyse studies on the association between pregnancy intention and antenatal care. We reviewed studies reporting on pregnancy intention and antenatal care from PubMed, Popline, CINHAL and Jstor search engines by developing search strategies. Study quality was assessed for biases in selection, definition of exposure and outcome variables, confounder adjustment, and type of analyses. Adjusted odds ratios, standard errors and sample size were extracted from the included studies and meta-analyzed using STATA version 11. Heterogeneity among studies was assessed using Q test statistic. Effect-size was measured by Odds ratio. Pooled odds ratio for the effects of unintended pregnancy on the use of antenatal care services were calculated using the random effects model. Our results indicate increased odds of delayed antenatal care use among women with unintended pregnancies (OR 1.42 with 95% CI, 1.27, 1.59) as compared to women with intended pregnancies. Sub-group analysis for developed (1.50 with 95% CI, 1.34, 1.68) and developing (1. 36 with 95% CI, 1.13, 1.65) countries showed significant associations. Moreover, there is an increased odds of inadequate antenatal care use among women with unintended pregnancies as compared to women with intended pregnancies (OR 1.64, 95% CI: 1.47, 1.82). Subgroup analysis for developed (OR, 1.86; 95% CI: 1.62, 2.14) and developing (OR, 1.54; 95% CI: 1.33, 1.77) countries also showed a statistically significant association. However, there were heterogeneities in the studies included in this analysis. Unintended pregnancy is associated with late initiation
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Incidence of nevirapine-associated hepatitis in an antenatal clinic ...
African Journals Online (AJOL)
based highly active antiretroviral therapy at a dedicated antenatal antiretroviral clinic between July 2004 and December 2006. Results. Three hundred and ninety women were included in the analysis. Median age was 29 (interquartile range (IQR)
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Mak, Donna B; Regan, Annette K; Joyce, Sarah; Gibbs, Robyn; Effler, Paul V
2015-04-01
Although influenza vaccination is an important component of antenatal care and is recommended and funded by the Australian government, vaccination uptake has been low. This study compared seasonal influenza vaccination uptake among pregnant Western Australian (WA) women and identified factors associated with vaccination uptake. Adult women who were pregnant during the 2012 and 2013 influenza vaccination seasons were selected at random and invited to complete a computer-assisted telephone interview survey about whether they received influenza vaccination during pregnancy. Data analyses were weighted to the age distribution of women of reproductive age in WA. Multivariate logistic regression was used to identify factors associated with vaccination uptake. Between 2012 and 2013, the proportion of WA women whose antenatal care provider recommended influenza vaccination increased from 37.6 to 62.1% and vaccination uptake increased from 23.0 to 36.5%. The antenatal care provider's advice to have influenza vaccine was the single most important factor associated with vaccination (OR 11.1, 95% CI 7.9-15.5). Most women (63.7%) were vaccinated in general practice, 18.8% in a public hospital antenatal clinic and 11.0% at their workplace. Wanting to protect their infant from infection (91.2%) and having the vaccine recommended by their GP (60.0%) or obstetrician (51.0%) were commonly reported reasons for vaccination; worrying about side effects was a common reason for nonvaccination. To optimise maternal and infant health outcomes, Australian antenatal care providers and services need to incorporate both the recommendation and delivery of influenza vaccination into routine antenatal care. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
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Tsai, Yi-Jing; Hsu, Yu-Yun; Hou, Ting-Wei; Chang, Chiung-Hsin
2018-03-01
Women may experience significant stress during pregnancy, and antenatal care and education provide a means to address this. E-health, the use of computer and information technology for health care, has been incorporated into antenatal care and education, but e-health has not been evaluated for its usefulness in addressing stress. The objective of this study was to investigate the effectiveness of a web-based antenatal care and education system on pregnancy-related stress, general self-efficacy, and satisfaction with antenatal care. A quasi-experimental design enrolled pregnant women at 16 to 24 weeks' gestation with a low-risk pregnancy. Women in the control group (n = 67) received routine antenatal care; women in the experimental group (n = 68) also received a web-based antenatal care and education program in the second trimester. Pregnancy stress and general self-efficacy were assessed at study entry and again at 36 to 38 weeks' gestation; satisfaction with care was assessed at the study endpoint. When the pretest scores were controlled, the women in the experimental group reported significantly lower pregnancy-related stress (F = 12.9, P web-based antenatal care and education system can improve pregnancy-related stress and general self-efficacy among pregnant women. Integrating health care with web-based or internet-based interventions may improve the quality of antenatal care. © 2018 by the American College of Nurse-Midwives.
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La terapia hormonal de reemplazo en la pre y pos menopausia: tendencias y controversias
Directory of Open Access Journals (Sweden)
Sánchez-Ramírez, Georgina
2008-07-01
Full Text Available Con la finalidad de contribuir a una actualización del estado del arte y bajo una perspectiva crítica, se realizó una revisión bibliográfica sobre las indicaciones terapéuticas de la Terapia de Reemplazo Hormonal, así como las diferentes controversias, usos y beneficios durante la pre y la posmenopausia. Los beneficios demostrados hasta el momento de la THR, son la corrección de la atrofia urogenital y/o vaginal y la disminución de las molestias de los síntomas vasomotores (los sofocos o bochornos, los vértigos, las sensaciones de hormigueo en las extremidades y palpitaciones y el aumento de la DMO que puede prevenir las fracturas de cadera y vértebras. Las dosis recomendadas para la administración de THR han variado con el tiempo, cobrando fuerza últimamente la corriente clínica que recomienda dosis menores que las utilizadas en años anteriores, ya que se están demostrando los mismos beneficios, disminuyendo los riesgos asociados a su uso, lo cual requiere una actualización en la información que manejan tanto los médicos como las usuarias. Existe además la necesidad de ampliar las investigaciones sobre el uso de otro tipo de terapias para aliviar la sintomatología climatérica diferente a la THR.
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Socio-economic and Demographic Determinants of Antenatal Care Services Utilization in Central Nepal
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Srijana Pandey, PhD
2014-09-01
Full Text Available Background/Objective: The importance of maternal health services in lessening maternal mortality and morbidity as well as neonatal deaths has received substantial recognition in the past decade. The lack of antenatal care has been identified as a risk factor for maternal mortality and other adverse pregnancy outcomes. The purpose of this study was to determine the factors affecting attendance of antenatal care services in Nepal. Methods: This is a cross-sectional descriptive study carried out in Central Nepal. Using semi-structured questionnaire, interviews were conducted with married women aged between 15-49 years, who had delivered their babies within one year. Systematic random sampling method was used to select the sample. Results were obtained by frequency distribution and cross-tabulation of the variables. Results: More than half of the women were not aware of the consequences of lack of antenatal care. Age, education, income, type of family were strongly associated with the attendance at antenatal care service. Conclusions and Public Health Implications: In Nepal and in other developing countries, maternal mortality and morbidity continue to pose challenges to the health care delivery system. Variety of factors including socio-demographic, socio-economic, cultural and service availability as well as accessibility influences the use of maternal health services.
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Antenatal care attendance, a surrogate for pregnancy outcome? The case of Kumasi, Ghana.
Asundep, Ntui N; Jolly, Pauline E; Carson, April; Turpin, Cornelius A; Zhang, Kui; Tameru, Berhanu
2014-07-01
Antenatal care (ANC) has been shown to influence infant and maternal outcomes. WHO recommends 4 ANC visits for uncomplicated pregnancies. However, pregnant women in Ghana are required to attend 8-13 antenatal visits. We investigated the association of ANC attendance with adverse pregnancy outcomes (defined as low infant birth weight, stillbirth, preterm delivery or small for gestational age). A quantitative cross-sectional study was conducted on 629 women, age 19-48 years who presented for delivery at two selected public hospitals and 16 traditional birth attendants from July to November 2011. Socio-demographic and antenatal information were collected using a structured questionnaire. ANC attendance, medical and obstetric/gynecological history were abstracted from maternal antenatal records. Data were analyzed using Chi square and logistic regression. Twenty-two percent of the women experienced an adverse outcome. Eleven percent of the women attended 5 children) was also associated with adverse birth outcomes. Women screened for syphilis or use of insecticide-treated bed nets had a 40 and 36% (p = 0.0447 and p = 0.0293) reduced likelihood of experiencing an adverse pregnancy outcome respectively. After adjusting for confounders, attending pregnancy outcome compared with ≥4 ANC visits (Adjusted OR 2.55; 95% CI 1.16-5.63; p = 0.0202). Attending pregnancy outcomes for uncomplicated pregnancies.
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Induced abortion among women attending antenatal clinics in ...
African Journals Online (AJOL)
Objectives: Unsafe abortion is a public health concern because of its impact on maternal morbidity and mortality. The objective of this study was to document on induced abortion in Yaounde, Cameroon. Design: Cross-sectional study. Setting: Six antenatal clinics in Yaounde, Cameroon. Methods: Women attending ...
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Variables influencing delay in antenatal clinic attendance among ...
African Journals Online (AJOL)
and to make recommendations based on the research findings for the development of policies that will ensure early .... Table 1: Antenatal service utilisation by pregnant adolescents in Lesotho (First visits ... fail to recognise that they are pregnant ..... Demographic and Health Survey 2004. Calverton, Maryland. 2. Safe.
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factors affecting antenatal care service utilization in yem special ...
African Journals Online (AJOL)
jhon
assess antenatal care utilization and factors that affect it in Yem Special Woreda, South Western Ethiopia. METHODS: A ... A pre-tested structured questionnaire consisting of information on socio- ..... model and access to medical care: does it.
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Dimensions of quality of antenatal care service at Suez, Egypt
Directory of Open Access Journals (Sweden)
Hanan Abbas Abdo Abdel Rahman El Gammal
2014-01-01
Full Text Available Introduction: The 5 th millennium development goal aims at reducing maternal mortality by 75% by the year 2015. According to the World Health Organization, there was an estimated 358,000 maternal deaths globally in 2008. Developing countries accounted for 99% of these deaths of which three-fifths occurred in Sub-Saharan Africa. In primary health care (PHC, quality of antenatal care is fundamental and critically affects service continuity. Nevertheless, medical research ignores the issue and it is lacking scientific inquiry, particularly in Egypt. Aim of the Study: The aim of the following study is to assess the quality of antenatal care in urban Suez Governorate, Egypt. Materials and Methods: A cross-sectional primary health care center (PHCC based study conducted at five PHCC in urban Suez, Egypt. The total sample size collected from clients, physicians and medical records. Parameters assessed auditing of medical records, assessing provider and pregnant women satisfaction. Results: Nearly 97% of respondents were satisfied about the quality of antenatal care, while provider′s satisfaction was 61% and for file, auditing was 76.5 ° 5.6. Conclusion: The present study shows that client satisfaction, physicians′ satisfaction and auditing of medical record represent an idea about opportunities for improvement.
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Dimensions of Quality of Antenatal Care Sservice at Suez, Egypt
Rahman El Gammal, Hanan Abbas Abdo Abdel
2014-01-01
Introduction: The 5th millennium development goal aims at reducing maternal mortality by 75% by the year 2015. According to the World Health Organization, there was an estimated 358,000 maternal deaths globally in 2008. Developing countries accounted for 99% of these deaths of which three-fifths occurred in Sub-Saharan Africa. In primary health care (PHC), quality of antenatal care is fundamental and critically affects service continuity. Nevertheless, medical research ignores the issue and it is lacking scientific inquiry, particularly in Egypt. Aim of the Study: The aim of the following study is to assess the quality of antenatal care in urban Suez Governorate, Egypt. Materials and Methods: A cross-sectional primary health care center (PHCC) based study conducted at five PHCC in urban Suez, Egypt. The total sample size collected from clients, physicians and medical records. Parameters assessed auditing of medical records, assessing provider and pregnant women satisfaction. Results: Nearly 97% of respondents were satisfied about the quality of antenatal care, while provider's satisfaction was 61% and for file, auditing was 76.5 ± 5.6. Conclusion: The present study shows that client satisfaction, physicians’ satisfaction and auditing of medical record represent an idea about opportunities for improvement. PMID:25374861
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Antenatal diagnosis of congenital deafness.
Isaacson, G
1988-01-01
Advances in the field of antenatal diagnosis have made possible the detection of profound sensorineural hearing loss prior to birth. Fetal motion in response to sound and auditory evoked potential testing can determine the presence of fetal hearing in the third trimester of pregnancy. Imaging modalities including ultrasound, computed tomography, and magnetic resonance imaging hold promise for the diagnosis of some forms of congenital deafness in the second trimester fetus. The methods by which congenital deafness soon may be diagnosed and the implications for the otologist are discussed.
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Ibanez, Gladys; Bernard, Jonathan Y.; Rondet, Claire; Peyre, Hugo; Forhan, Anne; Kaminski, Monique; Saurel-Cubizolles, Marie-Josèphe
2015-01-01
Introduction Studies have shown that depression or anxiety occur in 10–20% of pregnant women. These disorders are often undertreated and may affect mothers and children’s health. This study investigates the relation between antenatal maternal depression, anxiety and children’s early cognitive development among 1380 two-year-old children and 1227 three-year-old children. Methods In the French EDEN Mother-Child Cohort Study, language ability was assessed with the Communicative Development Inventory at 2 years of age and overall development with the Ages and Stages Questionnaire at 3 years of age. Multiple regressions and structural equation modeling were used to examine links between depression, anxiety during pregnancy and child cognitive development. Results We found strong significant associations between maternal antenatal anxiety and poorer children’s cognitive development at 2 and 3 years. Antenatal maternal depression was not associated with child development, except when antenatal maternal anxiety was also present. Both postnatal maternal depression and parental stimulation appeared to play mediating roles in the relation between antenatal maternal anxiety and children’s cognitive development. At 3 years, parental stimulation mediated 13.2% of the effect of antenatal maternal anxiety while postnatal maternal depression mediated 26.5%. Discussion The partial nature of these effects suggests that other mediators may play a role. Implications for theory and research on child development are discussed. PMID:26317609
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Mwansa-Kambafwile, Judith; Cousens, Simon; Hansen, Thomas; Lawn, Joy E
2010-04-01
In high-income countries, administration of antenatal steroids is standard care for women with anticipated preterm labour. However, although >1 million deaths due to preterm birth occur annually, antenatal steroids are not routine practice in low-income countries where most of these deaths occur. To review the evidence for and estimate the effect on cause-specific neonatal mortality of administration of antenatal steroids to women with anticipated preterm labour, with additional analysis for the effect in low- and middle-income countries. We conducted systematic reviews using standardized abstraction forms. Quality of evidence was assessed using an adapted GRADE approach. Existing meta-analyses were reviewed for relevance to low/middle-income countries, and new meta-analysis was performed. We identified 44 studies, including 18 randomised control trials (RCTs) (14 in high-income countries) in a Cochrane meta-analysis, which suggested that antenatal steroids decrease neonatal mortality among preterm infants (preterm babies currently receive little or no medical care. It is plausible that antenatal steroids may be of even greater effect when tested in these settings. Based on high-grade evidence, antenatal steroid therapy is very effective in preventing neonatal mortality and morbidity, yet remains at low coverage in low/middle-income countries. If fully scaled up, this intervention could save up to 500 000 neonatal lives annually.
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Directory of Open Access Journals (Sweden)
Jones Asafo Akowuah
2018-01-01
Full Text Available Access to quality healthcare still remains a major challenge in the efforts at reversing maternal morbidity and mortality. Despite the availability of established maternal health interventions, the health of the expectant mother and the unborn child remains poor due to low utilisation of interventions. The study examined the socioeconomic determinants of antenatal care utilisation in peri-urban Ghana using pregnant women who are in their third trimester. Two-stage sampling technique was used to sample 200 pregnant women who were in their third trimester from the District Health Information Management System software. Well-structured questionnaire was the instrument used to collect data from respondents. Descriptive statistics and inferential statistics including binary logit regression model were used to analyse the data with the help of SPSS and STATA software. The results showed varying utilisation levels of ANC. From the regression result, age, household size, and occupational status were identified as the important socioeconomic determinants of antenatal care utilisation among the respondents. The important system factors which influence antenatal care utilisation by the respondents are distance to ANC, quality of service, and service satisfaction. The study concludes that socioeconomic and health system factors are important determinants of antenatal care utilisation. Stepping up of interventions aimed at improving the socioeconomic status and addressing health system and proximity challenges could be helpful in improving antenatal care utilisation by pregnant women in Ghana.
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Nash, Meredith
2018-04-01
To examine how first-time fathers in rural Tasmania experienced father-only antenatal support/education groups. Semistructured interviews with expectant fathers were used for this study. Purposive sampling was used to recruit fathers in 2014. Participants were recruited face-to-face via email through a government health service and not-for-profit organisation that runs a state-wide fatherhood program. Several participants were recruited through a company that holds antenatal education classes for men in a pub. Data were analysed thematically. Three rural Tasmanian areas (South, Central Coast and Northern Midlands) PARTICIPANTS: Twenty-five men from three rural areas of Tasmania, ≥18 years, about to become first-time father with partner at least 20 weeks pregnant. Semistructured interviews explored men's experiences of father-only antenatal education groups. Four themes emerged from the thematic analysis: (i) motivations for attending antenatal groups; (ii) the effect of the group setting on men's experiences; (iii) masculine stereotypes in antenatal groups; and (iv) strategies to support fathers. Data show men wanted to join the groups and learn about being an involved father. They often felt uncomfortable sharing experiences in discussion-based groups. They tended to prefer information-based groups which were not premised on sharing emotions. Men offered strategies to improve father-only antenatal education groups. Tasmanian antenatal education/support programs need improvement. Providing men with multiple opportunities to connect with other fathers is critical to improving support. Groups can be improved by accounting for multiple and complex constructions of masculinity, increasing the number of sessions offered and altering the structure. © 2017 National Rural Health Alliance Inc.
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Proportion and Factors Associated with late Antenatal Care Booking ...
African Journals Online (AJOL)
AJRH Managing Editor
Booking among Pregnant Mothers in Gondar Town, North West ... of booking, perceived the right time of booking beyond 12 weeks of pregnancy, were not autonomous to use antenatal care ..... blood cell folate concentration at 10-12 weeks.
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Hildingsson, Ingegerd; Andersson, Ewa; Christensson, Kyllike
2014-06-01
A decade ago a national cohort of Swedish-speaking women were surveyed about their expectations on antenatal care. Today, antenatal care in Sweden still operates under similar circumstances while changes have occurred in society and the pregnant population. To compare expectations of antenatal care in pregnant women recruited 2009-2010 to those of pregnant women from a national cohort in 1999-2000. An additional aim was to compare antenatal expectations in women recruited to a clinical trial and subsequently received group based or standard antenatal care. A cross-sectional pre-study of 700 women recruited to a clinical trial and a historical cohort of 3061 women from a Swedish national survey. Data was collected by a questionnaire in early pregnancy for both cohorts and before the clinical trial started. In early pregnancy 79% of the women in the study sample reported a preference for the recommended number of visits, which is slightly higher than in the national cohort (70%). Continuity of the caregiver was still important with 95% vs 97% of the women rated it important to meet the same midwife at subsequent antenatal visits. The content of care rank order showed a change over time with lower expectations in health check-ups and emotional content and higher expectations in information needs, respect and partner involvement. Women approached in early pregnancy had lower expectations about medical and emotional check-ups and parent education but higher expectations regarding information, being met with respect and the involvement of the partner compared to women 10 years ago. Continuity of a midwife caregiver was still important and women seem more willing to follow the recommended number of antenatal visits. Asking women about their expectations regarding antenatal care could be a means to individualize the care. Copyright © 2014 Elsevier B.V. All rights reserved.
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Antenatal stress: An Irish case study.
LENUS (Irish Health Repository)
Carolan-Olah, Mary
2013-05-16
BACKGROUND:: stress in pregnancy is common and impacts negatively on women, infants and families. A number of factors contribute to high levels of stress in pregnancy, including financial concerns, marital discord, low support systems and low socio-economic status. OBJECTIVES:: the aim of this study was to evaluate stress anxiety levels and depressive symptoms among low risk women in an area in Ireland that was particularly impacted by the 2008 economic crisis. DESIGN:: a quantitative descriptive cross-sectional design was used. Data were collected using the Edinburgh Postnatal Depression Scale (EPDS), the Perceived Stress Scale and the State Trait Anxiety Inventory (STAI). Data was collected at a single time during the second trimester. SETTING:: this paper reports a case study of one maternity service in Ireland. Participants included low risk pregnant women who were attending the hospital clinic for routine antenatal care. RESULTS:: of 150 questionnaires distributed, 74 completed questionnaires were returned indicating a 49.3% return rate. Findings indicated high levels of stress, anxiety and depressive symptomatology among participants. There were no significant difference in mean EPDS score for different age groups (F4,69=2.48, P=0.052), living arrangements (F4,68=0.90, P=0.5) or usual occupation (F4,69=1.45, P=0.2). A score of ≥12 was taken as indicative of probable antenatal depression and 86.5% of participants responded with a score of 12 or above. PSS scores were also high and more than three quarters of respondents scored ≥15 (75.6%) and more than a third had scores ≥20 (35.1%), out of a total score of 40. There was a significant difference in mean PSS score between the different age groups (F4,69=3.60, P=0.010) but not for living arrangements or usual occupation. A STAI score of ≥39 was taken as indicative of antenatal anxiety, and 74.3% of participants responded with a score of 39 or above. There were no significant differences in mean STAI
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de Leeuw, J.|info:eu-repo/dai/nl/380590913; Eggenhuisen, J.T.|info:eu-repo/dai/nl/322850274; Cartigny, M.J.B.|info:eu-repo/dai/nl/304823716
Submarine leveed channels are sculpted by turbidity currents that are commonly highly stratified. Both the concentration and the grain size decrease upward in the flow, and this is a fundamental factor that affects the location and grain size of deposits around a channel. This study presents
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Directory of Open Access Journals (Sweden)
Sinja Alexandra Ernst
2017-01-01
Full Text Available Objective. To identify care-related and maternal risk factors for the antenatal nondetection of IUGR. Methods. In this hospital-based case-control study we compared antenatally undetected IUGR neonates (cases to detected IUGR neonates (controls. Data were collected using newborn documentation sheets and standardized personal interviews with the mothers. We calculated antenatal detection rates and used uni- and multivariable logistic regression models to assess the association of antenatal nondetection of IUGR and maternal and care-related factors. Results. A total of 161 neonates from three hospitals were included in the study. Suboptimal fetal growth was identified antenatally in n=77 pregnancies while in n=84 it was not detected antenatally (antenatal detection rate: 47.8%. Severity of IUGR, maternal complications, and a Doppler examination during the course of pregnancy were associated with IUGR detection. We did not find statistically significant differences regarding parental socioeconomic status and maternal migration background. Conclusions. In our study, about half of all pregnancies affected by suboptimal growth remained undetected. Future in-depth studies with larger study populations should further examine factors that could increase antenatal detection rates for IUGR.
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DEFF Research Database (Denmark)
Axelsen, Solveig Forberg; Brixval, Carina Sjöberg; Due, Pernille
2014-01-01
Little is known about which elements antenatal education should encompass to meet the needs of parents today. Psycho-social aspects relating to couple- and parenthood have generally not been covered in Danish antenatal education, although studies suggest that parents need this information. The aim...
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Cisplatin Therapy Does Not Worsen Renal Function in Severe Antenatal Bartter Syndrome.
Welch, Thomas R; Shaffer, David R; Feldman, Darren R
2017-01-01
A 30-year-old man with severe antenatal Bartter syndrome, diagnosed and treated in infancy, developed testicular carcinoma. Despite the known renal complications of cisplatin, this drug was used for his chemotherapy because of its superior antineoplastic effect. Nonsteroidal anti-inflammatory drug administration was continued during cisplatin therapy. Despite an increase in his oral potassium requirement, renal function was maintained following completion of chemotherapy. In spite of its significant associated nephrotoxicity, cisplatin can be used in patients with severe antenatal Bartter syndrome if required for therapy of malignancy.
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Bergström, Malin; Kieler, Helle; Waldenström, Ulla
2011-12-01
To study women's and men's satisfaction with two models of antenatal education: natural childbirth preparation with psychoprophylaxis, and standard antenatal education including preparation for childbirth and parenthood but no psychoprophylaxis. Randomised controlled multicentre trial. 15 Antenatal clinics in Sweden between January 2006 and May 2007. 1087 Nulliparous women and 1064 of their partners. Both models had four two-hour sessions during pregnancy and one session post partum. The natural model was manual-based and focused on childbirth preparation, including psychoprophylaxis. In the standard care model, the group leader was free to choose her teaching approach, with an equal amount of time allocated to preparation for childbirth and for parenthood. Women's and men's evaluation of antenatal education at three months post partum. The proportion of women and men in each model that expressed satisfaction with the education were compared using χ(2) test. More women and men in the natural groups were satisfied with the education compared with the standard care groups: women 76% versus 68% (p = 0.03) and men 73% versus 65% (p = 0.03). The figures were similar for satisfaction with the childbirth preparation component: 78% and 62% in women (p psychoprophylaxis may better meet expectant parents' expectations than standard antenatal education in Sweden. Copyright © 2010 Elsevier Ltd. All rights reserved.
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Directory of Open Access Journals (Sweden)
Mirkuzie Alemnesh H
2012-12-01
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
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Directory of Open Access Journals (Sweden)
Andrew B Ross
Full Text Available BACKGROUND: In June of 2010, an antenatal ultrasound program to perform basic screening for high-risk pregnancies was introduced at a community health care center in rural Uganda. Whether the addition of ultrasound scanning to antenatal visits at the health center would encourage or discourage potential patients was unknown. Our study sought to evaluate trends in the numbers of antenatal visits and deliveries at the clinic, pre- and post-introduction of antenatal ultrasound to determine what effect the presence of ultrasound at the clinic had on these metrics. METHODS AND FINDINGS: Records at Nawanyago clinic were reviewed to obtain the number of antenatal visits and deliveries for the 42 months preceding the introduction of ultrasound and the 23 months following. The monthly mean deliveries and antenatal visits by category (first visit through fourth return visit were compared pre- and post- ultrasound using a Kruskal-Wallis one-way ANOVA. Following the introduction of ultrasound, significant increases were seen in the number of mean monthly deliveries and antenatal visits. The mean number of monthly deliveries at the clinic increased by 17.0 (13.3-20.6, 95% CI from a pre-ultrasound average of 28.4 to a post-ultrasound monthly average of 45.4. The number of deliveries at a comparison clinic remained flat over this same time period. The monthly mean number of antenatal visits increased by 97.4 (83.3-111.5, 95% CI from a baseline monthly average of 133.5 to a post-ultrasound monthly mean of 231.0, with increases seen in all categories of antenatal visits. CONCLUSIONS: The availability of a low-cost antenatal ultrasound program may assist progress towards Millennium Development Goal 5 by encouraging women in a rural environment to come to a health care facility for skilled antenatal care and delivery assistance instead of utilizing more traditional methods.
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Acharya, Dilaram; Khanal, Vishnu; Singh, Jitendra Kumar; Adhikari, Mandira; Gautam, Salila
2015-08-12
Antenatal care has several benefits for expecting mothers and birth outcomes; yet many mothers do not utilise this service in Nepal. Mass media may play an important role in increasing the use of antenatal care and other maternal health services. However, the effect of mass media on increasing health service utilisation has remained an under studied area in Nepal. The aim of this study was to investigate the impact of mass media on the utilisation of antenatal care services in rural Nepal. A community-based cross-sectional study was conducted in Sinurjoda Village Development Committee of Dhanusha District, Nepal. A total of 205 mothers of children aged under 1 year were selected using systematic random sampling. Logistic regression was employed to examine the association between selected antenatal care services and mass media exposure after adjusting for other independent variables. A majority of mothers were exposed to mass media. Radio was accessible to most (60.0%) of the participants followed by television (43.41%). Mothers exposed to mass media were more likely to attending antenatal visits [Odds ratio (OR) 6.28; 95% CI (1.01-38.99)], taking rest and sleep during pregnancy [OR 2.65; 95% CI (1.13-6.26)], and receiving TT immunization [OR 5.12; 95% CI (1.23-21.24)] than their non-exposed counterparts. The study reported a positive influence of mass media on the utilisation of antenatal care services in Nepal. Therefore, further emphasis should be given to increase awareness of women of rural Nepal through mass media to improve utilisation of antenatal care services in Nepal.
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Directory of Open Access Journals (Sweden)
Joice Fabíola Meneguel
Full Text Available CONTEXT: Although the benefits of antenatal corticosteroids have been widely demonstrated in other countries, there are few studies among Brazilian newborn infants. OBJECTIVE: To evaluate the effectiveness of antenatal corticosteroids on the incidence of respiratory distress syndrome and intra-hospital mortality among neonates with a gestational age of less than 34 weeks. TYPE OF STUDY: Cross-sectional. SETTING: A tertiary-care hospital. PARTICIPANTS: Neonates exposed to any dose of antenatal corticosteroids for fetal maturation up to 7 days before delivery, and newborns paired by sex, birth weight, gestational age and time of birth that were not exposed to antenatal corticosteroids. The sample obtained consisted of 205 exposed newborns, 205 non-exposed and 39 newborns exposed to antenatal corticosteroids for whom it was not possible to find an unexposed pair. PROCEDURES: Analysis of maternal and newborn records. MAIN MEASUREMENTS: The primary clinical outcomes for the two groups were compared: the incidence of respiratory distress syndrome and intra-hospital mortality; as well as secondary outcomes related to neonatal morbidity. RESULTS: Antenatal corticosteroids reduced the occurrence of respiratory distress syndrome (OR: 0.33; 95% CI: 0.21-0.51 and the protective effect persisted when adjusted for weight, gestational age and the presence of asphyxia (adjusted OR: 0.27; 95% CI: 0.17-0.43. The protective effect could also be detected through the reduction in the need for and number of doses of exogenous surfactant utilized and the number of days of mechanical ventilation needed for the newborns exposed to antenatal corticosteroids. Their use also reduced the occurrence of intra-hospital deaths (OR: 0.51: 95% CI: 0.38-0.82. However, when adjusted for weight, gestational age, presence of prenatal asphyxia, respiratory distress syndrome, necrotizing enterocolitis and use of mechanical ventilation, the antenatal corticosteroids did not maintain the
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The impact of newspaper advertising on a regional antenatal health campaign.
Berry, J M
1984-01-01
In 1981 the West Midlands Health services undertook a publicity campaign aimed at helping women to understand more about keeping healthy during pregnancy and encouraging them to seek early ante-natal care. A series of full page advertisements on ante-natal care were placed in local newspapers in the Region. Set out here are the findings of two studies of the impact of the publicity campaign. The first shows how far people's knowledge of what to do during pregnancy was altered by the publicity, and the second shows what people thought of the advertisements themselves and the further information sent to them on request.
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Antenatal Magnesium Sulfate and Neurologic Outcome in Preterm Infants
Doyle, Lex W.; Crowther, Caroline A.; Middleton, Philippa; Marret, Stephane
OBJECTIVE: To systematically review rates of neurologic outcomes reported in childhood for the preterm fetus exposed to antenatal magnesium sulfate. DATA SOURCES: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, CENTRAL (The Cochrane Library 2008, Issue 3), relevant
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Socio-demographic determinants of antenatal clinic utilization in a ...
African Journals Online (AJOL)
Socio-demographic determinants of antenatal clinic utilization in a Nigerian university teaching hospital. ... CONCLUSION:Among other social factors female education improved women's ability to take decisions on reproductive matters. Poor education and low socioeconomic status not only increase women's vulnerability ...
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Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Lauemøller, Stine Glenstrup; Andersen, Stig Krøger; Due, Pernille; Koushede, Vibeke
2015-02-28
The aims of antenatal education are broad and encompass outcomes related to pregnancy, birth, and parenthood. Both form and content of antenatal education have changed over time without evidence of effects on relevant outcomes. The effect of antenatal education in groups, with participation of a small number of participants, may differ from the effect of other forms of antenatal education due to, for example, group dynamic. The objective of this systematic review is to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes. Bibliographic databases (Medline, EMBASE, CENTRAL, CINAHL, Web of Science, and PsycINFO) were searched. We included randomized and quasi-randomized trials irrespective of language, publication year, publication type, and publication status. Only trials carried out in the Western world were considered in this review. Studies were assessed for bias using the Cochrane risk of bias tool. Results are presented as structured summaries of the included trials and as forest plots. We identified 5,708 records. Of these, 17 studies met inclusion criteria. Studies varied greatly in content of the experimental and control condition. All outcomes were only reported in a single or a few trials, leading to limited or uncertain confidence in effect estimates. Given the heterogeneity in interventions and outcomes and also the high risk of bias of studies, we are unable to draw definitive conclusions as to the impact of small group antenatal education on obstetric and psycho-social outcomes. Insufficient evidence exists as to whether antenatal education in small classes is effective in regard to obstetric and psycho-social outcomes. We recommend updating this review following the emergence of well-conducted randomized controlled trials with a low risk of bias. PROSPERO CRD42013004319.
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Directory of Open Access Journals (Sweden)
Teka Senay Wolderufael
2018-05-01
Full Text Available Background: The utilization of antenatal care from a trained provider is important to monitor the pregnancy and to reduce morbidity and mortality risks for the mother and child during pregnancy and delivery. Methods: A communitybased cross-sectional study was conducted in Menit-Shasha Woreda Bench Maji zone, southwest Ethiopia. Quantitative and qualitative methods were employed for data collection. Simple random sampling technique was used to select the study localities and subjects (mothers those who gave birth in the last five years prior the survey period. Quantitative data was analyzed using SPSS for windows version 16 and qualitative data was narrated thematically and triangulated with quantitative findings. Results: A total of 639 women participated in the quantitative survey with respondent rate of 98.15%. The proportion of women who received antenatal care for their last pregnancy was only 15.5% (99. Out of this 10.3% received two to three visits. The main reasons mentioned for not attending antenatal care were lack of awareness, 490 (76.7% and absence of health problems during last pregnancy, 469 (73.4%. Multivariate analysis showed that there was significant association between antenatal care service utilization and ANC visit by health extension workers (AOR=4.042, 95%CI: 1.982, 8.244, and residential distance (AOR=4.214, 95% CI 1.025, 17.325, respectively (p<0.05. Conclusion: This study revealed low antenatal care service utilization. From those who had antenatal care service, the majority started it lately and received incomplete service. The utilization of antenatal care was influenced by home visit by health extension workers and by residential distance from health post. Thus it was recommended to strengthen home visit for improving community awareness on the importance of ANC utilization.
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Oficinas de estimulação cognitiva adaptadas para idosos analfabetos com transtorno cognitivo leve
Directory of Open Access Journals (Sweden)
Izabel Borges dos Santos
2012-12-01
Full Text Available Oficinas de estimulação cognitiva para idosos analfabetos com transtorno cognitivo leve é um tema pouco pesquisado. Objetivou-se verificar a autopercepção da memória em idosos analfabetos com transtorno cognitivo leve, antes e após oficinas de estimulação cognitiva, adaptadas para analfabetos. Trata-se de uma pesquisa qualitativa, realizada na Unidade de Saúde de Taguatinga-DF, envolvendo 63 idosos: 22 no Grupo Experimental (GE, com 10 oficinas; 21 no Grupo Controle 1 (GC1, com 10 palestras; e 20 no Grupo Controle 2 (GC2, sem intervenção. Foram realizadas entrevistas semiestruturadas antes e após intervenções, perguntando-se sobre memória. Aos GE e GC1 foram oferecidas atividades semanais de duas horas. A idade média foi 72,8 anos, 92% do sexo feminino. Na pré-intervenção, 82% haviam piorado memória no último ano. Na pós-intervenção, GC1 e GC2 mantiveram alterações da memória, enquanto GE melhorou cognição. Conclui-se que as oficinas e palestras proporcionaram melhora na funcionalidade e socialização/integração.
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Directory of Open Access Journals (Sweden)
Chun-Che Huang
2016-10-01
Conclusion: Our nationwide population-based study revealed increased risks of antenatal and perinatal complications among nurses compared with those among nonmedical working women. The large-scale observation of the increased antenatal and perinatal complications draws attention to the health issues faced by nursing personnel who represent one of the most important workforces in the healthcare system.
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Cognitive outcome in adolescents and young adults after repeat courses of antenatal corticosteroids.
Stålnacke, Johanna; Diaz Heijtz, Rochellys; Norberg, Hanna; Norman, Mikael; Smedler, Ann-Charlotte; Forssberg, Hans
2013-08-01
To investigate whether repeat courses of antenatal corticosteroids have long-term effects on cognitive and psychological functioning. In a prospective cohort study, 58 adolescents and young adults (36 males) who had been exposed to 2-9 weekly courses of betamethasone in utero were assessed with neuropsychological tests and behavior self-reports. Unexposed subjects (n = 44, 25 males) matched for age, sex, and gestational age at birth served as a comparison group. In addition, individuals exposed in utero to a single course (n = 25, 14 males) were included for dose-response analysis. Group differences were investigated using multilevel linear modeling. Mean scores obtained in 2 measures of attention and speed were significantly lower in subjects exposed to 2 or more antenatal corticosteroids courses (Symbol Search, P = .009; Digit Span Forward, P = .02), but these were not dose-dependent. Exposure to repeat courses of antenatal corticosteroids was not associated with general deficits in higher cognitive functions, self-reported attention, adaptability, or overall psychological function. Although this study indicates that repeat exposure to antenatal corticosteroids may have an impact on aspects of executive functioning, it does not provide support for the prevailing concern that such fetal exposure will have a major adverse impact on cognitive functions and psychological health later in life. Copyright © 2013 Mosby, Inc. All rights reserved.
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Garg, Bhawan Deep
2018-01-17
To evaluate whether antenatal MgSO 4 is beneficial or harmful in very preterm and extremely preterm neonates. We retrieved published literature through searches of PubMed or Medline, CINAHL, and the Cochrane Library. Results were restricted to systematic reviews, meta-analysis, randomized controlled trials (RCTs), and relevant observational studies. Evidence revealed that antenatal MgSO 4 has neuroprotective role in preterm neonates and it decreased the risk of cerebral palsy and gross motor dysfunction. Evidences regarding association of antenatal MgSO 4 with feed intolerance, NEC and SIP were from cohort studies and controversial. We should continue use antenatal MgSO 4 to all eligible patients according to protocol till the more robust evidence will suggest association with gastrointestinal complications. In the meantime, we should have a high index of suspicion of gastrointestinal complications in extremely preterms particularly <26 weeks of gestation.
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International Nuclear Information System (INIS)
Bandaralage, Sahan P.S.; Farnaghi, Soheil; Dulhunty, Joel M.; Kothari, Alka
2016-01-01
Holocarboxylase synthetase deficiency results in impaired activation of enzymes implicated in glucose, fatty acid and amino acid metabolism. Antenatal imaging and postnatal imaging are useful in making the diagnosis. Untreated holocarboxylase synthetase deficiency is fatal, while antenatal and postnatal biotin supplementation is associated with good clinical outcomes. Although biochemical assays are required for definitive diagnosis, certain radiologic features assist in the diagnosis of holocarboxylase synthetase deficiency. To review evidence regarding radiologic diagnostic features of holocarboxylase synthetase deficiency in the antenatal and postnatal period. A systematic review of all published cases of holocarboxylase synthetase deficiency identified by a search of Pubmed, Scopus and Web of Science. A total of 75 patients with holocarboxylase synthetase deficiency were identified from the systematic review, which screened 687 manuscripts. Most patients with imaging (19/22, 86%) had abnormal findings, the most common being subependymal cysts, ventriculomegaly and intraventricular hemorrhage. Although the radiologic features of subependymal cysts, ventriculomegaly, intraventricular hemorrhage and intrauterine growth restriction may be found in the setting of other pathologies, these findings should prompt consideration of holocarboxylase synthetase deficiency in at-risk children. (orig.)
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Energy Technology Data Exchange (ETDEWEB)
Bandaralage, Sahan P.S. [Gold Coast Hospital and Health Service, Southport, Queensland (Australia); Griffith University, School of Medicine, Southport, Queensland (Australia); Farnaghi, Soheil [Caboolture Hospital, Caboolture, Queensland (Australia); Dulhunty, Joel M.; Kothari, Alka [Redcliffe Hospital, Redcliffe, Queensland (Australia); The University of Queensland, School of Medicine, Herston, Queensland (Australia)
2016-03-15
Holocarboxylase synthetase deficiency results in impaired activation of enzymes implicated in glucose, fatty acid and amino acid metabolism. Antenatal imaging and postnatal imaging are useful in making the diagnosis. Untreated holocarboxylase synthetase deficiency is fatal, while antenatal and postnatal biotin supplementation is associated with good clinical outcomes. Although biochemical assays are required for definitive diagnosis, certain radiologic features assist in the diagnosis of holocarboxylase synthetase deficiency. To review evidence regarding radiologic diagnostic features of holocarboxylase synthetase deficiency in the antenatal and postnatal period. A systematic review of all published cases of holocarboxylase synthetase deficiency identified by a search of Pubmed, Scopus and Web of Science. A total of 75 patients with holocarboxylase synthetase deficiency were identified from the systematic review, which screened 687 manuscripts. Most patients with imaging (19/22, 86%) had abnormal findings, the most common being subependymal cysts, ventriculomegaly and intraventricular hemorrhage. Although the radiologic features of subependymal cysts, ventriculomegaly, intraventricular hemorrhage and intrauterine growth restriction may be found in the setting of other pathologies, these findings should prompt consideration of holocarboxylase synthetase deficiency in at-risk children. (orig.)
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Midwifery basics. Antenatal care: the options available.
Baston, Helen
2002-10-01
This new series of articles is aimed at student midwives. Its purpose is to provide them with a basic understanding of the main issues and concepts surrounding the delivery of antenatal care. Students will be encouraged to seek further information through a series of activities throughout the text. They will also be helped to link theory with practice by following 'Joanna' through her pregnancy.
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Directory of Open Access Journals (Sweden)
Mengesha Boko Geta
2017-01-01
Full Text Available Antenatal care (ANC is care given to pregnant mothers to timely identify and mitigate pregnancy related problems that can harm mother or fetus. Most of Ethiopian mothers present late for ANC. The aim of this paper was to assess determinants of early antenatal care initiation among pregnant women. Mothers attending Shebedino District Health Centers for ANC between January 12 and February 18, 2015, were invited to the study. Multistage sampling technique and structured questionnaire were used to collect data by trained data collectors. Univariate and bivariate analysis were conducted to study the association between explanatory and outcome variable. Out of 608 women, 132 [21.71%] had their first ANC within the recommended time [before or at 3 months]. Media access [AOR = 2.11 95% CI 1.00, 3.22], knowledge about the correct time of ANC booking [AOR = 4.49 95% CI 2.47, 6.16], and having been advised to book within 12 weeks [AOR = 4.14 95% CI 3.80, 5.21] were determinants of first-trimester booking. Health professionals and care providers should provide full information, advice, and appropriate care about early ANC for every eligible mother.
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Directory of Open Access Journals (Sweden)
Zeng-Liang Ruan
2018-01-01
Full Text Available Antenatal training through music and maternal talk to the unborn fetus is a topic of general interest for parents-to-be in China, but we still lack a comprehensive assessment of their effects on the development of autistic-like behaviors during early childhood. During 2014–2016, 34,749 parents of children around the age of 3 years who were enrolled at kindergarten in the Longhua district of Shenzhen participated in this study. Self-administered questionnaires regarding demographics, antenatal music training, and maternal talk to the fetus during pregnancy were completed by the children’s primary caregivers. Autistic-like behaviors were assessed using the Autism Behavioral Checklist. Tobit regression analyses revealed that antenatal music training and maternal talk to the fetus was associated with a reduction in autistic-like behaviors in children, with a dose-dependent relationship. Furthermore, factorial analysis of covariance indicated a significant interaction effect between antenatal music training and maternal talk to the fetus on the autistic-like behaviors and found that children who often experienced antenatal music training and maternal talk concurrently had the lowest risk of autistic-like behaviors, while children who were never exposed to maternal talk and only sometimes experienced antenatal music training had the highest risk. Our results suggest that antenatal training through both music and maternal talk to the unborn fetus might reduce the risk of children’s autistic-like behaviors at around 3 years of age.
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Ruan, Zeng-Liang; Liu, Li; Strodl, Esben; Fan, Li-Jun; Yin, Xiao-Na; Wen, Guo-Min; Sun, Deng-Li; Xian, Dan-Xia; Jiang, Hui; Jing, Jin; Jin, Yu; Wu, Chuan-An; Chen, Wei-Qing
2017-01-01
Antenatal training through music and maternal talk to the unborn fetus is a topic of general interest for parents-to-be in China, but we still lack a comprehensive assessment of their effects on the development of autistic-like behaviors during early childhood. During 2014-2016, 34,749 parents of children around the age of 3 years who were enrolled at kindergarten in the Longhua district of Shenzhen participated in this study. Self-administered questionnaires regarding demographics, antenatal music training, and maternal talk to the fetus during pregnancy were completed by the children's primary caregivers. Autistic-like behaviors were assessed using the Autism Behavioral Checklist. Tobit regression analyses revealed that antenatal music training and maternal talk to the fetus was associated with a reduction in autistic-like behaviors in children, with a dose-dependent relationship. Furthermore, factorial analysis of covariance indicated a significant interaction effect between antenatal music training and maternal talk to the fetus on the autistic-like behaviors and found that children who often experienced antenatal music training and maternal talk concurrently had the lowest risk of autistic-like behaviors, while children who were never exposed to maternal talk and only sometimes experienced antenatal music training had the highest risk. Our results suggest that antenatal training through both music and maternal talk to the unborn fetus might reduce the risk of children's autistic-like behaviors at around 3 years of age.
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Prevalence of malaria among pregnant women attending antenatal ...
African Journals Online (AJOL)
Malaria is a chronic parasitic disease that affects everybody but with pregnant women and children under the age of 5 years as its main target. The adverse complications of malaria in pregnancy makes it of immense public health importance. This study was designed to evaluate the prevalence of malaria among antenatal ...
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Intentions of Registered Antenatal Clinic Patients About Utilizing ...
African Journals Online (AJOL)
Background: Nigeria bears a sizeable proportion of the global HIV burden; mother to child transmission as a major contributor and prevention of mother to child transmission the hope for a HIV-free generation. Objective: To find evaluate how booked antenatal attendees intend to utilize the labour and delivery services of the ...
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practice of antenatal clinical breast examination in calabar
African Journals Online (AJOL)
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population of breast cancer patients in the country than in the west led to this study to determine the proportion of women ... UCTH is low and is significantly related to the cadre and gender of the attending physician. Obstetricians .... regular role nurses play in the antenatal clinics) ... breast and cervical cancer screening? J.
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Antenatal blood donation: Pregnant mothers' attitude, fears and ...
African Journals Online (AJOL)
Up to 150,000 pregnancy-related deaths could be avoided each year through access to safe blood. Antenatal blood donation, which will increase access to safe blood, is one of the ways to reduce maternal mortality in this environment. This study assessed the knowledge, attitude, fears and preferences of pregnant mothers ...
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Maternal antenatal depression and infant disorganized attachment at 12 months.
Hayes, Lisa J; Goodman, Sherryl H; Carlson, Elizabeth
2013-01-01
Although high rates of attachment disorganization have been observed in infants of depressed mothers, little is known about the role of antenatal depression as a precursor to infant attachment disorganization. The primary aim of this study was to examine associations between maternal antenatal depression and infant disorganization at 12 months in a sample of women (N = 79) at risk for perinatal depression. A secondary aim was to test the roles of maternal postpartum depression and maternal parenting quality as potential moderators of this predicted association. Among women with histories of major depressive episodes, maternal depressive symptoms were assessed at multiple times during pregnancy and the first year postpartum, maternal parenting quality was measured at three months postpartum, and attachment disorganization was assessed at 12 months postpartum. Results revealed that infants classified as disorganized had mothers with higher levels of depressive symptoms during pregnancy compared to infants classified as organized. Maternal parenting quality moderated this association, as exposure to higher levels of maternal depressive symptoms during pregnancy was only associated with higher rates of infant disorganized attachment when maternal parenting at three months was less optimal. These findings suggest that enhancing maternal parenting behaviors during this early period in development has the potential to alter pathways to disorganized attachment among infants exposed to antenatal maternal depressive symptoms, which could have enduring consequences for child wellbeing.
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Personalized Antenatal Consultations for Preterm Labor: Responding to Mothers' Expectations.
Gaucher, Nathalie; Nadeau, Sophie; Barbier, Alexandre; Janvier, Annie; Payot, Antoine
2016-11-01
To explore prospective mothers' perspectives regarding antenatal consultations by neonatology teams for threatened preterm delivery. In a prospective multicenter study, women at risk of preterm delivery between 26 and 32 weeks of gestational age were surveyed during the 72 hours following their antenatal consultation. The questionnaire used was developed and validated during a single-center study. Over 18 months, 229 mothers completed the survey (73% response rate), at a median gestational age of 30 weeks. Spouses/partners were present for 49% of consultations. Most women (90%) reported a positive experience. They found it important to discuss the outcomes of prematurity (96%), but 39% of them reported receiving too much information. Women wanted their spouse/partner to be present (71%) and wished to discuss parental concerns: their roles as mother of a premature baby (82%), their integration in their baby's care (83%), and a better understanding of the neonatal intensive care unit (NICU) environment, including antenatal NICU visits (69%). The majority (56%) wanted a follow-up consultation: this was less likely if a NICU visit had been offered (P parents with child-centered information. Although clinicians follow these guidelines, mothers want personalized information focusing on their individual concerns and questions, such as what they can do for their baby, how NICUs work, and the integration of their family. Copyright © 2016 Elsevier Inc. All rights reserved.
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Antenatal corticosteroid use in preterm birth at Kenyatta National ...
African Journals Online (AJOL)
Background: Preterm birth causes about 75% of neonatal deaths that are not attributable to congenital malformations. Antenatal corticosteroids (ACS) given to mothers at risk of preterm birth reduce the incidence/severity of RDS, intraventricular haemmorhage, necrotizing enterocolitis and neonatal deaths. The WHO ...
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Perceptions of pregnant adolescents on the antenatal care received ...
African Journals Online (AJOL)
2018-03-25
Mar 25, 2018 ... women because of the low self-esteem and stigma associated .... School again will help you to look young because when you give birth to three or four babies .... and older women delay seeking antenatal care14,17,18,21,26.
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Polyhydramnios, Transient Antenatal Bartter's Syndrome, and MAGED2 Mutations
Laghmani, Kamel; Beck, Bodo B.; Yang, Sung-Sen; Seaayfan, Elie; Wenzel, Andrea; Reusch, Bjorn; Vitzthum, Helga; Priem, Dario; Demaretz, Sylvie; Bergmann, Klasien; Duin, Leonie K.; Goebel, Heike; Mache, Christoph; Thiele, Holger; Bartram, Malte P.; Dombret, Carlos; Altmueller, Janine; Nuernberg, Peter; Benzing, Thomas; Levtchenko, Elena; Seyberth, Hannsjoerg W.; Klaus, Guenter; Yigit, Goekhan; Lin, Shih-Hua; Timmer, Albert; de Koning, Tom J.; Scherjon, Sicco; Schlingmann, Karl P.; Bertrand, Mathieu J. M.; Rinschen, Markus M.; de Backer, Olivier; Konrad, Martin; Koemhoff, Martin
2016-01-01
BACKGROUND Three' pregnancies with male offspring in one family were complicated by severe polyhydramnios and prematurity. One fetus died; the other two had transient massive salt-wasting and polyuria reminiscent of antenatal Bartter's syndrome. METHODS To uncover the molecular cause of this
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Medicinal Plants used during Antenatal Care by Pregnant Women in ...
African Journals Online (AJOL)
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used to manage anaemia and for child development and good health among the pregnant women. ... Keywords: Medicinal Plants, Antenatal, Traditional Birth Attendants, Uganda. Résumé ..... phenomenon, possibly due to their availability and.
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ANTENATAL CARE SERVICES STANDART COMPLIANCE OF VILLAGE MIDWIFE IN EAST JAVA PROVINCE
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Purwaningsih Purwaningsih
2017-04-01
Full Text Available Introduction: The high Maternal Mortality Rate (MMR require attention to implementing improvement programs and improving maternal health. According to data from East Java Health Offi ce AKI during 2009 were 260/100,000 live births. Indicators of maternal monitoring imple can be seen from figure K1 coverage (visit pregnant women in the first pregnancy and K4 (contact at least 4 times during pregnancy for antenatal care. Methods: This study was conducted with the observational design of the “cross-sectional”, is a study to learn the dynamics of the correlation between risk factors with effects, with the approach, observation or data collection at once at some point (time point approach. Result: Variable associated with compliance standards of village midwives in implementing the ANC in the province of East Java is the level of knowledge (p = 0.014 and the infrastructure required to ANC (p = 0.000. Other variables did not show a significant relationship such as: age (p = 0.121, status (p = 0.831, period of employment (p = 0.147, education (p = 0.153, training (p = 0.664, motivation (p = 0.525, supervision (p = 0.887, and rewards (p = 0.663. Discussion: District Health Office/City should do a refresher on antenatal care in midwife needs to be done, since there are those who have a suffi cient level of knowledge and less. Facilities and infrastructure that support the implementation of Antenatal Care (ANC should be facilitated effectively, to support midwives performance in implementing standards of care Antenatal Care.
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Lucy Burns
2011-01-01
Full Text Available Objective. This paper reports the findings comparing the obstetrical health, antenatal care, and psychosocial characteristics of pregnant women with a known history of substance dependence (n=41 and a comparison group of pregnant women attending a general antenatal clinic (n=47. Method. Face-to-face interviews were used to assess obstetrical health, antenatal care, physical and mental functioning, substance use, and exposure to violence. Results. The substance-dependent group had more difficulty accessing antenatal care and reported more obstetrical health complications during pregnancy. Women in the substance-dependent group were more likely to report not wanting to become pregnant and were less likely to report using birth control at the time of conception. Conclusions. The profile of pregnant women (in specialised antenatal care for substance dependence is one of severe disadvantage and poor health. The challenge is to develop and resource innovative and effective multisectoral systems to educate women and provide effective care for both women and infants.
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Finlayson, Kenneth; Downe, Soo
2013-01-01
Almost 50% of women in low- and middle-income countries (LMICs) don't receive adequate antenatal care. Women's views can offer important insights into this problem. Qualitative studies exploring inadequate use of antenatal services have been undertaken in a range of countries, but the findings are not easily transferable. We aimed to inform the development of future antenatal care programmes through a synthesis of findings in all relevant qualitative studies. Using a predetermined search strategy, we identified robust qualitative studies reporting on the views and experiences of women in LMICs who received inadequate antenatal care. We used meta-ethnographic techniques to generate themes and a line-of-argument synthesis. We derived policy-relevant hypotheses from the findings. We included 21 papers representing the views of more than 1,230 women from 15 countries. Three key themes were identified: "pregnancy as socially risky and physiologically healthy", "resource use and survival in conditions of extreme poverty", and "not getting it right the first time". The line-of-argument synthesis describes a dissonance between programme design and cultural contexts that may restrict access and discourage return visits. We hypothesize that centralised, risk-focused antenatal care programmes may be at odds with the resources, beliefs, and experiences of pregnant women who underuse antenatal services. Our findings suggest that there may be a misalignment between current antenatal care provision and the social and cultural context of some women in LMICs. Antenatal care provision that is theoretically and contextually at odds with local contextual beliefs and experiences is likely to be underused, especially when attendance generates increased personal risks of lost family resources or physical danger during travel, when the promised care is not delivered because of resource constraints, and when women experience covert or overt abuse in care settings.
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Directory of Open Access Journals (Sweden)
Kenneth Finlayson
Full Text Available BACKGROUND: Almost 50% of women in low- and middle-income countries (LMICs don't receive adequate antenatal care. Women's views can offer important insights into this problem. Qualitative studies exploring inadequate use of antenatal services have been undertaken in a range of countries, but the findings are not easily transferable. We aimed to inform the development of future antenatal care programmes through a synthesis of findings in all relevant qualitative studies. METHODS AND FINDINGS: Using a predetermined search strategy, we identified robust qualitative studies reporting on the views and experiences of women in LMICs who received inadequate antenatal care. We used meta-ethnographic techniques to generate themes and a line-of-argument synthesis. We derived policy-relevant hypotheses from the findings. We included 21 papers representing the views of more than 1,230 women from 15 countries. Three key themes were identified: "pregnancy as socially risky and physiologically healthy", "resource use and survival in conditions of extreme poverty", and "not getting it right the first time". The line-of-argument synthesis describes a dissonance between programme design and cultural contexts that may restrict access and discourage return visits. We hypothesize that centralised, risk-focused antenatal care programmes may be at odds with the resources, beliefs, and experiences of pregnant women who underuse antenatal services. CONCLUSIONS: Our findings suggest that there may be a misalignment between current antenatal care provision and the social and cultural context of some women in LMICs. Antenatal care provision that is theoretically and contextually at odds with local contextual beliefs and experiences is likely to be underused, especially when attendance generates increased personal risks of lost family resources or physical danger during travel, when the promised care is not delivered because of resource constraints, and when women experience
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Andreas Kuznik
2013-11-01
Full Text Available Untreated syphilis in pregnancy is associated with adverse clinical outcomes for the infant. Most syphilis infections occur in sub-Saharan Africa (SSA, where coverage of antenatal screening for syphilis is inadequate. Recently introduced point-of-care syphilis tests have high accuracy and demonstrate potential to increase coverage of antenatal screening. However, country-specific cost-effectiveness data for these tests are limited. The objective of this analysis was to evaluate the cost-effectiveness and budget impact of antenatal syphilis screening for 43 countries in SSA and estimate the impact of universal screening on stillbirths, neonatal deaths, congenital syphilis, and disability-adjusted life years (DALYs averted.The decision analytic model reflected the perspective of the national health care system and was based on the sensitivity (86% and specificity (99% reported for the immunochromatographic strip (ICS test. Clinical outcomes of infants born to syphilis-infected mothers on the end points of stillbirth, neonatal death, and congenital syphilis were obtained from published sources. Treatment was assumed to consist of three injections of benzathine penicillin. Country-specific inputs included the antenatal prevalence of syphilis, annual number of live births, proportion of women with at least one antenatal care visit, per capita gross national income, and estimated hourly nurse wages. In all 43 sub-Saharan African countries analyzed, syphilis screening is highly cost-effective, with an average cost/DALY averted of US$11 (range: US$2-US$48. Screening remains highly cost-effective even if the average prevalence falls from the current rate of 3.1% (range: 0.6%-14.0% to 0.038% (range: 0.002%-0.113%. Universal antenatal screening of pregnant women in clinics may reduce the annual number of stillbirths by up to 64,000, neonatal deaths by up to 25,000, and annual incidence of congenital syphilis by up to 32,000, and avert up to 2.6 million
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El oratorio de San Felipe Neri y la controversia sobre las comedias en la Valencia del siglo XVII
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Callado Estela, Emilio
2011-06-01
Full Text Available The present article analyzes some of the religious implications deriving from the famous controversy about the legality or illegality of theatre in the 17th century and in the city of Valencia. The question arose from an episode in which Don Luis Crespi de Borja was directly implicated. Crespi was the founder of the Oratory of Saint Philip Neri in the Valencian region and a persistent fighter against comedy. As a consequence of his position in this affair members of the Oratory were pursued by other ecclesiastical sectors favouring theatre.
El presente artículo analiza algunas de la implicaciones religiosas de la famosa controversia sobre la licitud o ilicitud del teatro, en el siglo XVII y en la ciudad de Valencia, a partir de un episodio protagonizado por don Luis Crespí de Borja, fundador del Oratorio de San Felipe Neri en tierras valencianas y consumado azote de las comedias, cuyo posicionamiento en este particular valdría a los oratorianos la persecución por parte de otros sectores eclesiásticos partidarios del arte escénico. -
The quality of risk factor screening during antenatal consultations in Niger.
Prual, A; Toure, A; Huguet, D; Laurent, Y
2000-03-01
A decade after the first International Conference on Safe Motherhood, maternal mortality remains very high in most West African countries, even in capital cities. The detection of high risk pregnancies, known as the risk approach, during antenatal consultations has been the basis of most maternal and child health programmes over the last decade. The effectiveness of antenatal care as a tool to prevent or predict obstetric complications is being questioned more and more. In addition to the scarcity of reliable data about the predictivity of most risk factors, the quality of the screening must be questioned. The goal of this study was to assess the frequency of risk factors among a sample of pregnant women attending antenatal care in Niger and to assess the quality of the screening of those risk factors. Overall, 330 pregnant women were enrolled in the study. Each woman was examined twice: the first time by a midwife, the second time by one of the authors but without knowledge of the results of the first consultation. Fifty-five percent of pregnant women had at least one risk factor, 31% had more than one. Ninety-one percent of the risk factors were detected at interview. The following risk factors were not systematically searched for by midwives: height (48.5%), blood pressure (43.6%), glycosuria (40.6%), vaginal bleeding (38.2%), oedema (37.3%), parity (17%), age (16%), previous caesarean section (15.2%), previous stillbirth (15.2%) and previous miscarriages (14.8%). This study has shown that, in Niger, the quality of screening for risk factors during antenatal consultation is poor. In the urban settings where this study took place, lack of personnel, lack of equipment, lack of time and poor compliance by women cannot be made responsible for this situation. While screening of these risk factors continues as policy, the quality of screening must be dramatically improved.
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Prematuridad extrema y uso materno de corticoides antenatal
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Ramón Acosta Díaz
2000-12-01
Full Text Available Con el objetivo de evaluar el uso de corticoides antenatal en las madres con amenaza de parto pretérmino y el efecto sobre los recién nacidos prematuros extremos, se realizó un estudio prospectivo, longitudinal, y analítico entre todos los niños nacidos vivos con edad gestacional menor de 31 semanas y peso inferior a 1 500 g, ocurridos en el Hospital Ginecoobstétrico Provincial Docente "Justo Legón Padilla" de Pinar del Río, desde enero de 1997 hasta julio de 1998. Se estudiaron los 53 niños con estas características. Los datos que se obtuvieron se depositaron en base de datos; para el procesamiento estadístico, se aplicó la prueba de chi cuadrado, con un nivel de significación de p In order to evaluate the antenatal use of adrenal cortex hormones in mothers with preterm delivery threat and its effect on extreme premature infants, it was conducted a prospective, longitudinal and analytical study among the live births with gestational age under 31 weeks and a weight lower than 1 500 g registered at "Justo Legón Padilla" Provincial Gynecoobstetric Teaching Hospital, in Pinar del Río, from January, 1997, to July, 1998. 53 children with these characteristics were studied. The collected data were entered in databases. The chi square test with a level of significance of p<0.05 was used for the statistical processing. Steroids were administered to 32 mothers. A statistically significant reduction of the hyaline membrane disease, the use of ventilation, the complications and mortality was observed with the antenatal use of maternal adrenal cortex hormones. There were no statistically significant differences between the study and the control group as regards sex, mean gestational age (29.0/28.9 weeks and weights (1207.9/1180.0 g.
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Taylor, Steve M.; Madanitsa, Mwayiwawo; Thwai, Kyaw-Lay; Khairallah, Carole; Kalilani-Phiri, Linda; van Eijk, Anna M.; Mwapasa, Victor; ter Kuile, Feiko O.; Meshnick, Steven R.
2017-01-01
Antenatal malaria screening with a rapid diagnostic test (RDT) and treatment only of women with positive RDT findings may potentially prevent low birth weight resulting from malaria. The consequences of subpatent antenatal infections below the detection limit of RDTs are incompletely understood. In
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Sallout, Bahauddin I.; Al-Hoshan, Manal S.; Attyyaa, Rehman A.; Al-Suleimat, Abdelmane A.
2008-01-01
The exact antenatal prevalence of congenital anomalies in Saudi society is unknown. Early antenatal diagnosis of congenital anomalies is crucial for early counseling, intervention and possible fetal therapy. The objective of this study was to evaluate the antenatal frequency of major congenital anomalies and malformations patterns in our hospital population and to evaluate the outcome and perinatal mortality rates for major congenital anomalies. This was a prospective study of the antenatal diagnosis of major fetal congenital anomalies conducted in the ultrasound Department of the Women's Specialized Hospital at King Fahd Medical City from for 7762 patients and 5379 babies delivered in our institution. We diagnosed 217 cases of fetal anomalies. The antenatal prevalence of congenital anomalies was 27.96 per 1000. The median maternal age at diagnosis was 27.5 years. Te median gestational age at diagnosis was 31 weeks. Genitourinary and cranial anomalies were the commonest; for 186 patients delivered in our institution, the birth prevalence was 34.57 per 1000 births. The median gestational age at delivery was 38 weeks. The perinatal mortality arte was 34.9% (65/186), including all cases of intrauterine fetal and neonatal deaths. The prevalence of major congenital anomalies in our population appears to be similar to international figures. Major congenital anomalies are a major cause of perinatal mortality. (author)
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Does antenatal care attendance prevent anemia in pregnancy at term?
African Journals Online (AJOL)
2014-10-03
: all > 0.05). Conclusion: The ... low socioeconomic class[11] and poor maternal education are some of .... significance was set at 95% confidence interval (CI). Results ... the antenatal attendees, a total of 3442 women satisfied.
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Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience
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Nwosu BO
2015-01-01
Full Text Available Betrand O Nwosu,1 George U Eleje,1 Amaka L Obi-Nwosu,2 Ita F Ahiarakwem,3 Comfort N Akujobi,4 Chukwudi C Egwuatu,4 Chukwudumebi O Onyiuke5 1Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria; 2Department of Family Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria; 3Department of Medical Microbiology, Imo State University Teaching Hospital, Orlu, Imo State, Nigeria; 4Department of Medical Microbiology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria; 5Department of Medical Microbiology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, NigeriaObjective: To determine the seroreactivity of pregnant women to syphilis in order to justify the need for routine antenatal syphilis screening.Methods: A multicenter retrospective analysis of routine antenatal venereal disease research laboratory (VDRL test results between 1 September 2010 and 31 August 2012 at three specialist care hospitals in south-east Nigeria was done. A reactive VDRL result is subjected for confirmation using Treponema pallidum hemagglutination assay test. Analysis was by Epi Info 2008 version 3.5.1 and Stata/IC version 10.Results: Adequate records were available regarding 2,156 patients and were thus reviewed. The mean age of the women was 27.4 years (±3.34, and mean gestational age was 26.4 weeks (±6.36. Only 15 cases (0.70% were seropositive to VDRL. Confirmatory T. pallidum hemagglutination assay was positive in 4 of the 15 cases, giving an overall prevalence of 0.19% and a false-positive rate of 73.3%. There was no significant difference in the prevalence of syphilis in relation to maternal age and parity (P>0.05.Conclusion: While the prevalence of syphilis is extremely low in the antenatal care population at the three specialist care hospitals in south-east Nigeria, false-positive rate is high and prevalence did not significantly vary with maternal age or
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Kaaya, S F; Mbwambo, J K; Kilonzo, G P; Van Den Borne, H; Leshabari, M T; Fawzi, M C Smith; Schaalma, H
2010-01-01
Depression during pregnancy may negatively influence social functioning, birth outcomes and postnatal mental health. A cross-sectional analysis of the baseline survey of a prospective study was undertaken with an objective of determining the prevalence and socio-demographic factors associated with depressive morbidity during pregnancy in a Tanzanian peri-urban setting. Seven hundred and eighty seven second to third trimester pregnant women were recruited at booking for antenatal care at two primary health care clinics. Prenatal structured interviews assessed socio-economic, quality of partner relationships and selected physical health measures. Depressive symptoms were measured at recruitment and three and eight months postpartum using the Kiswahili version of the Hopkins Symptom Checklist. Completed antenatal measures available for 76.2% participants, showed a 39.5% prevalence of depression. Having a previous depressive episode (OR 4.35, Ppartner (OR 1.89, Peconomic measures. In conclusion, clinically significant depressive symptoms are common in mid and late trimester antenatal clinic attendees. Interventions for early recognition of depression should target women with a history of previous depressive episodes or low satisfaction with ability to access basic needs, conflict in partner relationships and relatively earlier booking for antenatal care. Findings support a recommendation that antenatal services consider integrating screening for depression in routine antenatal care.
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Assefa, Enyew; Tadesse, Mekonnen
2017-08-01
The major causes for poor health in developing countries are inadequate access and under-use of modern health care services. The objective of this study was to identify and examine factors related to the use of antenatal care services using the 2011 Ethiopia Demographic and Health Survey data. The number of antenatal care visits during the last pregnancy by mothers aged 15 to 49 years (n = 7,737) was analyzed. More than 55% of the mothers did not use antenatal care (ANC) services, while more than 22% of the women used antenatal care services less than four times. More than half of the women (52%) who had access to health services had at least four antenatal care visits. The zero-inflated negative binomial model was found to be more appropriate for analyzing the data. Place of residence, age of mothers, woman's educational level, employment status, mass media exposure, religion, and access to health services were significantly associated with the use of antenatal care services. Accordingly, there should be progress toward a health-education program that enables more women to utilize ANC services, with the program targeting women in rural areas, uneducated women, and mothers with higher birth orders through appropriate media.
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determinants of first antenatal care visit by pregnant women
African Journals Online (AJOL)
2014-09-01
Sep 1, 2014 ... M. Turyasiima, R. Tugume, A. Openy, E. Ahairwomugisha, R. Opio, M. Ntunguka and N. Mahulo, Fifth year MBChB ... AT COMMUNITY BASED EDUCATION, RESEARCH AND SERVICE SITES IN ... health workers compared to those who initiate ... sub-Saharan Africa start antenatal care considerably.
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Routine antenatal syphilis screening in South West Nigeria - a ...
African Journals Online (AJOL)
Background: Untreated maternal syphilis is strongly associated with adverse birth outcomes, especially in women with high titre syphilis. The WHO recommends routine serological screening in pregnancy. Some workers have advised a reappraisal of this practice, having demonstrated low sero-prevalence in their antenatal ...
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Joseph Philip
2013-01-01
Full Text Available Background: Hemoglobinopathies are the most common inherited red cell disorders worldwide. Identification of these disorders is immensely important epidemiologically and for improved management protocols. Aim and Objectives: Our aim was to determine the prevalence of hemoglobinopathies in patients with microcytic hypochromic anemia and to assess the suitability of using high performance liquid chromatography (HPLC routinely for screening antenatal cases and patients with anemia. Materials and Methods: A total of 4335 cases received from Mar 2007 to Nov 2011 were studied for various hemoglobinopathies and variants on BIO RAD ′VARIANT′ analyzer. Results: Of the 4335 cases studied, 2119 were antenatal cases, 1710 patients with other disorders and 506 family studies. Of these, 688 cases displayed abnormal hemoglobin fractions on HPLC of which 140 were antenatal women. There were 455 cases of β thalassemia trait, 24 β thalassemia major, 20 thalassemia inter-media, 54 sickle cell trait, fivesickle cell disease, 21 double heterozygous β thalassemia-sickle cell trait, nineand 4 Hb D- Punjab heterozygous and homozygous respectively, three Hb D β Thalassemia trait, 20 and 37 Hb E homozygous and heterozygous respectively, three Hb E β Thalassemia trait and four cases of Hb Q India. Twenty nine adults had isolated HbF elevation. Conclusion: Our study found a high prevalence (15.8% of hemoglobinopathies amongst microcytic hypochromic anemia and antenatal cases. An accurate diagnosis helps in preventing unnecessary iron loading. Screening all antenatal cases with anemia helps in timely antenatal counseling, thus preventing the psychological trauma of bearing a transfusion dependent child for life.
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Review of antenatal-linked voluntary counseling and HIV testing in ...
African Journals Online (AJOL)
Review of antenatal-linked voluntary counseling and HIV testing in Sub-Saharan Africa: lessons and options for Ghana. ... Voluntary counselling and HIV testing has become an integral part of HIV prevention ... AJOL African Journals Online.
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Rukuni, Ruramayi; Bhattacharya, Sohinee; Murphy, Michael F; Roberts, David; Stanworth, Simon J; Knight, Marian
2016-05-01
Antenatal anemia is a major public health problem in the UK, yet there is limited high quality evidence for associated poor clinical outcomes. The objectives of this study were to estimate the incidence and clinical outcomes of antenatal anemia in a Scottish population. A retrospective cohort study of 80 422 singleton pregnancies was conducted using data from the Aberdeen Maternal and Neonatal Databank between 1995 and 2012. Antenatal anemia was defined as haemoglobin ≤ 10 g/dl during pregnancy. Incidence was calculated with 95% confidence intervals and compared over time using a chi-squared test for trend. Multivariable logistic regression was used to adjust for confounding variables. Results are presented as adjusted odds ratios with 95% confidence interval. The overall incidence of antenatal anemia was 9.3 cases/100 singleton pregnancies (95% confidence interval 9.1-9.5), decreasing from 16.9/100 to 4.1/100 singleton pregnancies between 1995 and 2012 (p Scottish population. However, given that anemia is a readily correctable risk factor for major causes of morbidity and mortality in the UK, further work is required to investigate appropriate preventive measures. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.
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Lau, Yan Kwan; Cassidy, Tali; Hacking, Damian; Brittain, Kirsty; Haricharan, Hanne Jensen; Heap, Marion
2014-01-01
Background Adequate antenatal care is important to both the health of a pregnant woman and her unborn baby. Given South Africa’s high rate of cellphone penetration, mobile health interventions have been touted as a potentially powerful means to disseminate health information. This study aimed to increase antenatal health knowledge and awareness by disseminating text messages about clinic procedures at antenatal visits, and how to be healthy during pregnancy. Methods Participants recruited wer...
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Directory of Open Access Journals (Sweden)
Federico A Silva
2011-07-01
Full Text Available En la endocarditis infecciosa aguda se describen complicaciones neurológicas entre 20% y 40% de los casos, lo cual representa un importante factor que predice morbimortalidad, secuelas y discapacidad. Esta entidad se caracteriza por un amplio espectro clínico debido a su compleja fisiopatología, que involucra entre otros, fenómenos inflamatorios, inmunes, infecciosos y embólicos. A pesar de la notable frecuencia de las complicaciones neurológicas en la endocarditis infecciosa, dadas especialmente por enfermedad cerebrovascular y neuroinfecciones, aun existen controversias acerca de algunos aspectos diagnósticos y terapéuticos, en parte por la poca evidencia disponible, las cuales se discuten a continuación, a partir de una serie de casos atendidos en la Fundación Cardiovascular de Colombia.Neurological complications of acute infective endocarditis are described in 20%-40% of cases, representing an important predictive factor of morbidity, mortality, sequels and disability. Acute endocarditis is characterized by a wide clinical spectrum due to its complex physiopathology that involves inflammatory, immune, infectious and embolic phenomena. Despite the remarkable frequency of neurological complications in the infective endocarditis especially by cerebrovascular disease and neuroinfections, there are still some controversies about some diagnostic and therapeutic aspects, partly because of the little evidence available. This paper describes a number of cases seen in the Fundación Cardiovascular de Colombia and discusses some aspects related with the diagnosis and treatment of the neurological complications of acute endocarditis.
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Mothers' Antenatal Depression and Their Children's Antisocial Outcomes
Hay, Dale F.; Pawlby, Susan; Waters, Cerith S.; Perra, Oliver; Sharp, Deborah
2010-01-01
Interviews of 120 British adolescents and their parents (80% of a random sample of antenatal patients drawn from a representative urban population and followed longitudinally) revealed that 40 (33%) had been arrested and/or had a diagnosis of "DSM-IV" conduct disorder by 16 years of age; of those, 18 (45%) had committed violent acts.…
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Variables influencing delay in antenatal clinic attendance among ...
African Journals Online (AJOL)
Although antenatal care is provided at different levels, Lesotho still has a ... This shortage of health care personnel and the impact of HIV/Aids result in ... of early attendance, denial of the pregnancy by the boyfriend, the fact that sex outside of ..... “My parents were still negotiating with ... want him to pay for the damage he did.
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Skilled antenatal care service utilization and its association with the ...
African Journals Online (AJOL)
Data were entered into EPI info version 7 statistical software and exported to STATA ... Conclusions: Skilled ANC service utilization is the joint effect of individual and ... analysis, skilled antenatal care service, women's health development team ...
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Directory of Open Access Journals (Sweden)
Mohd Azahadi Bin Omar
2017-08-01
Full Text Available Objective: The aim of the study is to determine the prevalence of gestational diabetes mellitus (GDM, its associated risk factors, foeto-maternal outcomes and prevalence of postnatal diabetes mellitus (DM. Methods: This is a cross-sectional study using retrospective data from existing antenatal records of new antenatal women who registered at 72 public health clinics in Selangor in January 2014. Results: A total of 745 antenatal records were reviewed. The prevalence of GDM women was 27.9% (n = 184. GDM risks were higher in women aged 35 years old and above and in those with maternal obesity. GDM women had a higher risk of having a non-spontaneous vaginal delivery compared to non-GDM women. The prevalence of postnatal DM among GDM mother was 12.1%. Working GDM mothers were at higher risk of developing postnatal DM. Conclusion: The prevalence of GDM among newly registered women attending antenatal public health care in Selangor was higher than previous studies. Health care personnel need to be vigilant in screening women with risk factors.
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Determinants of condom use among antenatal clinic attendees in ...
African Journals Online (AJOL)
Conclusion: The reported prevalence of ever use of a condom amongst antenatal clinic attendees is low and inconsistent especially among HIV positive women. Deliberate effort should be used to ensure condom access, availability and correct and consistent use of condoms by women in all sexual acts.
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perception and satisfaction with quality of antenatal care services ...
African Journals Online (AJOL)
of this new focus, measurement of customer satisfaction has become equally important in assessing ... Objectives: This study evaluated clients' perception of antenatal care quality at the University College Hospital (UCH), ..... National Health Insurance Scheme (NHIS), waivers for staff of the UCH and for People Living with.
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DEFF Research Database (Denmark)
Mola, Gylli; Wenger, Therese Ramstad; Salomonsson, Petra
2017-01-01
AIM: We investigated the consequences of applying different imaging guidelines for urological anomalies after first pyelonephritis in children with normal routine antenatal ultrasounds. METHODS: The cohort comprised 472 children treated for their first culture-positive pyelonephritis and investig......AIM: We investigated the consequences of applying different imaging guidelines for urological anomalies after first pyelonephritis in children with normal routine antenatal ultrasounds. METHODS: The cohort comprised 472 children treated for their first culture-positive pyelonephritis...... identified all patients initially treated with surgery and avoided 65 scintigraphies. CONCLUSION: Dilated VUR was the dominant anomaly in a cohort with first time pyelonephritis and normal antenatal ultrasound. The optimal imaging strategy after pyelonephritis must be identified....
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Factors Affecting Antenatal Corticosteroid Administration from the Obstetricians’ Viewpoint
Directory of Open Access Journals (Sweden)
Emel Kurtoğlu
2016-02-01
Full Text Available OBJECTIVE: We aimed to investigate the factors affecting antenatal corticosteroid administration from the obstetricians’ viewpoint. STUDY DESIGN: The pregnant women who delivered between 24 and 34 weeks of gestation were divided into two groups: Group 1, pregnant patients given corticosteroid therapy; Group 2, pregnant patients who were not given corticosteroid therapy. The indications for delivery, gestational week at administration, dosing, residence and manner of transfer of the patients to the tertiary center, and the interval between admission to hospital and delivery were evaluated. RESULTS: The percentage of patients who received antenatal corticosteroid treatment was 68.4%, whereas 31.6% of the pregnant women didn’t receive corticosteroid therapy. The most common indications for preterm delivery were preterm labor and severe preeclampsia. The interval between admission to hospital and delivery was significantly higher in group 1. CONCLUSION: Even though obstetricians are aware of the importance of corticosteroid treatment in preterm deliveries, indications for impending delivery can affect administration of the therapy.
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Tzelepis, Flora; Daly, Justine; Dowe, Sarah; Bourke, Alex; Gillham, Karen; Freund, Megan
2017-05-01
Tobacco use during pregnancy is substantially higher among Aboriginal women compared to non-Aboriginal women in Australia. However, no studies have investigated the amount or type of smoking cessation care that staff from Aboriginal antenatal and postnatal services provide to clients who smoke or staff confidence to do so. This study examined Aboriginal antenatal and postnatal staff confidence, perceived role and delivery of smoking cessation care to Aboriginal women and characteristics associated with provision of such care. Staff from 11 Aboriginal Maternal and Infant Health Services and eight Aboriginal Child and Family Health services in the Hunter New England Local Health District in Australia completed a cross-sectional self-reported survey (n = 67, response rate = 97.1%). Most staff reported they assessed clients' smoking status most or all of the time (92.2%). However, only a minority reported they offered a quitline referral (42.2%), provided follow-up support (28.6%) or provided nicotine replacement therapy (4.7%) to most or all clients who smoked. Few staff felt confident in motivating clients to quit smoking (19.7%) and advising clients about using nicotine replacement therapy (15.6%). Staff confident with talking to clients about how smoking affected their health had significantly higher odds of offering a quitline referral [OR = 4.9 (1.7-14.5)] and quitting assistance [OR = 3.9 (1.3-11.6)] to clients who smoke. Antenatal and postnatal staff delivery of smoking cessation care to pregnant Aboriginal women or mothers with young Aboriginal children could be improved. Programs that support Aboriginal antenatal and postnatal providers to deliver smoking cessation care to clients are needed. Aboriginal antenatal and postnatal service staff have multiple opportunities to assist Aboriginal women to quit smoking during pregnancy and postpartum. However, staff confidence and practices of offering various forms of smoking cessation support to pregnant Aboriginal
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Revised guidelines on management of antenatal hydronephrosis
Sinha, A.; Bagga, A.; Krishna, A; Bajpai, M.; Srinivas, M.; Uppal, R.; Agarwal, I.
2013-01-01
Widespread antenatal screening has resulted in increased detection of anomalies of the kidneys and urinary tract. The present guidelines update the recommendations published in 2000. Antenatal hydronephrosis (ANH) is transient and resolves by the third trimester in almost one-half cases. The presence of oligohydramnios and additional renal or extrarenal anomalies suggests significant pathology. All patients with ANH should undergo postnatal ultrasonography; the intensity of subsequent evaluation depends on anteroposterior diameter (APD) of the renal pelvis and/or Society for Fetal Urology (SFU) grading. Patients with postnatal APD exceeding 10 mm and/or SFU grade 3-4 should be screened for upper or lower urinary tract obstruction and vesicoureteric reflux (VUR). Infants with VUR should receive antibiotic prophylaxis through the first year of life, and their parents counseled regarding the risk of urinary tract infections. The management of patients with pelviureteric junction or vesicoureteric junction obstruction depends on clinical features and results of sequential ultrasonography and radionuclide renography. Surgery is considered in patients with increasing renal pelvic APD and/or an obstructed renogram with differential renal function <35-40% or its subsequent decline. Further studies are necessary to clarify the role of prenatal intervention, frequency of follow-up investigations and indications for surgery in these patients. PMID:23716913
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Utilization of pay-in antenatal leave among working women in Southern California.
Guendelman, Sylvia; Pearl, Michelle; Graham, Steve; Angulo, Veronica; Kharrazi, Martin
2006-01-01
Examine antenatal leave arrangements among pregnant workers in California, and the occupational, demographic and well-being characteristics associated with leave taking. Unlike most states, California provides paid pregnancy leave up to 4 weeks antenatally and 6-8 weeks postnatally. Weighted data from postpartum telephone interviews conducted between July 2002 and November 2003 were analyzed for 1214 women participating in a case-control study of birth outcomes in Southern California. Eligible women worked at least 20 h/week during the first two trimesters of pregnancy or through the date of prenatal screening. The overall response rate was 73%. Fifty-two percent of women took no leave, 32% took antenatal leave expecting to return to their job or employer sometime after giving birth, and 9% quit their jobs during pregnancy. For leave-takers with paid leave (69%), the state was the main source of pay (74%). Medical problems (52%) rather than maternity leave benefits (25%) were the most common stated reasons for taking leave. The strongest predictors of leave taking versus working through pregnancy were feeling stressed and tired (adjusted OR = 4.3, 95% CI [2.2-8.2]) and having young children (adjusted OR = 2.1, 95% CI [1.2-3.7]), followed by occupational factors (night shift, unfulfilling and inflexible work, short work tenure). Lack of employer-offered maternity leave benefits was associated with increased quitting relative to both leave taking and working through pregnancy. Maternity benefits influence quitting, but alone do not determine antenatal leave taking. Working pregnant women in California utilize leave cautiously and predominantly to cope with health problems, work dissatisfaction and fatigue.
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Feasibility of a Smartphone website to support antenatal Perineal massage in pregnant women.
Takeuchi, Shoko; Horiuchi, Shigeko
2017-10-16
In Japan, 85% of pregnant women do not practice antenatal perineal massage. Therefore, we developed a smartphone website to support the practice of antenatal perineal massage. The purpose of the present study was to evaluate the feasibility of our smartphone website. Pregnant women were recruited at five hospitals or clinics in Tokyo, Japan. Participants assigned to the smartphone website group (n = 74) were asked to register on the smartphone website. After completing registration, they could login and use all the contents of the website. After giving birth, participants completed a 5-item questionnaire evaluating the acceptability of the smartphone website. Participants assigned to the leaflet group (n = 71) received a leaflet on antenatal perineal massage and completed a similar 4-item questionnaire evaluating the leaflet. Data were collected from April 2014 to November 2014. Data analysis was performed using chi-square and t-tests to analyze responses to close-ended questions, and content analysis was conducted to analyze responses of open-ended questions. In the smartphone website group, 9 women (12.2%) did not register on the smartphone website. Approximately 80% of the women who responded indicated that the smartphone site was easy to understand and useful for practicing antenatal perineal massage. In the smartphone website group, the reply rate for reporting the frequency of massage was 43.6%. Although the ratings and frequency at which the material was accessed tended to be higher in the smartphone website group than in the leaflet group, there were no significant differences. Most pregnant women in the smartphone website group provided a favorable evaluation for the smartphone website. However, some participants had suggestions for improvement, which need to be incorporated in a revised version of the website. Therefore, the present study's results demonstrate the feasibility of a smartphone website to support the practice of antenatal perineal
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Factors Influencing Antenatal Care Service Utilization in Hadiya Zone
African Journals Online (AJOL)
Therefore, the objective of this study was to explore factors influencing antenatal care services utilization in Southern Ethiopia. METHODS: A community-based cross sectional study was conducted in Hadiya Zone of Southern Ethiopia from January to February 2009. A multi stage sampling technique was used to select the ...
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Quality of Antenatal care services in eastern Uganda: implications ...
African Journals Online (AJOL)
Good quality Antenatal Care (ANC) provides opportunity to detect and respond to risky maternal conditions. This study assessed quality of ANC services in eastern Uganda with a goal of benchmarking implications for interventions. Methods Data was collected from 15 health facilities in Eastern Uganda to establish capacity ...
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Taylor, Steve M; Madanitsa, Mwayiwawo; Thwai, Kyaw-Lay; Khairallah, Carole; Kalilani-Phiri, Linda; van Eijk, Anna M; Mwapasa, Victor; Ter Kuile, Feiko O; Meshnick, Steven R
2017-08-01
Antenatal malaria screening with a rapid diagnostic test (RDT) and treatment only of women with positive RDT findings may potentially prevent low birth weight resulting from malaria. The consequences of subpatent antenatal infections below the detection limit of RDTs are incompletely understood. In Malawi, pregnant women of any gravidity status were tested at each antenatal visit for Plasmodium falciparum, using an RDT and polymerase chain reaction analysis, and were followed until delivery. Associations between antenatal infections and delivery outcomes were assessed with Poisson regression or analysis of variance. Compared with women with no detected antenatal P. falciparum infection, women with positive RDT findings delivered babies with a lower mean birth weight (2960 vs 2867 g; mean difference, -93 g [95% confidence interval {CI}, -27 to -159]; P = .006); this was not observed among women with only subpatent infections (mean birth weight, 3013 g; mean difference, 54 [95% CI, -33-140]; P = .2268). These differences were apparent early in pregnancy, during the second trimester: compared with uninfected women, women with positive RDT findings delivered babies with a lower mean birth weight (mean difference, -94 g [95% CI, -31 to -156]; P = .003), but women with subpatent infections did not (mean difference, 36 g [95% CI, -49-122]; P = .409). Subpatent antenatal P. falciparum infections were not associated with adverse delivery outcomes. The association of patent infections at enrollment with low birth weight suggests the importance of preventing P. falciparum infection early in pregnancy. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
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Tesfaye, Gezahegn; Loxton, Deborah; Chojenta, Catherine; Semahegn, Agumasie; Smith, Roger
2017-11-15
Antenatal care uptake is among the key indicators for monitoring the progress of maternal outcomes. Early initiation of antenatal care facilitates the timely management and treatment of pregnancy complications to reduce maternal deaths. In Ethiopia, antenatal care utilization is generally low, and delayed initiation of care is very common. We aimed to systematically identify and synthesize available evidence on delayed initiation of antenatal care and the associated factors in Ethiopia. Studies published in English from 1 January 2002 to 30 April 2017 were systematically searched from PubMed, Medline, EMBASE, CINAHL and other relevant sources. Two authors independently reviewed the identified studies against the eligibility criteria. The included studies were critically appraised using the Joanna Briggs-MAStARI instrument for observational studies. Meta-analysis was conducted in RevMan v5.3 for Windows using a Mantel-Haenszel random effects model. The presence of statistical heterogeneity was checked using the Cochran Q test, and its level was quantified using the I 2 statistics. Pooled estimate of the proportion of the outcome variable was calculated. Pooled Odd Ratios with 95% CI were calculated to measure the effect sizes. The pooled magnitude of delayed antenatal care in Ethiopia was 64% (95% CI: 57%, 70%). Maternal age (OR = 0.70; 95% CI: 0.53, 0.93), place of residence (OR = 0.29, 95% CI: 0.16, 0.50), maternal education (OR = 0.49; 95% CI: 0.38, 0.63), husband's education (OR = 0.44; 95% CI: 0.23, 0.85), maternal occupation (OR = 0.75; 95% CI: 0.61, 0.93), monthly income (OR = 2.06; 95% CI: 1.23, 3.45), pregnancy intention (OR = 0.49; 95% CI: 0.40, 0.60), parity (OR = 0.46; 95% CI: 0.36, 0.58), knowledge of antenatal care (OR = 0.40; 95% CI: 0.32, 0.51), women's autonomy (OR = 0.38; 95% CI: 0.15, 0.94), partner involvement (OR = 0.24; 95% CI: 0.07, 0.75), pregnancy complications (OR = 0.23; 95% CI: 0.06, 0
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Clinical application of antenatal genetic diagnosis of osteogenesis imperfecta type IV.
Yuan, Jing; Li, Song; Xu, YeYe; Cong, Lin
2015-04-02
Clinical analysis and genetic testing of a family with osteogenesis imperfecta type IV were conducted, aiming to discuss antenatal genetic diagnosis of osteogenesis imperfecta type IV. Preliminary genotyping was performed based on clinical characteristics of the family members and then high-throughput sequencing was applied to rapidly and accurately detect the changes in candidate genes. Genetic testing of the III5 fetus and other family members revealed missense mutation in c.2746G>A, pGly916Arg in COL1A2 gene coding region and missense and synonymous mutation in COL1A1 gene coding region. Application of antenatal genetic diagnosis provides fast and accurate genetic counseling and eugenics suggestions for patients with osteogenesis imperfecta type IV and their families.
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Directory of Open Access Journals (Sweden)
Ítala P. Silveira
2004-01-01
Full Text Available Os autores relatam o caso de uma paciente do sexo feminino, 65 anos de idade, internada com anemia de longa evolução que se associou posteriormente a uma glomerulopatia manifestada por proteinúria, cilindrúria e perda de função renal. As cadeias leves no plasma e na urina estavam elevadas, sobretudo a fração kappa e uma biópsia renal estudada por imunofluorescência e microscopia eletrônica confirmou o diagnóstico de Doença de Depósito das Cadeias Leves. A nefropatia de cadeia leve ocorre pela superprodução de cadeia leve de imunoglobulina produzida por linfócitos B com deposição nas membranas tubulares e no glomérulo.The authors present a case of a 65-year-old female patient, with chronic anemia associated with glomerulopathy manifested as proteinuria, cylindruria and renal failure. There were high serum and urinary levels of light chains and the diagnosis was performed by renal biopsy, examined using immunofluorescence and by electron microscopy that showed light chain paraproteins. Nephropathy of light-chain deposition disease occurs due to an over-production of light chains from immunoglobulins produced by B lymphocytes with a deposit in tubular and glomerular membranes.
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Antenatal care strengthening in Jimma, Ethiopia
DEFF Research Database (Denmark)
Villadsen, Sarah Fredsted; Tersbøl, Britt Pinkowski; Negussie, Dereje
2014-01-01
Objective. We assessed how health system priorities matched user expectations and what the needs for antenatal care (ANC) strengthening were for improved maternal health in Jimma, Ethiopia. Methods. A questionnaire survey among all recent mothers in the study area was conducted to study the content...... was given high priority, and that contributed to a lack of continuity and privacy. To the women, poor user-provider interaction was a serious concern hindering the trust in the health care providers. Further, the care provision was compromised by the inadequate laboratory facilities, unstructured health...
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Antenatal clinical pelvimetry in primigravidae and outcome of labour ...
African Journals Online (AJOL)
Method: A retrospective study of clinical pelvimetry and outcome of labour in primigravidae. Results: The total number of primigravidae included in the study was 268 and of these, 74 were adjudged to have adequate pelvis at antenatal clinical pelvimetry. The APGAR scores at one and five minutes were significantly higher ...
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Antenatal mood and fetal attachment after assisted conception.
Fisher, Jane R W; Hammarberg, Karin; Baker, Gordon H W
2008-05-01
Australian women conceiving with ART are at fourfold risk of admission to early parenting treatment programs compared with those conceiving spontaneously. This study aimed to identify prevalence and determinants of antenatal mood disturbance and other risks for early parenting difficulties after assisted conception. A prospective longitudinal investigation from conception to 18 months postpartum using telephone interviews and self-report questionnaires. Melbourne IVF and Royal Women's Hospital Reproductive Services, Victoria, Australia. A consecutive cohort of English-speaking women with ultrasound-confirmed ART-conceived pregnancies. Standardized psychometric measures of mood, quality of marital relationship, mother-to-fetus emotional attachment, and personality. None. Of the 288 women with confirmed pregnancies, 239 were contactable, and 183 (77%) were recruited, 95% of whom completed both early and late pregnancy assessments. Participants were socioeconomically advantaged, had very good pregnancy health, exceptional marital relationships, normal personality styles, and intense affectionate attachment to the fetus. Very few (<5%) had clinically significant mood disturbance in late pregnancy. There were low rates of antenatal mood disturbance and other risk factors for postpartum depression. Pregnancy and motherhood might be idealized after ART conception, and preparation for the realities of infant care might then be insufficient.
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Danasekaran, Raja; Raja, Pavithra; Ranganathan, Karnaboopathy
2017-01-01
Considering the global and national level commitments in improving the maternal health as well as reducing the maternal mortality, assessment of factors influencing the delivery of antenatal healthcare services becomes essential. The aim is to assess the utilization of antenatal health services and to identify the factors influencing their utilization among women of fishermen population in Kanchipuram district, Tamil Nadu. The cross-sectional study was carried out among the mothers in Kovalam area of Kanchipuram district. Details were collected using a pretested questionnaire and analyzed using statistical software. The study included 284 mothers, of which 35% were illiterates. Nearly 60.21% have got registered with the Government sector, 59.51% of the mothers had three or more antenatal visits, 64.08% have received two doses of tetanus toxoid, and 73.24% have taken iron and folic acid tablets. Factors which were identified to have statistically significant association with better utilization of antenatal health services were age >30 years, higher educational status, skilled workers, those having their first child, and higher socioeconomic class. This study has reported the fact that antenatal healthcare services were not utilized fully by the community and the fishermen population being a special group has to be given the needed attention from the healthcare delivery system.
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Clients satisfaction of antenatal care services in public and private ...
African Journals Online (AJOL)
Background: Antenatal care involves screening for health and socioeconomic conditions likely to increase the possibility of specific adverse pregnancy outcomes, providing therapeutic interventions known to be effective and educating pregnant women about planning for safe birth. Quality and customer service have been ...
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Awareness and desirability of the Nigerian antenatal women about ...
African Journals Online (AJOL)
Results:Of the 650 subjects, 249(38.3%)were aware of analgesia use in labour and their sources of information were through media (30.9%), antenatal counselling (22.9%), friends/relations (17.3%), internet (5.6%) and others – literature/lectures/ symposium (22.9%). The only factor that influence awareness on logistic ...
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Wang, Hang; Li, Qinggang; Liu, Juan; Mendelsohn, Cathy; Salant, David J.; Lu, Weining
2011-01-01
Antenatal hydronephrosis and vesicoureteral reflux (VUR) are common renal tract birth defects. We recently showed that disruption of the Robo2 gene is associated with VUR in humans and antenatal hydronephrosis in knockout mice. However, the natural history, causal relationship and developmental origins of these clinical conditions remain largely unclear. Although the hydronephrosis phenotype in Robo2 knockout mice has been attributed to the coexistence of ureteral reflux and obstruction in the same mice, this hypothesis has not been tested experimentally. Here we used noninvasive high-resolution micro-ultrasonography and pathological analysis to follow the progression of antenatal hydronephrosis in individual Robo2-deficient mice from embryo to adulthood. We found that hydronephrosis progressed continuously after birth with no spontaneous resolution. With the use of a microbubble ultrasound contrast agent and ultrasound-guided percutaneous aspiration, we demonstrated that antenatal hydronephrosis in Robo2-deficient mice is caused by high-grade VUR resulting from a dilated and incompetent ureterovesical junction rather than ureteral obstruction. We further documented Robo2 expression around the developing ureterovesical junction and identified early dilatation of ureteral orifice structures as a potential fetal origin of antenatal hydronephrosis and VUR. Our results thus demonstrate that Robo2 is crucial for the formation of a normal ureteral orifice and for the maintenance of an effective anti-reflux mechanism. This study also establishes a reproducible genetic mouse model of progressive antenatal hydronephrosis and primary high-grade VUR. PMID:21949750
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Lethal Congenital Malformations in Fetuses-Antenatal Ultrasound or Perinatal Autopsy.
Grover, Sumit; Garg, Bhavna; Sood, Neena; Arora, Kamaldeep
2017-06-01
Congenital malformations (CMF) are major causes of fetal demise which can be detected antenatally by Ultrasonography (USG). We studied 100 perinatal autopsies for CMF. Sensitivity of USG was determined and accuracy of USG with that of autopsy was compared. At Autopsy 134 individual CMF were seen in 40 cases. The sensitivity of USG in detecting major CMF was 54.47%. A complete agreement between autopsy and USG findings was seen in 13/40 (32.5%) and partial agreement in 17/40 (42.5%) fetuses while autopsy completely changed antenatal diagnosis in 10/40 (25%) fetuses. Major findings were added in all 17 fetuses with partial agreement. In 2 cases, CMF suspected on USG were not detected on autopsy due to fetal maceration. Autopsy significantly adds to the prenatal USG diagnosis and may help in predicting the probability of recurrence, and thus counseling the affected couple to prevent any such future event.
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Tran, Thach Duc; Biggs, Beverley-Ann; Tran, Tuan; Simpson, Julie Anne; Hanieh, Sarah; Dwyer, Terence; Fisher, Jane
2013-01-01
The aim of this study was to examine the effects of antenatal exposure to iron deficiency anemia (IDA) and common mental disorders (CMD) on cognitive development of 6 months old infants in a developing country. A prospective population-based study in a rural province in Vietnam, which enrolled pregnant women at 12-20 weeks gestation and followed them up with their infants until six months postpartum. Criteria for IDA were Hb cognitive development was assessed by Bayley Scales of Infant and Toddler Development, 3rd Ed. Path analyses were performed to determine the direct and indirect, partly or fully mediated, causal effects of the antenatal exposures. A total of 497 pregnant women were recruited, of those 378 women provided complete data which were included in the analyses. Statistically significant direct adverse effects of persistent antenatal IDA (estimated difference of -11.62 points; 95% CI -23.01 to -0.22) and antenatal CMD (-4.80 points; 95% CI: -9.40 to -0.20) on infant Bayley cognitive scores at six months were found. Higher birthweight, household wealth, and self-rated sufficient supply of breastmilk were associated with higher cognitive scores. Maternal age >30 years and primiparity had an indirect adverse effect on infants' Bayley cognitive scores. These findings suggest that antenatal IDA and CMD both have adverse effects on child cognitive development, which if unrecognized and unaddressed are likely to be lasting. It is crucial that both these risks are considered by policy makers, clinicians, and researchers seeking to improve child cognitive function in developing countries.
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Sidhu, Meena; Bala, Renu; Akhtar, Naveen; Sawhney, Vijay
2015-01-01
Screening and detection of clinically significant antibodies among antenatal women plays an important role in transfusion safety and preventing hemolytic disease of fetus and newborn. Routine screening of antenatal women for antibodies is not done in all blood centres of our country and so immunization rates are not known in pregnant women. We studied the prevalence of alloantibodies and titration of Anti D among antenatal multiparous women in Jammu region. In present prospective study, 750 a...
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DEFF Research Database (Denmark)
Kristensen, F B; Andersen, K V; Andersen, A M
1995-01-01
To analyse physical examinations and laboratory tests reported in antenatal care visits in relation to official guidelines and reviews of appropriateness.......To analyse physical examinations and laboratory tests reported in antenatal care visits in relation to official guidelines and reviews of appropriateness....
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Antenatal Health Care Service Utilization in Slum Areas of Pokhara Sub-Metropolitan City, Nepal.
Sharma, D; Pokharel, H P; Budhathoki, S S; Yadav, B K; Pokharel, R K
2016-01-01
Half a million women die every year due to pregnancy and childbirth in the world. Among these death, 99% occur in the low and middle income countries. Antenatal care (ANC) provides an opportunity to deliver different services which are important in improving maternal survival. A descriptive cross sectional study was conducted from September 2012 - February 2013 among 400 married women of reproductive age group. A pre-tested structured questionnaire were used and data were analyzed using Statistical Package for Social Science(SPSS) for windows version 18.0. Frequency, crude and adjusted odds ratios and confidence intervals were performed. Nearly 27% had four or more antenatal health care utilization(ANC) visits on appropriate time according to schedule of World Health Organization(WHO). In logistic regression, ANC users were found to be more/less likely to be in age group 20 - 35 years (AOR =2.825, 95% CI: 1.166-6.843), education of spouse (AOR 0.361, 95% CI : 0.130-1.000), occupation of spouse (AOR = 0.261, 95% CI: 0.093 -0.739), monthly income of family > 20,000Nrs (AOR = 2.190, 95% CI: 1.041-4.606), planned pregnancy (AOR = 2.417, 95% CI: 1.047 -5.609), death of child (AOR = 3.153, 95% CI: 1.112 -8.944). This study demonstrated low antenatal care service utilization. Hence, there is a need to increase the availability and accessibility of antenatal care to all women.
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Althabe, Fernando; Belizán, José M; Mazzoni, Agustina; Berrueta, Mabel; Hemingway-Foday, Jay; Koso-Thomas, Marion; McClure, Elizabeth; Chomba, Elwyn; Garces, Ana; Goudar, Shivaprasad; Kodkany, Bhalchandra; Saleem, Sarah; Pasha, Omrana; Patel, Archana; Esamai, Fabian; Carlo, Waldemar A; Krebs, Nancy F; Derman, Richard J; Goldenberg, Robert L; Hibberd, Patricia; Liechty, Edward A; Wright, Linda L; Bergel, Eduardo F; Jobe, Alan H; Buekens, Pierre
2012-09-19
Preterm birth is a major cause of neonatal mortality, responsible for 28% of neonatal deaths overall. The administration of antenatal corticosteroids to women at high risk of preterm birth is a powerful perinatal intervention to reduce neonatal mortality in resource rich environments. The effect of antenatal steroids to reduce mortality and morbidity among preterm infants in hospital settings in developed countries with high utilization is well established, yet they are not routinely used in developing countries. The impact of increasing antenatal steroid use in hospital or community settings with low utilization rates and high infant mortality among premature infants due to lack of specialized services has not been well researched. There is currently no clear evidence about the safety of antenatal corticosteroid use for community-level births. We hypothesize that a multi country, two-arm, parallel cluster randomized controlled trial to evaluate whether a multifaceted intervention to increase the use of antenatal corticosteroids, including components to improve the identification of pregnancies at high risk of preterm birth and providing and facilitating the appropriate use of steroids, will reduce neonatal mortality at 28 days of life in preterm newborns, compared with the standard delivery of care in selected populations of six countries. 102 clusters in Argentina, Guatemala, Kenya, India, Pakistan, and Zambia will be randomized, and around 60,000 women and newborns will be enrolled. Kits containing vials of dexamethasone, syringes, gloves, and instructions for administration will be distributed. Improving the identification of women at high risk of preterm birth will be done by (1) diffusing recommendations for antenatal corticosteroids use to health providers, (2) training health providers on identification of women at high risk of preterm birth, (3) providing reminders to health providers on the use of the kits, and (4) using a color-coded tape to measure
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Directory of Open Access Journals (Sweden)
Althabe Fernando
2012-09-01
Full Text Available Abstract Background Preterm birth is a major cause of neonatal mortality, responsible for 28% of neonatal deaths overall. The administration of antenatal corticosteroids to women at high risk of preterm birth is a powerful perinatal intervention to reduce neonatal mortality in resource rich environments. The effect of antenatal steroids to reduce mortality and morbidity among preterm infants in hospital settings in developed countries with high utilization is well established, yet they are not routinely used in developing countries. The impact of increasing antenatal steroid use in hospital or community settings with low utilization rates and high infant mortality among premature infants due to lack of specialized services has not been well researched. There is currently no clear evidence about the safety of antenatal corticosteroid use for community-level births. Methods We hypothesize that a multi country, two-arm, parallel cluster randomized controlled trial to evaluate whether a multifaceted intervention to increase the use of antenatal corticosteroids, including components to improve the identification of pregnancies at high risk of preterm birth and providing and facilitating the appropriate use of steroids, will reduce neonatal mortality at 28 days of life in preterm newborns, compared with the standard delivery of care in selected populations of six countries. 102 clusters in Argentina, Guatemala, Kenya, India, Pakistan, and Zambia will be randomized, and around 60,000 women and newborns will be enrolled. Kits containing vials of dexamethasone, syringes, gloves, and instructions for administration will be distributed. Improving the identification of women at high risk of preterm birth will be done by (1 diffusing recommendations for antenatal corticosteroids use to health providers, (2 training health providers on identification of women at high risk of preterm birth, (3 providing reminders to health providers on the use of the kits, and
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Kanyangarara, Mufaro; Walker, Neff; Boerma, Ties
2018-01-01
Syphilis in pregnancy is an under-recognized public health problem, especially in sub-Saharan Africa which accounts for over 60% of the global burden of syphilis. If left untreated, more than half of maternal syphilis cases will result in adverse pregnancy outcomes including stillbirth and fetal loss, neonatal death, prematurity or low birth weight, and neonatal infections. Achieving universal coverage of antenatal syphilis screening and treatment has been the focus of the global campaign for the elimination of mother-to-child transmission of syphilis. However, little is known about the availability of antenatal syphilis screening and treatment across sub-Saharan Africa. The objective of this study was to estimate the 'likelihood of appropriate care' for antenatal syphilis screening and treatment by analyzing health facility surveys and household surveys conducted from 2010 to 2015 in 12 sub-Saharan African countries. In this secondary data analysis, we linked indicators of health facility readiness to provide antenatal syphilis detection and treatment from Service Provision Assessments (SPAs) and Service Availability and Readiness Assessments (SARAs) to indicators of ANC use from the Demographic and Health Surveys (DHS) to compute estimates of the 'likelihood of appropriate care'. Based on data from 5,593 health facilities that reported offering antenatal care (ANC) services, the availability of syphilis detection and treatment in ANC facilities ranged from 2% to 83%. The availability of syphilis detection and treatment was substantially lower in ANC facilities in West Africa compared to the other sub-regions. Levels of ANC attendance were high (median 94.9%), but only 27% of ANC attendees initiated care at less than 4 months gestation. We estimated that about one in twelve pregnant women received ANC early (<4 months) at a facility ready to provide syphilis detection and treatment (median 8%, range 7-32%). The largest implementation bottleneck identified was low
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Barriers to Antenatal Care in an Urban Community in the Gambia ...
African Journals Online (AJOL)
USER
This qualitative study investigated the barriers to obtaining access to antenatal care ... In-depth interviews were conducted with 25 pregnant women, 13 healthcare workers and 9 male partners. ..... observation of the clinic workplace might have.
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Directory of Open Access Journals (Sweden)
Denise Conceição da Silva
2008-06-01
Full Text Available O objeto da pesquisa foi a incorporação de tecnologias leves no contexto hospitalar, na ótica de enfermeiras, e sua relação com o cuidado de enfermagem. Objetivos: caracterizar as tecnologias consideradas leves no hospital, na ótica de enfermeiras, e analisar as concepções de enfermeiras sobre o uso dessas tecnologias no cuidado de enfermagem. Fundamentou-se na classificação dos diferentes tipos de tecnologias no trabalho em saúde e em pressupostos sobre o cuidado de enfermagem. Pesquisa exploratória, qualitativo-descritiva, desenvolvida em dois hospitais universitários na Cidade do Rio de Janeiro. Os dados foram coletados através da técnica de criatividade e sensibilidade "Almanaque", conjugada à entrevista semi-estruturada. Do discurso das enfermeiras emergiram tecnologias fundamentadas em suas experiências de cuidado. Suas concepções sobre tecnologias leves revelaram o que teoristas de enfermagem referem como atributos da relação humana no cuidado. Essas, quando discutidas no âmbito do cuidado de enfermagem, emergem como qualidades do cuidado em si.El objeto de la investigación fue la incorporación de tecnologías leves en hospitales, desde la perspectiva de las enfermeras y las relaciones establecidas con el cuidado de enfermería. Objetivos: caracterizar las tecnologías consideradas leves en el hospital, desde la perspectiva de las enfermeras; y analizar las concepciones de las enfermeras sobre el uso de estas tecnologías en el cuidado de enfermería. El estudio se fundamentó en la clasificación de diferentes tipos de tecnologías aplicadas en el área de la salud y en presuposiciones sobre el cuidado de enfermería. Investigación exploratoria, cualitativa y descriptiva, desarrollada en dos hospitales universitarios de la ciudad de Rio de Janeiro. Los datos fueron recolectados a través de dos técnicas: creatividad y sensibilidad, denominada "Almanaque," y entrevista semi-estructurada. De los discursos de las
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Implementing focussed antenatal care in sub-Saharan Africa: an ...
African Journals Online (AJOL)
A SWOT Analysis framework was used to assess the situational analysis of antenatal care programmes in sub-Saharan Africa while the Walt and Gilson policy analysis triangle was used to analyse the feasibility of introducing the new WHO ANC model into the sub-region. The content of the WHO model may need to be ...
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Antenatal screening for hepatitis B virus in HIV-infected and ...
African Journals Online (AJOL)
Background. Despite enormous strides in preventing hepatitis B virus (HBV) infection, perinatal transmission still contributes significantly to HBV epidemiology worldwide; this could account for approximately 50% of chronically infected individuals. Objective. To assess the need for HBV screening in antenatal clinics in the ...
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Kiwanuka, Tusuubira S; Ononge, Sam; Kiondo, Paul; Namusoke, Fatuma
2017-10-25
Antenatal iron supplementation is a cost effective way of reducing iron deficiency anaemia among pregnant women in resource limited countries like Uganda. Poor adherence to iron supplements has limited its effectiveness in reducing maternal anaemia as evidenced by the high burden of iron deficiency anemia in Sub-saharan Africa. The aim of this study was to determine the level of and factors associated with adherence to iron supplementation among women attending antenatal clinic at Mulago National Referral Hospital, Kampala, Uganda. Three hundred and seventy pregnant women were recruited in a cross sectional survey in Mulago National Referral Hospital antenatal clinic after informed consent between February and April 2014. Levels of adherence to iron supplements were assessed using visual analogue scale and factors associated collected using an interviewer administered questionnaire. About 12% (11.6%) of the mothers attending the antenatal clinic adhered to iron supplements over 30 day period. Mothers who had had four or more antenatal visits prior to the survey [odds ratio (OR) = 1.49, 95% confidence interval (CI) 1.12-1.97], had more than 2 week supply of iron supplements in the previous visit (OR 2.81, 95% CI 1.02-1.09), prior health education (OR 1.56, 95% CI 1.07-2.29) were more likely to adhere to iron supplements. Inadequate drug supplies and fear for side effects were the main reasons why participants missed the iron supplements. There was low adherence to iron supplements among mothers attending antenatal clinic at Mulago National Referral Hospital. We recommend a national evaluation of adherence to iron supplements and look at ways of increasing adherence.
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Redinger, S; Norris, S A; Pearson, R M; Richter, L; Rochat, T
2018-02-01
Depression and anxiety in the antenatal period are of public health concern given potential adverse effects for both mother and infant. Both are under-researched in the first trimester of pregnancy, especially in Africa. We examine the prevalence of first trimester antenatal depression and anxiety in a cohort of South African women and investigate associated risk factors. Data were collected from 946 women (2014-2016) in the Soweto First 1000 Days Cohort, a prospective pregnancy cohort in Soweto, South Africa. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale with a score of ⩾13 indicating probable depression. Anxiety was assessed using the short form of the State-Trait Anxiety Index with a score ⩾12 indicating probable anxiety. Prevalence of antenatal depression was 27% [95% confidence interval (CI) 24.2-29.8] and anxiety 15.2% (95% CI 12.9-17.5). Factors associated with antenatal depression and anxiety were predominantly relationship- and family-centred. Women who perceived that their partner made life harder for them had three-fold increased odds for depression [(odds ratio (OR) 3.33 [2.28-4.85] P<0.001], whereas those with family stressors had almost double the odds for depression (OR 1.78 [1.22-2.59] P=0.003) and anxiety (OR 1.75 [1.44-2.69] P=0.0011). Antenatal depression and anxiety are common in the first trimester of pregnancy, and partner and family relationship stressors are central. Longitudinal analysis is needed to determine if this is a phase of adjustment to pregnancy or onset of persistent symptomology. Early intervention may have secondary preventative effects and should involve the partner and family.
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Directory of Open Access Journals (Sweden)
Barun Bhai Patel
2016-01-01
Full Text Available Background: The maternal health status of Indian women was noted to be lower as compared to other developed countries. Promotion of maternal and child health has been one of the most important components of the Family Welfare Programme of the Government of India. For sustainable growth and development of country, there is a need to improve MCH Care in the country. Safe motherhood by providing good antenatal care (ANC is very important to reduce maternal mortality ratio and infant mortality rate and to achieve millennium development goals. Objectives: This study aimed to determine the level of knowledge, attitude, and practice on ANC among pregnant women attending the antenatal clinic at a Tertiary Care Hospital in Pune and their association with various sociodemographic factors. Materials and Methods: A cross-sectional study was carried out among 384 pregnant women in their 3 rd trimester attending the antenatal clinic in a Tertiary Care Hospital of Pune, Maharashtra during October 2011 to September 2012. Pretested questionnaire was used for collecting data by interview after obtaining informed consent. Statistical analysis was performed using SPSS version 20 and Epi Info Software. Results: Study reveals that about 58% women had adequate knowledge regarding ANC. It was found that almost all the variables such as age, education, occupation, parity, type of family, and socioeconomic status (SES had a significant association with awareness about ANC. 100% women were having a positive attitude toward ANC. Around 70%, women were practicing adequately, and variables such as education and SES had a significant association with practices about ANC. Conclusion: These findings can be used to plan a Health Intervention Program aiming to improve the maternal health practices and eventually improve the health status of the women.
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Ante-natal ionising radiation and cancer
International Nuclear Information System (INIS)
Anon.
1988-01-01
This editorial comments on the latest reports of the Oxford Survey of Childhood Cancer (now based on Birmingham). With 14759 pairs, the latest survey is over 10-fold larger than the 1958 report and the calculation of fatal childhood cancer rate at one case in 990 ante-natal radiographic examinations is rather larger than the early estimates, in spite of the fetal radiation dose having been halved and the cure rate for childhood leukemia being much improved. Comments are made on the comparisons with bomb survivors, and on the much increased fatal cancer incidence after first trimester radiography. (UK)
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Wan, Ming Wai; Moulton, Steff; Abel, Kathryn M.
2008-01-01
Objective: The study sought to (1) understand the perspectives of perinatal psychiatric and antenatal health service workers on the service and support needs of mothers with schizophrenia; (2) obtain their views on the feasibility and potential effectiveness of a proposed parenting intervention tailored for this group. Method: Twenty-eight perinatal psychiatry and antenatal service workers were interviewed using a semi-structured methodology, and anonymised verbatim transcripts analysed for c...
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Mall, Sumaya; Honikman, Simone; Evans, Bronwyn; Swartz, Leslie; Lund, Crick
2014-01-01
Antenatal mental distress has disabling consequences. It affects functioning and participation in daily activities and can lead to postnatal depression. This study employs the International Classification of Functioning Disability and Health (ICF), to explore the experiences of pregnant women with mental distress attending the Perinatal Mental Health Project (PMHP). The analysis also adopts Amartya Sen's capabilities approach to provide suggestions for appropriate interventions. We conducted in-depth interviews with seven pregnant women experiencing antenatal mental distress, three postnatal women who had experienced antenatal mental distress and seven health care providers all affiliated with the PMHP. We used an open-ended interview guide employing domains from the ICF as well as from the capabilities approach. Participants attributed their antenatal mental distress to a range of environmental factors. Difficulties in functioning were reported by participants including difficulties at work and caring for children. Participants stated that services provided by the PMHP have a positive impact on functioning and capabilities. The study suggests that the ICF is useful for exploring the impact of antenatal mental distress on functioning. It is well complemented by the capabilities approach to inform interventions. Implications for Rehabilitation Antenatal mental distress is a significant public health issue that impacts on women's functioning and participation exacerbated by social factors such as poverty and exposure to violence. This study explored restrictions in functioning and participation faced by women with antenatal mental distress including the ability to care for children, find meaningful employment and sustain relationships. Counselling services can play a role in restoring functioning and capabilities for women experiencing antenatal mental distress. Counselling services have the ability to discuss restrictions in functioning caused by antenatal mental
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Prevalence and Determinants of Early Antenatal Care Visit among ...
African Journals Online (AJOL)
AJRH Managing Editor
Antenatal care (ANC), which is given to pregnant women, is widely used for prevention, early diagnosis and treatment of general medical and ... Les soins prénatals (SP), que reçoivent les femmes enceintes, sont largement utilisés pour la prévention, le diagnostic précoce et ... syphilis, HIV/AIDS and severe anemia and.
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Audit of antenatal services in primary healthcare centres in Jos ...
African Journals Online (AJOL)
Introduction: Maternal mortality remains a big challenge in developing countries including Nigeria where the figures are amongst the highest in the world. The Nigerian government's response in providing primary healthcare centres (PHCs) in all local government areas is commendable but access to quality antenatal care is ...
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García Carracedo, Laura
2014-01-01
A partir de la hipótesis de que la mejora en habilidades sociales va a repercutir en mejorar la calidad de vida de las personas mayores, se ha desarrollado un programa de intervención dirigido a personas mayores con discapacidad auditiva y visual leve procedentes de la residencia “Casa Beneficencia” situada en la calle camino del cementerio en Valladolid. En el presente trabajo hemos utilizado diversas técnicas para la recogida de información previa y posterior diagnóstico de las necesidad...
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Francis Chateauraynaud
2011-01-01
Full Text Available Este artículo recapitula de modo sintético la trayectoria de un tipo de movimiento social —que se produce como resultado del deterioro paulatino del entorno natural— y, de modo concomitante, la formación de una corriente de la disciplina —que comporta toda una renovación teórica—: la llamada sociología pragmática. En el caso de Francia, se propone entender la génesis de dicho movimiento, su desarrollo en las dos últimas décadas, las lógicas de negociación a las que ha dado lugar en medio de conflictos y controversias, y los efectos prácticos que ha producido. Así, se delinean los ejes conceptuales de la tendencia, los campos de análisis que ha ido acotando y sus figuras más representativas.
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Tran, Thach Duc; Biggs, Beverley-Ann; Tran, Tuan; Simpson, Julie Anne; Hanieh, Sarah; Dwyer, Terence; Fisher, Jane
2013-01-01
Objectives The aim of this study was to examine the effects of antenatal exposure to iron deficiency anemia (IDA) and common mental disorders (CMD) on cognitive development of 6 months old infants in a developing country. Methods A prospective population-based study in a rural province in Vietnam, which enrolled pregnant women at 12–20 weeks gestation and followed them up with their infants until six months postpartum. Criteria for IDA were Hb cognitive development was assessed by Bayley Scales of Infant and Toddler Development, 3rd Ed. Path analyses were performed to determine the direct and indirect, partly or fully mediated, causal effects of the antenatal exposures. Results A total of 497 pregnant women were recruited, of those 378 women provided complete data which were included in the analyses. Statistically significant direct adverse effects of persistent antenatal IDA (estimated difference of −11.62 points; 95% CI −23.01 to −0.22) and antenatal CMD (−4.80 points; 95% CI: −9.40 to −0.20) on infant Bayley cognitive scores at six months were found. Higher birthweight, household wealth, and self-rated sufficient supply of breastmilk were associated with higher cognitive scores. Maternal age >30 years and primiparity had an indirect adverse effect on infants’ Bayley cognitive scores. Conclusions These findings suggest that antenatal IDA and CMD both have adverse effects on child cognitive development, which if unrecognized and unaddressed are likely to be lasting. It is crucial that both these risks are considered by policy makers, clinicians, and researchers seeking to improve child cognitive function in developing countries. PMID:24086390
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Dong, Shuying; Tong, Xuhui; Li, Jun; Huang, Cheng; Hu, Chengmu; Jiao, Hao; Gu, Yuchen
2013-01-01
In this study, we hypothesized that total flavonoid of Litsea coreana leve (TFLC) protects against focal cerebral ischemia/reperfusion injury. TFLC (25, 50, 100 mg/kg) was administered orally to a rat model of focal ischemia/reperfusion injury, while the free radical scavenging agent, edaravone, was used as a positive control drug. Results of neurological deficit scoring, 2,3,5-triphenyl tetrazolium chloride staining, hematoxylin-eosin staining and biochemical tests showed that TFLC at differ...
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Rashid, Abdul; Mohd, Rokiah
2017-11-02
Depression, a type of mental disorder which is portrayed by marked alterations in mood, is associated with distress and/or impaired functioning. Poor social support is an important risk factor for depression in pregnancy. An extensive literature search failed to show any published study conducted in Malaysia on antenatal depressive symptoms and the risk of poor social support on it. The aim of the study was to determine the risk of antenatal depressive symptoms due to poor social support. This cross sectional study was conducted among 3000 pregnant women attending antenatal clinics in Penang, Malaysia. Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal depressive symptoms and the Oslo-3 Social Support Scale (OSS-3) was used to measure social support. Odds ratio and adjusted odds ratio were used to quantify the risk of antenatal depressive symptoms due to poor social support. The prevalence of depressive symptoms was 20%. Using OSS-3 scale to gauge social support, most of the participants had moderate support (61.3%) followed by poor support (22%) and strong support (16.7%). Social support was found to be significantly associated with depressive symptoms in this study (OR 2.2, aOR 2.1, AR 45%). Considering that an expecting mother's psychological factors are important in the wellbeing of the mother and child, antenatal depression must be quickly identified. Screening pregnant women for social support can help identify women with higher risk of depression.
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Utilization of antenatal care services among teenagers in Ethiopia: A ...
African Journals Online (AJOL)
Background: Teenaged women suffer from a disproportionate share of reproductive health problem. The purpose of this study was to estimate the utilization of antenatal care (ANC) services among teenagers (13-19 years) during delivery in Ethiopia. Methodology: Raw data collected from all part of the country on child ...
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Directory of Open Access Journals (Sweden)
B. C. Santis
2013-06-01
Full Text Available Este trabalho tem por objetivo a caracterização de diferentes massas cerâmicas do estado de S. Paulo para a produção de agregados leves de argila calcinada visando à utilização em concretos de cimento Portland. A caracterização das massas cerâmicas deu-se por meio das técnicas de limites de liquidez e plasticidade, análise granulométrica, análise química e difração de raios X. Os corpos de prova confeccionados com essas massas cerâmicas, queimados a 900 ºC, foram caracterizados por meio da avaliação da retração linear, absorção de água, porosidade aparente, massa específica aparente, expansão por umidade e resistência à compressão. Os resultados desta pesquisa indicaram a viabilidade da produção de agregados leves de argila calcinada para utilização em concretos e os valores da massa específica (1,555 a 1,785 kg/m³ e da resistência à compressão (18,0 a 55,8 MPa apresentaram-se em um patamar intermediário entre os observados para a argila expandida (agregado leve comercial e para o agregado convencional (basalto.
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Maternal Antenatal Bereavement and Neural Tube Defect in Live-Born Offspring
DEFF Research Database (Denmark)
Ingstrup, Katja Glejsted; Wu, Chun Sen; Olsen, Jørn
2016-01-01
BACKGROUND: Maternal emotional stress during pregnancy has previously been associated with congenital neural malformations, but most studies are based on data collected retrospectively. The objective of our study was to investigate associations between antenatal maternal bereavement due to death...
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Corbett, Sarah; Chelimo, Carol; Okesene-Gafa, Kara
2014-10-17
To identify barriers to early initiation of antenatal care amongst pregnant women in South Auckland, New Zealand. Women in late pregnancy (>37 weeks gestation) or who had recently delivered (18 weeks (late bookers). The ethnic composition of the sample was: 43% Pacific Peoples, 20% Maori, 14% Asian, and 21% European or other ethnicities. The multivariate analysis indicated that women were significantly more likely to book late for antenatal care if they had limited resources (OR=1.86; 95% CI=1.17-2.93), no tertiary education (OR=1.96; 95% CI=1.23-3.15), or were not living with a husband/partner (OR=2.34; 95% CI=1.48-3.71). In addition, the odds of late booking for antenatal care was almost six times higher among Maori (OR=5.70; 95% CI=2.57-12.64) and Pacific (OR=5.90; 95% CI=2.83-12.29) women compared to those of European and other ethnicities. Late booking for antenatal care in the Counties Manukau District Health Board area (South Auckland) is associated with sociodemographic factors, social deprivation, and inadequate social support.
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Directory of Open Access Journals (Sweden)
Muhammad Ashraf Majrooh
Full Text Available BACKGROUND: Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In 'Pakistan' antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to 'Divisions' and 'Districts'. By population 'Punjab' is the largest province of Pakistan having 36 districts. This study was conducted to assess the coverage and quality antenatal care in the primary health care facilities in 'Punjab' province of 'Pakistan'. METHODS: Quantitative and Qualitative methods were used to collect data. Using multistage sampling technique nine out of thirty six districts were selected and 19 primary health care facilities of public sector (seventeen Basic Health Units and two Rural Health Centers were randomly selected from each district. Focus group discussions and in-depth interviews were conducted with clients, providers and health managers. RESULTS: The overall enrollment for antenatal checkup was 55.9% and drop out was 32.9% in subsequent visits. The quality of services regarding assessment, treatment and counseling was extremely poor. The reasons for low coverage and quality were the distant location of facilities, deficiency of facility resources, indifferent attitude and non availability of the staff. Moreover, lack of client awareness about importance of antenatal care and self empowerment for decision making to seek care were also responsible for low coverage. CONCLUSION: The coverage and quality of the antenatal care services in 'Punjab' are extremely compromised. Only half of the expected pregnancies are enrolled and
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Browne, Joyce L; Kayode, Gbenga A; Arhinful, Daniel; Fidder, Samuel A J; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin
2016-03-18
This study aims to evaluate the effect of maternal health insurance status on the utilisation of antenatal, skilled delivery and postnatal care. A population-based cross-sectional study. We utilised the 2008 Demographic and Health Survey data of Ghana, which included 2987 women who provided information on maternal health insurance status. Utilisation of antenatal, skilled delivery and postnatal care. Multivariable logistic regression was applied to determine the independent association between maternal health insurance and utilisation of antenatal, skilled delivery and postnatal care. After adjusting for socioeconomic, demographic and obstetric factors, we observed that among insured women the likelihood of having antenatal care increased by 96% (OR 1.96; 95% CI 1.52 to 2.52; p valuehealth insurance status plays a significant role in the uptake of the maternal, neonatal and child health continuum of care service. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
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'You've got it within you': the political act of keeping a wellness focus in the antenatal time.
Browne, Jenny; O'Brien, Maureen; Taylor, Jan; Bowman, Rebekah; Davis, Deborah
2014-04-01
by exploring midwives' communication techniques intended to promote a wellness focus in the antenatal period, this study identified strategies midwives use to amplify women's own resources and capacities, with the aim of reducing antenatal anxiety. a qualitative design utilising focus groups as a means of generating data. two Australian cities: Canberra, ACT and Sydney NSW. 14 experienced, practising midwives across two states/territories, employed in multiple hospitals and community settings. three themes emerged from the analysis: calm unhurriedness, speaking in wellness and reassuring bodies. Midwives in these focus groups used strategies in antenatal care that could be co-ordinated into a planned process for wellness focussed care. individually midwives used a variety of strategies specifically intended to facilitate women's capabilities, to employ worry usefully and to reduce anxiety. Midwives in the study clearly viewed this kind of wellness focussed care as their responsibility and their right. the midwives' collective wisdom could be shared and developed further into an overall salutogenic antenatal strategy to be used for the good of pregnant women and their infants. Copyright © 2013 Elsevier Ltd. All rights reserved.
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Directory of Open Access Journals (Sweden)
Binbin Peng
2018-02-01
Full Text Available Sea-level rise (SLR will magnify the impacts of storm surge; the resulting severe flooding and inundation can cause huge damage to coastal communities. Community leaders are considering implementing adaptation strategies, typically hard engineering projects, to protect coastal assets and resources. It is important to understand the costs and benefits of the proposed project before any decision is made. To mitigate the flooding impact of joint effects of storm surge and SLR, building levee segments is chosen to be a corresponding adaptation strategy to protect the real estate assets in the study area—the City of Miami, FL, USA. This paper uses the classic Cost-Benefit Analysis (CBA to assess the cost efficiency and proposes corresponding improvements in the benefit estimation, by estimating the avoided damages of implementing levee projects. Results show that the city will benefit from implementing levee projects along the Miami River in both a one-time 10 year storm event with SLR and cumulative long-term damage scenarios. This study also suggests that conducting CBA is a critical process before making coastal adaptation planning investment. A more meaningful result of cost effectiveness is estimated by accounting for the appreciation and time value. In addition, a sensitivity analysis is conducted to verify how the choice of discount rate influences the result. Uncertain factors including the rate of SLR, storm intensification, land use changes, and real estate appreciation are further analyzed.
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International Nuclear Information System (INIS)
Zubair, M.; Adil, M.M.; Alam, A.Y.; Qureshi, A.A.
2006-01-01
The objective of this study was to ascertain the prevalence of antenatal care, use of food supplements during pregnancy and lactation and factors responsible for not taking them in Tarlai, an urban slum of Islamabad. A Cross-sectional survey of 100 married women in the age range 15-45 years women utilizing and not utilizing antenatal care facilities during their previous pregnancy was carried out in April 2004. Data was collected through a structured questionnaire and processed and analyzed by using SPPS 10.0. Use of supplements was found high in women attending antenatal care. Realization of the importance of taking a healthy diet during pregnancy was significantly higher among women utilizing antenatal care. In most of the women's the diet remain unchanged. 56% women attended the antenatal care clinics. Those not taking food supplements, 39% were non affording, 21% had no concept of their benefits, 36% did not like to take and 4% felt nausea and vomiting. Just over 50% women received antenatal care. Utilization of antenatal care showed a positive impact on awareness of taking food supplements during pregnancy and lactation. (author)
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Energy Technology Data Exchange (ETDEWEB)
Zubair, M; Adil, M M; Alam, A Y; Qureshi, A A [Shifa College of Medicine, Islamabad (Pakistan)
2006-07-15
The objective of this study was to ascertain the prevalence of antenatal care, use of food supplements during pregnancy and lactation and factors responsible for not taking them in Tarlai, an urban slum of Islamabad. A Cross-sectional survey of 100 married women in the age range 15-45 years women utilizing and not utilizing antenatal care facilities during their previous pregnancy was carried out in April 2004. Data was collected through a structured questionnaire and processed and analyzed by using SPPS 10.0. Use of supplements was found high in women attending antenatal care. Realization of the importance of taking a healthy diet during pregnancy was significantly higher among women utilizing antenatal care. In most of the women's the diet remain unchanged. 56% women attended the antenatal care clinics. Those not taking food supplements, 39% were non affording, 21% had no concept of their benefits, 36% did not like to take and 4% felt nausea and vomiting. Just over 50% women received antenatal care. Utilization of antenatal care showed a positive impact on awareness of taking food supplements during pregnancy and lactation. (author)
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Directory of Open Access Journals (Sweden)
Wan-Ning Tseng
2016-12-01
Full Text Available Background: Antenatal steroid administration may benefit fetal lung maturity in preterm infants. Although some studies have shown that this treatment may increase asthma in childhood, the correlation between antenatal dexamethasone exposure and allergic diseases remains unclear. The purpose of this study is to investigate the association between antenatal dexamethasone and T cell expression in childhood allergic diseases. Methods: We recruited a cohort of preterm infants born at Kaohsiung Chang Gung Memorial Hospital between 2007 and 2010 with a gestational age of less than 35 weeks and body weight at birth of less than 1500 g. The status of antenatal exposure to steroids and allergic diseases were surveyed using a modified ISAAC questionnaire for subjects aged 2–5 years old. We analyzed Th1/Th2/Th17 expression of mRNA, cytokines (using the Magpix® my-system, and mental development index (MDI. Results: Among the 40 patients that were followed, the data showed that the antenatal dexamethasone exposure group (N = 24 had a significantly higher incidence of allergic diseases (75.0% vs. 18.8%, p < 0.0001 when compared to the non-dexamethasone exposure group (N = 16, especially with regard to asthma (41.7% vs. 0.0%, p = 0.003 and allergic rhinitis (58.3% vs. 18.8%, p = 0.013, but not atopic dermatitis. No statistical difference was observed in the mRNA expression levels of total white blood cell count between the dexamethasone exposure and non-exposure groups (p > 0.05. However, the asthma group had higher IL-5 levels (p = 0.009, and the MDI was shown to be significantly higher in the dexamethasone exposure group (90.38 ± 3.31 vs. 79.94 ± 3.58, p = 0.043 while no significant difference was found between the PDI of the two groups. Conclusions: Exposure to antenatal dexamethasone in preterm infants will increase their susceptibility to allergic diseases, particularly asthma and allergic rhinitis. Preterm infants’ exposure to antenatal
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Prevalence of malaria at booking among antenatal clients in a ...
African Journals Online (AJOL)
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2Institute for Advanced medical Research and Training, College of Medicine, Ibadan, Nigeria. 3Department of Obstetrics ... MATERIALS AND METHODS. We used a cross sectional ... all part of routine care in the. Prevalence of malaria at booking among antenatal clients in a secondary health care facility in Ibadan, Nigeria ...
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Directory of Open Access Journals (Sweden)
Fátima González Palau
2012-01-01
Full Text Available Debido al incremento en el porcentaje de adultos mayores, así como de las enfermedades degenerativas, existe un creciente interés en la determinación de métodos psicosociales eficaces dirigidos a sujetos con Deterioro Cognitivo leve. Recientes estudios experimentales exponen efectos positivos de las intervenciones cognitivas dirigidas a esta población, tanto en métodos tradicionales y como en estrategias de intervención por medio de nuevas tecnologías. la presente revisión proporciona un análisis sistemático de la literatura existente en miras de valorar el efecto y los alcances de las intervenciones cognitivas no farmacológicas existentes en la actualidad, dirigidas a adultos mayores con Deterioro Cognitivo leve.
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Hypnosis Antenatal Training for Childbirth (HATCh): a randomised controlled trial [NCT00282204].
Cyna, Allan M; Andrew, Marion I; Robinson, Jeffrey S; Crowther, Caroline A; Baghurst, Peter; Turnbull, Deborah; Wicks, Graham; Whittle, Celia
2006-03-05
Although medical interventions play an important role in preserving lives and maternal comfort they have become increasingly routine in normal childbirth. This may increase the risk of associated complications and a less satisfactory birth experience. Antenatal hypnosis is associated with a reduced need for pharmacological interventions during childbirth. This trial seeks to determine the efficacy or otherwise of antenatal group hypnosis preparation for childbirth in late pregnancy. A single centre, randomised controlled trial using a 3 arm parallel group design in the largest tertiary maternity unit in South Australia. Group 1 participants receive antenatal hypnosis training in preparation for childbirth administered by a qualified hypnotherapist with the use of an audio compact disc on hypnosis for re-enforcement; Group 2 consists of antenatal hypnosis training in preparation for childbirth using an audio compact disc on hypnosis administered by a nurse with no training in hypnotherapy; Group 3 participants continue with their usual preparation for childbirth with no additional intervention. Women > 34 and training as near as possible to 37 weeks gestation. Treatment allocations are concealed from treating obstetricians, anaesthetists, midwives and those personnel collecting and analysing data. Our sample size of 135 women/group gives the study 80% power to detect a clinically relevant fall of 20% in the number of women requiring pharmacological analgesia - the primary endpoint. We estimate that approximately 5-10% of women will deliver prior to receiving their allocated intervention. We plan to recruit 150 women/group and perform sequential interim analyses when 150 and 300 participants have been recruited. All participant data will be analysed, by a researcher blinded to treatment allocation, according to the "Intention to treat" principle with comprehensive pre-planned cost- benefit and subgroup analyses. If effective, hypnosis would be a simple, inexpensive
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Bergström, Malin; Rudman, Ann; Waldenström, Ulla; Kieler, Helle
2013-08-01
To explore if antenatal fear of childbirth in men affects their experience of the birth event and if this experience is associated with type of childbirth preparation. Data from a randomized controlled multicenter trial on antenatal education. 15 antenatal clinics in Sweden between January 2006 and May 2007. 762 men, of whom 83 (10.9%) suffered from fear of childbirth. Of these 83 men, 39 were randomized to psychoprophylaxis childbirth preparation where men were trained to coach their partners during labor and 44 to standard care antenatal preparation for childbirth and parenthood without such training. Experience of childbirth was compared between men with and without fear of childbirth regardless of randomization, and between fearful men in the randomized groups. Analyses by logistic regression adjusted for sociodemographic variables. Self-reported data on experience of childbirth including an adapted version of the Wijma Delivery Experience Questionnaire (W-DEQ B). Men with antenatal fear of childbirth more often experienced childbirth as frightening than men without fear: adjusted odds ratio 4.68, 95% confidence interval 2.67-8.20. Men with antenatal fear in the psychoprophylaxis group rated childbirth as frightening less often than those in standard care: adjusted odds ratio 0.30, 95% confidence interval 0.10-0.95. Men who suffer from antenatal fear of childbirth are at higher risk of experiencing childbirth as frightening. Childbirth preparation including training as a coach may help fearful men to a more positive childbirth experience. Additional studies are needed to support this conclusion. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.
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Kuwabara, James S.; Topping, Brent R.; Carter, James L.; Wood, Tamara M.; Parcheso, Francis; Cameron, Jason M.; Asbill, Jessica R.; Carlson, Rick A.; Fend, Steven V.
2012-01-01
Eight sampling trips were coordinated after engineered levee breaches hydrologically reconnected both Upper Klamath Lake and Agency Lake, Oregon, to adjacent wetlands. The reconnection, by a series of explosive blasts, was coordinated by The Nature Conservancy to reclaim wetlands that had for approximately seven decades been leveed for crop production. Sets of nonmetallic porewater profilers (U.S. Patent 8,051,727 B1; November 8, 2011; http://www.uspto.gov/web/patents/patog/ week45/OG/html/1372-2/US08051727-20111108.html.) were deployed during these trips in November 2007, June 2008, May 2009, July 2009, May 2010, August 2010, June 2011, and July 2011 (table 1). Deployments temporally spanned the annual cyanophyte bloom of Aphanizomenon flos-aquae and spatially involved three lake and four wetland sites. Spatial and temporal variation in solute benthic flux was determined by the field team, using the profilers, over an approximately 4-year period beginning 3 days after the levee breaches. The highest flux to the water column of dissolved organic carbon (DOC) was detected in the newly flooded wetland, contrasting negative or insignificant DOC fluxes at adjacent lake sites. Over the multiyear study, DOC benthic fluxes dissipated in the reconnected wetlands, converging to values similar to those for established wetlands and to the adjacent lake (table 2). In contrast to DOC, benthic sources of soluble reactive phosphorus, ammonium, dissolved iron and manganese from within the reconnected wetlands were consistently elevated (that is, significant in magnitude relative to riverine and established-wetland sources) indicating a multi-year time scale for certain chemical changes after the levee breaches (table 2). Colonization of the reconnected wetlands by aquatic benthic invertebrates during the study trended toward the assemblages in established wetlands, providing further evidence of a multiyear transition of this area to permanent aquatic habitat (table 3). Both the
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Controversias en el manejo actual de la coartación de la aorta
Directory of Open Access Journals (Sweden)
Edgardo Vanegas
2013-09-01
Full Text Available La coartación de la aorta fue descrita clásicamente como una simple estrechez del istmo aórtico que podría ser "curada" por medio de cirugía. En la actualidad se sabe que es la manifestación clínica de una vasculopatía arterial más amplia, en donde la afección del arco aórtico puede ser variable. La corrección quirúrgica ha demostrado ser un tratamiento efectivo para el manejo de la coartación aórtica nativa y permanece como el de elección en neonatos. De otra parte, la angioplastia con balón es el tratamiento de elección en niños con recoartación, cuyos resultados en la reducción aguda del gradiente aórtico posterior al manejo de la coartación nativa, son similares a los obtenidos con cirugía. La implantación de prótesis endovasculares (stents ha mostrado excelentes resultados a corto plazo tanto en niños mayores como en adultos con coartación nativa. En pacientes con coartación recurrente considerados de alto riesgo quirúrgico, la angioplastia con balón y la implantación de stent ofrecen una estrategia de manejo menos invasiva e igual de efectiva. Se prefiere el uso de stents sobre la angioplastia con balón en adultos y niños mayores con coartación recurrente, ya que el riesgo de recoartación y formación de aneurismas parece ser menor. No se cuenta con suficiente información acerca de los desenlaces a largo plazo posteriores al tratamiento percutáneo de la coartación aórtica. Este artículo revisa las controversias existentes en cuanto al manejo actual de esta condición.
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Controversias en el manejo actual de la coartación de la aorta
Directory of Open Access Journals (Sweden)
Edgardo Vanegas, MD
2013-09-01
Full Text Available La coartación de la aorta fue descrita clásicamente como una simple estrechez del istmo aórtico que podría ser “curada” por medio de cirugía. En la actualidad se sabe que es la manifestación clínica de una vasculopatía arterial más amplia, en donde la afección del arco aórtico puede ser variable. La corrección quirúrgica ha demostrado ser un tratamiento efectivo para el manejo de la coartación aórtica nativa y permanece como el de elección en neonatos. De otra parte, la angioplastia con balón es el tratamiento de elección en niños con recoartación, cuyos resultados en la reducción aguda del gradiente aórtico posterior al manejo de la coartación nativa, son similares a los obtenidos con cirugía. La implantación de prótesis endovasculares (stents ha mostrado excelentes resultados a corto plazo tanto en niños mayores como en adultos con coartación nativa. En pacientes con coartación recurrente considerados de alto riesgo quirúrgico, la angioplastia con balón y la implantación de stent ofrecen una estrategia de manejo menos invasiva e igual de efectiva. Se prefiere el uso de stents sobre la angioplastia con balón en adultos y niños mayores con coartación recurrente, ya que el riesgo de recoartación y formación de aneurismas parece ser menor. No se cuenta con suficiente información acerca de los desenlaces a largo plazo posteriores al tratamiento percutáneo de la coartación aórtica. Este artículo revisa las controversias existentes en cuanto al manejo actual de esta condición.
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The association of maternal social factors and antenatal care with ...
African Journals Online (AJOL)
Zinc is a crucial micronutrient in early childhood survival and the development of innate and acquired immunity. The objective is to determine the relationship between of maternal social class and antenatal care to serum zinc level in newborns in a tertiary and a rural hospital. It is prospective study using questionnaires on ...
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Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Andersen, Stig Krøger; Due, Pernille; Koushede, Vibeke
2014-02-13
The aims of antenatal education contain both outcomes related to pregnancy, birth and parenthood. Both content and methods of antenatal education have changed over time without evidence of effects on relevant outcomes. The effect of antenatal education in groups, with participation of a small number of participants, may differ from the effect of other forms of antenatal education. The latest Cochrane review, assessed as up-to-date in 2007, concluded that the effect of antenatal education for childbirth or parenthood or both remains largely unknown. This systematic review and meta-analysis aims to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes. Eligible studies include individually randomized as well as cluster-randomized trials irrespective of language, publication year, publication type, and publication status. Only interventions carried out in the Western world will be considered in this review. We will search the databases Medline, EMBASE, CENTRAL, CINAHL, Web of Science, and PsycINFO using relevant search terms. Two independent review authors will extract data and assess risk of bias. Results will be presented as structured summaries of the included trials. A meta-analysis will be conducted. We will assess heterogeneity by using both the Chi-squared test and the I-squared statistic, and conduct subgroup analysis separately for various intervention types. In healthcare systems with limited resources evidence of the effectiveness of services provided is important for decision making, and there is a need for policy makers to implement changes in healthcare systems based on scientific evidence. The effectiveness of antenatal education in small classes is still questioned. Therefore an up-to-date systematic review is needed.This systematic review protocol was registered within the International Prospective Register of Systematic Reviews (PROSPERO) as number CRD42013004319.
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Directory of Open Access Journals (Sweden)
Titaley Christiana R
2010-08-01
Full Text Available Abstract Background Antenatal care aims to prevent maternal and perinatal mortality and morbidity. In Indonesia, at least four antenatal visits are recommended during pregnancy. However, this service has been underutilized. This study aimed to examine factors associated with underutilization of antenatal care services in Indonesia. Methods We used data from Indonesia Demographic and Health Survey (IDHS 2002/2003 and 2007. Information of 26,591 singleton live-born infants of the mothers' most recent birth within five years preceding each survey was examined. Twenty-three potential risk factors were identified and categorized into four main groups, external environment, predisposing, enabling, and need factors. Logistic regression models were used to examine the association between all potential risk factors and underutilization of antenatal services. The Population Attributable Risk (PAR was calculated for selected significant factors associated with the outcome. Results Factors strongly associated with underutilization of antenatal care services were infants from rural areas and from outer Java-Bali region, infants from low household wealth index and with low maternal education level, and high birth rank infants with short birth interval of less than two years. Other associated factors identified included mothers reporting distance to health facilities as a major problem, mothers less exposed to mass media, and mothers reporting no obstetric complications during pregnancy. The PAR showed that 55% of the total risks for underutilization of antenatal care services were attributable to the combined low household wealth index and low maternal education level. Conclusions Strategies to increase the accessibility and availability of health care services are important particularly for communities in rural areas. Financial support that enables mothers from poor households to use health services will be beneficial. Health promotion programs targeting
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Directory of Open Access Journals (Sweden)
Marcelo Gomes Miguez
2015-08-01
Full Text Available The development of cities has always had a very close relation with water. However, cities directly impact land use patterns and greatly change natural landscapes, aggravating floods. Considering this situation, this paper intends to discuss lowland occupation and city sustainability in what regards urban stormwater management, fluvial space, and river restoration, aiming at minimizing flood risks and improving natural and built environment conditions. River plains tend to be attractive places for a city to grow. From ancient times, levees have been used to protect lowland areas along major watercourses to allow their occupation. However, urban rivers demand space for temporary flood storage. From a systemic point of view, levees along extensive river reaches act as canalization works, limiting river connectivity with flood plains, rising water levels, increasing overtopping risks and transferring floods downstream. Departing from this discussion, four case studies in the Iguaçu-Sarapuí River Basin, a lowland area of Rio de Janeiro State, Brazil, are used to compose a perspective in which the central point refers to the need of respecting watershed limits and giving space to rivers. Different aspects of low-lying city planning are discussed and analyzed concerning the integration of the built and natural environments.
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Child malnutrition and antenatal care: Evidence from three Latin American countries
N.F. Ramirez (Nohora); L.F. Gamboa (Luis); A.S. Bedi (Arjun Singh); R.A. Sparrow (Robert)
2012-01-01
textabstractThe importance of ever-earlier interventions to help children reach their physical and cognitive potential is increasingly being recognized. In part, as a result of this, in developing countries, antenatal care is becoming an important element of strategies to prevent child stunting in
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Thanatophoric dysplasia: Antenatal to postmortem
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Chanabasappa V Chavadi
2015-01-01
Full Text Available Thanatophoric dwarfism (TD, literally meaning death seeking dwarf, is the most common form of lethal bone dysplasia characterized by severe micromelia, extra folds of skin and narrow chest. Other signs include small ribs, underdeveloped lungs, cloverleaf skull, hypertelorism and protuberant abdomen. A short neck, depressed nasal bridge and hypoplastic mandible may also be present. Hydrocephalus is uncommon but is another poor prognostic sign. The diagnosis is usually made with the ultrasonography in the second trimester. Based on the morphological characters, this condition is sub-divided into type 1 and type 2. Fetuses with this condition are either still-born or die shortly after birth. Antenatal sonographic, postpartum radiological and autopsy findings of a case of type 1 TD with a relatively uncommon association of hydrocephalus is discussed.
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The antenatal prevention of congenital syphilis in a peri-urban ...
African Journals Online (AJOL)
The obstetric records of patients from Khayelitsha were examined to assess the efficiency of a system for the antenatal prevention of congenital syphilis, and to identify points of breakdown in the process. Seventy-seven (12,7%) of 607 mothers had serological evidence of syphilis, including 10 (32,3%) of31 mothers who had ...
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DEFF Research Database (Denmark)
Koushede, Vibeke; Brixval, Carina Sjöberg; Axelsen, Solveig Forberg
2013-01-01
To examine the efficacy and cost-effectiveness of group based antenatal education for improving childbirth and parenting resources compared to auditorium based education.......To examine the efficacy and cost-effectiveness of group based antenatal education for improving childbirth and parenting resources compared to auditorium based education....
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Wirtschafter, David D; Danielsen, Beate H; Main, Elliott K; Korst, Lisa M; Gregory, Kimberly D; Wertz, Andrew; Stevenson, David K; Gould, Jeffrey B
2006-05-01
The California Perinatal Quality Care Collaborative (CPQCC) was formed to seek perinatal care improvements by creating a confidential multi-institutional database to identify topics for quality improvement (QI). We aimed to evaluate this approach by assessing antenatal steroid administration before preterm (24 to 33 weeks of gestation) delivery. We hypothesized that mean performance would improve and the number of centers performing below the lowest quartile of the baseline year would decrease. In 1998, a statewide QI cycle targeting antenatal steroid use was announced, calling for the evaluation of the 1998 baseline data, dissemination of recommended interventions using member-developed educational materials, and presentations to California neonatologists in 1999-2000. Postintervention data were assessed for the year 2001 and publicly released in 2003. A total of 25 centers voluntarily participated in the intervention. Antenatal steroid administration rate increased from 76% of 1524 infants in 1998 to 86% of 1475 infants in 2001 (P < .001). In 2001, 23 of 25 hospitals exceeded the 1998 lower-quartile cutoff point of 69.3%. Regional collaborations represent an effective strategy for improving the quality of perinatal care.
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van der Eem, Lisette; Nyanza, Elias C.; van Pelt, Sandra; Ndaki, Pendo; Basinda, Namanya; Sundby, Johanne
2017-01-01
Antenatal care is essential to improve maternal and newborn health and wellbeing. The majority of pregnant women in Tanzania attend at least one visit. Since implementation of the focused antenatal care model, quality of care assessments have mostly focused on utilization and coverage of routine interventions for antenatal care. This study aims to assess the quality of antenatal care provision from a holistic perspective in a rural district in Tanzania. Structure, process and outcome components of quality are explored. This paper reports on data collected over several periods from 2012 to 2015 through facility audits of supplies and services, ANC observations and exit interviews with pregnant women. Additional qualitative methods were used such as interviews, focus group observations and participant observations. Findings indicate variable performance of routine ANC services, partly explained by insufficient resources. Poor performance was also observed for appropriate history taking, attention for client’s wellbeing, basic physical examination and adequate counseling and education. Achieving quality improvement for ANC requires increased attention for the process of care provision beyond coverage, including attention for response-based services, which should be assessed based on locally determined criteria. PMID:29236699
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On-site screening for syphilis at an antenatal clinic | Delport | South ...
African Journals Online (AJOL)
Objective. To determine the validity, predictive value and accuracy of the rapid plasma reagin card test performed on site to diagnose active syphilis in pregnant women so that immediate treatment can be offered to prevent congenital syphilis. Design. Open, descriptive study. Setting. Antenatal clinic, Mamelodi Hospital, ...
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Antenatal care strengthening for improved health behaviours in Jimma, Ethiopia, 2009-2011
DEFF Research Database (Denmark)
Villadsen, Sarah Fredsted; Negussie, Dereje; GebreMariam, Abebe
2016-01-01
(OR 2.4, 95% CI: 1.5; 3.5). There was no effect on infant immunisation coverage and negative effect on number of antenatal visits. The effect on various outcomes was modified by maternal education, and results indicate increased health facility delivery (OR 2.4, 95% CI: 0.8; 6.9) and breast feeding...... AND MEASUREMENTS: an intervention was designed participatorily and comprised trainings, supervisions, equipment, health education material, and adaption of guidelines. It was implemented at public facilities. Household surveys, before (2008) and after (2010) intervention, were conducted amongst all women who had...... given birth within the previous 12 months. The effect of the intervention was assessed by comparing the change in health behaviours (number of antenatal visits, health facility delivery, breast feeding, preventive infant health check, and infant immunisation) from before to after the intervention period...
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Jennifer, Fenwick; Elaine, Burns; Athena, Sheehan; Virginia, Schmied
2013-05-01
the aim of the study was to examine the dominant discourses that midwives draw on to present information on breast feeding in group-based antenatal education sessions. breast-feeding initiation rates are high among Australian women however, duration rates are low. Antenatal breast-feeding education is considered a key strategy in promoting breast feeding to childbearing women. The efficacy and effectiveness of such a strategy is equivocal and there is little qualitative work examining group-based antenatal breast-feeding education. discourse analysis was used to explore the language and practises of midwives facilitating group antenatal breast-feeding education sessions at two Australian maternity facilities. Nine sessions were observed and tape recorded over a 12 month period. Each session lasted between 60 and 140 mins. the analysis revealed four dominate discourses midwives used to promote breast feeding during group-based antenatal education session. The predominant discourses 'There is only one feeding option': breast feeding' and 'Selling the 'breast is best' reflected how midwives used their personal and professional commitment to breast feeding, within supportive and protective policy frameworks, to convince as many pregnant women as possible to commit to breast feeding. Sessions were organised to ensure women and their partners were 'armed' with as much information as possible about the value of breastmilk, successful positioning and attachment and practical strategies to deal with early breast-feeding problems. Antenatal commitment to breast feeding was deemed necessary if women were to overcome potential hurdles and maintain a commitment to the supply of breast milk. The latter two discourses, drawn upon to promote the breast-feeding message, presented infants as 'hard wired' to breast feed and male partners as 'protectors' of breast feeding. midwives clearly demonstrated a passion and enthusiasm for breast-feeding education. Examining the dominant
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Directory of Open Access Journals (Sweden)
Jamala A. Bawahab
2017-12-01
Full Text Available Objectives: To measure the prevalence of antenatal depression among pregnant women attending the primary health care (PHC antenatal care clinics in Jeddah, Saudi Arabia and to determine associated factors. Methods: Following a cross-sectional study design, 320 pregnant women attending the antenatal care clinics in the Ministry of Health PHC Centers in Jeddah, Saudi Arabia between January 1st 2017 and February 15th 2017 were interviewed. A self-administered questionnaire used for data collection asked about socio-demographic variables and included the Edinburgh Postnatal Depression Scale. Results: The most common contributor was the harming herself (mean±SD, 2.7±0.60. Factors significantly associated with depression among participants were the number of daughters, previous diagnosis of depression, and financial problems. Conclusions: The prevalence of antepartum depression among pregnant women in Jeddah is 57.5%, and the greatest contributor is the thought of harming herself.
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Costs of hospitalization in preterm infants: impact of antenatal steroid therapy
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Joice Fabiola Meneguel Ogata
2016-02-01
Full Text Available ABSTRACT OBJECTIVE: To estimate the costs of hospitalization in premature infants exposed or not to antenatal corticosteroids (ACS. METHOD: Retrospective cohort analysis of premature infants with gestational age of 26-32 weeks without congenital malformations, born between January of 2006 and December of 2009 in a tertiary, public university hospital. Maternal and neonatal demographic data, neonatal morbidities, and hospital inpatient services during the hospitalization were collected. The costs were analyzed using the microcosting technique. RESULTS: Of 220 patients that met the inclusion criteria, 211 (96% charts were reviewed: 170 newborns received at least one dose of antenatal corticosteroid and 41 did not receive the antenatal medication. There was a 14-37% reduction of the different cost components in infants exposed to ACS when the entire population was analyzed, without statistical significance. Regarding premature infants who were discharged alive, there was a 24-47% reduction of the components of the hospital services costs for the ACS group, with a significant decrease in the length of stay in the neonatal intensive care unit (NICU. In very-low birth weight infants, considering only the survivors, ACS promoted a 30-50% reduction of all elements of the costs, with a 36% decrease in the total cost (p = 0.008. The survivors with gestational age <30 weeks showed a decrease in the total cost of 38% (p = 0.008 and a 49% reduction of NICU length of stay (p = 0.011. CONCLUSION: ACS reduces the costs of hospitalization of premature infants who are discharged alive, especially those with very low birth weight and <30 weeks of gestational age.
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Costs of hospitalization in preterm infants: impact of antenatal steroid therapy.
Ogata, Joice Fabiola Meneguel; Fonseca, Marcelo Cunio Machado; Miyoshi, Milton Harumi; Almeida, Maria Fernanda Branco de; Guinsburg, Ruth
2016-01-01
To estimate the costs of hospitalization in premature infants exposed or not to antenatal corticosteroids (ACS). Retrospective cohort analysis of premature infants with gestational age of 26-32 weeks without congenital malformations, born between January of 2006 and December of 2009 in a tertiary, public university hospital. Maternal and neonatal demographic data, neonatal morbidities, and hospital inpatient services during the hospitalization were collected. The costs were analyzed using the microcosting technique. Of 220 patients that met the inclusion criteria, 211 (96%) charts were reviewed: 170 newborns received at least one dose of antenatal corticosteroid and 41 did not receive the antenatal medication. There was a 14-37% reduction of the different cost components in infants exposed to ACS when the entire population was analyzed, without statistical significance. Regarding premature infants who were discharged alive, there was a 24-47% reduction of the components of the hospital services costs for the ACS group, with a significant decrease in the length of stay in the neonatal intensive care unit (NICU). In very-low birth weight infants, considering only the survivors, ACS promoted a 30-50% reduction of all elements of the costs, with a 36% decrease in the total cost (p=0.008). The survivors with gestational age <30 weeks showed a decrease in the total cost of 38% (p=0.008) and a 49% reduction of NICU length of stay (p=0.011). ACS reduces the costs of hospitalization of premature infants who are discharged alive, especially those with very low birth weight and <30 weeks of gestational age. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.
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Prevalence of domestic violence among antenatal women attending a Nigerian hospital.
Gyuse, A N I; Ushie, A P; Etukidem, A
2009-01-01
Health is defined as a state of complete physical, mental, social and spiritual well being and not just the absence of disease. Domestic violence (synonyms: spouse abuse, partner or intimate violence, family violence) is a public health problem which is defined as any intentional abuse of a family member (mostly females but not exclusive) by his/her partner that causes pain or injury. There is paucity of data on domestic violence mainly because of under-reporting by the victims. However, domestic violence is said to be a more frequent occurrence than other recognized pregnancy complications such as pre-eclampsia, twin pregnancy or gestational diabetes for which women are routinely screened during the antenatal period. The aim of the study was to determine the prevalence of domestic violence in pregnant women attending the antenatal clinic of a local Nigerian mission hospital in Jos, Plateau state. This was a cross-sectional, descriptive study of women attending antenatal clinic at ECWA Evangel Hospital, Jos over a six month period using the Abuse Assessment Screen developed by McFarlane to detect the prevalence of domestic violence. The data were analysed using Epi Info Version 2002. Three hundred and forty pregnant women were studied. Majority of them were married and were mostly aged between 20 and 39 years. Domestic violence prevalence was 12.6% (43) in the current pregnancy and 63.2% (215) previously. The study establishes that women in our environment experience domestic violence during pregnancy and majority of them also have a previous history of abuse. There is the need to routinely screen for domestic violence in pregnant women so as to prevent potential adverse pregnancy outcomes and to interrupt existing abuse.
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The Ghanaian Woman's experience and perception of ultrasound use in antenatal care
International Nuclear Information System (INIS)
Mensah, Y. B.; Nkyekyer, K.; Mensah, K.
2014-01-01
The objective of this study is to evaluate how Ghanaian women perceive the use, and their assessment of the experience, of antenatal ultrasound scanning. A cross-sectional study, using interviewer administered questionnaire, from 25th February to 16th April, 2011 was conducted at the Obstetrics Units of Korle Bu Teaching Hospital, Accra, University of Ghana Hospital, Legon and Ga South District Hospital, Weija. A total of 337 clients were randomly selected after delivery and interviewed. Issues addressed included why women went for antenatal ultrasound, their knowledge of the uses of ultrasound in pregnancy, information provided by health care providers, clients’ eagerness to know the sex of their fetuses, and their overall assessment of the ultrasound scanning experience. The results of this study showed that the mean number of scans was 2.2(1.1). Most were performed on the request of a doctor or midwife; 154(45.7%) were not told the reasons for the request and 185(54.9%) did not have the results explained to them. For 239(70.9%) women the sonographer did not explain the procedure before the examination; 89(26.4%) were allowed to ask questions and 61(18.1%) were allowed to see their fetuses on the monitor. One hundred and sixty respondents (47.5%) asked for and were told the sex of their fetuses, with accuracy at delivery of 86.5%. Most respondents perceived antenatal ultrasound as a useful tool. There is lack of information flow from health care providers to clients concerning the indications for the ultrasound, the processes involved and the results of the procedure. Improvements in these areas are needed to enhance the experience of antenatal ultrasound among Ghanaian women
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Moon, Rebecca J; Harvey, Nicholas C; Cooper, Cyrus; D'Angelo, Stefania; Curtis, Elizabeth M; Crozier, Sarah R; Barton, Sheila J; Robinson, Sian M; Godfrey, Keith M; Graham, Nikki J; Holloway, John W; Bishop, Nicholas J; Kennedy, Stephen; Papageorghiou, Aris T; Schoenmakers, Inez; Fraser, Robert; Gandhi, Saurabh V; Prentice, Ann; Inskip, Hazel M; Javaid, M Kassim
2017-08-01
Single-nucleotide polymorphisms (SNPs) in genes related to vitamin D metabolism have been associated with serum 25-hydroxyvitamin D [25(OH)D] concentration, but these relationships have not been examined following antenatal cholecalciferol supplementation. To determine whether SNPs in DHCR7, CYP2R1, CYP24A1, and GC are associated with the response to gestational cholecalciferol supplementation. Within-randomization group analysis of the Maternal Vitamin D Osteoporosis Study trial of antenatal cholecalciferol supplementation. Hospital antenatal clinics. In total, 682 women of white ethnicity (351 placebo, 331 cholecalciferol) were included. SNPs at rs12785878 (DHCR7), rs10741657 (CYP2R1), rs6013897 (CYP24A1), and rs2282679 (GC) were genotyped. 1000 IU/d cholecalciferol from 14 weeks of gestation until delivery. 25(OH)D at randomization and 34 weeks of gestation were measured in a single batch (Liaison; Diasorin, Dartford, UK). Associations between 25(OH)D and the SNPs were assessed by linear regression using an additive model [β represents the change in 25(OH)D per additional common allele]. Only rs12785878 (DHCR7) was associated with baseline 25(OH)D [β = 3.1 nmol/L; 95% confidence interval (CI), 1.0 to 5.2 nmol/L; P D status following supplementation, whereas rs12785878 and rs6013897 (CYP24A1) were not. Genetic variation in DHCR7, which encodes 7-dehyrocholesterol reductase in the epidermal vitamin D biosynthesis pathway, appears to modify baseline 25(OH)D. In contrast, the response to antenatal cholecalciferol supplementation was associated with SNPs in CYP2R1, which may alter 25-hydroxylase activity, and GC, which may affect vitamin D binding protein synthesis or metabolite affinity. Copyright © 2017 Endocrine Society
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Path model of antenatal stress and depressive symptoms among Chinese primipara in late pregnancy.
Li, Yingtao; Zeng, Yingchun; Zhu, Wei; Cui, Ying; Li, Jie
2016-07-21
Antenatal maternal mental health problems have numerous consequences for the well-being of both mother and child. This study aimed to test and construct a pertinent model of antenatal depressive symptoms within the conceptual framework of a stress process model. This study utilized a cross-sectional study design. participants were adult women (18 years or older) having a healthy pregnancy, in their third trimester (the mean weeks gestation was 34.71). depressive and anxiety symptoms were measured by Zung's Self-rating Depressive and Anxiety Scale, stress was measured by Pregnancy-related Pressure Scale, social support and coping strategies were measured by Social Support Rating Scale and Simplified Coping Style Questionnaire, respectively. path analysis was applied to examine the hypothesized causal paths between study variables. A total of 292 subjects were enrolled. The final testing model showed good fit, with normed χ (2) = 32.317, p = 0.061, CFI = 0.961, TLI = 0.917, IFI = 0.964, NFI = 0.900, RMSEA = 0.042. This path model supported the proposed model within the theoretical framework of the stress process model. Pregnancy-related stress, financial strain and active coping have both direct and indirect effects on depressive symptoms. Psychological preparedness for delivery, social support and anxiety levels have direct effects on antenatal depressive symptoms. Good preparedness for delivery could reduce depressive symptoms, while higher levels of anxiety could significantly increase depressive symptoms. Additionally, there were indirect effects of miscarriage history, irregular menstruation, partner relationship and passive coping with depressive symptoms. The empirical support from this study has enriched theories on the determinants of depressive symptoms among Chinese primipara, and could facilitate the formulation of appropriate interventions for reducing antenatal depressive symptoms, and enhancing the mental health of
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Shared antenatal care fails to rate well with women of non-English-speaking backgrounds.
Small, R; Lumley, J; Yelland, J; Rice, P L
1998-01-05
To compare the views of women from non-English-speaking backgrounds who received antenatal care at a public hospital clinic with those whose care was shared between a public hospital clinic and a general practitioner. Structured interviews in the language of the woman's choice. Women were recruited from the postnatal wards of three maternity teaching hospitals in Melbourne between July 1994 and November 1995, and interviewed six to nine months later. Women born in Vietnam, Turkey and the Philippines who gave birth to a live healthy baby (over 1500 g) were eligible. Of 435 women recruited, 318 (Vietnamese [32.7%], Filipino [33.6%] and Turkish [33.6%]) completed the study. Women's ratings of their antenatal care overall and views on specific aspects of their antenatal care. Women in shared care (n = 151) were not more likely than women in public clinic care (n = 143) to rate their care as "very good" (odds ratio [OR], 1.38; 95% confidence interval [95% CI], 0.72-2.63). Satisfaction with particular aspects of care (waiting times, opportunity to ask questions, whether caregivers were rushed, whether concerns were taken seriously) did not differ significantly between those in shared care and those in public clinic care. Women in shared care were not happier with their medical care than women in public clinic care (OR, 0.83; 95% CI, 0.35-1.96), but were more likely to see a caregiver who spoke their language (OR, 17.69; 95% CI, 6.15-69.06), although two-thirds still saw a GP who spoke only English. Shared antenatal care is not more satisfying than public clinic care for women from non-English-speaking backgrounds. Further evaluation of shared care is clearly needed.
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Comportamiento isohídrico o anisohídrico en vides…. ¿Una controversia sin fin?
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Hugalde, I. P.
2014-04-01
Full Text Available De acuerdo al tipo de respuesta estomática, muchas especies han sido clasificadas como isohídricas o anisohídricas. Las plantas isohídricas son aquellas que cierran sus estomas cuando sensan una caída en el potencial hídrico del suelo, o un aumento en la demanda atmosférica. Al contrario, las plantas anisohídricas no cierran sus estomas y continúan transpirando aun cuando el contenido hídrico del suelo disminuya. Como consecuencia, su potencial hídrico foliar (ΨL cae, y la planta sufre estrés hídrico. En general, se considera que la vid es una planta que evita el estrés hídrico mediante un manejo estomático eficiente. Sin embargo, algunas variedades han mostrado tener un control más estricto que otras. Por esto, algunas variedades pueden ser clasificadas como isohídricas o anisohídricas. Actualmente, esta clasificación se encuentra bajo gran controversia debido a que muchas variedades clasificadas de una manera, mostraron comportamientos opuestos según diferentes situaciones ambientales, climáticas y edáficas. En consecuencia, muchos autores opinan que para variedades de vid esta clasificación no es correcta ni rigurosa. Nuestro estudio pone en revisión, una vez más, el comportamiento de cuatro variedades de vid: (Syrah, Grenache, Malbec y Chardonnay bajo déficit hídrico moderado, tratando de explicar los comportamientos según variables fisiológicas como conductancia estomática (gs, conductancia hidráulica (kH y déficit parcial de vapor (dpv; definiendo qué comportamiento confiere mayor tolerancia a sequía.
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Antenatal Testing – A Reevaluation
Signore, Caroline; Freeman, Roger K.; Spong, Catherine Y.
2009-01-01
In August 2007, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institutes of Health Office of Rare Diseases, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics cosponsored a 2-day workshop to reassess the body of evidence supporting antepartum assessment of fetal well-being, identify key gaps in the evidence, and formulate recommendations for further research. Participants included experts in obstetrics and fetal physiology, and representatives from relevant stakeholder groups and organizations. This article is a summary of the discussions at the workshop, including synopses of oral presentations on the epidemiology of stillbirth and fetal neurological injury, fetal physiology, techniques for antenatal monitoring, and maternal and fetal indications for monitoring. Finally, a synthesis of recommendations for further research compiled from three breakout workgroups is presented. PMID:19300336
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Phillips, Louise; Thomas, Dona
2015-08-01
to explore and gain insight into the expectations and experiences of women with a pre-existing diagnosis of mental illness, of their first booking appointment; to make recommendations for practice development and collaborative partnership working between healthcare professionals. a qualitative design using semi structured interviews and thematic analysis of the data. QSR NVivo 10 software is used to organise the data into themes. the interviews took place either at the women׳s homes, or within the antenatal service with the consent of the woman and relevant practitioners. twelve participants were selected from one antenatal clinic and one perinatal mental health service. the themes identified within the data included the lack of information prior to the initial midwife booking appointment; the perception of too much information at the initial booking appointment and women not being clear about their mental health needs at this time; a general positivity about disclosing mental illness diagnoses; overall positive thoughts about midwives although some midwives appeared less knowledgeable about bipolar disorder, and perceptions about a lack of joined up working between antenatal and perinatal mental health services. it is recommended that GPs receive adequate training in order to equip them with the skills needed to discuss sensitive issues around perinatal mental illness and the impact on pregnancy and childbirth. Women require more information about their booking appointment, and it would be beneficial for their emotional and physical health needs to be assessed at each follow-up antenatal appointment. Midwives need to be facilitated to receive up-to-date knowledge of antenatal and postnatal mental illness and treatments, and the referral process to perinatal mental health services. Copyright © 2015 Elsevier Ltd. All rights reserved.
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Luz, Rita; George, Astrid; Vieux, Rachel; Spitz, Elisabeth
2017-03-01
Parental (parent-to-infant) attachment and parenting alliance are defined as two important components of psychoaffective adjustment to the parental role. This study aimed to build a predictive model of parental attachment and parenting alliance for mothers and fathers using partial least squares-structural equation modeling. Specifically, we were interested in assessing how adult romantic attachment, marital quality, and psychological distress influenced parental attachment (parent-to-infant) and parenting alliance. Forty heterosexual couples completed questionnaires during the third trimester of pregnancy and 2 months after childbirth. Results showed that adult romantic attachment, marital quality, and psychological distress were important antenatal determinants of parental attachment and parenting alliance, although they behaved differently for mothers and fathers. Hence, different predictive models were therefore proposed for mothers and fathers. Mothers' attachment to the child was influenced by internal factors as adult attachment dimensions; for fathers, it also depended on mothers' antenatal attachment to the child and on marital quality. Concerning parenting alliance, both mothers and fathers depended on own and partner's variables. Antenatal variables are important for what occurs during the transition to parenthood in terms of parenting adjustment and act differently for mothers and fathers. It thus is important to assess the psychological functioning of both mothers and fathers. © 2017 Michigan Association for Infant Mental Health.
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Using the Cascade Model to Improve Antenatal Screening for the Hemoglobin Disorders
Gould, Dinah; Papadopoulos, Irena; Kelly, Daniel
2012-01-01
Introduction: The inherited hemoglobin disorders constitute a major public health problem. Facilitators (experienced hemoglobin counselors) were trained to deliver knowledge and skills to "frontline" practitioners to enable them to support parents during antenatal screening via a cascade (train-the-trainer) model. Objectives of…
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COMPARATIVE STUDY OF EFFICACY OF FERROUS SULPHATE AND CARBONYL IRON IN ANEMIA OF ANTENATAL WOMEN
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Radhika
2015-03-01
Full Text Available Iron deficiency anemia is the most common and important public health problem all over the world in the risk group of antenatal women. Research is going on to improve the iron status of the pregnant women with different forms of iron available. In this regard, Carbonyl Iron is showing promising results in improving the red cell mass with better compliance. 120 antenatal women were recruited in this study. The study comprised of 6weeks for each patient. They were given Carbonyl Iron 100 mg/day and FeS04 100gm/day . Before and after treatment all the baseline and specific investigations were one. Results were tabulated, comparison and significance were tested by unpaired student ’s’ test and their 'p' value was calculated. Results were shown graphically also. Carbonyl Iron showed improvement in hemoglobin, PCV and better than ferrous Sulphate (P <0.001. Incidence of side effects were less with Carbonyl Iron than Ferrous Sulphate, better compliance was seen with Carbonyl Iron. In conclusion, the present study s howed that Carbonyl Iron had better efficacy and safety in the management of Iron deficiency anemia in antenatal women than ferrous Sulphate
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Farmer, Jane; Stimpson, Paul; Tucker, Janet
2003-11-01
There is evidence of variation and some ambiguity about self-perceived relative professional roles in antenatal care in the UK. There is little information about models of antenatal care provision in UK rural areas. In rural areas, in particular, women have limited choice in accessing health care professionals or alternative primary care delivery settings. In the light of a recent review of Scottish maternity services, it is important and timely to examine models of care and interprofessional working in antenatal care in rural areas. This study explores midwives' and GPs' perceptions about their relative professional roles in remote and rural general practice in Scotland. A questionnaire survey involving all 174 Scottish remote and rural general practices (using one definition of rurality) was conducted, followed by 20 interviews. At least one professional returned a completed questionnaire from 91% of rural practices. A number of areas of dissonance were noted between GPs' and midwives' perceptions of their roles in maternity care and, given the context of service provision, these may impact upon rural patients. Findings are relevant to wider debates on extending the primary care team and strengthening inter-disciplinary working, particularly in rural areas.
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Antenatal renal pelvic dilatation; the long-term outlook
Energy Technology Data Exchange (ETDEWEB)
Duncan, K.A. [Royal Aberdeen Children' s Hospital and Aberdeen Maternity Hospital, Foresterhill, Aberdeen (United Kingdom)]. E-mail: k.duncan@nhs.net
2007-02-15
Aim: The purpose of this study was twofold: first to provide data for more accurate counselling of parents with regard to prognosis, and second, to ensure that by following a policy of selective micturating cystourethography (MCUG), significant pathology is not missed, in particular vesicoureteric reflux (VUR). (MCUG is only undertaken if the renal pelvic diameter (RPD) is {>=} 10 mm or if there is calyceal or ureteric dilatation.) Material and methods: Data were collected prospectively over a 6-year period. Pre and postnatal imaging findings were collected for all infants in whom a RPD of {>=} 5 mm was identified at any gestational age. The imaging records of all patients were reviewed in 2005 for evidence of pathology detected after re-presentation with symptoms. The age range at review varied from 2-8 years. Results: Complete data were available in 527 infants. The risk of significant pathology was related to the degree of antenatal renal pelvic dilatation varying from 6% for a RPD of 5 mm at 20 weeks gestation to 38% at 10mm. At 28-33 weeks gestation the risk varied from 5% at 5 mm to 15% at 10 mm. Subsequent imaging record review revealed only one patient with grade II VUR in the study population not picked up by our selective MCUG policy. Conclusion: The present study provides prognostic information that can be given to parents both antenatally and postnatally, and reassurance that a selective MCUG policy is appropriate.
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Antenatal renal pelvic dilatation; the long-term outlook
International Nuclear Information System (INIS)
Duncan, K.A.
2007-01-01
Aim: The purpose of this study was twofold: first to provide data for more accurate counselling of parents with regard to prognosis, and second, to ensure that by following a policy of selective micturating cystourethography (MCUG), significant pathology is not missed, in particular vesicoureteric reflux (VUR). (MCUG is only undertaken if the renal pelvic diameter (RPD) is ≥ 10 mm or if there is calyceal or ureteric dilatation.) Material and methods: Data were collected prospectively over a 6-year period. Pre and postnatal imaging findings were collected for all infants in whom a RPD of ≥ 5 mm was identified at any gestational age. The imaging records of all patients were reviewed in 2005 for evidence of pathology detected after re-presentation with symptoms. The age range at review varied from 2-8 years. Results: Complete data were available in 527 infants. The risk of significant pathology was related to the degree of antenatal renal pelvic dilatation varying from 6% for a RPD of 5 mm at 20 weeks gestation to 38% at 10mm. At 28-33 weeks gestation the risk varied from 5% at 5 mm to 15% at 10 mm. Subsequent imaging record review revealed only one patient with grade II VUR in the study population not picked up by our selective MCUG policy. Conclusion: The present study provides prognostic information that can be given to parents both antenatally and postnatally, and reassurance that a selective MCUG policy is appropriate
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Efectos y controversias de los ácidos grasos omega-3: effects and controversies Omega-3 fatty acids
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Fernando Manzur
Full Text Available Gracias al descubrimieno del mecanismo de acción de los ácidos grasos omega-3 para disminuir las arritmias ventriculares, éstos han vuelto a cobrar importancia por su efecto cardio-protector. La ingestión de ácidos grasos omega-3 disminuye el riesgo de trombosis y accidentes cerebro-vasculares al disminuir los lípidos sanguíneos, mejorando en esta forma la función endotelial. Sin embargo, algunos estudios epidemiológicos no han encontrado una relación directa a este respecto y además hay controversia respecto a las dosis necesarias para lograr este efecto cardio-protector. Hay estudios que reportan que el contenido de metil-mercurio en peces afecta la disposición de los ácidos grasos omega-3. En el Caribe colombiano se ha encontrado contaminación de peces con metil-mercurio.Thanks to the discovery of omega-3 fatty acids’ mechanism of action, these have regained importance due to its cardio-protective effect. The ingestion of omega-3 fatty acids diminishes the risk of thrombosis and cerebro-vascular accidents by lowering serum lipids and improving endothelial function. Nevertheless, some epidemiological studies have not found a direct relationship with them and there is controversy with regard to the doses needed in order to achieve this cardio-protective effect. There are studies reporting that the methyl-mercury content in fish affects omega-3 fatty acids’ disposal. In the Colombian Caribbean region, fish contamination with methyl-mercury has been found.
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O'Kelly, Sonia M; Moore, Zena Eh
2017-12-04
The female perineum becomes suffused and stretched during pregnancy, and further strain during vaginal childbirth contributes to approximately 85% of women experiencing some degree of trauma to the perineal region. Multiple factors play a role in the type and severity of trauma experienced, including parity, delivery method, and local practices. There is ongoing debate about best midwifery practice to reduce perineal trauma. Once perineal trauma has occurred, treatment also varies greatly, depending on its degree and severity, local practice and customs, and personal preference. In order to optimise wound-healing outcomes, it is important that wounds are assessed and managed in an appropriate and timely manner. A perineal wound may cause significant physical and/or psychological impact in the short or long term, however little evidence is available on this subject.Antenatal education serves to prepare women and their partners for pregnancy, delivery and the postpartum period. The delivery of this education varies widely in type, content, and nature. This review examined antenatal education which is specifically tailored towards perineal care and wound healing in the postnatal period via formal channels. Appropriate patient education positively impacts on wound-healing rates and compliance with wound care. Risk factors that contribute to the breakdown of wounds and poor healing rates may be addressed antenatally in order to optimise postnatal wound healing. It is important to assess whether or not antenatal wound-care education positively affects perineal healing, in order to empower women to incorporate best practice, evidence-based treatment with this important aspect of self-care in the immediate postnatal period. To evaluate the effects of antenatal education on perineal wound healing in postnatal women who have birthed in a hospital setting, and who have experienced a break in the skin of the perineum as a result of a tear or episiotomy, or both. We searched
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Effect of antenatal corticosteroids on postmortem brain weight of preterm babies.
Murphy, D J
2001-07-01
To investigate the effects of single and repeated courses of antenatal corticosteroids on brain growth in very preterm babies. Retrospective study of 110 very preterm babies delivered at a single University Teaching Hospital between 1992 and 1999 who had a full necropsy including detailed examination of the brain. Mean brain weight did not differ significantly between babies who received corticosteroids and those who did not 160 vs. 157 g, (p=0.82), nor was there a difference between mean brain weight of stillborn or liveborn babies in relation to steroid use 164 vs. 159 g, (p=0.84) and 156 vs. 152g (p=0.81). There was no apparent dose-response relationship between the total number of doses of corticosteroids or timing since the first dose of corticosteroids and brain weight, p=0.95 and p=0.87. Single and multiple courses of antenatal corticosteroids had no significant effect on brain growth in babies delivered preterm who died but long-term follow-up studies are required to evaluate the functional neurological outcome of surviving children.
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Victora, C G; Matijasevich, A; Silveira, Mf; Santos, Is; Barros, A J D; Barros, F C
2010-07-01
Socio-economic inequalities in maternal and child health are ubiquitous, but limited information is available on how much the quality of care varies according to wealth or ethnicity in low- and middle-income countries. Also, little information exists on quality differences between public and private providers. Quality of care for women giving birth in 2004 in Pelotas, Brazil, was assessed by measuring how many of 11 procedures recommended by the Ministry of Health were performed. Information on family income, self-assessed skin colour, parity and type of provider were collected. Antenatal care was used by 98% of the 4244 women studied (mean number of visits 8.3), but the number of consultations was higher among better-off and white women, who were also more likely to start antenatal care in the first trimester. The quality of antenatal care score ranged from 0 to 11, with an overall mean of 8.3 (SD 1.7). Mean scores were 8.9 (SD 1.5) in the wealthiest and 7.9 (SD 1.8) in the poorest quintiles (P differences seemed to be due to attendance patterns rather than discrimination. Mean quality scores were higher in the private 9.3 (SD 1.3) than in the public sector 8.1 (SD 1.6) (P differences were not explained by maternal characteristics or by attendance patterns. Special efforts must be made to improve quality of care in the public sector. Poor and black women should be actively encouraged to start antenatal care early in pregnancy so that they can fully benefit from it. There is a need for regular monitoring of antenatal attendances and quality of care with an equity lens, in order to assess how different social groups are benefiting from progress in health care.
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Antenatal care visits' absenteeism at a secondary care medical facility in Southwest Nigeria.
Oloko, Olakunle; Ogunbode, Olayinka Oladunjoye; Roberts, Olumuyiwa; Arowojolu, Ayodele Olatunji
2016-11-01
Antenatal care (ANC) is a specialised pattern of care organised for pregnant women with the goal of maintaining good health and promoting safe delivery of healthy infants. It is an indispensable part of effective maternity care services. This study identified the factors responsible for absenteeism from ANC follow-up visits. It was a hospital-based prospective cross-sectional descriptive study conducted at a faith based secondary healthcare facility in Ibadan, Nigeria. Relevant data were retrieved using interviewer-administered structured questionnaires and antenatal health record cards. The major reasons identified for absenteeism were delay in receiving hospital services due to long queues at service points and understaffing. The pregnant women aged 35 years and above were the most likely to miss the visits. Therefore, there is the need for hospital administrators and health care givers to make the services patient-friendly.
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FACTORS LEAD TO DEPRESION DURING ANTENATAL CARE EVERY TRIMESTER OF PREGNANT MOTHER
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Eddy Surya Kurniawan
2013-03-01
Full Text Available The most important factor in reducing maternal and infant mortality rates began during pregnancy. In 2000, one in twenty children die before reaching the age of five years and a mother died of childbirth out of every 325 live births. The death rate in research mainly indicated comparable levels of depression due to stress in pregnant women. The occurrence of symptoms of depression during the perinatal period can be easily recognized. Depression during pregnancy is a common mood disorder such as depression that occurs in the laity in general, where the incidence of depression will occur chemical changes in the brain. Each trimester of pregnancy are at risk of psychological disorders respectively. Antenatal care plays a very important for the safety of the mother and fetus, minimizing the risks of pregnancy, and reduce the number of neonatal deaths. Nursing antenatal care should have run in accordance with minimum standards for pregnant women to obtain a safe childbirth and satisfying.
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Boah, Michael; Mahama, Abraham B; Ayamga, Emmanuel A
2018-05-03
Research has shown that use of antenatal services by pregnant women and delivery in health facilities with skilled birth attendants contribute to better delivery outcomes. However, a gap exists in Ghana between the use of antenatal care provided by health facilities and delivery in health facilities with skilled birth attendants by pregnant women. This study sought to identify the predictors of health facility delivery by women in a rural district in Ghana. This was a cross-sectional study conducted in June 2016. Women who delivered in the past 6 months preceding the study were interviewed. Data on socio-demographic characteristics, use of antenatal care, place of delivery and reasons for home delivery were collected from study participants. Chi-square test and multiple logistic regression analysis were used to assess an association between women's socio-demographic and obstetric characteristics and place of delivery at 95% confidence interval. The study found that 98.8% of women received antenatal care services at least once during their recent pregnancy, and 67.9% attended antenatal care at least four times before delivery. However, 61.9% of the women delivered in a health facility with a skilled attendant. The frequently mentioned reason for home delivery was "unaware of onset of labour and delivery". The odds for delivery at a health facility were reduced among women with four living children [(AOR = 0.07, CI = 0.15-0.36, p = 0.001)], with no exposure to delivery care information [(AOR = 0.06, CI = 0.01-0.34, p = 0.002), who started their first ANC visit from the second trimester of pregnancy[(AOR = 0.003, CI = 0.01-0.15, p facilities although visits to antenatal care sessions were high, an indication that there was the need to intensify health education on early initiation of antenatal care, signs of labour and delivery, and importance of health facility delivery.
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Symon, Andrew G; Whitford, Heather; Dalzell, Janet
2013-07-01
breast-feeding initiation rates have improved in Scotland, but exclusive and partial breast-feeding rates fall rapidly for several reasons. We aimed to examine whether antenatal feeding intention was associated with satisfaction with infant feeding method; and to explore the similarities and differences in infant feeding experience of women with different antenatal feeding intention scores. antenatal questionnaire assessment of infant feeding intentions, based on the theory of planned behaviour; two-weekly postnatal follow-up of infant feeding practice by text messaging; final telephone interview to determine reasons for and satisfaction with infant feeding practice. 355 women in eastern Scotland were recruited antenatally; 292 completed postnatal follow up. Antenatal feeding intentions broadly predicted postnatal practice. The highest satisfaction scores were seen in mothers with no breast-feeding intention who formula fed from birth, and those with high breast-feeding intention who breastfed for more than 8 weeks. The lowest satisfaction scores were seen in those with high intention scores who only managed to breast feed for less than 3 weeks. This suggests that satisfaction with infant feeding is associated with achieving feeding goals, whether artificial milk or breast feeding. Reasons for stopping breast feeding were broadly similar over time (too demanding, pain, latching, perception of amount of milk, lack of professional support, sibling jealousy). Perseverance appeared to mark out those women who managed to breast feed for longer; this was seen across the socio-economic spectrum. Societal and professional pressure to breast feed was commonly experienced. satisfaction with actual infant feeding practice is associated with antenatal intention; levels are higher for those meeting their goals, whether formula feeding from birth or breast feeding for longer periods. Perceived pressure to breast feed raises questions about informed decision making. Identifying
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Wang, Yang; Wang, Xiaohua; Liu, Fangnan; Jiang, Xiaoning; Xiao, Yun; Dong, Xuehan; Kong, Xianglei; Yang, Xuemei; Tian, Donghua; Qu, Zhiyong
2016-01-01
Few studies have looked at the relationship between psychological and the mental health status of pregnant women in rural China. The current study aims to explore the potential mediating effect of negative automatic thoughts between negative life events and antenatal depression. Data were collected in June 2012 and October 2012. 495 rural pregnant women were interviewed. Depressive symptoms were measured by the Edinburgh postnatal depression scale, stresses of pregnancy were measured by the pregnancy pressure scale, negative automatic thoughts were measured by the automatic thoughts questionnaire, and negative life events were measured by the life events scale for pregnant women. We used logistic regression and path analysis to test the mediating effect. The prevalence of antenatal depression was 13.7%. In the logistic regression, the only socio-demographic and health behavior factor significantly related to antenatal depression was sleep quality. Negative life events were not associated with depression in the fully adjusted model. Path analysis showed that the eventual direct and general effects of negative automatic thoughts were 0.39 and 0.51, which were larger than the effects of negative life events. This study suggested that there was a potentially significant mediating effect of negative automatic thoughts. Pregnant women who had lower scores of negative automatic thoughts were more likely to suffer less from negative life events which might lead to antenatal depression.
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Directory of Open Access Journals (Sweden)
DaLiao Xiao
Full Text Available In utero exposure to adverse environmental factors increases the risk of cardiovascular disease in adulthood. The present study tested the hypothesis that antenatal hypoxia causes a gender-dependent programming of altered arterial blood pressure response (BP in adult offspring. Time-dated pregnant rats were divided into normoxic and hypoxic (10.5% O2 from days 15 to 21 of gestation groups. The experiments were conducted in adult offspring. Antenatal hypoxia caused intrauterine growth restriction, and resulted in a gender-dependent increase Angiotensin II (Ang II-induced BP response in male offspring, but significant decrease in BP response in female offspring. The baroreflex sensitivity was not significantly altered. Consistent with the reduced blood pressure response, antenatal hypoxia significantly decreased Ang II-induced arterial vasoconstriction in female offspring. Ovariectomy had no significant effect in control animals, but significantly increased Ang II-induced maximal BP response in prenatally hypoxic animals and eliminated the difference of BP response between the two groups. Estrogen replacement in ovariectomized animals significantly decreased the BP response to angiotensin II I only in control, but not in hypoxic animals. The result suggests complex programming mechanisms of antenatal hypoxia in regulation of ovary function. Hypoxia-mediated ovary dysfunction results in the phenotype of reduced vascular contractility and BP response in female adult offspring.
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Hussein, Mohamed Ali
2014-01-01
Women's relative lack of decision-making power and their unequal access to employment, finances, education, basic health care, and other resources are considered to be the root causes of their ill-health and that of their children. The main purpose of this paper is to examine the interactive relation between women's empowerment and the use of maternal health care. Two model specifications are tested. One assumes no correlation between empowerment and antenatal care while the second specification allows for correlation. Both the univariate and the recursive bivariate probit models are tested. The data used in this study is EDHS 2008. Factor Analysis Technique is also used to construct some of the explanatory variables such as the availability and quality of health services indicators. The findings show that women's empowerment and receiving regular antenatal care are simultaneously determined and the recursive bivariate probit is a better approximation to the relationship between them. Women's empowerment has significant and positive impact on receiving regular antenatal care. The availability and quality of health services do significantly increase the likelihood of receiving regular antenatal care. PMID:25140310
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Lau, C T; Kan, A; Shek, N; Tam, P; Wong, K K Y
2017-01-01
Congenital pulmonary airway malformation (CPAM) is an increasingly recognized disease with potential mortality. Owing to limited published studies, the true incidence is yet to be determined. We carried out this prospective study with the aim to estimate its true incidence on a population basis. An antenatal ultrasonography program was implemented since 2009. Fetuses with suspected intra-thoracic lesions were monitored by regular follow-ups. Antenatal course, postnatal outcomes, and other demographics were compared to those of patients with CPAM in the previous decades (1989-2008). The incidence of CPAM was calculated in different periods. 66 CPAM patients were identified between 2009 and 2014 with 62 patients being detected by antenatal scan. In contrast, 45 patients were identified between 1989 and 2008 with 27 patients being detected antenatally. The incidence rate during the past and recent period was estimated as ~1 in 27,400 and ~1 in 7200 live births, respectively (p = 0.024). With increasing awareness of clinicians and the universal use of latest ultrasound technology, it is likely that more CPAM cases will be detected in the future. Here, we presented our best estimated incidence rate of CPAM, yet only a larger scale study can reveal its true incidence.
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Rahmani, Zuhal; Brekke, Mette
2013-05-06
Despite attempts from the government to improve ante- and perinatal care, Afghanistan has once again been labeled "the worst country in which to be a mom" in Save the Children's World's Mothers' Report. This study investigated how pregnant women and health care providers experience the existing antenatal and obstetric health care situation in Afghanistan. Data were obtained through one-to-one semi-structured interviews of 27 individuals, including 12 women who were pregnant or had recently given birth, seven doctors, five midwives, and three traditional birth attendants. The interviews were carried out in Kabul and the village of Ramak in Ghazni Province. Interviews were taped, transcribed, and analyzed according to the principles of Giorgi's phenomenological analysis. Antenatal care was reported to be underused, even when available. Several obstacles were identified, including a lack of knowledge regarding the importance of antenatal care among the women and their families, financial difficulties, and transportation problems. The women also reported significant dissatisfaction with the attitudes and behavior of health personnel, which included instances of verbal and physical abuse. According to the health professionals, poor working conditions, low salaries, and high stress levels contributed to this matter. Personal contacts inside the hospital were considered necessary for receiving high quality care, and bribery was customary. Despite these serious concerns, the women expressed gratitude for having even limited access to health care, especially treatment provided by a female doctor. Health professionals were proud of their work and enjoyed the opportunity to help their community. This study identified several obstacles which must be addressed to improve reproductive health in Afghanistan. There was limited understanding of the importance of antenatal care and a lack of family support. Financial and transportation problems led to underuse of available care
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Turton, Mervyn Sydney; Henkel, Ralf Reinhold; Africa, Charlene Wilma Joyce
2017-12-01
Although the association between periodontal disease (PD) and adverse pregnancy outcomes has gained recognition amongst antenatal healthcare workers, not much has changed in practice to address it. This prospective study tested the hypothesis that BANA (N-benzoyl-DL-arginine-2-naphthylamide), a diagnostic test for PD, may inform obstetricians and other antenatal healthcare practitioners, of the risk of adverse pregnancy outcomes in mothers attending antenatal clinics. At first visit, the presence of suspected periodontopathogens was assessed by BANA testing of dental plaque from 443 mothers attending antenatal clinics in KwaZulu-Natal, South Africa and an association later sought with pregnancy outcomes. The accuracy of BANA to predict adverse pregnancy outcomes was evaluated by the calculation of likelihood ratios. The study complied with the Declaration of Helsinki. Significant differences were found between pregnancy outcomes of BANA-negative and BANA-positive mothers (p periodontal therapy to reduce the risk of adverse pregnancy outcomes and could form part of the routine antenatal examination.
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Antenatal dietary patterns and depressive symptoms during pregnancy and early post-partum.
Baskin, Rachel; Hill, Briony; Jacka, Felice N; O'Neil, Adrienne; Skouteris, Helen
2017-01-01
Perinatal depression is a debilitating disorder experienced during pregnancy and/or the first year post-partum. Recently, maternal dietary intake during pregnancy has emerged as a possible area of intervention for the prevention of mental disorders in women and their offspring. However, the relationship between antenatal diet quality and perinatal depressive symptoms remains poorly understood. The current study explored the predictive role of antenatal diet quality for antenatal and post-natal depressive symptoms. Pregnant women (n = 167) were recruited between February 2010 and December 2011. Women completed the Edinburgh Postnatal Depression Scale at time 1 [T1, mean weeks gestation = 16.70, standard deviation (SD) = 0.91], time 2 (T2, mean weeks gestation = 32.89, SD = 0.89) and time 3 (T3, mean weeks post-partum = 13.51, SD = 1.97) and a food frequency questionnaire at T1 and T2. Diet quality was determined by extracting dietary patterns via principal components analysis. Two dietary patterns were identified: 'healthy' (including fruit, vegetables, fish and whole grains) and 'unhealthy' (including sweets, refined grains, high-energy drinks and fast foods). Associations between dietary patterns and depressive symptoms were investigated by path analyses. While both 'healthy' and 'unhealthy' path models showed good fit, only one significant association consistent with study hypotheses was found, an 'unhealthy' diet was associated with increased depressive symptoms at 32 weeks gestation. Given that this association was cross-sectional, it was not possible to make any firm conclusions about the predictive nature of either dietary patterns or depressive symptoms. Dietary intervention studies or larger prospective studies are therefore recommended. © 2015 John Wiley & Sons Ltd.
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Burguet, A; Kaminski, M; Truffert, P; Menget, A; Marpeau, L; Voyer, M; Roze, J C; Escande, B; Cambonie, G; Hascoet, J M; Grandjean, H; Breart, G; Larroque, B
2005-01-01
To assess the relation between cigarette smoking during pregnancy and neonatal respiratory distress syndrome (RDS) in very preterm birth, and to analyse the differential effect of antenatal steroids on RDS among smokers and non-smokers. A population based cohort study (the French Epipage study). Regionally defined births in France. A total of 858 very preterm liveborn singletons (27-32 completed weeks of gestation) of the French Epipage study were included in this analysis. The odds ratio for RDS in relation to smoking in pregnancy was estimated using a logistic regression to control for gestational age. The odds ratio for RDS in relation to antenatal steroids was estimated taking into account an interaction between antenatal steroids and cigarette smoking, using multiple logistic regression to control for gestational age, birthweight ratio, main causes of preterm birth, mode of delivery, and sex. The odds ratio for RDS in relation to smoking in pregnancy adjusted for gestational age (aOR) was 0.59 (95% confidence interval (CI) 0.44 to 0.79). The aOR for RDS in relation to antenatal steroids was 0.31 (95% CI 0.19 to 0.49) in babies born to non-smokers and 0.63 (95% CI 0.38 to 1.05) in those born to smokers; the difference was significant (p = 0.04). Cigarette smoking during pregnancy is associated with a decrease in the risk of RDS in very preterm babies. Although antenatal steroids reduce the risk of RDS in babies born to both smokers and non-smokers, the reduction is smaller in those born to smokers.
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Ventolini, Gary; Neiger, Ran; Mathews, Lindsey; Adragna, Norma; Belcastro, Marc
2008-02-01
We studied the effect of antenatal corticosteroids on the incidence of respiratory disorders in singleton neonates born between 34 and 36 weeks of gestation. Retrospective analysis was conducted of the incidence of respiratory distress syndrome (RDS) and other respiratory disorders (need for mechanical ventilation, continuous positive airway pressure, and prolonged oxygen therapy) among singleton neonates delivered between 34 and 36 weeks of gestation who were exposed to antenatal corticosteroids, compared with neonates who were not exposed. Statistical analyses included two-tailed T tests, two-way analysis of variance for continuous data, and chi-square analysis for ratios. A probability of 0.05 was considered significant. Between January 1, 2000, and December 31, 2004, 1078 neonates were born between 34 and 36 weeks of gestation. Information regarding antenatal corticosteroids was available in 1044: 574 neonates (53.2%) were exposed to antenatal corticosteroids and 470 (43.6%) were not. One thousand and eighteen neonates were admitted to the neonatal intensive care unit. Respiratory disorders were diagnosed in 140 of those exposed to antenatal steroids (24.4%) and in 382 of the nonexposed (81.3%) ( P < 0.0001). Two hundred and ten neonates (20.6%) developed RDS: Of those, 43 were exposed to antenatal corticosteroids and 167 were not (incidence of RDS was 7.5% and 35.5%, respectively; P = 0.0001). The beneficial effects of corticosteroids were similar in both genders. It appears that the exposure of singleton pregnancies to antenatal corticosteroids between 24 and 34 weeks of gestation is associated with a significantly lower incidence of respiratory disorders among neonates born at 34 to 36 weeks of gestation. Further studies are needed to determine whether administering antenatal steroids to women experiencing preterm labor after 34 weeks of gestation would be associated with a similar beneficial effect.
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Zampieri, Nicola; Scirè, Gabriella; Zambon, Carla; Ottolenghi, Alberto; Camoglio, Francesco Saverio
2009-04-01
Abdominal cystic formations in newborns are relatively common and often diagnostic suspicion arises before birth as a result of ultrasound scans carried out during pregnancy. Prenatal ovarian torsion is a rare condition very difficult to manage in the first days of life. We report and discuss the management of prenatal ovarian torsion with a free-floating abdominal cyst detected on prenatal ultrasound. We recorded the cases of antenatal abdominal cysts detected on ultrasound at the Department of Antenatal Diagnosis between January 2003 and January 2007. Only patients with a free-floating cyst were included in the study. Clinical and surgical findings were then recorded. Two out of 57 patients underwent surgery for a free-floating abdominal cyst during the second day of life. Postnatal ultrasound, Doppler ultrasound, and laparoscopic exploration were useful to identify an unusual presentation of antenatal ovarian torsion with a complete atresia of the Fallopian tube. The cases reported in this study suggest that a good clinical approach to all cases of abdominal cysts detected on prenatal ultrasound scans require postnatal Doppler and abdominal ultrasound with a laparoscopic exploration. Free-floating abdominal cysts are rare but, at the same time, strictly correlated with autoamputation of the ovary/Fallopian tube complex.
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Antenatal Diagnosis of an XXX Female
Krone, Lawrence R.; Prichard, Lorraine L.; Bradshaw, Christy L.; Jones, Oliver W.; Peterson, Raymond M.; Dixson, Barbara K.
1975-01-01
This report describes the first antenatal diagnosis of an XXX female. Over 150 postnatal cases of XXX females have been described. There is no specific phenotype associated with the sex chromosome abnormality and most such persons are fertile. The frequency of XXX females in mental institutions is 3.9 per 1,000 female subjects whereas the frequency in consecutive newborn infants is 1.1 per 1,000 newborns. Chi-square analysis shows this difference cannot be due to chance. On the other hand, data from consecutive newborn studies suggest that intellectual development in XXX newborns is within normal range. Available evidence favors normal development in XXX female infants although the risk for developmental disabilities may be higher for the XXX than for the XX infant. ImagesFigure 1. PMID:1154778
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Owaka, Isaac Ogweno; Nyanchoka, Margaret Keraka; Atieli, Harryson Etemesi
2017-01-01
The objective of this study was to investigate factors contributing to intimate partner violence in pregnancy among antenatal attendees at the health facilities in West Pokot Sub-County. The study was done in West Pokot Sub-County. Using cross sectional study design, a total of 238 antenatal attendees were systematically sampled for the study. Four focused group discussions and 20 key informant interviews were conducted for qualitative data collection. Qualitative data was consolidated into various themes while bivariate and logistic regression analysis was done to determine factors associated with experience of IPV in the index of pregnancy with P ≤ 0.05 being considered significant. The study found prevalence of overall, physical, psychological and sexual IPV in pregnancy to be 66.9%, 29.9%, 55.8% and 39.2% respectively. After adjusting for confounders, Overall IPV in pregnancy was significantly associated with Alcohol intake by partner (OR 2.116, 95% CI 1.950-2.260, P 0.000) and partner's level of education (OR 1.265, 95% CI 1.079-1.487, P 0.031), while psychological and sexual IPV was significantly associated with age of partner (OR 2.292, 95% CI 2.123-2.722, P 0.007) and age of pregnant women (OR 1.174, 95% CI 1.001-1.397 P 0.049) respectively. The care offered to antenatal attendees experiencing IPV was not in line with WHO guidelines and standard on handling gender based violence cases. The study finding indicates that IPV in pregnancy among antenatal attendees in West Pokot is very high. This unearths the gaps on gender based violence interventions in the maternal and child health programs.
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Lavin, T; Pattinson, R C
2018-01-01
To explore stillbirth risk across gestation in three provinces of South Africa with different antenatal care schedules. Retrospective audit of perinatal death data using South Africa's Perinatal Problem Identification Programme. In 2008, the Basic Antenatal Care Programme was introduced in Limpopo and Mpumalanga provinces, reducing appointments to five visits at booking, 20, 26, 32, 38 weeks and 41 weeks if required. In the Western Cape province seven appointments remained at booking, 20, 26, 32, 34, 36, 38 and 41 weeks if required. All audited stillbirths (n = 4211) between October 2013 to August 2015 in Limpopo, Mpumalanga and Western Cape. Stillbirth risk (26-42 weeks of gestation, >1000 g) across gestation was calculated using Yudkin's method. Stillbirth risk was compared between provinces and relative risks were calculated between Limpopo/ Mpumalanga and Western Cape. Stillbirth risk across gestation. Stillbirth risk peaked at 38 weeks of gestation in Limpopo (relative risk [RR] 3.11, 95% CI 2.40-4.03, P risk at 38 weeks gestation in Limpopo and Mpumalanga were statistically greater than both the 37 and 39 weeks gestation within provinces (P risk occurs after a 6-week absence of antenatal care. This calls for a refocus on the impact of reduced antenatal care visits during the third trimester. Reduced antenatal care in the third trimester may increase stillbirth risk. © 2017 Royal College of Obstetricians and Gynaecologists.
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Antenatal assessment of fetal maturity
International Nuclear Information System (INIS)
Gerstner, G.; Reinold, E.; Wolf, G.
1979-01-01
334 ultrasound-cephalometries and 231 X-ray fetographies were performed for antenatal assessment of fetal maturity as well as for exact estimation of gestational age in women with unknown date of confinement. The accuracy of the predictions was compared. Ultrasound-cephalometry gave best results when performed until the 20th week of gestation. A correct prediction was obtained in 80.4% of cases. After the 20th week of gestation, the accuracy of prediction decreased. Radiology on the contrary gave optimal results at the end of pregnancy. A correct prediction of the date of confinement was obtained in 73.8% of cases, when the X-ray fetography was performed between the 37th and 40th week of gestation. At the end of gestation radiography should be performed, if there is a discrepancy between ultrasound and clinical estimation or if ultrasound-cephalometry was not carried out in early pregnancy - especially if induction of labour is necessary. (author)
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Audit of antenatal steroid use in mothers of preterms admitted to a ...
African Journals Online (AJOL)
Background: Antenatal corticosteroids (ACS) are established as an effective method of reducing preterm morbidity and mortality. At the Korle Bu Teaching Hospital (KBTH), a tertiary referral centre in Ghana, it is recommended that a course of ACS should be given to mothers before delivery between 24 weeks to 34 weeks ...
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A study of risk factors for anaemia in pregnancy at the first antenatal ...
African Journals Online (AJOL)
A study of risk factors for anaemia in pregnancy at the first antenatal clinic visit at ... anaemia in pregnancy is very common in this country and it is a major cause of ... Moreover, early institution of intermittent preventive therapy for malaria ...
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Titaley, Christiana R; Hunter, Cynthia L; Heywood, Peter; Dibley, Michael J
2010-10-12
Antenatal, delivery and postnatal care services are amongst the recommended interventions aimed at preventing maternal and newborn deaths worldwide. West Java is one of the provinces of Java Island in Indonesia with a high proportion of home deliveries, a low attendance of four antenatal services and a low postnatal care uptake. This paper aims to explore community members' perspectives on antenatal and postnatal care services, including reasons for using or not using these services, the services received during antenatal and postnatal care, and cultural practices during antenatal and postnatal periods in Garut, Sukabumi and Ciamis districts of West Java province. A qualitative study was conducted from March to July 2009 in six villages in three districts of West Java province. Twenty focus group discussions (FGDs) and 165 in-depth interviews were carried out involving a total of 295 respondents. The guidelines for FGDs and in-depth interviews included the topics of community experiences with antenatal and postnatal care services, reasons for not attending the services, and cultural practices during antenatal and postnatal periods. Our study found that the main reason women attended antenatal and postnatal care services was to ensure the safe health of both mother and infant. Financial difficulty emerged as the major issue among women who did not fulfil the minimum requirements of four antenatal care services or two postnatal care services within the first month after delivery. This was related to the cost of health services, transportation costs, or both. In remote areas, the limited availability of health services was also a problem, especially if the village midwife frequently travelled out of the village. The distances from health facilities, in addition to poor road conditions were major concerns, particularly for those living in remote areas. Lack of community awareness about the importance of these services was also found, as some community members perceived
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Asztalos, Elizabeth V; Murphy, Kellie E; Willan, Andrew R; Matthews, Stephen G; Ohlsson, Arne; Saigal, Saroj; Armson, B Anthony; Kelly, Edmond N; Delisle, Marie-France; Gafni, Amiram; Lee, Shoo K; Sananes, Renee; Rovet, Joanne; Guselle, Patricia; Amankwah, Kofi; Saleem, Mariam; Sanchez, Johanna
2013-12-01
A single course of antenatal corticosteroid therapy is recommended for pregnant women at risk of preterm birth between 24 and 33 weeks' gestational age. However, 50% of women remain pregnant 7 to 14 days later, leading to the question of whether additional courses should be given to women remaining at risk for preterm birth. The Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study (MACS) was an international randomized clinical trial that compared multiple courses of antenatal corticosteroids with a single course in women at risk of preterm birth. To determine the effects of single vs multiple courses of antenatal corticosteroid therapy on death or neurodevelopmental disability (neuromotor, neurosensory, or neurocognitive/neurobehavioral function) at 5 years of age in children whose mothers participated in MACS. Our secondary aims were to determine the effect on height, weight, head circumference, blood pressure, intelligence, and specific cognitive (visual, spatial, and language) skills. Cohort follow-up study of children seen between June 2006 and May 2012 at 55 centers. In total, 1724 women (2141 children) were eligible for the study, of whom 1728 children (80.7% of the 2141 eligible children) participated and 1719 children contributed to the primary outcome. Single and multiple courses of antenatal corticosteroid therapy. The primary outcome was death or survival with a neurodevelopmental disability in 1 of the following domains: neuromotor (nonambulatory cerebral palsy), neurosensory (blindness, deafness, or need for visual/hearing aids), or neurocognitive/neurobehavioral function (abnormal attention, memory, or behavior). There was no significant difference between the groups in the risk of death or neurodevelopmental disability: 217 of 871 children (24.9%) in the multiple-courses group vs 210 of 848 children (24.8%) in the single-course group (odds ratio, 1.02 [95% CI, 0.81 to 1.29]; P = .84). Multiple courses, compared with a single
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Raine, Karen; Cockshaw, Wendell; Boyce, Philip; Thorpe, Karen
2016-10-01
Maternal mental health has enduring effects on children's life chances and is a substantial cost driver for child health, education and social services. A key linking mechanism is the quality of mother-infant interaction. A body of work associates maternal depressive symptoms across the antenatal and postnatal (perinatal) period with less-than-optimal mother-infant interaction. Our study aims to build on previous research in the field through exploring the association of a maternal personality trait, interpersonal sensitivity, measured in early pregnancy, with subsequent mother-infant interaction quality. We analysed data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to examine the association between antenatal interpersonal sensitivity and postnatal mother-infant interaction quality in the context of perinatal depressive symptoms. Interpersonal sensitivity was measured during early pregnancy and depressive symptoms in the antenatal year and across the first 21 months of the postnatal period. In a subsample of the ALSPAC, mother-infant interaction was measured at 12 months postnatal through a standard observation. For the subsample that had complete data at all time points (n = 706), hierarchical regression examined the contribution of interpersonal sensitivity to variance in mother-infant interaction quality. Perinatal depressive symptoms predicted little variance in mother-infant interaction. Antenatal interpersonal sensitivity explained a greater proportion of variance in mother-infant interaction quality. The personality trait, interpersonal sensitivity, measured in early pregnancy, is a more robust indicator of subsequent mother-infant-interaction quality than perinatal depressive symptoms, thus affording enhanced opportunity to identify vulnerable mother-infant relationships for targeted early intervention.
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Andréia Brogni
2013-01-01
Este trabalho busca produzir cermet (Cinza-Fe) pela tecnologia do pó utilizando cinza leve produzida com a queima do carvão mineral em termoelétrica para uma possível utilização e aplicação na usinagem. Esse estudo tem como objetivo específico caracterizar e analisar as propriedades mecânicas e metalúrgicas das amostras obtidas a partir das misturas. Utilizouse o ferro como componente da mistura em função do baixo custo e vasta disponibilidade. Após a obtenção da cinza leve, determinou-se o t...
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Identifying the women at risk of antenatal anxiety and depression: A systematic review.
Biaggi, Alessandra; Conroy, Susan; Pawlby, Susan; Pariante, Carmine M
2016-02-01
Pregnancy is a time of increased vulnerability for the development of anxiety and depression. This systematic review aims to identify the main risk factors involved in the onset of antenatal anxiety and depression. A systematic literature analysis was conducted, using PubMed, PsychINFO, and the Cochrane Library. Original papers were included if they were written in English and published between 1st January 2003 and 31st August 2015, while literature reviews and meta-analyses were consulted regardless of publication date. A final number of 97 papers were selected. The most relevant factors associated with antenatal depression or anxiety were: lack of partner or of social support; history of abuse or of domestic violence; personal history of mental illness; unplanned or unwanted pregnancy; adverse events in life and high perceived stress; present/past pregnancy complications; and pregnancy loss. The review does not include a meta-analysis, which may have added additional information about the differential impact of each risk factor. Moreover, it does not specifically examine factors that may influence different types of anxiety disorders, or the recurrence or persistence of depression or anxiety from pregnancy to the postpartum period. The results show the complex aetiology of antenatal depression and anxiety. The administration of a screening tool to identify women at risk of anxiety and depression during pregnancy should be universal practice in order to promote the long-term wellbeing of mothers and babies, and the knowledge of specific risk factors may help creating such screening tool targeting women at higher risk. Copyright © 2016 Elsevier B.V. All rights reserved.
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Efecto de la restitución temprana de la nutrición oral en la pancreatitis aguda leve
Vega Sandoval, Carlos Andres; Isaza Restrepo, Andres; Moscoso Daza, Alejandro
2010-01-01
Aunque el manejo nutricional de los pacientes con Pancreatitis Aguda Severa ha sido bien establecido por la evidencia disponible, el inicio de la vía oral en Pancreatitis Leve no ha sido igualmente estudiado. El objetivo de este estudio es evaluar el efecto del inicio temprano de la nutrición por vía oral en estos pacientes. Métodos: Realizamos un descriptivo serie de comparación de casos en los cuales comparamos la evolución y resultados del manejo de los pacientes con pancreatitis aguda ant...
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Jayasinghe, C; Polson, R; van Woerden, H C; Wilson, P
2018-05-04
Although antenatal iron supplementation is beneficial to mothers, its impact on the neurodevelopment of offspring is controversial. A systematic review and meta-analysis was undertaken to assess whether routine maternal antenatal iron supplementation confers later neurodevelopmental benefit to offspring. Electronic databases were searched using MESH terms or key words and identified papers were reviewed by two independent reviewers. The study quality was assessed using the Cochrane risk of bias assessment tool. The review was registered in the PROSPERO CRD data base. Seven publications were identified, based on four randomised trials published between 2006 and 2016. Three of the trials were in the Asian sub-continent. A range of tools were used to evaluate neurodevelopment. Meta-analysis of outcomes from the three RCTs meeting our inclusion criteria showed minimal effect of antenatal iron supplementation on the neurodevelopment of offspring, which was not statistically significant: weighted mean difference of 0.54 (95% CI: -0.67 to 1.75); test for overall effect Z = 0.87; p = 0.38; and heterogeneity 48%. Meta-analysis of outcomes of these RCTs at later stages of development produced similar results. The benefit of routine antenatal iron supplementation on neurodevelopment in offspring was not statistically significant in this relatively limited set of trials, and some benefit cannot be excluded in areas with a high prevalence of maternal anaemia. A large randomized controlled trial showing significant benefit would be required to modify our conclusions.
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Olivier, Jocelien D. A.; Akerud, Helena; Poromaa, Inger Sundstrom
2015-01-01
During pregnancy the risk for a woman to develop a depressive episode is as high as 20%. Antenatal depression is not harmless for the developing child as several changes, including neurodevelopmental alterations, have been reported. Sometimes it is unavoidable to treat a pregnant mother with
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Labrín Díaz, Paula
2015-01-01
El objetivo de este trabajo es la construcción de instrumentos (inexistentes) que permitan evaluar los indicadores de la conducta vocacional en estudiantes con discapacidad intelectual leve que asisten al nivel laboral en centros de educación especial chilenos. Los indicadores que se consideran, acordes con los planteamientos de Rivas , son los siguientes : Historial personal, intereses vocacionales, factores de personalidad , habilidades y destrezas y estilos de aprendizaje. Los par...
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Densmore, Brenda K.; Burton, Bethany L.; Dietsch, Benjamin J.; Cannia, James C.; Huizinga, Richard J.
2014-01-01
During the 2011 Mississippi River Basin flood, the U.S. Geological Survey evaluated aspects of critical river infrastructure at the request of and in support of local, State, and Federal Agencies. Geotechnical and hydrographic data collected by the U.S. Geological Survey at numerous locations were able to provide needed information about 2011 flood effects to those managing the critical infrastructure. These data were collected and processed in a short time frame to provide managers the ability to make a timely evaluation of the safety of the infrastructure and, when needed, to take action to secure and protect critical infrastructure. Critical infrastructure surveyed by the U.S. Geological Survey included levees, bridges, pipeline crossings, power plant intakes and outlets, and an electrical transmission tower. Capacitively coupled resistivity data collected along the flood-protection levees surrounding the Omaha Public Power District Nebraska City power plant (Missouri River Levee Unit R573), mapped the near-subsurface electrical properties of the levee and the materials immediately below it. The near-subsurface maps provided a better understanding of the levee construction and the nature of the lithology beneath the levee. Comparison of the capacitively coupled resistivity surveys and soil borings indicated that low-resistivity value material composing the levee generally is associated with lean clay and silt to about 2 to 4 meters below the surface, overlying a more resistive layer associated with sand deposits. In general, the resistivity structure becomes more resistive to the south and the southern survey sections correlate well with the borehole data that indicate thinner clay and silt at the surface and thicker sand sequences at depth in these sections. With the resistivity data Omaha Public Power District could focus monitoring efforts on areas with higher resistivity values (coarser-grained deposits or more loosely compacted section), which typically are
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Qiu, Anqi; Shen, Mojun; Buss, Claudia; Chong, Yap-Seng; Kwek, Kenneth; Saw, Seang-Mei; Gluckman, Peter D; Wadhwa, Pathik D; Entringer, Sonja; Styner, Martin; Karnani, Neerja; Heim, Christine M; O'Donnell, Kieran J; Holbrook, Joanna D; Fortier, Marielle V; Meaney, Michael J
2017-05-01
This study included 168 and 85 mother-infant dyads from Asian and United States of America cohorts to examine whether a genomic profile risk score for major depressive disorder (GPRSMDD) moderates the association between antenatal maternal depressive symptoms (or socio-economic status, SES) and fetal neurodevelopment, and to identify candidate biological processes underlying such association. Both cohorts showed a significant interaction between antenatal maternal depressive symptoms and infant GPRSMDD on the right amygdala volume. The Asian cohort also showed such interaction on the right hippocampal volume and shape, thickness of the orbitofrontal and ventromedial prefrontal cortex. Likewise, a significant interaction between SES and infant GPRSMDD was on the right amygdala and hippocampal volumes and shapes. After controlling for each other, the interaction effect of antenatal maternal depressive symptoms and GPRSMDD was mainly shown on the right amygdala, while the interaction effect of SES and GPRSMDD was mainly shown on the right hippocampus. Bioinformatic analyses suggested neurotransmitter/neurotrophic signaling, SNAp REceptor complex, and glutamate receptor activity as common biological processes underlying the influence of antenatal maternal depressive symptoms on fetal cortico-limbic development. These findings suggest gene-environment interdependence in the fetal development of brain regions implicated in cognitive-emotional function. Candidate biological mechanisms involve a range of brain region-specific signaling pathways that converge on common processes of synaptic development. © The Author 2017. Published by Oxford University Press.
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The perception of midwives regarding psychosocial risk assessment during antenatal care
Directory of Open Access Journals (Sweden)
Johanna M. Mathibe-Neke
2014-05-01
Full Text Available Background: The physiological and psychological changes caused by pregnancy may increase a woman’s vulnerability to depression, which may in turn have adverse effects on both maternal and foetal wellbeing. Inadequate psychosocial risk assessment of women by midwives may lead to lack of psychosocial support during pregnancy and childbirth. Pregnant women who lack psychosocial support may experience stress, anxiety and depression that could possibly affect foetal wellbeing. Objective:The objective of this study was toexplore and describe the perception of psychosocial risk assessment and psychosocial care by midwives providing antenatal care to pregnant women. Method: An interpretive and descriptive qualitative approach was adopted. Three focus group interviews were conducted with midwives working in three Maternal Obstetric Units in Gauteng Province, using a semi-structured interview guide. The constant comparison data analysis approach was used. Results:Findings revealed that midwives are aware of and have encountered a high prevalence of psychosocial problems in pregnant women. Furthermore, they acknowledged the importance of psychosocial care for pregnant women although they stated that they were not equipped adequately to offer psychosocial assessment and psychosocial care. Conclusion:The findings provided a basis for incorporation of psychosocial care into routine antenatal care.
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Directory of Open Access Journals (Sweden)
J. A. Swift
2016-01-01
Full Text Available The current emphasis on obstetric risk management helps to frame gestational weight gain as problematic and encourages intervention by healthcare professionals. However pregnant women have reported confusion, distrust, and negative effects associated with antenatal weight management interactions. The MAGIC study (MAnaging weiGht In pregnanCy sought to examine women’s self-reported experiences of usual-care antenatal weight management in early pregnancy and consider these alongside weight monitoring behaviours and future expectations. 193 women (18 yrs+ were recruited from routine antenatal clinics at the Nottingham University Hospital NHS Trust. Self-reported gestation was 10–27 weeks, with 41.5% (n=80 between 12 and 14 and 43.0% (n=83 between 20 and 22 weeks. At recruitment 50.3% of participants (n=97 could be classified as overweight or obese. 69.4% of highest weight women (≥30 kg/m2 did not report receiving advice about weight, although they were significantly more likely compared to women with BMI < 30 kg/m2. The majority of women (regardless of BMI did not express any barriers to being weighed and 40.8% reported weighing themselves at home. Women across the BMI categories expressed a desire for more engagement from healthcare professionals on the issue of bodyweight. Women are clearly not being served appropriately in the current situation which simultaneously problematizes and fails to offer constructive dialogue.
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International Nuclear Information System (INIS)
Khoso, A.; Khan, A.Z.; Sayed, S.A.; Rafique, G.
2016-01-01
Background: Antenatal Care is one of the fundamental rights for women to safeguard their health. Neonatal mortality rates have remained relatively static, compared to the decline in infant and under 5 mortality rates, adverse practices regarding breast feeding and pre-lacteal feeds being the important factors responsible. This study aimed to explore the Antenatal Care, delivery and breast feeding practices in three districts of Blotchiness. Methods: It was a qualitative phenomenological design using Constrictive approach. The study was conducted in three districts of Baluchistan province, Gwadar, Quetta, Qila Saifullah. There were a total of 14 Focus Group Discussions with women regarding Antenatal Care, delivery and Breast feeding practices, followed by audio taping, transcription as verbatim and analysis through Nvivo version 2. A process was deployed for identification and reporting of the components in order to ensure quality and validity of the qualitative findings. Results: Across the sites, women attended ANC at least once. However, their descriptions of ANC often varied. The women preferred Dais instead of doctors, due to the affordability, customs and availability. A lack of trained doctors and long distances to get a check-up lead to home deliveries in the study setting. Colostrum was discarded by majority of the mothers, while prelacteal feed was a common practice. Conclusion: This paper has explored factors affecting ANC attendance, delivery and breast feeding practices across three settings. Both the demand and supply side factors have an important influence on practices. (author)
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Raskin, Maryna; Easterbrooks, M Ann; Lamoreau, Renee S; Kotake, Chie; Goldberg, Jessica
2016-01-01
This study explores the longitudinal trajectories of depressive symptoms in young mothers and investigate the consequences of maternal depression for children's birth outcomes and behavioral adjustment. Antenatal depression puts children of young mothers at risk for adjustment difficulties by adversely impacting birth outcomes and maternal symptoms after birth. Data were drawn from a three-wave randomized, controlled trial of a statewide home visiting program for young primiparous women. A subsample of women (n = 400) who were prenatal at intake was used in the analysis. Mothers were divided into an antenatally depressed group (ADG; 40%) and a healthy group (HG) based on their symptoms at intake. Mothers reported depressive symptoms at intake and 12- and 24-month follow-up, and filled out a checklist of child behavior problems at 24 months follow-up. Perinatal and birth outcomes were derived from the Electronic Birth Certificate collected by the State Department of Public Health at discharge from the hospital. ADG and HG had similar pregnancy characteristics and birth outcomes, but ADG reported more child behavioral problems. Multigroup latent growth curve analysis provided evidence for distinct depression trajectories. A mediation hypothesis was not supported. In both groups, steeper increase in symptoms over time predicted more mother-reported child behavioral problems. Findings are consistent with studies linking antenatal depression with post-birth symptoms, underscoring the importance of prenatal screening for depression. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
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An, Selena J; George, Asha S; LeFevre, Amnesty E; Mpembeni, Rose; Mosha, Idda; Mohan, Diwakar; Yang, Ann; Chebet, Joy; Lipingu, Chrisostom; Baqui, Abdullah H; Killewo, Japhet; Winch, Peter J; Kilewo, Charles
2015-10-04
Integration of HIV into RMNCH (reproductive, maternal, newborn and child health) services is an important process addressing the disproportionate burden of HIV among mothers and children in sub-Saharan Africa. We assess the structural inputs and processes of care that support HIV testing and counselling in routine antenatal care to understand supply-side dynamics critical to scaling up further integration of HIV into RMNCH services prior to recent changes in HIV policy in Tanzania. This study, as a part of a maternal and newborn health program evaluation in Morogoro Region, Tanzania, drew from an assessment of health centers with 18 facility checklists, 65 quantitative and 57 qualitative provider interviews, and 203 antenatal care observations. Descriptive analyses were performed with quantitative data using Stata 12.0, and qualitative data were analyzed thematically with data managed by Atlas.ti. Limitations in structural inputs, such as infrastructure, supplies, and staffing, constrain the potential for integration of HIV testing and counselling into routine antenatal care services. While assessment of infrastructure, including waiting areas, appeared adequate, long queues and small rooms made private and confidential HIV testing and counselling difficult for individual women. Unreliable stocks of HIV test kits, essential medicines, and infection prevention equipment also had implications for provider-patient relationships, with reported decreases in women's care seeking at health centers. In addition, low staffing levels were reported to increase workloads and lower motivation for health workers. Despite adequate knowledge of counselling messages, antenatal counselling sessions were brief with incomplete messages conveyed to pregnant women. In addition, coping mechanisms, such as scheduling of clinical activities on different days, limited service availability. Antenatal care is a strategic entry point for the delivery of critical tests and counselling messages
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Ruan, Zeng-Liang; Liu, Li; Strodl, Esben; Fan, Li-Jun; Yin, Xiao-Na; Wen, Guo-Min; Sun, Deng-Li; Xian, Dan-Xia; Jiang, Hui; Jing, Jin; Jin, Yu; Wu, Chuan-An; Chen, Wei-Qing
2018-01-01
Antenatal training through music and maternal talk to the unborn fetus is a topic of general interest for parents-to-be in China, but we still lack a comprehensive assessment of their effects on the development of autistic-like behaviors during early childhood. During 2014–2016, 34,749 parents of children around the age of 3 years who were enrolled at kindergarten in the Longhua district of Shenzhen participated in this study. Self-administered questionnaires regarding demographics, antenatal...
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2015-03-01
142+00 to 144+00. These areas are located approximately 1,000 feet south of Rosa Parks Way and the photos show sags and sinkholes on the landside...sloughing and slides, lost sod, displaced riprap, and sinkhole development to portions of the right and left descending banks of Salt Creek. 1.4 AUTHORITY... sinkhole development. The proposed project repairs include reshaping the levee banks back to a 3:1 slope and replacing lost bank material with compacted
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Rukundo, Godfrey Zari; Abaasa, Catherine; Natukunda, Peace Byamukama; Ashabahebwa, Bob Harold; Allain, Dominic
2015-12-23
Globally, about 11% of all annual births involve adolescents aged 15-19 years. Uganda has one of the highest teenage pregnancy rates in Sub-Saharan Africa. This study assessed stakeholders' views concerning factors affecting availability, accessibility and utilization of teenager friendly antenatal services in Mbarara Municipality, southwestern Uganda. This was a cross-sectional descriptive study utilizing Key Informant Interviews (KIIs). It was conducted in three divisions of Mbarara Municipality. The KIIs were held six Village Health Team (VHT) members, three gynecologists, six midwives, three Community leaders (LC 3 Secretaries for women affairs), one police officer from the Family and Child protection unit at Mbarara Police and three Traditional Birth Attendants (TBAs). Data analysis was done manually by identifying emergent themes which were later coded and organized into concepts which were later developed into explanations. Reproductive health stakeholders generally considered teenage pregnancy to be among the high risk pregnancies that need to be handled with care. In addition, the reproductive health workers described their experience with teenagers as challenging due to their limited skills when it comes to addressing adolescent-specific needs. Adolescent-friendly services were defined as those that could provide privacy, enough time and patience when dealing with teenagers. With this description, there were no teenager-friendly antenatal services in Mbarara municipality at the time of the study. There is need for proactive steps to establish these services if the needs of this subgroup are to be met. There are no teenager friendly antenatal services in Mbarara municipality and few teenagers access and utilise the available general antenatal services. There is need for specialized training for health workers who deal with pregnant teens in Mbarara Municipality in order for them to provide teenager friendly services.
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Risk factors for RhD immunisation despite antenatal and postnatal anti-D prophylaxis
Koelewijn, J. M.; de Haas, M.; Vrijkotte, T. G. M.; van der Schoot, C. E.; Bonsel, G. J.
2009-01-01
Objective To identify risk factors for Rhesus D (RhD) immunisation in pregnancy, despite adequate antenatal and postnatal anti-D prophylaxis in the previous pregnancy. To generate evidence for improved primary prevention by extra administration of anti-D Ig in the presence of a risk factor. Design
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Vasquez-Vivar, Jeannette; Shi, Zhongjie; Luo, Kehuan; Thirugnanam, Karthikeyan; Tan, Sidhartha
2017-10-01
Antenatal brain hypoxia-ischemia, which occurs in cerebral palsy, is considered a significant cause of motor impairments in children. The mechanisms by which antenatal hypoxia-ischemia causes brain injury and motor deficits still need to be elucidated. Tetrahydrobiopterin is an important enzyme cofactor that is necessary to produce neurotransmitters and to maintain the redox status of the brain. A genetic deficiency of this cofactor from mutations of biosynthetic or recycling enzymes is a well-recognized factor in the development of childhood neurological disorders characterized by motor impairments, developmental delay, and encephalopathy. Experimental hypoxia-ischemia causes a decline in the availability of tetrahydrobiopterin in the immature brain. This decline coincides with the loss of brain function, suggesting this occurrence contributes to neuronal dysfunction and motor impairments. One possible mechanism linking tetrahydrobiopterin deficiency, hypoxia-ischemia, and neuronal injury is oxidative injury. Evidence of the central role of the developmental biology of tetrahydrobiopterin in response to hypoxic ischemic brain injury, especially the development of motor deficits, is discussed. Copyright © 2017. Published by Elsevier B.V.
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Garnweidner, Lisa M; Sverre Pettersen, Kjell; Mosdøl, Annhild
2013-12-01
to explore experiences with nutrition-related information during routine antenatal care among women of different ethnical backgrounds. individual interviews with seventeen participants were conducted twice during pregnancy. Data collection and analysis were inspired by an interpretative phenomenological approach. participants were purposively recruited at eight Mother and Child Health Centres in the area of Oslo, Norway, where they received antenatal care. participants had either immigrant backgrounds from African and Asian countries (n=12) or were ethnic Norwegian (n=5). Participants were pregnant with their first child and had a pre-pregnancy Body Mass Index above 25 kg/m(2). participants experienced that they were provided with little nutrition-related information in antenatal care. The information was perceived as presented in very general terms and focused on food safety. Weight management and the long-term prevention of diet-related chronic diseases had hardly been discussed. Participants with immigrant backgrounds appeared to be confused about information given by the midwife which was incongruent with their original food culture. The participants were actively seeking for nutrition-related information and had to navigate between various sources of information. the midwife is considered a trustworthy source of nutrition-related information. Therefore, antenatal care may have considerable potential to promote a healthy diet to pregnant women. Findings suggest that nutrition communication in antenatal care should be more tailored towards women's dietary habits and cultural background, nutritional knowledge as well as level of nutrition literacy. Copyright © 2012 Elsevier Ltd. All rights reserved.
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Gökçe İsbir, Gözde; İnci, Figen; Önal, Hatice; Yıldız, Pelin Dıkmen
2016-11-01
Fear of birth and low childbirth self-efficacy is predictive of post-traumatic stress disorder symptoms following childbirth. The efficacy of antenatal education classes on fear of birth and childbirth self-efficacy has been supported; however, the effectiveness of antenatal classes on post-traumatic stress disorder symptoms after childbirth has received relatively little research attention. This study examined the effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder symptoms following childbirth. Quasi-experimental study. The study was conducted in a city located in the Middle Anatolia region of Turkey and data were collected between December 2013 and May 2015. Two groups of women were compared-an antenatal education intervention group (n=44), and a routine prenatal care control group (n=46). The Wijma Delivery Expectancy/Experience Questionnaire, Version A and B, Childbirth Self-efficacy Inventory and Impact of Event Scale-Revised was used to assess fear of childbirth, maternal self-efficacy and PTSD symptoms following childbirth. Compared to the control group, women who attended antenatal education had greater childbirth self-efficacy, greater perceived support and control in birth, and less fear of birth and post-traumatic stress disorder symptoms following childbirth (all comparisons, ppost-traumatic stress disorder symptoms after childbirth. Copyright © 2016 Elsevier Inc. All rights reserved.
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Calidad de vida relacionada con la salud en pacientes con diagnóstico de hipertensión arterial leve
Stefano Vinaccia; Japcy Margarita Quiceno; Ángela Gómez; Lina Marcela Montoya
2007-01-01
El propósito de esta investigación fue evaluar las dimensiones de la calidad de vida relacionadas con la salud en 282 pacientes con hipertensión arterial leve de la ciudad de Medellín, Colombia. Se utilizó el Cuestionario de Calidad de Vida en Hipertensión Arterial (CHAL). Los resultados evidenciaron un cierto deterioro en la calidad de vida de estos pacientes en lo que concierne al estado de ánimo y principalmente en sus manifestaciones somáticas.
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Directory of Open Access Journals (Sweden)
C. Casado Sánchez
2008-12-01
Full Text Available La reconstrucción mamaria mediante colgajo DIEP (Deep Inferior Epigastric Perforator se encuentra condicionada en muchas ocasiones por características de la paciente o del tratamiento oncológico recibido, de tal forma que diversos grupos de trabajo contraindican este método en caso de existir alguno de esos factores. Nosotros hemos realizado un estudio de los mismos, analizando su impacto sobre la viabilidad del colgajo y su correlación con las complicaciones postoperatorias, para optimizar así su indicación. Los condicionantes analizados son el tabaco, las intervenciones quirúrgicas previas que afecten en alguna medida la pared abdominal, el sobrepeso u obesidad de la paciente, el volumen de la mama contralateral, el tratamiento radioterápico anterior o posterior a la reconstrucción, y finalmente el gasto sanitario que supone. Estas controversias son a su vez las más discutidas en la literatura al respecto. Se valoran los resultados obtenidos tras 55 reconstrucciones mamarias mediante colgajo DIEP entre enero de 2000 y noviembre de 2005, así como los estudios y publicaciones más recientes existentes sobre esta materia. Hemos encontrado una pobre correlación entre los índices de fracaso del colgajo y las controversias estudiadas, determinando así dos contraindicaciones absolutas para que una paciente pudiese beneficiarse de un colgajo DIEP: abdominoplastia previa y radioterapia adyuvante tras reconstrucción inmediata. Los excelentes resultados que se obtienen globalmente, nos llevan a recomendar este colgajo por encima de otras opciones terapéuticas.The use of DIEP (Deep Inferior Epigastric Perforator flap surgery in breast reconstruction is often conditioned by the patient and the oncologic treatment characteristics to such an extent that several working groups advise against this surgical procedure when any of these factors is present. In the study of this interaction, an analysis of its impact on the flap feasibility and its
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Betrán, Ana Pilar; Bergel, Eduardo; Griffin, Sally; Melo, Armando; Nguyen, My Huong; Carbonell, Alicia; Mondlane, Santos; Merialdi, Mario; Temmerman, Marleen; Gülmezoglu, A Metin
2018-01-01
High levels of maternal and newborn mortality and morbidity remain a daunting reality in many low-income countries. Several interventions delivered during antenatal care have been shown to improve maternal and newborn outcomes, but stockouts of medical supplies at point of care can prevent implementation of these services. We aimed to evaluate whether a supply chain strategy based on the provision of kits could improve quality of care. We did a pragmatic, stepped-wedge, cluster-randomised controlled trial at ten antenatal care clinics in Mozambique. Clinics were eligible if they were not already implementing the proposed antenatal care package; they served at least 200 new pregnant women per year; they had Maternal and Child Health (MCH) nurses; and they were willing to participate. All women attending antenatal care visits at the participating clinics were included in the trial. Participating clinics were randomly assigned to shift from control to intervention on prespecified start dates. The intervention involved four components (kits with medical supplies, a cupboard to store these supplies, a tracking sheet to monitor stocks, and a one-day training session). The primary outcomes were the proportion of women screened for anaemia and proteinuria, and the proportion of women who received mebendazole in the first antenatal care visit. The intervention was delivered under routine care conditions, and analyses were done according to the intention-to-treat principle. This trial is registered with the Pan African Clinical Trial Registry, number PACTR201306000550192. Between March, 2014, and January, 2016, 218 277 antenatal care visits were registered, with 68 598 first and 149 679 follow-up visits. We found significant improvements in all three primary outcomes. In first visits, 5519 (14·6%) of 37 826 women were screened for anaemia in the control period, compared with 30 057 (97·7%) of 30 772 in the intervention period (adjusted odds ratio 832·40; 99
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Directory of Open Access Journals (Sweden)
María del Carmen Rodríguez Martínez
2017-05-01
Full Text Available Esta revisión bibliográfica pretende ofrecer una visión de las posibilidades que ofrecen las nuevas tecnologías a personas mayores con deterioro cognitivo leve-moderado para retardar o frenar los síntomas de deterioro cognitivo. Actualmente, las nuevas tecnologías de la información y la comunicación tienen mucho protagonismo y se han convertido en una herramienta con mucho potencial para este tipo de personas. Para ello, se han analizado una serie de estudios sobre el uso de las nuevas tecnologías en personas mayores con trastornos cognitivos con el fin de ofrecer una visión más clara sobre los datos obtenidos hasta el día de hoy respecto a este campo de investigación en Terapia Ocupacional. Se seleccionaron un total de 204 artículos, tras un proceso de duplicación y tras pasar diferentes herramientas de calidad, quedaron un total de 7 artículos. Los resultados encontrados indican que las nuevas tecnologías contribuyen a disminuir algunos síntomas asociados a la enfermedad, como la ansiedad y la depresión, mejorando además ciertas funciones cognitivas en personas que tienen un deterioro cognitivo leve-moderado, siendo importante combinarlas con las terapias tradicionales.
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Antenatal screening for HIV, hepatitis B and syphilis in the Netherlands is effective
Coul, E.L.M. op de; Hahné, S.; Weert, Y.M. van; Oomen, P.; Smit, S.; Ploeg, C.P.B. van der; Notermans, D.W.; Boer, K.; Sande1, M.A.B. van der
2011-01-01
A screening programme for pregnant women has been in place since the 1950s in the Netherlands. In 2004 universal HIV screening according to opting out was implemented. Here, we describe the evaluation of the effectiveness of antenatal screening in the Netherlands for 2006-2008 for HIV, hepatitis B
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Antenatal screening for HIV, hepatitis B and syphilis in the Netherlands is effective
op de Coul, E.L.M.; Hahne, S.; van Weert, Y.W.M.; Oomen, P.; Smit, C.; van der Ploeg, K.P.B.; Notermans, D.W.; Boer, K.; van der Sande, M.A.B.
2011-01-01
Background: A screening programme for pregnant women has been in place since the 1950s in the Netherlands. In 2004 universal HIV screening according to opting out was implemented. Here, we describe the evaluation of the effectiveness of antenatal screening in the Netherlands for 2006-2008 for HIV,
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Rwakarema, Mechtilda; Premji, Shahirose S.; Nyanza, Elias Charles; Riziki, Ponsiano; Palacios-Derflingher, Luz
2015-01-01
Background Psychosocial health problems, specifically depression during pregnancy, can have negative impact on birth outcomes, postnatal mental health of the mother, and infant health. Antenatal depression is more prevalent among women in low- and middle-income countries than among women in high-income countries. Risk factors for antenatal depression reported in the literature relate to pregnant women in South Asia. Consequently, this study assessed depression in pregnancy and related psychos...
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Asamoah, Benedict O; Agardh, Anette; Pettersson, Karen Odberg; Östergren, Per-Olof
2014-08-29
Improving maternal and reproductive health still remains a major challenge in most low-income countries especially in sub-Saharan Africa. The growing inequality in access to maternal health interventions is an issue of great concern. In Ghana, inadequate attention has been given to the inequality gap that exists amongst women when accessing antenatal care during pregnancy and skilled attendance at birth. This study therefore aimed at investigating the magnitude and trends in income-, education-, residence-, and parity-related inequalities in access to antenatal care and skilled attendance at birth. A database was constructed using data from the Ghana Demographic and Health Surveys (DHS) 1988, 1993, 1998, 2003, and 2008. The surveys employed standard DHS questionnaires and techniques for data collection. We applied regression-based Total Attributable Fraction (TAF) as an index for measuring socioeconomic inequalities in antenatal care and skilled birth attendance utilization. The rural-urban gap and education-related inequalities in the utilization of antenatal care and skilled birth attendants seem to be closing over time, while income- and parity-related inequalities in the use of antenatal care are on a sharp rise. Income inequality regarding the utilization of skilled birth attendance was rather low and stable from 1988 to 1998, increased sharply to a peak between 1998 and 2003, and then leveled-off after 2003. The increased income-related inequalities seen in the use of antenatal care and skilled birth attendance should be addressed through appropriate strategies. Intensifying community-based health education through media and door-to-door campaigns could further reduce the mentioned education- and parity-related inequalities. Women should be highly motivated and incentivized to attend school up to secondary level or higher. Education on the use of maternal health services should be integrated into basic schools so that women at the lowest level would be
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Haddrill, Rosalind; Jones, Georgina L; Anumba, Dilly; Mitchell, Caroline
2017-10-14
Delayed access to antenatal care in high income countries is associated with poor maternal, fetal and neonatal outcomes. The aim was to synthesise the diverse body of evidence around women's views of early antenatal care and barriers to attendance in such countries. Critical Interpretive Synthesis integrates the process of systematic review with the qualitative methods of meta-ethnography and grounded theory, with a focus on theory generation to inform policy, practice and future research. Database searches were conducted, supplemented with reference and citation tracking and website searching between February 2014 and April 2016. Qualitative data analysis methods were used to extract and summarise the key themes from each study. A taxonomy of constructs was created, with the synthesis developed to thread these together. Fifty-four papers were synthesised, including qualitative, quantitative, mixed method and systematic review, published between 1987 and 2016. Seventeen constructs around the core concept of 'acceptance of personal and public pregnancies' were produced. Acceptance of the 'personal' pregnancy considers the contribution of mindset in the recognition and acceptance of pregnancy, influenced by knowledge of pregnancy symptoms, pregnancy planning and desire. Acceptance of the 'public' pregnancy considers women's assessment of the social consequences of pregnancy, and the relevance and priority of antenatal care. Critical Interpretive Synthesis offers a systematic yet creative approach to the synthesis of diverse evidence. The findings offer new perspectives on women's perceptions of early pregnancy and attendance for care, which may be used to facilitate timely antenatal provision for all pregnant women. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
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Sidhu, Meena; Bala, Renu; Akhtar, Naveen; Sawhney, Vijay
2016-09-01
Screening and detection of clinically significant antibodies among antenatal women plays an important role in transfusion safety and preventing hemolytic disease of fetus and newborn. Routine screening of antenatal women for antibodies is not done in all blood centres of our country and so immunization rates are not known in pregnant women. We studied the prevalence of alloantibodies and titration of Anti D among antenatal multiparous women in Jammu region. In present prospective study, 750 antenatal multiparous women attending antenatal clinics were typed for ABO and D antigens. Alloantibody screening was done, if positive, specificity of alloantibody was ascertained by using commercially available red cell panel by tube method. Rate of alloimmunization was correlated with Rh D status, gravida, previous transfusion history and bad obstetric history. Titration of alloantibody D was done in first and third trimester of pregnancy. In present study most common blood group detected was B positive (38.4 %). Rh D negative cases constituted 7.6 % of total cases. Rate of alloimmunization was 2 %. A significant correlation was seen between Rh D-negative and alloimmunization (21 % in D-negative and 0.45 % in D-positive). There is significant increasing degree of alloimmunization with increase in Gravida. Alloimmunization in females with bad obstetric history was high (4.41 %) as compared to females with no bad obstetric history showing only 1.76 %. Alloantibodies detected were Anti-D, Anti-E, Anti-C and Anti-K. Anti-D constituted 80 % of all alloantibodies detected. Six women in their third trimester had raised titers of anti-D. Most common alloantibody detected was anti-D (80 %). Alloantibodies to other Rh antigens and Kell blood group systems were also identified. To minimize alloimmunization in Rh D negative women, proper Anti D immunoprophylaxis should be implemented.
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Antenatal hypnosis training and childbirth experience: a randomized controlled trial.
Werner, Anette; Uldbjerg, Niels; Zachariae, Robert; Wu, Chun Sen; Nohr, Ellen A
2013-12-01
Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience. In a randomized, controlled, single-blinded trial, 1,222 healthy nulliparous women were allocated to one of three groups during pregnancy: A hypnosis group participating in three 1-hour sessions teaching self-hypnosis to ease childbirth, a relaxation group receiving three 1-hour lessons in various relaxation methods and Mindfulness, and a usual care group receiving ordinary antenatal care only. Wijmas Delivery Expectancy/Experience Questionnaire (W-DEQ) was used to measure the childbirth experience 6 weeks postpartum. The intention-to-treat analysis indicated that women in the hypnosis group experienced their childbirth as better compared with the other two groups (mean W-DEQ score of 42.9 in the Hypnosis group, 47.2 in the Relaxation group, and 47.5 in the Care as usual group (p = 0.01)). The tendency toward a better childbirth experience in the hypnosis group was also seen in subgroup analyses for mode of delivery and for levels of fear. In this large randomized controlled trial, a brief course in self-hypnosis improved the women's childbirth experience. © 2013, Copyright the Authors Journal compilation © 2013, Wiley Periodicals, Inc.
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Directory of Open Access Journals (Sweden)
Hassan H. M. Zaky
2014-01-01
Full Text Available Women’s relative lack of decision-making power and their unequal access to employment, finances, education, basic health care, and other resources are considered to be the root causes of their ill-health and that of their children. The main purpose of this paper is to examine the interactive relation between women’s empowerment and the use of maternal health care. Two model specifications are tested. One assumes no correlation between empowerment and antenatal care while the second specification allows for correlation. Both the univariate and the recursive bivariate probit models are tested. The data used in this study is EDHS 2008. Factor Analysis Technique is also used to construct some of the explanatory variables such as the availability and quality of health services indicators. The findings show that women’s empowerment and receiving regular antenatal care are simultaneously determined and the recursive bivariate probit is a better approximation to the relationship between them. Women’s empowerment has significant and positive impact on receiving regular antenatal care. The availability and quality of health services do significantly increase the likelihood of receiving regular antenatal care.
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Rehabilitación por el ejercicio de la escoliosis idiopática leve en niños y adolescentes
Bertoncelli, María Laura
2013-01-01
La Sociedad Internacional para el Estudio de la Escoliosis (Scoliosis Research Society) la define como "una curvatura lateral de la columna con rotación de las vértebras dentro de la curva". La escoliosis idiopática es una patología de origen multifactorial que causa una alteración en la postura corporal. La indicación de diferentes técnicas de gimnasia postural ha sido una práctica habitual como parte del tratamiento conservador de la escoliosis idiopática leve(EIL) en niños y adolescente...
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Garnweidner-Holme, Lisa Maria; Lukasse, Mirjam; Solheim, Miriam; Henriksen, Lena
2017-04-19
Intimate partner violence (IPV) against women constitutes a major public health problem. Antenatal care is considered a window of opportunity to disclose and to communicate about IPV. However, little is known about how women from different ethnic backgrounds wish to communicate about their experiences with IPV during pregnancy in antenatal care. The aim of the present study was to explore how women from different ethnic backgrounds experienced IPV and what their recommendations were about how midwives should communicate about IPV in antenatal care. Qualitative individual interviews with eight women who had experienced IPV during pregnancy were conducted and analysed using thematic analysis. The participants were purposively recruited from three crisis shelters in South-East Norway. The participants either had immigrant backgrounds (n = 5) or were ethnic Norwegians (n = 3). All participants received antenatal care by a midwife. Although none of the participants were asked about IPV during antenatal care, they wished to talk about their experiences. Most participants felt that it would be important for the midwife to make them aware that they were victims of violence. Participants offered different suggestions on how and when midwives should talk about IPV. Facilitators to talk about IPV with the midwife were a good relationship with and the trustworthiness of the midwife, information about possible negative health outcomes for the newborn owing to IPV and knowing that the midwife could help them. The main barriers to talk about IPV with the midwife were that the participants were accompanied by their husbands during antenatal care, fear that the Child Welfare Service would take away their children after disclosure and cultural acceptance of violence. Participants with immigrant backgrounds also experienced difficulties in talking about IPV owing to their limited language skills. They thought that professionally trained interpreters with experience of IPV
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Antenatal Bartter Syndrome: A Review
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Y. Ramesh Bhat
2012-01-01
Full Text Available Antenatal Bartter syndrome (ABS is a rare autosomal recessive renal tubular disorder. The defective chloride transport in the loop of Henle leads to fetal polyuria resulting in severe hydramnios and premature delivery. Early onset, unexplained maternal polyhydramnios often challenges the treating obstetrician. Increasing polyhydramnios without apparent fetal or placental abnormalities should lead to the suspicion of this entity. Biochemical analysis of amniotic fluid is suggested as elevated chloride level is usually diagnostic. Awareness, early recognition, maternal treatment with indomethacin, and amniocentesis allow the pregnancy to continue. Affected neonates are usually born premature, have postnatal polyuria, vomiting, failure to thrive, hypercalciuria, and subsequently nephrocalcinosis. Hypokalemia, metabolic alkalosis, secondary hyperaldosteronism and hyperreninaemia are other characteristic features. Volume depletion due to excessive salt and water loss on long term stimulates renin-angiotensin-aldosterone system resulting in juxtaglomerular hyperplasia. Clinical features and electrolyte abnormalities may also depend on the subtype of the syndrome. Prenatal diagnosis and timely indomethacin administration prevent electrolyte imbalance, restitute normal growth, and improve activity. In this paper, authors present classification, pathophysiology, clinical manifestations, laboratory findings, complications, and prognosis of ABS.
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Antenatal Bartter Syndrome: A Review
Bhat, Y. Ramesh; Vinayaka, G.; Sreelakshmi, K.
2012-01-01
Antenatal Bartter syndrome (ABS) is a rare autosomal recessive renal tubular disorder. The defective chloride transport in the loop of Henle leads to fetal polyuria resulting in severe hydramnios and premature delivery. Early onset, unexplained maternal polyhydramnios often challenges the treating obstetrician. Increasing polyhydramnios without apparent fetal or placental abnormalities should lead to the suspicion of this entity. Biochemical analysis of amniotic fluid is suggested as elevated chloride level is usually diagnostic. Awareness, early recognition, maternal treatment with indomethacin, and amniocentesis allow the pregnancy to continue. Affected neonates are usually born premature, have postnatal polyuria, vomiting, failure to thrive, hypercalciuria, and subsequently nephrocalcinosis. Hypokalemia, metabolic alkalosis, secondary hyperaldosteronism and hyperreninaemia are other characteristic features. Volume depletion due to excessive salt and water loss on long term stimulates renin-angiotensin-aldosterone system resulting in juxtaglomerular hyperplasia. Clinical features and electrolyte abnormalities may also depend on the subtype of the syndrome. Prenatal diagnosis and timely indomethacin administration prevent electrolyte imbalance, restitute normal growth, and improve activity. In this paper, authors present classification, pathophysiology, clinical manifestations, laboratory findings, complications, and prognosis of ABS. PMID:22518185
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Determinants of folic acid knowledge and use among antenatal women.
LENUS (Irish Health Repository)
McDonnell, R
1999-06-01
Although recommendations on folic acid use were issued by health authorities in a number of countries in the early 1990s, uptake of peri-conceptional folic acid is still disappointingly low. Regardless of food fortification policies, folic acid promotion will probably be required in most countries to optimize folate levels among women of child-bearing age. The aim of this study was to examine folic acid knowledge and use, and their determinants among antenatal women in the east of Ireland in 1997.
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Emelumadu, Obiageli F.; Onyeonoro, Ugochukwu Uchenna; Ukegbu, Andrew Ugwunna; Ezeama, Nkiru N.; Ifeadike, Chigozie Ozoemena; Okezie, Obasi Kanu
2014-01-01
Background: This is a cross-sectional descriptive study aimed at assessing antenatal care service attendees’ perception of quality of maternal healthcare (MHC) services in Anambra State, southeast Nigeria. Materials and Methods: A total of 310 pregnant women utilising antenatal care (ANC) services in three purposively selected primary health centres (PHCs) in rural communities in Anambra State were studied. Reponses were elicited from the participants selected consecutively over a 4-month period, using a pre-tested, semi-structured interviewer-administered questionnaire on socio-demographic characteristics, utilisation and perception of MHC services. Data collected were analysed using SPSS version 17. Results: Findings showed that utilisation of facility for both antenatal (97.0%; 95% CI, 94.4–98.4%) and natal services (92.7%; 95% CI 89.2–95.2%) were quite high. Generally, most of the women were satisfied with MHC services (89.7%). Most of them were satisfied with the staff attitude (85.1%), waiting time (84.1%) and cost of services (79.5%). Being ≥30 years (X2 = 4.61, P = 0.032), married (X2 = 9.70, P = 0.008) and multiparous (X2 = 9.14, P = 0.028), as well as utilisation of formal health facility for antenatal (X2 = 26.94, P = 0.000) and natal (X2 = 33.42, P = 0.000) services were associated with satisfaction with maternal health services. Conclusions: The study showed high level of satisfaction with quality of maternal health services among antenatal attendees and highlights the need to strengthen interventions that increase uptake of formal MHC services. PMID:24791050
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Brady, Vivienne; Lalor, Joan
2017-12-01
the aim of this research was to initiate active consultation with women and antenatal educators in the development and delivery of antenatal education that was mutually relevant. a Participatory Action Research approach influenced by feminist concerns was used to guide the research. Data were analysed by the researcher and participants using a Voice Centred Relational Method of Analysis. an Antenatal Education service in a consultant-led tertiary referral unit in Ireland. research findings revealed women's desires to build relationships through ANE to cope with anticipated loneliness and isolation after birth; however, environmental, structural, and organisational factors prohibited opportunity to build space for human connection. Participating women valued external and authoritative knowledge as truth, but concomitantly sought opportunity and space through classes to learn from the real life experiences of other mothers. Women lacked confidence in embodied knowing and their power to birth and demonstrated unquestioning acceptance of the predetermined nature of hospital birth and biomedical model of maternity care. in this research, we envisioned that hospital-based ANE, relevant and grounded in the needs and life experiences of women, could be developed, with a view to supporting women's decision-making processes, and understanding of pregnancy, birth and early motherhood. Participatory Action Research using a Voice Centred Relational Method of Analysis offered an opportunity to foster ethical and dialogic activity between learner and facilitator, underpinned by acknowledgement of the value of women's experiences; however, space for expression of new and useful knowledge in preparation for motherhood was limited by institutional context. Copyright © 2017 Elsevier Ltd. All rights reserved.
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Las controversias sociocientíficas en los contenidos de enseñanza de la química cosmética
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Diana Lineth Parga Lozano
2016-10-01
Full Text Available Este artículo presenta los resultados de una investigación desarrollada desde la Universidad Pedagógica Nacional de Bogotá, entre el año 2014 y el 2015, la cual evaluó en el contexto actual colombiano, el contenido curricular de la asignatura Química Cosmética en la formación de profesionales en el área de la Estética Facial y Corporal. Esta evaluación permitió estudiar el impacto que tiene en la caracterización de los contenidos el hecho que un profesional haya sido formado o no con esta asignatura. El carácter inductivo de la investigación permitió, a partir del análisis de los datos obtenidos, estructurar una propuesta macrocurricular, mesocurricular y microcurricular (bajo controversias sociocientíficas, la cual incluye (para los ámbitos internacional y nacional una valoración de la ubicación de la asignatura en el plan de estudios de las instituciones que ofertan carreras de Estética Facial y Corporal en Colombia. La relación con la utilidad que tienen los resultados de este trabajo de investigación pretende entre otros, plantear al Ministerio de Educación Nacional la consideración de estos resultados para fines pertinentes en la definición de políticas académicas en este sentido.
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Sherwood, James M.; Huitger, Carrie A.; Ebner, Andrew D.; Koltun, G.F.
2008-01-01
The USGS, in cooperation with the Ohio Emergency Management Agency, conducted a study in the Wheeling Creek Basin to (1) evaluate and contrast land-cover characteristics from 2001 with characteristics from 1979 and 1992; (2) compare current streambed elevation, slope, and geometry with conditions present in the late 1980s; (3) look for evidence of channel filling and over widening in selected undredged reaches; (4) estimate flood elevations for existing conditions in both undredged and previously dredged reaches; (5) evaluate the height of the levees required to contain floods with selected recurrence intervals in previously dredged reaches; and (6) estimate flood elevations for several hypothetical dredging and streambed aggradation scenarios in undredged reaches. The amount of barren land in the Wheeling Creek watershed has decreased from 20 to 1 percent of the basin area based on land-cover characteristics from 1979 and 2001. Barren lands appear to have been converted primarily to pasture, presumably as a result of surface-mine reclamation. Croplands also decreased from 13 to 8 percent of the basin area. The combined decrease in barren lands and croplands is approximately offset by the increase in pasture. Stream-channel surveys conducted in 1987 and again in 2006 at 21 sites in four previously dredged reaches of Wheeling Creek indicate little change in the elevation, slope, and geometry of the channel at most sites. The mean change in width-averaged bed and thalweg elevations for the 21 cross sections was 0.1 feet. Bankfull widths, mean depths, and cross-sectional areas measured at 12 sites in undredged reaches were compared to estimates determined from regional equations. The mean percentage difference between measured and estimated bankfull widths was -0.2 percent, suggesting that bankfull widths in the Wheeling Creek Basin are generally about the same as regional averages for undisturbed basins of identical drainage area. For bankfull mean depth and cross
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Ingram, Emily R; Robertson, Iain K; Ogden, Kathryn J; Dennis, Amanda E; Campbell, Joanne E; Corbould, Anne M
2017-06-01
Gestational diabetes mellitus (GDM) is associated with life-long increased risk of type 2 diabetes: affected women are advised to undergo oral glucose tolerance testing (OGTT) at 6-12 weeks postpartum, then glucose screening every 1-3 years. We investigated whether in women with GDM, antenatal clinical factors predicted postpartum abnormal glucose tolerance and compliance with screening. In women with GDM delivering 2007 to mid-2009 in a single hospital, antenatal/obstetric data and glucose tests at 6-12 weeks postpartum and during 5.5 years post-pregnancy were retrospectively collected. Predictors of return for testing and abnormal glucose tolerance were identified using multivariate analysis. Of 165 women, 117 (70.9%) returned for 6-12 week postpartum OGTT: 23 (19.6%) were abnormal. Smoking and parity, independent of socioeconomic status, were associated with non-return for testing. Fasting glucose ≥5.4 mmol/L on pregnancy OGTT predicted both non-return for testing and abnormal OGTT. During 5.5 years post-pregnancy, 148 (89.7%) women accessed glucose screening: nine (6.1%) developed diabetes, 33 (22.3%) had impaired fasting glucose / impaired glucose tolerance. Predictors of abnormal glucose tolerance were fasting glucose ≥5.4 mmol/L and 2-h glucose ≥9.3 mmol/L on pregnancy OGTT (~2.5-fold increased risk), and polycystic ovary syndrome (~3.4 fold increased risk). Risk score calculation, based on combined antenatal factors, did not improve predictions. Antenatal clinical factors were modestly predictive of return for testing and abnormal glucose tolerance post-pregnancy in women with GDM. Risk score calculations were ineffective in predicting outcomes: risk scores developed in other populations require validation. Ongoing glucose screening is indicated for all women with GDM. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
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Extracranial vascular malformation: value of antenatal and postnatal MRI in management
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Roche, C.J.; Pilling, D.W. [Dept. of Radiology, Royal Liverpool Children' s Hospital NHS Trust (United Kingdom); Walkinshaw, S.A. [Dept. of Fetal Medicine, Liverpool Women' s Hospital (United Kingdom); May, P.L. [Dept. of Neurosurgery, Royal Liverpool Children' s Hospital NHS Trust (United Kingdom)
2001-10-01
We report a case where fetal MRI using a low-field-strength magnet (0.5 T) accurately confirmed a large extracranial vascular malformation, which was suspected on antenatal US. Fetal MRI enabled better counselling of the parents and allowed suitable plans to be made regarding method of delivery and early management of the neonate. To our knowledge this is the first case of an extracranial vascular malformation imaged using fetal MRI. (orig.)
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Pell, C.; Meñaca, A.; Were, F.; Afrah, N.A.; Chatio, S.; Manda-Taylor, L.; Hamel, M.J.; Hodgson, A.; Tagbor, H.; Kalilani, L.; Ouma, P.; Pool, R.
2013-01-01
Background: Antenatal care (ANC) is a key strategy to improve maternal and infant health. However, survey data from sub-Saharan Africa indicate that women often only initiate ANC after the first trimester and do not achieve the recommended number of ANC visits. Drawing on qualitative data, this
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Determinants of condom use among antenatal clinic attendees in Dar es Salaam, Tanzania.
Msamanga, Gernard; Tchetgen, Eric; Spiegelman, Donna; Fawzi, Mary Kay Smith; Kaaya, Sylvia; Urassa, Willy; Hunter, David; Kapiga, Saidi; Fawzi, Wafaie
2009-08-01
To determine the demographic, socio-economic and psycho-social factors associated with condom use amongst antenatal clinic attendees in Dar es Salaam. A cross sectional study design was employed in four antenatal clinics in Dar es Salaam. Pregnant women were interviewed between April 1995 and July 1997 to find out if they have ever used a condom and if so whether they had used them consistently for all coital acts in the previous year. Of 1,585 women interviewed, 41% had their first sexual experience before age of 18 years and 82% had a history of having more than two sexual partners during their lifetime. Sixty-two percent of women had never used a condom. Although 40% had used a condom in the previous year only 12% used them consistently. Ever use of a condom increased significantly with the number of years of education of the respondent and her partner also with the respondent's financial independence. Women with > 9 years of education were twice as likely as women with condom users (prevalence ratio (PR) = 2.1, 95% confidence interval (CI) = 1.6-2.7). Professional women were almost twice as likely as housewives to have ever used a condom (PR = 1.8, 95% CI = 1.3-2.3). Women who reported that they have had more than four sexual partners during their lifetime were associated with nearly a four-fold higher lifetime rate of having ever used a condom, compared with a single lifetime partnership (PR = 3.9, 95% CI = 2.8-5.4). The reported prevalence of ever use of a condom amongst antenatal clinic attendees is low and inconsistent especially among HIV positive women. Deliberate effort should be used to ensure condom access, availability and correct and consistent use of condoms by women in all sexual acts.
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Katharine Hollingsworth
Full Text Available INTRODUCTION: Obesity in pregnancy is associated with increased risk of complications and adverse outcomes in mother and child. Childhood adverse experiences are known to have numerous negative physical and emotional sequelae. We aimed to examine if exposure to abuse and/or neglect in childhood increased the likelihood of pre-pregnancy obesity. METHODS: Demographic and clinical data including weight, height, mental health as measured by the General Health Questionnaire and exposure to childhood trauma as measured by the childhood trauma questionnaire was collected from 239 women attending antenatal care at an Australian tertiary hospital. RESULTS: More than one quarter of women were obese prior to pregnancy and approximately 20% of women self reported experiencing moderate to severe physical, sexual or emotional abuse. Almost 60% of women scored in the clinical range on the GHQ. Pre-pregnancy obesity in women attending antenatal care was associated with a self-reported history of emotional or physical abuse with those exposed to moderate or severe emotional or physical abuse having increased odds of being obese prior to pregnancy (O.R. and 95% CI: 2.40; 1.19-4.84 and 2.38; 1.18-4.79 respectively. There was no significant association between other forms of childhood maltreatment, demographic or current mental health status and pre-pregnancy obesity. CONCLUSIONS: The high rates of obesity, mental health problems and self reported childhood maltreatment in the Australian antenatal population are serious public health concerns due to the extra health risks conferred on mother and offspring. Exposure to physical or emotional abuse during childhood increases the likelihood of obesity in women attending antenatal care. Further research is required to determine reasons for this association.
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Andrés Sarmiento Lamus
2012-12-01
Full Text Available El artículo 62 del Estatuto de la Corte Internacional de Justicia establece que todo Estado que considere tener un interés de orden jurídico que pueda ser afectado por la decisión de un litigio podrá solicitar intervenir, siendo la Corte quien decida respecto de dicha solicitud. Los últimos desarrollos jurisprudenciales de la Corte en materia de intervención mostraban cómo las discusiones surgidas, a escala jurisprudencial y doctrinal, alrededor de la interpretación y aplicación de la intervención parecían haber desaparecido. Sin embargo, las recientes decisiones de la Corte respecto de las solicitudes de intervención de Costa Rica y Honduras en la Controversia Territorial y Marítima entre Nicaragua y Colombia han revivido de nuevo la controversia. Este artículo presenta una introducción general a la institución de la intervención, explicando la aplicación que la Corte ha dado a la misma y analiza cada uno de los requisitos que deben cumplirse para intervenir en asuntos sometidos a la Corte para su solución. Como conclusión, se realiza un comentario y análisis de las decisiones de la Corte en las más recientes solicitudes de intervención.
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Siu Bonnie WM
2012-03-01
Full Text Available Abstract Background Risk factors for postnatal depression (PND are under-explored in the Chinese populations. There is increasing recognition of the importance of identifying predictive factors during the antenatal period for PND. The present study aimed to identify the risk factors for postnatal depression in a community cohort of Chinese women with special focus on the antenatal risk factors. Methods Eight hundred and five Chinese women were interviewed during their third trimester of pregnancy and at around 2 months postnatally. Putative risk factors for PND were collected and the diagnosis of PND was confirmed by the Structured Clinical Interview for DSM-IV Axis I Disorders. The 2-month postnatal depression status was used as the dependent variable for univariate and multivariate analyses against putative risk factors. Results Marital dissatisfaction (Relative Risk = 8.27, dissatisfied relationship with mother-in-law (Relative Risk = 3.93, antenatal depressive symptomatology (Relative Risk = 3.90, and anxiety-prone personality (Relative Risk = 2.14 predicted PND in Chinese women independently. Conclusions Chinese women tend to keep their own feelings and emotions and it is important to monitor Chinese pregnant women with these predictive risk factors so that PND can be identified early.
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Bray, J K; Gorman, D R; Dundas, K; Sim, J
2010-08-01
There has been a twelve-fold increase in the number of New European migrants giving birth in Lothian between 2004 and 2007. The objective of this study was to audit obstetric care standards in Lothian for new migrants and recommend service improvements. A retrospective audit of 114/136 (84%) obstetric case records of new European migrants giving birth in Lothian hospitals in 2006 was conducted. Assessment was against care standards for antenatal booking, antenatal attendance and interpretation. Obstetric outcomes were audited against the general population. Eighty percent were primiparous. Fifty five percent had booked by the end of week 14. Mean birth weights and lengths of stay were similar to the general population. Intervention rates were 23% for Caesarean Sections (C/S) and 17% for instrumental deliveries (versus 27% and 19% respectively in the general population). Epidural or spinal anaesthesia was used for 57% compared to 50% of the general population. The interpretation services (ITS) were used infrequently. Full compliance with antenatal and interpretation standards was not achieved for this population. ITS was most commonly used to meet the needs of healthcare professionals, rather than as a routine. While there were no significant differences in maternity outcomes, poor communication did affect care.
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Fitrayeni Fitrayeni
2017-08-01
Full Text Available Antenatal Care (ANC yang berkualitas sesuai standar yang telah ditentukan oleh Pemerintah yaitu 1 kali dalam trimester I, 1 kali trimester II dan 2 kali trimester III untuk menurunkan angka kesakitan dan kematian ibu. Kota Padang menetapkan pelayanan ANC tersebut dengan 10 T. Penelitian ini bertujuan untuk mengetahui Penyebab rendahnya kelengkapan kunjungan ANC ibu hamil di wilayah kerja Puskesmas Pegambiran tahun 2013. Penelitian ini dilakukan bulan Januari - Oktober 2013 dengan desain cross sectional study. Jumlah populasi 87 orang, besar sampel 46 orang, metode pengambilan sampel proporsional sampling. Pengumpulan data menggunakan kuesioner, dan dianalisis secara univariat dan bivariat dengan uji chi square. Hasil penelitian ini didapatkan 63% responden memiliki tingkat pengetahuan rendah, 67,4% memiliki sikap negatif, 43,5% responden mengatakan peran bidan kurang baik saat kunjungan, 58,7% responden menyatakan keluarga tidak mendukung. Untuk itu diperlukan upaya peningkatan peran bidan, meningkatkan peran dan dukungan suami agar ibu hamil dapat melaksanakan kunjungan ANC dengan lengkap. Kata Kunci: Antenatal Care, Pengetahuan, Sikap, Peran Bidan, Dukungan Keluarga
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Reilly, E T C; Freeman, R M; Waterfield, M R; Waterfield, A E; Steggles, P; Pedlar, F
2014-12-01
To test whether supervised pelvic floor exercises antenatally will reduce the incidence of postpartum stress incontinence in at-risk primigravidae with bladder neck mobility, ultrasonically proven. Single blind, randomised controlled trial. Antenatal clinic in a UK NHS Trust Hospital. Two hundred and sixty-eight primigravidae attending an antenatal clinic at approximately 20 weeks of gestation with bladder neck mobility, on standardised valsalva, of 5 mm or more linear movement. The median age was 28, ranging from 16 to 47 years. Patients randomised to supervised pelvic floor exercises (n = 139) attended a physiotherapist at monthly intervals from 20 weeks until delivery. The exercises comprised three repetitions of eight contractions each held for six seconds, with two minutes rest between repetitions. These were repeated twice daily. At 34 weeks of gestation the number of contractions per repetition was increased to 12. Both the untreated control group and the study group received verbal advice on pelvic floor exercises from their midwives antenatally. Subjective reporting of stress incontinence at three months postpartum. Pelvic floor strength, using perineometry, and bladder neck mobility measured by perineal ultrasound. Of the 268 women enrolled, information on the main outcome variable was available for 110 in the control group and 120 in the study group. Fewer women in the supervised pelvic floor exercise group reported postpartum stress incontinence, 19.2% compared with 32.7% in the control group (RR 0.59 [0.37-0.92]). There was no change in bladder neck mobility and no difference in pelvic floor strength between groups after exercise, although all those developing postpartum stress incontinence had significantly poorer perineometry scores than those who were continent. The findings suggest that antenatal supervised pelvic floor exercises are effective in reducing the risk of postpartum stress incontinence in primigravidae with bladder neck mobility.
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Schmand, B.; Neuvel, J.; Smolders-de Haas, H.; Hoeks, J.; Treffers, P. E.; Koppe, J. G.
1990-01-01
Potential side effects of antenatal administration of corticosteroids to prevent neonatal respiratory distress syndrome were studied in 10- to 12-year-old children whose mothers had participated in a randomized, double-blind, placebo-controlled trial of betamethasone. Aspects of the children's
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Martin, L.; Hutton, E.K.; Gitsels-van der Wal, J.T.; Spelten, E.R.; Kuiper, F.; Pereboom, M.T.; Dulmen, S. van
2015-01-01
OBJECTIVE: antenatal counselling for congenital anomaly tests is conceptualised as having both Health Education (HE) and Decision-Making Support (DMS) functions. Building and maintaining a client-midwife relation (CMR) is seen as a necessary condition for enabling these two counselling functions.
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Martin, L.; Hutton, E.K.; Gitsels–van der Wal, J.T.; Spelten, E.R.; Kuiper, F.; Pereboom, M.T.R.; van Dulmen, S.
2015-01-01
Objective: antenatal counselling for congenital anomaly tests is conceptualised as having both Health Education (HE) and Decision-Making Support (DMS) functions. Building and maintaining a client-midwife relation (CMR) is seen as a necessary condition for enabling these two counselling functions.
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Martin, L.; Hutton, E.K.; Gitsels-van der Wal, J.T.; Spelten, E.R.; Kuiper, F.; Pereboom, M.T.R.; Dulmen, S. van
2015-01-01
Objective: antenatal counselling for congenital anomaly tests is conceptualised as having both Health Education (HE) and Decision-Making Support (DMS) functions. Building and maintaining a client–midwife relation (CMR) is seen as a necessary condition for enabling these two counselling functions.
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Divya Bhadoo
2015-01-01
Full Text Available Aims: Study on prognostic significance of antenatal ultrasonography and renin angiotensin system activation in predicting disease severity in posterior urethral valves. Materials and Methods: Antenatally diagnosed hydronephrosis patients were included. Postnatally, they were divided into two groups, posterior urethral valve (PUV and non-PUV. The studied parameters were: Gestational age at detection, surgical intervention, ultrasound findings, cord blood and follow up plasma renin activity (PRA values, vesico-ureteric reflux (VUR, renal scars, and glomerular filtration rate (GFR. Results: A total of 25 patients were included, 10 PUV and 15 non-PUV. All infants with PUV underwent primary valve incision. GFR was less than 60 ml/min/1.73 m 2 body surface area in 4 patients at last follow-up. Keyhole sign, oligoamnios, absent bladder cycling, and cortical cysts were not consistent findings on antenatal ultrasound in PUV. Cord blood PRA was significantly higher (P < 0.0001 in PUV compared to non-PUV patients. Gestational age at detection of hydronephrosis, cortical cysts, bladder wall thickness, and amniotic fluid index were not significantly correlated with GFR while PRA could differentiate between poor and better prognosis cases with PUV. Conclusions: Ultrasound was neither uniformly useful in diagnosing PUV antenatally, nor differentiating it from cases with non-PUV hydronephrosis. In congenital hydronephrosis, cord blood PRA was significantly higher in cases with PUV compared to non-PUV cases and fell significantly after valve ablation. Cord blood PRA could distinguish between poor and better prognosis cases with PUV.
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Westland, Rik; Hack, Wilfried W; van der Horst, Henricus J R; Uittenbogaard, Lukas B; van Hagen, Johanna M; van der Valk, Paul; Kamsteeg, Erik J; van den Heuvel, Lambert P; van Wijk, Joanna A E
2012-12-01
Bartter syndrome encompasses a variety of inheritable renal tubular transport disorders characterized by hypokalemia and hypochloremic metabolic alkalosis. Bartter syndrome Type III is caused by genetic alterations in the chloride channel kidney B (CLCNKB) gene and often presents in the first 2 years of life, known as classic Bartter syndrome. However, in rare cases Bartter syndrome Type III has an antenatal presentation with polyhydramnios, premature delivery and severe dehydration in the first weeks of life. Associations between congenital anomalies of the kidney and urinary tract and Bartter syndrome are extremely rare. This case report presents a girl with Bartter syndrome Type III due to a homozygous CLCNKB mutation and bilateral congenital anomalies of the kidney and urinary tract. In addition, we describe the antenatal presentation as well as its perinatal management.