WorldWideScience

Sample records for antenatal leve controversias

  1. menopausia: tendencias y controversias

    Directory of Open Access Journals (Sweden)

    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

  2. Dams and Levees: Safety Risks

    Science.gov (United States)

    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

  3. At leve med osteoporose

    DEFF Research Database (Denmark)

    Hansen, Carrinna; Abrahamsen, Bo; Konradsen, Hanne

    Baggrund: Livet med kronisk sygdom, heriblandt osteoporose, giver anledning til verdensomspændende udfordringer. Osteoporose er ofte en usynlig tilstand før knoglebrud opstår, det er anslået, at hver tredje kvinde og en af fire mænd over 50 år i Europa vil opleve disse typer af knoglebrud og det...... med betydelig sygelighed og dødelighed til følge. At leve med en kronisk tilstand påvirker ofte menneskets livssituation, både specifikt, emotionelt og eksistentielt, hvordan dette opleves er individuelt og det er endnu uklart hvordan osteoporose påvirker den enkeltes livssituation. Formål: At opnå en...... dybere forståelse af livet med osteoporose ved at undersøge ny-diagnosticerede kvinders erfaringer med at leve med osteoporose når medicinsk behandling med henblik på frakturforebyggelse var ordineret. Metode: Et kvalitativt studie med en fænomenologisk-hermeneutisk tilgang, samt et longitudinelt design...

  4. Bayesian networks in levee reliability

    NARCIS (Netherlands)

    Roscoe, K.; Hanea, A.

    2015-01-01

    We applied a Bayesian network to a system of levees for which the results of traditional reliability analysis showed high failure probabilities, which conflicted with the intuition and experience of those managing the levees. We made use of forty proven strength observations - high water levels with

  5. leve a moderada

    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

  6. Længe leve hurraforskning?

    DEFF Research Database (Denmark)

    Skytte Gørtz, Kim Erik

    2008-01-01

    Kapitlet tager afsæt i den gældende coachforskning og problematiserer herved, hvordan og hvorvidt denne forskning kan og skal leve op til videnskabelige kriterier. På baggrund af en lang række undersøgelser af effekter af coaching gennemgås, hvilke metodiske udfordringer der opstår, hvis og såfremt...

  7. National Levee Database, series information for the current inventory of the Nation's levees.

    Data.gov (United States)

    Federal Geographic Data Committee — The National Levee Database is authoritative database that describes the location and condition of the Nation’s levees. The database contains 21 feature classes...

  8. El confesor regio Fray Luis Aliaga y la controversia Inmaculista

    Directory of Open Access Journals (Sweden)

    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.

  9. Erosion of Earthen Levees by Wave Action

    Science.gov (United States)

    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.

  10. Transient Seepage for Levee Engineering Analyses

    Science.gov (United States)

    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.

  11. 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.

  12. Controversia. La Ética Periodística

    Directory of Open Access Journals (Sweden)

    Leonard Sussman

    2015-01-01

    Full Text Available Leonard R. Sussman y Rodrigo Santillán Peralbo, se refieren, desde su particular punto de vista, a la ética en el periodismo. Sussman quien por varios años ha desempeñado la Vicepresidencia de la Comisión Nacional de los Estados Unidos para la Unesco, al tratar de la conciencia del periodista, indica que el punto de partida para cualquier Código de Etica es que el periodismo hay que dejarlo a los periodistas, señalando que se debe buscar la verdad y la objetividad, eliminando la parcialidad personal, polúica, racial y social. Santillán, que es Vicepresidente de la Federación Latinoamericana de Periodistas, FELAP, analiza la liberación y la dependencia del periodista, indicando que el derecho de los pueblos a la libertad de expresión es y seguirá siendo una utopia en tanto se mantenga el carácter privado de los medios de comunicación social. De alli que cualquier norma de ética, agrega, debe surgir del análisis del sistema imperante. En cuanto a la objetividad señala que el periodista "objetivo" se vuelve dócil criatura del sistema a quien, además, se les despoja de su libertad de pensar. Respecto a la imparcialidad, dice, que el periodista tiene dos alternativas: está al servicio del sistema o está al servicio de Sil pueblo y sus intereses. Los diferentes criterios que sobre el tratamiento a la ética periodistica señalan Sussman y Santillán, establecen una verdadera controversia que presentamos a consideración de nuestros lectores. [Lincoln Larrea Benalcázar}.

  13. CONTROVERSIA: UN ESPACIO PARA LA DISCUSIÓN Y LAS ALTERNATIVAS

    OpenAIRE

    Ramos, Francisco

    2012-01-01

    Este pequeño escrito presenta el apartado Controversia. La Controversia de P3T constará de 3-4 artículos que girarán en torno a una temática específica vinculada a las políticas públicas y los impactos en el territorio. La intención de la sección es promover la reflexión y el debate, y asimismo se pretende fomentar la formulación de alternativas.

  14. Hydrodynamic and sedimentological controls governing formation of fluvial levees

    Science.gov (United States)

    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.

  15. 33 CFR 203.51 - Levee owner's manual.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Levee owner's manual. 203.51... Program § 203.51 Levee owner's manual. (a) Authority. In accordance with section 202(f) of Public Law 104-303, the Corps will provide a levee owner's manual to the non-Federal sponsor of all flood control...

  16. Pseudo-Quintilian's Major Declamations 18 and 19: two controversiae figuratae

    NARCIS (Netherlands)

    Breij, B.M.C.

    2006-01-01

    This article contributes to the study of figured speech by offering an analysis of pseudo-Quintilian's Declamationes Maiores 18 and 19, two controversiae figuratae. After an introduction of the relevant rhetorical concepts, an account is given of figured speech on all levels in both declamations.

  17. Cibola High Levee Pond annual report 2004

    Science.gov (United States)

    Mueller, Gordon A.; Carpenter, Jeanette; Marsh, Paul C.

    2005-01-01

    This represents the fourth and last annual report of a five year study investigating the early life ecology of the bonytail and razorback sucker at Cibola High Levee Pond. The work in 2004 included: telemetry studies, collection of physical water quality measurements, zooplankton samples, netting fish, the collection of scale samples for aging, predator/prey tank tests and a preliminary analysis of the data base.

  18. Traumatismo craneoencefálico leve

    Science.gov (United States)

    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

  19. Controversias tecnocientíficas públicas: la pericia no es siempre suficiente

    Directory of Open Access Journals (Sweden)

    Eduard Aibar

    2002-04-01

    Full Text Available Las controversias públicas sobre temas tecnocientíficos son uno de los fenómenos más característicos de nuestra época, no sólo por su número, sino también por su intensidad y virulencia: muchas se acaban convirtiendo en problemas sociopolíticos de primera magnitud. Este trabajo explora el papel que el conocimiento experto tiene en este tipo de situaciones conflictivas. Por una parte, se pone en duda la imagen convencional de la ciencia y la tecnología que, durante mucho tiempo, ha condicionado la comprensión de este tipo de controversias. Por otra, a partir de una distinción analítica entre ciencia normal y ciencia regulativa, y sobre la base de una perspectiva constructivista y simétrica, se estudian los límites de la pericia tecnocientífica en la clausura de las controversias públicas. Full text (HTML | In Spanish Las controversias públicas sobre temas tecnocientíficos son uno de los fenómenos más característicos de nuestra época, no sólo por su número, sino también por su intensidad y virulencia: muchas se acaban convirtiendo en problemas sociopolíticos de primera magnitud. Este trabajo explora el papel que el conocimiento experto tiene en este tipo de situaciones conflictivas. Por una parte, se pone en duda la imagen convencional de la ciencia y la tecnología que, durante mucho tiempo, ha condicionado la comprensión de este tipo de controversias. Por otra, a partir de una distinción analítica entre ciencia normal y ciencia regulativa, y sobre la base de una perspectiva constructivista y simétrica, se estudian los límites de la pericia tecnocientífica en la clausura de las controversias públicas.

  20. Controversias tecnocientíficas públicas: la pericia no es siempre suficiente

    Directory of Open Access Journals (Sweden)

    Eduard Aibar

    2002-04-01

    Full Text Available Las controversias públicas sobre temas tecnocientíficos son uno de los fenómenos más característicos de nuestra época, no sólo por su número, sino también por su intensidad y virulencia: muchas se acaban convirtiendo en problemas sociopolíticos de primera magnitud. Este trabajo explora el papel que el conocimiento experto tiene en este tipo de situaciones conflictivas. Por una parte, se pone en duda la imagen convencional de la ciencia y la tecnología que, durante mucho tiempo, ha condicionado la comprensión de este tipo de controversias. Por otra, a partir de una distinción analítica entre ciencia normal y ciencia regulativa, y sobre la base de una perspectiva constructivista y simétrica, se estudian los límites de la pericia tecnocientífica en la clausura de las controversias públicas.

  1. National Levee Database: monitoring, vulnerability assessment and management in Italy

    Science.gov (United States)

    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

  2. Factors and Processes Affecting Delta Levee System Vulnerability

    Directory of Open Access Journals (Sweden)

    Steven J. Deverel

    2016-12-01

    Full Text Available doi: https://doi.org/10.15447/sfews.2016v14iss4art3We appraised factors and processes related to human activities and high water, subsidence, and seismicity. Farming and drainage of peat soils caused subsidence, which contributed to levee internal failures. Subsidence rates decreased with time, but still contributed to levee instability. Modeling changes in seepage and static slope instability suggests an increased probability of failure with decreasing peat thickness. Additional data is needed to assess the spatial and temporal effects of subsidence from peat thinning and deformation. Large-scale, state investment in levee upgrades (> $700 million since the mid-1970s has increased conformance with applicable standards; however, accounts conflict about corresponding reductions in the number of failures. Modeling and history suggest that projected increases in high-flow frequency associated with climate change will increase the rate of levee failures. Quantifying this increased threat requires further research. A reappraisal of seismic threats resulted in updated ground motion estimates for multiple faults and earthquake-occurrence frequencies. Estimated ground motions are large enough to induce failure. The immediate seismic threat, liquefaction, is the sudden loss of strength from an increase in the pressure of the pore fluid and the corresponding loss of inter-particle contact forces. However, levees damaged during an earthquake that do not immediately fail may eventually breach. Key sources of uncertainty include occurrence frequencies and magnitudes, localized ground motions, and data for liquefaction potential. Estimates of the consequences of future levee failure range up to multiple billions of dollars. Analysis of future risks will benefit from improved description of levee upgrades and strength as well as consideration of subsidence, the effects of climate change, and earthquake threats. Levee habitat ecosystem benefits in this highly

  3. Un frammento di una declamazione di Cicerone e due controversiae senecane

    Directory of Open Access Journals (Sweden)

    Emanuele Berti

    2010-11-01

    Full Text Available Nella quarta controversia del l. I della raccolta Oratorum et rhetorum sententiae divisiones colores Seneca il Vecchio cita una sententia tratta da una controversia di Cicerone, l’unico frammento a noi noto di una declamazione ciceroniana. Sull’autenticità di tale frammento sono stati avanzati dei dubbi, ma l’analisi dei riferimenti all’attività declamatoria di Cicerone contenuti nella sua corrispondenza, suffragati da un passo dell’Institutio oratoria di Quintiliano, porta alla conclusione che le declamazioni ciceroniane, in particolare quelle tenute negli ultimi anni della sua vita insieme ad alcuni importanti personaggi (come Irzio e Pansa, nonostante il loro carattere privato avevano conosciuto qualche forma di circolazione presso un pubblico più vasto, tanto che la loro memoria poteva essersi conservata almeno fino all’epoca di Quintiliano. Ciò accresce la possibilità che anche il frammento trasmesso da Seneca sia autentico ; e la notizia senecana assume una rilevanza più generale per la storia dello sviluppo del genere declamatorio a Roma, documentando la natura e i temi degli esercizi retorici svolti da Cicerone, che risultano essere del tutto simili a quelli praticati dai retori dell’età imperiale.Il testo della sententia è andato perduto per un guasto della tradizione manoscritta senecana ; ma la parafrasi data da Seneca consente di ricostruirne il contenuto e di stabilire che essa sviluppava un particolare color difensivo, che forma il cardine dell’argomentazione anche in due controversiae della raccolta senecana, applicato dai singoli retori in varianti diverse, che sembrano però rifarsi tutte al precedente ciceroniano. La testimonianza di Seneca offre così un piccolo ma significativo esempio dell’aemulatio Ciceronis e della fortuna immediata di questo autore nelle scuole di retorica del primo impero.

  4. Sustentabilidad y economía: la controversia de la valoración ambiental

    OpenAIRE

    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...

  5. Controversias en torno al Déficit de Atención

    OpenAIRE

    Setien Camacho, Joseba

    2013-01-01

    RESUMEN En este trabajo abordamos algunas de las controversias que han surgido en torno al Déficit de Atención, un trastorno infantil caracterizado por una dificultad para implicarse en una actividad de forma sostenida. En primer lugar, algunos dudan de la misma existencia del trastorno. Nosotros trataremos de demostrar que el trastorno es real y que puede llegar a limitar severamente la vida de quienes lo padecen. Dado que la incidencia de casos ha ido en aumento, otro aspecto en discusión e...

  6. Inversiones y solución de controversias en el MERCOSUR

    Directory of Open Access Journals (Sweden)

    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.

  7. Game Theory and Risk-Based Levee System Design

    Science.gov (United States)

    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.

  8. 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.

  9. Postnatal Imaging of Antenatal Hydronephrosis

    Directory of Open Access Journals (Sweden)

    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.

  10. Determinación de una controversia socio-científica a nivel local : el caso del agua como recurso natural en prensa

    OpenAIRE

    Díaz Moreno, Naira Concepción

    2014-01-01

    Las controversias sociocientíficas surgen y nos rodean en los temas más actuales y emergentes como transgénicos, homeopatía, etc. Dada la importancia que tienen las controversias en las últimas propuestas educativas (Sadler y Zeidler, 2009), esta tesis doctoral está centrada en el estudio de indicadores para determinar controversias sociocientíficas en prensa que puedan servir a los profesores para su uso en el aula de ciencias. La percepción de déficit hídrico existente en Almería en oposici...

  11. La controversia de la utilidad de la estimulación ventricular para la estratificación de riesgo en el síndrome de Brugada

    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.

  12. Using Levee Setbacks to Increase Floodplain Connectivity and Reduce Flood Risk

    Science.gov (United States)

    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.

  13. 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.

  14. Numerical Hydrodynamic Study of Hypothetical Levee Setback Scenarios

    Science.gov (United States)

    2018-01-01

    ER D C /C HL T R- 18 -1 Flood and Coastal Systems Research and Development Program Numerical Hydrodynamic Study of Hypothetical Levee...public release; distribution is unlimited. The U.S. Army Engineer Research and Development Center (ERDC) solves the...nation’s toughest engineering and environmental challenges. ERDC develops innovative solutions in civil and military engineering , geospatial sciences

  15. Las controversias sociocientíficas: temáticas e importancia para la educación científica

    Directory of Open Access Journals (Sweden)

    Naira Díaz Moreno

    2012-01-01

    Full Text Available Las controversias socio-científicas surgen y nos rodean en los temas más actuales y emergentes de nuestra sociedad: transgénicos, homeopatía, impacto de las telefonías, etc. Por eso creemos importante exponer en qué consiste una controversia socio-científica, estudiar la relación entre las temáticas de controversias que aparecen en prensa y en la literatura didáctica así como si es posible el uso de estas controversias en el contexto escolar. La imagen consensuada con la que suelen aparecer las noticias científicas en los medios de comunicación va a dificultar su utilización en el aula. Del análisis documental de la literatura didáctica, hemos podido seleccionar actividades que utilizan controversias y que pueden ser usadas como modelo para utilizar las controversias en el aula de ciencias y desarrollar distintas finalidades en el alumnado: alfabetización científica, pensamiento crítico, fomento de la cultura científica, etc.

  16. Fishery and Ecological Investigations of Main Stem Levee Borrow Pits Along the Lower Mississippi River.

    Science.gov (United States)

    1984-12-01

    add to levee stability. V Levee Borra Pits 16. Borrow pits form a chain of water bodies along the riverward base of the 1600-mile main line levee...Sister Lake, Michigan, to be 86 pounds per acre based on rotenone treatment . 215. Standing stock estimates averaged 174 pounds per acre from 139

  17. Antenatal diagnosis of congenital deafness.

    Science.gov (United States)

    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.

  18. Experimental study on distributed optical fiber-based approach monitoring saturation line in levee engineering

    Science.gov (United States)

    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.

  19. Group antenatal care: new pedagogic method for antenatal care--a pilot study.

    Science.gov (United States)

    Wedin, Kathe; Molin, Johan; Crang Svalenius, Elizabeth L

    2010-08-01

    to investigate how women who attended group antenatal care experienced the information they received, compared with women who attended traditional antenatal care, and their satisfaction with the form of care. The aim was also to determine the effect of group antenatal care on women's social networks compared with traditional antenatal care. a pilot study with an intervention group (group antenatal care) and a control group (traditional antenatal care). Both groups were selected through informed choice. A questionnaire and a follow-up telephone call, using a structured questionnaire, were used to evaluate both groups. for each woman who had chosen to be in the intervention group, two women who had chosen traditional antenatal care were selected from the same antenatal clinic and given the same questionnaire. 35/45 (77%) women in the intervention group returned a completed questionnaire, compared with 40/85 (48%) women in the control group. There was little difference in satisfaction with information between the two groups, and overall satisfaction was high. at six months post partum, the women who attended group antenatal care still met others from the group more regularly than the women who attended traditional antenatal care. group antenatal care is well accepted by women, and can better utilise midwives' time. Copyright 2008 Elsevier Ltd. All rights reserved.

  20. Determinants of Antenatal Care Use in Ghana

    NARCIS (Netherlands)

    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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. La evidencia acerca de la controversia de las vacunas que contienen timerosal y su asociación con el autismo

    OpenAIRE

    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...

  6. Morphology of fluvial levee series along a river under human influence, Maros River, Hungary

    Science.gov (United States)

    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.

  7. Lidar-based mapping of flood control levees in south Louisiana

    Science.gov (United States)

    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.

  8. Diabetes tipo 2 y obesidad leve: tratamiento quirúrgico

    OpenAIRE

    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...

  9. Å leve et menneskeverdig liv - Martha Nussbaums globale helseetikk

    OpenAIRE

    Odin Lysaker

    2015-01-01

    Nylig igangsatte FN Post-2015, sin nye utviklingsagenda. Sentralt er en global kamp for bedret helse, hvor det å leve et menneskeverdig liv står i sentrum. Imidlertid er forståelsen av selve helsebegrepet omstridt. Noen mener at det bør knyttes an til jus og menneskerettigheter, mens andre foreslår etikk og menneskeverd. Dette hviler i sin tur på motstridende menneskesyn i den globale helseetiske diskursen, nemlig mennesket som enten autonomt eller avhengig. I artikkelen analyserer jeg denne ...

  10. Antenatal education in the transition to motherhood

    OpenAIRE

    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...

  11. 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....

  12. Antenatal Bartter Syndrome: A Review

    Directory of Open Access Journals (Sweden)

    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.

  13. Behaviour of levee on softsoil caused by rapid drawdown

    Science.gov (United States)

    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.

  14. 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

  15. Tree growth and recruitment in a leveed floodplain forest in the Mississippi River Alluvial Valley, USA

    Science.gov (United States)

    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

  16. La disputa fronteriza entre India y China: origen y evolución de la controversia

    Directory of Open Access Journals (Sweden)

    José Elías Esteve Moltó

    2008-01-01

    Full Text Available Con la emergencia de la India independiente y de la China maoísta a mediados del siglo pasado, los dos nuevos gobiernos de Delhi y Pekín comenzaron a convivir en un marco de armonía bajo los principios de coexistencia pacífica y una política de hermandad entre ambos pueblos, conocida como Hindi-Chini Bhai Bhai. Sin embargo, a pesar de estas actitudes amistosas iniciales, la herencia colonial británica en la India y las consecuencias de la anexión china del territorio tibetano, vinieron a desestabilizar este equilibrio, con el enfrentamiento de las pretensiones soberanistas de ambos Estados emergentes sobre distintas zonas fronterizas.El análisis del origen y la evolución de la controvertida línea fronteriza entre India y China en distintos sectores, nos muestra que dicha cuestión no atañe únicamente a un conflicto de demarcación territorial. El inestable devenir de las relaciones bilateralesentre los dos gigantes asiáticos, que han transcurrido entre el conflicto armado y la imperante necesidad de entendimiento, inevitablemente dejan entrever la relevancia y la interconexión con otros problemas de enorme trascendencia geoestratégica y de decisivas consecuencias jurídicas en el orden internacional.De este modo, se puede vislumbrar que esta controversia central, ha sido de forma irremediable el detonante de otras complejas situaciones desestabilizadoras del orden internacional, como son, la ocupación china del Tíbet, la guerra fronteriza entre China e India, la cuestionable cesión de parte del territorio de Cachemira al régimen de Pekín por parte del Gobierno de Islamabad, la consecuente cooperación china con el programa nuclear pakistaní, el estacionamiento permanente de tropas y de armamento nuclear chino en los límites fronterizos, o las más recientes y alarmantes devastaciones ambientales al otro lado de la frontera india en los Himalayas, cuyas consecuencias regionales pueden llegar a ser catastr

  17. La evidencia acerca de la controversia de las vacunas que contienen timerosal y su asociación con el autismo

    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.

  18. Cecilia Eudave, Alberto Ortiz y José Carlos Rovira (eds., Personajes históricos y controversias en la narrativa mexicana contemporánea

    Directory of Open Access Journals (Sweden)

    Clara María Avilés

    2015-09-01

    Full Text Available Reseña bibliográfica del libro de Cecilia Eudave, Alberto Ortiz y José Carlos Rovira (eds., Personajes históricos y controversias en la narrativa mexicana contemporánea, Alicante, Publicaciones de la Universidad de Alicante, 2014, 317 pp.

  19. Slope Instability of the Earthen Levee in Boston, UK: Numerical Simulation and Sensor Data Analysis

    NARCIS (Netherlands)

    Melnikova, N.B.; Jordan, D.; Krzhizhanovskaya, V.V.; Sloot, P.M.A.

    2014-01-01

    The paper presents a slope stability analysis for a heterogeneous earthen levee in Boston, UK, which is prone to occasional slope failures under tidal loads. Dynamic behavior of the levee under tidal fluctuations was simulated using a finite element model of variably saturated linear elastic

  20. Natural levee evolution in the Rhine-Meuse delta, the Netherlands, during the first millennium CE

    NARCIS (Netherlands)

    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

  1. An assessment of two methods for identifying undocumented levees using remotely sensed data

    Science.gov (United States)

    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.

  2. Monitoreo neurofisiológico intraoperatorio en Pediatría: controversias actuales Intraoperative neurophysiological monitoring in pediatrics: Current controversies

    Directory of Open Access Journals (Sweden)

    Miguel E. Habeych S.

    2012-04-01

    Full Text Available Introducción: el monitoreo neurofisiológico intraoperatorio es una nueva aplicación de la neurofisiología clínica. Mediante la detección inmediata de alteraciones funcionales durante procedimientos médico-quirúrgicos, pretende minimizar la aparición de lesiones neurológicas. Objetivos: se enumeran sus indicaciones en el paciente pediátrico. Se mencionan sus modalidades estándar y se discuten algunas de las más actuales controversias sobre sus principales indicaciones en éstas edades. Conclusiones: para la selección de las controversias nos valimos de las únicas cuatro revisiones existentes en la literatura. Se concluye que a pesar de tan reciente aplicación, representa una herramienta importante en la prevención y/o reducción de posibles lesiones neurológicas, en cerca del 5% de procedimientos médico-quirúrgicos, buena parte de las cuales, se realizan en pacientes pediátricos. Salud UIS 2012; 44 (1: 7-16Introduction: intraoperative neurophysiological monitoring is a new application of clinical neurophysiology. Through the immediate detection of functional alterations during medical or surgical procedures, it pretends to minimize the appearance of neurological lesions. Objetive: its indications in pediatric patients are enumerated. Its standard modalities are mentioned, and, current controversies on some of its most important indications are discussed. Conclusions: for the controversies selection we used the only four existent literature reviews. It is concluded, that despite such a recent application, it represents an important tool in the prevention and/or reduction of possible neurological lesions in close to 5% of medical-surgical procedures, many of these of which, are performed in pediatric patients. Salud UIS 2012; 44 (1: 7-16

  3. Uncertainty and Expert Assessment for Supporting Evaluation of Levees Safety

    Directory of Open Access Journals (Sweden)

    Hathout Michel

    2016-01-01

    Full Text Available In France, levees remain most of the time badly maintained; these long linear structures show signs of weaknesses on numerous occasions. Only incomplete information is usually available. The general lack of data describing the behavior of the infrastructure during unwanted events led to estimate their safety mainly from expert judgment. Thus the ability of the expert to predict the level of functioning of an infrastructure for a type of hazard and its intensity is crucial. An error of judgment can have very serious consequences and the production of reliable information requires the ability of the expert to report accurately the uncertainties in its estimations, as well as associated confidence. In order to meet this need, our research within Incertu project (French Ministry of Ecology funding aims to produce relevant scientific approaches and tools for the collection and processing reliable experts’ statements or combined with a confidence level in the context of uncertain information and input data.

  4. Number and timing of antenatal HIV testing

    DEFF Research Database (Denmark)

    Nguyen Thi Thuy, Hanh; Gammeltoft, Tine; Rasch, Vibeke

    2011-01-01

    ABSTRACT: BACKGROUND: HIV testing for pregnant women is an important component for the success of prevention of mother-to-child transmission of HIV (PMTCT). A lack of antenatal HIV testing results in loss of benefits for HIV-infected mothers and their children. However, the provision of unnecessary...... repeat tests at a very late stage of pregnancy will reduce the beneficial effects of PMTCT and impose unnecessary costs for the individual woman as well as the health system. This study aims to assess the number and timing of antenatal HIV testing in a low-income setting where PMTCT programmes have been...... scaled up to reach first level health facilities. METHODS: A cross-sectional community-based study was conducted among 1108 recently delivered mothers through face-to-face interviews following a structured questionnaire that focused on socio-economic characteristics, experiences of antenatal care and HIV...

  5. 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.

  6. Pattern and Determinants of Antenatal Booking at Abakaliki ...

    African Journals Online (AJOL)

    Background: Antenatal care is one of the pillars of SAFE Motherhood Initiative aimed at preventing adverse pregnancy outcome. Early antenatal booking is recommended for this benefit. Aim: The objective of this study was to determine the antenatal booking pattern of pregnant women and its determinants. Subjects and ...

  7. Acceptability of focused antenatal care by pregnant Nigerian women ...

    African Journals Online (AJOL)

    Context: In 2002, the World Health Organization (WHO) proposed "Focused Antenatal Care (FANC)"model for developing countries and it is aimed at addressing some of the challenges associated with the traditional model of antenatal care and to improve the quality of antenatal care services rendered. Despite its wide ...

  8. Perceived cost in the utilization of antenatal care services by ...

    African Journals Online (AJOL)

    Perceived cost in the utilization of antenatal care services by pregnant women in Abeokuta South. ... An adequate reproductive health education campaign is advocated to improve on the utilization of antenatal care services. Training and retraining of antenatal care service provider and legislation to entrench the regular ...

  9. 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.

  10. Factors Influencing Antenatal Care Service Utilization in Hadiya Zone

    African Journals Online (AJOL)

    Analysis was done using SPSS for windows version 16. RESULT: This study revealed that antenatal care service utilization in the study area was 86.3%. However, from those who attended antenatal care service 406 (68.2%) started antenatal care visit during the second trimester of pregnancy and significant proportion 250 ...

  11. Antenatal care and pregnancy outcome in Ghana, the importance of ...

    African Journals Online (AJOL)

    The antenatal characteristics of 503 pregnant women attending maternal and child health clinics in Accra were studied to ascertain the influence of antenatal care on pregnancy outcome. Gestation age of first antenatal care attendance, duration of nutrients supplementation during pregnancy, infant birth-weight and level of ...

  12. Factors associated with delayed antenatal care attendance in Malawi

    African Journals Online (AJOL)

    Background: Antenatal care has been identified as pivotal to improving maternal and child health in Malawi. Though Malawian women consistently seek antenatal care, they rarely do so during their first trimester. The purpose of this study was to identify barriers to antenatal care uptake among Malawian women. This article ...

  13. The prevalence of glucose intolerance among antenatal clients at ...

    African Journals Online (AJOL)

    Objectives: To determine the prevalence of and associated factors for glucose intolerance among antenatal clients at Kenyatta National Hospital at 24-36 weeks of gestation. Design: Cross-sectional analytical study. Setting: Kenyatta National Hospital antenatal clinic. Subjects: One hundred and two (102) antenatal mothers ...

  14. Terrestrial Lidar Datasets of New Orleans, Louisiana, Levee Failures from Hurricane Katrina, August 29, 2005

    Science.gov (United States)

    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.

  15. Transient Flow through an Unsaturated Levee Embankment during the 2011 Mississippi River Flood

    Science.gov (United States)

    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.

  16. Antenatal care in practice: an exploratory study in antenatal care clinics in the Kilombero Valley, south-eastern Tanzania

    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

  17. ROUTINE ANTENATAL SYPHILIS SCREENING IN SOUTH WEST ...

    African Journals Online (AJOL)

    serological screening in pregnancy and treatment with injectable penicillin, including the partner, as a routine part of antenatal care6. Ideally, this screening should be done during the first trimester or at the first ante- natal visit of the woman and again early in the third trimester, even in low- prevalence populations. There.

  18. Sociodemographic factors influencing adherence to antenatal iron ...

    African Journals Online (AJOL)

    Sociodemographic factors influencing adherence to antenatal iron supplementation recommendations among pregnant women in Malawi: Analysis of data from ... Focusing on education interventions that target populations with low rates of iron supplement intake, including campaigns to increase the number of women who ...

  19. Prevalence of Antenatal Depressive Symptoms and Associated

    African Journals Online (AJOL)

    GB

    2017-01-01

    Jan 1, 2017 ... ABSTRACT. BACKGROUND: Antenatal depression is one of the common problems during pregnancy with a magnitude of 20% to 30% globally. It can negatively endanger women's and off springs lives. As there are scarce reports on this area in Northern Ethiopia, it is important to carry out different studies ...

  20. Prevalence of antenatal depressive symptoms and associated ...

    African Journals Online (AJOL)

    Background: Antenatal depression is one of the common problems during pregnancy with a magnitude of 20% to 30% globally. It can negatively endanger women's and off springs lives. As there are scarce reports on this area in Northern Ethiopia, it is important to carry out different studies that explore the magnitude of the ...

  1. Obstetric outcomes and antenatal access among adolescent ...

    African Journals Online (AJOL)

    T Govender

    Background: Pregnancy among adolescents in South Africa is a growing concern as it may be associated with adverse socio- economic and health impacts. Timeous initiation and optimal utilisation of antenatal care (ANC) services is imperative to ensure positive pregnancy outcomes. However, this is not always possible ...

  2. Natural levee evolution in the Rhine-Meuse delta, the Netherlands, during the first millennium CE

    Science.gov (United States)

    Pierik, H. J.; Stouthamer, E.; Cohen, K. M.

    2017-10-01

    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 and their feedbacks. We mapped the levee morphology and elevation by combining LiDAR imagery, lithological borehole data, soil mapping, radiocarbon dates, archaeological data, and GIS-reconstruction techniques. From the detailed levee reconstructions we quantified natural levee dimensions and evaluated the temporal changes therein. The dimensions and the changes therein were then linked to external forcings (increasing suspended sediment load, variable flooding intensity) and to natural preconditions (e.g., delta plain width, flood basin configuration). We show that natural preconditions are an important control on levee shape. This is demonstrated for the upper delta where the relatively narrow delta plain combined with strong compartmentation (i.e., the occurrence of many alluvial ridges and enclosed flood basins) caused the flood levels to be amplified allowing the natural levees to grow relatively high. Compartmentation also seems to have stimulated trapping of coarse-grained overbank sediments, explaining the clear downstream trend in levee width. This effect was probably further aided by the clearance of the riparian forests, mainly in the upstream and central delta, which caused the coarser fraction of the suspended load to be further dispersed into the flood basin leading to wider levees. In the first millennium CE several new river courses formed that avoided the areas of natural levee relief of abandoned alluvial ridges. On these fossil alluvial ridges, the topographical expression gradually reduced because of widespread flood basin trapping of overbank sediment, which led to topographic levelling. The natural levees that formed during this period along the new

  3. Childbirth and parenting preparation in antenatal classes.

    Science.gov (United States)

    Barimani, M; Forslund Frykedal, K; Rosander, M; Berlin, A

    2018-02-01

    to describe topics (1) presented by midwives' during antenatal classes and the amount of time spent on these topics and (2) raised and discussed by first-time parents and the amount of time spent on these topics. qualitative; data were gathered using video or tape recordings and analysed using a three-pronged content analysis approach, i.e., conventional, summative, and directed analyses. 3 antenatal courses in 2 antenatal units in a large Swedish city; 3 midwives; and 34 course participants. class content focused on childbirth preparation (67% of the entire antenatal course) and on parenting preparation (33%). Childbirth preparation facilitated parents' understanding of the childbirth process, birthing milieu, the partner's role, what could go wrong during delivery, and pain relief advantages and disadvantages. Parenting preparation enabled parents to (i) plan for those first moments with the newborn; (ii) care for/physically handle the infant; (iii) manage breastfeeding; (iv) manage the period at home immediately after childbirth; and (v) maintain their relationship. During the classes, parents expressed concerns about what could happened to newborns. Parents' questions to midwives and discussion topics among parents were evenly distributed between childbirth preparation (52%) and parenting preparation (48%). childbirth preparation and pain relief consumed 67% of course time. Parents particularly reflected on child issues, relationship, sex, and anxiety. Female and male participants actively listened to the midwives, appeared receptive to complex issues, and needed more time to ask questions. Parents appreciated the classes yet needed to more information for managing various post-childbirth situations. while midwifery services vary among hospitals, regions, and countries, midwives might equalise content focus, offer classes in the second trimester, provide more time for parents to talk to each other, allow time in the course plan for parents to bring up new

  4. Solución de controversias en los tratados bilaterales de inversión: mapa de situación en América del Sur

    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.

  5. 2005 United States Army Corps of Engineers (USACE) Post-Hurricane Katrina Levee Surveys

    Data.gov (United States)

    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...

  6. Guidelines for Installation of Utilities Beneath Corps of Engineers Levees Using Horizontal Directional Drilling

    National Research Council Canada - National Science Library

    Latorre, Carlos

    2002-01-01

    ... of proposed drilling for infrastructure modifications and installation of utilities. Critical considerations include setback distances, levee toe stability, thickness and integrity of the top stratum, and other geotechnical parameters...

  7. Aggradation of Leveed Channels and Their Flood Plains in Arroyo Bottoms

    Science.gov (United States)

    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

  8. Possible Weakening Processes Imposed on California's Earthen Levees under Protracted Drought

    Science.gov (United States)

    Robinson, J. D.; Vahedifard, F.; AghaKouchak, A.

    2015-12-01

    California is currently suffering from a multiyear extreme drought and the impacts of the drought are anticipated to worsen in a warming climate. The resilience of critical infrastructure under extreme drought conditions is a major concern which has not been well understood. Thus, there is a crucial need to improve our understanding about the potential threats of drought on infrastructure and take subsequent actions in a timely manner to mitigate these threats and adopt our infrastructure for forthcoming extreme events. The need is more pronounced for earthen levees, since their functionality to protect limited water resources and dryland is more critical during drought. A significant amount of California's levee systems are currently operating under a high risk condition. Protracted drought can further threaten the structural competency of these already at-risk levee systems through several thermo-hydro mechanical weakening processes that undermine their stability. Viable information on the implications of these weakening processes, particularly on California's earthen levees, is relatively incomplete. This article discusses, from a geotechnical engineering perspective, how California's protracted drought might threaten the integrity of levee systems through the imposition of several thermo-hydro mechanical weakening processes. Pertinent facts and statistics regarding the drought in California are presented and discussed. Catastrophic levee failures and major damages resulting from drought-induce weakening processes such as shear strength reduction, desiccation cracking, land subsidence and surface erosion, fissuring and soil softening, and soil carbon oxidation are discussed to illustrate the devastating impacts that the California drought might impose on existing earthen levees. This article calls for further research in light of these potential drought-inducing weakening mechanisms to support mitigation strategies for reducing future catastrophic levee failures.

  9. Levee Vertical Land Motion Changes in the Sacramento-San Joaquin Delta

    Science.gov (United States)

    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.

  10. Burrowing activity in channel levees: impact of the invasive red swamp crayfish Procambarus clarkii

    Science.gov (United States)

    Solari, L.; Bendoni, M.; Consumi, L.; Haubrock, P.; Inghilesi, A.; Mazza, G.; Torrini, M.; Tricarico, E.

    2016-12-01

    The effect of animal burrowing, as an example of bioturbation on the stability of river levees has been recently raised to the scientific community as a consequence of the levee collapses of Secchia and Foenna rivers in Italy (Camici et al., 2010, 2014; Orlandini et al., 2015). Indeed, these authors showed that the presence of animal burrows is crucial in promoting the collapse of the bank. The American red swamp Crayfish Procambarus clarkii is an invasive species in Europe, mostly introduced for commercial purposes related to livestock. It is rapidly spreading throughout the Italian peninsula due to its plasticity, dispersal capability and high reproduction rate (Souty-Grosset et al., 2016). As well as the negative effects on local biodiversity, it damages the levees of the irrigation channel leading to disastrous collapses, relevant repairing and maintenance costs. In this work, we present an experimental activity where specimens of P. clarkii were monitored while burrowing into a small-scale physical model of an earthen levee, coupled with the mathematical modelling of the variations induced by the burrows on the seepage flow patterns through the levee.Preliminary results show the burrowing structure was quite irregular. Generally, crayfish start burrowing under the water level, developing tunnels (diameter ranging 4-7cm) both horizontally and heading upward, also above the water level. Some tunnels showed one or more circular chambers. The highest burrowing activity was observed during the experiments carried out in summer, when the species has a peak of maximum activity due to the higher temperature. Mathematical modelling shows that, for given boundary conditions and experimental duration, the presence of burrows in the levee raises the phreatic line. Critical conditions for levee integrity may be associated either to the internal erosion and stability of the system of tunnels and to the emergence of the phreatic line of the landside of the levee slope. These

  11. Antenatal cytogenetic testing in Havana, Cuba.

    Science.gov (United States)

    Méndez-Rosado, Luis A; Quiñones, Olga; Molina, Odalys; González, Nereida; del Sol, Marylin; Maceiras, Luanda; Bravo, Yomisleidy

    2014-01-01

    INTRODUCTION Antenatal cytogenetic testing was started in Havana in 1984, as a diagnostic option for fetal chromosome complement. The techniques applied are amniocyte culture, chorionic villus sampling, cordocentesis and fluorescence in situ hybridization in interphase cells. OBJECTIVE Describe the results of antenatal cytogenetic testing in the cytogenetic laboratory of the Cuba's National Medical Genetics Center in Havana, from 1984 through 2012. METHODS A retrospective descriptive study was carried out of the 22,928 pregnant women who had antenatal testing with conclusive results during the period 1984-2012. Information was obtained from laboratory databases for four antenatal diagnostic techniques. Variables studied were: antenatal diagnostic method, indications for genetic testing, type of chromosomal abnormality detected and couple's decision concerning pregnancy continuation if hereditary disease was diagnosed. Results were reported in absolute numbers and percentages. RESULTS Overall positivity was 2.8% (641 cases). Of the total, 20,565 samples were from amniocyte culture (558 positive cases, 2.7%); 1785 chorionic villus sampling (38 positive, 2.1%); 407 cord blood culture (28 positive, 6.9%); and 171 fluorescence in situ hybridization in interphase cells (17 positive, 9.9%). Advanced maternal age was the predominant indication for amniocyte culture and chorionic villus sampling. Positivity was higher for the two less frequently used methods, cordocentesis (6.9% positivity) and fluorescence in situ hybridization (9.9%). The predominant chromosomal abnormality was Down syndrome, with 45.4% of cases detected (291/641; 279 pure lines and 12 mosaic trisomies), followed by Edward syndrome with 12% (77/641, 71 pure lines and 6 mosaics) and Patau syndrome 4.7% (30/641, 27 pure lines and 3 mosaics). Sexual aneuploidy with pure lines affected 6.9% of cases (44/641) and with mosaicism 4.7% (30/641). Structural chromosomal abnormalities were detected in 22.5% of cases

  12. Application of GPR Method for Detection of Loose Zones in Flood Levee

    Science.gov (United States)

    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.

  13. 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.

  14. Is antenatal antibody screening worthwhile in Chinese?

    Science.gov (United States)

    Wong, K F; Tse, K T; Lee, A W; Mak, C S; So, C C

    1997-06-01

    A total of 1997 pregnant women were screened during their first antenatal visit for irregular antibodies for the prevention of haemolytic disease of the newborn. Patient sera were tested against a panel of group O screen cells including one with the expression of Miltenberger determinants GP.Mur. 17 women (0.85%) had irregular antibodies of which four were of potential clinical significance, including one with anti-D, two with anti-E and one with anti-D, anti-E and anti-G. Although antenatal antibody screening is mandatory in Western populations, our results suggest that this may not be necessary in the Chinese population except for those who are Rh D-negative or who have a history of haemolytic disease of the newborn.

  15. Screening Mississippi River Levees Using Texture-Based and Polarimetric-Based Features from Synthetic Aperture Radar Data

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    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

  16. Antenatally detected solid tumour of kidney

    Science.gov (United States)

    Panda, Shasanka Shekhar; Mandelia, Ankur; Gupta, Devendra Kumar; Singh, Amit

    2014-01-01

    Congenital renal tumours are rare and usually benign. Polyhydramnios is the most common mode of presentation. Although most cases have been diagnosed postnatally, with advances in imaging technology, an increasing number of cases are being detected on antenatal scans. We describe a case of solid tumour of kidney detected in the second trimester of pregnancy and managed by surgery in the postnatal period. PMID:24526198

  17. Antenatal and intrapartum prediction of shoulder dystocia.

    Science.gov (United States)

    Gupta, Manish; Hockley, Christine; Quigley, Maria A; Yeh, Peter; Impey, Lawrence

    2010-08-01

    To (1) develop algorithms to calculate the risk of shoulder dystocia at individual deliveries; (2) evaluate screening for shoulder dystocia. Retrospective analysis of 40284 consecutive term cephalic singleton pregnancies using a 'train and test' method. Four models were derived using logistic regression and tested (birthweight alone; birthweight and other independent antenatal variables; birthweight and all independent antenatal and intrapartum variables; and all independent variables excluding birthweight). Shoulder dystocia occurred in 240 deliveries (0.6%). Birthweight was the most important risk factor although 98 cases (41%) occurred in babies weighing shoulder dystocia of >10%. Although the antenatal model had high predictability (area under curve 0.89), it was no better than birthweight alone and had a sensitivity of 52.4%. Where birthweight was excluded, prediction of shoulder dystocia was poor. Antepartum and labour calculation of the risk of shoulder dystocia is possible. Whilst greatly hindered by the inaccuracy of estimating weight, it allows due weight to be given to factors which may already be influencing clinical practice. However, shoulder dystocia cannot be predicted with sufficient accuracy to allow universal screening. Copyright 2010. Published by Elsevier Ireland Ltd.

  18. Levee Seepage Detection in the Sacramento-San Joaquin Delta Using Polarimetric SAR

    Science.gov (United States)

    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

  19. Prognostic accuracy of antenatal neonatology consultation.

    Science.gov (United States)

    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

  20. [Related factors to lack of implementation of antenatal corticosteroids].

    Science.gov (United States)

    Corona-Gutiérrez, América Aime; Olivares-Ramírez, Araceli; Fajardo-Dueñas, Sergio

    2015-10-01

    Despite the known benefits of antenatal corticosteroids therapy its use in clinical practice is not generalized. To identify factors related to antenatal corticosteroids non administration. Cross-sectional and descriptive study that included patients admitted to Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", who had indication for antenatal corticosteroids therapy but did not receive it. Variables: antenatal corticosteroids therapy prescription, factors related to antenatal corticosteroids therapy non administration and lapsed time between diagnosis and birth. Antenatal corticosteroids therapy were not prescribed in 79 (94%) of 84 patients. Main related factors were imminent birth and severe maternal complication. The longer amount of time from diagnosis to birth was before hospitalization (91 vs. 9%, p <0.0005). The biggest and best opportunity for the administration of inducers of fetal lung maturity is during prenatal care, when cases with increased risk of preterm birth are detected.

  1. Antenatal services for Aboriginal women: the relevance of cultural competence.

    Science.gov (United States)

    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

  2. Antenatal pertussis vaccination: Are we implementing best evidence into practice?

    Science.gov (United States)

    Krishnaswamy, Sushena; Wallace, Euan; Buttery, Jim; Giles, Michelle

    2016-12-01

    Maternal immunisation is the most effective strategy to reduce infant morbidity and mortality from pertussis infection, and is now standard of care in many countries, including Australia. However, uptake cannot be guaranteed unless the barriers to implementing programs locally are understood. Education and resources for antenatal care providers, embedding vaccination within antenatal care, and provision of culturally appropriate information for pregnant women are integral to a successful antenatal vaccination program. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  3. An assessment of antenatal care among Syrian refugees in Lebanon.

    Science.gov (United States)

    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

  4. Å leve et menneskeverdig liv - Martha Nussbaums globale helseetikk

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    Odin Lysaker

    2015-11-01

    Full Text Available Nylig igangsatte FN Post-2015, sin nye utviklingsagenda. Sentralt er en global kamp for bedret helse, hvor det å leve et menneskeverdig liv står i sentrum. Imidlertid er forståelsen av selve helsebegrepet omstridt. Noen mener at det bør knyttes an til jus og menneskerettigheter, mens andre foreslår etikk og menneskeverd. Dette hviler i sin tur på motstridende menneskesyn i den globale helseetiske diskursen, nemlig mennesket som enten autonomt eller avhengig. I artikkelen analyserer jeg denne debatten ut fra det jeg hevder er Martha Nussbaums globale helseetikk, som baseres på hennes kapabilitetstilnærming så vel som begrep om ‘helse som livskvalitet’. Min konklusjon er at Nussbaums normative begrunnelse for Post-2015 ut fra et kroppslig forankret menneskeverd er det mest overbevisende av de to konkurrerende svarene.Nøkkelord: global helseetikk, Martha Nussbaum, menneskeverd, menneskerettigheter, post-2015English summary: Living a dignified life - Martha Nussbaum's global health ethicsThe UN recently launched Post-2015, which is its new development agenda. Central here is the global struggle for improved health, in which what it takes to live a dignified life is stressed. However, the understanding of the notion of health is disputed. Some believe that it should be linked to law and the human rights, while others suggest ethics and human dignity. Which in turn rests on conflicting stands in the global health ethical discourse regards to the view of humanity, namely either as autonomous or dependent. In the paper I analyse this discourse, in which my point of departure is Martha Nussbaum’s capabilities approach as well as her concept of health as life quality. This I read exactly as a global health ethics. Thus, I conclude that between the two competing answers, Nussbaum’s normative justification for Post-2015 on the basis of bodily grounded human dignity is the most convincing.Keywords: global health ethics, Martha Nussbaum

  5. Women's education level, antenatal visits and the quality of skilled antenatal care: a study of three African countries.

    Science.gov (United States)

    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.

  6. Efectos y controversias de los ácidos grasos omega-3: effects and controversies Omega-3 fatty acids

    Directory of Open Access Journals (Sweden)

    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.

  7. 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.

  8. Geophysical characterization of the Lollie Levee near Conway, Arkansas, using capacitively coupled resistivity, coring, and direct push logging

    Science.gov (United States)

    Gillip, Jonathan A.; Payne, Jason

    2011-01-01

    A geophysical characterization of Lollie Levee near Conway, Arkansas, was conducted in February 2011. A capacitively coupled resistivity survey (using Geometric's OhmMapper) was completed along the top and toe of the 6.7-mile levee. Two-dimensional inversions were conducted on the geophysical data. As a quality-control measure, cores and direct push logs were taken at approximately 1-mile intervals along the levee. The capacitively coupled resistivity survey, the coring, and the direct push logs were used to characterize the geologic materials. Comparison of the cores and the direct push log data, along with published resistivity values, indicates that resistivity values of 200 Ohm-meters or greater represent relatively clean sand, with decreasing resistivity values occurring with increasing silt and clay content. The cores indicated that the levee is composed of a heterogeneous mixture of sand, silt, and clay. The capacitively coupled resistivity sections confirm that the levee is composed of a heterogeneous mixture of high and low resistivity materials and show that the composition of the levee varies spatially. The geologic materials underlying the levee vary spatially as a result of the geologic processes that deposited them. In general, the naturally deposited geologic materials underlying the levee contain a greater amount of low resistivity materials in the southern extent of the levee.

  9. 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)

  10. Proceedings of the Repair, Evaluation, Maintenance, and Rehabilitation Research Program Workshop on Levee Rehabilitation Held at Vicksburg, Mississippi on 17 March 1992

    Science.gov (United States)

    1994-08-01

    a a a 0 0.2 0.4 0.6 0.8 1.0 1.2 CSR Figure 22. Liquefaction assessment, east levee, reach a, boring SL-7-90, column B 35 Seismic Assessment ot Pajero ...A Photos of Damage and Repair San Lorenzo River Levees and Pajaro River Levees Seismic Assessment of Pajero and San Lorenzo River Levees 45 211ý a...Assessment of Pajero and Sen Lorenzo River Levees , ,’i ’ ’’- a. Damage at drainage structure, left bank levee (looking upstream) .IS b. Damage to

  11. Carbonate Channel-Levee Systems Influenced by Mass-Transport Deposition, Browse Basin, Australia

    Science.gov (United States)

    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 (interactions with MTC's are similar to siliciclastic analogs. The similarity in stratigraphic patterns between siliciclastic and carbonate depositional systems suggests similar formative processes related to submarine mass 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

  12. Laboratory Modeling of Self-Formed Leveed Channels From Sediment-Laden Flows Entering Still Water

    Science.gov (United States)

    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

  13. 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.

  14. Mecanismos de solución de controversias en la contratación derivada de contratos financiados con recursos del Banco Mundial

    OpenAIRE

    Caicedo Bello, Elizabeth

    2015-01-01

    Esta tesis se ocupa de analizar la eficacia de la cláusula de solución de controversias contractuales dispuesta en la contratación estatal que es financiada con recursos del Banco Mundial –regla de excepción a la aplicación del Estatuto General de Contratación Pública– pues en las normas de contratación de dicho organismo, se ha previsto que ante un conflicto contractual corresponde a un conciliador (versión 2008 de las normas Banco Mundial) o a un mediador (versión 2013) “tomar una decisión”...

  15. Controversias etiológicas, diagnósticas y terapéuticas de la periodontitis agresiva Etiologic, diagnostic and therapeutic contorversies on aggressive periodontitis

    OpenAIRE

    N Discepoli; A. Bascones Martínez

    2008-01-01

    Se revisa la bibliografía más reciente al resguardo de la Periodontitis Agresiva, con particular atención a la etiología multifactorial, al diagnóstico, clínico y de laboratorio, y a la fase terapéutica. Se revisan también las controversias entre las diferentes clasificaciones que se propusieron hasta hoy.In this paper is reviewed the most recent bibliography about Aggressive Periodontitis, with particular attention on its multifactor aetiology, on diagnostic, clinic and laboratory, and on th...

  16. 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 ...

  17. 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 ...

  18. Perception of prenatal services by antenatal clinic attendees in a ...

    African Journals Online (AJOL)

    It has also been recognised that most women who registered for antenatal care in a particular health institution, do not go back to the same centre to deliver when in labour. Skilled attendant delivery is very low in Nigeria. While many reasons can be adduced for this health seeking behaviour, antenatal care satisfaction is ...

  19. Influence of pregnancy perceptions on patterns of seeking antenatal ...

    African Journals Online (AJOL)

    Maternal mortality remains a challenge in Sub-Saharan Africa including Uganda. Antenatal Care (ANC) is one of the recommended measures to improve maternal and child health. However, the influence of pregnancy definition and perception on patterns of seeking regular and timely antenatal care among women in the ...

  20. 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, ...

  1. Seroprevalence of hepatitis B virus among antenatal attendees at ...

    African Journals Online (AJOL)

    Abstract. Background: Pregnant women infected with hepatitis B virus (HBV) can transmit the infection to their fetuses and newborns. Despite the above, screening of antenatal attendees is not yet done as a routine in many Nigerian Hospitals that offer antenatal services, inclusive of University of Abuja Teaching Hospital.

  2. Prevalence and factors associated with late antenatal care visit ...

    African Journals Online (AJOL)

    Flora

    Conclusion: Late first antenatal clinic visit was high in Lushoto, and was highly associated with unmarried and unemployment status. Therefore, provision of continuous health education and community sensitization on the importance of timely seeking ANC services should be strengthened. Keywords: pregnancy, antenatal ...

  3. Utilisation of antenatal and maternity services by mothers seeking ...

    African Journals Online (AJOL)

    Background: Utilisation of antenatal and maternity services is an important maternal health indicator. Increasing the proportion of mothers who are cared for in health facilities during pregnancy, childbirth and puerperium reduces the health risks to mothers and their children. Objective: To determine the utilisation of antenatal ...

  4. Prevalence Of HIV Infection Among Antenatal Attendees At Uyo ...

    African Journals Online (AJOL)

    This retrospective study was conducted at the maternity unit of the University of Uyo Teaching Hospital Uyo. The aim was to determine the prevalence of HIV infection among pregnant women receiving antenatal care in the center. The voluntary counselling and testing register, the partner notification and antenatal clinic ...

  5. HIV Prevalence amongst Clients Attending Antenatal Clinic at the ...

    African Journals Online (AJOL)

    One hundred and ten (42%) booked in the 3 trimester while only 34 (13%) booked in the 1 trimester. HIV seroprevalence is high amongst antenatal women in Makurdi and intervention strategies should be scaled up for prevention of vertical transmission of the virus. Keywords: HIV prevalence,Antenatal Clinic, Makurdi.

  6. 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 ...

  7. 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 ...

  8. 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 ...

  9. 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 ...

  10. Antenatal Care Services Utilization among Women of Reproductive ...

    African Journals Online (AJOL)

    Satisfaction received from antenatal and delivery services was also higher in the urban settings (p= 0.000). Conclusion: Rural-urban differences exist in the utilization of antenatal care services, with a higher proportion of urban women utilizing these services. Increased health education of women, especially in the rural ...

  11. Perception of prenatal services by antenatal clinic attendees in a ...

    African Journals Online (AJOL)

    DR ADDAH A.O

    2015-09-30

    Sep 30, 2015 ... not go back to the same centre to deliver when in labour. Skilled attendant delivery is very low in Nigeria. While many reasons can be adduced for this health seeking behaviour, antenatal care satisfaction is one of them. We decided to study how satisfied are the antenatal subjects at the Federal Medical ...

  12. 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.

  13. 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 ...

  14. Knowledge and attitudes of pregnant women towards antenatal care ...

    African Journals Online (AJOL)

    Health knowledge is one of the key factors enabling pregnant women to be aware of their rights and health status in order to seek appropriate antenatal health care services. The primary aim of this study was to explore pregnant women`s knowledge and attitudes towards antenatal care services at Tshino village, Vhembe ...

  15. 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 ...

  16. Gender preferences among antenatal women: a cross-sectional ...

    African Journals Online (AJOL)

    Background: A balanced sex ratio is essential for a stable society. Objective: The main objective of the present research was to study the perceptions of women attending the antenatal care (ANC) facility regarding their gender preferences and family composition. Method: In this cross-sectional study 132 antenatal women ...

  17. Reasons Given by Pregnant Women for Late Initiation of Antenatal ...

    African Journals Online (AJOL)

    2010-06-01

    Jun 1, 2010 ... no advantages in booking for antenatal care in the first three months of pregnancy. This seems to be because antenatal care is viewed primarily as curative rather than preventive in the study population. Research is needed to determine the best approaches for health education programmes to correct the ...

  18. 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 ...

  19. 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.

  20. Experience of using FEM for real-time flood early warning systems: Monitoring and modeling Boston levee instability

    NARCIS (Netherlands)

    Melnikova, N.B.; Jordan, D.; Krzhizhanovskaya, V.V.

    2015-01-01

    Boston levee has a documented history of slope slippages under tidal fluctuations reaching 6-m range on spring tides. A finite element model of the Boston levee has been developed in the off-line mode; after that, it was integrated into the common information space of the UrbanFlood early warning

  1. Propriedades espectrais da matéria orgânica leve-livre e leve intra-agregado de dois latossolos sob plantio direto e preparo convencional

    Directory of Open Access Journals (Sweden)

    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.

  2. La incorporación de los “ADR” al sistema de resolución de controversias sobre inversiones extranjeras

    Directory of Open Access Journals (Sweden)

    Enrique Fernández Masiá

    2015-03-01

    Full Text Available En los últimos años, los problemas planteados por el arbitraje internacional en el ámbito de las disputas inversor-Estado han eliminado en gran medida muchas de las ventajas que aquel tenía respecto a la posibilidad de acudir a los tribunales estatales. La opción de acudir a los métodos de solución de controversias alternativos –ADR- podría suponer una mejora en la actual configuración del sistema de solución de controversias inversor-Estado, logrando una respuesta más eficaz, rápida y adecuada a los intereses de las partes enfrentadas. Para ello, en primer lugar, se hace necesario contar con reglas específicas que tengan en cuenta las especiales características de este tipo de disputas –Reglas IBA- y, en segundo lugar, es preciso que los Estados sean conscientes de la propia existencia de estos ADR e impulsen una acción conjunta que permita incluirlos de manera expresa en los futuros Acuerdos Internacionales de Inversión.

  3. 75 FR 6364 - Process for Requesting a Variance From Vegetation Standards for Levees and Floodwalls

    Science.gov (United States)

    2010-02-09

    ... to reflect organizational changes and incorporate current agency-wide review processes. DATES... provides a clearly defined process to implement Section 202(g) of WRDA 1996. 5. Definition of a Levee... Regional Integration Team (RIT) process, for an Agency Technical Review (ATR). d. The ATR leader shall...

  4. 44 CFR 65.10 - Mapping of areas protected by levee systems.

    Science.gov (United States)

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Mapping of areas protected by... IDENTIFICATION AND MAPPING OF SPECIAL HAZARD AREAS § 65.10 Mapping of areas protected by levee systems. (a... (especially in constricted areas); expected wind and wave action; ice loading; impact of debris; slope...

  5. Finite element analysis of levee stability for flood early warning systems

    NARCIS (Netherlands)

    Melnikova, N.B.

    2014-01-01

    Floods are common natural disasters frequently taking their dramatic toll in global warming conditions. Hundreds and thousands kilometres of sensor-monitored flood protection barriers are built at the coastlines all over the world. The power of computational science helps levee maintainers in

  6. The use of seismic tomograms for the identification of internal problems with earthen dams and levees

    Science.gov (United States)

    According to the National Inventory of dams (NID, 2009), out of the 84,134 dams in the US, more than 87% (73,423) are earthen dams. The majority of these earthen dams are past or approaching their design life expectancy of 50 years. According to the National committee on Levee Safety (NCLS, 2009),...

  7. Red River of the North Walsh and Pembina Countries, North Dakota Farmstead Ring Levees.

    Science.gov (United States)

    1983-12-01

    resource needs in the metro - politan area. Farmstead ring N/A Assesses the potential Ongoing. levee analysis for Federal involve- ment in developing...sites. C-2-4 AW31ID11 C 7TCICAL XFOUKATIOU CTIOE 3 gEooEics SCT =u 3 TABM OF CWKT Item Paso INTRODUCTION C-3-1 ECONOMIC CHARACTERISTICS C-3-2 Population

  8. Leve de Variatie! Een onderzoek naar de beleving van en de publiciteit rondom Oktober Kennismaand 2010

    NARCIS (Netherlands)

    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

  9. Aquatic Biological Inventory, Hillview Drainage and Levee District, Greene and Scott Counties, Illinois.

    Science.gov (United States)

    1982-01-11

    alkalinity, acidity, temperature and salinity . The 24 Yi - COE-HAS-S.I/DISC4.8 1/09/82 phytoplankton taxa collected in the Hillview Drainage and Levee...Amphipoda Gammarus pseudolimnaeus 148 3.61 Ephemeroptera Baetis app 210 5.12 Trichoptera Hydropsychidae 1,055 25.73 Hydropsyche bettani 97 2.37

  10. ON LAND SLIDE DETECTION USING TERRASAR-X OVER EARTHEN LEVEES

    Directory of Open Access Journals (Sweden)

    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.

  11. Levee Safety: Army Corps and FEMA Have Made Little Progress in Carrying Out Required Activities

    Science.gov (United States)

    2016-07-01

    removing debris and unwanted vegetation from the levees, areas adjacent to floodwalls, and channels; controlling damage caused by animals (e.g...commitment to good government is reflected in its core values of accountability, integrity, and reliability. The fastest and easiest way to obtain copies

  12. Geophysical investigation of a dutch levee and canal using various seismic and GPR techniques

    NARCIS (Netherlands)

    Noorlandt, R.P.; Kleine, M.P.E. de; Kruiver, P.P.; Bakker, M.A.J.; Mesdag, C.S.; Hoogendoorn, R.M.

    2011-01-01

    A geophysical survey has been carried out on the Juliana Canal and levee in the south of the Netherlands. For a stretch of about 35 km along this canal various construction works are planned, to deepen and widen the canal. The canal is in a geological setting such that leakage from the canal to the

  13. Developments in Levee Reliability and Flood Risk Analysis in the Netherlands

    NARCIS (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

  14. 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....

  15. Numerical modelling of levee stability based on coupled mechanical, thermal and hydrogeological processes

    Directory of Open Access Journals (Sweden)

    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.

  16. Curva J. Controversias

    Directory of Open Access Journals (Sweden)

    Edwin Rolando Castillo-Velarde

    2010-12-01

    Full Text Available Para el logro de un óptimo control de la hipertensión arterial, además de entender adecuadamente su base fisiopatológica, clínica, terapéutica, se requiere conocer el sustento que poseen las recomendaciones sobre los objetivos de tratamiento, así como los beneficios y riesgos del mismo. En este sentido, una consecuencia descrita asociada al manejo antihipertensivo es la presencia de la curva J, es decir la presencia de un aumento de riesgo cardiovascular asociado a la reducción de la presión diastólica. Si bien esta curva ha sido debatida por muchos años, existen múltiples reportes sobre su existencia y su impacto sobre la morbimortalidad, por lo cual constituye una referencia importante en el momento de establecer nuestros objetivos de tratamiento.

  17. Teaching antenatal counseling skills to neonatal providers.

    Science.gov (United States)

    Stokes, Theophil A; Watson, Katie L; Boss, Renee D

    2014-02-01

    Counseling a family confronted with the birth of a periviable neonate is one of the most difficult tasks that a neonatologist must perform. The neonatologist's goal is to facilitate an informed, collaborative decision about whether life-sustaining therapies are in the best interest of this baby. Neonatologists are trained to provide families with a detailed account of the morbidity and mortality data they believe are necessary to facilitate a truly informed decision. Yet these complicated and intensely emotional conversations require advanced communication and counseling skills that our current fellowship-training strategies are not adequately providing. We review educational models for training neonatology fellows to provide antenatal counseling at the threshold of viability. We believe that training aimed at teaching these skills should be incorporated into the neonatal-perinatal medicine fellowship. The optimal approaches for teaching these skills remain uncertain, and there is a need for continued innovation and outcomes-based research. Published by Elsevier Inc.

  18. Antenatal Diagnosis of an XXX Female

    Science.gov (United States)

    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

  19. 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

  20. Antenatal steroids and fluid balance in very low birthweight infants.

    Science.gov (United States)

    Dimitriou, G; Kavvadia, V; Marcou, M; Greenough, A

    2005-11-01

    To determine if insensible water loss (IWL) differed between infants exposed or not exposed antenatally to corticosteroids and to explore possible mechanisms for the early postnatal diuresis associated with antenatal steroid exposure. Retrospective analysis of prospectively collected data. Level three neonatal intensive care unit. Ninety six infants, median gestational age 27.5 weeks (range 23-33). Comparison of the IWL, urine output and osmolality, fluid input, electrolyte imbalance, respiratory illness severity (as assessed by surfactant requirement, maximum peak inspiratory pressure, and inspired oxygen concentration), and cardiovascular status (as assessed by inotrope requirement) between infants with antenatal corticosteroid exposure and gestational age matched controls. The infants exposed to antenatal steroids differed significantly from the controls in having both a lower IWL (p = 0.0135) and a higher urine output (p = 0.0036) on day 1, and fewer developed hyponatraemia (p = 0.027) on day 2. Fewer of those exposed to antenatal steroids required inotropes (p = 0.06), but their respiratory status was similar to that of the controls. Infants exposed to antenatal corticosteroids have a lower IWL. The results suggest that greater skin maturation, but also better perfusion rather than less severe respiratory status, explains the early diuresis in infants exposed to antenatal steroids.

  1. Grain-size segregation and levee formation in geophysical mass flows

    Science.gov (United States)

    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.

  2. Acolhimento: tecnologia leve nos processos gerenciais do enfermeiro Acogimiento: tecnología leve en los procesos gerenciales del enfermero Welcoming: soft technology in nurse's management processes

    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

  3. The antenatal diagnosis of cephalothoracopagus Janiceps conjoined twins.

    Science.gov (United States)

    Ramadani, H M; Johnshrud, N; al Nasser, M; Rayes, O

    1994-02-01

    A case of cephalothoracopagus conjoined twins (Janiceps twins) is presented. The abnormality was detected antenatally by the use of ultrasonography and confirmed postnatally, clinically and by computed tomography (CT scan).

  4. Perceptions of pregnant adolescents on the antenatal care received ...

    African Journals Online (AJOL)

    Perceptions of pregnant adolescents on the antenatal care received at Ndirande Health Centre in Blantyre, Malawi. Maria Chifuniro Chikalipo, Linda Nyondo Mipando, Rabecca Chikondi Ngalande, Sadandaula Rose Muheriwa, Ursula Kalimembe Kafulafula ...

  5. 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)

  6. Perceived Factors Influencing the Choice of Antenatal Care and ...

    African Journals Online (AJOL)

    Perceived Factors Influencing the Choice of Antenatal Care and Delivery Centres among Childbearing Women In Ibadan North South-Western, Nigeria. EE Ewa, CJ Lasisi, SO Maduka, AE Ita, UW Ibor, OA Anjorin ...

  7. 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

  8. Risk factors for antenatal depression, postnatal depression and parenting stress.

    Science.gov (United States)

    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

  9. Risk factors for antenatal depression, postnatal depression and parenting stress

    OpenAIRE

    Leigh, Bronwyn; Milgrom, Jeannette

    2008-01-01

    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...

  10. Prevalence of antenatal depressive symptoms among women in Sabah, Malaysia.

    Science.gov (United States)

    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.

  11. Clínica y política : la controversia psicoanalítica sobre la homosexualidad en los Estados Unidos

    OpenAIRE

    Gavilano Llosa, María Pilar

    2010-01-01

    Se hace una revisión histórica de la controversia psicoanalítica sobre homosexualidad en los Estados Unidos, desde la implantación del psicoanálisis en Norteamérica hasta la época contemporánea. Se confronta dos teorías extremas acerca de la normalidad o patología de la homosexualidad con la intención de dilucidar sus bases de sustentación en la teoría y en la práctica analítica. A historical review of the controversies regarding homosexuality in the United States is made...

  12. River Activism, “Levees-Only” and the Great Mississippi Flood of 1927

    Directory of Open Access Journals (Sweden)

    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.

  13. SIRS Digues 2.0: A Cooperative Software For Levees Management

    Directory of Open Access Journals (Sweden)

    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.

  14. The Legacy of the 1948 Underseepage and Crevasse Maps, Lower Mississippi River Levees

    Science.gov (United States)

    2017-04-01

    for wider dissemination. This map folio identifies sand boil locations, historic crevasses, severity of seepage, and extent of seepage control ...comprehensive study by USACE (1956) into levee underseepage and its control . This map folio was limited in distribution, never officially published as a...technical memorandum/report, and was thought to have been lost. The map folio was discovered as part of ongoing research into sand boils in the LMV and

  15. Combined Wave and Surge Overtopping of Levees: Flow Hydrodynamics and Articulated Concrete Mat Stability

    Science.gov (United States)

    2008-08-01

    armoring systems must resist the forces of fast -flowing, turbulent water that has overtopped the levee crest. Figure 4 illustrates the three overtopping...2 2 2 % % % A u Ah s s h R C H H cR (1) and − =2 22 % % %A u Au ss u R C HgH cR (2) where: hA2% = peak flow depth exceeded by 2

  16. Cultural Resources Survey, Testing, and Exploratory Trenching for the Louisiana State Penitentiary Levee Enlargement Project, West Feliciana Parish, Louisiana

    National Research Council Canada - National Science Library

    2001-01-01

    2The results of a Phase I cultural resources survey and a Phase II National Register testing program within the proposed levee enlargement at Louisiana State Penitentiary, West Feliciana Parish, Louisiana are presented...

  17. A Case History of Embankment Failure: Geological and Geotechnical Aspects of the Celotex Levee Failure, New Orleans, Louisiana

    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...

  18. Uso del tratamiento acupuntural en pacientes con trastorno depresivo recurrente leve

    Directory of Open Access Journals (Sweden)

    Roberto Anselmo Ramos Valverde

    2014-08-01

    Full Text Available La efectividad probada del tratamiento acupuntural en el episodio depresivo leve posibilitó realizar un estudio continuado y 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 trastorno depresivo recurrente 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 y marzo de 2013. La muestra quedó constituida por 60 pacientes que cumplieron los criterios diagnóstico 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 la astenia y el insomnio fueron los síntomas asociados más frecuentes; la depresión se eliminó en un mínimo de los pacientes que recibieron tratamiento con acupuntura y los síntomas asociados persistieron notablemente en los mismos. Por lo que se concluye que el tratamiento tradicional acupuntural no es una terapia efectiva en los pacientes con trastorno depresivo recurrente leve

  19. 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.

  20. Obtenção de concreto leve utilizando agregados reciclados

    Directory of Open Access Journals (Sweden)

    Paulo César Correia Gomes

    Full Text Available O concreto leve pode ser obtido pela substituição do agregado convencional por agregado de menor densidade, como a argila expandida, a qual apresenta também alta porosidade e absorção de água elevada. Essas propriedades se assemelham às dos agregados reciclados de resíduos de construção, o que os torna aptos para a obtenção de um concreto leve. Porém, os agregados reciclados diferem quanto a composição variável, menor resistência a esforços e à abrasão, e formato mais irregular. Assim, o artigo analisa como algumas propriedades dos agregados reciclados influenciam no comportamento do concreto leve nos estados fresco e endurecido. O estudo utilizou dois tipos de agregados reciclados, um oriundo de blocos vazados de concreto com EPS (ARBCE e outro de blocos cerâmicos (ARBC, com o propósito de entender a variabilidade dos materiais caracterizando as composições desses agregados e verificar a viabilidade de aplicação deles na obtenção de concretos leves. Os agregados reciclados foram britados por dois diferentes equipamentos (moinho argamassadeira para o ARBC e britador de martelo para o ARBCE. Os agregados reciclados obtidos desses processos distintos apresentaram distribuição granulométrica e forma diferentes. Com ambos os agregados reciclados foi possível produzir concretos leves, ou seja, com massa específica abaixo de 2,00 g/cm³. As resistências à compressão aos 28 dias entre 9,0 e 13,0 MPa indicam uso em elementos sem função estrutural, mas aplicáveis em componentes construtivos de resistência moderada (p.ex. painéis e blocos.

  1. Insect diversity in organic rice fields under two management systems of levees vegetation.

    Science.gov (United States)

    Acosta, L G; Jahnke, S M; Redaelli, L R; Pires, P R S

    2017-11-01

    Simplified environments characterize agroecosystems, reducing the diversity of associated plants, which are not cultivated for economic purposes, causing unbalances that can promote the emergence of cultivated plants pests, as well as the reduction of their natural enemies. Management systems that increase diversity in agroecosystems can extend the action of natural enemies of pests. Studies to understand the diversity of insects associated with rice cultivation and determine their ecological guilds can provide information about the composition and structure of such ecosystems, which can be applied to integrated pest management. Therefore, the study aimed to describe and compare groups of insects in irrigated rice fields, with organic management using two different systems of levees vegetation management, and relate them to the phenological states of rice cultivation (seedling, vegetative, and reproductive). Samples were taken in a plantation located in Águas Claras district of Viamão, RS. The total area of 18 ha was divided into two. A subarea called not cut (NC), where wild vegetation of levees was maintained, and the subarea named cut (C), where monthly cuts were made to levees vegetation, from the beginning of soil preparation until the harvest. From October 2012 to March 2013 were held weekly collections in quadrats randomly located in both the rice fields and the levees. A total of 800 insects were collected, 429 in the C subarea and 371 in the NC. There were identified 97 morphospecies in the C and 108 in NC, being 54 shared between the subareas. The captured insects were grouped into guilds: saprophages (C = 38.2%; NC = 27.5%), phytophagous (C = 28.5%; NC = 33.2%), entomophagous (grouping parasitoids and predators) (C = 29.4%; NC = 35%) and finally other insects (C = 4 %; NC = 4.3%). The peak abundance of phytophagous and entomophagous was registered in the vegetative stage of rice. At the same stage the UPGMA analysis showed that similarity in species

  2. S-wave velocity measurements along levees in New Orleans using passive surface wave methods

    Science.gov (United States)

    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

  3. Insect diversity in organic rice fields under two management systems of levees vegetation

    Directory of Open Access Journals (Sweden)

    L. G. Acosta

    2017-03-01

    Full Text Available Abstract Simplified environments characterize agroecosystems, reducing the diversity of associated plants, which are not cultivated for economic purposes, causing unbalances that can promote the emergence of cultivated plants pests, as well as the reduction of their natural enemies. Management systems that increase diversity in agroecosystems can extend the action of natural enemies of pests. Studies to understand the diversity of insects associated with rice cultivation and determine their ecological guilds can provide information about the composition and structure of such ecosystems, which can be applied to integrated pest management. Therefore, the study aimed to describe and compare groups of insects in irrigated rice fields, with organic management using two different systems of levees vegetation management, and relate them to the phenological states of rice cultivation (seedling, vegetative, and reproductive. Samples were taken in a plantation located in Águas Claras district of Viamão, RS. The total area of 18 ha was divided into two. A subarea called not cut (NC, where wild vegetation of levees was maintained, and the subarea named cut (C, where monthly cuts were made to levees vegetation, from the beginning of soil preparation until the harvest. From October 2012 to March 2013 were held weekly collections in quadrats randomly located in both the rice fields and the levees. A total of 800 insects were collected, 429 in the C subarea and 371 in the NC. There were identified 97 morphospecies in the C and 108 in NC, being 54 shared between the subareas. The captured insects were grouped into guilds: saprophages (C = 38.2%; NC = 27.5%, phytophagous (C = 28.5%; NC = 33.2%, entomophagous (grouping parasitoids and predators (C = 29.4%; NC = 35% and finally other insects (C = 4 %; NC = 4.3%. The peak abundance of phytophagous and entomophagous was registered in the vegetative stage of rice. At the same stage the UPGMA analysis showed that

  4. 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...... 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....

  5. 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.

  6. Evaluation of antenatal risk factors lit Cape Verde.

    Science.gov (United States)

    Wessel, H; Bergstrorn, S; Cnattingius, S; Dupret, A; Reitmaier, P

    1996-08-01

    The prevalence of antenatal risk factors and their association with adverse pregnancy outcome were prospectively studied in the county of Praia, Cape Verde. Of 4693 women registering for antenatal care, 8% were randomly selected from October 1991 through December 1992. Eventually 358 women were observed until puerperium when a physical examination and a structured interview took place. Three out of four women of the cohort were exposed to risk factors according to the existing risk classification in Praia, and 9% presented high risk factors. Thirty two percent of the cohort faced adverse pregnancy outcomes. Adverse pregnancy outcomes were significantly increased among women who presented high risk factors, but 82% of all adverse outcomes occurred among other women. The antenatal risk classification investigated cannot be considered an effective tool for detection of women at risk of adverse pregnancy outcome.

  7. 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.

  8. EFFECT OF THYROID DYSFUNCTION IN ANTENATAL MOTHERS

    Directory of Open Access Journals (Sweden)

    Anasooya Parail Sankaran

    2016-12-01

    Full Text Available BACKGROUND The aim of the study is to study the effect of thyroid dysfunction in antenatal mothers in Alappuzha one of the coastal areas in South Kerala over a period from January 2012 to January 2015. MATERIALS AND METHODS It is a descriptive study of the effect of thyroid dysfunction among pregnant ladies attending OBG Department in Government Medical College, Alappuzha, a rural medical college at coastal areas of Kerala over a period of 3 years. RESULTS The incidence is found to be maximum in the coastal area, i.e. 84.9%, but p-valve 0.625 is not statistically significant. Thyroid disorder is mostly seen in primigravida (57.8% and between the age of 20 and 25 yrs. (43.2% and the most commonly seen disorder among is subclinical hypothyroidism (73.7% (p valve <.005, which is statistically significant. There is significant increase in maternal complications like preeclampsia, (RR-8.54, p-value 0.014 recurrent abortion (RR-91.13, p-value 0.000, prolonged period of infertility (RR-55.16, p-value 0.000, anaemia (RR-11.37, p-value 0.003 is seen in subclinical hypothyroidism. The foetal complications seen are oligamnios (7.8%, MSAF (9.2%, foetal distress (12.1%, PROM (5.1% and FGR (10.9%. The neonates were admitted in NICU in view of NEC (1.5%, NNJ (24.1%, MAS (6.9%, TTNB (9.5% and HIE (2.9%. CONCLUSION The present study is intended to study the maternal and foetal effects of thyroid dysfunction. After the study, we concluded that there are many adverse maternal, foetal and neonatal effects in pregnancies complicated with thyroid dysfunction. In coastal area, the disease has got a high prevalence and hence there is a need for proper screening and early diagnosis. Proper treatment options are given to the patient.

  9. Midwives' views on appropriate antenatal counselling for congenital anomaly tests: Do they match clients' preferences?

    NARCIS (Netherlands)

    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.

  10. Midwives' views on of appropriate antenatal counselling for congenital anomaly tests: do they match clients' preferences?

    NARCIS (Netherlands)

    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.

  11. Marcadores de estrés oxidativo en hipertensión leve

    Directory of Open Access Journals (Sweden)

    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.

  12. Seepage and Piping through Levees and Dikes using 2D and 3D Modeling Codes

    Science.gov (United States)

    2016-06-01

    Flood & Coastal Storm Damage Reduction Program ERDC/CHL TR-16-6 June 2016 Seepage and Piping through Levees and Dikes Using 2D and 3D Modeling Codes...of this Technical Report is to evaluate the benefits of three- dimensional ( 3D ) modeling of common seepage and piping issues along embankments over...traditional two-dimensional (2D) models . To facilitate the evaluation, one 3D model , two 2D cross-sectional models , and one 2D plan-view model were

  13. [Prevention of preterm birth complications by antenatal corticosteroid administration].

    Science.gov (United States)

    Schmitz, T

    2016-12-01

    To evaluate short- and long-term benefits and risks associated with antenatal administration of a single course of corticosteroids and the related strategies: multiple and rescue courses. The PubMed database, the Cochrane Library and the recommendations from the French and foreign obstetrical societies or colleges have been consulted. Antenatal administration of a single course of corticosteroids before 34 weeks of gestation is associated in the neonatal period with a significant reduction of respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC) and death (LE1), and in possibly childhood with a reduction of cerebral palsy and increased psychomotor development index and intact survival (LE3). However, this treatment is associated with alterations of the HPA axis response persisting until 8 weeks after birth (LE2) and possibly with insulin resistance in adulthood (LE3). Antenatal corticosteroid administration after 34 weeks is associated, with high number needed to treat, with reduced respiratory morbidity (LE2), with no significant effect on neurological (LE2) or digestive (LE2) morbidities. Because of a very favourable benefit/risk balance, antenatal administration of a single course of corticosteroids is recommended for women at risk of preterm delivery before 34 weeks (grade A). The minimum gestational age for treatment will depend on the threshold chosen to start neonatal intensive care in maternity units and perinatal networks (Professional consensus). After 34 weeks, evidences are not consistent enough to recommend systematic antenatal corticosteroid treatment (grade B), however, a course might be indicated in the clinical situations associated with the higher risk of "severe" RDS, mainly in case of planned cesarean delivery (gradeC). In case of imminent preterm birth, pre-empting the second betamethasone injection is not recommended (gradeC), because this policy might be associated with increased rates of

  14. Gestational age at initiation of antenatal care in a tertiary hospital ...

    African Journals Online (AJOL)

    Gestational age at initiation of antenatal care in a tertiary hospital, Southwestern Nigeria. ... care is still prevalent in our environment. Therefore, pregnant women should be adequately informed about the concept of early antenatal registration. Keywords: Antenatal care, gestational age, initiation, Nigeria, Southwestern ...

  15. 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 ...

  16. factors affecting antenatal care service utilization in yem special ...

    African Journals Online (AJOL)

    jhon

    BACKGROUND: worldwide, about half a million women die every year in connection with pregnancy and childbirth, 99% of which occurs in low and middle income countries. Antenatal care provides an opportunity to deliver different services which are important in improving maternal survival. The objective of this study was ...

  17. 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 ...

  18. pathways utilized for antenatal health seeking among women in the ...

    African Journals Online (AJOL)

    2015-03-01

    Mar 1, 2015 ... 1 Department of Population, Family and Reproductive Health, University of Ghana School of Public Health,. P. O. Box LG 13 Legon, Accra, Ghana, ... hemorrhage, hypertensive diseases, and a high burden of infectious morbidity.4 .... When asked to chronicle the places they had sought antenatal care, it was ...

  19. 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 ...

  20. Prevalence and factors associated with late antenatal care visit ...

    African Journals Online (AJOL)

    The objective of this study was to determine the prevalence and factors associated with late antenatal booking among pregnant women in Lushoto district of north-eastern Tanzania. Methods: This hospital based cross sectional study involved pregnant women and was conducted in August-September 2015. A standardized ...

  1. Prevalence of malaria parasitaemia in the booking antenatal (ANC ...

    African Journals Online (AJOL)

    We studied 270 patients attending the booking antenatal clinic recruited for three months in the Lagos State University Teaching Hospital (LASUTH), Nigeria. Each patient was screened for malaria parasites using Giemsa's stain of thick and thin blood films on 2 ml venous blood. Parameters on the age, parity, gestation at ...

  2. Pattern and Determinants of Antenatal Booking at Abakaliki ...

    African Journals Online (AJOL)

    E‑mail: researchdivision2@gmail.com. Reference. 1. Onoh R, Umeora O, Agwu U, Ezegwui H, Ezeonu P,. Onyebuchi A. Pattern and determinants of Antenatal Booking at Abakaliki Southeast Nigeria. Ann Med Health Sci Res. 2012;2:169‑75. Access this article online. Quick Response Code: Website: www.amhsr.org. DOI:.

  3. Do freequent Antenatal Care Visits ensure access and adherence to ...

    African Journals Online (AJOL)

    Do freequent Antenatal Care Visits ensure access and adherence to Intermittent preventive treatment of Malaria in pregnancy in an Urban Hospital in South West Nigeria? ... Respondents were enrolled over a period of three months in a secondary healthcare facility within 24 hours of delivery. Demographic details, delivery ...

  4. Factors associated with delayed Antenatal Care attendance in Malawi

    African Journals Online (AJOL)

    SITWALA COMPUTERS

    15,16 school, and to be stigmatized. The stigma and shame of an unwanted pregnancy influenced delaying antenatal care. Despite the small sample size, our study reveals that unplanned or unwanted pregnancies were one of the factors associated with delayed ANC attendance. This was especially apparent if the woman ...

  5. Prevalence and antenatal determinants of orofacial clefts in Benin ...

    African Journals Online (AJOL)

    The prevalence and antenatal determinants of cleft lip and palate were determined. Result: Cleft lip and palate were often encountered in clinical practice in Benin City with a prevalence of 1.35%. The results showed that orofacial clefts were commoner in females and that the combined unilateral cleft lip and palate was the ...

  6. 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.

  7. health care providers' knowledge and practice of focused antenatal ...

    African Journals Online (AJOL)

    order to ensure safe pregnancy, labour and puerperium. Qualitative antenatal services are care given to pregnant women by a skilled .... ANC card.” “I paid particular attention to all new clients and those referred by TBAs and probed to know reasons why they left the TBAs”. “I used their ANC card to document their personal.

  8. Determinants of Home Delivery among Women attending Antenatal ...

    African Journals Online (AJOL)

    USER

    Unskilled home delivery is a threat to maternal and child health. In northern Nigeria, many pregnant women attend antenatal care but opt to deliver at home despite knowing the potential consequences. An institutional delivery, helps reduce various complications during childbirth, and therefore decreases the rates of ...

  9. Gender preferences among antenatal women: a cross-sectional ...

    African Journals Online (AJOL)

    Keywords: Gender preferences; family composition; antenatal women; coastal South India. DOI: http://dx.doi.org/10.4314/ahs.v15i2.31 ... Gender bias, even when not disastrous, may still generate greater debility among surviving .... in America and the Caribbean (with the exception of. Bolivia) along with several Southeast ...

  10. Determinants of Home Delivery among Women attending Antenatal ...

    African Journals Online (AJOL)

    The study concluded that, pregnant women are aware of the importance of antenatal care and, do deliver at home due to behavioural, sociocultural and religious preferences. To combat the maternal mortality in this region, values and beliefs of the women and families should be put into cognizance. Additionally, healthcare ...

  11. 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 ...

  12. Cash Transfers to Increase Antenatal Care Utilization in Kisoro ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    University of Michigan, Ann Arbor, MI, USA1; Kisoro District Hospital, Kisoro, Uganda2; Albert Einstein College of Medicine,. Bronx, NY, USA3. *For correspondence: Email: chavkahn@med.umich.edu; phone: 1-201-394-9637. Abstract. The World Health Organization recommends four antenatal visits for pregnant women in ...

  13. Factors contributing to non-compliance with the standard antenatal ...

    African Journals Online (AJOL)

    Background: Non-compliance with at least four standard antenatal care (ANC) visits is a critical public health problem. In Rwanda, the proportion of pregnant women who follow the four ANC remains relatively low (43.9%) although it has relatively increased. Objectives: To assess the level of knowledge of selected pregnant ...

  14. determinants of first antenatal care visit by pregnant women

    African Journals Online (AJOL)

    2014-09-01

    Sep 1, 2014 ... September 2014. EAsT AFRICAN MEDICAL JOURNAL. 317. East African Medical Journal Vol. 91 No. 9 September 2014. DETERMINANTS OF FIRST ANTENATAL CARE VISIT BY PREGNANT WOMEN AT COMMUNITY BASED. EDUCATION, RESEARCH AND SERVICE SITES IN NORTHERN UGANDA.

  15. Patterns of Antenatal Care Seeking Behavior in South East Nigeria ...

    African Journals Online (AJOL)

    that appropriate antenatal care (ANC) is important in reducing maternal morbidity and mortality, there is limited information on inequities on ANC seeking pattern among the pregnant women in Nigeria. Aim: The study was designed to explore inequities due to age, education, and socioeconomic status (SES) of women of ...

  16. Antenatal Deep Vein Thrombosis with an Underlying Thrombophilia ...

    African Journals Online (AJOL)

    Antenatal Deep Vein Thrombosis with an Underlying Thrombophilia. Emmanuel K Srofenyoh, Ali Samba, Enyonam Y Kwawukume. Abstract. Deep vein thrombosis (DVT) can cause severe morbidity in the puerperium and, less commonly, during pregnancy. A woman who developed DVT as a result of thrombophilia was ...

  17. Game-based online antenatal breastfeeding education: A pilot.

    Science.gov (United States)

    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.

  18. 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 ...

  19. Gestational Age At First Antenatal Attendance In Sagamu, Western ...

    African Journals Online (AJOL)

    This study was a carried out to determine to the gestation age first antenatal attendance at our centre and find out factors that influence it, with the aim of making suggestions that will encourage early booking for ANC Subjects and Methods: A cross – sectional study was carried out amongst pregnant women that came to ...

  20. Placenta accreta: MRI antenatal diagnosis and surgical correlation.

    Science.gov (United States)

    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.

  1. Attitude and perceptions of women on routine antenatal ultrasound ...

    African Journals Online (AJOL)

    Attitude and perceptions of women on routine antenatal ultrasound examination in Nnewi, South East, Nigeria. ... Journal of Biomedical Investigation ... at Nnamdi Azikiwe University Teaching Hospital, Nnewi to determine the attitude and perceptions of pregnant women towards routine ultrasound examination in pregnancy.

  2. 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 ...

  3. Seroprevalence of rubella antibodies among antenatal patients in ...

    African Journals Online (AJOL)

    Objectives: To determine the seroprevalence of rubella virus infection among antenatal patients aged between 15 and 45 years in the Western Cape province of South Africa, in order to provide data to determine the need for vaccination to protect women of childbearing age. Design: A cross-sectional study. Setting Virology ...

  4. Upright or dorsal? childbirth positions among antenatal clinic ...

    African Journals Online (AJOL)

    These positions such as kneeling and squatting were the norm for childbirth in indigenous Nigerian custom. However, westernization has largely replaced them with supine positions. Objective: This study was conducted to compare the knowledge, attitude and experience regarding childbirth positions between antenatal ...

  5. Prevalence of malaria at booking among antenatal clients in a ...

    African Journals Online (AJOL)

    Administrator

    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 ...

  6. 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 .... of Ethiopia. The town has 9 kebeles - the smallest administrative units in Ethiopia. There are two hospitals (one government and one private), two health centers, ten private clinics,.

  7. 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 ...

  8. Antenatal prevention of mother to child transmission of HIV

    African Journals Online (AJOL)

    infected and 370,000 children died due to HIV. The vast majority of children ac- quired HIV through vertical transmission from mother to child.1. During 2006 the sero-positive HIV prevalence amongst women attending antenatal clinics in the public health sector within South Africa was 29.1%.2. The province with the lowest ...

  9. Antenatal glucocorticoids and neonatal inflammation-associated proteins.

    Science.gov (United States)

    Faden, Maheer; Holm, Mari; Allred, Elizabeth; Fichorova, Raina; Dammann, Olaf; Leviton, Alan

    2016-12-01

    To date, studies of the relationship between antenatal glucocorticoids (AGC) and neonatal inflammation in preterm newborns have been largely limited to umbilical cord blood specimens. To explore the association between exposure to antenatal glucocorticoids and concentrations of inflammation-related proteins in whole blood collected from very preterm newborns at multiple times during the first postnatal month. We measured the protein concentrations on postnatal day 1 (N=1118), day 7 (N=1138), day 14 (N=1030), day 21 (N=936) and day 28 (N=877) from infants born before the 28th week of gestation and explored the relationship between antenatal steroid receipt and protein concentrations in the highest and lowest quartiles. The creation of multinomial logistic regression models (adjusted for potential confounders) allowed us calculate odds ratios and 95% confidence intervals. Twenty of 420 assessments [21 (proteins)×2 (exposure levels: partial and full)×2 (quartile levels: top and bottom)×5 (days)] were statistically significant without any cohesive pattern. Among infants born before 28 weeks of gestational age, neither full, nor partial courses of antenatal glucocorticoids have a sustained anti-inflammatory effect. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Antenatal glucocorticoids: where are we after forty years?

    Science.gov (United States)

    McKinlay, C J D; Dalziel, S R; Harding, J E

    2015-04-01

    Since their introduction more than forty years ago, antenatal glucocorticoids have become a cornerstone in the management of preterm birth and have been responsible for substantial reductions in neonatal mortality and morbidity. Clinical trials conducted over the past decade have shown that these benefits may be increased further through administration of repeat doses of antenatal glucocorticoids in women at ongoing risk of preterm and in those undergoing elective cesarean at term. At the same time, a growing body of experimental animal evidence and observational data in humans has linked fetal overexposure to maternal glucocorticoids with increased risk of cardiovascular, metabolic and other disorders in later life. Despite these concerns, and somewhat surprisingly, there has been little evidence to date from randomized trials of longer-term harm from clinical doses of synthetic glucocorticoids. However, with wider clinical application of antenatal glucocorticoid therapy there has been greater need to consider the potential for later adverse effects. This paper reviews current evidence for the short- and long-term health effects of antenatal glucocorticoids and discusses the apparent discrepancy between data from randomized clinical trials and other studies.

  11. 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 ...

  12. Antenatal Care and Skilled Birth Attendance in Three Communities ...

    African Journals Online (AJOL)

    This study assessed antenatal care (ANC) coverage, place of delivery and use of skilled birth assistants in three communities in Kaduna State, Nigeria. The sample included 332 women who had delivered within two years of the survey. ANC attendance rates were high, with 76.2% of women reporting at least one visit, and ...

  13. 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 ...

  14. 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 ...

  15. 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 ...

  16. Skilled antenatal care service utilization and its association with the ...

    African Journals Online (AJOL)

    Background: In response to high maternal and perinatal morbidities and mortalities in Ethiopia, "Women's Health Development Army" was established to enhance utilization of skilled maternity services including antenatal care (ANC). However, its effect on skilled ANC service utilization is not well measured. Our study was ...

  17. 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 ...

  18. perception and satisfaction with quality of antenatal care services ...

    African Journals Online (AJOL)

    particularly for ethical reasons4. Women's perceptions of antenatal visits significantly influence their assessment of quality of services that are provided5. As a result of this new focus, measurement of customer satisfaction has become equally important in assessing system performance. Patient satisfaction has traditionally ...

  19. Perceptions of pregnant adolescents on the antenatal care received ...

    African Journals Online (AJOL)

    2018-03-25

    Mar 25, 2018 ... Two major themes emerged from the findings: a) caring b) motivation for attending antenatal care. .... childbirth as narrated in the quote below. ... quotes below. “The care we received I can say the reception was good. I heard that when you come to this clinic they will touch your abdomen, ask you to.

  20. Determinants Of Antenatal Care Services Utilization In Emevor ...

    African Journals Online (AJOL)

    The difference is not significant (P > 0.05). A majority of the women who attained secondary education (69%), post-secondary education (96%), those whose husbands had secondary education (69%), postsecondary education (82%) and those who had income-yielding occupations (72%) utilized ante-natal care services.

  1. Bacterial Vaginosis in Antenatal Patients in Abakaliki, Nigeria.

    African Journals Online (AJOL)

    (92.5%) did not have BV. The antenatal complications observed among these 80 participants include: malaria, epistaxis, mumps, polyhydramnios and pregnancy induced hypertension. Table 3 shows the distribution of these complications among those with and those without bacterial vaginosis. It can be seen that one out of ...

  2. Polyhydramnios, Transient Antenatal Bartter's Syndrome, and MAGED2 Mutations

    NARCIS (Netherlands)

    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

  3. Barriers to uptake of antenatal maternal screening tests in Senegal

    NARCIS (Netherlands)

    Koster, W.; Ondoa, P.; Sarr, A.M.; Sow, A.L.; Schultsz, C.; Sakande, J.; Diallo, S.; Pool, R.

    2016-01-01

    Background: Evidence exists that selective antenatal maternal screening tests contribute to the reduction of maternal morbidity and mortality. However, data are lacking on coverage with the complete set of recommended tests. The study aimed to identify barriers to uptake of the complete set of tests

  4. Determinants of antenatal care, institutional delivery and postnatal ...

    African Journals Online (AJOL)

    Results: Overall, 54% of women had at least four ANC visits, 37% delivered in health facility and 29% of new born had postnatal care within two of births. Factors that consistently predict the utilization of the three MCH services are maternal and husband's level education, place of residence, wealth level and parity. Antenatal ...

  5. Is antenatal screening for rubella and cytomegalovirus justified?

    African Journals Online (AJOL)

    Abstract Altogether 2 250 asymptomatic pregnant women attending an antenatal clinic were investigated for serological evidence of past exposure to rubella and cytomegalovirus (CMV) as well as for active primary infection or reinfectionJreactivation. Only. 7 (0,3%) active rubella infections were diagnosed, none of them ...

  6. 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 ...

  7. 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 ...

  8. 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 ...

  9. Attitude To Caesarean Section Amongst Antenatal Clients In Ibadan ...

    African Journals Online (AJOL)

    This was a cross-sectional study carried out on 372 clients receiving antenatal care at a rural, suburban and urban centres, in order to assess the acceptance of caesarean delivery amongst them and the factors influencing their attitude. Caesarean section was acceptable to 65.7%. Many respondents will refuse the surgery, ...

  10. Quality and uptake of antenatal and postnatal care in Haiti.

    Science.gov (United States)

    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

  11. 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.

  12. Oficinas de estimulação cognitiva adaptadas para idosos analfabetos com transtorno cognitivo leve

    Directory of Open Access Journals (Sweden)

    Izabel Borges dos Santos

    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.

  13. Understanding delayed access to antenatal care: a qualitative interview study

    Science.gov (United States)

    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

  14. Application of the TDR technique for the detection of changes in the internal structure of an earthen flood levee

    Science.gov (United States)

    Janik, Grzegorz; Dawid, Małgorzata; Walczak, Amadeusz; Słowińska-Osypiuk, Joanna; Skierucha, Wojciech; Wilczek, Andrzej; Daniel, Anna

    2017-03-01

    Failures of earthen flood protection structures cause enormous material loss. Despite this, in the majority these are structures that were built decades ago. As an example, in Poland, the time of operation of approximately three quarters of existing levees and embankments is over 40 years. A similar situation exists in many other European countries. In the period 1998-2009 the economic losses caused by floods amounted to over 60 thousand million Euro. This accounts for approximately one third of the total losses caused by environmental factors. Ruptures of embankments or levees occur as a result of long-lasting elevated water levels in rivers, and such events are always preceded by changes in their internal structure. Such changes cannot be detected from the outside. This paper presents a new method, never used before, for the determination of changes in the internal structure of the body of a levee. The dynamics of the displacements is described by means of new mathematical formulae. The input data necessary for their application include the dynamics of changes in the value of volumetric moisture that is measured with a freely selected short time step by means of the time-domain-reflectrometry technique. The formulae were created on the basis of hitherto unnoticed and uninterpreted drops in moisture a moment before and a moment after the saturation of inner spaces of the levee body. The results obtained from calculations were compared with data from measurements on a physical model of a levee. The settlement values calculated using the method proposed are convergent with those of the true settlement. The maximum relative error was as low as 19%. The method proposed permits the location of changes in the internal structure of a levee before its rupture. Its application is the main component of a system of early warning against floods.

  15. Sedimentological analysis and bed thickness statistics from a Carboniferous deep-water channel-levee complex: Myall Trough, SE Australia

    Science.gov (United States)

    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

  16. Capacitively coupled resistivity survey of the levee surrounding the Omaha Public Power District Nebraska City Power Plant, June 2011

    Science.gov (United States)

    Burton, Bethany L.; Cannia, James C.

    2011-01-01

    This report is a release of digital data from a capacitively coupled resistivity survey conducted on June 13, 2011, on the flood-protection levees surrounding the Omaha Public Power District Nebraska City power plant. The U.S. Geological Survey Crustal Geophysics and Geochemistry Science Center and the Nebraska Water Science Center performed the survey in response to a flood on the Missouri River. A single line of resistivity profiling was completed along the center line of the section of levee 573 that surrounds the power plant.

  17. 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

    BACKGROUND: 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. METHODS...... 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...

  18. Análisis de controversias en reconstrucción mamaria con colgajo DIEP Analysis of debated uses in mammary reconstruction with DIEP flap

    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

  19. Actividades para fortalecer la formación de valores en escolares con retraso mental leve

    Directory of Open Access Journals (Sweden)

    Hermenegildo Aranda Romero

    2017-11-01

    Full Text Available Se presentan actividades encaminadas a fortalecer la formación de valores que deben tener los escolares con retraso mental leve Para la realización de este trabajo se tuvieron en cuenta métodos empíricos y teóricos, los principios pedagógicos por los cuales se rige el sistema educacional, así como las ideas de hombres Carlos Marx, José Martí, Fidel Castro Ruz, Luria, Leontiev, Vigotski y otros. Los cuales han permitido ofrecer la búsqueda de procedimientos metodológicos ordenados, con actividades concretas para fortalecer la formación de valores.

  20. Ciliated hepatic foregut cyst: from antenatal diagnosis to surgery

    International Nuclear Information System (INIS)

    Betalli, Pietro; Gobbi, Dalia; Gamba, PierGiorgio; Zanon, Giovanni F.; Talenti, Enrico; Alaggio, Rita

    2008-01-01

    Ciliated hepatic foregut cyst is the only ciliated cystic lesion known to occur in the liver. It is an extremely rare, benign and solitary cyst that probably arises from remnants of the embryonic foregut in the liver. We report a 16-month-old girl who underwent surgical excision of a hepatic cyst discovered during antenatal ultrasonography. Surgical exploration and excision were performed because of the uncertain aetiology of the cyst and because on postnatal follow-up US the size of the mass had increased causing extrinsic biliary obstruction. Pathology revealed a ciliated hepatic foregut cyst. This is the fourth child affected by this lesion reported in the literature, the second undergoing surgical excision, and the second with antenatal diagnosis. (orig.)

  1. 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

  2. Improvements in the Weeding of Levee Slope of Terraced Paddy Fields with Statutory Regulation of Places of Scenic Beauty

    Science.gov (United States)

    Uchikawa, Yoshiyuki; Kimura, Kazuhiro; Hirata, Ayumi

    A growing number of terraced paddy fields in Japan are being conserved as cultural assets like places of scenic beauty. This has meant that the task of weeding levee slope of these terraced paddy fields has become increasingly important, not only for general maintenance of the terraced paddy fields, but also because of the impact landscape, vegetation and the surrounding environment. However, the steep gradient of the levee slope and lack of footholds mean that the workability and safety associated with this weeding work is problematic. In addition, in the event that an area has been designated as a cultural asset, there are restrictions regarding how it can be modified and local farmers are reluctant to change their traditional farming methods in such cases. This study therefore sought to clarify the actual condition of the levee slope weeding work undertaken in the places of scenic beauty Obasute Tanada district. Empirical validations of potential measures for reforming the work environment were evaluated based on the findings of this investigation. We demonstrated that it is possible to modify current work practices while still maintaining and preserving the terraced paddy fields, even in designated scenic locations. To improve the working environment for levee slope weeding, we propose creating berms to serve as footholds at the toes of slopes.

  3. Efetividade de uma intervenção fisioterapêutica cognitivo-motora em idosos institucionalizados com comprometimento cognitivo leve e demência leve

    Directory of Open Access Journals (Sweden)

    Alessandra Vieira Menezes

    Full Text Available Resumo O objetivo desta pesquisa foi verificar a efetividade de quatro meses de intervenção fisioterapêutica cognitivo-motora, com frequência semanal única, na cognição, mobilidade e independência funcional de idosos com comprometimento cognitivo e demência leves residentes em instituição. Sob um ensaio clínico controlado, 15 sujeitos foram alocados entre grupo experimental (GE e controle (GC. Para avaliação dos sujeitos foram aplicados os instrumentos: Mini-Exame do Estado Mental, Teste de Fluência Verbal e Bateria de Avaliação Frontal para análise das funções cognitivas; Escala de Equilíbrio Funcional de Berg e Teste Timed Up and Go para verificação da mobilidade, e Escala de Barthel e Índice de Pfeffer para mensuração da independência funcional. O procedimento estatístico envolveu a aplicação do teste t de Student, sob significância de 5%. Quanto aos resultados, o GE apresentou melhor desempenho apenas nos testes relacionados à mobilidade ao final da intervenção (p < 0,05. A intervenção proposta apresentou eficácia sobre a mobilidade, mas não na cognição e independência funcional. O curto período de tempo e a baixa frequência semanal podem estar relacionados aos resultados obtidos.

  4. 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.

  5. Polyhydramnios, Transient Antenatal Bartter's Syndrome, and MAGED2 Mutations.

    Science.gov (United States)

    Laghmani, Kamel; Beck, Bodo B; Yang, Sung-Sen; Seaayfan, Elie; Wenzel, Andrea; Reusch, Björn; Vitzthum, Helga; Priem, Dario; Demaretz, Sylvie; Bergmann, Klasien; Duin, Leonie K; Göbel, Heike; Mache, Christoph; Thiele, Holger; Bartram, Malte P; Dombret, Carlos; Altmüller, Janine; Nürnberg, Peter; Benzing, Thomas; Levtchenko, Elena; Seyberth, Hannsjörg W; Klaus, Günter; Yigit, Gökhan; Lin, Shih-Hua; Timmer, Albert; de Koning, Tom J; Scherjon, Sicco A; Schlingmann, Karl P; Bertrand, Mathieu J M; Rinschen, Markus M; de Backer, Olivier; Konrad, Martin; Kömhoff, Martin

    2016-05-12

    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. To uncover the molecular cause of this possibly X-linked disease, we performed whole-exome sequencing of DNA from two members of the index family and targeted gene analysis of other members of this family and of six additional families with affected male fetuses. We also evaluated a series of women with idiopathic polyhydramnios who were pregnant with male fetuses. We performed immunohistochemical analysis, knockdown and overexpression experiments, and protein-protein interaction studies. We identified a mutation in MAGED2 in each of the 13 infants in our analysis who had transient antenatal Bartter's syndrome. MAGED2 encodes melanoma-associated antigen D2 (MAGE-D2) and maps to the X chromosome. We also identified two different MAGED2 mutations in two families with idiopathic polyhydramnios. Four patients died perinatally, and 11 survived. The initial presentation was more severe than in known types of antenatal Bartter's syndrome, as reflected by an earlier onset of polyhydramnios and labor. All symptoms disappeared spontaneously during follow-up in the infants who survived. We showed that MAGE-D2 affects the expression and function of the sodium chloride cotransporters NKCC2 and NCC (key components of salt reabsorption in the distal renal tubule), possibly through adenylate cyclase and cyclic AMP signaling and a cytoplasmic heat-shock protein. We found that MAGED2 mutations caused X-linked polyhydramnios with prematurity and a severe but transient form of antenatal Bartter's syndrome. MAGE-D2 is essential for fetal renal salt reabsorption, amniotic fluid homeostasis, and the maintenance of pregnancy. (Funded by the University of Groningen and others.).

  6. Antenatal Surveillance in Twin Pregnancies Using the Biophysical Profile.

    Science.gov (United States)

    Booker, Whitney; Fox, Nathan S; Gupta, Simi; Carroll, Rachel; Saltzman, Daniel H; Klauser, Chad K; Rebarber, Andrei

    2015-11-01

    Objectives-The nonstress test is currently the most widely used modality for antenatal surveillance in twin pregnancies, with a quoted false-positive rate of 11%-12%. Our objective was to report our experience with the sonographic portion of the biophysical profile in twin pregnancies as the primary screening modality.Methods-Women with twin pregnancies delivered by a single maternal-fetal medicine practice from 2005 to 2013 were included. We excluded monoamniotic twins. Twin pregnancies began weekly sonography for the biophysical profile starting at 32 to 33 weeks, or earlier if indicated. The nonstress test was performed if the sonographic biophysical profile score was less than 8 of 8. We reviewed biophysical profile scores and outcomes for all patients who delivered at 33 weeks or later to assess the false-positive rate for the biophysical profile, as well as the incidence of intrauterine fetal death (IUFD) after initiation of antenatal surveillance.Results-A total of 539 twin pregnancies were included. The incidence of IUFD per patient was 2 per 539 (0.4%; 95% confidence interval [CI], 0.1%-1.3%), and the incidence of IUFD per fetus was 2 per 1078 (0.19%; 95% CI, 0.05%-0.7%). The overall positive screen rate was 24 per 539 (4.45%; 95% CI, 3.0%-6.5%). The false-positive screen rate, defined as an abnormal biophysical profile that did not diagnose an IUFD or lead to delivery, was 10 per 539 (1.9%; 95% CI, 1.0%-3.4%).Conclusions-In twin pregnancies the use of the sonographic biophysical profile for routine antenatal surveillance has a low false-positive rate, with a very low incidence of IUFD. The sonographic biophysical profile should be considered as a primary mode for antenatal surveillance in twin pregnancies, with a reflex nonstress test for an abnormal score. © 2015 by the American Institute of Ultrasound in Medicine.

  7. Antenatal diagnosis of Patau syndrome with previous anomalous baby

    OpenAIRE

    Keerthi Kocherla; Vasantha Kocherla

    2014-01-01

    Patau syndrome is the least common and most severe of the viable autosomal trisomies with median survival of fewer than 3 days was first identified as a cytogenetic syndrome in 1960. Patau syndrome is caused by an extra copy of chromosome 13. In this case report, we present antenatal imaging findings and gross foetal specimen correlation of foetus with Patau syndrome confirmed by karyotyping in third gravida who had significant previous obstetric history of gastrochisis in monochorionic and...

  8. Men's Violence against Women – a Challenge in Antenatal Care

    OpenAIRE

    Stenson, Kristina

    2004-01-01

    Men’s violence against women is a universal issue affecting health, human rights and gender-equality. In pregnancy, violence is a risk for both the mother and her unborn child. The overall aims were: to determine the prevalence of such violence in a Swedish pregnant population, to investigate pregnant women’s attitudes to questioning about exposure to violence, and to evaluate experience gained by antenatal care midwives having routinely questioned pregnant women regarding violence. All women...

  9. 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.

  10. Effect of aerobic exercise during pregnancy on antenatal depression

    Science.gov (United States)

    El-Rafie, Mervat M; Khafagy, Ghada M; Gamal, Marwa G

    2016-01-01

    Background Antenatal depression is not uncommon and is associated with a greater risk of negative pregnancy outcomes. Aim Exploring the effect of exercise in preventing and treating antenatal depression. Methods This was a prospective interventional controlled study carried out in 100 pregnant women treated at the Ain-Shams Family Medicine Center and Maadi Outpatient Clinic, Cairo, Egypt. The participants were divided into two groups (n=50 in the exercise group and n=50 in the control group). The exercise group regularly attended supervised sessions for 12 weeks. The activities in each session included walking, aerobic exercise, stretching, and relaxation. The control group completed their usual antenatal care. The Center for Epidemiological Studies Depression Scale (CES-D) was used to assess depression symptoms at the first interview and immediately after the 12-week intervention. Results Compared to the control group, the exercise group showed significantly improved depressive symptoms as measured with the CES-D after the 12-week intervention on the CES-D (P=0.001). Within groups, the exercise group demonstrated a significant improvement of depressive symptoms from baseline to intervention completion, while the control group demonstrated no significant changes over time. Conclusion Exercise during pregnancy was positively associated with reduced depressive symptoms. PMID:26955293

  11. Antenatal screening and the gendering of genetic responsibility

    Directory of Open Access Journals (Sweden)

    Reed Kate

    2007-09-01

    Full Text Available Abstract Background The objective of this study is to explore men's and women's perceptions of antenatal blood screening. The study will assess the impact of these perceptions on decision-making regarding diagnostic testing and selective abortion, and on parental feelings of genetic responsibility. By exploring gender and antenatal screening in this way, the research aims to contribute to our understanding of lay perceptions of genetic screening and increase our knowledge of the decision-making process in screening. Research design This qualitative study will be based on semi-structured interviews with twenty pregnant women and twenty male partners in the post-industrial city of Sheffield, UK. All interviews will be taped, transcribed and analysed thematically using NVIVO, a qualitative software package. Discussion The findings of this study have relevance to existing debates on the social and ethical implications of reproductive genetics. A better understanding of male and female perceptions of the screening process could improve guidance and practice in antenatal screening and genetic counselling. It will also inform and contribute to the development of theory on gender and genetic screening.

  12. Effects of lateral confinement in natural and leveed reaches of a gravel-bed river: Snake River, Wyoming, USA

    Science.gov (United States)

    Leonard, Christina M.; Legleiter, Carl; Overstreet, Brandon T.

    2017-01-01

    This study examined the effects of natural and anthropogenic changes in confining margin width by applying remote sensing techniques – fusing LiDAR topography with image-derived bathymetry – over a large spatial extent: 58 km of the Snake River, Wyoming, USA. Fused digital elevation models from 2007 and 2012 were differenced to quantify changes in the volume of stored sediment, develop morphological sediment budgets, and infer spatial gradients in bed material transport. Our study spanned two similar reaches that were subject to different controls on confining margin width: natural terraces versus artificial levees. Channel planform in reaches with similar slope and confining margin width differed depending on whether the margins were natural or anthropogenic. The effects of tributaries also differed between the two reaches. Generally, the natural reach featured greater confining margin widths and was depositional, whereas artificial lateral constriction in the leveed reach produced a sediment budget that was closer to balanced. Although our remote sensing methods provided topographic data over a large area, net volumetric changes were not statistically significant due to the uncertainty associated with bed elevation estimates. We therefore focused on along-channel spatial differences in bed material transport rather than absolute volumes of sediment. To complement indirect estimates of sediment transport derived by morphological sediment budgeting, we collected field data on bed mobility through a tracer study. Surface and subsurface grain size measurements were combined with bed mobility observations to calculate armoring and dimensionless sediment transport ratios, which indicated that sediment supply exceeded transport capacity in the natural reach and vice versa in the leveed reach. We hypothesize that constriction by levees induced an initial phase of incision and bed armoring. Because levees prevented bank erosion, the channel excavated sediment by

  13. Antenatal small-class education versus auditorium-based lectures to promote positive transitioning to parenthood

    DEFF Research Database (Denmark)

    Koushede, Vibeke; Brixval, Carina Sjöberg; Thygesen, Lau Caspar

    2017-01-01

    trial, we examined the effect of antenatal education in small classes versus auditorium-based lectures on perceived stress, parenting stress, and parenting alliance. A total of 1,766 pregnant women were randomised to receive: antenatal education in small classes three times in pregnancy and one time......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...... alliance six months postpartum was examined using the non-parametric Wilcoxon rank-sum test. Antenatal education in small classes had a small beneficial main effect on global feelings of stress six months postpartum and a statistically significant interaction between time and group favoring antenatal...

  14. A baixa estatura leve está associada ao aumento da pressão arterial em adolescentes com sobrepeso

    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

  15. Quality of antenatal care provided by nurse midwives in an Urban health centre with regard to low-risk antenatal mothers

    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.

  16. Evaluation of the use of reach transmissivity to quantify leakage beneath Levee 31N, Miami-Dade County, Florida

    Science.gov (United States)

    Nemeth, Mark S.; Wilcox, Walter M.; Solo-Gabriele, Helena M.

    2000-01-01

    A coupled ground- and surface-water model (MODBRANCH) was developed to estimate ground-water flow beneath Levee 31N in Miami-Dade County, Florida, and to simulate hydrologic conditions in the surrounding area. The study included compilation of data from monitoring stations, measurement of vertical seepage rates in wetlands, and analysis of the hydrogeologic properties of the ground-water aquifer within the study area. In addition, the MODBRANCH code was modified to calculate the exchange between surface-water channels and ground water using a relation based on the concept of reach transmissivity. The modified reach-transmissivity version of the MODBRANCH code was successfully tested on three simple problems with known analytical solutions. It was also tested and determined to function adequately on one field problem that had previously been solved using the unmodified version of the software. The modified version of MODBRANCH was judged to have performed satisfactorily, and it required about 60 percent as many iterations to reach a solution. Additionally, its input parameters are more physically-based and less dependent on model-grid spacing. A model of the Levee 31N area was developed and used with the original and modified versions of MODBRANCH, which produced similar output. The mean annual modeled ground-water heads differed by only 0.02 foot, and the mean annual canal discharge differed by less than 1.0 cubic foot per second. Seepage meters were used to quantify vertical seepage rates in the Everglades wetlands area west of Levee 31N. A comparison between results from the seepage meters and from the computer model indicated substantial differences that seemed to be a result of local variations in the hydraulic properties in the topmost part of the Biscayne aquifer. The transmissivity of the Biscayne aquifer was estimated to be 1,400,000 square feet per day in the study area. The computer model was employed to simulate seepage of ground water beneath Levee 31N

  17. Three-dimensional imaging, change detection, and stability assessment during the centerline trench levee seepage experiment using terrestrial light detection and ranging technology, Twitchell Island, California, 2012

    Science.gov (United States)

    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

  18. Antenatal umbilical coiling index as a predictor of perinatal outcome.

    Science.gov (United States)

    Mittal, Ankita; Nanda, Smiti; Sen, Jyotsna

    2015-04-01

    To evaluate the relationship between sonographic measurements of umbilical cord coiling index during late second trimester of pregnancy and perinatal outcome. This prospective study was conducted on two hundred pregnant women with uncomplicated, singleton pregnancy between 20 to 24 weeks of gestation. The antenatal umbilical coiling index (UCI) was calculated by doing a transabdominal ultrasound at the time of induction into the study as the reciprocal of the pitch of one complete vascular coil. The patients were followed up till delivery and any adverse antenatal and/or perinatal event was noted. The mean value for the UCI was noted to be 0.36 + 0.07 coils/cm with a 95% CI of 0.35-0.37. The values for the 10th and the 90th percentile were 0.26 and 0.46 coils/cm respectively. Accordingly the cases were divided into three groups- hypocoiled (UCI UCI between 10th-90th percentile)-162 and hypercoiled (UCI >90th percentile)-20. Hypocoiling was observed to be significantly associated with preterm labour pains (P value 0.0344), oligohydramnios (P value 0.0021), intrapartum foetal heart rate abnormalities (P value 0.0012), instrumental vaginal delivery (P value 0.0275) and low birth weight (P value 0.0344). Hypercoiling was found to be significantly associated with intrauterine growth restriction (P value 0.0323), foetal heart rate abnormalities during labour (0.0399) and low birth weight (P value 0.0095). Abnormal umbilical coiling index in the form of either hypo- or hypercoiling is associated with several adverse antenatal and neonatal outcomes.

  19. [Neuroprotection for preterm infants with antenatal magnesium sulphate].

    Science.gov (United States)

    Marret, S; Ancel, P-Y

    2016-12-01

    To evaluate in preterm born children the neuroprotective benefits and the risks, at short- and long-term outcome, of the antenatal administration of magnesium sulphate (MgSO 4 ) in women at imminent risk of preterm delivery. Computer databases Medline, the Cochrane Library and the recommendations of various international scientific societies. Given the demonstrated benefit of antenatal MgSO 4 intravenous administration on the reduction of cerebral palsy rates and the improvement of motor development in children born preterm, it is recommended for all women whose imminent delivery is expected or programmed before 32 weeks of gestation (WG) (grade A). The analysis of the literature finds no argument for greater benefit of antenatal MgSO 4 administration in sub-groups of gestational age, or depending on the type of pregnancy (single or multiple pregnancy) or with the cause of preterm birth (NP2). Its administration is recommended before 32 WG, if single or multiple pregnancy, whatever the cause of prematurity (grade B). It is recommended 4g loading dose (professional consensus). With a loading dose of 4g intravenous (IV) in 20min, the serum magnesium is lower than with intramuscular suggesting a preference for the IV route (professional consensus). It is proposed to use a maintenance dose of 1g/h until delivery with a maximum recommended duration of 12hours without exceeding a cumulative dose of 50g (professional consensus). These doses are without severe adverse maternal side effects or adverse effects in newborns at short- and medium-term outcome (NP1). It is recommended to administer magnesium sulfate to the women at high risk of imminent preterm birth before 32 WG, whether expected or planned (grade A), with a 4g IV loading dose followed by a maintenance dose of 1g/h for 12hours (professional consensus), the pregnancy is single or multiple, whatever the cause of prematurity (professional consensus). Copyright © 2016. Published by Elsevier Masson SAS.

  20. Prematuridad extrema y uso materno de corticoides antenatal

    Directory of Open Access Journals (Sweden)

    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.

  1. Antenatal breast expression: a critical review of the literature.

    Science.gov (United States)

    Chapman, Tegan; Pincombe, Jan; Harris, Mary

    2013-03-01

    to critically review literature related to the practice of antenatal breast expression (ABE) and the reasons for this practice. a critical review of available literature was undertaken by accessing Internet and library resources. Articles were to be documented in English. No restrictions were placed on dates due to the important historical background of this topic. Keywords used to refine the search included antenatal breast expression, colostrum, antenatal breast-feeding education and midwives and International Board Certified Lactation Consultants (IBCLC). the literature search discovered ABE has been performed historically to prepare breasts for breast-feeding postnatally. It is presently being taught to store colostrum to prevent neonatal hypoglycaemia or hasten production of Lactogenesis 2. Studies relating to nipple stimulation were also critically appraised due to concerns of premature labour. the safety and efficacy of ABE has yet to be demonstrated. The three studies related to the benefits teaching of this skill were small in size with methodological flaws. Trials related to nipple stimulation were also found to have substantial limitations. The reasons for and physicality of performing ABE vs. nipple stimulation differed markedly. While recent teaching of ABE has been encouraged through available commentaries, case studies and policies (in view of the documented positive effects of early colostrum administration), the benefits of this practice are yet to be substantiated. large, credible RCTs are needed to confirm efficacy and safety of this technique. A survey exploring the prevalence of ABE practices is also indicated and to explore the information currently provided by midwives to women in their care. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  2. The influence of antenatal care on pregnancy outcome.

    Science.gov (United States)

    Ekwempu, C C

    1988-01-01

    Analysis of medical records at the Ahmad Bello University Teaching Hospital in Zaria compared the effects of antenatal care in booked and unbooked women. 22,774 pregnancies resulted in 22,725 deliveries. Pregnancy complications were most prevalent in unbooked patients and included anemia, pregnancy-induced hypertension, malpresentation, and malposition of the fetal head. Lower incidence of cephalopelvic disproportion (CPD) occurred in booked teenage patients. Unbooked patients' operative delivery rate was 3 times greater; 6.4% of the booked patients and 18.2% of the unbooked patients had cesarean sections. Labor complications were higher among unbooked patients compared to unbooked patients. These complications include CPD (18.1%), prolonged labor (15.8%), retained placenta (12%), eclampsia (5.5%), pre- eclampsia (7.5%), and uterine rupture (2.6%). Excluding vaginal deliveries, occurrences of vesico-vaginal fistula were greater in unbooked patients. The maternal mortality rate for unbooked subjects was 24/1000 and 1/1000 for booked patients across all parity and age groups; thus, antenatal care is related to lowered maternal mortality. Furthermore, antenatal care has a positive effect on fetal outcome; perinatal mortality is 3 times less in booked patients. Higher perinatal rates are associated with home deliveries. Overall, the educated booked patients experienced reduced perinatal deaths (30/1000) and maternal mortality (2.5/1000 deliveries) compared to the uneducated unbooked patients (perinatal deaths=259/1000 and 28.9 maternal deaths/1000 deliveries); however, booking status had a greater positive influence than education as evident in a perinatal death rate of 44/1000 for uneducated booked patients compared to 169/1000 for uneducated unbooked subjects. It is suggested that traditional birth attendants be better trained and employed in the national primary health care organization.

  3. Antenatal testing for cystic fibrosis in Cuba, 1988-2011.

    Science.gov (United States)

    Collazo, Teresa; López, Ixchel; Clark, Yulia; Piloto, Yaixa; González, Laura; Gómez, Manuel; García, Marileivis; Reyes, Lidice; Rodríguez, Fidel

    2014-01-01

    INTRODUCTION Cystic fibrosis is a multisystem autosomal recessive disease with wide variability in clinical severity. It is incurable and characterized by elevated and premature mortality, as well as poor quality of life. Its frequency, lethality and devastating impact on both the physical and psychological wellbeing of patients and their families, make it a serious health problem. Its frequency in Cuba is 1 in 9862 live births, where marked molecular heterogeneity of the CFTR gene makes molecular diagnosis difficult. Six mutations have been identified that together enable molecular characterization of only 55.5% of cystic fibrosis chromosomes. This paper presents national results of antenatal diagnostic testing, using direct and indirect methods, for detection of cystic fibrosis. OBJECTIVE Characterize the Cuban public health system's experience with antenatal molecular testing for cystic fibrosis from 1988 through 2011. METHODS A retrospective descriptive study was conducted with results of antenatal diagnostic testing of amniotic fluid, performed nationwide from 1988 through 2011, for 108 fetuses of couples with some risk of having children affected by cystic fibrosis, who requested testing. Polymerase chain reaction detected mutations p.F508del, p.G542X, p.R1162X, p.R334W, p.R553X and c.3120+1G>A, and markers XV2C and KM19. Data were analyzed using absolute frequencies and percentages, and presented in tables. RESULTS For 93 cases (86.1%), testing for cystic fibrosis was done using direct analysis of mutations p.F508del, p.G542X, p.R1162X, p.R334W, p.R553X and c.3120+1G>A; five cases (4.6%) were tested indirectly using markers XV2C/Taq I and KM19/Pst I; and 10 (9.3%) were tested using a combination of the two methods. A total of 72 diagnoses (66.7% of studies done) were concluded, of which there were 20 healthy fetuses, 16 affected, 27 carrier, and 9 who were either healthy or carriers of an unknown mutation. CONCLUSIONS Direct or indirect molecular study was

  4. 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.

  5. Measuring the adequacy of antenatal health care: a national cross-sectional study in Mexico.

    Science.gov (United States)

    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.

  6. Propuesta de un marco para la secuenciación didáctica de Controversias Socio-Científicas. Estudio con dos actividades alrededor de la genética

    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.

  7. A qualidade de vida de pessoas com deficiência mental leve

    Directory of Open Access Journals (Sweden)

    Fernanda Saviani-Zeoti

    Full Text Available Não é prática comum dar voz a pessoas com deficiência, mesmo quando se trata da investigação de sua própria qualidade de vida. Assim, este estudo teve por objetivo conhecer a opinião de 15 adultos com deficiência mental leve em relação a sua qualidade de vida e a opinião de seus cuidadores também a esse respeito, por meio de um instrumento que avalia a qualidade de vida (WHOQOL-Bref. Os dados foram analisados estatisticamente e comparados. Os resultados mostram que a diferença entre as avaliações foi pequena nas questões referentes à satisfação com os domínios físico, psicológico, das relações sociais e do meio ambiente. A avaliação feita pelas pessoas com deficiência foi apenas ligeiramente superior àquela feita por seus cuidadores. Não houve diferença estatisticamente significativa entre as avaliações, do que se conclui que as pessoas com deficiência mental são capazes de falar de suas próprias vidas de maneira positiva e bastante realista.

  8. The Eroticism of Artificial Flesh in Villiers de L'Isle Adam's L'Eve Future

    Directory of Open Access Journals (Sweden)

    Patricia Pulham

    2008-10-01

    Full Text Available Villiers de L'Isle Adam's 'L'Eve Future' published in 1886 features a fictional version of the inventor Thomas Edison who constructs a complex, custom-made android for Englishman Lord Ewald as a substitute for his unsatisfactory lover. Hadaly, the android, has a number of literary and cultural precursors and successors. Her most commonly accepted ancestor is Olympia in E. T. A. Hoffmann's 'The Sandman' (1816 and among her fascinating descendants are Oskar Kokoschka's 'Silent Woman'; Model Borghild, a sex doll designed by German technicians during World War II;‘Caracas' in Tommaso Landolfi's short story ‘Gogol's Wife' (1954; a variety of gynoids and golems from the realms of science fiction, including Ira Levin's 'Stepford Wives' (1972; and, most recently, that silicon masterpiece - the Real Doll. All, arguably, have their genesis in the classical myth of Pygmalion. This essay considers the tension between animation and stasis in relation to this myth, and explores the necrophiliac aesthetic implicit in Villiers's novel.

  9. Efeito do metacaulim nas propriedades do concreto leve estrutural = Effect of metacaulim on the properties of structural lightweight concrete

    Directory of Open Access Journals (Sweden)

    João Adriano Rossignolo

    2007-01-01

    Full Text Available Este trabalho apresenta os resultados da avaliação das modificações promovidas pelo Metacaulim no desempenho das propriedades do concreto com agregados leves. Foi analisado o efeito do Metacaulim na resistência à compressão, na resistência à tração por compressão diametral, no módulo de deformação, na absorção de água por imersão e na carbonatação do concreto com agregados leves. Nos resultados obtidos verificou-se que a adição de Metacaulim melhorou significativamente o desempenho da resistência à compressão, da resistência à tração por compressão diametral e da absorção de água por imersão e da carbonatação dos concretos leves.This paper deals with properties of lightweight aggregate concrete (LWAC with Metacaulim, made with Brazilian lightweight aggregate (LWA. Compressive strength, splitting tensile strength, modulus of elasticity and water absorption were tested. The inclusion of Metacaulim in the LWAC decreased water absorption and increasedcompressive strength and splitting tensile.

  10. Timing of antenatal care and ART initiation in HIV-infected pregnant ...

    African Journals Online (AJOL)

    In this review of routinely collected data from five community health centres in the Johannesburg Health District, we assess timing of antenatal care and antiretroviral therapy (ART) initiation in HIV-infected pregnant women before and after the introduction of nurse-initiated management of ART in antenatal clinics. There are ...

  11. On-site screening for maternal syphilis in an antenatal clinic

    African Journals Online (AJOL)

    thirty-seven pregnant patients attending an ante- natal clinic for the flrst ... in the majority ofcases during the first visit to an antenatal clinic. S Air Med J 1993; 83: 723-724. Pregnant women may seek antenatal care late in pregnancy. In most cases a further 2 .... penicillin G 2 400 000 units inrramuscularly. They were asked to ...

  12. No Moderating Effect of 5-HTTLPR on Associations between Antenatal Anxiety and Infant Behavior

    Science.gov (United States)

    Braithwaite, Elizabeth C.; Ramchandani, Paul G.; O'Connor, Thomas G.; van IJzendoorn, Marinus H.; Bakermans-Kranenburg, Marian J.; Glover, Vivette; Netsi, Elena; Evans, Jonathan; Meaney, Michael J.; Murphy, Susannah E.

    2013-01-01

    Objective: Maternal antenatal anxiety is associated with an increased risk of behavioral disturbances in offspring. Recent work has suggested that the effect of maternal antenatal anxiety on infant temperament at 6 months is moderated by the serotonin transporter polymorphism 5-HTTLPR, with carriers of the short allele more susceptible to the…

  13. 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...

  14. Integrating couple relationship education in antenatal education - A study of perceived relevance among expectant Danish parents

    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...... and after pregnancy....

  15. Effect of Daily Antenatal Iron Supplementation on Plasmodium Infection in Kenyan Women: A Randomized Clinical Trial

    NARCIS (Netherlands)

    Mwangi, Martin N.; Roth, Johanna M.; Smit, Menno R.; Trijsburg, Laura; Mwangi, Alice M.; Demir, Ayşe Y.; Wielders, Jos P. M.; Mens, Petra F.; Verweij, Jaco J.; Cox, Sharon E.; Prentice, Andrew M.; Brouwer, Inge D.; Savelkoul, Huub F. J.; Andang'o, Pauline E. A.; Verhoef, Hans

    2015-01-01

    Anemia affects most pregnant African women and is predominantly due to iron deficiency, but antenatal iron supplementation has uncertain health benefits and can increase the malaria burden. To measure the effect of antenatal iron supplementation on maternal Plasmodium infection risk, maternal iron

  16. Effect of daily antenatal iron supplementation on plasmodium infection in Kenyan women. A randomized clinical trial

    NARCIS (Netherlands)

    Mwangi, M.N.; Roth, J.M.; Smit, M.R.; Trijsburg, Laura; Mwangi, A.M.; Demir, A.Y.; Wielders, J.P.M.; Mens, P.F.; Verweij, J.J.; Cox, S.E.; Prentice, A.M.; Brouwer, I.D.; Savelkoul, H.F.J.; Andang'o, P.E.A.; Verhoef, J.C.M.

    2015-01-01

    Importance Anemia affects most pregnant African women and is predominantly due to iron deficiency, but antenatal iron supplementation has uncertain health benefits and can increase the malaria burden. Objective To measure the effect of antenatal iron supplementation on maternal Plasmodium infection

  17. A nationwide population analysis of antenatal and perinatal complications among nurses and nonmedical working women

    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.

  18. (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 ...

  19. 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...

  20. Antenatal oligohydramnios of renal origin: postnatal therapeutic and prognostic challenges.

    Science.gov (United States)

    Kemper, M J; Neuhaus, T J; Timmermann, K; Hueneke, B; Laube, G; Harps, E; Mueller-Wiefel, D E

    2001-12-01

    Urinary tract anomalies (UTA) including polycystic kidney disease nowadays can be detected antenatally by ultrasound. The concomitant presence of oligohydramnios has been regarded as a severe risk factor for renal dysfunction and pulmonary hypoplasia, although clinical data after birth are scarce. We report the postnatal course and long-term follow-up of 10 infants with oligohydramnios due to congenital UTA from two pediatric nephrology centers. The underlying final diagnoses were autosomal-recessive polycystic kidney disease (ARPKD, n = 2), familial tubular dysgenesis (n = 2) and bilateral renal hypoplasia (n = 6) including 3 children with posterior urethral valves. Two children died in the neonatal period while 8 children are currently alive at a median age of 2.5 (range 1.1-10) years. In the postnatal period, respiratory failure necessitating mechanical ventilation occurred in 7 infants (including the 2 non-survivors). All surviving children had chronic renal failure, which could be managed conservatively in 6 children (median GFR 45 (range 15-53) ml/min/1.73 m2) while 2 reached end-stage renal disease; one undergoing preemptive kidney transplantation and one peritoneal dialysis. Seven of 8 children reached normal developmental milestones. In conclusion, the presence of antenatal oligohydramnios in infants with UTA does not always carry a poor prognosis. The high incidence of perinatal complications, the complexity of underlying causes and the prevalence of postnatal chronic renal dysfunction calls for a multidisciplinary approach in the management of these children.

  1. Antenatal hypnosis training and childbirth experience: a randomized controlled trial.

    Science.gov (United States)

    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.

  2. 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.

  3. La fuerza ilocutiva en los debates medievales castellanos de controversia y su plasmación lingüística

    Directory of Open Access Journals (Sweden)

    Elena LEAL ABAD

    2008-10-01

    Full Text Available La presencia de actos de habla indirectos en algunas tipologías de diálogos literarios medievales, especialmente en los que presentan un carácter didáctico-moralizante, no siempre obedece a la noción de cortesía. El espíritu de controversia de estos textos origina que la falta de coincidencia entre modalidad del enunciado y modalidad de la enunciación se relacione con un deseo de distanciamiento dialéctico entre los personajes de la interacción, que tratan de socavar la imagen del interlocutor a través de enunciados que pretenden deslegitimar, ridiculizar o descalificar al adversario. Estos valores descorteses de los enunciados interrogativos derivan fundamentalmente del propio contenido proposicional aunque también constituyen indicios importantes la asimetría de los personajes que intervienen y las propias características del género discursivo. No obstante, en este mismo contexto aparecen mecanismos que tratan de contrarrestar la fuerza ilocutiva de estos actos descorteses minimizando el desacuerdo. En las páginas que siguen se tratará de determinar qué formas y estrategias lingüísticas se adoptan para acometer este tipo de actos y su relación con estructuras propias de la interacción comunicativa con el objetivo de captar una posible evolución de recursos o constancia de los mismos a lo largo de la historia del español.La présence d'actes de langage indirects dans certaines typologies de dialogues littéraires médiévaux, en particulier dans ceux qui présentent un caractère didactico-moralisant, n'obéit pas toujours à la notion de courtoisie. L'esprit de polémique de ces textes engendre la mise en relation du manque de coïncidence entre modalité de l'énoncé et modalité de l'énonciation et d’un désir d'éloignement dialectique entre les personnages de l'interaction, qui essayent de miner l'image de l'interlocuteur au travers d’énoncés qui prétendent délégitimer, ridiculiser ou discréditer l

  4. Fueros y sal: controversias fiscales entre la provincia de Álava y la corona durante el periodo Borbónico

    Directory of Open Access Journals (Sweden)

    María Rosario PORRES MARIJUÁN

    2009-11-01

    Full Text Available RESUMEN: A partir del reinado de Felipe II, la política fiscal de la Corona en relación a la sal entró en contradicción con algunos de los usos, costumbres y privilegios detentados por las provincias vascas en esa materia. Álava, como consumidora y productora con sus salinas de Añana mantuvo algunas controversias durante el primer período borbónico. Sus autoridades se enfrentaron a la Corona por cuestiones relacionadas con la sal en esta etapa que coincide con una fase evolutiva en la administración aduanera del Distrito de Cantabria. Una fase de reforma que tiene en 1740 la fecha clave, pues es entonces cuando se implanta la administración directa de la Corona sobre las rentas. Su objetivo era doble: la obtención de ingresos más elevados y más regulares, al mismo tiempo que hacer más efectiva la maquinaria aduanera en su fin de perseguir y eliminar las actividades fraudulentas. Álava tuvo que resignarse a la pérdida de ciertos privilegios relacionados con el consumo de la sal, pero nunca llegó a renunciar a los referidos al precio y su exención ante los continuos sobreprecios impuestos por la Corona con fines diversos. Las autoridades alavesas se aferraban a la figura del contrafuero en la medida en la que los fines destinatarios del «crecimiento» solían ser dos materias que los alaveses asumían a través de su propia hacienda: los servicios militares y el reparo de los caminos.ABSTRACT: From Philip ll’s reign onwards, the taxation policy of the Crown in relation to salt came into conflict with some of the uses, customs and privileges retained by the Basque provinces in this field. Alava, as both consumer and producer, with its Añana saltworks, sustained some controversy during the first Bourbon period. Its authorities opposed the Crown on questions related to salt iln this period, which coincided with a developmental phase in the customs administration of the district of Cantabria. The key date of this reform phase was

  5. Deterioro cognitivo leve: ¿dónde termina el envejecimiento normal y empieza la demencia?

    Directory of Open Access Journals (Sweden)

    Nilton Custodio

    2012-10-01

    Full Text Available Con el aumento de la prevalencia de demencia en el mundo, debemos poner especial atención a la evaluación diagnóstica de estadios previos a la demencia. El deterioro cognitivo leve (DCL podría ser considerado un estadio precoz de demencia, en especial de la enfermedad de Alzheimer (AD; por lo que consideramos importante un diagnóstico adecuado, mediante la utilización de instrumentos y técnicas fiables y sensibles, que permitan discriminar entre sujetos con envejecimiento normal y patológico. Los estudios epidemiológicos muestran una elevada prevalencia de DCL en la población general. Asimismo, se ha documentado la progresión de DCL a demencia y EA, sobre todo en sujetos con DCL del tipo amnésico. La edad, el estado de portador del APOE-ε4, la atrofia del hipocampo en resonancia magnética y la presencia de algunos biomarcadores en líquido cefalorraquídeo parecen influir en la conversión. Se sugiere que el estudio de pacientes con sospecha de DCL sea el mismo que se emplea en la sospecha de demencia y EA. La evaluación neuropsicológica es la única prueba que permite confirmar el diagnóstico y nos ayuda a realizar una adecuada clasificación de los subtipos de DCL: amnésico, multidominio y monodominio no amnésico.

  6. Does the time of delivery after antenatal corticosteroids matter?

    Directory of Open Access Journals (Sweden)

    Patrícia Campos

    2016-01-01

    Full Text Available Introduction: Preterm delivery is associated with an increased risk of newborn morbidity and mortality. Respiratory distress syndrome (RDS is the most common comorbidity. It has been proven that this syndrome can be prevented with the administration of antenatal corticosteroids to women at risk of preterm delivery, before 35 weeks of gestational age.Aim: To evaluate the risk factors, severity, co-morbidities, and mortality of RDS in newborns of less than 35 weeks of gestational age, with specific emphasis on the association between the elapsed time since the administration of the last dose of a full cycle of corticosteroids and the frequency and severity of RDS.Methods: This descriptive retrospective study includes all newborns of less than 35 weeks of gestational age, who were born at our center between January 1, 2012 and December 31, 2014 and admitted to Neonatal Intensive Care Unit (NICU. Newborns with major malformations, chromosomopathies, hydrops, congenital TORCH infection or outborns were excluded. RDS was diagnosed according to the criteria of the Update on the European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants (2013 and classified with a grade of I to III, in accord with radiographic results.Results: A total of 234 newborns were studied, of which 35.5% had RDS. Antenatal corticosteroids were used for 90.1% of all newborns. When adjusted to the severity of RDS, birth weight, gestational age, and vasopressor support were all predictive factors of newborn mortality. A ROC curve identified a cut-off of at most 10.5 hours between the last dose of a full cycle of corticosteroids and the delivery as higher risk of onset of RDS and another cut-off of at most 6.5 hours as higher risk of onset of moderate to severe RDS (sensitivity of 80.0% and 83.3%, respectively.Conclusion: The last dose of a full antenatal corticosteroids cycle must be given at least 10.5 hours prior to delivery to

  7. Assessing the potential impact of extending antenatal steroids to the late preterm period.

    Science.gov (United States)

    Souter, Vivienne; Kauffman, Ellen; Marshall, Alice J; Katon, Jodie G

    2017-10-01

    In 2016, guidance statements were issued by the Society for Maternal-Fetal Medicine and the American Congress of Obstetricians and Gynecologists about extending antenatal steroid use to selected late preterm singleton pregnancies. We sought to review antenatal steroid use prior to the 2016 guidance statements and assess the potential impact of these. This cohort study used chart-abstracted data from singleton deliveries from Jan. 1, 2012, through March 31, 2016, at 12 centers participating in the Obstetrics Clinical Outcomes Assessment Program, a quality initiative in Washington State. Pregnancies with missing gestation at delivery, fetal anomalies, or antepartum demise were excluded. Antenatal steroid use prior to the 2016 guidance was evaluated based on the percentage of early preterm deliveries (23 +0 -33 +6 weeks) and the percentage of all pregnancies that received antenatal steroids. Newborn complication rates were calculated for late preterm deliveries (34+0 +0 -36 +6 weeks), grouped by whether they would be potentially eligible or ineligible for antenatal steroids based on the 2016 guidance statements. The opportunity for antenatal steroids was missed in 21.8% (226/1034) of early preterm deliveries and of all those who received antenatal steroids, 32.2% (614/1908) delivered at term. Of preterm deliveries, 74% (n = 2942) were in the late preterm period. In all, 80% (n = 2363) of late preterm deliveries were potentially eligible for antenatal steroids and 60% of these (n = 1411) delivered at 36 weeks. The rate of respiratory complications in newborns delivering at 34 and 35 weeks was higher in the group potentially eligible for late preterm antenatal steroids compared to those in the ineligible group. Of those delivering at 36 weeks, no differences were detected in prevalence of respiratory complications by potential eligibility for antenatal steroids; however, compared with the ineligible group, those potentially eligible had a lower risk of neonatal

  8. Health education during antenatal care: the need for more

    Directory of Open Access Journals (Sweden)

    Al-Ateeq MA

    2015-02-01

    Full Text Available Mohammed A Al-Ateeq,1 Amal A Al-Rusaiess21College of Medicine, King Saud Bin Abdul-Aziz University for Health Sciences, 2Department of Family Medicine and Primary Health Care, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia Abstract: The aim of health education during ante natal is to provide advice, education, ­reassurance and support, to address and treat the minor problems of pregnancy, and to provide effective screening during the pregnancy. Exploring current practices in this regard revealed the need for more organized educational activities to ensure high quality and clients satisfaction. Keywords: antenatal care, health education, pregnant women, postpartum, misconceptions

  9. Effects of antenatal glucocorticoids on the developing brain.

    Science.gov (United States)

    Carson, Ross; Monaghan-Nichols, A Paula; DeFranco, Donald B; Rudine, Anthony C

    2016-10-01

    Glucocorticoids (GCs) regulate distinct physiological processes in the developing fetus, in particular accelerating organ maturation that enables the fetus to survive outside the womb. In preterm birth, the developing fetus does not receive sufficient exposure to endogenous GCs in utero for proper organ development predisposing the neonate to complications including intraventricular hemorrhage, respiratory distress syndrome (RDS) and necrotizing enterocolitis (NEC). Synthetic GCs (sGCs) have proven useful in the prevention of these complications since they are able to promote the rapid maturation of underdeveloped organs present in the fetus. While these drugs have proven to be clinically effective in the prevention of IVH, RDS and NEC, they may also trigger adverse developmental side effects. This review will examine the current clinical use of antenatal sGC therapy in preterm birth, their placental metabolism, and their effects on the developing brain. Published by Elsevier Inc.

  10. Approaches to the management of antenatally diagnosed congenital tumours

    Energy Technology Data Exchange (ETDEWEB)

    Mahony, Rhona; McParland, Peter [National Maternity Hospital, Department of Fetal and Maternal Medicine, Dublin (Ireland)

    2009-11-15

    Congenital fetal tumours are rare, but current imaging modalities including US and MRI facilitate antenatal diagnosis and investigation, allowing a presumptive diagnosis and management strategy. Although the prevalence of fetal tumours is difficult to ascertain, an incidence of 7.2 per 100,000 live births has previously been reported, with the incidence of neonatal malignancy estimated at 36.5 per million births. Teratomas and neuroblastomas are the most common solid tumours described. Tumours may be very large or associated with severe hydrops leading to significant dystocia with the potential for difficult vaginal or caesarean delivery. Once the diagnosis of a fetal tumour is made, optimal management incorporates a multidisciplinary approach including obstetrician, neonatologist, paediatric surgeon and paediatric oncologist so that counselling is appropriate and a clear management plan is in place for parents. (orig.)

  11. Autosomal Recessive Polycystic Kidney Disease: Antenatal Diagnosis and Histopathological Correlation

    Directory of Open Access Journals (Sweden)

    Dayananda Kumar Rajanna

    2013-01-01

    Full Text Available Autosomal recessive polycystic kidney disease (ARPKD is one of the most common inheritable disease manifesting in infancy and childhood with a frequency of 1:6,000 to 1:55,000 births. The patient in her second trimester presented with a history of amenorrhea. Ultrasound examination revealed bilateral, enlarged, hyperechogenic kidneys, placentomegaly, and severe oligohydramnios. The pregnancy was terminated. An autopsy was performed on the fetus. Both the kidneys were found to be enlarged and the cut surface showed numerous cysts. The liver sections showed changes due to fibrosis. The final diagnosis of autosomal recessive polycystic kidney disease was made based on these findings. In this article, we correlate the ante-natal ultrasound and histopathological findings in autosomal recessive polycystic kidney disease.

  12. Obesity, antenatal depression, diet and gestational weight gain in a population cohort study.

    Science.gov (United States)

    Molyneaux, Emma; Poston, Lucilla; Khondoker, Mizanur; Howard, Louise M

    2016-10-01

    The aims of this paper are to examine: (1) the relationship between high pre-pregnancy BMI and antenatal depression; (2) whether BMI and antenatal depression interact to predict diet and gestational weight gain (GWG). Data came from the Avon Longitudinal Study of Parents and Children (ALSPAC). Underweight women were excluded. Pre-pregnancy BMI was self-reported and antenatal depression was assessed using the Edinburgh Postnatal Depression Scale at 18 and 32 weeks' gestation to identify persistently elevated depressive symptoms (EPDS>12). Dietary patterns were calculated from food frequency questionnaires at 32 weeks' gestation. GWG was categorised using the USA Institute of Medicine guidelines. This study included 13,314 pregnant women. Obese women had significantly higher odds of antenatal depression than normal weight controls after adjusting for socio-demographics and health behaviours (aOR 1.39, 95%CI 1.05-1.84). Every unit increase in pre-pregnancy BMI was associated with approximately 3% higher odds of antenatal depression (aOR 1.03, 95%CI 1.01-1.05). Antenatal depression was not meaningfully associated with dietary patterns after adjusting for confounders and was not associated with inadequate or excessive GWG. There was no evidence for an interaction of depression and BMI on either diet or GWG. Healthcare professionals should be aware of the dose-response relationship between high pre-pregnancy BMI and antenatal depression.

  13. Antenatal embolization of a large placental chorioangioma: a case report

    Directory of Open Access Journals (Sweden)

    Babic Inas

    2012-07-01

    Full Text Available Abstract Introduction A chorioangioma is the most common benign tumor of the placenta. The majority of pregnancies with chorioangiomas are asymptomatic. Pregnancies with large chorioangiomas are associated with maternal and fetal complications, such as growth restriction, cardiomegaly, congestive heart failure, fetal anemia, thrombocytopenia, nonimmune hydrops and intrauterine fetal death. There are several modalities of treatment published to date with various results. Our case was the third such case report published on the successful treatment with antenatal embolization of the feeding vessel of the chorioangioma. To the best of our knowledge, there have been no published cases about antenatal treatment of placental chorioangiomas in Saudi Arabia, or any other Gulf state. Case presentation We describe the case of a 28-year-old Arab woman diagnosed at 22 weeks of gestation with a chorioangioma. A glue material - enbucrilate (Histoacryl - was used for embolization of the feeding vessel. Intrauterine fetal blood transfusions were performed twice, as a treatment for fetal anemia. The fetus developed heart failure at 30 weeks of gestation. A Cesarean section was performed and the outcome was a live baby with right ventricular hypertrophy. The baby was admitted to our neonatal intensive care unit and discharged at 42 days following birth in a stable condition,with follow-up with our cardiology team. Conclusion In this case, we found that intrauterine embolization of the feeding vessel of a chorioangioma with Histoacryl was a valid treatment option that carried a small risk considering the good pregnancy outcome.

  14. Antenatal depression and adversity in urban South Africa

    Science.gov (United States)

    van Heyningen, Thandi; Myer, Landon; Onah, Michael; Tomlinson, Mark; Field, Sally; Honikman, Simone

    2017-01-01

    Background In low and middle-income countries (LMIC), common mental disorders affecting pregnant women receive low priority, despite their disabling effect on maternal functioning and negative impact on child health and development. We investigated the prevalence of risk factors for antenatal depression among women living in adversity in a low-resource, urban setting in Cape Town, South Africa. Methods The MINI Neuropsychiatric Interview (MINI Plus) was used to measure the diagnostic prevalence of depression amongst women attending their first antenatal visit at a primary-level, community-based clinic. Demographic data were collected followed by administration of questionnaires to measure psychosocial risk. Analysis examined the association between diagnosis of depression and psychosocial risk variables, and logistic regression was used to investigate predictors for major depressive episode (MDE). Results Among 376 women participating, the mean age was 26 years. The MINI-defined prevalence of MDE was 22%, with 50% of depressed women also expressing suicidality. MDE diagnosis was significantly associated with multiple socioeconomic and psychosocial risk factors, including a history of depression or anxiety, food insecurity, experience of threatening life events and perceived support from family. Limitations The use of self-report measures may have led to recall bias. Retrospective collection of clinical data limited our ability to examine some known risk factors for mental distress. Conclusions These findings confirm the high prevalence of MDE among pregnant women in LMIC settings. Rates of depression may be increased in settings where women are exposed to multiple risks. These risk factors should be considered when planning maternal mental health interventions. PMID:27285725

  15. 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

    INTRODUCTION: health systems in low-income settings are not sufficiently reaching the poor, and global disparities in reproductive health persist. The frequency and quality of health education during antenatal care is often low. Further studies are needed on how to improve the performance of health...... systems in low income settings to improve maternal and child health. OBJECTIVES: to assess the effectiveness of a participatory antenatal care intervention on health behaviours and to illuminate how the different socioeconomic groups responded to the intervention in Jimma, Ethiopia. SETTING, INTERVENTION...... facility delivery are encouraging and underline the need to scale up priority of antenatal care in the effort to reduce maternal and child health inequity....

  16. 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

    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...

  17. Quality and dose optimized CT trauma protocol. Recommendation from a university level-I trauma center

    Energy Technology Data Exchange (ETDEWEB)

    Kahn, Johannes; Boening, Georg; Rotzinger, Roman; Freyhardt, Patrick; Streitparth, Florian [Charite School of Medicine and Univ. Hospital Berlin (Germany). Dept. of Radiology; Kaul, David [Charite School of Medicine and Univ. Hospital Berlin (Germany). Dept. of Radiation Oncology; Schwabe, Philipp [Charite School of Medicine and Univ. Hospital Berlin (Germany). Dept. of Trauma Surgery; Maurer, Martin H. [Inselspital Bern (Switzerland). Dept. of Diagnostic, Interventional and Pediatric Radiology; Renz, Diane Miriam [Univ. Hospital Jena (Germany). Inst. of Diagnostic and Interventional Radiology

    2017-09-15

    As a supra-regional level-I trauma center, we evaluated computed tomography (CT) acquisitions of polytraumatized patients for quality and dose optimization purposes. Adapted statistical iterative reconstruction [(AS)IR] levels, tube voltage reduction as well as a split-bolus contrast agent (CA) protocol were applied. Materials and Methods 61 patients were split into 3 different groups that differed with respect to tube voltage (120 - 140 kVp) and level of applied ASIR reconstruction (ASIR 20 - 50%). The CT protocol included a native acquisition of the head followed by a single contrast-enhanced acquisition of the whole body (64-MSCT). CA (350 mg/ml iodine) was administered as a split bolus injection of 100 ml (2 ml/s), 20 ml NaCl (1 ml/s), 60 ml (4 ml/s), 40 ml NaCl (4 ml/s) with a scan delay of 85s to detect injuries of both the arterial system and parenchymal organs in a single acquisition. Both the quantitative (SNR/CNR) and qualitative (5-point Likert scale) image quality was evaluated in parenchymal organs that are often injured in trauma patients. Radiation exposure was assessed. The use of IR combined with a reduction of tube voltage resulted in good qualitative and quantitative image quality and a significant reduction in radiation exposure of more than 40% (DLP 1087 vs. 647 mGy x cm). Image quality could be improved due to a dedicated protocol that included different levels of IR adapted to different slice thicknesses, kernels and the examined area for the evaluation of head, lung, body and bone injury patterns. In synopsis of our results, we recommend the implementation of a polytrauma protocol with a tube voltage of 120 kVp and the following IR levels: cCT 5mm: ASIR 20; cCT 0.625 mm: ASIR 40; lung 2.5 mm: ASIR 30, body 5 mm: ASIR 40; body 1.25 mm: ASIR 50; body 0.625 mm: ASIR 0. A dedicated adaptation of the CT trauma protocol (level of reduction of tube voltage and of IR) according to the examined body region (head, lung, body, bone) combined with a

  18. Valores de lipasa en pancreatitis biliar leve y su implicación en el manejo quirúrgico temprano

    OpenAIRE

    Angamarca Angamarca, Edison Fernando

    2016-01-01

    Introducción: la pancreatitis aguda biliar leve es una patología frecuente, con evolución favorable, si se evita complicaciones: pancreatitis recurrente, colecistitis, colangitis, colédocolitiasis, prevenibles realizando un tratamiento quirúrgico temprano; ¿Cuándo realizar la intervención? no está definida. El presente trabajo revisa la evolución de la enzima lipasa hasta su normalización y el tratamiento quirúrgico. Método: se realizó un estudio descriptivo prospectivo, de enero a diciem...

  19. Análisis de la eficiencia y seguridad de un protocolo de alta precoz en pancreatitis aguda leve

    OpenAIRE

    Serra Pla, Sheila

    2016-01-01

    OBJECTIVO: las primeras 24 horas de evolución son cruciales en los pacientes con diagnóstico de pancreatitis aguda (PA) ya que este es el periodo en el que un mayor número de pacientes presenta un fallo orgánico. Esto sugiere que los pacientes con PA leve (PAL) podrían ser identificados y dados de alta precozmente. El objetivo de este estudio es demostrar la viabilidad y seguridad de un protocolo de alta precoz en PAL. MATERIAL Y MÉTODOS: Estudio observacional prospectivo en un hospital d...

  20. Análisis de la eficiencia y seguridad de un protocolo de alta precoz en pancreatitis aguda leve /

    OpenAIRE

    Serra Pla, Sheila,

    2016-01-01

    OBJECTIVO: las primeras 24 horas de evolución son cruciales en los pacientes con diagnóstico de pancreatitis aguda (PA) ya que este es el periodo en el que un mayor número de pacientes presenta un fallo orgánico. Esto sugiere que los pacientes con PA leve (PAL) podrían ser identificados y dados de alta precozmente. El objetivo de este estudio es demostrar la viabilidad y seguridad de un protocolo de alta precoz en PAL. MATERIAL Y MÉTODOS: Estudio observacional prospectivo en un hospital de te...

  1. Análises moleculares em gestantes com diabete e hiperglicemia leve e em seus recém-nascidos

    OpenAIRE

    Gelaleti, Rafael Bottaro [UNESP

    2012-01-01

    O grupo IB corresponde a gestantes portadoras de hiperglicemia leve, ou seja, gestantes que apresentam rastreamento positivo, mas diagnóstico negativo para diabete gestacional (DMG) teste de tolerância a glicose (TTG100g normal), e resposta alterada no perfil glicêmico (PG). Este grupo foi, acidentalmente, identificado em 1983, quando projeto prospectivo foi desenvolvido para padronização do PG comparando-o com o TTG100g no diagnóstico do diabete na gestação. Essas gestantes apresentam resist...

  2. Sustainable antenatal care services in an urban Indigenous community: the Townsville experience.

    Science.gov (United States)

    Panaretto, Kathryn S; Mitchell, Melvina R; Anderson, Lynette; Larkins, Sarah L; Manessis, Vivienne; Buettner, Petra G; Watson, David

    2007-07-02

    To evaluate the impact of a sustained, community-based collaborative approach to antenatal care services for Indigenous women. Prospective quality improvement intervention, the Mums and Babies program, in a cohort of women attending Townsville Aboriginal and Islanders Health Service, 1 January 2000 - 31 December 2005 (MB group), compared with a historical control group (PreMB group), 1 January 1998 - 30 June 1999. Proportion of women having inadequate antenatal care and screening; perinatal indicators. The number of antenatal visits per pregnancy increased from three (interquartile range [IQR], two to six) in the PreMB group to six (IQR, four to ten) in the MB group (P Sustained access to a community-based, integrated, shared antenatal service has improved perinatal outcomes among Indigenous women in Townsville.

  3. Community outreach midwifery-led model improves antenatal access in a disadvantaged population.

    Science.gov (United States)

    Reeve, Carole; Banfield, Sally; Thomas, Amanda; Reeve, David; Davis, Stephanie

    2016-06-01

    This study aimed to assess the impact of a new model of antenatal care for women living in a very remote area. This is a retrospective 2-year evaluation of antenatal care. Two hundred thirteen pregnant women in Aboriginal communities in the Fitzroy Valley of Western Australia participated in this study. The implementation of a midwifery-led interdisciplinary model of antenatal outreach care. The indicators measured were numbers of antenatal visits, their location and quality care indicators (presentation in first trimester, alcohol and smoking, ultrasound and blood-borne virus screening) and outcome indicators (birth weight, prematurity, in utero deaths and mode of delivery). There was an increase in access to antenatal care and improvements in quality-of-care indicators. The proportion of visits provided in local Aboriginal communities increased from 10% to 24%. There were statistically significant increases in women presenting in the first trimester (40-58%), screening for alcohol and smoking (48-93%) and having an ultrasound in pregnancy (59-94%). There were no significant improvements in neonatal outcome indicators. There is a large disparity in maternal and child health outcomes between Aboriginal and Torres Strait Islander (Indigenous) and non-Indigenous Australians thought to be due to decreased access to antenatal care, poorer socioeconomic status and the associated risk factors. The change in model of care resulted in earlier presentation for antenatal care, increased numbers of antenatal visits and increased screening for risk factors. Regular auditing of services enables the identification of opportunity for improvement with the goal of improving health outcomes. © 2015 National Rural Health Alliance Inc.

  4. Child malnutrition and antenatal care: Evidence from three Latin American countries

    OpenAIRE

    Ramirez, N.F.; Gamboa, L.F.; Bedi, A.S.; Sparrow, R.A.

    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 utero and later. Notwithstanding their policy relevance and substantial expansion, empirical evidence on the role of antenatal care (ANC) programs in combating stunting is scarce. This study analyze...

  5. Knowledge and Attitude of Nigerian Pregnant Women towards Antenatal Exercise: A Cross-Sectional Survey

    OpenAIRE

    Mbada, Chidozie E.; Adebayo, Olubukayomi E.; Adeyemi, Adebanjo B.; Arije, Olujide O.; Dada, Olumide O.; Akinwande, Olabisi A.; Awotidebe, Taofeek O.; Alonge, Ibidun A.

    2014-01-01

    Background. Engagement in physical exercise in pregnancy is hamstrung by safety concerns, skepticism about usefulness, and limited individualized prescription guidelines. This study assessed knowledge and attitude of pregnant women towards antenatal exercises (ANEx). Methods. The cross-sectional study recruited 189 pregnant women from six selected antenatal clinics in Ile-Ife, South-West, Nigeria. Data were obtained on maternal characteristics, knowledge, and attitude towards ANEx. Results. R...

  6. Lack of Availability of Antenatal Vaccination Information on Obstetric Care Practice Web Sites.

    Science.gov (United States)

    Chamberlain, Allison T; Koram, Allison L; Whitney, Ellen A S; Berkelman, Ruth L; Omer, Saad B

    2016-01-01

    To estimate the proportion of obstetric practice web sites in the United States providing information on antenatal influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination. Using www.healthgrades.com, a national random sample of 1,003 obstetric practice web sites was examined for provision of information on antenatal vaccination and other preventive prenatal health topics. Data were collected for this cross-sectional study between September 25, 2014, and November 12, 2014. χ tests and odds ratios were calculated to determine significance and magnitude of associations between provision of antenatal vaccination information and other practice characteristics. Of 1,003 web sites examined, 229 (22.8%) posted information pertaining to antenatal vaccinations. Only 105 web sites (10.5%) provided up-to-date information about both antenatal influenza and Tdap vaccination. Compared with the proportion posting on antenatal vaccination, significantly more web sites posted on safe foods (40.8%; Pvaccination (safe foods: 45.7% compared with 7.1%; odds ratio [OR] 11.07, 95% confidence interval [CI] 7.65-16.01; safe medications: 45.4% compared with 9.6%; OR 7.8, CI 5.58-10.89; safe exercise: 45.9% compared with 8.4%; OR 9.2, CI 6.5-13.03). A majority of obstetric care practice web sites do not provide information on antenatal vaccinations. Obstetric practices should consider using their web sites to provide reliable information on antenatal vaccinations as many already do for other prenatal health topics.

  7. Do assisted-reproduction twin pregnancies require additional antenatal care?

    Science.gov (United States)

    Jauniaux, E; Ben-Ami, I; Maymon, R

    2013-02-01

    obviously at higher risk of perinatal complications than singletons due to a natural increase in the incidence of fetal anomalies, antenatal disorders and obstetric and neonatal complications associated with the development of two fetuses instead of one. Overall, our review indicates that some antenatal complications are more frequent in assisted-conception twin pregnancies than in spontaneous twin pregnancies but their prevalence is low and thus their impact on the morbidity and mortality of an individual assisted-conception twin pregnancy is limited. Assisted reproduction treatment has become available to older women with pre-existing maternal medical conditions such as chronic hypertension and diabetes. The increased obstetrical risks in this population must be considered prior to attempts at assisted conception, and the transfer of more than one embryo should be avoided in women with a pre-existing maternal medical condition. Copyright © 2012 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  8. Urban Floods in Lowlands—Levee Systems, Unplanned Urban Growth and River Restoration Alternative: A Case Study in Brazil

    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.

  9. A utilização de betões leves em estruturas mistas aço-betão

    OpenAIRE

    Cruz, Paulo J. S.; Valente, Isabel

    2008-01-01

    Neste artigo são apresentados alguns dos principais resultados dos trabalhos de investigação que, ao longo dos últimos anos, têm sido desenvolvidos na Universidade do Minho com vista ao estudo da aplicabilidade de betões leves em estruturas mistas aço-betão. Essa investigação, com um carácter bastante aprofundado e um âmbito muito alargado compreende os seguintes ensaios: de caracterização dos agregados leves, de caracterização mecânica e de durabilidade de betões leves de várias resistências...

  10. Socio Demographic Factors Determining the Adequacy of Antenatal Care among Pregnant Women Visiting Ekiti State Primary Health Centers

    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.

  11. Knowledge, Perception, and Attitude of Pregnant Women Towards the Role of Physical Therapy in Antenatal Care - A Cross Sectional Study

    Directory of Open Access Journals (Sweden)

    Nayak R

    2016-01-01

    Full Text Available Background: Physiotherapy plays an essential role in obstetrics, both in the antenatal and postnatal periods. Antenatal exercises are recommended for the health benefits and safe delivery that they secure of pregnant mothers. However, studies on the efficacy of this approach in developing countries like India are limited in literature.The objective of this study was to determine knowledge, perception, and attitude of pregnant women towards the role of physical therapy in antenatal care. Methods: A descriptive survey research design was used for this cross-sectional study. A total of 106 pregnant women attending regular antenatal checkups in tertiary care centers in Mangalore, Karnataka, India were recruited. Data were obtained on maternal characteristics, knowledge, perception, and attitude towards the role of physiotherapy in antenatal care. Results: 46% of subjects knew about antenatal exercises. The majority of them were not aware or not sure about the different type of antenatal exercises avaliable.60% of the respondents had a positive attitude to physiotherapy during antenatal care. However, only 30% of the participants had adequate knowledge of the benefits of antenatal exercise and this was not influenced by maternal sociodemographic characteristics. Conclusion: A majority of Indian pregnant women demonstrate inadequate knowledge but have positive attitude towards role of physiotherapy in antenatal care.

  12. Effects of Antenatal Maternal Depression and Anxiety on Children's Early Cognitive Development: A Prospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Gladys Ibanez

    Full Text Available 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.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.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%.The partial nature of these effects suggests that other mediators may play a role. Implications for theory and research on child development are discussed.

  13. Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment.

    Science.gov (United States)

    Serçekuş, Pınar; Başkale, Hatice

    2016-03-01

    to examine the effects of antenatal education on fear of childbirth, maternal self-efficacy, and maternal and paternal attachment. quasi-experimental study, comparing an antenatal education group and a control group. 63 pregnant women and their husbands. demographic data forms, the Wijma Delivery Expectancy/Experience Questionnaire, the Childbirth Self-Efficacy Inventory, the Maternal Attachment Inventory and the Postnatal Paternal-Infant Attachment Questionnaire were used for data collection. antenatal education was found to reduce the fear of childbirth and to increase childbirth-related maternal self-efficacy. However, antenatal education was found to have no effect on parental attachment. it is recommended that widespread antenatal education programmes should be provided in developing countries, and the content of the education programme about parental attachment should be increased. this study found that antenatal education has no influence on maternal and paternal attachment. As such, there is a need to increase the content of the education programme about parental attachment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Social capital and antenatal depression among Chinese primiparas: A cross-sectional survey.

    Science.gov (United States)

    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.

  15. The Transition of Benthic Nutrient Sources after Planned Levee Breaches Adjacent to Upper Klamath and Agency Lakes, Oregon

    Science.gov (United States)

    Kuwabara, James S.; Topping, Brent R.; Carter, James L.; Parcheso, Francis; Cameron, Jason M.; Asbill, Jessica R.; Fend, Steven V.; Duff, John H.; Engelstad, Anita C.

    2010-01-01

    Four sampling trips were coordinated after planned levee breaches that hydrologically reconnected both Upper Klamath Lake and Agency Lake, Oregon, to adjacent wetlands. Sets of nonmetallic pore-water profilers were deployed during these trips in November 2007, June 2008, May 2009, and July 2009. Deployments temporally spanned the annual cyanophyte bloom of Aphanizomenon flos-aquae (AFA) and spatially involved three lake and four wetland sites. Profilers, typically deployed in triplicate at each lake or wetland site, provided high-resolution (centimeter-scale) estimates of the vertical concentration gradients for diffusive-flux determinations. Estimates based on molecular diffusion may underestimate benthic flux because solute transport across the sediment-water interface can be enhanced by processes including bioturbation, bioirrigation and groundwater advection. Water-column and benthic samples were also collected to help interpret spatial and temporal trends in diffusive-flux estimates. Data from these samples complement taxonomic and geochemical analyses of bottom-sediments taken from Upper Klamath Lake (UKL) in prior studies. This ongoing study provides information necessary for developing process-interdependent solute-transport models for the watershed (that is, models integrating physical, geochemical, and biological processes) and supports efforts to evaluate remediation or load-allocation strategies. To augment studies funded by the U.S. Bureau of Reclamation (USBR), the Department of the Interior supported an additional full deployment of pore-water profilers in November 2007 and July 2009, immediately following the levee breaches and after the crash of the annual summer AFA bloom. As observed consistently since 2006, benthic flux of 0.2-micron filtered, soluble reactive phosphorus (that is, biologically available phosphorus, primarily as orthophosphate; SRP) was consistently positive (that is, out of the sediment into the overlying water column) and

  16. Antenatal and postnatal depression: A public health perspective

    Directory of Open Access Journals (Sweden)

    Saurabh R Shrivastava

    2015-01-01

    Full Text Available Depression is widely prevalent among women in the child-bearing age, especially during the antenatal and postnatal period. Globally, post-partum depression has been reported in almost 10% to 20% of mothers, and it can start from the moment of birth, or may result from depression evolving continuously since pregnancy. The presence of depression among women has gained a lot of attention not only because of the rising incidence or worldwide distribution, but also because of the serious negative impact on personal, family and child developmental outcomes. Realizing the importance of maternal depression on different aspects-personal, child, and familial life, there is a crucial need to design a comprehensive public health policy (including a mental health strategy, to ensure that universal psychosocial assessment in perinatal women is undertaken within the primary health care system. To conclude, depression during pregnancy and in the postnatal period is a serious public health issue, which essentially requires continuous health sector support to eventually benefit not only the woman, but also the family, the community, and health care professionals.

  17. Antenatal diagnosis of agenesis of the corpus callosum

    International Nuclear Information System (INIS)

    Craven, I.; Bradburn, M.J.; Griffiths, P.D.

    2015-01-01

    Aim: To estimate the diagnostic performance of ultrasound in detecting agenesis of the corpus callosum (ACC). Materials and methods: A retrospective review was performed of 1722 in utero MRI examinations. All cases were identified in which the fetus had been referred from ultrasonography with a diagnosis of ACC and those in which ACC was given as a diagnosis on the in utero MRI study. The MRI was assumed to provide the correct diagnosis of ACC and descriptive statistics of diagnostic accuracy for ultrasound were calculated. Results: Of the 1722 ultrasound examinations performed, 121 had a diagnosis of ACC and approximately 50% were confirmed at MRI. Forty-two fetuses with ACC not suspected at ultrasonography were also identified at MRI. Ultrasonography had a positive predictive value of 47% (95% CI: 38–56%) and a negative predictive value of 97% (95% CI: 96–98%) for detecting ACC. Conclusion: Ultrasound is poor in diagnosing ACC and in utero MRI should be performed if there is any suspicion on antenatal ultrasonography. - Highlights: • The diagnosis of agenesis of the corpus callosum in the fetus is challenging on ultrasonography. • Agenesis of the corpus callosum is frequently overcalled and missed on ultrasonography. • If suspicion of agenesis of the corpus callosum is raised, should be performed

  18. Integrating active tuberculosis case finding in antenatal services in Zambia.

    Science.gov (United States)

    Kancheya, N; Luhanga, D; Harris, J B; Morse, J; Kapata, N; Bweupe, M; Henostroza, G; Reid, S E

    2014-12-01

    Three out-patient antenatal care (ANC) clinics in Lusaka, Zambia. To estimate tuberculosis (TB) prevalence in human immunodeficiency virus (HIV) infected and symptomatic, non-HIV-infected pregnant women and explore the feasibility of routine TB screening in ANC settings. Peer educators administered TB symptom questionnaires to pregnant women attending their first ANC clinic visit. Presumptive TB patients were defined as all HIV-infected women and symptomatic non-HIV-infected women. Sputum samples were tested using smear microscopy and culture to estimate TB prevalence. All 5033 (100%) women invited to participate in the study agreed, and 17% reported one or more TB symptoms. Among 1152 presumed TB patients, 17 (1.5%) had previously undiagnosed culture-confirmed TB; 2 (12%) were smear-positive. Stratified by HIV status, TB prevalence was 10/664 (1.5%, 95%CI 0. 7-2.8) among HIV-infected women and 7/488 (1.4%, 95%CI 0.6-2.9) among symptomatic non-HIV-infected women. In HIV-infected women, the only symptom significantly associated with TB was productive cough; symptom screening was only 50% sensitive. There is a sizable burden of TB in pregnant women in Zambia, which may lead to adverse maternal and infant outcomes. TB screening in ANC settings in Zambia is acceptable and feasible. More sensitive diagnostics are needed.

  19. Antenatal fetal magnetocardiography: a new method for fetal surveillance?

    Science.gov (United States)

    Quinn, A; Weir, A; Shahani, U; Bain, R; Maas, P; Donaldson, G

    1994-10-01

    To establish the reliability of fetal magnetocardiography as a method of measuring the time intervals of the fetal heart during the antenatal period. A prospective study. Wellcome Biomagnetism Unit, Southern General Hospital. One hundred and six low risk pregnant women at 20 to 42 weeks gestation. Success in obtaining QRS complexes, P waves and T waves. Correlation of time intervals with fetal outcome. The technique was acceptable to pregnant women. A QRS complex was successfully demonstrated in 68 (67%) of the unaveraged traces. Using off-line averaging techniques on these 68 cases, P waves were obtained in 75% and T waves in 72%. Although good quality traces were obtained throughout the range of gestational ages, in general it was more difficult below 28 weeks. QRS duration (R2 = 7%, P = 0.02) demonstrated a positive linear correlation with increasing gestation. Of the 35 (51%) cases with umbilical vein pH analysis available, only one result was less than 7.2. No significant relation was found between measurements of the fetal waveforms and the pH results. The technique of fetal magnetocardiography provides a significant advance in the technological field for the demonstration of QRS complexes and the full PQRST waveforms in gestations from 20 weeks onwards. With further technical improvements the clinical impact of this technique can be assessed more fully.

  20. HIV-1 Genetic Diversity in Antenatal Cohort, Canada

    Science.gov (United States)

    Akouamba, Bertine S.; Viel, Janique; Charest, Hugues; Merindol, Natacha; Samson, Johanne; Lapointe, Normand; Brenner, Bluma G.; Lalonde, Richard; Harrigan, P. Richard; Boucher, Marc

    2005-01-01

    We studied HIV genetic diversity in a cohort of 127 pregnant, HIV-infected women who received prenatal care at Sainte-Justine Hospital in Montreal, Canada, between 1999 and 2003. Clade assignments were derived by phylogenetic analysis of amplified pol sequences. Genotyping was successful in 103 of 127 women, 59 (57.3%) of whom were infected with clade B HIV-1, and 44 (42.7%) with nonclade B viruses, including subtypes A, C, D, F, G, and H. Four sequences remained unassigned. Forty-three of 44 women infected with non-clade B viruses were newcomers from sub-Saharan Africa, and subtype identity was consistent with those circulating in their countries of origin. These results highlight the epidemiologic importance of non-B HIV-1 in antenatal populations in a large North American urban center, underscore the influence of population movements on clade intermixing, and identify a group of patients who could be targeted for surveillance and drug therapy followup. PMID:16102312

  1. Late entry to antenatal care in New South Wales, Australia

    Directory of Open Access Journals (Sweden)

    Rubin George

    2006-08-01

    Full Text Available Abstract Aims This study aimed to assess the prevalence of women who entered antenatal care (ANC late and to identify factors related to the late entry to ANC in New South Wales (NSW in 2004. Methods The NSW Midwives Data Collection contained data of 85,034 women who gave birth in 2004. Data were downloaded using SAS and transferred to STATA 8.0. Entering ANC after 12 weeks of gestation was classified as late. The Andersen Health Seeking Behaviour Model was used for selection and analyses of related factors. Regression and hierarchical analyses were used to identify significant factors and their relative contributions to the variation of pregnancy duration at entry to ANC. Results 41% of women commenced ANC after 12 weeks of gestation. Inequality existed between groups of women with predisposing characteristics and enabling resources contributed more to the variation in pregnancy duration at entry to ANC than needs. The groups of women with highest risk were teenagers, migrants from developing countries, women living in Western Sydney, Aboriginal and Torres Strait Islanders, women with three or more previous pregnancies and heavy smokers. The high risk groups with largest number of women were migrants from developing countries and women living in Western Sydney. Conclusion A large number of women in NSW entered ANC late in their pregnancies. Efforts to increase early entry to ANC should be targeted on identified high risk groups of women.

  2. Antenatal nephromegaly and propionic acidemia: a case report.

    Science.gov (United States)

    Bernheim, Ségolène; Deschênes, Georges; Schiff, Manuel; Cussenot, Isabelle; Niel, Olivier

    2017-03-30

    Propionic acidemia (PA) is a rare but severe recessive autosomal disease, presenting with non specific signs in the first years of life. Prenatal diagnosis is invasive (amniocentesis) and limited to suspect cases. No screening test has been described, in particular no correlations between prenatal sonography and PA have been documented so far. We report the case of a boy with fetal bilateral nephromegaly and hyperechogenic kidneys, along with neonatal acute kidney injury; no etiology could be found in the first months of life. At 3 months of life, he presented with tachypnea and altered mental status, which lead to the diagnosis of PA. The renal ultrasound at 8 months of life, after a symptomatic treatment of PA had been initiated, showed a regression of the renal abnormalities. This case describes PA as a novel cause of large and hyperechogenic kidneys in the antenatal period. It suggests that, when confronted to fetal nephromegaly, hyperechogenic kidneys and risk factors of metabolic disease such as consanguineous parents, PA should be considered, and a prenatal test should be proposed.

  3. Antenatal care among currently married women in Rajasthan, India

    Directory of Open Access Journals (Sweden)

    Alok Chauhan

    2012-10-01

    Full Text Available Objective: To assess the utilization of antenatal care (ANC services among currently married women in Rajasthan. Methods: The data have been extracted from District Level Household and Facility Survey (DLHS-3 which was conducted during 2007-2008, all over India. A total of 12 458 currently married women in the age group of 15-49 were taken as the sample for the study. Cross tabulation and binary logistic regression method were applied to determine the factors influencing ANC. Results: Out of 12 458 respondents, 43.4 percent women not received even a single ANC during their pregnancy period. 45.1 percent of the women not received tetanus toxoid injection and 13.0 percent of the women not received Iron folic acid tablets during their pregnancy period. Only 6.6 percent of women fulfilled the minimum recommendation with regard ANC services. Conclusions: The study points to the avenues through which policy makers can formulate and implement policies on a realistic basis by identifying critical variables and target groups for effective utilisation of ANC.

  4. Possibilities of antenatal prevention of food allergy in young children

    Directory of Open Access Journals (Sweden)

    O. V. Tarasova

    2016-01-01

    Full Text Available Objective: to determine the efficiency of antenatal prevention of food allergy in children. A total of 248 mother-child pairs were followed up. According to their maternal feeding pattern during pregnancy, the newborn infants were divided into 3 subgroups. Subgroup 1 consisted of 37 infants whose mothers had ingested a hypoallergenic diet during pregnancy. Subgroup 2 entered 29 babies, whose mothers had adhered to a hypoallergenic diet and received the probiotic Lactobacillus reuteri Protectis in the last stages of gestation. Subgroup 3 comprised 82 infants whose mothers had received a diet with a hypoallergenic substitute of cow’s milk for the New Zealand goat’s milk Amalthea in combination with the probiotic during pregnancy.There were no differences between the neonatal groups in anthropometric indicators. Analysis of intestinal microbiota showed that significantly more children had an increasing amount of Klebsiella, enterococci, Candida albicans, and Staphylococcus aureus in the comparison group (p<0.05. Subgroup 3 babies whose mother had received lactobacilli and the whole goat’s milk Amalthea were more frequently found to have normal levels of bifidobacteria and lactobacilli (p<0.05 and a smaller number of opportunistic pathogens (p<0.05 in the enteric flora. In addition, the hypoallergenic diet including goat’s milk and/or Lactobacillus reuteri Protectis in mothers in the last stages of gestation reduced the frequency and degree of sensitization to cow’s and goat’s milk in the infants.

  5. Valorização de resíduos da indústria da celulose na produção de agregados leves

    OpenAIRE

    Pinto, Susana de Jesus Fernandes

    2005-01-01

    Este trabalho tem como objectivo estudar a aplicação industrial de um conjunto de resíduos da indústria da celulose (lamas primárias e biológicas, dregs e grits) no processo de produção de agregados leves de argila expandida. A metodologia experimental envolveu quatro etapas: recolha e caracterização das matérias primas; incorporação dos resíduos no fabrico de agregados leves; ensaios industriais e caracterização final dos produtos obtidos. As formulações desenvolvidas envol...

  6. Desenvolvimento de pastas leves utilizando incorporadores de ar para aplicação em poços de petróleo

    OpenAIRE

    Santos, Herculana Torres dos

    2013-01-01

    A cimentação é uma das operações mais importantes realizadas durante a fase de construção de um poço de petróleo, pois tem o objetivo de vedar zonas permeáveis e fornecer suporte para a coluna de revestimento. Zonas de interesse depletadas ou com baixa pressão de fratura requerem pastas cimentantes de baixa densidade. Métodos tradicionais para produzir pastas leves incluem a formação de espumas, o uso de microesferas ocas de vidro ou de aditivos leves. O objetivo desse trabalho é estudar past...

  7. Prevalence, Specificity and Titration of Red Cell Alloantibodies in Multiparous Antenatal Females at a Tertiary Care Centre from North India

    OpenAIRE

    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...

  8. Antenatal hydronephrosis: Negative predictive value of normal postnatal ultrasound - a 5-year study

    Energy Technology Data Exchange (ETDEWEB)

    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

  9. Influence of Population Demography and Immunization History on the Impact of an Antenatal Pertussis Program

    Science.gov (United States)

    Campbell, Patricia Therese; McVernon, Jodie; McIntyre, Peter; Geard, Nicholas

    2016-01-01

    Background. Antenatal pertussis vaccination is being considered as a means to reduce the burden of infant pertussis in low- and middle-income countries (LMICs), but its likely impact in such settings is yet to be quantified. Methods. An individual-based model was used to simulate the demographic structure and dynamics of a population with characteristics similar to those of LMICs. Transmission of pertussis within this population was simulated to capture the incidence of infection in (1) the absence of vaccination; (2) with a primary course only (three doses of diphtheria, tetanus, and pertussis vaccines [DTP3] commencing in 1985, 1995, or 2005 at 20%, 50%, or 80% coverage); and (3) with the addition of an antenatal pertussis program. Results. Modeled annual incidence averaged over the period 2015–2024 reduced with increasing DTP3 coverage, regardless of the year childhood vaccination commenced. Over the same period, the proportion of infants born with passive protection did not change substantially compared with the prevaccination situation, regardless of DTP3 coverage and start year. We found minimal impact of antenatal vaccination on infection in all infants when mothers were eligible for a single antenatal dose. When mothers were eligible for multiple antenatal doses, incidence in infants aged 0–2 months was reduced by around 30%. This result did not hold for the full 0- to 1-year age group, for whom antenatal vaccination did not reduce infection levels. Conclusions. While antenatal vaccination could potentially reduce infant mortality in LMICs, broader gains at the population level are likely to be achieved by focusing efforts on increasing DTP3 coverage. PMID:27838675

  10. 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.

  11. 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

  12. Antenatal domestic violence, maternal mental health and subsequent child behaviour: a cohort study.

    Science.gov (United States)

    Flach, C; Leese, M; Heron, J; Evans, J; Feder, G; Sharp, D; Howard, L M

    2011-10-01

    To investigate the long-term impact of antenatal domestic violence on maternal psychiatric morbidity and child behaviour. Cohort study. Avon, UK. A birth cohort of 13,617 children and mother dyads were followed to 42 months of age. Experiences of domestic violence and depressive symptoms were gathered at 18 weeks of gestation and up to 33 months after birth, together with maternal, paternal and child characteristics. Child behavioural problems were assessed at 42 months using the Revised Rutter Questionnaire. Logistic regression with the use of multiple imputation employing chained equations for missing data. Antenatal domestic violence was associated with high levels of maternal antenatal (odds ratio [OR], 4.02; 95% confidence interval [CI], 3.4-4.8) and postnatal (OR, 1.29; 95% CI, 1.02-1.63) depressive symptoms after adjustment for potential confounders. Antenatal domestic violence predicted future behavioural problems at 42 months in the child before adjustment for possible confounding and mediating factors (OR, 1.87; 95% CI, 1.45-2.40); this association was not significant after adjustment for high levels of maternal antenatal depressive symptoms, postnatal depressive symptoms or domestic violence since birth. Antenatal domestic violence is associated with high levels of both maternal antenatal and postnatal depressive symptoms. It is also associated with postnatal violence, and both are associated with future behavioural problems in the child at 42 months. This is partly mediated by maternal depressive symptoms in the ante- or postnatal period. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  13. Factors Affecting Husband Participation in Antenatal Care Attendance and Delivery

    Science.gov (United States)

    Rumaseuw, R.; Berliana, S. M.; Nursalam, N.; Efendi, F.; Pradanie, R.; Rachmawati, P. D.; Aurizki, G. E.

    2018-02-01

    The government has implemented several programs to prevent and reduce a mother’s mortality rate by enhancing active role of the family. The most responsible family member on maintaining the pregnancy and delivery process is the husband. The husband must be active to take care of his wife. Active participation of the husband in accompanying his wife during pregnancy and the delivery process is one of the substantial factors, which helps the husband to take decisions related to the health of his wife. This study aimed to identify variables and its trends, which significantly affect a husband’s participation in accompanying his wife during pregnancy and the delivery process. The data used in this study was from an Indonesian Demographic Health Survey 2012. The study used binary logistic regression as the analysis method. The result showed as many as 8,237 husbands accompanied their wife in antenatal care and the delivery process. The significant variables affecting the husband participation are the age of the wife, the education of wife, the education of the husband, the occupational status of the wife and the husband, the number of children, pregnancy status, and residency region. The possibility for a husband to accompany his wife is larger in several factors, such as the wife being between the ages of 21 - 35 years old, a husband who minimally graduated from junior high school, a working husband, as well as a wife, and the number of children less than and equal to two and the expected pregnancy. The government should consider those factors to create policy related women’s health and integrate the factors into various sectors.

  14. Contraception awareness and practice among antenatal attendees in Uyo, Nigeria

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    Augustine Vincent Umoh

    2011-12-01

    Full Text Available INTRODUCTION: Contraception is major component of reproductive health. The study aims to document the awareness of contraception and its use in Uyo, South-south Nigeria and provide useful information for future intervention strategies. METHODS: A cross-sectional study using pretested questionnaires among antenatal attendees in a tertiary and a secondary health facility in Uyo. RESULTS: A total of 550 women took part in the study. Majority of respondents (92.4% were aware of contraception while 52.6% had ever used any form of contraception. The condom (60.3% and the pill (49.9% were the most common forms of contraception that the women had heard of, mostly from the doctor (36.9%, radio (33.8% and nurse (28.5%. The condom (46.7%, withdrawal method (14.1% and the pills (13.3% were the most commonly used forms of contraception. Majority of the women (70.5% planned to use contraception in the future and this intention was significantly related to the woman's educational status (p<0.05 but not to religion or occupation. Fear of side effects, uncertainty about its need, partner objection and previous side effects were the common reasons given for unwillingness to use contraception in the future. CONCLUSION: Our study has shown that while there is good contraceptive awareness in Uyo, Nigeria, this is not matched by commensurate contraceptive prevalence but prospects for improvement exist. There�s need to tackle known obstacles to contraceptive uptake. Also targeted campaigns and every available opportunity should be used to provide reproductive counseling to women especially on contraception.

  15. Parents' experiences and perceptions of group-based antenatal care in four clinics in Sweden.

    Science.gov (United States)

    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

  16. Impact of antenatal glucocorticosteroids on whole-genome expression in preterm babies.

    Science.gov (United States)

    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.

  17. Antenatal diagnosis, prevalence and outcome of major congenital anomalies in Saudi Arabia: A hospital based study

    International Nuclear Information System (INIS)

    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)

  18. Public health facility resource availability and provider adherence to first antenatal guidelines in a low resource setting in Accra, Ghana.

    Science.gov (United States)

    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.

  19. Effectiveness of advertising availability of prenatal ultrasound on uptake of antenatal care in rural Uganda: A cluster randomized trial.

    Science.gov (United States)

    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.

  20. Newborn bloodspot screening for cystic fibrosis: What do antenatal and postnatal women know about cystic fibrosis?

    Science.gov (United States)

    Fitzgerald, C; Linnane, B; Heery, E; Conneally, N; George, S; Fitzpatrick, P

    2016-07-01

    The Republic of Ireland has one of the highest reported incidences of cystic fibrosis (CF) in the world (1/1353) with an estimated carrier rate of 1/20. No cure exists, however there have been significant advances in available treatments. Newborn bloodspot screening (NBS) for CF was added to the NBS programme in Ireland in July 2011. Little is known about antenatal or postnatal women's knowledge about CF. This was a cross-sectional study of 662 antenatal (≥36weeks gestation) and 480 postnatal women (post NBS). Women were asked to self-complete a questionnaire including 14 CF knowledge questions. Among the respondents significantly more postnatal than antenatal women were aware that CF is included on the NBS (81.8% vs 63.5%; pdiagnosis. Copyright © 2015 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

  1. Effect of preterm birth and antenatal corticosteroid treatment on lactogenesis II in women.

    Science.gov (United States)

    Henderson, Jennifer J; Hartmann, Peter E; Newnham, John P; Simmer, Karen

    2008-01-01

    The onset of copious milk secretion after birth is known as lactogenesis II. The objective of this study was to investigate the effect of preterm birth and antenatal corticosteroids on the timing of lactogenesis II after birth. Women who had received antenatal betamethasone treatment and were expressing for a preterm infant whose gestational age was lactogenesis II. The volume of milk was reduced further when antenatal corticosteroids were administered between 28 and 34 weeks' gestation and delivery occurred 3 to 9 days later. In view of the advantages of mothers' own milk, additional support with lactation is recommended for mothers of preterm infants, particularly those who have been treated with corticosteroids before the delivery.

  2. Teenage pregnancy antenatal and perinatal morbidity: results from a tertiary centre in Greece.

    Science.gov (United States)

    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.

  3. The efficacy of antenatal steroid therapy in preterm neonates in Shariati Hospital

    Directory of Open Access Journals (Sweden)

    Jamal A

    1996-07-01

    Full Text Available The newborn who is born before terms is a candidate for the development of idiopathic respiratory distress syndrome. The intense hypoxia and acidosis that ensue as the consequence of inadequate alveolar-capillary exchange of oxygen and carbon dioxid may prove fatal antenatal steroid therapy can affect RDS (Respiratory Distress Syndrom and its complications. The newborn before 34 weeks have a significantly lowered incidence of RDS and neonatal mortality from RDS with antenatal steroid therapy. In a retrospective study we compared 37 preterm infants whose mothers had received corticosteroids to 29 similar but untreated infants. The study showed that antenatal steroid therapy reduced neonatal mortality from RDS more than reducing the incidence of RDS and further it was concluded that this beneficial effect was more significant in female fetus than male fetus, but it was not significant statistically

  4. The influence of antenatal exposure to phthalates on subsequent female reproductive development in adolescence

    DEFF Research Database (Denmark)

    Hart, Roger; Doherty, Dorota A; Frederiksen, Hanne

    2014-01-01

    We hypothesised that antenatal exposure to ubiquitous phthalates may lead to an earlier menarche and a lower prevalence of polycystic ovarian syndrome (PCOS) and polycystic ovarian morphology (PCO) in adolescence. The Western Australian Pregnancy Cohort (Raine) Study recruited 3000 women at 18...... weeks of gestation in 1989-91, 1377 had antenatal serum stored without thawing at -80°C. An unselected subset was evaluated in the early follicular phase for PCO and PCOS by ultrasound and serum evaluation in adolescence. Serum was analysed for Anti-Mullerian Hormone (AMH), inhibin B, sex.......m) was protective against PCOS in adolescence (p=0.001, p=0.005, respectively). There were negative associations of MEP with PCO (p=0.022), and MEP with serum AMH (p=0.031). Consequently our data suggests that antenatal exposure to environmental phthalates may be associated with oestrogenic and/or anti...

  5. Antenatal and postnatal depression in women with obesity: a systematic review.

    Science.gov (United States)

    Steinig, Jana; Nagl, Michaela; Linde, Katja; Zietlow, Grit; Kersting, Anette

    2017-08-01

    Obesity and depression are prevalent complications during pregnancy and associated with severe health risks for the mother and the child. The co-occurrence of both conditions may lead to a particular high-risk group. This review provides a systematic overview of the association between pre-pregnancy obesity and antenatal or postnatal depression. We conducted a systematic electronic literature search for English language articles published between January 1990 and March 2017. Inclusion criteria were (a) adult pregnant women, (b) women with pre-pregnancy obesity and normal weight controls, (c) definition of obesity according to the IOM 1990/2009 criteria, (d) established depression measure, and (e) report on the association between pre-pregnancy obesity and antenatal or postnatal depression. Fourteen (eight prospective (PS), six cross-sectional (CS)) studies were included. One study reported data from a large community-based sample, and one reported cross-national data. Of 13 studies examining pre-pregnancy obesity and antenatal depression, 9 found a higher risk or higher levels of antenatal depression among women with obesity relative to normal weight (6 PS, 3 CS), while 4 studies found no association (2 PS, 2 CS). Of four studies examining pre-pregnancy obesity and postnatal depression, two studies found a positive association (two PS), one study (CS) reported different findings for different obesity classes, and one study found none (PS). The findings suggest that women with obesity are especially vulnerable to antenatal depression. There is a need to develop appropriate screening routines and targeted interventions to mitigate negative health consequences for the mother and the child. Research addressing the association between obesity and postnatal depression is too limited to draw solid conclusions. Results are mainly based on selective samples, and there is a need for further high-quality prospective studies examining the association between pre

  6. Rapid voluntary testing and counseling for HIV. Acceptability and feasibility in Zambian antenatal care clinics.

    Science.gov (United States)

    Bakari, J P; McKenna, S; Myrick, A; Mwinga, K; Bhat, G J; Allen, S

    2000-11-01

    Voluntary testing and counseling (VTC) for HIV/AIDS is now widely accepted as an effective HIV prevention and control strategy among heterosexual couples in sub-Saharan Africa. The most appropriate format and venue for VTC remains a topic of debate among clinicians and public health professionals. Our research done in Lusaka, Zambia, took a tripartite approach to exploring the most acceptable format and venue for VTC: a community survey of attitudes towards VTC, a pre- and postcounseling knowledge survey, and a pilot study of same-day VTC in urban antenatal care clinics. A community survey of 181 individuals was conducted in July-August 1996 based on a structured questionnaire. A pre- and post-VTC intervention knowledge survey was conducted during the same period among 82 couples attending the Zambia-UAB HIV Research Project (ZUHRP) HIV VTC center in Lusaka. Finally, same-day HIV VTC was pilot tested in six antenatal clinic locations during February-May 1997 and June-August 1998. The community survey revealed that 98% of participants support promotion of HIV VTC in the community and 83.8% prefer the same-day testing format. The knowledge survey revealed misconceptions about discordance within a couple and perinatal transmission of HIV. Pilot testing in antenatal clinics was well received, with 84% of pregnant women requesting testing and 25% having positive HIV serologies. Women with primary school or less education, those seeking antenatal care in local clinics, and those seen before the third trimester of pregnancy were more likely to request HIV testing. Testing and counseling for HIV were shown to be feasible and effective in the antenatal clinic setting. Implementation of same-day HIV VTC in antenatal clinics is an effective strategy to prevent vertical transmission and should be expanded to include couples to leverage a decrease in heterosexual transmission as well.

  7. Routine antenatal syphilis screening in South west Nigeria- a questionable practice.

    Science.gov (United States)

    Olubukola, Adesina; Adesina, Oladokun

    2010-06-01

    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 population. In view of this, the aim of this study was to determine the seroprevalence of syphilis in the antenatal population presenting at a major hospital in south-west Nigeria. This was a cross sectional study of healthy pregnant Nigerian women attending Adeoyo Maternity Hospital in the capital of Oyo State. The case record of every pregnant woman presenting for their first antenatal clinic visit over a 4-month period (September 1st to December 31st 2006) was reviewed. During the study period, two thousand six hundred and seventy-eight women sought antenatal care. Three hundred and sixty-nine women (369; 13.4%) had incomplete records and were excluded from analysis. The records of the 2,318(86.6%) women with adequate records were subsequently reviewed. The mean age of the women was 27.4 years (± 5.34) and the mean gestational age 26.4 weeks (±6.36). The modal parity was 0. Only three patients were found to be reactive for syphilis giving a prevalence of 0.13%. The sero- prevalence value in this study is quite low and may justify the call to discontinue routine antenatal syphilis screening. However, a more rigorous screening program using diagnostic tests with higher sensitivity maybe necessary before jettisoning this traditional aspect of antenatal care.

  8. Antenatal glucocorticoid treatment and polymorphisms of the glucocorticoid and mineralocorticoid receptors are associated with IQ and behavior in young adults born very preterm

    NARCIS (Netherlands)

    Voorn, B. van der; Pal, S.M. van der; Rotteveel, J.; Finken, M.J.

    2015-01-01

    Context: Preterm survivors exhibit neurodevelopmental impairments. Whether this association is influenced by antenatal glucocorticoid treatment and glucocorticoid sensitivity is unknown. Objectives: To study the effects of antenatal glucocorticoid treatment and glucocorticoid receptor (GR) and

  9. Satisfaction of antenatal mothers with the care provided by nurse-midwives in an urban secondary care unit

    Directory of Open Access Journals (Sweden)

    Ruby Angeline Pricilla

    2016-01-01

    Full Text Available Background: The satisfaction of antenatal women to antenatal services has rarely been studied in India. In a nation with a maternal mortality ratio of 178/100,000 live births, it is crucial to explore all avenues to reduce it. Aims: Our study aims to assess the pregnant women's satisfaction with regard to antenatal care services provided by nurse-midwives in an urban health center in South India. Methods: We administered a satisfaction of care questionnaire to 200 consecutive antenatal women attending the nurse run antenatal clinics from April 2014 to November 2014. The date entry was done using Epi-Data system and the analysis by SPSS version 16. Statistical Analysis Used: The absolute distribution of each of the question in the satisfaction of care questionnaire was calculated as proportions. The relationship between satisfaction of care and parity, number of visits, years of experience of the care provider and mother's education was tested using Mann–Whitney test for two independent groups. Results: The mean age of the mothers was 23.5 years. More than 95% of the mothers expressed satisfaction with the number of antenatal visits components of antenatal care. Only 31.8% of the mothers were satisfied with the health education on family planning. There was no significant relationship between satisfaction of care and parity of mothers or years of experience of care provider. Conclusions: Pregnant women attending a nurse run antenatal care service have positively expressed satisfaction of care provided therein.

  10. Perspectives of men on antenatal and delivery care service utilisation in rural western Kenya: a qualitative study

    NARCIS (Netherlands)

    Kwambai, Titus K.; Dellicour, Stephanie; Desai, Meghna; Ameh, Charles A.; Person, Bobbie; Achieng, Florence; Mason, Linda; Laserson, Kayla F.; ter Kuile, Feiko O.

    2013-01-01

    Poor utilisation of facility-based antenatal and delivery care services in Kenya hampers reduction of maternal mortality. Studies suggest that the participation of men in antenatal and delivery care is associated with better health care seeking behaviour, yet many reproductive health programs do not

  11. Mobile phones improve antenatal care attendance in Zanzibar: a cluster randomized controlled trial

    DEFF Research Database (Denmark)

    Lund, S.; Nielsen, Birgitte Bruun; Hemed, M

    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...... 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...

  12. Optimal timing of antenatal corticosteroids in women with bleeding placenta previa or low-lying placenta.

    Science.gov (United States)

    Alsayegh, Eman; Barrett, Jon; Melamed, Nir

    2018-01-11

    Administrating a single course of antenatal corticosteroids to women at risk of preterm birth between 24 and 34 weeks of gestation has been shown to decrease neonatal morbidity and mortality. There is evidence that the optimal timing for the administration of antenatal corticosteroids is within 1-7 days before birth as the effect of antenatal corticosteroids has been shown to decline 7 days after administration. Therefore, given that antenatal corticosteroids are the single most effective intervention in cases of preterm birth, efforts should be made to optimize the timing of administration of antenatal corticosteroids. To test the hypothesis that the timing of antenatal corticosteroids in women with vaginal bleeding due to placenta previa or low-lying placenta can be optimized by identifying women at low risk of imminent delivery. This was a retrospective cohort study of all women admitted to a tertiary referral center at 24-34 weeks' gestation with vaginal bleeding due to placenta previa or low-lying placenta between 2003 and 2014. Multivariable logistic regression analysis was used to identify factors that are independently associated with delivery within 14 days from admission. A total of 202 women who met the inclusion criteria were admitted with vaginal bleeding in the presence of placenta previa or low-lying placenta during the study period, of whom 31 (15.3%) and 44 (21.8%) gave birth within 7 and 14 days from admission, respectively. The following factors were independently associated with delivery within 14 days from admission: complete placenta previa (odds (OR) 3.57, 95%CI 1.57-9.03), severe bleeding at presentation (OR 17.14, 95%CI 2.92-100.70), uterine contractions at presentation (OR 6.02, 95%CI 1.91-19.00), and cervical length placenta previa or low-lying placenta, it seems possible to identify a subgroup of women in whom the likelihood of delivery within 14 days is low. This information may allow for selective (rather than routine) administration

  13. A holistic antenatal model based on yoga, Ayurveda, and Vedic guidelines.

    Science.gov (United States)

    Rakhshani, Abbas; Nagarathna, Raghuram; Sharma, Ahalya; Singh, Amit; Nagendra, Hongasandra Ramarao

    2015-01-01

    The prevalence of pregnancy complications are on the rise globally with severe consequences. According to the World Health Organization (WHO, 2009), every minute, at least one woman dies and 20 are affected by the complications related to pregnancy or childbirth. While the root cause of pregnancy complications is unclear, it likely has physical, psychological, social, and spiritual aspects. The Vedas are a rich source of antenatal health care guidelines in all these aspects. The primary objective of the authors was to compile the scriptural and scientific evidence for a holistic antenatal model of yoga with emphasis on sociocultural Indian practices.

  14. Antenatal corticosteroids beyond 34 weeks gestation: What do we do now?

    Science.gov (United States)

    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

  15. Prevalence and Risk Factors of Antenatal Depression among Omani Women in a Primary Care Setting; Cross-sectional study

    Directory of Open Access Journals (Sweden)

    Mohammed Al-Azri

    2016-02-01

    Full Text Available Objectives: This study aimed to identify the prevalence of antenatal depression and the risk factors associated with its development among Omani women. No previous studies on antenatal depression have been conducted in Oman. Methods: This descriptive cross-sectional study was carried out between January and November 2014 in Muscat, Oman. Pregnant Omani women ≥32 gestational weeks who were attending one of 12 local primary care health centres in Muscat for routine antenatal care were invited to participate in the study (n = 986. An Arabic version of the validated self-administered Edinburgh Postnatal Depression Scale questionnaire was used to measure antenatal depression. A cut-off score of ≥13 was considered to indicate probable depression. Results: A total of 959 women participated in the study (response rate: 97.3%. Of these, 233 were found to have antenatal depression (24.3%. A bivariate analysis showed that antenatal depression was associated with unplanned pregnancies (P = 0.010, marital conflict (P = 0.001 and a family history of depression (P = 0.019. The adjusted odds ratio (OR after logistic multivariate regression analysis showed that antenatal depression was significantly associated with unplanned pregnancies (OR: 1.37; 95% confidence interval [CI]: 1.02–1.86 and marital conflict (OR: 13.83; 95% CI: 2.99–63.93. Conclusion: The prevalence of antenatal depression among the studied Omani women was high, particularly in comparison to findings from other Arab countries. Thus, antenatal screening for depression should be considered in routine primary antenatal care. Couples should also be encouraged to seek psychological support should marital conflicts develop during pregnancy.

  16. Socio-economic status influences the relationship between obesity and antenatal depression: Data from a prospective cohort study.

    Science.gov (United States)

    Molyneaux, E; Pasupathy, D; Kenny, L C; McCowan, L M E; North, R A; Dekker, G A; Walker, J J; Baker, P N; Poston, L; Howard, L M

    2016-09-15

    Obesity has been associated with increased risk of antenatal depression, but little is known about this relationship. This study tested whether socio-economic status (SES) influences the relationship between obesity and antenatal depression. Data were taken from the Screening for Pregnancy Endpoints (SCOPE) cohort. BMI was calculated from measured height and weight at 15±1 weeks' gestation. Underweight women were excluded. SES was indicated by self-reported household income (dichotomised around the median: low SES ≤£45,000; high SES >£45,000). Antenatal depression was defined as scoring ≥13 on the Edinburgh Postnatal Depression Scale at both 15±1 and 20±1 weeks' gestation, to identify persistently elevated symptoms of depression. Five thousand five hundred and twenty two women were included in these analyses and 5.5% had persistently elevated antenatal depression symptoms. There was a significant interaction between SES and BMI on the risk of antenatal depression (p=0.042). Among high SES women, obese women had approximately double the odds of antenatal depression than normal weight controls (AOR 2.11, 95%CI 1.16-3.83, p=0.014, adjusted for confounders). Among low SES women there was no association between obesity and antenatal depression. The interaction effect was robust to alternative indicators of SES in sensitivity analyses. 1) Antenatal depression was assessed with a self-reported screening measure; and 2) potential mediators such as stigma and poor body-image could not be examined. Obesity was only associated with increased risk of antenatal depression among high SES women in this sample. Healthcare professionals should be aware that antenatal depression is more common among low SES women, regardless of BMI category. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  17. Timing and factors associated with first antenatal care booking among pregnant mothers in Gondar Town; North West Ethiopia.

    Science.gov (United States)

    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.

  18. Does female education explain the disparity in the use of antenatal ...

    African Journals Online (AJOL)

    Background: Nigeria is among the countries with a high number of annual maternal deaths partly due to low utilization of maternal health services (MHS). Objective: This study aimed to explore whether there is an association between women's level of education and the appropriate use of antenatal and delivery services.

  19. 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 ...

  20. 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, ...

  1. Barriers to antenatal care in an urban community in the Gambia: an ...

    African Journals Online (AJOL)

    This qualitative study investigated the barriers to obtaining access to antenatal care in a small, urban government-supported health centre in the Gambia. It thus addresses an important issue related to maternal health and the prevention of maternal deaths. In-depth interviews were conducted with 25 pregnant women, ...

  2. Stigma and Attitudes towards Antenatal Depression and Antidepressant Use during Pregnancy in Healthcare Students

    Science.gov (United States)

    Gawley, Laura; Einarson, Adrienne; Bowen, Angela

    2011-01-01

    Depression in pregnancy or antenatal depression (AD) occurs in approximately one in five women, with potentially deleterious effects to the mother and fetus. People are encouraged to get treatment for depression; however, pregnant women can experience stigma when they reach out for help with depression. Research indicates that healthcare…

  3. The effect of mother's age, parity and antenatal clinic attendance on ...

    African Journals Online (AJOL)

    Dr. Gil Cusack. Lecturer. Bunda College of Agriculture. P.O. Box 219. Lilongwe. Maternity unit of Mitundu Rural Hospital were analyzed to assess the effect of mother's age, parity and attendance at ante-natal clinics on birth weight. In' order to find more detailed information on factors affecting birth weight, another 40 mothers.

  4. Antenatal depression in coastal South India: Prevalence and risk factors in the community.

    Science.gov (United States)

    George, Christina; Lalitha, Anoop R N; Antony, Abish; Kumar, Arun V; Jacob, K S

    2016-03-01

    Antenatal depression is a highly prevalent disorder with serious implications on maternal and child outcomes. There are few studies examining this in low-middle-income community settings. To determine the prevalence of antenatal depression in women from a coastal rural background in Kerala and Tamil Nadu and to determine its associated factors. In this cross-sectional community-based study, in 202 antenatal women, standard interview and diagnostic criteria (Clinical Interview Schedule-Revised (CIS-R)) were employed for identifying depression and examining a wide range of putative clinical and sociocultural risk factors including domestic violence. There was a 16.3% prevalence of depression among the 202 women sampled. The possible risk factors after stepwise backward regression were pressure to have a male child, 11.48 (2.36-55.78); financial difficulties, 8.23 (2.49-27.22); non-arranged marriage, 6.05 (1.72-21.23); history of miscarriage-still birth, 5.77 (1.55-21.43) and marital conflict, 9.55 (2.34-38.98). There is a need to develop strategies for recognition and appropriate intervention for antenatal depression, in the context of locally relevant risk factors, so as to improve both maternal and child outcomes. © The Author(s) 2015.

  5. The patient-provider relationship and antenatal care uptake at two ...

    African Journals Online (AJOL)

    While sub-Saharan. Africa has adopted the WHO model, the continued promotion of antenatal care attendance and utilization has been difficult. Although some countries have reported high. (> 90%) ANC attendance rates, these numbers may be misleading; attendance is often reported as at least one visit during pregnancy ...

  6. A review of antenatal corticosteroid use in premature neonates in a ...

    African Journals Online (AJOL)

    Background. Antenatal corticosteroid (ANS) use in premature neonates has become a standard of practice. However, there is low ANS coverage in low- to middle-income countries (LMICs). Recent studies have questioned the efficacy of ANSs in such countries. Objective. To review the use of ANSs in preterm neonates at ...

  7. Factors Affecting Antenatal Care Attendance: Results from Qualitative Studies in Ghana, Kenya and Malawi

    NARCIS (Netherlands)

    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

  8. An instrument for broadened risk assessment in antenatal health care including non-medical issues.

    NARCIS (Netherlands)

    A.A. Vos (Amber); M.J. van Veen (Mieke); E. Birnie (Erwin); S. Denktaş (Semiha); E.A.P. Steegers (Eric); G.J. Bonsel (Gouke)

    2015-01-01

    markdownabstractGrowing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed

  9. 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 ...

  10. Psychological development of children who were treated antenatally with corticosteroids to prevent respiratory distress syndrome

    NARCIS (Netherlands)

    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

  11. PREVALENCE OF Rh NEGATIVE PREGNANCY IN ANTENATAL WOMEN WITH EVALUATION OF MATERNAL AND FOETAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Gorle Rama Devi

    2016-12-01

    Full Text Available BACKGROUND Haemolytic disease of the newborn secondary to Rhesus-D isoimmunisation contributes significantly to perinatal morbidity and mortality. There is a need for adequate counseling of pregnant women regarding the importance of detection of blood grouping and Rh typing during the antenatal period in order to prevent haemolytic disease of the newborn. The aim of this study is to estimate the prevalence of Rhesus-negative pregnancy in the antenatal women and evaluate the maternal and foetal outcome during the period of September 2014 to August 2015. MATERIALS AND METHODS All Rh-negative pregnant women who attended the Antenatal Clinic in Government Victoria Hospital were followed up till delivery and also postnatally regarding the maternal and foetal outcome. All the data was collected and results were analysed. RESULTS The prevalence of Rh-negative pregnancies in Government Victoria Hospital/Andhra Medical College, Visakhapatnam, was 4.268% out of 376 antenatal Rh-negative cases, 8 cases developed preeclampsia, 5 cases developed foetal growth restriction with severe oligoamnios, 2 cases associated with gestational diabetes mellitus and caesarean section was done in 120 cases. Regarding neonatal outcome, 366 were live born babies, 5 were early neonatal deaths and 5 were intrauterine deaths. CONCLUSION In our study, the prevalence of Rh-negative pregnancy is 4.268%. Despite the low prevalence of Rh-negative pregnancy, Rhisoimmunisation remains a determining factor responsible for perinatal morbidity.

  12. Risk Factors for RhD Immunisation Despite Antenatal and Postnatal Anti-D Prophylaxis COMMENT

    NARCIS (Netherlands)

    Koelewijn, J. M.; de Haas, M.; Vrijkotte, T. G. M.; van der Schoot, C. E.; Bonsel, G. J.

    2010-01-01

    Despite routine antenatal and postnatal administration of anti-D immunoglobulin (Ig) during pregnancy and delivery in a previous pregnancy, 0.1% to 0.3% of women are found to have Rhesus D (RhD) antibodies in their next pregnancy. The primary aim of this case-control study was to identify causative

  13. Risk factors for RhD immunisation despite antenatal and postnatal anti-D prophylaxis

    NARCIS (Netherlands)

    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

  14. Socio-economic and Demographic Determinants of Antenatal Care Services Utilization in Central Nepal

    Directory of Open Access Journals (Sweden)

    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.

  15. MR imaging in cases of antenatal suspected appendicitis--a meta-analysis.

    Science.gov (United States)

    Blumenfeld, Yair J; Wong, Amy E; Jafari, Anahita; Barth, Richard A; El-Sayed, Yasser Y

    2011-03-01

    Appendicitis is the most common surgical emergency in pregnancy. Acute appendicitis is often difficult to diagnose clinically, and concerns regarding antenatal CT imaging limit its use resulting in high false negative rates at laparotomy. MRI has recently been reported as a reasonable alternative to CT imaging in cases of suspected appendicitis. Our objective was to perform a meta-analysis of recently published data regarding the utility of MR imaging in cases of antenatal suspected acute appendicitis. We searched the PubMed database using keywords 'MRI', 'appendicitis', and 'pregnancy'. Five case series describing the role of MRI in cases of antenatal appendicitis were included. The sensitivity, specificity, positive, and negative predictive values were calculated. Two hundred twenty-nine patients were included in the study. In the first analysis in which non-diagnostic scans were excluded, the sensitivity, specificity, positive and negative predictive values of MRI for diagnosing appendicitis were 95.0%, 99.9%, 90.4%, and 99.5%, respectively. In the second analysis, which included non-diagnostic scans, the sensitivity, specificity, positive and negative predictive values were 90.5%, 98.6%, 86.3%, and 99.0%, respectively MR imaging may be useful in cases of suspected antenatal appendicitis. Data are still limited and larger prospective studies are necessary to confirm this finding.

  16. Child malnutrition and antenatal care: Evidence from three Latin American countries

    NARCIS (Netherlands)

    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

  17. Oral health status of pregnant women attending the ante-natal clinic ...

    African Journals Online (AJOL)

    Oral health status of pregnant women attending the ante-natal clinic of University of Port Harcourt Teaching Hospital. ... Higher proportion of patients with secondary and tertiary education had high DMFT scores which increased with gestational age of the patients. These were not statistically significant (p values = 0.946 and ...

  18. Pattern of utilization of ante-natal and delivery services in a semi ...

    African Journals Online (AJOL)

    Data was analysed using Epi-info version 3.5.1 software package. Level of statistical significance was set at p <0.05. Results: There was a high level of utilization of antenatal/delivery services in the community. Barriers to utilization of ANC/ delivery services include lack of money, distance from health facility, long waiting ...

  19. Antenatal corticosteroids administration: are we giving them at the right time?

    Science.gov (United States)

    Wong, Tiffany Tuck Chin; Tung, Janice Su Zhen; Lau, Hester Chang Qi; Tagore, Shephali

    2018-02-01

    Antenatal corticosteroids before preterm births are considered to be most effective 48 h after and up to 1 week after the first dose. We aim to evaluate: (1) our practice of administration of antenatal corticosteroids in Singapore; (2) admission characteristics of women for discriminatory factors of spontaneous preterm delivery within 1 week. This is a retrospective study in a tertiary obstetrics unit in Singapore. 3044 women who delivered live births (at term or preterm) from 1st November 2014 to 31st January 2015, who were at risk of spontaneous or induced preterm delivery, were included. Data related to the time of and indications for antenatal corticosteroids administration, characteristics assessed at the time of presentation, and time of delivery were collected and analysed. 85.9% of women who delivered at gestational age ≤ 34 +6 received at least one dose. 22.1% had delivered within the window of efficacy. Gestational age > 32 weeks at presentation, uterine activity on tocography and cervical dilation with effacement were associated with preterm delivery within 1 week of presentation. Overall, our antenatal corticosteroids administration rate is comparable to that attained by centres in other developed countries. It is difficult but important to discriminate women who will benefit from this timely intervention.

  20. Lithium exposure during pregnancy: outcomes for women who attended a specialist antenatal clinic.

    Science.gov (United States)

    Frayne, Jacqueline; Nguyen, Thinh; Mok, Tabitha; Hauck, Yvonne; Liira, Helena

    2017-06-15

    Lithium treatment in pregnancy represents a significant dilemma for women and treating health professionals alike. The complexity of risk-benefit analysis is impacted by limited information. A cohort study of 33 women with severe mental illness, who were prescribed lithium at any time during the pregnancy, and gave birth between December 2007 and January 2015 at a specialist antenatal clinic in Western Australia. A descriptive comparison for women who continued lithium throughout pregnancy, and those who ceased on discovery of pregnancy was undertaken examining demographic, obstetric, neonatal and psychiatric variables. Women who were prescribed lithium, irrespective of whether they continued or discontinued the medication represented a high risk group obstetrically, with high rates of smoking overall (33%) medical comorbidities (54%) and antenatal complications (88%). Preconception counseling occurred in 33% of the cohort but increased the likelihood of continuing lithium in pregnancy (p = .007). Compared to those who ceased lithium, women who remained on lithium through the pregnancy had increased rates of fetal ultrasound abnormalities such as abdominal circumference >90th % (p = .005). Psychiatric relapses through the antenatal and immediate postpartum period appeared to be due to a combination of factors. Pregnant women with severe mood disorders treated with lithium are a vulnerable, high-risk obstetric population who would benefit from preconception counseling, regular antenatal care in a tertiary center, delivery with neonatal pediatric support and experienced psychiatric management.

  1. Heteronormative communication with lesbian families in antenatal care, childbirth and postnatal care.

    Science.gov (United States)

    Röndahl, Gerd; Bruhner, Elisabeth; Lindhe, Jenny

    2009-11-01

    Heteronormative communication with lesbian families in antenatal care, childbirth and postnatal care. This paper is a report of a study of lesbian parents' experience of antenatal care, childbirth and postnatal care. In a strictly heteronormative-based care system, 'parents' naturally implies a man and a woman, and all communication and routines are based on heterosexual couples. A qualitative interview study was carried out in 2008. Ten mothers, eight of whom were in a relationship with another woman, participated. The participants had experience from several care facilities from three different cities in central Sweden. Most participants had positive experiences but also complained that the focus was not always on the pregnancy and that no parenthood education had been offered. Heteronormativity was communicated by midwives and nursing staff throughout the process - from antenatal care to postnatal care, via forms, journals, verbal communication and orientation visits. This was experienced as embarrassing for the participant parents, and they also described encountering what they interpreted as embarrassment on the part of care providers. Participants called for increased knowledge about lesbian parenting, since they believed this would influence and facilitate communication, not least with midwives in antenatal care. Midwives educated in lesbian issues could ask questions and communicate in a more neutral way at the first meeting, and thereby make prospective parents feel less insecure. Special parenthood education groups for lesbians are recommended so that lesbian couple can meet others with similar experiences and so that the focus will be on prospective parenthood and not on their sexual orientation.

  2. 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.

  3. Empowerment and use of antenatal care among women in Ghana: a cross-sectional study.

    Science.gov (United States)

    Sipsma, Heather; Ofori-Atta, Angela; Canavan, Maureen; Udry, Christopher; Bradley, Elizabeth

    2014-11-01

    Empowerment among women in the context of a romantic relationship may affect the use of reproductive healthcare services; however, current literature examining this association is limited and inconsistent. We therefore aimed to examine the relationship between several measures of empowerment and use of inadequate antenatal care among women in Ghana. We conducted a cross-sectional study using data from a nationally representative cohort of women in Ghana. Our analytic sample was limited to non-pregnant women who had been pregnant and involved in a relationship within the last 12 months. We used multivariable logistic regression to assess the associations between empowerment and inadequate use of antenatal care and interaction terms to assess moderation by education. Approximately 26% of women received inadequate antenatal care. Multivariable analysis indicated that having experienced physical abuse in the past year was directly associated with inadequate use of antenatal care (OR = 5.12; 95% CI = 1.35, 19.43) after adjusting for socio-demographic characteristics. This effect was particularly pronounced among women with no formal education and was non-significant among women with at least some formal education (P-value for interaction empowerment among women in Ghana and other low-income countries, particularly among those with no formal education. Furthermore, the involvement of male partners will be critical for improving reproductive health outcomes, and increasing education among girls in these settings is likely a strong approach for improving reproductive health and buffering effects of low empowerment among women.

  4. Antenatal depression and antidepressants during pregnancy : Unraveling the complex interactions for the offspring

    NARCIS (Netherlands)

    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

  5. Late start of antenatal care among ethnic minorities in a large cohort of pregnant women

    NARCIS (Netherlands)

    Alderliesten, M. E.; Vrijkotte, T. G. M.; van der Wal, M. F.; Bonsel, G. J.

    2007-01-01

    OBJECTIVES: The objectives of this study were to investigate the difference in timing of the first antenatal visit between ethnic groups and to explore the contribution of several noneconomic risk factors. DESIGN: Prospective cohort study. SETTING: All independent midwifery practices in the city of

  6. 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 ...

  7. Gestational age at initiation of antenatal care in a tertiary hospital ...

    African Journals Online (AJOL)

    2016-01-02

    Jan 2, 2016 ... Aim: This study seeks to determine the time of initiation of antenatal care among pregnant women and possible factors influencing ... of safe motherhood, and it refers to the totality of health ... Department of Obstetrics and Gynaecology, Ekiti State University, Departments of 1Medical Social Services and.

  8. The prevalence of glucose inTolerance among anTenaTal clienTs ...

    African Journals Online (AJOL)

    2011-09-09

    Sep 9, 2011 ... Exclusion criteria: Clients who had pre-gestational diabetes mellitus, those already diagnosed with glucose intolerance in the current pregnancy or in previous pregnancy, clients who did not consent and clients on medications for chronic treatment. Sampling frame: This consisted of antenatal mothers.

  9. On-site screening for maternal syphilis in an antenatal clinic ...

    African Journals Online (AJOL)

    An RPR test was performed on site in the antenatal clinic and by the reference laboratory where a Treponema pallidum haemagglutination test was also performed. Measurements and results. The results of the RPR test were compared with results reported by the laboratory for sensitivity, specificity, negative and positive ...

  10. Quality of Antenatal Services at the Primary Care Level in Southwest ...

    African Journals Online (AJOL)

    A survey of 452 pregnant women accessing care at first level public health facilities in a local government area in southwest Nigeria was conducted to assess their perspectives on the quality of antenatal care received. Majority of the women expressed satisfaction with the level of expertise and basic technical competence of ...

  11. Pattern of utilization of ante-natal and delivery services in a semi ...

    African Journals Online (AJOL)

    Pattern of utilization of ante-natal and delivery services in a semi-urban community of. North-Central Nigeria. Jimoh Maryam Abimbola1, Akande Tanimola Makanjuola1, Salaudeen Adekunle Ganiyu1,. Uthman Mohammed Mubashir Babatunde1, Durowade Kabir Adekunle2, Aremu Ayodele Olatayo3. 1. Department of ...

  12. Mandatory HIV testing and uptake of ante-natal services in a primary ...

    African Journals Online (AJOL)

    But several health institutions in Nigeria insist on an HIV test before certain services are given. Fears have been expressed that such mandatory HIV testing might lead to poorer uptake of associated services. Aim: To assess the impact of mandatory HIV testing on the uptake of ante-natal services in a primary health centre ...

  13. Using the Cascade Model to Improve Antenatal Screening for the Hemoglobin Disorders

    Science.gov (United States)

    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…

  14. Audit of Antenatal Care at a Rural District of KZN, South Africa ...

    African Journals Online (AJOL)

    We conducted this audit to evaluate the quality of antenatal care/services provided against the set national standards at the first (booking) visit, and visits at 28 and 36 weeks of gestation, as part of a quality improvement initiative.Methods: A retrospective cross-sectional descriptive study was undertaken, targeting women ...

  15. Current evidence on antenatal care provision for women with intellectual disabilities: A systematic review.

    Science.gov (United States)

    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

  16. Entre armas leves e a regulamentação internacional: para que lado o Brasil dirige uma política pública?

    OpenAIRE

    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...

  17. Avaliação do desempenho estrutural em serviço de lajes treliçadas pré-moldadas de concretos com agregados leves

    OpenAIRE

    Oliveira,Anderson de; Garcia,Sergio Luis González; Cordeiro,Guilherme Chagas

    2011-01-01

    O concreto com agregado leve tem sido cada vez mais empregado em razão da reduzida massa específica, do elevado isolamento térmico e acústico e da melhoria na resistência estrutural a carregamentos cíclicos. Neste trabalho foram estudados concretos com agregados leves com resistência à compressão em torno de 20 MPa e seu desempenho estrutural em lajes treliçadas pré-moldadas. Utilizaram-se três diferentes concretos com valores de massa específica entre 1.200 e 1.600 kg/m³. Os concretos foram ...

  18. Programas psicosociales de intervención cognitiva en población con signos de deterioro cognitivo leve (DCL: Revisión de efectos y eficacia

    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.

  19. As categorias aspectuais e a formação de construções com o Verbo leve dar

    Directory of Open Access Journals (Sweden)

    Ana Paula Scher

    2005-11-01

    Full Text Available Este trabalho revela que, embora bastante produtiva, a ocorrência de sentenças com a forma "dar uma Xada em Y", no português do Brasil, depende de algumas restrições semânticas bastante sistemáticas. Através da observação de um conjunto de dados baseados na intuição de vários falantes do português brasileiro, descreve-se, em termos dos traços temporais que compõem as categorias aspectuais, a interpretação semântica que se pode atribuir a sentenças como essas, em que uma nominalização em -ada ocorre associada ao verbo leve dar. Ao final, sugere-se que a formação de tais sentenças depende da presença ou não de alguns dos traços temporais intrínsecos às eventualidades denotadas pelos predicados dos quais derivam.

  20. As categorias aspectuais e a formação de construções com o Verbo leve dar

    Directory of Open Access Journals (Sweden)

    Ana Paula Scher

    2013-11-01

    Full Text Available Este trabalho revela que, embora bastante produtiva, a ocorrência de sentenças com a forma "dar uma Xada em Y", no português do Brasil, depende de algumas restrições semânticas bastante sistemáticas. Através da observação de um conjunto de dados baseados na intuição de vários falantes do português brasileiro, descreve-se, em termos dos traços temporais que compõem as categorias aspectuais, a interpretação semântica que se pode atribuir a sentenças como essas, em que uma nominalização em -ada ocorre associada ao verbo leve dar. Ao final, sugere-se que a formação de tais sentenças depende da presença ou não de alguns dos traços temporais intrínsecos às eventualidades denotadas pelos predicados dos quais derivam.

  1. CAMBIOS EN LA EXPRESIÓN DE LOS MARCADORES DE DISFUNCIÓN ENDOTELIAL PAL-1/PAI-2 EN PREECLAMPSIA LEVE Y SEVERA, Y EN GESTANTES NORMOTENSAS SANAS

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    Rodrigo Valenzuela Grau

    2012-01-01

    Full Text Available Objetivo: Determinar las concentraciones del Inhibidor del Activador del Plasminógeno tipo 1 y 2(PAI 1 y 2 y del factor de crecimiento placentario (PIGF como marcadores de disfunción endotelial y angiogénesis en preeclampsia(PE leve y severa, respectivamente. Métodos: Estudio de casos y controles realizado en el Hospital Clínico de la Universidad de Chile durante junio del 2009 y diciembre del 2010. La población estuvo conformada por embarazadas adscritas durante el periodo de estudio y fue dividida en tres grupos: controles (n= 18, PE leve (n=9, PE severa (n=23. Se determinaron las concentraciones de PIGF y PAI-1/PAI-2 mediante técnicas de inmunoensayo a partir de las muestras obtenidas de cada paciente. Para el análisis estadístico se utilizó test de ANOVA-Bonferroni. Se consideró significativo un p < 0.05. Resultados: Se observó niveles menores de PlGF y mayores de PAI-1/PAI-2 en PE en comparación con los controles. Mujeres con PE severa mostraron niveles más altos de relación PAI-1/PAI-2 que mujeres con PE leve (p < 0.05. No hubo diferencia significativa para PlGF entre PE leve y severa. Conclusiones: La gravedad de la preeclampsia podría reflejarse en alteraciones de los biomarcadores de disfunción endotelial y angiogénesis. La medición de PlGF y relación PAI-1/PAI-2 en embarazos tempranos podría tener un valor pronóstico en el desarrollo de PE.

  2. Evaluación de la conducta vocacional de estudiantes con discapacidad intelectual leve en etapa de transición escuela-empleo

    OpenAIRE

    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...

  3. Vitamin D nutritional status and antenatal depressive symptoms in African American women.

    Science.gov (United States)

    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-OHDclinical 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.

  4. 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.

  5. Can antenatal classes reduce the rate of cesarean section in southern Italy?

    Science.gov (United States)

    Cantone, Daniela; Pelullo, Concetta Paola; Cancellieri, Mariagrazia; Attena, Francesco

    2017-04-01

    Among European Countries, Italy has the highest rate of cesarean section (36.8%), and in the Campania region this rate reaches 60.0%. We conducted a retrospective cohort study to evaluate whether participation in antenatal classes during pregnancy reduces the rate of cesarean delivery in southern Italy. We selected three local health authorities, with the lowest, the highest, and an intermediate rate of cesarean delivery. The study included 1893 mothers who brought their children for vaccination and were interviewed about their participation in antenatal classes and their obstetric history. The main causes of cesarean section given in the interview were clinical indications (61.0%), previous cesarean section (31.0%) and woman's request (8.0%). When we excluded emergency cesarean delivery, we found a moderate association between participation in antenatal classes and cesarean section reduction (relative risk=1.27; 95% CI=1.08-1.49; in percentage values from 49.3% to 38.8%). Private hospitals and the two local health authorities with higher baseline rates of cesarean section showed an enhanced reduction of these rates. Our paper shows moderate efficacy of antenatal classes, which reduced the occurrence of cesarean section by about 10%. However, the cesarean section rate remained high. As it is possible that different classes have a different level of efficacy, a further study on a standardized model of an antenatal classes is in progress, to assess its efficacy in term of cesarean section reduction, with the purpose of its widespread implementation to the whole region. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  6. Is routine antenatal venereal disease research laboratory test still justified? Nigerian experience.

    Science.gov (United States)

    Nwosu, Betrand O; Eleje, George U; Obi-Nwosu, Amaka L; Ahiarakwem, Ita F; Akujobi, Comfort N; Egwuatu, Chukwudi C; Onyiuke, Chukwudumebi O C

    2015-01-01

    To determine the seroreactivity of pregnant women to syphilis in order to justify the need for routine antenatal syphilis screening. 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. 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). 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 parity. Because syphilis is still a serious but preventable and curable disease, screening with VDRL alone, without confirmatory tests may not be justified. Because of the increase in the demand for evidence-based medicine and litigation encountered in medical practice, we may advocate that confirmatory test for syphilis is introduced in routine antenatal testing to reduce the problem of false positives. The government should increase the health budget that will include free routine antenatal testing including the T. pallidum hemagglutination assay.

  7. Solución de controversias inversor-Estado en los nuevos tratados de integración regional: el caso del Acuerdo de Asociación Transpacífico

    Directory of Open Access Journals (Sweden)

    Magdalena Bas Vilizzio

    2016-08-01

    Full Text Available En la actualidad el Derecho de la integración comprende la regulación de áreas que dos décadas atrás conformaban sistemas regulados en paralelo, en particular el comercio intrazona y la protección y promoción de inversiones, entre otros temas. Asimismo, el concepto de región se ha flexibilizado, englobando situaciones diversas como las de región ampliada o tratados mega regionales. En este marco, el presente artículo tiene como objetivo el análisis del Acuerdo de Asociación Transpacífico, en vistas que tres Estados Latinoamericanos son partes signatarias: Chile, México y Perú. Se opta por el estudio particular de la Sección B del Capítulo 9 relativo a la solución de controversias inversor-Estado, como tema típico de los tratados de integración de última generación. Se parte de un análisis crítico de los principales aspectos procesales del arbitraje ad hoc en los foros externos a los cuales remite, así como las excepciones más importantes, por ejemplo las medidas de control del tabaco, una innovación en los acuerdos económicos. El trabajo cierra con las reflexiones finales, entre las cuales se destaca que si bien el Acuerdo TPP presenta innovaciones que implican avances en la reforma del sistema, en gran medida replica disposiciones de otros tratados comerciales y/o de inversiones dejando sin resolver gran parte de los problemas existentes.

  8. Los (defectos del texto: controversias en torno a las prácticas rituales de los musulmanes europeos The faults of the text: debates about the ritual practices of european muslims

    Directory of Open Access Journals (Sweden)

    Alberto López Bargados

    2010-06-01

    Full Text Available Tras revisar la aplicación de las diversas teorías del ritual elaboradas por la antropología a contextos islámicos, y más específicamente los análisis efectuados sobre la práctica del sacrificio durante la festividad del Ayd al-adha, el artículo analiza las dificultades que encuentran las diversas comunidades musulmanas afincadas en Europa para llevar a cabo dicho sacrificio y las eventuales transformaciones a las que se ve sometida la práctica ritual. Asimismo, el artículo convierte las controversias que envuelven la práctica sacrificial islámica en Europa en un ejemplo ilustrativo de un problema general, a saber, el que se genera en torno al lugar que las prácticas religiosas deben ocupar en el espacio público europeo.After revising the application of the different theories of the ritual offered by anthropology in Muslim contexts, and more specifically, the analysis of the practice of the sacrifice during the Ayd al-adha feast, the article seeks out the problems that diverse Muslim communities settled in Europe encounter in order for the sacrifice to take place and the eventual changes that subdue the ritual practice. At the same time, the article considers the controversy surrounding the Muslim practice of sacrifice in Europe as an example of a general problem about the place that the religious practices should occupy in the European public sphere.

  9. Antenatal Training with Music and Maternal Talk Concurrently May Reduce Autistic-Like Behaviors at around 3 Years of Age

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    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.

  10. Avaliação do desempenho estrutural em serviço de lajes treliçadas pré-moldadas de concretos com agregados leves

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    Anderson de Oliveira

    Full Text Available O concreto com agregado leve tem sido cada vez mais empregado em razão da reduzida massa específica, do elevado isolamento térmico e acústico e da melhoria na resistência estrutural a carregamentos cíclicos. Neste trabalho foram estudados concretos com agregados leves com resistência à compressão em torno de 20 MPa e seu desempenho estrutural em lajes treliçadas pré-moldadas. Utilizaram-se três diferentes concretos com valores de massa específica entre 1.200 e 1.600 kg/m³. Os concretos foram avaliados com relação à resistência à compressão (aos 3, 7 e 28 dias e à absorção total de água (aos 28 dias. Com os três tipos de concreto foram produzidas e ensaiadas à flexão lajes pré-moldadas (duas lajes para cada tipo de concreto, com a avaliação de seu comportamento no estado limite de serviço (ELS para cargas de curta duração, ou seja, sem considerar efeitos ao longo do tempo. Os resultados mostraram o potencial do uso de concretos com agregados leves nesse tipo de laje estrutural.

  11. Efeito do metacaulim nas propriedades do concreto leve estrutural - DOI: 10.4025/actascitechnol.v29i1.87

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    João Adriano Rossignolo

    2007-12-01

    Full Text Available Este trabalho apresenta os resultados da avaliação das modificações promovidas pelo Metacaulim no desempenho das propriedades do concreto com agregados leves. Foi analisado o efeito do Metacaulim na resistência à compressão, na resistência à tração por compressão diametral, no módulo de deformação, na absorção de água por imersão e na carbonatação do concreto com agregados leves. Nos resultados obtidos verificou-se que a adição de Metacaulim melhorou significativamente o desempenho da resistência à compressão, da resistência à tração por compressão diametral e da absorção de água por imersão e da carbonatação dos concretos leves.

  12. First record of resting cysts of the benthic dinoflagellate Prorocentrum leve in a natural reservoir in Gujan-Mestras, Gironde, France.

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    Mertens, Kenneth Neil; Gu, Haifeng; Pospelova, Vera; Chomérat, Nicolas; Nézan, Elisabeth; Gurdebeke, Pieter Roger; Bogus, Kara; Vrielinck, Henk; Rumebe, Myriam; Meteigner, Claire

    2017-12-01

    The resting cysts of the benthic dinoflagellate Prorocentrum leve from a natural reservoir in Gujan-Mestras (Gironde, France) were described in this study. The incubated urn-shaped cysts gave rise to cells of P. leve. Morphological observations through light microscopy and scanning electron microscopy, particularly of the periflagellar platelets, combined with large subunit ribosomal DNA sequences obtained through single-cell analysis confirm their affinity to the species P. leve. The cysts were characterized by a specific shape and the presence of an anterior plug. This is the first conclusive evidence for fossilizable resting stages within the Prorocentrales, one of the major orders within the Dinophyceae. Palynological treatments show that the cysts and endospores withstand hydrochloric and hydrofluoric acids. Micro-Fourier transform infrared analysis on single specimens suggests that the composition of the endospore is cellulosic and the cyst wall a more robust, noncellulosic β-glucan. The spectra overall are similar to other published spectra of resting cysts from autotrophic, planktonic dinoflagellates. © 2017 Phycological Society of America.

  13. A Case Study of Preliminary Cost-Benefit Analysis of Building Levees to Mitigate the Joint Effects of Sea Level Rise and Storm Surge

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    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.

  14. Antenatal counselling for congenital anomaly tests: an exploratory video-observational study about client-midwife communication.

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    Martin, Linda; Hutton, Eileen K; Gitsels-van der Wal, Janneke T; Spelten, Evelien R; Kuiper, Fleur; Pereboom, Monique T R; van Dulmen, Sandra

    2015-01-01

    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. However, little is known about how these functions are fulfilled in daily practice. This study aims to describe the relative expression of the antenatal counselling functions; to describe the ratio of client versus midwife conversational contribution and to get insight into clients' characteristics, which are associated with midwives' expressions of the functions of antenatal counselling. exploratory video-observational study. 269 videotaped antenatal counselling sessions for congenital anomaly tests provided by 20 midwives within six Dutch practices. we used an adapted version of the Roter Interaction Analysis System to code the client-midwife communication. Multilevel linear regression analyses were used to analyse associations between clients' characteristics and midwives' expressions of antenatal counselling in practice. most utterances made during counselling were coded as HE (41%); a quarter as DMS (23%) and 36% as CMR. Midwives contributed the most to the HE compared to clients or their partners (91% versus 9%) and less to the DMS function of counselling (61% versus 39%). Multilevel analyses showed an independent association between parity and shorter duration of antenatal counselling; (β=-3.01; pcounselling of multipara was less compared to nulliparous. antenatal counselling for congenital anomaly tests by midwives is focused on giving HE compared to DMS. The relatively low contribution of clients during DMS might indicate poor DMS given by midwives. Counselling of multipara was significantly shorter than counselling of nulliparous; multiparae received less HE as well as DMS compared to nulliparous women. our findings should encourage midwives to reflect on the process of

  15. Prevention of pulmonary hypoplasia and pulmonary vascular remodeling by antenatal simvastatin treatment in nitrofen-induced congenital diaphragmatic hernia

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    Makanga, Martine; Maruyama, Hidekazu; Dewachter, Celine; Da Costa, Agnès Mendes; Hupkens, Emeline; de Medina, Geoffrey; Naeije, Robert

    2015-01-01

    Congenital diaphragmatic hernia (CDH) has a high mortality rate mainly due to lung hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). Simvastatin has been shown to prevent the development of pulmonary hypertension (PH) in experimental models of PH. We, therefore, hypothesized that antenatal simvastatin would attenuate PPHN in nitrofen-induced CDH in rats. The efficacy of antenatal simvastatin was compared with antenatal sildenafil, which has already been shown to improve pathological features of PPHN in nitrofen-induced CDH. On embryonic day (E) 9.5, nitrofen or vehicle was administered to pregnant Sprague-Dawley rats. On E11, nitrofen-treated rats were randomly assigned to antenatal simvastatin (20 mg·kg−1·day−1 orally), antenatal sildenafil (100 mg·kg−1·day−1 orally), or placebo administration from E11 to E21. On E21, fetuses were delivered by cesarean section, killed, and checked for left-sided CDH. Lung tissue was then harvested for further pathobiological evaluation. In nitrofen-induced CDH, simvastatin failed to reduce the incidence of nitrofen-induced CDH in the offspring and to increase the body weight, but improved the lung-to-body weight ratio and lung parenchyma structure. Antenatal simvastatin restored the pulmonary vessel density and external diameter, and reduced the pulmonary arteriolar remodeling compared with nitrofen-induced CDH. This was associated with decreased lung expression of endothelin precursor, endothelin type A and B receptors, endothelial and inducible nitric oxide synthase, together with restored lung activation of apoptotic processes mainly in the epithelium. Antenatal simvastatin presented similar effects as antenatal therapy with sildenafil on nitrofen-induced CDH. Antenatal simvastatin improves pathological features of lung hypoplasia and PPHN in experimental nitrofen-induced CDH. PMID:25617377

  16. Perspectives of men on antenatal and delivery care service utilisation in rural western Kenya: a qualitative study.

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    Kwambai, Titus K; Dellicour, Stephanie; Desai, Meghna; Ameh, Charles A; Person, Bobbie; Achieng, Florence; Mason, Linda; Laserson, Kayla F; Ter Kuile, Feiko O

    2013-06-21

    Poor utilisation of facility-based antenatal and delivery care services in Kenya hampers reduction of maternal mortality. Studies suggest that the participation of men in antenatal and delivery care is associated with better health care seeking behaviour, yet many reproductive health programs do not facilitate their involvement. This qualitative study conducted in rural Western Kenya, explored men's perceptions of antenatal and delivery care services and identified factors that facilitated or constrained their involvement. Eight focus group discussions were conducted with 68 married men between 20-65 years of age in May 2011. Participants were of the Luo ethnic group residing in Asembo, western Kenya. The area has a high HIV-prevalence and polygamy is common. A topic guide was used to guide the discussions and a thematic framework approach for data analysis. Overall, men were positive in their views of antenatal and delivery care, as decision makers they often encouraged, some even 'forced', their wives to attend for antenatal or delivery care. Many reasons why it was beneficial to accompany their wives were provided, yet few did this in practice unless there was a clinical complication. The three main barriers relating to cultural norms identified were: 1) pregnancy support was considered a female role; and the male role that of provider; 2) negative health care worker attitudes towards men's participation, and 3) couple unfriendly antenatal and delivery unit infrastructure. Although men reported to facilitate their wives' utilisation of antenatal and delivery care services, this does not translate to practice as adherence to antenatal-care schedules and facility based delivery is generally poor. Equally, reasons proffered why they should accompany their wives are not carried through into practice, with barriers outweighing facilitators. Recommendations to improve men involvement and potentially increase services utilisation include awareness campaigns targeting

  17. The effect of antenatal administration of solcoseryl on hepatic glycogen synthesis in rat fetuses with intrauterine growth retardation.

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    Takahashi, H; Cheng, K M; Araki, T

    1993-06-01

    The effect of antenatal solcoseryl administration on hepatic glycogen synthesis and storage was studied in normal developing and intrauterine growth-retarded (IUGR) rat fetuses using biochemical analyses. The maximal effect of solcoseryl occurred 2 hours after administration. The glycogen content of the liver showed a significant increase in normal and IUGR fetuses with antenatal solcoseryl administration compared to their non-solcoseryl counterparts (p solcoseryl administration. Active synthase also increased in normal fetuses with antenatal solcoseryl administration (p solcoseryl administration stimulates hepatic glycogen synthesis and storage in IUGR rat fetuses, and thus might favorably influence the development of neonatal hypoglycemia.

  18. A study on knowledge and practices of antenatal care among pregnant women attending antenatal clinic at a Tertiary Care Hospital of Pune, Maharashtra

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    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.

  19. Monitoring of levees, bridges, pipelines, and other critical infrastructure during the 2011 flooding in the Mississippi River Basin: Chapter J in 2011 floods of the central United States

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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

  20. Targeted routine antenatal anti-D prophylaxis in the prevention of RhD immunisation--outcome of a new antenatal screening and prevention program.

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    Eleonor Tiblad

    Full Text Available OBJECTIVE: To estimate the incidence of RhD immunisation after implementation of first trimester non-invasive fetal RHD screening to select only RhD negative women carrying RHD positive fetuses for routine antenatal anti-D prophylaxis (RAADP. MATERIALS AND METHODS: We present a population-based prospective observational cohort study with historic controls including all maternity care centres and delivery hospitals in the Stockholm region, Sweden. All RhD negative pregnant women were screened for fetal RHD genotype in the first trimester of pregnancy. Anti-D immunoglobulin (250-300 µg was administered intramuscularly in gestational week 28-30 to participants with RHD positive fetuses. Main outcome measure was the incidence of RhD immunisation developing during or after pregnancy. RESULTS: During the study period 9380 RhD negative women gave birth in Stockholm. Non-invasive fetal RHD genotyping using cell-free fetal DNA in maternal plasma was performed in 8374 pregnancies of which 5104 (61% were RHD positive and 3270 (39% RHD negative. In 4590 pregnancies with an RHD positive test the women received antenatal anti-D prophylaxis. The incidence of RhD immunisation in the study cohort was 0.26 percent (24/9380 (95% CI 0.15-0.36% compared to 0.46 percent (86/18546 (95% CI 0.37 to 0.56% in the reference cohort. The risk ratio (RR for sensitisation was 0.55 (95% CI 0.35 to 0.87 and the risk reduction was statistically significant (p = 0.009. The absolute risk difference was 0.20 percent, corresponding to a number needed to treat (NNT of 500. CONCLUSIONS: Using first trimester non-invasive antenatal screening for fetal RHD to target routine antenatal anti-D prophylaxis selectively to RhD negative women with RHD positive fetuses significantly reduces the incidence of new RhD immunisation. The risk reduction is comparable to that reported in studies evaluating the outcome of non selective RAADP to all RhD negative women. The cost-effectiveness of this

  1. Antenatal corticosteroids trial in preterm births to increase neonatal survival in developing countries: study protocol

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    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

  2. Antenatal corticosteroids trial in preterm births to increase neonatal survival in developing countries: study protocol.

    Science.gov (United States)

    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

  3. 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

  4. The quality of free antenatal and delivery services in Northern Sierra Leone.

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    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

  5. Prevalencia del deterioro cognitivo leve en mayores institucionalizados Prevalencia of the mild cognitive impairment in institutionalized elders

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    Jesús Manuel Vallejo Sánchez

    2010-12-01

    Full Text Available Introducción y objetivo: el concepto de deterioro cognitivo leve (DCL define un estado previo en el declinar cognitivo hacia la demencia, donde se observan cambios cognitivos identificables mediante una adecuada evaluación clínica y neuropsicológica. Nuestro objetivo es conocer la prevalencia del deterioro cognitivo leve en la Residencia José Matía Calvo. Método: estudio observacional descriptivo transversal de los residentes institucionalizados con ausencia de patología neurológica o deterioro cognitivo severo de la Residencia de Mayores José Matía Calvo de Cádiz. Se cribó a los sujetos con el mini examen cognoscitivo en la versión de Lobo durante enero de 2008, obteniéndose una muestra de la que se estudiaron variables sociodemográficas y de control (estado cognitivo. Resultados: se desprende que la prevalencia de DCL en los ancianos institucionalizados en nuestro centro es del 27%, cifra más elevada que la aportada como media por algunos autores para la población general (15%-20%, pero menor que la establecida en otras residencias de mayores, que oscilan entre el 38,7% y el 44%. Conclusiones: el aumento constatado de la prevalencia del deterioro cognitivo en la población mayor y su repercusión en el nivel de independencia y calidad de vida de los mayores institucionalizados justifica la necesidad de identificar precozmente tal alteración para iniciar, lo antes posible, programas de intervención dirigidos a retrasar la dependencia, potenciar las capacidades residuales y mejorar la calidad de vida de estos ancianos.Introduction and objetive: the concept of Mild cognitive impairment defines a previous state in to decline cognitive towards the dementia, where are observed cognitive identifiable changes by means of a suitable clinical and evaluation and neuropsycological. To know the prevalencia of the cognitive slight deterioration in our center. Methods: observacional, descriptively and transversely study of the residents

  6. TRATAMENTO TÉRMICO DE PRECIPITAÇÃO - T6 APLICADO EM RODA DE LIGA LEVE DE MOTOCICLETA

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    Ricardo Orcélio Miranda de Oliveira

    2014-11-01

    Full Text Available As ligas de alumínio da série A356 (Al-Si-Mg são usadas extensivamente em componentes de manufatura para indústria automotiva e aeroespacial devido a suas propriedades físicas e mecânicas. São utilizadas em muitas aplicações estruturais que requerem uma alta resistência a baixo peso, alta resistência e tenacidade ao impacto, baixo coeficiente de expansão térmica, boa resistência à corrosão e excelente fluidez, como ligas de fundição para produção de rodas de liga leve. Nesse sentido, o objetivo principal deste trabalho é avaliar os efeitos do tratamento térmico de precipitação – T6 sobre a microestrutura e propriedades mecânicas da liga A356/Al-7Si-0,3Mg. Para tanto, uma roda de motocicleta foi utilizada e o tratamento térmico aplicado na própria indústria de fabricação, conforme padrões estabelecidos. Os resultados alcançados mostram uma microestrutura eutética composta de Si (esferoidizado mais os intermetálicos de Fe, que foram observados entre as ramificações interdendríticas. Ensaios de dureza Rocwell B foram realizados e os valores obtidos correspondem aos padrões estabelecidos.

  7. Early antenatal care visit: a systematic analysis of regional and global levels and trends of coverage from 1990 to 2013.

    Science.gov (United States)

    Moller, Ann-Beth; Petzold, Max; Chou, Doris; Say, Lale

    2017-10-01

    The timing of the first antenatal care visit is paramount for ensuring optimal health outcomes for women and children, and it is recommended that all pregnant women initiate antenatal care in the first trimester of pregnancy (early antenatal care visit). Systematic global analysis of early antenatal care visits has not been done previously. This study reports on regional and global estimates of the coverage of early antenatal care visits from 1990 to 2013. Data were obtained from nationally representative surveys and national health information systems. Estimates of coverage of early antenatal care visits were generated with linear regression analysis and based on 516 logit-transformed observations from 132 countries. The model accounted for differences by data sources in reporting the cutoff for the early antenatal care visit. The estimated worldwide coverage of early antenatal care visits increased from 40·9% (95% uncertainty interval [UI] 34·6-46·7) in 1990 to 58·6% (52·1-64·3) in 2013, corresponding to a 43·3% increase. Overall coverage in the developing regions was 48·1% (95% UI 43·4-52·4) in 2013 compared with 84·8% (81·6-87·7) in the developed regions. In 2013, the estimated coverage of early antenatal care visits was 24·0% (95% UI 21·7-26·5) in low-income countries compared with 81·9% (76·5-87·1) in high-income countries. Progress in the coverage of early antenatal care visits has been achieved but coverage is still far from universal. Substantial inequity exists in coverage both within regions and between income groups. The absence of data in many countries is of concern and efforts should be made to collect and report coverage of early antenatal care visits to enable better monitoring and evaluation. Department of Reproductive Health and Research, WHO and UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction. Copyright © This is an Open Access article published under the

  8. Effectiveness of advertising availability of prenatal ultrasound on uptake of antenatal care in rural Uganda: A cluster randomized trial.

    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

  9. A baixa estatura leve está associada ao aumento da pressão arterial em adolescentes com sobrepeso La baja estatura leve está asociada al aumento de la presión arterial en adolescentes con sobrepeso Mild stunting is associated with higher blood pressure in overweight adolescents

    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

  10. The use of midwife-led primary antenatal care by obese women in The Netherlands: An explorative cohort study.

    Science.gov (United States)

    Daemers, Darie O A; van Limbeek, Evelien B M; Budé, Luc M; Wijnen, Hennie A A; Nieuwenhuijze, Marianne J; de Vries, Raymond G

    2017-06-01

    to study the effect of body mass index (BMI) on the use of antenatal care by women in midwife-led care. an explorative cohort study. 11 Dutch midwife-led practices. a cohort of 4421 women, registered in the Midwifery Case Registration System (VeCaS), who received antenatal care in midwife-led practices in the Netherlands and gave birth between October 2012 and October 2014. the mean start of initiation of care was at 9.3 (SD 4.6) weeks of pregnancy. Multiple linear regression showed that with an increasing BMI initiation of care was significantly earlier but BMI only predicted 0.2% (R 2 ) of the variance in initiation of care. The mean number of face-to- face antenatal visits in midwife-led care was 11.8 (SD 3.8) and linear regression showed that with increasing BMI the number of antenatal visits increased. BMI predicted 0.1% of the variance in number of antenatal visits. The mean number of antenatal contacts by phone was 2.2 (SD 2.6). Multiple linear regression showed an increased number of contacts by phone for BMI categories 'underweight' and 'obese class I'. BMI categories predicted 1% of the variance in number of contacts by phone. BMI was not a relevant predictor of variance in initiation of care and number of antenatal visits. Obese pregnant women in midwife-led practices do not delay or avoid antenatal care. Taking care of pregnant women with a high BMI does not significantly add to the workload of primary care midwives. Further research is needed to more fully understand the primary maternal health services given to obese women. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Preparing fathers for the transition to parenthood: recommendations for the content of antenatal education.

    Science.gov (United States)

    May, Chris; Fletcher, Richard

    2013-05-01

    Fathers now provide more care for their babies and children than they have in the past, and a large body of evidence supports the important role that father involvement plays in determining child and family outcomes. Fathers have also become the primary source of informal support for most mothers and it is now customary for fathers to attend antenatal education in this supporting role. However, many fathers remain unprepared for their personal transition to parenthood and this has important implications for all of the family. Antenatal education is likely to be more effective for fathers when it addresses fathers' needs but the literature is unclear about what fathers need to know. This paper presents evidence-based recommendations for core subject matter to be addressed when preparing men for the important challenges of new fatherhood. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Clinical application of antenatal genetic diagnosis of osteogenesis imperfecta type IV.

    Science.gov (United States)

    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.

  13. Lethal Congenital Malformations in Fetuses-Antenatal Ultrasound or Perinatal Autopsy.

    Science.gov (United States)

    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.

  14. Antenatal management of the expectant mother and extreme preterm infant at the limits of viability.

    LENUS (Irish Health Repository)

    Khan, R

    2012-01-31

    We explored the opinions of healthcare providers on the antenatal management and outcome of preterm delivery at less than 28 weeks gestation. An anonymous postal questionnaire was sent to health care providers. The response rate was 55% (74% Obstetrician, 70% neonatologist). Twenty four weeks is the limit at which most would advocate intervention. At 23 weeks 67% of neonatologists advocate antenatal steroids. 50% of all health care providers advocate cardiotocographic monitoring at 24 weeks gestation. Written information on survival and long-term outcome is provided by 8% of the respondents. Neonatologists (50%) were more likely than obstetrician (40%) to advocate caesarean section at 25 weeks. We conclude that 24 weeks is the limit at which most would advocate intervention. Significant variation exists both between and within each health care group at less than 25 weeks. Establishment and provision of national outcome data may aid decision making at the limits of viability.

  15. Fetal echopsy (ultrasonographic autopsy of an acardius myelancephalus and its correlation with antenatal ultrasonographic findings

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    Balakumar Karippaliyil

    2015-01-01

    Full Text Available Aberrant transplacental arteriovenous shunts between the placental and cord vessels of monozygotic monoamniotic twins or triplets result in the formation of an acardius. The prenatal diagnosis of this condition has been reported occasionally in the literature. A subtype categorized as acardius myelancephalus was diagnosed at 32 weeks of gestation by ultrasonography (USG. The pregnancy was aborted because of poor prognostic predictors and the acardius was subjected to ultrasonographic autopsy (fetal echopsy. The antenatal USG features were correlated with echopsy findings for confirmation of the antenatal findings and for a better visual perception of the prenatal diagnostic features. The echopsy revealed more precise details. Fetal echopsy avoids the medicolegal problems concerned with parental consent for classical invasive fetal autopsy.

  16. Impact on infants' cognitive development of antenatal exposure to iron deficiency disorder and common mental disorders.

    Science.gov (United States)

    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 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.

  17. Providing antenatal corticosteroids for preterm birth: a quality improvement initiative in Cambodia and the Philippines.

    Science.gov (United States)

    Smith, Jeffrey Michael; Gupta, Shivam; Williams, Emma; Brickson, Kate; Ly Sotha, Keth; Tep, Navuth; Calibo, Anthony; Castro, Mary Christine; Marinduque, Bernabe; Hathaway, Mark

    2016-12-01

    To determine whether a simple quality improvement initiative consisting of a technical update and regular audit and feedback sessions will result in increased use of antenatal corticosteroids among pregnant women at risk of imminent preterm birth delivering at health facilities in the Philippines and Cambodia. Non-randomized, observational study using a pre-/post-intervention design conducted between October 2013 and June 2014. A total of 12 high volume facilities providing Emergency Obstetric and Newborn Care services in Cambodia (6) and Philippines (6). A technical update on preterm birth and use of antenatal corticosteroids, followed by monthly audit and feedback sessions. The proportion of women at risk of imminent preterm birth who received at least one dose of dexamethasone. Coverage of at least one dose of dexamethasone increased from 35% at baseline to 86% at endline in Cambodia (P Cambodia and Philippines. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care.

  18. Late Antenatal Care Booking And Its Predictors Among Pregnant Women In South Western Nigeria

    Directory of Open Access Journals (Sweden)

    Adekanle DA

    2008-04-01

    Full Text Available Introduction: Antenatal care is concerned mainly with prevention, early diagnosis and treatment of general medical and pregnancy associated disorders. For it to be meaningful, early booking is recommended, however, late booking is still a major problem.Objective: To determine the prevalence of late booking in our environment and factors related to it.Methodology: A descriptive cross-sectional study using structured interviewer assisted questionnaires.Results: Mean gestational age at booking was 20.3±6.2 weeks. Prevalence of late entry to antenatal care was 82.6%. Maternal education and age remained significant factors influencing late booking.Conclusion: Late booking is still a major problem in this part of the world. Public enlightenment, health education coupled with women empowerment would be helpful in reducing the problem

  19. Antenatal care visits' absenteeism at a secondary care medical facility in Southwest Nigeria.

    Science.gov (United States)

    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.

  20. Maternal bereavement in the antenatal period and oral cleft in the offspring

    DEFF Research Database (Denmark)

    Ingstrup, Katja Glejsted; Liang, H.; Olsen, J.

    2013-01-01

    STUDY QUESTION: Is maternal bereavement (emotional stress) due to loss of a close relative in the antenatal period associated with the risk of oral cleft in the offspring? SUMMARY ANSWER: Our study suggests prenatal maternal bereavement is associated with an increased risk of oral cleft in the of......STUDY QUESTION: Is maternal bereavement (emotional stress) due to loss of a close relative in the antenatal period associated with the risk of oral cleft in the offspring? SUMMARY ANSWER: Our study suggests prenatal maternal bereavement is associated with an increased risk of oral cleft...... RESULTS AND THE ROLE OF CHANCE: In total, 3043 children were diagnosed with a cleft; 968 with cleft lip, 1206 with cleft lip and palate and 869 with a cleft palate. For overall bereavement the prevalence was 1.7 per 1 000 live born in the unexposed children and 2.2 per 1 000 live born in the exposed...

  1. Impact on infants' cognitive development of antenatal exposure to iron deficiency disorder and common mental disorders.

    Directory of Open Access Journals (Sweden)

    Thach Duc Tran

    Full Text Available 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 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.

  2. FACTORS LEAD TO DEPRESION DURING ANTENATAL CARE EVERY TRIMESTER OF PREGNANT MOTHER

    Directory of Open Access Journals (Sweden)

    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.

  3. Factors associated with antenatal depression in pregnant Korean females: the effect of bipolarity on depressive symptoms

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    Park CM

    2014-06-01

    Full Text Available Chul Min Park,1 Hye-Jin Seo,2 Young-Eun Jung,3 Moon-Doo Kim,3 Seong-Chul Hong,4 Won-Myong Bahk,5 Bo-Hyun Yoon,6 Min Hee Hur,7 Jae Min Song31Department of Obstetrics and Gynecology, School of Medicine, Jeju National University, Jeju, 2Department of Psychiatry, Yeonkang Hospital, Jeju, 3Department of Psychiatry, 4Department of Preventive Medicine, School of Medicine, Jeju National University, Jeju, 5Department of Psychiatry, Yeouido St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, 6Department of Psychiatry, Naju National Hospital, Naju, 7School of Medicine, Jeju National University, Jeju, KoreaBackground: This cross-sectional study sought to identify factors associated with antenatal depression in pregnant Korean females, including sociodemographic parameters, social support, social conflict, and bipolarity.Methods: Eighty-four pregnant women were recruited to complete questionnaires on sociodemographic factors, obstetric history, depressive symptoms, and bipolarity. Depressive symptoms were assessed using the Korean version of the Edinburgh Postnatal Depression Scale. Bipolarity was assessed using the Korean version of the Mood Disorder Questionnaire.Results: Nineteen participants (22.6% had positive Mood Disorder Questionnaire scores, suggesting the presence of bipolarity, and were significantly more likely to score high on the Edinburgh Postnatal Depression Scale. Antenatal depression was associated with bad marital communication and marital dissatisfaction.Conclusion: These results suggest that spousal interactions play a significant role in antenatal depression, and pregnant women with bipolarity may be more depressed than those without bipolarity.Keywords: antenatal depression, bipolarity, pregnancy, Korea

  4. An instrument for broadened risk assessment in antenatal health care including non-medical issues

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    Amber Amanda Vos

    2015-03-01

    Full Text Available Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting.Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers.Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined.Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

  5. An instrument for broadened risk assessment in antenatal health care including non-medical issues

    Directory of Open Access Journals (Sweden)

    Amber Amanda Vos

    2015-03-01

    Full Text Available Introduction: Growing evidence on the risk contributing role of non-medical factors on pregnancy outcomes urged for a new approach in early antenatal risk selection. The evidence invites to more integration, in particular between the clinical working area and the public health domain. We developed a non-invasive, standardized instrument for comprehensive antenatal risk assessment. The current study presents the application-oriented development of a risk screening instrument for early antenatal detection of risk factors and tailored prevention in an integrated care setting. Methods: A review of published instruments complemented with evidence from cohort studies. Selection and standardization of risk factors associated with small for gestational age, preterm birth, congenital anomalies and perinatal mortality. Risk factors were weighted to obtain a cumulative risk score. Responses were then connected to corresponding care pathways. A cumulative risk threshold was defined, which can be adapted to the population and the availability of preventive facilities. A score above the threshold implies multidisciplinary consultation between caregivers. Results: The resulting digital score card consisted of 70 items, subdivided into four non-medical and two medical domains. Weighing of risk factors was based on existing evidence. Pilot-evidence from a cohort of 218 pregnancies in a multi-practice urban setting showed a cut-off of 16 points would imply 20% of all pregnant women to be assessed in a multidisciplinary setting. A total of 28 care pathways were defined. Conclusion: The resulting score card is a universal risk screening instrument which incorporates recent evidence on non-medical risk factors for adverse pregnancy outcomes and enables systematic risk management in an integrated antenatal health care setting.

  6. Response to Antenatal Cholecalciferol Supplementation Is Associated With Common Vitamin D-Related Genetic Variants.

    Science.gov (United States)

    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

  7. 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

  8. ANTENATAL CARE SERVICES STANDART COMPLIANCE OF VILLAGE MIDWIFE IN EAST JAVA PROVINCE

    Directory of Open Access Journals (Sweden)

    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.

  9. Extracranial vascular malformation: value of antenatal and postnatal MRI in management

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  10. Antenatal insults modify newborn olfactory function by nitric oxide produced from neuronal nitric oxide synthase.

    Science.gov (United States)

    Drobyshevsky, Alexander; Yu, Lei; Yang, Yirong; Khalid, Syed; Luo, Kehuan; Jiang, Rugang; Ji, Haitao; Derrick, Matthew; Kay, Leslie; Silverman, Richard B; Tan, Sidhartha

    2012-10-01

    Newborn feeding, maternal, bonding, growth and wellbeing depend upon intact odor recognition in the early postnatal period. Antenatal stress may affect postnatal odor recognition. We investigated the exact role of a neurotransmitter, nitric oxide (NO), in newborn olfactory function. We hypothesized that olfactory neuron activity depended on NO generated by neuronal NO synthase (NOS). Utilizing in vivo functional manganese enhanced MRI (MEMRI) in a rabbit model of cerebral palsy we had shown previously that in utero hypoxia-ischemia (H-I) at E22 (70% gestation) resulted in impaired postnatal response to odorants and poor feeding. With the same antenatal insult, we manipulated NO levels in the olfactory neuron in postnatal day 1 (P1) kits by administration of intranasal NO donors or a highly selective nNOS inhibitor. Olfactory function was quantitatively measured by the response to amyl acetate stimulation by MEMRI. The relevance of nNOS to normal olfactory development was confirmed by the increase of nNOS gene expression from fetal ages to P1 in olfactory epithelium and bulbs. In control kits, nNOS inhibition decreased NO production in the olfactory system and increased MEMRI slope enhancement. In H-I kits the MEMRI slope did not increase, implicating modification of endogenous NO-mediated olfactory function by the antenatal insult. NO donors as a source of exogenous NO did not significantly change function in either group. In conclusion, olfactory epithelium nNOS in newborn rabbits probably modulates olfactory signal transduction. Antenatal H-I injury remote from delivery may affect early functional development of the olfactory system by decreasing NO-dependent signal transduction. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Selective imaging modalities after first pyelonephritis failed to identify significant urological anomalies, despite normal antenatal ultrasounds

    DEFF Research Database (Denmark)

    Mola, Gylli; Wenger, Therese Ramstad; Salomonsson, Petra

    2017-01-01

    scintigraphies. Using the European Association of Paediatric Urology guidance would have missed three urological patients, one with initial surgery, and avoided 46 scintigraphies. Investigating patients under two years with ultrasound and scintigraphy, and just ultrasound in children over two years, would have...... 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....

  12. Intimate partner violence in pregnancy among antenatal attendees at health facilities in West Pokot county, Kenya.

    Science.gov (United States)

    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.

  13. Fetal Intracranial Hemorrhage (Fetal Stroke: Report of Four Antenatally Diagnosed Casesand Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ying-Fen Huang

    2006-06-01

    Conclusion: This small series demonstrate that an antenatal diagnosis of fetal stroke with intraventricular hemorrhage Grades III and IV or with brain parenchymal involvement appears to be associated with poor neurologic outcome. Due to the significant neonatal neurologic impairment and potential medicolegal implications of antepartum fetal ICH, it follows that obstetricians and sonographers should be familiar with predisposing factors and typical diagnostic imaging findings of rare in utero ICH events.

  14. Antenatal services for pregnant teenagers in Mbarara Municipality, Southwestern Uganda: health workers and community leaders' views.

    Science.gov (United States)

    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.

  15. Shared antenatal care fails to rate well with women of non-English-speaking backgrounds.

    Science.gov (United States)

    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.

  16. Antenatal steroids in preterm labour for the prevention of neonatal deaths due to complications of preterm birth.

    Science.gov (United States)

    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.

  17. Factors related to the use of antenatal care services in Ethiopia: Application of the zero-inflated negative binomial model.

    Science.gov (United States)

    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.

  18. Socio-economic and partner relationship factors associated with antenatal depressive morbidity among pregnant women in Dar es Salaam, Tanzania.

    Science.gov (United States)

    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.

  19. Poor social support as a risk factor for antenatal depressive symptoms among women attending public antennal clinics in Penang, Malaysia.

    Science.gov (United States)

    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.

  20. Perspectives regarding antenatal care, delivery and breast feeding practices of women from Baluchistan, Pakistan

    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)

  1. Antenatal and Postnatal Psychopathology Among Women with Current and Past Eating Disorders: Longitudinal Patterns

    Science.gov (United States)

    Easter, Abigail; Solmi, Francessca; Bye, Amanda; Taborelli, Emma; Corfield, Freya; Schmidt, Ulrike; Treasure, Janet; Micali, Nadia

    2015-01-01

    This study aims to investigate longitudinal patterns of psychopathology during the antenatal and postnatal periods among women with current (C-ED) and past (P-ED) eating disorders. Women were recruited to a prospective longitudinal study: C-ED (n = 31), P-ED (n = 29) and healthy control (HC; n = 57). Anxiety, depression and ED symptoms were measured at four time points: first/second trimester, third trimester, 8 weeks and 6 months postpartum. Linear mixed effects models were used to test for group differences. Women with C-ED and P-ED, in all diagnostic categories, had significantly higher levels of psychopathology at all time points. ED symptoms decreased in the C-ED group, compared with an overall increase in the other two groups but subsequently increased after pregnancy. Overall, depression and state and trait anxiety scores decreased in the C-ED group compared with the HC group throughout the antenatal and postnatal periods. High levels of psychopathology are common throughout the antenatal and postnatal periods among women with current and past ED, and despite some overall reductions, symptoms remain clinically significant. © 2014 The Authors. European Eating Disorders Review published by John Wiley & Sons, Ltd. PMID:25345371

  2. Antenatal and postnatal radiologic diagnosis of holocarboxylase synthetase deficiency: a systematic review

    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.)

  3. Antenatal and postnatal radiologic diagnosis of holocarboxylase synthetase deficiency: a systematic review

    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.)

  4. COMPARATIVE STUDY OF EFFICACY OF FERROUS SULPHATE AND CARBONYL IRON IN ANEMIA OF ANTENATAL WOMEN

    Directory of Open Access Journals (Sweden)

    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

  5. Antenatal exposure to antidepressants is associated with altered brain development in very preterm-born neonates.

    Science.gov (United States)

    Podrebarac, Samantha K; Duerden, Emma G; Chau, Vann; Grunau, Ruth E; Synnes, Anne; Oberlander, Tim F; Miller, Steven P

    2017-02-07

    Antenatal exposure to selective serotonin reuptake inhibitors (SSRIs) is associated with an enhanced risk of preterm birth. Very preterm-born neonates (brain development. To examine whether antenatal-SSRI exposure was associated with adverse neonatal brain microstructural and metabolic development using diffusion tensor and magnetic resonance spectroscopic imaging. Of 177 neonates enrolled, 14 (8%) were antenatally exposed to SSRIs. Neonates were scanned twice (median week 32; interquartile range [IQR]: 30.4-33.6) and again at term-equivalent age (40.1, IQR: 38.6-42.1). Using a region-of-interest approach, N-acetylaspartate to choline ratios (NAA/Cho), lactate to choline ratios, white and gray matter fractional anisotropy (FA), mean, axial, radial diffusivity (MD, AD, RD) values were extracted from white and gray matter subcortical regions. Neurodevelopment was assessed at 18 months, corrected age. SSRI-exposed neonates exhibited increased FA and decreased MD, AD and RD values in the superior white matter (pbrain development requires further attention. Future research is directed at determining the mechanism of this relationship and the contribution of maternal mood. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  6. Promoting antenatal steroid use for fetal maturation: results from the California Perinatal Quality Care Collaborative.

    Science.gov (United States)

    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.

  7. Depression Trajectories of Antenatally Depressed and Nondepressed Young Mothers: Implications for Child Socioemotional Development.

    Science.gov (United States)

    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.

  8. ANTENATAL DETERMINANTS OF PARENTAL ATTACHMENT AND PARENTING ALLIANCE: HOW DO MOTHERS AND FATHERS DIFFER?

    Science.gov (United States)

    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.

  9. Are recommendations about routine antenatal care in Australia consistent and evidence-based?

    Science.gov (United States)

    Hunt, Jennifer M; Lumley, Judith

    2002-03-18

    To describe the variability and evidence base of recommendations in Australian protocols and national policies about six aspects of routine antenatal care. Comparison of recommendations from local protocols, national guidelines and research about number of visits, screening for gestational diabetes (GDM), syphilis, hepatitis C (HCV), and HIV, and advice on smoking cessation. Australian public hospitals with more than 200 births/year, some smaller hospitals in each State and Territory, and all Divisions of General Practice were contacted in 1999 and 2000. We reviewed 107 protocols, which included 80% of those requested from hospitals and 92% of those requested from Divisions. Frequency and consistency of recommendations. Recommendations about syphilis testing were notable in demonstrating consistency between local protocols, national policies and research evidence. Most protocols recommended screening for GDM, despite lack of good evidence of its effectiveness in improving outcomes. Specific approaches to screening for GDM varied widely. Coverage and specific recommendations about testing for HIV and HCV were also highly variable. Smoking-cessation information and advice was rarely included, despite good evidence of the effectiveness of interventions in improving outcomes. No national policies about the number of routine visits and smoking cessation could be identified. There were inconsistent national policies for both HIV and GDM screening. Antenatal care recommended in protocols used in Australia varies, and is not always consistent with national policies or research evidence. Producing and disseminating systematic reviews of research evidence and national guidelines might reduce this variability and improve the quality of Australian antenatal care.

  10. Unusual presentation of antenatal ovarian torsion: free-floating abdominal cysts. Our experience and surgical management.

    Science.gov (United States)

    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.

  11. La Corte Internacional de Justicia y la intervención de terceros en cuestiones marítimas: A propósito de la decisión en las solicitudes de intervención de Costa Rica y Honduras en la Controversia territorial y marítima (Nicaragua vs. Colombia

    Directory of Open Access Journals (Sweden)

    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.

  12. Interventions (other than pharmacological, psychosocial or psychological) for treating antenatal depression.

    Science.gov (United States)

    Dennis, Cindy-Lee; Allen, Kim

    2008-10-08

    Although pregnancy was once thought of as a time of emotional well-being for many women, conferring 'protection' against psychiatric disorders, a recent meta-analysis of 21 studies suggests the mean prevalence rate for depression across the antenatal period is 10.7%, ranging from 7.4% in the first trimester to a high of 12.8% in the second trimester. Due to maternal treatment preferences and potential concerns about fetal and infant health outcomes, non-pharmacological treatment options are needed. To assess the effects, on mothers and their families, of non-pharmacological/psychosocial/psychological interventions compared with usual antepartum care in the treatment of antenatal depression. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (August 2007), the Cochrane Collaboration Depression Anxiety and Neurosis Group's Trials Registers (CCDANCTR-Studies and CCDANCTR-References) (January 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 3), MEDLINE (1966 to January 2007), EMBASE (1980 to January 2007) and CINAHL (1982 to January 2007). We scanned secondary references and contacted experts in the field to identify other published or unpublished trials. All published, unpublished and ongoing randomised controlled trials of non-pharmacological/psychosocial/psychological interventions to treat antenatal depression. All review authors independently participated in the evaluation of methodological quality and data extraction. . We included one US three-armed randomised controlled trial in this review, incorporating 61 outpatient antenatal women who met Diagnostic and Statistical Manual for Mental Disorders-IV criteria for major depression. Maternal massage, compared to non-specific acupuncture (control group), did not significantly decrease the number of women diagnosed with clinical depression immediately post-treatment (one trial, n = 38; risk ratio (RR) 0.80, 95% confidence interval (CI) 0.25 to 2

  13. Caracterização de massas cerâmicas do estado de S. Paulo para produção de agregados leves para concreto

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    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.

  14. Intervenções de Cessação de Tabagismo em Fumantes Leves: Uma Revisão Sistemática

    Directory of Open Access Journals (Sweden)

    Taynara Dutra Batista Formagini

    2015-12-01

    Full Text Available Apesar da diminuição da prevalência de fumantes, o número de tabagistas de baixo consumo de cigarro tem aumentado, comumente denominados de fumantes leves ou intermitentes. É sabido que qualquer quantidade de consumo de tabaco pode trazer danos à saúde. A pesquisa sobre essa população é escassa e pouco se sabe sobre intervenções de cessação de tabagismo direcionadas a esses grupos. Dessa forma, o objetivo do presente estudo foi realizar uma revisão sistemática a fim de descrever estudos que apresentam intervenções para fumantes leves e intermitentes. As pesquisas foram conduzidas nas bases de dados PubMed, PsycInfo, SciELO e Pepsic. Palavras-chave incluíram: [light smoker, non-daily smoker, intermittent smoker; social smoking, occasional smoking, low-level smoking] AND [intervention studies, clinical trial and evaluation studies] AND [tobacco use cessation, tobacco use disorder]. Nove artigos preencheram os critérios de inclusão e foram analisados. Os resultados apontaram que intervenções bem-sucedidas incluíram aconselhamento e uso de medicamentos, tais como intervenção breve, tratamento de reposição de nicotina, Vareniclina, educação em saúde, entre outros. No entanto, intervenções ainda estão em estágio inicial. Destaca-se a necessidade de mais investigações sobre intervenções específicas para fumantes de baixo consumo, desenvolvimento de escalas de dependência exclusivas para esse grupo e estudos epidemiológicos para compreender quem são os fumantes leves e intermitentes, especialmente no Brasil.

  15. Levee Areas - USACE IENC

    Data.gov (United States)

    Department of Homeland Security — These inland electronic Navigational charts (IENCs) were developed from available data used in maintenance of Navigation channels. Users of these IENCs should be...

  16. Antenatal treatment with corticosteroids for preterm neonates: impact on the incidence of respiratory distress syndrome and intra-hospital mortality

    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

  17. Soldagem por ponto no estado sólido de ligas leves Solid state spot welding of lightweight alloys

    Directory of Open Access Journals (Sweden)

    Leonardo Contri Campanelli

    2011-09-01

    Full Text Available A recente preocupação quanto às mudanças climáticas vem impulsionando pesquisas em eficiência energética dos meios de transportes no sentido de reduzir a emissão de gases. Uma das principais soluções consiste na redução do peso estrutural através da aplicação de novos materiais, como as ligas leves de alumínio e magnésio. Entretanto, novos usos ficam muitas vezes limitados pela dificuldade de união desses materiais. A técnica de soldagem por fricção e mistura (FSW é um processo de união no estado sólido que surge como uma alternativa viável para substituir ou complementar as tecnologias de união consagradas. Como uma junta contínua não é sempre a requisitada, duas tecnologias de união por ponto derivadas do FSW estão em desenvolvimento: soldagem por fricção e mistura por ponto (FSSW e soldagem por fricção por ponto (FSpW. Além de fornecerem juntas de elevada resistência e praticamente isentas de defeitos, estas técnicas apresentam alta eficiência energética, curto ciclo de soldagem, facilidade de automação e compatibilidade com o meio-ambiente, fazendo frente às técnicas convencionais de união por ponto, como a soldagem por resistência por ponto (RSW e a rebitagem.The recent concern about climate change has stimulated research into transport energy efficiency in order to reduce the emission of gases. One of the main solutions is to reduce the structural weight through the application of new materials, such as aluminum and magnesium lightweight alloys. However, new applications are often limited by the difficulty of joining these materials. Friction Stir Welding (FSW is a solid state joining technique that emerges as a viable alternative to replace or complement the established joining technologies. As a continuous weld is not always requested, two spot welding technologies derived from FSW are under development: Friction Stir Spot Welding (FSSW and Friction Spot Welding (FSpW. Besides providing

  18. Eficacia de un programa de entrenamiento fisico y cognitivo basado en nuevas tecnologias en poblacion mayor saludable y con signos de deterioro cognitivo leve: Long Lasting Memories

    OpenAIRE

    González Palau, Fátima

    2013-01-01

    [ES] Introducción. Long Lasting Memories (LLM) es un proyecto internacional apoyado por la Unión Europea, que apunta a la validación de una plataforma TIC, que combine ejercicios cognitivos con la actividad física por medio de nuevas tecnologías. El objetivo del presente estudio es determinar la eficacia de la plataforma LLM en la mejoría de funciones cognitivas, síntomas depresivos y quejas subjetivas de memoria en adultos mayores saludables y con sin signos de deterioro cognitivo leve (DCL)...

  19. Calidad de vida relacionada con la salud en pacientes con diagnóstico de hipertensión arterial leve

    OpenAIRE

    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.

  20. Evaluación del bienestar psicológico y estrategias de afrontamiento en padres con niños o adolescentes con retraso mental leve

    OpenAIRE

    Zapata, Analía; Bastida, Marisa; Quiroga, Adriana; Charra, Salomé; Leiva, Juan Manuel

    2013-01-01

    Tener un hijo con discapacidad intelectual supone una fuente de conflictos tanto para la dinámica familiar como para los propios adolescentes. Es probable que la familia tenga que reestructurarse para afrontar los niveles de estrés que puedan influir sobre el bienestar de sus miembros. Esta investigación evalúa el bienestar psicológico de los padres con un niño y/o adolescente entre 9 y 14 años con retraso mental leve, estrategias de afrontamiento y posibles relaciones entre estas variables. ...