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Sample records for birth certificate controls

  1. Validation of 1989 Tennessee birth certificates using maternal and newborn hospital records.

    Science.gov (United States)

    Piper, J M; Mitchel, E F; Snowden, M; Hall, C; Adams, M; Taylor, P

    1993-04-01

    In 1989, the state of Tennessee adopted a new birth certificate which incorporates changes recommended by the National Center for Health Statistics in the revised US Standard Certificate of Live Birth. The data now being collected are intended to provide improved information for understanding maternal and infant health issues. To assess data quality, the authors compared information reported on the 1989 Tennessee birth certificates with the same data obtained from an ongoing case-control study in which the delivery hospital medical records of mothers and infants were reviewed by trained nurse abstractors using a structured data collection instrument. Cases (n = 1,016) were all infants born in Tennessee in 1989 with birth weights less than 1,500 g or other infants who died during the first 28 days of life. The infants were identified from linked birth-death certificate files. Control infants (n = 634) were randomly selected from the noncase population. The most reliable information obtained from birth certificates was descriptive demographic data and birth weight. The quality of information obtained from the new birth certificate checkboxes varied. Routine medical procedures were better reported on the birth certificates than relatively uncommon conditions and occurrences, even serious ones. Caution is needed in using birth certificate data for assessment of maternal medical risk factors, complications of labor and delivery, abnormal conditions of the newborn, and congenital anomalies, since sensitivity is low.

  2. Validity of parental work information on the birth certificate

    Directory of Open Access Journals (Sweden)

    Langlois Peter H

    2008-03-01

    Full Text Available Abstract Background In the most recent revision (2003 of the U.S. standard certificate of live births, the National Center for Health Statistics recommended that all states collect maternal and paternal usual occupation. Because such information might be useful in the surveillance of job-related risk areas, we assessed the quality of parental work information on the U.S. birth certificate. Methods Occupational histories obtained from maternal interviews with Texas (USA participants in the National Birth Defects Prevention Study were linked to and compared with parental work information on birth certificates. With occupational information from interviews serving as the gold standard, we assessed the quality of occupational information on the birth certificate with measures of sensitivity, specificity, and the kappa statistic. Results Of the 649 births available for study, parental occupation agreed between the birth certificate and interview for 77% of mothers and 63% of fathers with similar agreement by case-control status. Among occupations and industries with 10 or more workers by interview, sensitivity of the birth certificate information ranged from 35% to 100% for occupational groups and 55% to 100% for industrial sectors. Specificities of occupations/industries studied ranged from 93 to 100%. Kappa statistics for maternal occupations (0.76 to 0.90 and industries (0.59 to 0.94 were higher than those for paternal occupations (0.48 to 0.92 and industries (0.47 to 0.89. Mothers were frequently misclassified as homemakers or otherwise unemployed while the paternal information was often missing altogether on the birth certificate. Women who worked as health diagnosing and treating practitioners were the least likely (0% and women in food preparation or serving occupations were the most likely (65% to be misclassified as not employed on the birth certificate. Among fathers, the proportion of missing occupations was the lowest for occupations in

  3. THE LAWFUL CONSEQUENCES OF BIRTH CERTIFICATE ON CHILDREN ABROGATION

    Directory of Open Access Journals (Sweden)

    Natasya Immanuela Sandjojo

    2017-12-01

    Full Text Available Research due to the law on the abrogation of birth certificates against children aims to know the effect of law affecting the child, as well as review of the determination and judgment in court that play a role in the birth certificate abrogation. This research describes the importance of birth certificate because of the low public awareness to perform birth registration. The study uses normative juridical research, which faces legal issues with the process of discovering legal rules, principles, and legal doctrines, with deductive methods, starting from the general thing and then generating specific and legitimate answers. Based on the results of the study, that the abrogation of birth certificate brings great lawful consequences for the child, especially the status and position of the child, as well as the right of alimentation,  which in this study included some examples of determination and court decision about the birth certificate abrogation.

  4. Birth Settings and the Validation of Neonatal Seizures Recorded in Birth Certificates Compared to Medicaid Claims and Hospital Discharge Abstracts Among Live Births in South Carolina, 1996-2013.

    Science.gov (United States)

    Li, Qing; Jenkins, Dorothea D; Kinsman, Stephen L

    2017-05-01

    Objective Neonatal seizures in the first 28 days of life often reflect underlying brain injury or abnormalities, and measure the quality of perinatal care in out-of-hospital births. Using the 2003 revision of birth certificates only, three studies reported more neonatal seizures recorded among home births ​or planned out-of-hospital births compared to hospital births. However, the validity of recording neonatal seizures or serious neurologic dysfunction across birth settings in birth certificates has not been evaluated. We aimed to validate seizure recording in birth certificates across birth settings using multiple datasets. Methods We examined checkbox items "seizures" and "seizure or serious neurologic dysfunction" in the 1989 and 2003 revisions of birth certificates in South Carolina from 1996 to 2013. Gold standards were ICD-9-CM codes 779.0, 345.X, and 780.3 in either hospital discharge abstracts or Medicaid encounters jointly. Results Sensitivity, positive predictive value, false positive rate, and the kappa statistic of neonatal seizures recording were 7%, 66%, 34%, and 0.12 for the 2003 revision of birth certificates in 547,177 hospital births from 2004 to 2013 and 5%, 33%, 67%, and 0.09 for the 1998 revision in 396,776 hospital births from 1996 to 2003, and 0, 0, 100%, -0.002 among 660 intended home births from 2004 to 2013 and 920 home births from 1996 to 2003, respectively. Conclusions for Practice Despite slight improvement across revisions, South Carolina birth certificates under-reported or falsely reported seizures among hospital births and especially home births. Birth certificates alone should not be used to measure neonatal seizures or serious neurologic dysfunction.

  5. Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants.

    Directory of Open Access Journals (Sweden)

    Amos Grünebaum

    Full Text Available Over the last decade, planned home births in the United States (US have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status.The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of midwives or the home birth setting are more closely associated with the increased neonatal mortality of planned midwife-attended home births in the United States.This study is a secondary analysis of our prior study. The 2006-2009 period linked birth/infant deaths data set was analyzed to examine total neonatal deaths (deaths less than 28 days of life in term singleton births (37+ weeks and newborn weight ≥ 2,500 grams without documented congenital malformations by certification status of the midwife: certified nurse midwives (CNM, nurse midwives certified by the American Midwifery Certification Board, and "other" or uncertified midwives who are not certified by the American Midwifery Certification Board.Neonatal mortality rates in hospital births attended by certified midwives were significantly lower (3.2/10,000, RR 0.33 95% CI 0.21-0.53 than home births attended by certified midwives (NNM: 10.0/10,000; RR 1 and uncertified midwives (13.7/10,000; RR 1.41 [95% CI, 0.83-2.38]. The difference in neonatal mortality between certified and uncertified midwives at home births did not reach statistical levels (10.0/10,000 births versus 13.7/10,000 births p = 0.2.This study confirms that when compared to midwife-attended hospital births, neonatal mortality rates at home births are significantly increased. While NNM was increased in planned homebirths attended by uncertified midwives when compared to certified midwives, this difference was not statistically significant. Neonatal

  6. Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Brent, Robert L; Levene, Malcolm I; Chervenak, Frank A

    2016-01-01

    Over the last decade, planned home births in the United States (US) have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status. The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of midwives or the home birth setting are more closely associated with the increased neonatal mortality of planned midwife-attended home births in the United States. This study is a secondary analysis of our prior study. The 2006-2009 period linked birth/infant deaths data set was analyzed to examine total neonatal deaths (deaths less than 28 days of life) in term singleton births (37+ weeks and newborn weight ≥ 2,500 grams) without documented congenital malformations by certification status of the midwife: certified nurse midwives (CNM), nurse midwives certified by the American Midwifery Certification Board, and "other" or uncertified midwives who are not certified by the American Midwifery Certification Board. Neonatal mortality rates in hospital births attended by certified midwives were significantly lower (3.2/10,000, RR 0.33 95% CI 0.21-0.53) than home births attended by certified midwives (NNM: 10.0/10,000; RR 1) and uncertified midwives (13.7/10,000; RR 1.41 [95% CI, 0.83-2.38]). The difference in neonatal mortality between certified and uncertified midwives at home births did not reach statistical levels (10.0/10,000 births versus 13.7/10,000 births p = 0.2). This study confirms that when compared to midwife-attended hospital births, neonatal mortality rates at home births are significantly increased. While NNM was increased in planned homebirths attended by uncertified midwives when compared to certified midwives, this difference was not statistically significant. Neonatal mortality rates

  7. Midwife-attended births in the United States, 1990-2012: results from revised birth certificate data.

    Science.gov (United States)

    Declercq, Eugene

    2015-01-01

    Data on attendance at birth by midwives in the United States have been available on the national level since 1989, allowing for the documentation of long-term trends. New items on payer source and prepregnancy body mass index (BMI) from a 2003 revision of the birth certificate provide an opportunity to examine additional aspects of US midwifery practice. The data in this report are based on records on birth attendant gathered as part of the US National Standard Certificate of Live Birth from a public use Web site, Vital Stats (http://www.cdc.gov/nchs/VitalStats.htm), which allows users to create and download specialized tables. Analysis of new items on prepregnancy BMI and birth payer source are limited to the 38 states (86% of US births) that adopted the revised birth certificate by 2012. Between 1989 and 2012, the proportion of all births attended by certified nurse-midwives (CNMs) increased from 3.3% to 7.9%. The proportion of vaginal births attended by CNMs reached an all-time high of 11.9%. Births attended by "other midwives" (typically certified professional midwives) rose to a peak of 28,343, or 0.7% of all US births. The distribution of payer source for CNM-attended births (44% Medicaid; 44% private insurance; 6% self-pay) is very similar to the national distribution, whereas the majority (53%) of births attended by other midwives are self-pay. Women whose births are attended by other midwives are less likely (13%) to have a prepregnancy BMI in the obese range than women attended by CNMs (19%) or overall (24%). The total number of births attended by CNMs and other midwives has remained steady or grown at a time when total US births have declined, resulting in the largest proportions of midwife-attended births in the quarter century that such data have been collected. © 2015 by the American College of Nurse-Midwives.

  8. An Evaluation of New York City's 2015 Birth Certificate Gender Marker Regulation.

    Science.gov (United States)

    Lee, Erica J; Gurr, Danielle; Van Wye, Gretchen

    2017-10-01

    In 1971, the New York City (NYC) Department of Health and Mental Hygiene amended Section 207.05 of the NYC Health Code to allow individuals who had undergone "convertive surgery" (interpreted by the code to mean genital surgery) to amend the gender on their birth certificates. This surgery requirement was removed in 2015. In a survey evaluating the regulation change, we sought to characterize the transgender population newly eligible to obtain a gender-congruent NYC birth certificate by comparing respondents with and without genital surgery. We mailed a 42-question survey with each newly issued birth certificate. We compared respondents across current gender identity, race, Hispanic ethnicity, age, insurance status, income, current general health status, other transition-related care obtained, and healthcare access, stigma, and discrimination. Of 642 applicants, 219 responded and were thus enrolled in our 5-year study (34.1%). Most (n = 158 out of 203 who answered, 77.8%) had not received genital surgery. Compared to respondents with genital surgery, respondents without surgery were significantly more likely to be transgender men (50.0% vs. 20.0%); younger (median age 32 vs. 56.5); on Medicaid (31.6% vs. 11.1%); identify as Hispanic (28.5% vs. 8.9%); and live in households making gender-congruent birth certificate. Jurisdictions with such requirements should consider similar regulation changes to address the inequities that this requirement likely imposes in accessing birth certificates.

  9. Neonatal Mortality of Planned Home Birth in the United States in Relation to Professional Certification of Birth Attendants

    OpenAIRE

    Gr?nebaum, Amos; McCullough, Laurence B.; Arabin, Birgit; Brent, Robert L.; Levene, Malcolm I.; Chervenak, Frank A.

    2016-01-01

    Introduction Over the last decade, planned home births in the United States (US) have increased, and have been associated with increased neonatal mortality and other morbidities. In a previous study we reported that neonatal mortality is increased in planned home births but we did not perform an analysis for the presence of professional certification status. Purpose The objective of this study therefore was to undertake an analysis to determine whether the professional certification status of...

  10. Birth of Identity: Understanding the Value and Policy Considerations of Using Birth Certificates for Identity Resolution

    Science.gov (United States)

    Duncan, Jeffrey Dean

    2015-01-01

    Exchanging patient-specific information across heterogeneous information systems is a critical but increasingly complex and expensive challenge. Lacking a universal unique identifier for healthcare, patient records must be linked using combinations of identity attributes such as name, date of birth, and sex. A state's birth certificate registry…

  11. Accuracy of assisted reproductive technology information on birth certificates: Florida and Massachusetts, 2004-06.

    Science.gov (United States)

    Cohen, Bruce; Bernson, Dana; Sappenfield, William; Kirby, Russell S; Kissin, Dmitry; Zhang, Yujia; Copeland, Glenn; Zhang, Zi; Macaluso, Maurizio

    2014-05-01

    Assisted Reproductive Technology (ART) includes fertility procedures where both egg and sperm are handled in the lab. ART use has increased considerably in recent years, accounting for 47,090 livebirths in the U.S. in 2010. ART increases the probability of multiple gestation births, which are at higher risks than singletons for adverse outcomes. Additionally, ART is associated with a greater risk of complications during pregnancy, labour, and delivery, and increased risk of adverse perinatal outcomes in singleton births. We merged Florida and Massachusetts birth records from 2004-06 with the National ART Surveillance System (NASS) and using NASS as the gold standard, calculated sensitivity, specificity, and positive predictive value (PPV) of ART reporting on the birth certificates by maternal, infant, and hospital characteristics. We fit random-effects logistic regression models to evaluate simultaneously the association of ART reporting with these predictors while accounting for correlation among births occurring in the same hospital. Sensitivity of ART reporting on the birth certificate was 28.9% in Florida and 41.4% in Massachusetts. Specificity was >99% in both states. PPV was 45.5% in Florida and 54.6% in Massachusetts. The odds of ART reporting varied by state and by several maternal and delivery characteristics including age, parity, history of fetal loss, plurality, race/Hispanic ethnicity, delivery payment source, pre-existing conditions, and complications during pregnancy or labour and delivery. There was significant under-reporting of ART procedures on the birth certificates. Using data on ART births identified only from birth certificates yields a biased sample of the population of ART births. © 2014 John Wiley & Sons Ltd.

  12. Who and where are the uncounted children? Inequalities in birth certificate coverage among children under five years in 94 countries using nationally representative household surveys.

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    Bhatia, Amiya; Ferreira, Leonardo Zanini; Barros, Aluísio J D; Victora, Cesar Gomes

    2017-08-18

    Birth registration, and the possession of a birth certificate as proof of registration, has long been recognized as a fundamental human right. Data from a functioning civil registration and vital statistics (CRVS) system allows governments to benefit from accurate and universal data on birth and death rates. However, access to birth certificates remains challenging and unequal in many low and middle-income countries. This paper examines wealth, urban/rural and gender inequalities in birth certificate coverage. We analyzed nationally representative household surveys from 94 countries between 2000 and 2014 using Demographic Health Surveys and Multiple Indicator Cluster Surveys. Birth certificate coverage among children under five was examined at the national and regional level. Absolute measures of inequality were used to measure inequalities in birth certificate coverage by wealth quintile, urban/rural residence and sex of the child. Over four million children were included in the analysis. Birth certificate coverage was over 90% in 29 countries and below 50% in 36 countries, indicating that more than half the children under five surveyed in these countries did not have a birth certificate. Eastern & Southern Africa had the lowest average birth certificate coverage (26.9%) with important variability among countries. Significant wealth inequalities in birth certificate coverage were observed in 74 countries and in most UNICEF regions, and urban/rural inequalities were present in 60 countries. Differences in birth certificate coverage between girls and boys tended to be small. We show that wealth and urban/rural inequalities in birth certificate coverage persist in most low and middle income countries, including countries where national birth certificate coverage is between 60 and 80%. Weak CRVS systems, particularly in South Asia and Africa lead rural and poor children to be systematically excluded from the benefits tied to a birth certificate, and prevent these

  13. Maternal and perinatal aspects of birth defects: a case-control study

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    Geiza Cesar Nhoncanse

    2014-03-01

    Full Text Available Objective: To assess the prevalence of congenital defects and to investigate their maternal and perinatal associated aspects by reviewing Birth Certificates. Methods: Among all born alive infants from January 2003 to December 2007 in Maternidade da Santa Casa de Misericórdia of São Carlos, Southeast Brazil (12,199 infants, cases were identified as the newborns whose Birth Certificates registered any congenital defect. The same sex neonate born immediately after the case was chosen as a control. In total, 13 variables were analyzed: six were maternal related, three represented labor and delivery conditions and four were linked to fetal status. The chi-square and Fisher's exact tests were used to compare the variables, being significant p<0.05. Results: The prevalence of congenital defects was 0.38% and the association of two or more defects represented 32% of all cases. The number of mothers whose education level was equal or less than eight years was significantly higher among the group with birth defects (p=0.047. A higher frequency of prematurity (p<0.001 and cesarean delivery (p=0.004 was observed among children with birth defects. This group also showed lower birth weight and Apgar scores in the 1st and the 5th minute (p<0.001. Conclusions: The prevalence of congenital defect of 0.38% is possibly due to underreporting. The defects notified in the Birth Certificates were only the most visible ones, regardless of their severity. There is a need of adequate epidemiological monitoring of birth defects in order to create and expand prevention and treatment programs.

  14. Association of missing paternal demographics on infant birth certificates with perinatal risk factors for childhood obesity

    Directory of Open Access Journals (Sweden)

    Erika R. Cheng

    2016-07-01

    Full Text Available Abstract Background The role of fathers in the development of obesity in their offspring remains poorly understood. We evaluated associations of missing paternal demographic information on birth certificates with perinatal risk factors for childhood obesity. Methods Data were from the Linked CENTURY Study, a database linking birth certificate and well-child visit data for 200,258 Massachusetts children from 1980–2008. We categorized participants based on the availability of paternal age, education, or race/ethnicity and maternal marital status on the birth certificate: (1 pregnancies missing paternal data; (2 pregnancies involving unmarried women with paternal data; and (3 pregnancies involving married women with paternal data. Using linear and logistic regression, we compared differences in smoking during pregnancy, gestational diabetes, birthweight, breastfeeding initiation, and ever recording a weight for length (WFL ≥ the 95th percentile or crossing upwards ≥2 WFL percentiles between 0–24 months among the study groups. Results 11,989 (6.0 % birth certificates were missing paternal data; 31,323 (15.6 % mothers were unmarried. In adjusted analyses, missing paternal data was associated with lower birthweight (β -0.07 kg; 95 % CI: −0.08, −0.05, smoking during pregnancy (AOR 4.40; 95 % CI: 3.97, 4.87, non-initiation of breastfeeding (AOR 0.39; 95 % CI: 0.36, 0.42, and with ever having a WFL ≥ 95th percentile (AOR 1.10; 95 % CI: 1.01, 1.20. Similar associations were noted for pregnancies involving unmarried women with paternal data, but differences were less pronounced. Conclusions Missing paternal data on the birth certificate is associated with perinatal risk factors for childhood obesity. Efforts to understand and reduce obesity risk factors in early life may need to consider paternal factors.

  15. Birth Control

    Science.gov (United States)

    Birth control, also known as contraception, is designed to prevent pregnancy. Birth control methods may work in a number of different ... eggs that could be fertilized. Types include birth control pills, patches, shots, vaginal rings, and emergency contraceptive ...

  16. Who and where are the uncounted children? Inequalities in birth certificate coverage among children under five years in 94 countries using nationally representative household surveys

    OpenAIRE

    Bhatia, Amiya; Ferreira, Leonardo Zanini; Barros, Alu?sio J. D.; Victora, Cesar Gomes

    2017-01-01

    Background Birth registration, and the possession of a birth certificate as proof of registration, has long been recognized as a fundamental human right. Data from a functioning civil registration and vital statistics (CRVS) system allows governments to benefit from accurate and universal data on birth and death rates. However, access to birth certificates remains challenging and unequal in many low and middle-income countries. This paper examines wealth, urban/rural and gender inequalities i...

  17. Birth control pills - combination

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000655.htm Birth control pills - combination To use the sharing features on ... both progestin and estrogen. What Are Combination Birth Control Pills? Birth control pills help keep you from ...

  18. Essure Permanent Birth Control

    Science.gov (United States)

    ... Prosthetics Essure Permanent Birth Control Essure Permanent Birth Control Share Tweet Linkedin Pin it More sharing options ... Print Essure is a a permanently implanted birth control device for women (female sterilization). Implantation of Essure ...

  19. Birth Control

    Science.gov (United States)

    ... even if you aren’t going for birth control. What doesn’t work to prevent pregnancy? top It’s ... and taking care of a baby’s many needs. What if I need birth control in an emergency? top Emergency contraception (EC) is ...

  20. Birth Control Shot

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    ... Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Birth Control Shot KidsHealth / For Teens / Birth Control Shot What's ...

  1. Birth Control Ring

    Science.gov (United States)

    ... Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Birth Control Ring KidsHealth / For Teens / Birth Control Ring What's ...

  2. Birth Control Pill

    Science.gov (United States)

    ... Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Birth Control Pill KidsHealth / For Teens / Birth Control Pill What's ...

  3. Birth Control Patch

    Science.gov (United States)

    ... Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Birth Control Patch KidsHealth / For Teens / Birth Control Patch What's ...

  4. Adequacy of antenatal care and its relationship with low birth weight in Botucatu, Sao Paulo, Brazil: a case-control study

    OpenAIRE

    Fonseca, Cátia Regina Branco da [UNESP; Louzada Strufaldi, Maria Wany; Carvalho, Lidia Raquel de [UNESP; Puccini, Rosana Fiorini [UNESP

    2014-01-01

    Background: Birth weight reflects gestational conditions and development during the fetal period. Low birth weight (LBW) may be associated with antenatal care (ANC) adequacy and quality. the purpose of this study was to analyze ANC adequacy and its relationship with LBW in the Unified Health System in Brazil.Methods: A case-control study was conducted in Botucatu, São Paulo, Brazil, 2004 to 2008. Data were collected from secondary sources (the Live Birth Certificate), and primary sources (the...

  5. Birth control pills - progestin only

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000656.htm Birth control pills - progestin only To use the sharing features ... estrogen in them. What Are Progestin Only Birth Control Pills? Birth control pills help keep you from ...

  6. 28 CFR 551.21 - Birth control.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Birth control. 551.21 Section 551.21... Birth Control, Pregnancy, Child Placement, and Abortion § 551.21 Birth control. Medical staff shall provide an inmate with advice and consultation about methods for birth control and, where medically...

  7. Access control based on attribute certificates for medical intranet applications.

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    Mavridis, I; Georgiadis, C; Pangalos, G; Khair, M

    2001-01-01

    Clinical information systems frequently use intranet and Internet technologies. However these technologies have emphasized sharing and not security, despite the sensitive and private nature of much health information. Digital certificates (electronic documents which recognize an entity or its attributes) can be used to control access in clinical intranet applications. To outline the need for access control in distributed clinical database systems, to describe the use of digital certificates and security policies, and to propose the architecture for a system using digital certificates, cryptography and security policy to control access to clinical intranet applications. We have previously developed a security policy, DIMEDAC (Distributed Medical Database Access Control), which is compatible with emerging public key and privilege management infrastructure. In our implementation approach we propose the use of digital certificates, to be used in conjunction with DIMEDAC. Our proposed access control system consists of two phases: the ways users gain their security credentials; and how these credentials are used to access medical data. Three types of digital certificates are used: identity certificates for authentication; attribute certificates for authorization; and access-rule certificates for propagation of access control policy. Once a user is identified and authenticated, subsequent access decisions are based on a combination of identity and attribute certificates, with access-rule certificates providing the policy framework. Access control in clinical intranet applications can be successfully and securely managed through the use of digital certificates and the DIMEDAC security policy.

  8. Perinatal risks of planned home births in the United States.

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    Grünebaum, Amos; McCullough, Laurence B; Brent, Robert L; Arabin, Birgit; Levene, Malcolm I; Chervenak, Frank A

    2015-03-01

    We analyzed the perinatal risks of midwife-attended planned home births in the United States from 2010 through 2012 and compared them with recommendations from the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) for planned home births. Data from the US Centers for Disease Control and Prevention's National Center for Health Statistics birth certificate data files from 2010 through 2012 were utilized to analyze the frequency of certain perinatal risk factors that were associated with planned midwife-attended home births in the United States and compare them with deliveries performed in the hospital by certified nurse midwives. Home birth deliveries attended by others were excluded; only planned home births attended by midwives were included. Hospital deliveries attended by certified nurse midwives served as the reference. Perinatal risk factors were those established by ACOG and AAP. Midwife-attended planned home births in the United States had the following risk factors: breech presentation, 0.74% (odds ratio [OR], 3.19; 95% confidence interval [CI], 2.87-3.56); prior cesarean delivery, 4.4% (OR, 2.08; 95% CI, 2.0-2.17); twins, 0.64% (OR, 2.06; 95% CI, 1.84-2.31); and gestational age 41 weeks or longer, 28.19% (OR, 1.71; 95% CI, 1.68-1.74). All 4 perinatal risk factors were significantly higher among midwife-attended planned home births when compared with certified nurse midwives-attended hospital births, and 3 of 4 perinatal risk factors were significantly higher in planned home births attended by non-American Midwifery Certification Board (AMCB)-certified midwives (other midwives) when compared with home births attended by certified nurse midwives. Among midwife-attended planned home births, 65.7% of midwives did not meet the ACOG and AAP recommendations for certification by the American Midwifery Certification Board. At least 30% of midwife-attended planned home births are not low risk and not within

  9. Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births.

    Science.gov (United States)

    Wax, Joseph R; Pinette, Michael G; Cartin, Angelina; Blackstone, Jacquelyn

    2010-02-01

    We sought to evaluate perinatal morbidity by delivery location (hospital, freestanding birth center, and home). Selected 2006 US birth certificate data were accessed online from the Centers for Disease Control and Prevention. Low-risk maternal and newborn outcomes were tabulated and compared by birth facility. A total of 745,690 deliveries were included, of which 733,143 (97.0%) occurred in hospital, 4661 (0.6%) at birth centers, and 7427 (0.9%) at home. Compared with hospital deliveries, home and birthing center deliveries were associated with more frequent prolonged and precipitous labors. Home births experienced more frequent 5-minute Apgar scores home and birthing center deliveries were associated with less frequent chorioamnionitis, fetal intolerance of labor, meconium staining, assisted ventilation, neonatal intensive care unit admission, and birthweight Home births are associated with a number of less frequent adverse perinatal outcomes at the expense of more frequent abnormal labors and low 5-minute Apgar scores. Copyright 2010 Mosby, Inc. All rights reserved.

  10. [Evaluation of data on live birth certificates from the Information System on Live Births (SINASC) in Campinas, São Paulo, 2009].

    Science.gov (United States)

    Gabriel, Guilherme Paiva; Chiquetto, Letícia; Morcillo, André Moreno; Ferreira, Maria do Carmo; Bazan, Ivan Gilberto M; Daolio, Luísa Dias; Lemos, Jéssica J Rocha; Carniel, Emília de Faria

    2014-09-01

    To assess the completeness and reliability of the Information System on Live Births (Sinasc) data. A cross-sectional analysis of the reliability and completeness of Sinasc's data was performed using a sample of Live Birth Certificate (LBC) from 2009, related to births from Campinas, Southeast Brazil. For data analysis, hospitals were grouped according to category of service (Unified National Health System, private or both), 600 LBCs were randomly selected and the data were collected in LBC-copies through mothers and newborns' hospital records and by telephone interviews. The completeness of LBCs was evaluated, calculating the percentage of blank fields, and the LBCs agreement comparing the originals with the copies was evaluated by Kappa and intraclass correlation coefficients. The percentage of completeness of LBCs ranged from 99.8%-100%. For the most items, the agreement was excellent. However, the agreement was acceptable for marital status, maternal education and newborn infants' race/color, low for prenatal visits and presence of birth defects, and very low for the number of deceased children. The results showed that the municipality Sinasc is reliable for most of the studied variables. Investments in training of the professionals are suggested in an attempt to improve system capacity to support planning and implementation of health activities for the benefit of maternal and child population. Copyright © 2014 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  11. Birth Control: How to Use Your Diaphragm

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    ... Emotional Well-Being Mental Health Sex and Birth Control Sex and Sexuality Birth Control Family Health Infants and Toddlers Kids and Teens ... MoreBMI Calculator Vasectomy: What to ExpectProgestin-Only Birth Control PillsDepo-Provera: An Injectable ContraceptiveTubal Sterilization (Tubal Ligation) ...

  12. Efficient linking of birth certificate and newborn screening databases for laboratory investigation of congenital cytomegalovirus infection and preterm birth: Florida, 2008.

    Science.gov (United States)

    DePasquale, John M; Freeman, Karen; Amin, Minal M; Park, Sohyun; Rivers, Samantha; Hopkins, Richard; Cannon, Michael J; Dy, Bonifacio; Dollard, Sheila C

    2012-02-01

    The objectives of this study are (1) to design an accurate method for linking newborn screening (NBS) and state birth certificate databases to create a de-identified study database; (2) To assess maternal cytomegalovirus (CMV) seroprevalence by measuring CMV IgG in newborn dried blood spots; (3) To assess congenital CMV infection among newborns and possible association with preterm birth. NBS and birth databases were linked and patient records were de-identified. A stratified random sample of records based on gestational age was selected and used to retrieve blood spots from the state NBS laboratory. Serum containing maternal antibodies was eluted from blood spots and tested for the presence of CMV IgG. DNA was extracted from blood spots and tested for the presence of CMV DNA. Analyses were performed with bivariable and multivariable logistic regression models. Linkage rates and specimen collection exceeded 98% of the total possible yielding a final database with 3,101 newborn blood spots. CMV seroprevalence was 91% among Black mothers, 83% among Hispanic mothers, 59% among White mothers, and decreased with increasing amounts of education. The prevalence of CMV infection in newborns was 0.45% and did not vary significantly by gestational age. Successful methods for database linkage, newborn blood spots collection, and de-identification of records can serve as a model for future congenital exposure surveillance projects. Maternal CMV seroprevalence was strongly associated with race/ethnicity and educational level. Congenital CMV infection rates were lower than those reported by other studies and lacked statistical power to examine associations with preterm birth.

  13. Associations between birth registration and early child growth and development: evidence from 31 low- and middle-income countries.

    Science.gov (United States)

    Jeong, Joshua; Bhatia, Amiya; Fink, Günther

    2018-05-30

    Lack of legal identification documents can impose major challenges for children in low- and middle-income countries (LMICs). The aim of this study was to investigate the association between not having a birth certificate and young children's physical growth and developmental outcomes in LMICs. We combined nationally representative data from the Multiple Indicator Cluster Surveys in 31 LMICs. For our measure of birth registration, primary caregivers reported on whether the child had a birth certificate. Early child outcome measures focused on height-for-age z-scores (HAZ), weight-for-age z-scores (WAZ), weight-for-height z-scores (WHZ), and standardized scores of the Early Childhood Development Index (ECDI) for a subsample of children aged 36-59 months. We used linear regression models with country fixed effects to estimate the relationship between birth registration and child outcomes. In fully adjusted models, we controlled for a variety of child, caregiver, household, and access to child services covariates, including cluster-level fixed effects. In the total sample, 34.7% of children aged 0-59 months did not possess a birth certificate. After controlling for covariates, not owning a birth certificate was associated with lower HAZ (β = - 0.18; 95% CI: -0.23, - 0.14), WAZ (β = - 0.10, 95% CI: -0.13, - 0.07), and ECDI z-scores (β = - 0.10; 95% CI: -0.13, - 0.07) among children aged 36-59 months. Our findings document links between birth registration and children's early growth and development outcomes. Efforts to increase birth registration may be promising for promoting early childhood development in LMICs.

  14. No certificate, no chocolate

    CERN Multimedia

    Computer Security Team

    2013-01-01

    Are you already ready to use “certificates” to log into CERN or to connect to the global “eduroam” wireless network? No, I am not talking about your birth certificate, medical certificates or academic certificates. I am referring to “certificates” used for authentication where you would usually use a password.   These digital certificates are a valid alternative to cumbersome passwords. Like the aforementioned personal certificates, a digital certificate is an official document that proves who you are or your qualifications. Your personal digital CERN certificate is tied to your digital identity at CERN. In that respect, a digital certificate is like a password. It is a credential that you must not share with anybody else! With your digital certificate, I can impersonate you and take over your mailbox, your web sessions and more… Digital certificates bind your digital identity to a public/private-key infrastructu...

  15. Birth control pills overdose

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/002599.htm Birth control pill overdose To use the sharing features on ... the medicine was prescribed for the person Poison Control Your local poison center can be reached directly ...

  16. [Prevalence of Down syndrome using certificates of live births and fetal deaths in México 2008-2011].

    Science.gov (United States)

    Sierra Romero, María Del Carmen; Navarrete Hernández, Eduardo; Canún Serrano, Sonia; Reyes Pablo, Aldelmo E; Valdés Hernández, Javier

    Down syndrome (DS) or trisomy 21 is the most common genetic cause of mental retardation with the clinical presentation of a series of well-defined characteristics. Advanced maternal age has been associated with DS. The databases of all the certificates of live births and fetal deaths in Mexico were combined. Codes based on the International Classification of Diseases 10 th Revision (ICD-10) in Chapter XVII "Congenital malformations, deformations and chromosomal abnormalities" were selected. A database of 8,250,375 births during the period 2008-2011 was constructed: 99.2% were live births with 0.8% of fetal deaths and 3,076 cases diagnosed with DS. The importance of this report is to initiate an epidemiological surveillance of newborn cases of DS nationwide and by state using census information systems available in the country since 2008. An increased risk has been observed for having a child with DS since the mother is ≥ 35 years, as has been reported in other studies. Copyright © 2014 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  17. Declaração de nascido vivo: análise do seu preenchimento no Município de Ribeirão Preto, São Paulo, Brasil Certificates of live birth: analysis of completion in the city of Ribeirão Preto, São Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Flávia Cristiane Mishima

    1999-04-01

    Full Text Available O estudo tem como objetivos identificar o fluxo de preenchimento das Declarações de Nascidos Vivos (DNs e analisar a consistência das informações contidas nas mesmas. Para a coleta de dados utilizou-se uma DN-Controle, preenchida com base nas informações contidas nos prontuários do recém-nascido e da mãe, as quais foram comparadas com os dados contidos na DN-Oficial, disponível no Departamento de Informática da Secretaria Municipal da Saúde de Ribeirão Preto. A amostragem constitui-se de 911 DNs dos nascimentos ocorridos no mês de julho de 1996. Da análise dos dados verificou-se que o fluxo de preenchimento da DN é heterogêneo entre os hospitais, envolvendo desde o pediatra até a escriturária, e às vezes, funcionários administrativos. Em relação à consistência das informações, identificou-se uma concordância elevada, acima de 90% em 13 das 18 variáveis comparadas nas DNs e em metade dos hospitais investigados; a discordância ocorreu, principalmente, naquelas informações referentes ao número de filhos tidos, número de consultas pré-natal, grau de instrução da mãe e nome do pai.The study aims to identify the frequency with which certificates of live birth are filled out and to analyze the data they provide. To gather the data, the authors used a model birth certificate filled out by research assistants based on information obtained from the reports on mothers and newborns. This information was then compared to data contained in the official birth certificates available in the Information Technology Division of the Municipal Health Department. The sample consisted of 911 certificates of live birth from July 1996 in the ten maternity wards of the city of Ribeirão Preto. Data analysis showed that frequency of completion of birth certificates differs by hospital, involving both physicians and administrative personnel. The authors identified a high level of agreement in the data, i.e., over 90% in 13 of 18

  18. Controllable entanglement sudden birth of Heisenberg spins

    International Nuclear Information System (INIS)

    Zheng Qiang; Zhi Qijun; Zhang Xiaoping; Ren Zhongzhou

    2011-01-01

    We investigate the Entanglement Sudden Birth (ESB) of two Heisenberg spins A and B. The third controller, qutrit C is introduced, which only has the Dzyaloshinskii-Moriya (DM) spin-orbit interaction with qubit B. We find that the DM interaction is necessary to induce the Entanglement Sudden Birth of the system qubits A and B, and the initial states of the system qubits and the qutrit C are also important to control its Entanglement Sudden Birth. (authors)

  19. Birth Control - Multiple Languages

    Science.gov (United States)

    ... Methods - English PDF How to Switch Birth Control Methods - 简体中文 (Chinese, Simplified (Mandarin dialect)) ... Reproductive Health Access Project Non-Contraceptive Indications for Hormonal Contraceptive Products - English PDF Non- ...

  20. Planned home birth and the association with neonatal hypoxic ischemic encephalopathy.

    Science.gov (United States)

    Wasden, Shane W; Chasen, Stephen T; Perlman, Jeffrey M; Illuzzi, Jessica L; Chervenak, Frank A; Grunebaum, Amos; Lipkind, Heather S

    2017-12-20

    To evaluate the association between planned home birth and neonatal hypoxic ischemic encephalopathy (HIE). This is a case-control study in which a database of neonates who underwent head cooling for HIE at our institution from 2007 to 2011 was linked to New York City (NYC) vital records. Four normal controls per case were then randomly selected from the birth certificate data after matching for year of birth, geographic location, and gestational age. Demographic and obstetric information was obtained from the vital records for both the cases and controls. Location of birth was analyzed as hospital or out of hospital birth. Details from the out of hospital deliveries were reviewed to determine if the delivery was a planned home birth. Maternal and pregnancy characteristics were examined as covariates and potential confounders. Logistic regression was used to determine the odds of HIE by intended location of delivery. Sixty-nine neonates who underwent head cooling for HIE had available vital record data on their births. The 69 cases were matched to 276 normal controls. After adjusting for pregnancy characteristics and mode of delivery, neonates with HIE had a 44.0-fold [95% confidence interval (CI) 1.7-256.4] odds of having delivered out of hospital, whether unplanned or planned. Infants with HIE had a 21.0-fold (95% CI 1.7-256.4) increase in adjusted odds of having had a planned home birth compared to infants without HIE. Out of hospital birth, whether planned home birth or unplanned out of hospital birth, is associated with an increase in the odds of neonatal HIE.

  1. 75 FR 70871 - Photo Requirements for Pilot Certificates

    Science.gov (United States)

    2010-11-19

    ... upgrading a pilot certificate (such as going from a student to a sport, recreational, or private pilot... interaction with the FAA (for example, change of name, citizenship, date of birth, or gender) would be a... final rule. Finally, a private, recreational, or sport pilot certificate holder would have 5 years after...

  2. Birth control - slow release methods

    Science.gov (United States)

    Contraception - slow-release hormonal methods; Progestin implants; Progestin injections; Skin patch; Vaginal ring ... might want to consider a different birth control method. SKIN PATCH The skin patch is placed on ...

  3. Birth control pills - overview

    Science.gov (United States)

    ... of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Birth Control Read more NIH MedlinePlus Magazine Read more Health ...

  4. Progestin-Only Birth Control Pills

    Science.gov (United States)

    ... this problem. Things to consider There is no contraceptive method that is perfect, even when used correctly. ... and Fitness Exercise Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health Sex and Birth Control ...

  5. Birth control, population control, and family planning: an overview.

    Science.gov (United States)

    Critchlow, D T

    1995-01-01

    This overview of the US birth control movement reflects on the emergence of family planning policy due to the efforts of Margaret Sanger, feminists, and the civil rights movement, the eugenics motive to limit "deviant" populations, and the population control movement, which aims to solve social and economic problems through fertility control. Population control moved through three stages: from the cause of "voluntary motherhood" to advance suffrage and women's political and social status, to the concept of "birth control" promoted by socialist feminists to help empower women and the working class, to, from 1920 on, a liberal movement for civil rights and population control. Physicians such as Dr. Robert Latou Dickinson legitimized the movement in the formation of the Committee on Maternal Health in 1925, but the movement remained divided until 1939, when Sanger's group merged with the American Birth Control League, the predecessor of the present Planned Parenthood Federation of America. A key legal decision in 1939 in the United States v. One Package amended the Comstock Act and allowed for the distribution of birth control devices by mail to physicians. Sanger, after a brief retirement, formed the International Planned Parenthood Federation and supported research into the pill. Eugenicists through the Committee on Maternal Health supported Christopher Tietze and others developing the pill. Final constitutional access to contraception based on the right to privacy was granted in Griswold v. Connecticut. The ruling in Eisenstadt v. Baird in 1972 extended this right to unmarried persons. The right to privacy was further extended in the Roe v. Wade decision in 1973 on legal abortion. The argument for improving the quality of the population remained from the formation of the Population Reference Bureau in 1929 through the 1960s. Under the leadership of Rockefeller, population control was defined as justified on a scientific and humanitarian basis. US government support

  6. 9 CFR 79.5 - Issuance of certificates.

    Science.gov (United States)

    2010-01-01

    ... AGRICULTURE INTERSTATE TRANSPORTATION OF ANIMALS (INCLUDING POULTRY) AND ANIMAL PRODUCTS SCRAPIE IN SHEEP AND... the consignee. Certificates must indicate the flock of birth for any breeding sheep born after January...

  7. Residential Agricultural Pesticide Exposures and Risks of Spontaneous Preterm Birth.

    Science.gov (United States)

    Shaw, Gary M; Yang, Wei; Roberts, Eric M; Kegley, Susan E; Stevenson, David K; Carmichael, Suzan L; English, Paul B

    2018-01-01

    Pesticides exposures are aspects of the human exposome that have not been sufficiently studied for their contribution to risk for preterm birth. We investigated risks of spontaneous preterm birth from potential residential exposures to 543 individual chemicals and 69 physicochemical groupings that were applied in the San Joaquin Valley of California during the study period, 1998-2011. The study population was derived from birth certificate data linked with Office of Statewide Health Planning and Development maternal and infant hospital discharge data. After exclusions, the analytic study base included 197,461 term control births and 27,913 preterm case births. Preterm cases were more narrowly defined as 20-23 weeks (n = 515), 24-27 weeks (n = 1,792), 28-31 weeks (n = 3,098), or 32-36 weeks (n = 22,508). The frequency of any (versus none) pesticide exposure was uniformly lower in each preterm case group relative to the frequency in term controls, irrespective of gestational month of exposure. All odds ratios were below 1.0 for these any versus no exposure comparisons. The majority of odds ratios were below 1.0, many of them statistically precise, for preterm birth and exposures to specific chemical groups or chemicals. This study showed a general lack of increased risk of preterm birth associated with a range of agriculture pesticide exposures near women's residences.

  8. Use of Modern Birth Control Methods Among Rural Communities in ...

    African Journals Online (AJOL)

    elearning

    ABSTRACT. This paper studied the extent of utilization of Modern Birth Control Methods (MBCM) among rural dwellers in ... respondents used MBCM while 57% of them used the traditional birth control methods. ..... School of Public Health.

  9. Births: Final Data for 1999. National Vital Statistics Reports, Volume 49, Number 1.

    Science.gov (United States)

    Ventura, Stephanie J.; Martin, Joyce A.; Curtin, Sally C.; Menacker, Fay; Hamilton, Brady E.

    This report presents data on U.S. births using information from the birth certificates of the 3.96 million births in 1999. Data are presented for maternal demographics (age, live-birth order, race, Hispanic origin, marital status, and educational attainment); maternal characteristics (medical risk factors, weight gain, tobacco use, and alcohol…

  10. Projection Operator: A Step Towards Certification of Adaptive Controllers

    Science.gov (United States)

    Larchev, Gregory V.; Campbell, Stefan F.; Kaneshige, John T.

    2010-01-01

    One of the major barriers to wider use of adaptive controllers in commercial aviation is the lack of appropriate certification procedures. In order to be certified by the Federal Aviation Administration (FAA), an aircraft controller is expected to meet a set of guidelines on functionality and reliability while not negatively impacting other systems or safety of aircraft operations. Due to their inherent time-variant and non-linear behavior, adaptive controllers cannot be certified via the metrics used for linear conventional controllers, such as gain and phase margin. Projection Operator is a robustness augmentation technique that bounds the output of a non-linear adaptive controller while conforming to the Lyapunov stability rules. It can also be used to limit the control authority of the adaptive component so that the said control authority can be arbitrarily close to that of a linear controller. In this paper we will present the results of applying the Projection Operator to a Model-Reference Adaptive Controller (MRAC), varying the amount of control authority, and comparing controller s performance and stability characteristics with those of a linear controller. We will also show how adjusting Projection Operator parameters can make it easier for the controller to satisfy the certification guidelines by enabling a tradeoff between controller s performance and robustness.

  11. Birth control and family planning

    Science.gov (United States)

    ... of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Birth Control Read more NIH MedlinePlus Magazine Read more Health ...

  12. FastStats: Births -- Method of Delivery

    Science.gov (United States)

    ... 1990–2013 [PDF – 423 KB] Primary Cesarean Delivery Rates, by State: Results From the Revised Birth Certificate, 2006–2012 [PDF – 274 KB] Related Links Vital Statistics downloadable public use data files American College of ...

  13. Towards the certification of non-deterministic control systems for safety-critical applications: analysing aviation analogies for possible certification strategies

    CSIR Research Space (South Africa)

    Burger, CR

    2011-11-01

    Full Text Available Current certification criteria for safety-critical systems exclude non-deterministic control systems. This paper investigates the feasibility of using human-like monitoring strategies to achieve safe non-deterministic control using multiple...

  14. Socioeconomic position in early life, birth weight, childhood cognitive function, and adult mortality

    DEFF Research Database (Denmark)

    Osler, M; Andersen, A-M N; Due, P

    2003-01-01

    . The data were analysed using Cox regression. SETTING: The metropolitan area of Copenhagen, Denmark. SUBJECTS: 7493 male singletons born in 1953, who completed a questionnaire with various cognitive measures, in school at age 12 years, and for whom birth certificates with data on birth and parental...... with all cause mortality. The association between father's social class and mortality attenuated (HR(working class)1.30 (1.08 to 1.56); HR(unknown class)1.81 (1.30 to 2.52)) after control for birth weight and cognitive function. Mortality from cardiovascular diseases and violent deaths was also......OBJECTIVE: To examine the relation between socioeconomic position in early life and mortality in young adulthood, taking birth weight and childhood cognitive function into account. DESIGN: A longitudinal study with record linkage to the Civil Registration System and Cause of Death Registry...

  15. Other Factors That Affect Heart Disease: Birth Control Pills

    Science.gov (United States)

    ... are considering using one, keep these guidelines in mind: Don't mix smoking and "the pill." If you smoke cigarettes, make a serious effort to quit. If you cannot quit, choose a different form of birth control. Cigarette smoking boosts the risk of serious health problems from birth ...

  16. How Would Children Register Their Own Births? Insights from a Survey of Students Regarding Birth Registration Knowledge and Policy Suggestions in Kenya.

    Directory of Open Access Journals (Sweden)

    Matthew Pelowski

    Full Text Available Birth registration and obtaining physical birth certificates impose major challenges in developing countries, with impact on child and community health, education, planning, and all levels of development. However despite initiatives, universal registration is elusive, leading to calls for new approaches to understanding the decisions of parents. In this paper, we report results of a survey of students in grades six to eight (age ~12-16 in an under-registered area of Kenya regarding their own understanding of registration issues and their suggestions for improvement. These students were selected because they themselves were also nearing the age for high school enrollment/entrance examinations, which specifically requires possession of a birth certificate. This assessment was also a companion to our previous representative survey of adults in the same Kenyan region, allowing for parent-child comparison. Results supported previous research, showing that only 43% had birth certificates. At the same time, despite these low totals, students were themselves quite aware of registration factors and purposes. The students also made quite prescient sources for understanding their households' motivations, with many of their suggestions-for focus on communication of pragmatic benefits, or automatic measures shifting responsibility from parents-mirroring our own previous suggestions, and showing a level of pragmatism not witnessed when surveying their parents. This paper therefore adds evidence to the discussion of registration policy planning. More generally, it also builds on an important trend regarding the treatment of children as stakeholders and important sources of information, and raising an intriguing new avenue for future research.

  17. Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap

    Science.gov (United States)

    ... ACOG Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap Home For Patients Search ... Format Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap Contraception What are barrier ...

  18. [Medical certificates in occupational accidents, in common law and social affairs].

    Science.gov (United States)

    El Banna, S; Van de Vyvere, A; Beauthier, J-P

    2013-09-01

    Physicians are asked to complete certificates within their profession. These certificates relate to various aspects of an individual's life, from birth to the end of life. The nature of requests is striking by its diversity. As a first step, the authors recall the outline of a certificate and its structure, as well as traps, hazards and risks to avoid. In a second step they describe three specific situations for the certificate: in the context of work accidents, common law accidents and social matters. All materials can not be treated in this space, so they refer the reader to the main bibliographic sources useful in this matter.

  19. 78 FR 979 - Petition for Positive Train Control Safety Plan Approval and System Certification of the...

    Science.gov (United States)

    2013-01-07

    ...] Petition for Positive Train Control Safety Plan Approval and System Certification of the Electronic Train... the Federal Railroad Administration (FRA) for Positive Train Control (PTC) Safety Plan (PTCSP) approval and system certification of the Electronic Train Management System (ETMS) as required by 49 U.S.C...

  20. Errors in registered birth weight and its implications for mortality statistics

    OpenAIRE

    Anand, D; Pharoah, P

    2000-01-01

    BACKGROUND—Birth weight mortality statistics are important for examining trends and monitoring the outcomes of neonatal care.
AIM—To determine the effects of errors in the registered birth weight on birth weight specific mortality.
METHODS—All twins born in England and Wales during 1993-95 comprise the denominator population. For those twins that died, the Office for National Statistics (ONS) provided copies of the death certificates. From the information on the death cer...

  1. Placental histology in spontaneous and indicated preterm birth: A case control study

    NARCIS (Netherlands)

    Nijman, Tobias A. J.; van Vliet, Elvira O. G.; Benders, Manon J. N.; Mol, Ben Willem J.; Franx, Arie; Nikkels, Peter G. J.; Oudijk, Martijn A.

    2016-01-01

    Placental pathology is an important contributor in preterm birth, both spontaneous and indicated. The aim of this study was to describe and compare placental histological features of spontaneous preterm birth versus indicated preterm birth. A case control study was performed at the University

  2. Women and postfertilization effects of birth control: consistency of beliefs, intentions and reported use

    Directory of Open Access Journals (Sweden)

    Kim Han S

    2005-11-01

    Full Text Available Abstract Background This study assesses the consistency of responses among women regarding their beliefs about the mechanisms of actions of birth control methods, beliefs about when human life begins, the intention to use or not use birth control methods that they believe may act after fertilization or implantation, and their reported use of specific methods. Methods A questionnaire was administered in family practice and obstetrics and gynecology clinics in Salt Lake City, Utah, and Tulsa, Oklahoma. Participants included women ages 18–50 presenting for any reason and women under age 18 presenting for family planning or pregnancy care. Analyses were based on key questions addressing beliefs about whether specific birth control methods may act after fertilization, beliefs about when human life begins, intention to use a method that may act after fertilization, and reported use of specific methods. The questionnaire contained no information about the mechanism of action of any method of birth control. Responses were considered inconsistent if actual use contradicted intentions, if one intention contradicted another, or if intentions contradicted beliefs. Results Of all respondents, 38% gave consistent responses about intention to not use or to stop use of any birth control method that acted after fertilization, while 4% gave inconsistent responses. The corresponding percentages for birth control methods that work after implantation were 64% consistent and 2% inconsistent. Of all respondents, 34% reported they believed that life begins at fertilization and would not use any birth control method that acts after fertilization (a consistent response, while 3% reported they believed that life begins at fertilization but would use a birth control method that acts after fertilization (inconsistent. For specific methods of birth control, less than 1% of women gave inconsistent responses. A majority of women (68% or greater responded accurately about the

  3. 9 CFR 2.133 - Certification for random source dogs and cats.

    Science.gov (United States)

    2010-01-01

    ..., DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Miscellaneous § 2.133 Certification for random source... of birth or, if unknown, then the approximate age; (iv) The color and any distinctive markings; and...

  4. Nursing, social contexts, and ideologies in the early United States birth control movement.

    Science.gov (United States)

    Lagerwey, M D

    1999-12-01

    Using historical discourse analysis, this study provides a thematic analysis of writings of nursing and birth control as found in The Birth Control Review from 1917 to 1927. The author contrasts this publication with the official journal of the American Nurses Association, the American Journal of Nursing from the same years to explore nursing voices and silences in early birth control stories. In dialogue with social contexts, nursing endeavors and inactivity have played important yet conflicting roles in the birth control movement in the United States. Nursing writings from the early twentieth century reflect eugenic beliefs, national fears of immigrants, and ambivalence about women's roles in society and the home. Nurses simultaneously empowered women to choose when to become pregnant and reinforced nativist and paternalistic views of the poor.

  5. Ethnicity, maternal risk, and birth weight among Hispanics in Massachusetts, 1987-89.

    OpenAIRE

    Cohen, B B; Friedman, D J; Mahan, C M; Lederman, R; Munoz, D

    1993-01-01

    National data reveal that low birth weight and infant mortality rates among Hispanics are, in general, between the rates for whites and those for blacks. The question remains, do differences in low birth weight reflect distributions of known risk factors, or do ethnic differences persist after simultaneously adjusting for intervening variables? In this study, Massachusetts birth certificate data for 206,973 white non-Hispanic infants and 19,571 Hispanic infants are used to examine differences...

  6. Assimilation and Health: Evidence From Linked Birth Records of Second- and Third-Generation Hispanics.

    Science.gov (United States)

    Giuntella, Osea

    2016-12-01

    This study explores the effects of assimilation on the health of Hispanics in the United States, using ethnic intermarriage as a metric of acculturation. I exploit a unique data set of linked confidential use birth records in California and Florida from 1970-2009. The confidential data allow me to link mothers giving birth in 1989-2009 to their own birth certificate records in 1970-1985 and to identify second-generation siblings. Thus, I can analyze the relationship between the parental exogamy of second-generation Hispanic women and the birth outcomes of their offspring controlling for grandmother fixed effects as well as indicators for second generation's birth weight. Despite their higher socioeconomic status, third-generation children of second-generation intermarried Hispanic women are more likely to have poor health at birth, even after I account for second-generation health at birth and employ only within-family variations in the extent of assimilation. I find that a second-generation Hispanic woman married to a non-Hispanic man is 9 % more likely to have a child with low birth weight relative to a second-generation woman married to another Hispanic. These results largely reflect the higher incidence of risky behaviors (e.g., smoking during pregnancy) among intermarried Hispanic women.

  7. User type certification for advanced flight control systems

    Science.gov (United States)

    Gilson, Richard D.; Abbott, David W.

    1994-01-01

    Advanced avionics through flight management systems (FMS) coupled with autopilots can now precisely control aircraft from takeoff to landing. Clearly, this has been the most important improvement in aircraft since the jet engine. Regardless of the eventual capabilities of this technology, it is doubtful that society will soon accept pilotless airliners with the same aplomb they accept driverless passenger trains. Flight crews are still needed to deal with inputing clearances, taxiing, in-flight rerouting, unexpected weather decisions, and emergencies; yet it is well known that the contribution of human errors far exceed those of current hardware or software systems. Thus human errors remain, and are even increasing in percentage as the largest contributor to total system error. Currently, the flight crew is regulated by a layered system of certification: by operation, e.g., airline transport pilot versus private pilot; by category, e.g., airplane versus helicopter; by class, e.g., single engine land versus multi-engine land; and by type (for larger aircraft and jet powered aircraft), e.g., Boeing 767 or Airbus A320. Nothing in the certification process now requires an in-depth proficiency with specific types of avionics systems despite their prominent role in aircraft control and guidance.

  8. Gender inequality, economic growth, and the intergenerational transmission of adverse health consequences at birth.

    Science.gov (United States)

    Qian, Mengcen; Chou, Shin-Yi; Deily, Mary E; Liu, Jin-Tan

    2018-03-01

    We estimate a gender differential in the intergenerational transmission of adverse birth outcomes. We link Taiwan birth certificates from 1978 to 2006 to create a sample of children born in the period 1999-2006 that includes information about their parents and their maternal grandmothers. We use maternal-sibling fixed effects to control for unobserved family-linked factors that may be correlated with birth outcomes across generations, and define adverse birth outcomes as small for gestational age. We find that when a mother is in the 5th percentile of birth weight for her gestational age, then her female children are 49-53% more likely to experience the same adverse birth outcome compared to other female children, while her male children are 27-32% more likely to experience this relative to other male children. We then investigate whether long-run improvements in local socio-economic conditions experienced by the child's family, as measured by intergenerational changes in town-level maternal education, affect the gender differential. We find no evidence that intergenerational improvements in socioeconomic conditions reduce the gender differential. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Birth Control and Low-Income Mexican-American Women: The Impact of Three Values.

    Science.gov (United States)

    Ortiz, Silvia; Casas, Jesus Manuel

    1990-01-01

    Assesses relationship between Mexican-American women's birth-control attitudes, knowledge, and usage, and values of motherhood, male dominance, and sexual expression. Multiple regression analysis links contraception attitudes with traditional values, regardless of acculturation. Establishes positive link between birth-control use and traditional…

  10. Effect of International Standards Certification on Firm-Level Exports: An Application of the Control Function Approach

    OpenAIRE

    Tsunehiro Otsuki

    2011-01-01

    Growing number of firms in developing countries have earned certifications such as International Standards Organization (ISO) as it enhances reputation of their company or brand and attract buyers particularly in export market. This study evaluates the effect of international standards certification on firm's export performance in Europe and Central Asia by applying the control function approach with endogenous treatment effect to firm-level data. Certification is found to increase export sha...

  11. Predictors of certification in infection prevention and control among infection preventionists: APIC MegaSurvey findings.

    Science.gov (United States)

    Kalp, Ericka L; Harris, Jeanette J; Zawistowski, Grace

    2018-06-06

    The 2015 APIC MegaSurvey was completed by 4,078 members to assess infection prevention practices. This study's purpose was to examine MegaSurvey results to relate infection preventionist (IP) certification status with demographic characteristics, organizational structure, compensation benefits, and practice and competency factors. Descriptive statistics were used to examine population characteristics and certification status. Bivariate logistic regression was performed to evaluate relationships between independent variables and certification status. Variables demonstrating statistical significance (P Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  12. [Transition in the midwifery profession. 25. The prewar birth control movement and the concept of eugenics].

    Science.gov (United States)

    Obayashi, M

    1987-08-01

    The concept of eugenics played a significant role in the pre-war birth control movement. Some favored birth control from the standpoint of an individual's right to happiness, while others were against it from the standpoint of preservation of good stock for the nation. Yamamoto, Nobuharu (1889-1929), who translated Margaret Sanger's speech and her book in 1922, advocated birth control purely from a biologist's point of view. Birth control is necessary for the survival of strong healthy human beings capable of overcoming all the difficulties in their lives. Birth control is a form of natural selection consciously done to avoid overburdening and wasting individual lives. Nagai, Sen (1876-1957) was opposed to birth control from eugenicc' point of view. He became the 1st president of Japan Racial Hygiene Society in 1930 and founded Eugenics/Marriage Counseling Clinic in 1933. In his book on eugenics published in 1936 he stressed the importance of continuation of race by protecting good stock and eliminating poor stock by sterilization. Birth control was opposed because it will shorten the life of an ethnic group or a race. Furuya, Yoshio (1890-1974), also a racial hygiene major, supported population policies based on eugenics. He studied a trend in childbirth among women of different professions and geographical areas. Educated and cultured urban upper-middle class women showed a sudden decline in childbirth in their later years of marriage, suggesting the prevalence of birth control among them, while less educated low-income women continued to reproduce. He opposed to birth control but was in favor of sterilization for eliminating poor stock.

  13. The correspondence between interracial births and multiple-race reporting.

    Science.gov (United States)

    Parker, Jennifer D; Madans, Jennifer H

    2002-12-01

    Race-specific health statistics are routinely reported in scientific publications; most describe health disparities across groups. Census 2000 showed that 2.4% of the US population identifies with more than 1 race group. We examined the hypothesis that multiple-race reporting is associated with interracial births by comparing parental race reported on birth certificates with reported race in a national health survey. US natality data from 1968 through 1998 and National Health Interview Survey data from 1990 through 1998 were compared, by year of birth. Overall multiple-race survey responses correspond to expectations from interracial births. However, there are discrepancies for specific multiple-race combinations. Projected estimates of the multiple-race population can be only partially informed by vital records.

  14. Developmental origins of polycystic ovary syndrome (PCOS), a case control study comparing birth weight in women with PCOS and control group.

    Science.gov (United States)

    Sadrzadeh, Sheda; Painter, Rebecca C; Lambalk, Cornelis B

    2016-10-01

    Evidence from various epidemiological studies and experimental animal studies has linked adverse intrauterine circumstances with health problems in adult life. This field of investigation is known as Developmental Origins of Health and Disease (DOHaD). Studies investigating the relation between developing polycystic ovary syndrome (PCOS) in adulthood and birth weight have yielded inconsistent results: PCOS is described more often in women with low birth weight and high birth weight, while other studies have failed to establish any relation. In this retrospective case-control study, we evaluated whether women diagnosed with PCOS had lower birth weight compared to women with a regular menstrual cycle (controls). Binary logistic regression models were used to analyze the data and correct for known confounders. About 65 women with PCOS and 96 controls were recruited for this purpose. The average birth weight of PCOS women (3357 g) did not differ from the average birth weight of controls (3409 g). Mean age at menarche differed significantly between groups, 13.7  years and 12.8  years (p = 0.006), respectively, for PCOS women and controls. In conclusion, we could not confirm the effect of adverse intrauterine conditions, reflected in birth weight, on developing PCOS.

  15. Birth weight and order as risk factors for childhood central nervous system tumors.

    Science.gov (United States)

    MacLean, Jane; Partap, Sonia; Reynolds, Peggy; Von Behren, Julie; Fisher, Paul Graham

    2010-09-01

    To determine whether birth characteristics related to maternal-fetal health in utero are associated with the development of childhood central nervous system tumors. We identified, from the California Cancer Registry, 3733 children under age 15 diagnosed with childhood central nervous system tumors between 1988 and 2006 and linked these cases to their California birth certificates. Four controls per case, matched on birth date and sex, were randomly selected from the same birth files. We evaluated associations of multiple childhood CNS tumor subtypes with birth weight and birth order. Low birth weight was associated with a reduced risk of low-grade gliomas (OR=0.67; 95% CI, 0.46 to 0.97) and high birth weight was associated with increased risk of high-grade gliomas (OR=1.57; 95% CI, 1.16 to 2.12). High birth order (fourth or higher) was associated with decreased risk of low-grade gliomas (OR=0.75; 95% CI, 0.56 to 0.99) and increased risk of high-grade gliomas (OR=1.32; 95% CI, 1.01 to 1.72 for second order). Factors that drive growth in utero may increase the risk of low-grade gliomas. There may be a similar relationship in high-grade gliomas, although other factors, such as early infection, may modify this association. Additional investigation is warranted to validate and further define these findings. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  16. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study.

    Science.gov (United States)

    Gill, Christopher J; Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H

    2011-02-03

    To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Prospective, cluster randomised and controlled effectiveness study. Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers' homes, in rural village settings. 127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district. Using an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits). The primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data. Among 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by intervention birth attendants (0.37, 0.17 to 0.81) and by 81% within the first two days

  17. "Natural family planning": effective birth control supported by the Catholic Church.

    OpenAIRE

    Ryder, R E

    1993-01-01

    During 20-22 September Manchester is to host the 1993 follow up to last year's "earth summit" in Rio de Janeiro. At that summit the threat posed by world overpopulation received considerable attention. Catholicism was perceived as opposed to birth control and therefore as a particular threat. This was based on the notion that the only method of birth control approved by the church--natural family planning--is unreliable, unacceptable, and ineffective. In the 20 years since E L Billings and co...

  18. Birth characteristics and the risk of childhood leukaemias and lymphomas in New Zealand: a case-control study

    Directory of Open Access Journals (Sweden)

    Dockerty John D

    2006-09-01

    Full Text Available Abstract Background Some studies have found that lower parity and higher or lower social class (depending on the study are associated with increased risks of childhood acute lymphoblastic leukaemia (ALL. Such findings have led to suggestions that infection could play a role in the causation of this disease. An earlier New Zealand study found a protective effect of parental marriage on the risk of childhood ALL, and studies elsewhere have reported increased risks in relation to older parental ages. This study aimed to assess whether lower parity, lower social class, unmarried status and older parental ages increase the risk of childhood ALL (primarily. These variables were also assessed in relation to the risks of childhood acute non-lymphoblastic leukaemia, non-Hodgkin's lymphomas and Hodgkin's disease. Methods A case control study was conducted. The cases were 585 children diagnosed with leukaemias or lymphomas throughout New Zealand over a 12 year period. The 585 age and sex matched controls were selected at random from birth records. Birth records from cases (via cancer registration record linkage and from controls provided accurate data on maternal parity, social class derived from paternal occupation, maternal marital status, ages of both parents, and urban status based on the address on the birth certificate. Analysis was by conditional logistic regression. Results There were no statistically significant associations overall between childhood ALL and parity of the mother, social class, unmarried maternal status, increasing parental ages (continuous analysis, or urban status. We also found no statistically significant associations between the risks of childhood acute non-lymphoblastic leukaemia, non-Hodgkin lymphomas, or Hodgkin's disease and the variables studied. Conclusion This study showed no positive results though of reasonable size, and its record linkage design minimised bias. Descriptive studies (eg of time trends of ALL show that

  19. Are residents of mountain-top mining counties more likely to have infants with birth defects? The West Virginia experience.

    Science.gov (United States)

    Lamm, Steven H; Li, Ji; Robbins, Shayhan A; Dissen, Elisabeth; Chen, Rusan; Feinleib, Manning

    2015-02-01

    Pooled 1996 to 2003 birth certificate data for four central states in Appalachia indicated higher rates of infants with birth defects born to residents of counties with mountain-top mining (MTM) than born to residents of non-mining-counties (Ahern 2011). However, those analyses did not consider sources of uncertainty such as unbalanced distributions or quality of data. Quality issues have been a continuing problem with birth certificate analyses. We used 1990 to 2009 live birth certificate data for West Virginia to reassess this hypothesis. Forty-four hospitals contributed 98% of the MTM-county births and 95% of the non-mining-county births, of which six had more than 1000 births from both MTM and nonmining counties. Adjusted and stratified prevalence rate ratios (PRRs) were computed both by using Poisson regression and Mantel-Haenszel analysis. Unbalanced distribution of hospital births was observed by mining groups. The prevalence rate of infants with reported birth defects, higher in MTM-counties (0.021) than in non-mining-counties (0.015), yielded a significant crude PRR (cPRR = 1.43; 95% confidence interval [CI] = 1.36-1.52) but a nonsignificant hospital-adjusted PRR (adjPRR = 1.08; 95% CI = 0.97-1.20; p = 0.16) for the 44 hospitals. So did the six hospital data analysis ([cPRR = 2.39; 95% CI = 2.15-2.65] and [adjPRR = 1.01; 95% CI, 0.89-1.14; p = 0.87]). No increased risk of birth defects was observed for births from MTM-counties after adjustment for, or stratification by, hospital of birth. These results have consistently demonstrated that the reported association between birth defect rates and MTM coal mining was a consequence of data heterogeneity. The data do not demonstrate evidence of a "Mountain-top Mining" effect on the prevalence of infants with reported birth defects in WV. © 2014 Wiley Periodicals, Inc.

  20. Trends in characteristics of women choosing contraindicated home births.

    Science.gov (United States)

    Zafman, Kelly B; Stone, Joanne L; Factor, Stephanie H

    2018-04-12

    To characterize the American College of Obstetricians and Gynecologists (ACOG) contraindicated home births and the women who are receiving these births in hopes of identifying venues for intervention. The National Center for Health Statistics (NCHS) birth certificate records from 1990 to 2015 were used. "Planned home births" were defined as those births in which birthplace was coded as "residence" and birth attendant was coded as "certified nurse midwife (CNM)" or "other midwife". Contraindicated home births were defined as "planned home births" from 1990 to 2015 that had one or more of the ACOG risk factors for home births, which include vaginal birth after prior cesarean delivery (VBAC), breech presentation and multiple gestations. A review of trends in contraindicated home births from 1990 to 2015 suggests that they are increasing in number (481-1396) and as a percentage of total births (0.01%-0.04%, P95%), which is most frequently initiated in the first trimester. The majority of home births were paid out-of-pocket (65%-69%). The increasing number of contraindicated home births in the United States requires public health action. Home births are likely a matter of choice rather than a lack of resources. It is unclear if women choose home births while knowing the risk or due to a lack of information. Prenatal education about contraindicated home births is possible, as almost all women receive prenatal care.

  1. Trends in birth weight-specific and -adjusted infant mortality rates in Taiwan between 2004 and 2011.

    Science.gov (United States)

    Liang, Fu-Wen; Chou, Hung-Chieh; Chiou, Shu-Ti; Chen, Li-Hua; Wu, Mei-Hwan; Lue, Hung-Chi; Chiang, Tung-Liang; Lu, Tsung-Hsueh

    2018-06-01

    A yearly increase in the proportion of very low birth weight (VLBW) live births has resulted in the slowdown of decreasing trends in crude infant mortality rates (IMRs). In this study, we examined the trends in birth weight-specific as well as birth weight-adjusted IMRs in Taiwan. We linked three nationwide datasets, namely the National Birth Reporting Database, National Birth Certification Registry, and National Death Certification Registry databases, to calculate the IMRs according to the birth weight category. Trend tests and mortality rate ratios in the periods 2010-2011 and 2004-2005 were used to examine the extent of reduction in birth weight-specific and birth weight-adjusted IMRs. The proportion of VLBW (births increased from 0.78% in 2004-2005 to 0.89% in 2010-2011, thus exhibiting a 15% increase. The extents of the decreases in birth weight-specific IMRs in the 500-999, 1000-1499, 1500-1999, 2000-2499, and 2500-2999 g birth weight categories were 15%, 33%, 43%, 30%, and 28%, respectively, from 2004-2005 to 2010-2011. The reduction in IMR in each birth weight category was larger than the reduction in the crude IMR (13%). By contrast, the IMR in the birth weight category exhibited a 56% increase during the study period. The IMRs were calculated by excluding all live births with a birth weight of birth weight-adjusted IMRs, which were calculated using a standard birth weight distribution structure for adjustment, exhibited similar extent reductions. In countries with an increasing proportion of VLBW live births, birth weight-specific or -adjusted IMRs are more appropriate than other indices for accurately assessing the real extent of reduction in IMRs. Copyright © 2017. Published by Elsevier B.V.

  2. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study

    Science.gov (United States)

    Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H

    2011-01-01

    Objective To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Design Prospective, cluster randomised and controlled effectiveness study. Setting Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers’ homes, in rural village settings. Participants 127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district. Interventions Using an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits). Main outcome measures The primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data. Results Among 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by

  3. Female Gynecologists and Their Birth Control Clinics: Eugenics in Practice in 1920s-1930s China.

    Science.gov (United States)

    David, Mirela

    2018-01-01

    Yang Chao Buwei, the first Chinese translator of Margaret Sanger's What Every Girl Should Know, was the first female gynecologist to open up a birth control clinic in China. By the 1930s, other female gynecologists, like Guo Taihua, had internalized and combined national and eugenic concerns of race regeneration to focus on the control of women's reproduction. This symbiosis between racial regeneration and birth control is best seen in Yang Chongrui's integration of birth control into her national hygiene program. This article traces the efforts of pioneer gynecologists in giving contraceptive advice at their birth control clinics, which they framed as a humanitarian effort to ease the reproductive burden of working-class women. It also examines their connections with Sanger's international birth control movement, and their advocacy of contraception as practitioners, translators, and educators. The author argues that these Chinese female gynecologists not only borrowed, but adapted, Western scientific knowledge to Chinese social conditions through their writings and translations and in their clinical work.

  4. Methods of Preventives to keep Birth Control in the Quran

    Directory of Open Access Journals (Sweden)

    Ahmad Yunus Mohd Noor

    2017-12-01

    Full Text Available This research is mainly concerned about the methods set by the Quran for preserving the human breeding, which is regarded the main pillar not only for the future survival of the humankind, but also for assuring its permanence and continuity. Taking this into consideration, the Quran has addressed this issue by setting solid preventive tools that ensure the continuity and prosperity of the human offspring in a normal manner. The objective of the research is to shed light on the importance of protecting the human offspring in the Quran, since neglecting its importance could lead to the corruption of the whole society and its members. The research attempts also to tackle the various preventive tools that the Quran has adopted for protecting the normal continuity and prosperity of the human offspring. The research proposes to study the Quranic verses that address the protection of the human offspring and the various preventive tools that should be adopted, along with the accredited analysis and statements of purpose of the Quranic verses, with reference to the approved sources of interpretation. Apart of the findings are that the Quran has set two main methods for protecting the human offspring that is; the preventive tools for protecting the amount of birth control, and the preventive tools for maintaining the quality of birth control. The preventive tools for protecting the amount of birth control include the forbidding of being monastic, the prohibiting of killing children for fear of poverty, and the forbidding of falling into immorality, either outwardly or inwardly. They also include the establishment of prayer, giving charity, reciting Dhikr (remembrance and asking of forgiveness. The preventive tools for maintaining the quality of birth control, however, include not approaching adultery, prohibiting adoption, and forbidding incest, the people of shirk and immorality and blasphemy.

  5. Births: final data for 2004.

    Science.gov (United States)

    Martin, Joyce A; Hamilton, Brady E; Sutton, Paul D; Ventura, Stephanie J; Menacker, Fay; Kirmeyer, Sharon

    2006-09-29

    This report presents 2004 data on U.S. births according to a wide variety of characteristics. Data are presented for maternal demographic characteristics including age, live-birth order, race, Hispanic origin, marital status, and educational attainment; maternal lifestyle and health characteristics (medical risk factors, weight gain, and tobacco use); medical care utilization by pregnant women (prenatal care, obstetric procedures, characteristics of labor and/or delivery, attendant at birth, and method of delivery); and infant characteristics (period of gestation, birthweight, Apgar score, congenital anomalies, and multiple births). Also presented are birth and fertility rates by age, live-birth order, race, Hispanic origin, and marital status. Selected data by mother's state of residence are shown, as well as data on month and day of birth, sex ratio, and age of father. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. Descriptive tabulations of data reported on the birth certificates of the 4.1 million births that occurred in 2004 are presented. Denominators for population-based rates are post-censal estimates derived from the U.S. 2000 census. In 2004, 4,112,052 births were registered in the United States, less than 1 percent more than the number in 2003. The crude birth rate declined slightly; the general fertility rate increased by less than 1 percent. Childbearing among teenagers and women aged 20-24 years declined to record lows. Rates for women aged 25-34 and 45-49 years were unchanged, whereas rates for women aged 35-44 years increased. All measures of unmarried childbearing rose in 2004. Smoking during pregnancy continued to decline. No improvement was seen in the timely initiation of prenatal care. The cesarean delivery rate jumped 6 percent to another all-time high, whereas the rate of vaginal birth after previous cesarean fell by 13 percent. Preterm and low birthweight rates continued their steady rise

  6. Birth complications control between midwives among women in ...

    African Journals Online (AJOL)

    Independent t-test and contingency chi-square were used in testing the null hypotheses. Results: The result showed that women delivered by traditional midwives have more negative control of delivery pain caused by birth complication than their counterparts who are delivered by western trained midwives; On the basis of ...

  7. Socioeconomic position in early life, birth weight, childhood cognitive function, and adult mortality. A longitudinal study of Danish men born in 1953

    DEFF Research Database (Denmark)

    Osler, M; Andersen, Anne-Marie Nybo; Due, P

    2003-01-01

    . The data were analysed using Cox regression. SETTING: The metropolitan area of Copenhagen, Denmark. SUBJECTS: 7493 male singletons born in 1953, who completed a questionnaire with various cognitive measures, in school at age 12 years, and for whom birth certificates with data on birth and parental...... with all cause mortality. The association between father's social class and mortality attenuated (HR(working class)1.30 (1.08 to 1.56); HR(unknown class)1.81 (1.30 to 2.52)) after control for birth weight and cognitive function. Mortality from cardiovascular diseases and violent deaths was also......OBJECTIVE: To examine the relation between socioeconomic position in early life and mortality in young adulthood, taking birth weight and childhood cognitive function into account. DESIGN: A longitudinal study with record linkage to the Civil Registration System and Cause of Death Registry...

  8. Simultaneous Authentication and Certification of Arms-Control Measurement Systems

    International Nuclear Information System (INIS)

    MacArthur, Duncan W.; Hauck, Danielle K.; Thron, Jonathan L.

    2012-01-01

    Most arms-control-treaty-monitoring scenarios involve a host party that makes a declaration regarding its nuclear material or items and a monitoring party that verifies that declaration. A verification system developed for such a use needs to be trusted by both parties. The first concern, primarily from the host party's point of view, is that any sensitive information that is collected must be protected without interfering in the efficient operation of the facility being monitored. This concern is addressed in what can be termed a 'certification' process. The second concern, of particular interest to the monitoring party, is that it must be possible to confirm the veracity of both the measurement system and the data produced by this measurement system. The monitoring party addresses these issues during an 'authentication' process. Addressing either one of these concerns independently is relatively straightforward. However, it is more difficult to simultaneously satisfy host party certification concerns and monitoring party authentication concerns. Typically, both parties will want the final access to the measurement system. We will describe an alternative approach that allows both parties to gain confidence simultaneously. This approach starts with (1) joint development of the measurement system followed by (2) host certification of several copies of the system and (3) random selection by the inspecting party of one copy to be use during the monitoring visit and one (or more) copy(s) to be returned to the inspecting party's facilities for (4) further hardware authentication; any remaining copies are stored under joint seal for use as spares. Following this process, the parties will jointly (5) perform functional testing on the selected measurement system and then (6) use this system during the monitoring visit. Steps (1) and (2) assure the host party as to the certification of whichever system is eventually used in the monitoring visit. Steps (1), (3), (4), and (5

  9. Simultaneous Authentication and Certification of Arms-Control Measurement Systems

    Energy Technology Data Exchange (ETDEWEB)

    MacArthur, Duncan W. [Los Alamos National Laboratory; Hauck, Danielle K. [Los Alamos National Laboratory; Thron, Jonathan L. [Los Alamos National Laboratory

    2012-07-09

    Most arms-control-treaty-monitoring scenarios involve a host party that makes a declaration regarding its nuclear material or items and a monitoring party that verifies that declaration. A verification system developed for such a use needs to be trusted by both parties. The first concern, primarily from the host party's point of view, is that any sensitive information that is collected must be protected without interfering in the efficient operation of the facility being monitored. This concern is addressed in what can be termed a 'certification' process. The second concern, of particular interest to the monitoring party, is that it must be possible to confirm the veracity of both the measurement system and the data produced by this measurement system. The monitoring party addresses these issues during an 'authentication' process. Addressing either one of these concerns independently is relatively straightforward. However, it is more difficult to simultaneously satisfy host party certification concerns and monitoring party authentication concerns. Typically, both parties will want the final access to the measurement system. We will describe an alternative approach that allows both parties to gain confidence simultaneously. This approach starts with (1) joint development of the measurement system followed by (2) host certification of several copies of the system and (3) random selection by the inspecting party of one copy to be use during the monitoring visit and one (or more) copy(s) to be returned to the inspecting party's facilities for (4) further hardware authentication; any remaining copies are stored under joint seal for use as spares. Following this process, the parties will jointly (5) perform functional testing on the selected measurement system and then (6) use this system during the monitoring visit. Steps (1) and (2) assure the host party as to the certification of whichever system is eventually used in the monitoring visit

  10. Talking about Birth Control in 1877: Gender, Class, and Ideology in the Knowlton Trial

    Directory of Open Access Journals (Sweden)

    Janssen Flore

    2017-11-01

    Full Text Available This article explores the debate around widening access to birth control information in the late nineteenth century through a case study of Annie Besant’s participation in the 1877 Knowlton Trial. Examining Besant’s rhetoric at the trial and in related publications, it highlights the public and performative nature of her campaign to facilitate access to birth control information for working-class married couples. With reference to the representation of issues of gender and social class and the shifting focus from the private to the public in Besant’s rhetoric, the article argues that the late nineteenth-century debate around birth control access was a middle-class debate about working-class life and experience.

  11. 42 CFR 493.638 - Certificate fees.

    Science.gov (United States)

    2010-10-01

    ... for quality control, quality assurance, and proficiency testing purposes) and specialties tested, with... collected by HHS under the laboratory program must be sufficient to cover the general costs of administering... certificates and certificates of compliance, the costs include issuing the certificates, collecting the fees...

  12. Maternal periodontal disease and preterm birth: A case-control study

    Directory of Open Access Journals (Sweden)

    Pushpalatha Govindaraju

    2015-01-01

    Full Text Available Background and Objective: Preterm birth (PTB is an important issue in public health and is a major cause for infant mortality and morbidity. There is a growing consensus that systemic diseases elsewhere in the body may influence PTB. Recent studies have hypothesized that maternal periodontitis could be a high-risk factor for PTB. The aim of the present study was to investigate the relationship between maternal periodontitis on PTB. Materials and Methods: Forty systemically healthy primiparous mothers aged 18–35 years were recruited for the study. Based on inclusion and exclusion criteria, they were categorized into PTB group as cases and full term birth group (FTB as controls. PTB cases (n = 20 defined as spontaneous delivery before/<37 completed weeks of gestation. Controls (FTB were normal births at or after 37 weeks of gestation. Data on periodontal status, pregnancy outcome variables, and information on other factors that may influence adverse pregnancy outcomes were collected within 2 days of labor. Data were subjected to Student's t-test and Pearson's correlation coefficient statistical analysis. Results: Statistically significant difference with respect to the gestational period at the time of delivery and birth weight of the infants in (PTB group (<0.001 compared to (FTB group was observed. Overall, there was statistically significant poor periodontal status in the (PTB group compared to (FTB group. The statistical results also showed a positive correlation between gestational age and clinical parameters. Conclusion: An observable relationship was noticed between periodontitis and gestational age, and a positive correlation was found with respect to PTB and periodontitis. Further studies should be designed to establish periodontal disease as an independent risk factor for PTB/preterm low birth weight.

  13. A lost chance? Birth control policies in the Mao's China (1949-1976

    Directory of Open Access Journals (Sweden)

    Daniel Gomá

    2010-12-01

    Full Text Available This article analyzes the birth control policies in China during the Maoist era (1949- 1976. Considering Chinese and foreign sources, it is explained how the different campaigns of family planning took place and how these campaigns were subjected positively and negatively to the policies of the supreme leader Mao Zedong. Although only the last one had a real impact on the fight against overpopulation, all campaigns helped to promote the necessity of confronting this phenomenon. More importantly, they laid the foundations of the birth control policies that currently take place in China.

  14. Birth Control Explorer

    Science.gov (United States)

    Menu Sex Ed Ask Us Anything Videos Games & Quizzes Connect Search About Find a Health Center X Sort by Advanced Search Show/Hide Content Types Article Game Poll Q&A Series Quiz Video Leave un-checked to search all types Search Sex Ed by Topic show topics hide topics Birth ...

  15. Birth attendance and magnitude of obstetric complications in Western Kenya: a retrospective case-control study.

    Science.gov (United States)

    Liambila, Wilson N; Kuria, Shiphrah N

    2014-09-08

    Skilled birth attendance is critical in the provision of child birth related services. Yet, literature is scanty on the outcomes of child birth related complications in situations where majority of women deliver under the care of non-skilled birth attendants compared to those who are assisted by skilled providers. The study sought to assess the nature of childbirth related complications among the skilled and the non-skilled birth attendants in Western Kenya. A case-control study was conducted among women aged 15-49 years at the household. Controls were individually matched to cases on the basis of age and socio-economic status. A total of 294 cases and 291 controls were interviewed. Data were collected on various demographic and socio-economic characteristics and women's perception on the quality of care. All independent variables were analysed initially in bivariate models and those that were significantly associated with obstetric complications were included in multiple logistic regression model in order to control for confounding factors. Odds ratios (ORs), with 95% confidence intervals, were computed to show the association between the occurrence, magnitude and the extent to which child birth related complications were managed. Demographic and socio-economic characteristics of the cases and controls were similar. About 52% of the deliveries were assisted by skilled birth attendants while non-skilled providers attended to 48% of them. The odds of the occurrence of obstetric complications were greater among the women who were attended to by skilled providers in health facilities: adjusted odds ratio (AOR): 1.32 (CI 0.95, 1.84) than among those who were assisted by unskilled birth attendants, AOR 0.76 (CI 0.55, 1.06). Undignified care, high delivery and transport costs and fear of hospital procedures such as HIV tests and mishandling of the placenta were cited as some of the barriers to facility deliveries. Skilled birth attendants in facilities were associated

  16. Access to the Birth Control Pill and the Career Plans of Young Men and Women

    DEFF Research Database (Denmark)

    Steingrimsdottir, Herdis

    The paper explores the effect of unrestricted access to the birth control pill on young people’s career plans, using annual surveys of college freshmen from 1968 to 1980. In particular it addresses the question of who was affected by the introduction of the birth control pill by looking at career...

  17. Effectiveness of the Maternal and Child Health handbook in Burundi for increasing notification of birth at health facilities and postnatal care uptake.

    Science.gov (United States)

    Kaneko, Kayo; Niyonkuru, Jacques; Juma, Ndereye; Mbonabuca, Térence; Osaki, Keiko; Aoyama, Atsuko

    2017-01-01

    In Burundi, birth certificate ownership (56.4%) and postnatal care (PNC) coverage (30%) remain low. Birth certificates prove birth registration and allow clients to receive free medical care including PNC. To obtain birth certificates, notification of birth by witnesses is indispensable. However, use of existing parallel home-based records for mother and child has prevented clients from successfully receiving notification of birth and related information. To assess the effectiveness of the Maternal and Child Health (MCH) handbook for increasing notification of birth at health facilities and PNC uptake. Pre- and post-introduction measurement were applied including: (i) structured interviews with two different sets of randomly selected mothers having infants aged less than six weeks at the pre- or post-studies; and (ii) secondary data from the national health management information system. 95.1% of mothers had an MCH handbook post-study. Significant improvement was observed in the proportion of mothers receiving notification of birth at health facilities, from 4.6% to 61.0% (95% confidence interval [CI]: 55.9%-66.2%), and the proportion of mothers receiving guidance on PNC, from 35.9% to 64.2% (95% CI: 59.2%-69.3%). The annual PNC coverage (43.9% to 54.2%; p increased from 2013 to 2014. Among MCH handbook owners, mothers giving birth at hospitals/clinics had 2.62 higher odds (95% CI: 1.63-4.22) of obtaining notification of birth than mothers giving birth at health centers. Conversely, mothers delivering at hospitals/clinics had 0.51 lower odds (95% CI: 1.63-4.22) of receiving PNC guidance than mothers delivering at health centers. As previous studies showed, the MCH handbook appeared to help health personnel provide guidance on PNC, thereby it may have increased PNC. Furthermore, this study suggests the handbook contributed to every birth being counted. However, to increase the effectiveness of the handbook, health personnel should be encouraged toward its proper

  18. Voluntary certification and disclosure of internal controls over Australian financial reporting, audit fees and value relevance

    OpenAIRE

    Garg, Mukesh

    2017-01-01

    This thesis draws on agency theory to primarily investigate whether CEOs’ and CFOs’ voluntary certification of internal controls over financial reporting (hereafter, ICFR) is associated with audit fees and value relevance of Australian financial reports. The thesis also examines whether corporate governance and audit quality are associated with the likelihood that firms provide the CEOs’ and CFOs’ voluntary ICFR certification. While agency theory predicts that firms with high agency costs are...

  19. WASTE CERTIFICATION PROGRAM PLAN - REVISION 7

    International Nuclear Information System (INIS)

    MORGAN, LK

    2002-01-01

    The primary changes that have been made to this revision reflect the relocation of the Waste Certification Official (WCO) organizationally from the Quality Services Division (QSD) into the Laboratory Waste Services (LWS) Organization. Additionally, the responsibilities for program oversight have been differentiated between the QSD and LWS. The intent of this effort is to ensure that those oversight functions, which properly belonged to the WCO, moved with that function; but retain an independent oversight function outside of the LWS Organization ensuring the potential for introduction of organizational bias, regarding programmatic and technical issues, is minimized. The Waste Certification Program (WCP) itself has been modified to allow the waste certification function to be performed by any of the personnel within the LWS Waste Acceptance/Certification functional area. However, a single individual may not perform both the technical waste acceptance review and the final certification review on the same 2109 data package. Those reviews must be performed by separate individuals in a peer review process. There will continue to be a designated WCO who will have lead programmatic responsibility for the WCP and will exercise overall program operational oversite as well as determine the overall requirements of the certification program. The quality assurance organization will perform independent, outside oversight to ensure that any organizational bias does not degrade the integrity of the waste certification process. The core elements of the previous WCP have been retained, however, the terms and process structure have been modified.. There are now two ''control points,'' (1) the data package enters the waste certification process with the signature of the Generator Interface/Generator Interface Equivalent (GI/GIE), (2) the package is ''certified'', thus exiting the process. The WCP contains three steps, (1) the technical review for waste acceptance, (2) a review of the

  20. Birth ball or heat therapy? A randomized controlled trial to compare the effectiveness of birth ball usage with sacrum-perineal heat therapy in labor pain management.

    Science.gov (United States)

    Taavoni, Simin; Sheikhan, Fatemeh; Abdolahian, Somayeh; Ghavi, Fatemeh

    2016-08-01

    Labor pain and its management is a major concern for childbearing women, their families and health care providers. This study aimed to investigate the effects of two non-pharmacological methods such as birth ball and heat therapy on labor pain relief. This randomized control trial was undertaken on 90 primiparous women aged 18-35 years old who were randomly assigned to two intervention (birth ball and heat) and control groups. The pain score was recorded by using Visual Analogue Scale (VAS) before the intervention and every 30 min in three groups until cervical dilatation reached 8 cm. The mean pain severity score in the heat therapy group was less than that of in control group at 60 and 90 min after intervention (p pain scores in the birth ball group after all three investigated times in comparison to control group. Both heat therapy and birth ball can use as inexpensive complementary and low risk treatment for labor pain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. First birth Caesarean section and subsequent fertility: a population-based study in the USA, 2000-2008.

    Science.gov (United States)

    Kjerulff, K H; Zhu, J; Weisman, C S; Ananth, C V

    2013-12-01

    Is first birth Caesarean delivery associated with a lower likelihood of subsequent childbearing when compared with first birth vaginal delivery? In this study of US women whose first delivery was in 2000, those who had a Caesarean delivery were less likely to have a subsequent live birth than those who delivered vaginally. Some studies have reported lower birth rates subsequent to Caesarean delivery in comparison with vaginal delivery, while other studies have reported no difference. We conducted a retrospective cohort study of 52 498 women who had a first singleton live birth in the State of Pennsylvania, USA in 2000 and were followed to the end of 2008 via Pennsylvania birth certificate records to identify subsequent live births during the 8- to 9-year follow-up period. Birth certificate records of first singleton births were linked to the hospital discharge data for each mother and newborn, and linked to all birth certificate records for each mother's subsequent deliveries which occurred in 2000 to the end of 2008. Poisson regression models were used to evaluate the association between first birth factors and whether or not there was a subsequent live birth during the follow-up period. Over an average of 8.5 years of follow-up, 40.2% of women with a Caesarean first birth did not have a subsequent live birth, compared with 33.1% of women with a vaginal first birth (risk ratio (RR): 1.21, 95% confidence interval (CI): 1.18-1.25). Adjustment for the demographic confounders of maternal age, race, education, marital status and health insurance coverage attenuated the RR to 1.16 (95% CI: 1.13-1.19). Specific pregnancy and childbirth-related complications associated with not having a subsequent live birth included diabetes-related disorders, abnormalities of organs and soft tissues of the pelvis, fetal abnormalities, premature or prolonged rupture of membranes, hypertensive disorders, amnionitis, fetal distress and other maternal health problems. However, adjustment

  2. Maternal veterinary occupation and adverse birth outcomes in Washington State, 1992-2014: a population-based retrospective cohort study.

    Science.gov (United States)

    Meisner, Julianne; Vora, Manali V; Fuller, Mackenzie S; Phipps, Amanda I; Rabinowitz, Peter M

    2018-05-01

    Women in veterinary occupations are routinely exposed to potential reproductive hazards, yet research into their birth outcomes is limited. We conducted a population-based retrospective cohort study of the association between maternal veterinary occupation and adverse birth outcomes. Using Washington State birth certificate, fetal death certificate and hospital discharge data from 1992 to 2014, we compared birth outcomes of mothers in veterinary professions (n=2662) with those in mothers in dental professions (n=10 653) and other employed mothers (n=8082). Relative risks (RRs) and 95% CIs were estimated using log binomial regression. Outcomes studied were premature birth (veterinary support staff separately. While no statistically significant associations were found, we noted a trend for SGA births in all veterinary mothers compared with dental mothers (RR=1.16, 95% CI 0.99 to 1.36) and in veterinarians compared with other employed mothers (RR=1.37, 95% CI 0.96 to 1.96). Positive but non-significant association was found for malformations among children of veterinary support staff. These results support the need for further study of the association between veterinary occupation and adverse birth outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  3. The relationship between maternal periodontitis and preterm low birth weight: A case-control study

    Directory of Open Access Journals (Sweden)

    Satheesh Mannem

    2011-01-01

    Full Text Available Background: The relationship between periodontal diseases in pregnancy and children born prematurely or with low birth weight has been increasingly investigated, showing positive and negative results, respectively. Objective: To evaluate the association between Maternal Periodontitis and Preterm delivery or Low Birth Weight. Materials and Methods: In this case-control study, 104 pregnant women without systemic disease or other risk factors for preterm labor were chosen. The control group (n = 52 had term labor (infants ≥37 weeks and the case group (n = 52 had preterm labor (infants <37 weeks. Plaque index, bleeding index, and birth weight were measured. Results: The data of plaque index (cases 1.21±0.56; controls 0.63±0.31, bleeding index (cases, 2.08±0.62; controls, 1.52±0.61, birth weight (cases, 2.01±0.36; controls 2.87±0.32, and Probing Pocket Depth (PPD ≥4mm and Clinical Attachment Level (CAL ≥3mm in at least 4 teeth (odds ratio 137.50, P value < 0.0001 revealed a statistically significant difference between the two groups P< 0.05. Conclusions: A noticeable relationship between periodontal health and duration of pregnancy; periodontal disease could be a risk factor for preterm labor. Oral hygiene maintenance should be a part of prenatal care protocol.

  4. Periodontal disease and spontaneous preterm birth: a case control study

    Directory of Open Access Journals (Sweden)

    Eley Barry

    2006-07-01

    Full Text Available Abstract Background Several studies have suggested an association between periodontal disease and prematurity but this finding has not been consistently observed. Methods Case control study. Cases (n = 50 were women who had delivered after spontaneous preterm labor at Results There was no difference in the proportion of sites with significant attachment loss (≥3 mm: Cases-3.2%, Controls-2.2% p = 0.21. The gingival crevicular fluid concentrations of elastase and gingipain were elevated in cases vs. controls 238.8 uU/ul vs. 159.6 uU/ul p = .007 and 2.70 uU/ul vs. 1.56 uU/ul p = .001. On multivariate analysis, the mean log concentration of elastase, but not of gingipain, remained a significant predictor of preterm labor p = .0.015. Conclusion We found no evidence that clinical periodontal disease is associated with spontaneous preterm birth. Elevated gingival crevicular fluid levels of elastase were associated with preterm birth but further research is needed before this can be assumed to be a causal relationship.

  5. Certification of thermal solar systems in the Netherlands and monitoring the results of certification

    NARCIS (Netherlands)

    Ree, B.G.C. van der

    1996-01-01

    Due to the rapid growth of the solar energy market in the Netherlands, quality control of solar systems is well under way. An important tool to improve the infrastructure of the solar market is certification of solar energy systems. Certification in the Netherlands is being developed in two projects

  6. Does Certification Change the Trajectory of Tree Cover in Working Forests in The Tropics? An Application of the Synthetic Control Method of Impact Evaluation

    Directory of Open Access Journals (Sweden)

    Pushpendra Rana

    2018-02-01

    Full Text Available Certification by the Forest Stewardship Council (FSC remains rare among forest management units (FMUs in natural tropical forests, presenting a challenge for impact evaluation. We demonstrate application of the synthetic control method (SCM to evaluate the impact of FSC certification on a single FMU in each of three tropical forest landscapes. Specifically, we estimate causal effects on tree cover change from the year of certification to 2012 using SCM and open-access, pan-tropical datasets. We demonstrate that it is possible to construct synthetic controls, or weighted combinations of non-certified FMUs, that followed the same path of tree cover change as the certified FMUs before certification. By using these synthetic controls to measure counterfactual tree cover change after certification, we find that certification reduced tree cover loss in the most recent year (2012 in all three landscapes. However, placebo tests show that in one case, this effect was not significant, and in another case, it followed several years in which certification had the opposite effect (increasing tree cover loss. We conclude that SCM has promise for identifying temporally varying impacts of small-N interventions on land use and land cover change.

  7. Association of the Affordable Care Act Dependent Coverage Provision With Prenatal Care Use and Birth Outcomes.

    Science.gov (United States)

    Daw, Jamie R; Sommers, Benjamin D

    2018-02-13

    The effect of the Affordable Care Act (ACA) dependent coverage provision on pregnancy-related health care and health outcomes is unknown. To determine whether the dependent coverage provision was associated with changes in payment for birth, prenatal care, and birth outcomes. Retrospective cohort study, using a differences-in-differences analysis of individual-level birth certificate data comparing live births among US women aged 24 to 25 years (exposure group) and women aged 27 to 28 years (control group) before (2009) and after (2011-2013) enactment of the dependent coverage provision. Results were stratified by marital status. The dependent coverage provision of the ACA, which allowed young adults to stay on their parent's health insurance until age 26 years. Primary outcomes were payment source for birth, early prenatal care (first visit in first trimester), and adequate prenatal care (a first trimester visit and 80% of expected visits). Secondary outcomes were cesarean delivery, premature birth, low birth weight, and infant neonatal intensive care unit (NICU) admission. The study population included 1 379 005 births among women aged 24-25 years (exposure group; 299 024 in 2009; 1 079 981 in 2011-2013), and 1 551 192 births among women aged 27-28 years (control group; 325 564 in 2009; 1 225 628 in 2011-2013). From 2011-2013, compared with 2009, private insurance payment for births increased in the exposure group (36.9% to 35.9% [difference, -1.0%]) compared with the control group (52.4% to 51.1% [difference, -1.3%]), adjusted difference-in-differences, 1.9 percentage points (95% CI, 1.6 to 2.1). Medicaid payment decreased in the exposure group (51.6% to 53.6% [difference, 2.0%]) compared with the control group (37.4% to 39.4% [difference, 1.9%]), adjusted difference-in-differences, -1.4 percentage points (95% CI, -1.7 to -1.2). Self-payment for births decreased in the exposure group (5.2% to 4.3% [difference, -0.9%]) compared with the

  8. Servo-control for maintaining abdominal skin temperature at 36C in low birth weight infants.

    Science.gov (United States)

    Sinclair, J C

    2002-01-01

    Randomized trials have shown that the neonatal mortality rate of low birth-weight babies can be reduced by keeping them warm. For low birth-weight babies nursed in incubators, warm conditions may be achieved either by heating the air to a desired temperature, or by servo-controlling the baby's body temperature at a desired set-point. In low birth weight infants, to determine the effect on death and other important clinical outcomes of targeting body temperature rather than air temperature as the end-point of control of incubator heating. Standard search strategy of the Cochrane Neonatal Review Group. Searches were made of the Cochrane Controlled Trials Register (CCTR) (Cochrane Library, Issue 4, 2001) and MEDLINE, 1966 to November 2001. Randomized or quasi-randomized trials which test the effects of having the heat output of the incubator servo-controlled from body temperature compared with setting a constant incubator air temperature. Trial methodologic quality was systematically assessed. Outcome measures included death, timing of death, cause of death, and other clinical outcomes. Categorical outcomes were analyzed using relative risk and risk difference. Meta-analysis assumed a fixed effect model. Two eligible trials were found. In total, they included 283 babies and 112 deaths. Compared to setting a constant incubator air temperature of 31.8C, servo-control of abdominal skin temperature at 36C reduces the neonatal death rate among low birth weight infants: relative risk 0.72 (95% CI 0.54, 0.97); risk difference -12.7% (95% CI -1.6, -23.9). This effect is even greater among VLBW infants. During at least the first week after birth, low birth weight babies should be provided with a carefully regulated thermal environment that is near the thermoneutral point. For LBW babies in incubators, this can be achieved by adjusting incubator temperature to maintain an anterior abdominal skin temperature of at least 36C, using either servo-control or frequent manual

  9. Apgar score of 0 at 5 minutes and neonatal seizures or serious neurologic dysfunction in relation to birth setting.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Sapra, Katherine J; Brent, Robert L; Levene, Malcolm I; Arabin, Birgit; Chervenak, Frank A

    2013-10-01

    To examine the occurrence of 5-minute Apgar scores of 0 and seizures or serious neurologic dysfunction for 4 groups by birth setting and birth attendant (hospital physician, hospital midwife, free-standing birth center midwife, and home midwife) in the United States from 2007-2010. Data from the United States Centers for Disease Control's National Center for Health Statistics birth certificate data files were used to assess deliveries by physicians and midwives in and out of the hospital for the 4-year period from 2007-2010 for singleton term births (≥37 weeks' gestation) and ≥2500 g. Five-minute Apgar scores of 0 and neonatal seizures or serious neurologic dysfunction were analyzed for 4 groups by birth setting and birth attendant (hospital physician, hospital midwife, freestanding birth center midwife, and home midwife). Home births (relative risk [RR], 10.55) and births in free-standing birth centers (RR, 3.56) attended by midwives had a significantly higher risk of a 5-minute Apgar score of 0 (P births attended by physicians or midwives. Home births (RR, 3.80) and births in freestanding birth centers attended by midwives (RR, 1.88) had a significantly higher risk of neonatal seizures or serious neurologic dysfunction (P births attended by physicians or midwives. The increased risk of 5-minute Apgar score of 0 and seizures or serious neurologic dysfunction of out-of-hospital births should be disclosed by obstetric practitioners to women who express an interest in out-of-hospital birth. Physicians should address patients' motivations for out-of-hospital delivery by continuously improving safe and compassionate care of pregnant, fetal, and neonatal patients in the hospital setting. Copyright © 2013 Mosby, Inc. All rights reserved.

  10. Pesticide Applicator Certification Training, Manual No. 1a: Agricultural Pest Control. a. Plant.

    Science.gov (United States)

    Allen, W. A.; And Others

    This manual provides information needed to meet the minimum standards for certification as an applicator of pesticides in the agricultural plant pest control category. Adapted for the State of Virginia, the text discusses: (1) the basics of insecticides; (2) insect pests; (3) selection and calibration of applicator equipment; and (4) the proper…

  11. The association of birth model with resilience variables and birth experience: Home versus hospital birth.

    Science.gov (United States)

    Handelzalts, Jonathan E; Zacks, Arni; Levy, Sigal

    2016-05-01

    to study home, natural hospital, and medical hospital births, and the association of these birth models to resilience and birth experience. cross-section retrospective design. participants were recruited via an online survey system. Invitations to participate were posted in five different Internet forums for women on maternity leave, from September 2014 to August 2015. the sample comprised 381 post partum healthy women above the age of 20, during their maternity leave. Of the participants: 22% gave birth at home, 32% gave birth naturally in a hospital, and 46% of the participants had a medical birth at the hospital. life Orientation Test Revised (LOT-R), General Self-Efficacy Scale, Sense of Mastery Scale, Childbirth Experience Questionnaire (CEQ). women having had natural births, whether at home or at the hospital, significantly differed from women having had medical births in all aspects of the birth experience, even when controlling for age and optimism. Birth types contributed to between 14% and 24% of the explained variance of the various birth experience aspects. home and natural hospital births were associated with a better childbirth experience. Optimism was identified as a resilience factor, associated both with preference as well as with childbirth experience. physically healthy and resilient women could be encouraged to explore the prospect of home or natural hospital births as a means to have a more positive birth experience. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Spontaneous vaginal delivery in the birth-chair versus in the conventional dorsal position: a matched controlled comparison.

    Science.gov (United States)

    Scholz, H S; Benedicic, C; Arikan, M G; Haas, J; Petru, E

    2001-09-17

    The aim of the study was to assess the effect of a birth-chair on obstetric outcome. We reviewed the hospital records of 220 consecutive pregnant women who gave birth on a birth-chair at our institution. The control group consisted of 440 pregnant women who preceded and followed the index cases and who had spontaneous vaginal deliveries in the conventional dorsal supine position. The controls were matched for parity and for the attending mid-wife. Patients who delivered in the birth-chair had significantly lower rates of episiotomy and manual separation of the placenta. The umbilical blood cord pH was significantly higher in neonates of the birth-chair group. The duration of labour, rate of perineal and vaginal injury, Apgar scores and rate of admission to a neonatal intermediate care unit were not influenced by the mode of delivery. Our data support previous studies that a birth-chair delivery may be a safe alternative to conventional delivery in the supine position.

  13. United States home births increase 20 percent from 2004 to 2008.

    Science.gov (United States)

    MacDorman, Marian F; Declercq, Eugene; Mathews, T J

    2011-09-01

    After a gradual decline from 1990 to 2004, the percentage of births occurring at home increased from 2004 to 2008 in the United States. The objective of this report was to examine the recent increase in home births and the factors associated with this increase from 2004 to 2008. United States birth certificate data on home births were analyzed by maternal demographic and medical characteristics. In 2008, there were 28,357 home births in the United States. From 2004 to 2008, the percentage of births occurring at home increased by 20 percent from 0.56 percent to 0.67 percent of United States births. This rise was largely driven by a 28 percent increase in the percentage of home births for non-Hispanic white women, for whom more than 1 percent of births occur at home. At the same time, the risk profile for home births has been lowered, with substantial drops in the percentage of home births of infants who are born preterm or at low birthweight, and declines in the percentage of home births that occur to teen and unmarried mothers. Twenty-seven states had statistically significant increases in the percentage of home births from 2004 to 2008; only four states had declines. The 20 percent increase in United States home births from 2004 to 2008 is a notable development that will be of interest to practitioners and policymakers. (BIRTH 38:3 September 2011). © 2011, Copyright the Authors. Journal compilation © 2011, Wiley Periodicals, Inc.

  14. Improved Birth Weight for Black Infants: Outcomes of a Healthy Start Program

    Science.gov (United States)

    Zielinski, Ruth; James, Arthur; Charoth, Remitha M.; del Carmen Sweezy, Luz

    2014-01-01

    Objectives. We determined whether participation in Healthy Babies Healthy Start (HBHS), a maternal health program emphasizing racial equity and delivering services through case management home visitation, was associated with improved birth outcomes for Black women relative to White women. Methods. We used a matched-comparison posttest-only design in which we selected the comparison group using propensity score matching. Study data were generated through secondary analysis of Michigan state- and Kalamazoo County–level birth certificate records for 2008 to 2010. We completed statistical analyses, stratified by race, using a repeated-measures generalized linear model. Results. Despite their smoking rate being double that of their matched counterparts, Black HBHS participants delivered higher birth-weight infants than did Black nonparticipants (P = .05). White HBHS participants had significantly more prenatal care than did White nonparticipants, but they had similar birth outcomes (P = .7 for birth weight; P = .55 for gestation). Conclusions. HBHS participation is associated with increased birth weights among Black women but not among White women, suggesting differential program gains for Black women. PMID:24354844

  15. Preterm Birth and Low Birth Weight Following Icsi- Pregnancies

    OpenAIRE

    Aygül Demirol; Süleyman Güven; Timur Gürgan

    2006-01-01

    OBJECTIVE: To report preterm birth and low birth weight rate of intracytoplasmic sperm injection (ICSI) related pregnancies and to compare our data with literature findings. STUDY DESIGN: Three-hundred and eighty-nine pregnancies following controlled ovarian hyperstimulation and intracytoplasmic sperm injection were retrospectively evaluated. Patients’ characteristics including age, gestational age at delivery and birth weight were noted from special clinic files. Women with early pregnanc...

  16. Why Did My Doctor Prescribe Birth Control Pills for My Acne?

    Science.gov (United States)

    ... Health Food & Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Why Did My Doctor Prescribe Birth Control Pills for My Acne? KidsHealth / For Teens / Why ...

  17. Setting up a control and certification system for organic farming in developing countries: the case of Algeria

    OpenAIRE

    ZIANE, Mrs Djamila

    2002-01-01

    The main objective of this work is to define the steps and the procedures to set up an effective control and certification system for Algeria, that is compatible with local peculiarities and realities and which complies with the International Regulations. The aim of this initiative is to offer a cost-efficient and credible inspection and certification for organic products to farmers, processors and traders. Doing so, the access to export and domestic markets should be facilitated. Furthermore...

  18. Macrosomic births in abuja: A case–control study of predisposing ...

    African Journals Online (AJOL)

    Macrosomic births in abuja: A case–control study of predisposing factors and early neonatal outcome. ... Journal Home > Vol 20, No 3 (2017) > ... Independent predictors of macrosomia were parental high social class (P = 0.000), gestational weight gain of ≥15 kg (P = 0.000), and previous history of macrosomia (P = 0.002).

  19. Tacit consent: the Church and birth control in northern Italy.

    Science.gov (United States)

    Dalla-Zuanna, Gianpiero

    2011-01-01

    This article employs novel documentation to examine ways in which the Church's moral rules on contraception were (or were not) communicated to parishioners in a predominantly Catholic context in a period of rapid fertility decline: the diocese of Padua, in the northeastern Italian region of Veneto, during the first half of the twentieth century. The account is based on documents that have until now been overlooked: the moral cases discussed during the periodic meetings among Padua priests in the years 1916–58, and the written answers provided by priests in response to a question asked of them concerning their efforts to combat the limiting of births. This documentation reveals the limited effect on the reproductive behavior of the position of the Catholic Church against birth control.

  20. Certification plan for safety and PRA codes

    International Nuclear Information System (INIS)

    Toffer, H.; Crowe, R.D.; Ades, M.J.

    1990-05-01

    A certification plan for computer codes used in Safety Analyses and Probabilistic Risk Assessment (PRA) for the operation of the Savannah River Site (SRS) reactors has been prepared. An action matrix, checklists, and a time schedule have been included in the plan. These items identify what is required to achieve certification of the codes. A list of Safety Analysis and Probabilistic Risk Assessment (SA ampersand PRA) computer codes covered by the certification plan has been assembled. A description of each of the codes was provided in Reference 4. The action matrix for the configuration control plan identifies code specific requirements that need to be met to achieve the certification plan's objectives. The checklist covers the specific procedures that are required to support the configuration control effort and supplement the software life cycle procedures based on QAP 20-1 (Reference 7). A qualification checklist for users establishes the minimum prerequisites and training for achieving levels of proficiency in using configuration controlled codes for critical parameter calculations

  1. Use of birth control pills, condoms, and withdrawal among U.S. high school students.

    Science.gov (United States)

    Everett, S A; Warren, C W; Santelli, J S; Kann, L; Collins, J L; Kolbe, L J

    2000-08-01

    To examine the use of contraception at last sexual intercourse among currently sexually active adolescents. We analyzed data from national school-based Youth Risk Behavior Surveys (YRBS) conducted in 1991, 1993, 1995, and 1997. The YRBS is a self-administered, anonymous survey which uses a national probability sample of U.S. students in public and private schools from grades 9 through 12. From 1991 to 1997, condom use significantly increased (from 46% to 57%), birth control pill use decreased (from 21% to 17%), and use of withdrawal significantly decreased (from 18% to 13%). In 1997, although more students were using condoms, 13% reported using withdrawal and 15% reported using no method to prevent pregnancy at last sexual intercourse. In 1997, condom use among females was significantly lower in the 9th grade than in the 12th grade (p birth control pill use was higher (p birth control pill use by their partner increased (p schools, and other influential societal institutions should promote the correct and continued use of condoms as essential protection against sexually transmitted diseases and human immunodeficiency virus infection.

  2. Migrated Essure permanent birth control device: sonographic findings.

    Science.gov (United States)

    Khati, Nadia Juliet; Gorodenker, Joseph; Brindle, Kathleen Ann

    2014-05-01

    We report a case of a migrated Essure permanent birth control device. The correct diagnosis was made on conventional two-dimensional and three-dimensional pelvic sonography 7 years after placement of the device when the patient presented with persistent right-sided pain. The 3-month post placement hysterosalpingogram had shown an appropriately occluded right fallopian tube but had overlooked the abnormal position of the right Essure device, which was too proximal and extending slightly in the uterine cavity. Copyright © 2013 Wiley Periodicals, Inc.

  3. Reforming birth registration law in England and Wales?

    Directory of Open Access Journals (Sweden)

    Julie McCandless

    2017-06-01

    Full Text Available The Law Commission of England and Wales is considering what its 13th Programme of Law Reform should address. During the consultation process, a project on birth registration law has been mooted. This is a very welcome proposal given that civil birth registration in England and Wales is a compulsory procedure that not only finds its roots in the early Victorian era, but also remains very similar, at least in terms of form and the information that is recorded. I first use two recent legal challenges to illustrate why the current system is coming under increasing pressure. I further use these examples to caution against a law reform agenda that is narrowly focused on the precise information recorded, without a preliminary and wider examination of what the role and purpose of birth registration is, and should be, in society. I argue that this needs to be addressed before the state can justify the parameters of the information recorded. I then use an outline of historical reforms relating to the registration of births outside of marriage to highlight the normative two-parent family model that underpins the birth registration system. I argue that legal reform must be cognizant of the tenacity of this normative family model, particularly in relation to reform proposals surrounding donor conception and the annotation of birth certificates. Finally, I draw attention to wider developments in family law that cast birth registration as a social policy tool for the facilitation of parent–child relationships, particularly unmarried fathers.

  4. Induced abortion on demand and birth rate in Sami-speaking municipalities and a control group in Finnmark, Norway

    Directory of Open Access Journals (Sweden)

    Jan Norum

    2013-05-01

    Full Text Available Objectives. The objective of this study was to analyze the birth and induced abortion on demand (IAD rate among women in Sami-speaking communities and a control group in Finnmark County, Norway. Methods. The 6 northern municipalities included in the administration area of the Sami language law (study group were matched with a control group of 9 municipalities. Population data (numbers, sex and age were accessed from Statistics Norway. Data on birth rate and IAD during the time period 1999–2009 were derived from the Medical Birth Registry (MBR of Norway. Data on number of women in fertile age (15–44 years were obtained from Statistics Norway. Between 2001 and 2008, this age group was reduced by 12% (Sami and 23% (controls, respectively. Results. Finnmark County has a high IAD rate and 1 in 4 pregnancies (spontaneous abortions excluded ended in IAD in the study and control groups. The total fertility rate per woman was 1.94 and 1.87 births, respectively. There was no difference between groups with regard to the IAD/birth ratio (P=0.94 or general fertility rate GFR (P=0.82. Conclusions. Women in the Sami-majority area and a control group in Finnmark County experienced a similar frequency of IAD and fertility rate.

  5. Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study

    OpenAIRE

    Gill, Christopher J; Phiri-Mazala, Grace; Guerina, Nicholas G; Kasimba, Joshua; Mulenga, Charity; MacLeod, William B; Waitolo, Nelson; Knapp, Anna B; Mirochnick, Mark; Mazimba, Arthur; Fox, Matthew P; Sabin, Lora; Seidenberg, Philip; Simon, Jonathon L; Hamer, Davidson H

    2011-01-01

    Objective To determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare. Design Prospective, cluster randomised and controlled effectiveness study. Setting Lufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers’ homes, in rural village s...

  6. Sex selection and health at birth among Indian immigrants.

    Science.gov (United States)

    González, Libertad

    2018-05-01

    I use birth-certificate data for Spain to document extremely son-biased sex ratios at birth among Indian immigrants (122 boys per 100 girls), especially at higher parities. I also show that the children of Indian immigrants display poor health outcomes during infancy. For instance, almost 10% of boys with Indian parents are born prematurely, compared with 6% of boys with native parents. However, there is no evidence of a gender gap in infant health among the children of Indian immigrants. I provide evidence suggesting that the poor outcomes of Indian children at birth may be attributed to the low endowments of Indian mothers, while the absence of a gender gap may be driven by the fact that the parents who would invest less in girls are less likely to carry the pregnancies of girls to term (more likely to practice sex-selective abortion), combined with the lower cost of prenatal investments in Spain (compared with India). Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Time Delayed Stage-Structured Predator-Prey Model with Birth Pulse and Pest Control Tactics

    Directory of Open Access Journals (Sweden)

    Mei Yan

    2014-01-01

    Full Text Available Normally, chemical pesticides kill not only pests but also their natural enemies. In order to better control the pests, two-time delayed stage-structured predator-prey models with birth pulse and pest control tactics are proposed and analyzed by using impulsive differential equations in present work. The stability threshold conditions for the mature prey-eradication periodic solutions of two models are derived, respectively. The effects of key parameters including killing efficiency rate, pulse period, the maximum birth effort per unit of time of natural enemy, and maturation time of prey on the threshold values are discussed in more detail. By comparing the two threshold values of mature prey-extinction, we provide the fact that the second control tactic is more effective than the first control method.

  8. Intimate partner violence and postpartum contraceptive use: the role of race/ethnicity and prenatal birth control counseling.

    Science.gov (United States)

    Cha, Susan; Chapman, Derek A; Wan, Wen; Burton, Candace W; Masho, Saba W

    2015-09-01

    Intimate partner violence (IPV) is a major problem that could affect reproductive decision making. The aim of this study is to examine the association between IPV and contraceptive use and assess whether the association varies by receipt of prenatal birth control counseling and race/ethnicity. This study analyzed the 2004-2008 national Pregnancy Risk Assessment Monitoring System (PRAMS) that included 193,310 women with live births in the United States. IPV was determined by questions that asked about physical abuse by a current or former partner in the 12 months before or during pregnancy. The outcome was postpartum contraceptive use (yes vs. no). Multiple logistic regression analyses were conducted to assess the influence of experiencing IPV at different periods (preconception IPV, prenatal IPV, both preconception and prenatal IPV, preconception and/or prenatal IPV). Data were stratified to assess differential effects by race/ethnicity and receipt of birth control counseling. Approximately 6.2% of women reported IPV, and 15.5% reported no postpartum contraceptive use. Regardless of the timing of abuse, IPV-exposed women were significantly less likely to report contraceptive use after delivery. This was particularly true for Hispanic women who reported no prenatal birth control counseling and women of all other racial/ethnic groups who received prenatal birth control counseling. IPV victimization adversely affects the use of contraceptive methods following delivery in women with live births. Birth control counseling by health providers may mitigate these effects; however, the quality of counseling needs further investigation. Better integration of violence prevention services and family planning programs is greatly needed. Consistent with national recommendations by the U.S. Preventive Service Task Force, clinicians and public health workers are strongly encouraged to screen for IPV. Health providers should educate women on effective contraceptive options and

  9. Trends and racial differences in birth weight and related survival.

    Science.gov (United States)

    Alexander, G R; Tompkins, M E; Allen, M C; Hulsey, T C

    1999-06-01

    In the past two decades, infant mortality rates in the United States declined in African-American and White populations. Despite this, racial disparities in infant mortality rates have increased and rates of low birth weight deliveries have shown little change. In this study, we examine temporal changes in birth weight distributions, birth weight specific neonatal mortality, and the birth weight threshold for an adverse risk of survival within both racial groups in order to explore the mechanisms for the disparities in infant mortality rates. Single live births born to South Carolina resident mothers between 1975 and 1994 and considered White or African-American based on the mother's report of maternal race on the birth certificate were selected for investigation. We define the birth weight threshold for adverse survival odds as the birth weight at which 50% or more of infants in the population died within the first month of life. Despite significant increases in very low birth weight percentages, neonatal mortality rates markedly declined. Birth weight specific neonatal mortality decreased for both races, although greater reductions accrued to White low birth weight infants. By the end of the study period, the birth weight at which over 50% of newborns died within the first month of life was 696 g for Whites and 673 g for African-Americans. The ongoing decline in neonatal mortality is mainly due to reductions in birth weight specific neonatal mortality, probably related to high-risk obstetric and neonatal care. Technological developments in these areas may have differentially benefited Whites, resulting in an increasing racial disparity in mortality rates. Moreover, the relatively greater and increasing mortality risk from postmaturity and macrosomia in infants of African-America mothers may further exacerbate the racial gap in infant mortality.

  10. Mortality incidence estimation using federal death certificate and natality data with an application to Tay-Sachs disease.

    Science.gov (United States)

    Jalal, Kabir; Carter, Randy L

    2015-09-01

    For confidentiality reasons, US federal death certificate data are incomplete with regards to the dates of birth and death for the decedents, making calculation of total lifetime of a decedent impossible and thus estimation of mortality incidence difficult. This paper proposes the use of natality data and an imputation-based method to estimate age-specific mortality incidence rates in the face of this missing information. By utilizing previously determined probabilities of birth, a birth date and death date are imputed for every decedent in the dataset. Thus, the birth cohort of each individual is imputed, and the total on-study time can be calculated. This idea is implemented in two approaches for estimation of mortality incidence rates. The first is an extension of a person-time approach, while the second is an extension of a life table approach. Monte Carlo simulations showed that both approaches perform well in comparison to the ideal complete data methods, but that the person-time method is preferred. An application to Tay-Sachs disease is demonstrated. It is concluded that the imputation methods proposed provide valid estimates of the incidence of death from death certificate data without the need for additional assumptions under which usual mortality rates provide valid estimates. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Birth preference in women undergoing treatment for childbirth fear: A randomised controlled trial.

    Science.gov (United States)

    Larsson, Birgitta; Karlström, Annika; Rubertsson, Christine; Ternström, Elin; Ekdahl, Johanna; Segebladh, Birgitta; Hildingsson, Ingegerd

    2017-12-01

    Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment. Pregnant women classified with childbirth fear (≥60 on the Fear Of Birth Scale) (n=258) were recruited at one university hospital and two regional hospitals over one year. The participants were randomised (1:1) to intervention (Internet-based Cognitive Behaviour Therapy (ICBT)) (n=127) or standard care (face-to-face counselling) (n=131). Data were collected by questionnaires in pregnancy week 20-25 (baseline), week 36 and two months after birth. Caesarean section preference decreased from 34% to 12% in the ICBT group and from 24% to 20% in the counselling group. Two months after birth, the preference for caesarean increased to 20% in the ICBT group and to 29% in the counselling group, and there was no statistically significant change over time. Women in the ICBT group were less satisfied with the treatment (OR 4.5). The treatment had no impact on or worsened their childbirth fear (OR 5.5). There were no differences between the groups regarding birth experience. Women's birth preferences fluctuated over the course of pregnancy and after birth regardless of treatment method. Women felt their fear was reduced and were more satisfied with face-to-face counselling compared to ICBT. A higher percentage were lost to follow-up in ICBT group suggesting a need for further research. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  12. Recent Trends in Out-of-Hospital Births in the United States.

    Science.gov (United States)

    MacDorman, Marian F; Declercq, Eugene; Mathews, T J

    2013-01-01

    Although out-of-hospital births are still relatively rare in the United States, it is important to monitor trends in these births, as they can affect patterns of facility usage, clinician training, and resource allocation, as well as health care costs. Trends and characteristics of home and birth center births are analyzed to more completely profile contemporary out-of-hospital births in the United States. National birth certificate data were used to examine a recent increase in out-of-hospital births. After a gradual decline from 1990 to 2004, the number of out-of-hospital births increased from 35,578 in 2004 to 47,028 in 2010. In 2010, 1 in 85 US infants (1.18%) was born outside a hospital; about two-thirds of these were born at home, and most of the rest were born in birth centers. The proportion of home births increased by 41%, from 0.56% in 2004 to 0.79% in 2010, with 10% of that increase occurring in the last year. The proportion of birth center births increased by 43%, from 0.23% in 2004 to 0.33% in 2010, with 14% of the increase in the last year. About 90% of the total increase in out-of hospital births from 2004 to 2010 was a result of increases among non-Hispanic white women, and 1 in 57 births to non-Hispanic white women (1.75%) in 2010 was an out-of-hospital birth. Most home and birth center births were attended by midwives. Home and birth center births in the United States are increasing, and the rate of out-of-hospital births is now at the highest level since 1978. There has been a decline in the risk profile of out-of-hospital births, with a smaller proportion of out-of-hospital births in 2010 than in 2004 occurring to adolescents and unmarried women and fewer preterm, low-birth-weight, and multiple births. © 2013 This article is a U.S. Government work and is in the public domain in the United States.

  13. Certification of OHS management in a Nordic context

    DEFF Research Database (Denmark)

    Hendriksen, Kåre; Jørgensen, Kirsten; Jørgensen, Ulrik

    2009-01-01

    ’s management to decide which elements of OHS performance they commit to while the only explicit OHS demand is to comply with legal requirements. Additionally the certification is covered by the accreditation standard requirements of confidentiality, where as the validity of a certificate end up being hidden...... for the involved stakeholders. The consequences of these foundational elements of the existing management standard are analysed and exemplified. The Nordic Minister Council has funded the project, OHS Certification as Control Instrument and Control Strategy, which together with earlier studies of the working...

  14. Arsenic in drinking water and adverse birth outcomes in Ohio.

    Science.gov (United States)

    Almberg, Kirsten S; Turyk, Mary E; Jones, Rachael M; Rankin, Kristin; Freels, Sally; Graber, Judith M; Stayner, Leslie T

    2017-08-01

    Arsenic in drinking water has been associated with adverse reproductive outcomes in areas with high levels of naturally occurring arsenic. Less is known about the reproductive effects of arsenic at lower levels. This research examined the association between low-level arsenic in drinking water and small for gestational age (SGA), term low birth weight (term LBW), very low birth weight (VLBW), preterm birth (PTB), and very preterm birth (VPTB) in the state of Ohio. Exposure was defined as the mean annual arsenic concentration in drinking water in each county in Ohio from 2006 to 2008 using Safe Drinking Water Information System data. Birth outcomes were ascertained from the birth certificate records of 428,804 births in Ohio from the same time period. Multivariable generalized estimating equation logistic regression models were used to assess the relationship between arsenic and each birth outcome separately. Sensitivity analyses were performed to examine the roles of private well use and prenatal care utilization in these associations. Arsenic in drinking water was associated with increased odds of VLBW (AOR 1.14 per µg/L increase; 95% CI 1.04, 1.24) and PTB (AOR 1.10; 95% CI 1.06, 1.15) among singleton births in counties where water was positively associated with VLBW and PTB in a population where nearly all (>99%) of the population was exposed under the current maximum contaminant level of 10µg/L. Current regulatory standards may not be protective against reproductive effects of prenatal exposure to arsenic. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Risk factors and birth prevalence of birth defects and inborn errors of ...

    African Journals Online (AJOL)

    Children with any birth defect or metabolic errors of metabolism at birth or in the neonatology section were our sample for study. Control group was randomly selected from the cases with normal live births. Blood tests were performed for children suspected to suffer from genetic blood disorders. The principal BD as per the ...

  16. Inclusion of non-viable neonates in the birth record and its impact on infant mortality rates in Shelby County, Tennessee, USA

    Directory of Open Access Journals (Sweden)

    Bryan Lee Williams

    2010-02-01

    Full Text Available Rates of infant death are one of the most common indicators of a population’s overall health status. Infant mortality rates (IMRs are used to make broad inferences about the quality of health care, effects of health policies and even environmental quality. The purpose of our study was threefold: i to examine the characteristics of births in the area in relation to gestational age and birthweight; ii to estimate infant mortality using variable gestational age and/or birthweight criteria for live birth, and iii to calculate proportional mortality ratios for each cause of death using variable gestational age and/or birthweight criteria for live birth. We conducted a retrospective analysis of all Shelby County resident-linked birth and infant death certificates during the years 1999 to 2004. Descriptive test statistics were used to examine infant mortality rates in relation to specific maternal and infant risk factors. Through careful examination of 1999-2004 resident-linked birth and infant death data sets, we observed a disproportionate number of non-viable live births (≤20 weeks gestation or ≤350 grams in Shelby County. Issuance of birth certificates to these non-viable neonates is a factor that contributes to an inflated IMR. Our study demonstrates the complexity and the appropriateness of comparing infant mortality rates in smaller geographic units, given the unique characteristics of live births in Shelby County. The disproportionate number of pre-viable infants born in Shelby County greatly obfuscates neonatal mortality and de-emphasizes the importance of post-neonatal mortality.

  17. Fifty Shades: ambivalence about birth control in an erotic bestseller and its cultural implications.

    Science.gov (United States)

    Maierhofer, Waltraud; Israel, Emanuella

    2017-04-01

    The Fifty Shades trilogy by E.L. James has taken the world by storm and become a cultural phenomenon. The lack of contraceptive use in the erotic fiction, first pointed out by bloggers, is analysed in this article and compared to medical information. James may be praised for sexualising condom use. However, her protagonist makes poor choices in terms of hormonal contraception and is negligent about its use, resulting in an unintended pregnancy and resolved in marital bliss and motherhood. What is of more interest here than a possible message about contraceptive use, is the outcome that the fiction's negligence in birth control and responsibility affirms an ideology in which female sexuality and sexual experimentation can only be tolerated within the context of procreation and affirmation of motherhood. Subsequently, the cultural significance of the trilogy's popularity and its tension between sexual exploration, birth control and fertility is explored. In a globally popular fantasy published more than five decades after the introduction of the pill, the protagonist's lack of attention to reliable birth control leads to a telling dichotomy that combines adventurous exploration of female sexuality and affirmation of the nuclear family.

  18. The Work of Inscription: Antenatal Care, Birth Documents, and Shan Migrant Women in Chiang Mai.

    Science.gov (United States)

    Seo, Bo Kyeong

    2017-12-01

    For transnational migrant populations, securing birth documents of newly born children has crucial importance in avoiding statelessness for new generations. Drawing on discussions of sovereignty and political subjectivization, I ask how the fact of birth is constituted in the context of transnational migration. Based on ethnographic data collected from an antenatal clinic in Thailand, this article describes how Shan migrant women from Myanmar (also known as Burma) utilize reproductive health services as a way of assuring a safe birth while acquiring identification documents. Paying close attention to technologies of inscription adopted for maternal care and birth registration, I argue that enacting bureaucratic documents offers a chance for migrant women to bridge the interstice between human and citizen. Birth certificates for migrant children, while embodying legal ambiguity and uncertainty, epitomize non-citizen subjects' assertion of their political relationship with the state. © 2016 by the American Anthropological Association.

  19. Experience gained with certification of instruments for the system for nuclear material physical protection, accounting, and control

    International Nuclear Information System (INIS)

    Gus'kov, O.M.; Egorov, V.V.; Morozov, O.S.; Novikov, V.M.

    1999-01-01

    Results of the tests have confirmed the expedience of certification of the equipment, especially imported items. For the use of imported equipment at Russian facilities, it is justified to accommodate the accompanying documents thereto for the Russian standards. Equipment items shipped to Russia should be prepared for the certification tests and/or operation. When taking decision on the certification of imported equipment, it is expedient to preliminarily estimate the instrument's parameters and its operation in Russia. To solve the question whether the imported equipment is usable for Russia and what engineering support and maintenance is needed for its operation, it would be justified to create the Center for engineering support of instruments to be used for nuclear material protection, control and accounting on the basis of one of institutes dealing with the development of instruments for these application [ru

  20. A hugh marketing research task: birth control.

    Science.gov (United States)

    Simon, J L

    1968-02-01

    Research in underdeveloped countries to sell family planning is discussed. The article also aims at pinpointing other possible research areas. Census reports were actually the earliest work relevant to birth control. Later came the research on psychosocial factors affecting family size in developed countries. After World War I, client oriented research into family planning began. The history of this type of research is discussed with more emphasis on the surveys of the knowledge, attitude and contraception practices (KAP) in various countries. The author claims the KAP surveys to be the largest worldwide market research job ever done. Propagands campaigns, contraceptive costs, bonuses for contraceptive practices, and effectiveness of persuasion techniques are discussed.

  1. 76 FR 17444 - In the Matter of Certain Vaginal Ring Birth Control Devices; Notice of Investigation

    Science.gov (United States)

    2011-03-29

    ... INTERNATIONAL TRADE COMMISSION [Inv. No. 337-TA-768] In the Matter of Certain Vaginal Ring Birth... importation, and the sale within the United States after importation of certain vaginal ring birth control... investigation, issue an exclusion order and cease and desist orders. ADDRESSES: The complaint, except for any...

  2. 38 CFR 21.9720 - Certification of enrollment.

    Science.gov (United States)

    2010-07-01

    ... standard college degree, the institution of higher learning's certification will include— (i) The... learning has no prescribed maximum time for completion, the certification must include an ending date based...), 3684) (Approved by the Office of Management and Budget under control number 2900-0073) ...

  3. Birth outcomes of cases with isolated atrial septal defect type II--a population-based case-control study.

    Science.gov (United States)

    Vereczkey, Attila; Kósa, Zsolt; Csáky-Szunyogh, Melinda; Urbán, Róbert; Czeizel, Andrew E

    2013-07-01

    In general, epidemiological studies have evaluated cases with congenital cardiovascular abnormalities together. The aim of this study is to describe the birth outcomes of cases with isolated/single atrial septal defect type II (ASD-II, i.e. only a fossa ovalis defect) after surgical correction or lethal outcome in the light of maternal sociodemographic data. Comparison of birth outcomes and maternal characteristics of cases with ASD-II and controls without defect. The population-based Hungarian Case-Control Surveillance of Congenital Abnormalities. Hungarian newborn infants with or without ASD-II. Medically recorded birth outcomes, maternal age and birth order were evaluated. Marital and employment status was based on maternal information. The lifestyle factors were analyzed in a subsample of mothers visited at home based on a personal interview with mothers and their close relatives, and the family consensus was accepted. Mean gestational age at delivery and birthweight, rate of preterm birth and low birthweight, maternal age, birth order, marital and employment status. The evaluation of 471 cases with ASD-II and 38,151 controls without any defects showed a female excess in cases with ASD-II, having shorter gestational age and lower mean birthweight, and thus a higher rate of preterm births and low birthweight. Intrauterine growth restriction and shorter gestational age were found in cases with ASD-II, particularly in female children. These factors may have a general developmental process in which there was not closure of the foramen ovale, thus echocardiographic screening of these babies might be of value. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  4. Emergency contraception – a neglected option for birth control

    Directory of Open Access Journals (Sweden)

    Eka R. Gunardi

    2013-12-01

    Full Text Available Emergency contraception (EC is any method of contraception which is used after intercourse and before the potential time of implantation, in order to prevent pregnancy after an unprotected or inadequately protected sexual intercourse, or cases of rape. Use of emergency contraception could halve the number of unintended pregnancies and the consequent need for abortion, but unfortunately many medical professionals and the public are not aware of it. Two methods are available for emergency contraception, namely emergency contraception pills (ECPs and copper-bearing intrauterine devices (Cu-IUDs. There are two regimens of ECP, the levonorgestrel regimen and combined regimen. The levonorgestrel regimen is preferred as it is more effective and causes less side effects. ECPs should be administered as soon as possible after unprotected or inadequately protected sex, being most effective if initiated within 24 hours. Cu-IUDs can be inserted up to 5 days after unprotected sexual intercourse. Emergency contraception mainly works by preventing fertilization, and does not interrupt and established pregnancy. Emergency contraception is very safe, therefore can be offered to women who have had unprotected intercourse and wish to prevent pregnancy. It must only be used as a backup method of birth control. (Med J Indones. 2013;22:248-52. doi: 10.13181/mji.v22i4.609Keywords: Birth control, copper-IUD, emergency contraception, emergency contraceptive pills, levonorgestrel

  5. CDC Vital Signs: Preventing Repeat Teen Births

    Science.gov (United States)

    ... control after they have given birth. Although teen birth rates have been falling for the last two decades, ... effective forms of birth control. SOURCE: National Vital Statistics System, teens, ages 15–19, 2010 Larger image ...

  6. Influence of birth weight on differences in infant mortality by social class and legitimacy.

    Science.gov (United States)

    Leon, D A

    1991-01-01

    OBJECTIVE--To investigate the influence of birth weight on the pronounced social class differences in infant mortality in Britain. DESIGN--Analysis of routine data on births and infant deaths. SETTING--England and Wales. SUBJECTS--All live births and infant deaths, 1983-5. MAIN OUTCOME MEASURE--Mortality in infants by social class, birth weight, and legitimacy according to birth and death certificates. RESULTS--Neonatal and postneonatal mortality (deaths/1000 births) increased with social class. Neonatal and postneonatal mortality was 4.2/1000 and 2.3/1000 respectively for social class I and 6.8/1000 and 5.6/1000 respectively for social class V. Mortality was lower among births registered within marriage (postneonatal 3.5/1000; neonatal 5.2/1000) than among those jointly registered outside marriage (5.1/1000; 6.4/1000); mortality was highest in those solely registered outside marriage (7.2/1000; 7.0/1000). For neonatal mortality the effect of social class varied with birth weight. Social class had little effect on neonatal mortality in low birthweight babies and increasing effect in heavier babies. For postneonatal mortality the effect of social class was similar for all birth weights and was almost as steep as for all birth weights combined. CONCLUSION--Birth weight mediates little of the effect of social class on postneonatal mortality. PMID:1954421

  7. Feminism, biomedicine and the 'reproductive destiny' of women in clinical texts on the birth control pill.

    Science.gov (United States)

    Carson, Andrea

    2018-07-01

    The birth control pill is one of the most popular forms of contraception in North America and has been a key player in women's rights activism for over 50 years. In this paper, I conduct a feminist deconstructive analysis of 12 biomedical texts on the birth control pill, published between 1965 and 2016. This study is situated amongst the feminist scholarship that challenges the representation of women's bodies in biomedicine. Findings suggest that clinical texts on the birth control pill continue to universalise women's lives and experiences, and essentialise them based on their reproductive capacities. One way the texts accomplish this is by making women absent or passive in the literature thereby losing concern for the diversity of their lives, interpretations and identities as more than reproductive beings. The consequence of such representations is that biomedical texts disseminate limited forms of knowledge, in particular concerning definitions of 'natural' and 'normal' behaviour, with important consequences for the embodied experiences of women.

  8. 40 CFR 94.203 - Application for certification.

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) CONTROL OF EMISSIONS FROM MARINE COMPRESSION-IGNITION ENGINES Certification Provisions § 94.203 Application for certification. (a) For each engine family that complies with all applicable standards and... application of the engine (e.g., used to propel planing vessels, use to propel vessels with variable-pitch...

  9. Evaluating the Role of Birth Weight and Gestational Age on Acute Lymphoblastic Leukemia Risk Among Those of Hispanic Ethnicity.

    Science.gov (United States)

    Barahmani, Nadia; Dorak, M Tevfik; Forman, Michele R; Sprehe, Michael R; Scheurer, Michael E; Bondy, Melissa L; Okcu, M Fatih; Lupo, Philip J

    2015-01-01

    High birth weight is an established risk factor for childhood acute lymphoblastic leukemia (ALL), especially in children younger than 5 years of age at diagnosis. The goal of this study was to explore the association between being born large for gestational age and the risk for ALL by race/ethnicity to determine if the role of this risk factor differed by these characteristics. The authors compared birth certificate data of 575 children diagnosed with ALL who were younger than 5 years and included in the Texas Cancer Registry, Texas Department of Health, between the years 1995 and 2003 with 11,379 controls matched by birth year. Stratified odds ratios were calculated for risk of ALL by birth weight for gestational age, categorized in 3 groups, small, appropriate, and large for gestational age (SGA, AGA, and LGA, respectively), for each race/ethnicity group. The risk of developing ALL was higher among Hispanics who were LGA (odds ratio [OR] = 1.90, 95% confidence interval [CI]: 1.34-2.68) compared with LGA non-Hispanic whites (OR = 1.27, 95% CI: 0.87-1.86) after adjusting for infant gender, year of birth, maternal age, birth order, and presence of Down syndrome. However, the difference was not statistically significant. These results suggest that there may be differences in the association between higher growth in utero and risk of childhood ALL among Hispanics versus non-Hispanic whites.

  10. Month and Season of Birth as a Risk Factor for Alzheimer’s Disease: A Nationwide Nested Case-control Study

    Directory of Open Access Journals (Sweden)

    Anna-Maija Tolppanen

    2016-03-01

    Full Text Available Objectives: Season of birth, an exogenous indicator of early life environment, has been related to higher risk of adverse psychiatric outcomes but the findings for Alzheimer’s disease (AD have been inconsistent. We investigated whether the month or season of birth are associated with AD. Methods: A nationwide nested case-control study including all community-dwellers with clinically verified AD diagnosed in 2005 to 2012 (n=70 719 and up to four age- sex- and region of residence-matched controls (n=282 862 residing in Finland. Associations between month and season of birth and AD were studied with conditional logistic regression. Results: Month of birth was not associated with AD (p=0.09. No strong associations were observed with season (p=0.13, although in comparison to winter births (December-February summer births (June-August were associated with higher odds of AD (odds ratio, 1.03; 95% confidence interval, 1.00 to 1.05. However, the absolute difference in prevalence in winter births was only 0.5% (prevalence of those born in winter were 31.7% and 32.2% for cases and controls, respectively. Conclusions: Although our findings do not support the hypothesis that season of birth is related to AD/dementia risk, they do not invalidate the developmental origins of health and disease hypothesis in late-life cognition. It is possible that season does not adequately capture the early life circumstances, or that other (postnatal risk factors such as lifestyle or socioeconomic factors overrule the impact of prenatal and perinatal factors.

  11. Birth order and risk of hepatocellular carcinoma in chronic carriers of hepatitis B virus: a case-control study in The Gambia.

    Science.gov (United States)

    Shimakawa, Yusuke; Lemoine, Maud; Bottomley, Christian; Njai, Harr Freeya; Ndow, Gibril; Jatta, Abdoulie; Tamba, Saydiba; Bojang, Lamin; Taal, Makie; Nyan, Ousman; D'Alessandro, Umberto; Njie, Ramou; Thursz, Mark; Hall, Andrew J

    2015-10-01

    Early age at infection with Hepatitis B virus (HBV) increases the risk of chronic infection. Moreover, early HBV infection may further independently increase the risk of hepatocellular carcinoma (HCC) beyond its effect on chronicity. The distribution of birth order, a proxy for mode and timing of HBV transmission, was compared in The Gambia between hepatitis B surface antigen (HBsAg)-positive HCC cases recruited from hospitals (n = 72) and two HBsAg-positive control groups without HCC: population-based controls from a community HBV screening (n = 392) and hospital-based controls (n = 63). HCC risk decreased with increasing birth order in the population-based case-control analysis. Using first birth order as the reference, the odds ratios were 0.52 (95% CI: 0.20-1.36), 0.52 (0.17-1.56), 0.57 (0.16-2.05) and 0.14 (0.03-0.64) for second, third, fourth and greater than fourth birth order respectively (P = 0.01). A similar inverse association was observed in the hospital-based case-control comparison (P = 0.04). Compared to controls, HCC cases had earlier birth order, a proxy for young maternal age and maternal HBV viraemia at birth. This finding suggests that in chronic HBV carriers perinatal mother-to-infant transmission may increase HCC risk more than horizontal transmission. Providing HBV vaccine within 24 h of birth to interrupt perinatal transmission might reduce the incidence of HCC in The Gambia. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Liberalization of Birth Control and the Unmarried Share of Births

    DEFF Research Database (Denmark)

    Kennes, John; Knowles, John

    Half of unmarried births are to women who are already mothers, and a quarter to women who were previously married. We develop a model of equilibrium matching and fertility to replicate these facts. We use the model to revisit the hypothesis that liberalization of the Pill and abortion caused...

  13. Adolescents' Interpretations of the Birth Control Behavior of a Soap Opera Couple.

    Science.gov (United States)

    Walsh-Childers, Kim

    A study investigated whether adolescents' schemas about contraceptive use would influence their perceptions that a soap opera couple used birth control during sex. The study also examined the effects of increasing explicitness of characters' conversations about contraceptives on viewers' perceptions of the couple's contraceptive use. Thirty-six…

  14. Modeling The Effects of Mother’s Age at First Birth on Child Health at Birth

    OpenAIRE

    Mbu Daniel Tambi

    2014-01-01

    This study models the impact of mother’s age at first birth on child health at birth in Cameroon. The objectives are: (1) investigate the implication of mother’s age at first birth on child health at birth; (2) examine the impact of mother’s age groups on birth weight, and (3) suggest economic policies to ameliorate the mother’s age – child health relationship. We make used of the control function approach to determine the relationship between mother’s age at first birth and birth...

  15. Thyroid Medication Use and Birth Defects in the National Birth Defects Prevention Study.

    Science.gov (United States)

    Howley, Meredith M; Fisher, Sarah C; Van Zutphen, Alissa R; Waller, Dorothy K; Carmichael, Suzan L; Browne, Marilyn L

    2017-11-01

    Thyroid disorders are common among reproductive-aged women, with hypothyroidism affecting 2 to 3% of pregnancies, and hyperthyroidism affecting an additional 0.1 to 1%. We examined associations between thyroid medications and individual birth defects using data from the National Birth Defects Prevention Study (NBDPS). The NBDPS is a multisite, population-based, case-control study that included pregnancies with estimated delivery dates from 1997 to 2011. We analyzed self-reported thyroid medication use from mothers of 31,409 birth defect cases and 11,536 unaffected controls. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression for birth defects with five or more exposed cases, controlling for maternal age, race/ethnicity, and study center. Crude ORs and exact 95% CIs were estimated for defects with 3 to 4 exposed cases. Thyroid hormone was used by 738 (2.3%) case and 237 (2.1%) control mothers, and was associated with anencephaly (OR = 1.68; 95% CI, 1.03-2.73), holoprosencephaly (OR = 2.48; 95% CI, 1.13-5.44), hydrocephaly (1.77; 95% CI, 1.07-2.95) and small intestinal atresia (OR = 1.81; 95% CI, 1.04-3.15). Anti-thyroid medication was used by 34 (0.1%) case and 10 (<0.1%) control mothers, and was associated with aortic valve stenosis (OR = 6.91; 95% CI, 1.21-27.0). While new associations were identified, our findings are relatively consistent with previous NBDPS analyses. Our findings suggest thyroid medication use is not associated with most birth defects studied in the NBDPS, but may be associated with some specific birth defects. These results should not be interpreted to suggest that medications used to treat thyroid disease are teratogens, as the observed associations may reflect effects of the underlying thyroid disease. Birth Defects Research 109:1471-1481, 2017.© 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  16. A multinational case-control study on childhood brain tumours, anthropogenic factors, birth characteristics and prenatal exposures

    DEFF Research Database (Denmark)

    Vienneau, Danielle; Infanger, Denis; Feychting, Maria

    2016-01-01

    supplement intake) in relation to risk of brain tumour diagnosis among 7-19 year olds. The multinational case-control study in Denmark, Sweden, Norway and Switzerland (CEFALO) included interviews with 352 (participation rate=83.2%) eligible cases and 646 (71.1%) population-based controls. Interview data were...... complemented with data from birth registries and validated by assessing agreement (Cohen's Kappa). We used conditional logistic regression models matched on age, sex and geographical region (adjusted for maternal age and parental education) to explore associations between birth factors and childhood brain...... during pregnancy was indicative of a protective effect (OR 0.75, 95%-CI: 0.56-1.01). No association was seen for maternal smoking during pregnancy or working during pregnancy. We found little evidence that the considered birth factors were related to brain tumour risk among children and adolescents....

  17. Migration and its influence on the knowledge and usage of birth control methods among Afghan women who stay behind.

    Science.gov (United States)

    Roosen, I; Siegel, M

    2018-05-01

    The objective of this article is to investigate the link between migration and knowledge and use of birth control methods among female household members (of migrants) who stay behind in Afghanistan. Migrants can remit birth control information received in the destination country to non-migrants staying in the origin country, who may as a consequence adjust their health behaviour accordingly. The consequences of this interaction for knowledge and use are what we aim to test. Population-based secondary analysis of cross-sectional data. This study used cross-sectional data from the Afghan Mortality Survey (2010). Using ordinary least squares regression and propensity score matching, this research studies to what extent having a migrant in the household influences the knowledge and use of birth control among non-migrant Afghan women. Women who stay behind are defined in this research as those with a migrant household member who moved between 2005 and 2010. Results indicated that non-Pashtun women with a migrant household member showed greater knowledge of contraceptive methods using injectables, birth control pill and lactational amenorrhea method compared to those women without a migrant household member. Less knowledge of male sterilisation and emergency contraception is observed for all women (both Pashtun and non-Pashtun) with a migrant in their household on male sterilisation and emergency contraception compared to the women without a migrant in the household. In addition, we show that Pashtun women with a migrant in the household had lower levels of overall knowledge and were less likely to use birth control methods than women without a migrant household member. In Afghanistan, given the proximity, religious similarity and sociocultural customs mainly men migrate either to Pakistan or Iran. The findings suggest that migrants in different destination countries transfer different information (or fail to successfully transfer information) about birth control methods

  18. Development of new NDT certification scheme in Singapore

    International Nuclear Information System (INIS)

    Wong, B.S.; Prabhakaran, K.G.; Babu, S.K.; Kuppuswamy, N.

    2009-01-01

    Nondestructive testing plays a vital role in Singapore Industry either it is construction or it it oil and gas. To cope up with the future demands for nondestructive testing personnel and cater to the local industry needs for qualified and certified NDT operators, Nondestructive Testing Society (Singapore)-NDTSS launched the SGNDT Certification Scheme. The aim of the organization is to promote and standardize the quality of NDT through education and training based on a scheme that is on par with internationally recognized 3rd party certifications. The certification also provides a greater confidence to the clients and end users who utilize the NDT test results provided by the certified operators. NDE certification in Singapore varies from industries and currently relies on the in-house certification scheme based on SNT-TC-1A where organizations find it difficult to standardize the skill and reliability of operators. NDE Certification system varies globally from countries to countries. A proper certification system is required to produce successful NDT Practitioners to suit the local industry. This paper outlines the development of Singapore NDT Certification Scheme (SGNDT), the operations, levels of qualification, the method of operation and control measures. The Training and Certification committee, Quality Management system within the certification scheme and the current system practiced in Singapore are discussed in this paper. The paper also highlights the importance of third party certification scheme. (author)

  19. Birth characteristics and Wilms tumors in children in the Nordic countries: a register-based case-control study.

    Science.gov (United States)

    Schüz, Joachim; Schmidt, Lisbeth Samsø; Kogner, Per; Lähteenmäki, Päivi M; Pal, Niklas; Stokland, Tore; Schmiegelow, Kjeld

    2011-05-01

    Little is known about causes of Wilms tumor. Because of the young age at diagnosis, several studies have looked at various birth characteristics. We conducted a registry-based case-control study involving 690 cases of Wilms tumor aged 0-14 years, occurring in Denmark, Finland, Norway or Sweden during 1985-2006, individually matched to five controls drawn randomly from the Nordic childhood population. Information on birth characteristics was obtained from the population-based medical birth registries. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic regression analysis. We observed a distinct association between Wilms tumor and high birth weight (≥4 kg) for girls (OR 1.97, CI 1.50-2.59) but not for boys (1.04, 0.78-1.38); overall, the OR was 1.43 (1.17-1.74). Among girls, risk increased by 28% (15-42%) per 500 g increase in birth weight. Large-for-gestational age girls also had a higher risk (2.48, 1.51-4.05), whereas no effect was seen for boys (1.12, 0.60-2.07). An association was seen with Apgar score at 5 min birth order. In our large-scale, registry-based study, we confirmed earlier observations of an association between high birth weight and risk of Wilms tumor, but we found an effect only in girls. The higher risk of infants with low Apgar score might reflect hypoxia causing cell damage, adverse side effects of neonatal treatment or reverse causation as low Apgar score might indicate the presence of a tumor. Copyright © 2010 UICC.

  20. Low birth weight at term and its determinants in a tertiary hospital of Nepal: a case-control study.

    Directory of Open Access Journals (Sweden)

    Sudesh Raj Sharma

    Full Text Available Birth weight of a child is an important indicator of its vulnerability for childhood illness and chances of survival. A large number of infant deaths can be averted by appropriate management of low birth weight babies and prevention of factors associated with low birth weight. The prevalence of low birth weight babies in Nepal is estimated to be about 12-32%.Our study aimed at identifying major determinants of low birth weight among term babies in Nepal. A hospital-based retrospective case control study was conducted in maternity ward of Tribhuvan University Teaching Hospital from February to July 2011. A total of 155 LBW babies and 310 controls were included in the study. Mothers admitted to maternity ward during the study period were interviewed, medical records were assessed and anthropometric measurements were done. Risk factors, broadly classified into proximal and distal factors, were assessed for any association with birth of low-birth weight babies. Regression analysis revealed that a history of premature delivery (adjusted odds ratio; aOR5.24, CI 1.05-26.28, hard physical work during pregnancy (aOR1.48, CI 0.97-2.26, younger age of mother (aOR1.98, CI 1.15-3.41, mothers with haemoglobin level less than 11gm/dl (aOR0.51, CI0.24-1.07 and lack of consumption of nutritious food during pregnancy (aOR1.99, CI 1.28-3.10 were significantly associated with the birth of LBW babies. These factors should be addressed with appropriate measures so as to decrease the prevalence of low birth weight among term babies in Nepal.

  1. Recent changes in the trends of teen birth rates, 1981-2006.

    Science.gov (United States)

    Wingo, Phyllis A; Smith, Ruben A; Tevendale, Heather D; Ferré, Cynthia

    2011-03-01

    To explore trends in teen birth rates by selected demographics. We used birth certificate data and joinpoint regression to examine trends in teen birth rates by age (10-14, 15-17, and 18-19 years) and race during 1981-2006 and by age and Hispanic origin during 1990-2006. Joinpoint analysis describes changing trends over successive segments of time and uses annual percentage change (APC) to express the amount of increase or decrease within each segment. For teens younger than 18 years, the decline in birth rates began in 1994 and ended in 2003 (APC: -8.03% per year for ages 10-14 years; APC: -5.63% per year for ages 15-17 years). The downward trend for 18- and 19-year-old teens began earlier (1991) and ended 1 year later (2004) (APC: -2.37% per year). For each study population, the trend was approximately level during the most recent time segment, except for continuing declines for 18- and 19-year-old white and Asian/Pacific Islander teens. The only increasing trend in the most recent time segment was for 18- and 19-year-old Hispanic teens. During these declines, the age distribution of teens who gave birth shifted to slightly older ages, and the percentage whose current birth was at least their second birth decreased. Teen birth rates were generally level during 2003/2004-2006 after the long-term declines. Rates increased among older Hispanic teens. These results indicate a need for renewed attention to effective teen pregnancy prevention programs in specific populations. Copyright © 2011. Published by Elsevier Inc.

  2. Guidelines for developing certification programs for newly generated TRU waste

    International Nuclear Information System (INIS)

    Whitty, W.J.; Ostenak, C.A.; Pillay, K.K.S.; Geoffrion, R.R.

    1983-05-01

    These guidelines were prepared with direction from the US Department of Energy (DOE) Transuranic (TRU) Waste Management Program in support of the DOE effort to certify that newly generated TRU wastes meet the Waste Isolation Pilot Plant (WIPP) Waste Acceptance Criteria. The guidelines provide instructions for generic Certification Program preparation for TRU-waste generators preparing site-specific Certification Programs in response to WIPP requirements. The guidelines address all major aspects of a Certification Program that are necessary to satisfy the WIPP Waste Acceptance Criteria and their associated Compliance Requirements and Certification Quality Assurance Requirements. The details of the major element of a Certification Program, namely, the Certification Plan, are described. The Certification Plan relies on supporting data and control documentation to provide a traceable, auditable account of certification activities. Examples of specific parts of the Certification Plan illustrate the recommended degree of detail. Also, a brief description of generic waste processes related to certification activities is included

  3. Timing of birth for women with a twin pregnancy at term: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Haslam Ross R

    2010-10-01

    is a protocol for a randomised trial, the findings of which will contribute information about the optimal time of birth for women with an uncomplicated multiple pregnancy at and beyond 37 weeks gestation. Clinical Trial Registration Current Controlled Trials ISRCTN15761056

  4. Transactional price of an expected child and its application in birth control.

    Science.gov (United States)

    Li, X

    1993-01-01

    The theoretical presentation of the impact of the transactional price of an expected child (TPEC) on birth control led to the conclusion that successful birth control was a combination of birth utility theory and TPEC theory. In a hypothetical market, the assumption can be made that an expected price can be attached to a desired child or a transactional price can be attached for giving up the reproductive right to have an excess child. A consumer equilibrium model can characterize the changes in financial resources necessary in deciding on an appropriate number of children. In a general equilibrium model, couples would have to be compensated a certain amount as an inducement to forgo the right to have a second child. Prices of children can be determined by a distributional curve of this transactional price of expected excess children and the estimated marginal price for couples with two children. Under circumstances of limited resources, it would be cheaper to buy some couple's rights to forgo a child, and this price would vary with parity. The exact transactional price of each child by parity by each couple could be theoretically determined, if all couples told the truth about desired number of children. However, the complication is that this condition may not be possible, and couples may charge more for forgoing the right to a subsequent child that what they would actually accept. Also, the seller could ask one price and then charge more. A compromise would be to set prices only for lower parities and to set prices subject to the total funds available to the buyer. Very low prices would also decrease the effectiveness of birth control. The government could be a buyer or seller. Taxing couples for additional children would make the government a seller. When the government is the buyer, couples would be compensated for not having an additional child. Another possibility is a reward for having only a certain number of children and a tax for excess children, which

  5. Energetic certification in Europe

    International Nuclear Information System (INIS)

    1998-01-01

    At community level the problem of energy quality control in a building was introduced by EEC recommendation n. 93/76 in 1993. In this item are reported some notes on energetic certification in European countries [it

  6. Effects of infants' birth order, maternal age, and socio-economic status on birth weight.

    Science.gov (United States)

    Ghaemmaghami, Seyed J; Nikniaz, Leila; Mahdavi, Reza; Nikniaz, Zeinab; Razmifard, Farzad; Afsharnia, Farzaneh

    2013-09-01

    To determine the effects of infants' birth order, maternal age, and socioeconomic status (SES) on birth weight. This cross-sectional study included a sample of 858 mothers recruited over a 6-month period in 2010, in a defined population of 9 urban health centers, and who were admitted for their infants' first vaccination. Maternal clinical data, demographic data, and infants' birth weight were obtained from the interview and maternal hospital files. Multiple regression and analysis of variance were used for data analysis. First and fourth births had lower birth weights compared with second and third births in all maternal ages in controlling parity, birth weight increases with maternal age up to the early 24, and then tends to level off. Male gender, maternal age 20-24 years, second and third births had a significant positive effect on birth weight. Lower family economic status and higher educational attainment were significantly associated with lower birth weight. For women in the 15-19 and 40-44 years age groups, the second birth order was associated with the most undesirable effect on birth weight. Accessibility of health care services, parity, maternal age, and socioeconomic factors are strongly associated with infants' birth weight.

  7. Higher Prevalence of Left-Handedness in Twins? Not After Controlling Birth Time Confounders.

    Science.gov (United States)

    Heikkilä, Kauko; Vuoksimaa, Eero; Saari-Kemppainen, Aulikki; Kaprio, Jaakko; Rose, Richard J; Haukka, Jari; Pitkäniemi, Janne; Iivanainen, Matti

    2015-10-01

    Pregnancy- and birth-related factors may have an effect on handedness. Compared with singletons, twins have a lower birth weight, shorter gestational age, and are at higher risk for birth complications. We tested whether the prevalence of left-handedness is higher among twins than singletons, and if so, whether that difference is fully explained by pregnancy and birth-related differences between twins and singletons. We analyzed Finnish population-based datasets; included were 8,786 twins and 5,892 singletons with information on birth weight (n = 12,381), Apgar scores (n = 11,129), and gestational age (n = 11,811). Two twin cohorts were involved: FinnTwin12 included twins born during 1983-1987, and FinnTwin16 included twins born during 1974-1979. We had two comparison groups of singletons: 4,101 individuals born during 1986-1988 and enrolled in the Helsinki Ultrasound Trial, and 1,791 individuals who were partners of FinnTwin16 twins. We used logistic regression models with writing hand as the outcome for comparison and evaluating effects of covariates. Left-handedness was more common in twins (9.67%) than in singletons (8.27%; p = .004). However, Apgar scores were associated with handedness, and after controlling for covariates, we found no difference in the prevalence of left-handedness between twins and singletons. Increased left-handedness among twins, often reported by others, was evident in our data, but only among our older twin cohorts, and that association disappeared after removing effects of perinatal covariates.

  8. Pregnancy prevention among American Indian men ages 18 to 24: the role of mental health and intention to use birth control.

    Science.gov (United States)

    Rink, Elizabeth; FourStar, Kris; Medicine Elk, Jarrett; Dick, Rebecca; Jewett, Lacey; Gesink, Dionne

    2012-01-01

    The Fort Peck Sexual Health Project: A Contextual Analysis of Native American Men is a community-based participatory research (CBPR) project that explores the extent to which knowledge, attitudes, and beliefs about sex, intimate relationships, and mental health influence sexual and reproductive health. For the purpose of this study, the influence of age, fatherhood, and mental health factors related to historical trauma and loss on young American Indian (AI) men's intention to use birth control was examined. In-depth interviews were conducted with 112 Native American men between the ages of 18 and 24 years. The mean age reported was 21 years. Thirty-eight percent of the young men reported having children. The young men reported experiences of historical trauma during their lifetime as well as emotional responses due to historical losses. Ninety-five percent reported that it was very important that they use some form of birth control to prevent their partner from getting pregnant within the next year. Logistic regression analysis indicated that, as age increased, young men were less likely to use birth control to prevent pregnancy. The young men who reported feelings of loss due to experiences related to historical trauma and loss were more likely to use birth control. Findings from this study suggest that public health efforts to educate AI men about planned pregnancies and the use of birth control may be most effective in adolescence. Public health programs that address mental health concerns such as the emotional responses due to historical losses may assist young AI men in their decision to use birth control.

  9. Impact of police-reported intimate partner violence during pregnancy on birth outcomes.

    Science.gov (United States)

    Lipsky, Sherry; Holt, Victoria L; Easterling, Thomas R; Critchlow, Cathy W

    2003-09-01

    To examine the relationship of police-reported intimate partner violence during pregnancy and adverse birth outcomes. We conducted a population-based, retrospective, cohort study in Seattle, Washington, using Seattle police data and Washington State birth certificate files from January 1995 through September 1999. Exposed subjects were women with an intimate partner violence incident reported to police during pregnancy and who subsequently had a singleton live birth or fetal death registered in the state of Washington. Unexposed subjects were randomly selected Seattle residents with a singleton live birth or fetal death in the same time period and who did not report an incident. The main outcome measures were low birth weight (LBW less than 2500 g), very LBW (VLBW less than 1500 g), preterm birth (20-36 weeks' gestation), very preterm birth (20-31 weeks), and neonatal death (before discharge). Women reporting any partner violence during pregnancy were significantly more likely to have a LBW infant (adjusted odds ratio [aOR] 1.70; 95% confidence interval [CI] 1.20, 2.40), a VLBW infant (aOR 2.54; 95% CI 1.32, 4.91), a preterm birth (aOR 1.61; 95% CI 1.14, 2.28), a very preterm birth (aOR 3.71; 95% CI 1.80, 7.63), and a neonatal death (aOR 3.49; 95% CI 1.43, 8.50). Police-reported partner violence during pregnancy is significantly associated with an increased risk of adverse birth outcomes. There is a critical need to identify pregnancy among women with reported incidents and to provide women health and social service information and referrals, particularly referrals to high-risk pregnancy programs.

  10. New low-dose, extended-cycle pills with levonorgestrel and ethinyl estradiol: an evolutionary step in birth control.

    Science.gov (United States)

    Nelson, Anita

    2010-08-09

    To review milestones in development of oral contraceptive pills since their introduction in the US 50 years ago in order to better understand how a new formulation with low-dose estrogen in an extended-cycle pattern fits into the evolution of birth control pills. This is a review of trends in the development of various birth controls pills and includes data from phase III clinical trials for this new formulation. The first birth control pill was a very high-dose monophasic formulation with the prodrug estrogen mestranol and a first-generation progestin. Over the decades, the doses of hormones have been markedly reduced, and a new estrogen and several different progestins were developed and used in different dosing patterns. The final element to undergo change was the 7-day pill-free interval. Many of these same changes have been made in the development of extended-cycle pill formulation. The newest extended-cycle oral contraceptive formulation with 84 active pills, each containing 20 μg ethinyl estradiol and 100 μg levonorgestrel, represents an important evolution in birth control that incorporates lower doses of estrogen (to reduce side effects and possibly reduce risk of thrombosis), fewer scheduled bleeding episodes (to meet women's desires for fewer and shorter menses) and the use of low-dose estrogen in place of placebo pills (to reduce the number of days of unscheduled spotting and bleeding). Hopefully, this unique formation will motivate women to be more successful contraceptors.

  11. 40 CFR 745.90 - Renovator certification and dust sampling technician certification.

    Science.gov (United States)

    2010-07-01

    ... sampling technician certification. 745.90 Section 745.90 Protection of Environment ENVIRONMENTAL PROTECTION... technician certification. (a) Renovator certification and dust sampling technician certification. (1) To become a certified renovator or certified dust sampling technician, an individual must successfully...

  12. Critical evaluation of national vital statistics: the case of preterm birth trends in Portugal.

    Science.gov (United States)

    Correia, Sofia; Rodrigues, Teresa; Montenegro, Nuno; Barros, Henrique

    2015-11-01

    Using vital statistics, the Portuguese National Health Plan predicts that 14% of live births will be preterm in 2016. The prediction was based on a preterm birth rise from 5.9% in 2000 to 8.8% in 2009. However, the same source showed an actual decline from 2010 onwards. To assess the plausibility of national preterm birth trends, we aimed to compare the evolution of preterm birth and low birthweight rates between vital statistics and a hospital database. A time-trend analysis (2004-2011) of preterm birth (rates was conducted using data on singleton births from the national birth certificates (n = 801,783) and an electronic maternity unit database (n = 21,392). Annual prevalence estimates, ratios of preterm birth:low birthweight and adjusted prevalence ratios were estimated to compare data sources. Although the national prevalence of preterm birth increased from 2004 (5.4%), particularly between 2006 and 2009 (highest rate was 7.5% in 2007), and decreased after 2009 (5.7% in 2011), the prevalence at the maternity unit remained constant. Between 2006 and 2009, preterm birth was almost 1.4 times higher in the national statistics (using the national or the catchment region samples) than in the maternity unit, but no differences were found for low birthweight. Portuguese preterm birth prevalence seems biased between 2006 and 2009, suggesting that early term babies were misclassified as preterm. As civil registration systems are important to support public health decisions, monitoring strategies should be taken to assure good quality data. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  13. The Relevance of Maternal Socioeconomic Characteristics for Low Birth Weight - a Case-Control Study.

    Science.gov (United States)

    Altenhöner, T; Köhler, M; Philippi, M

    2016-03-01

    Introduction: The number of children born underweight (low birth weight, LBW) is increasing despite extensive prevention and screening programmes. The cost is high for the health system, and affected children are burdened with health predictors that can affect them negatively throughout their lives. This study investigates to what extent socioeconomic factors, in addition to known medical causes and the health behaviour of pregnant women, influence LBW. Materials and Methods: In this case-control study 131 mothers of singletons with a birth weight ≤ 2500 g (cases) and 323 mothers of normal birth weight babies (controls) were interviewed with respect to socioeconomic status, health behaviour and stress in the workplace. Medical data were collected by specialist staff using a questionnaire. Results: Independent of medical diagnosis and health behaviour, women with lower level education (OR [95 % CI] = 2.24 [1.12; 4.51]) and those who were not working (OR [95 % CI] = 1.82 [1.10; 3.00]) were more likely to have an LBW baby. No effect was shown for immigrant background (OR [95 % CI] = 1.14 [0.59; 2.21]) or stress in the workplace (OR [95 % CI] = 1.17 [0.90; 1.51]). Discussion and Conclusion: These results show that the association between social and health inequalities starts from before birth. In order to reduce the rising number of babies born underweight, socioeconomic determinants in the care and supervision of pregnant women should systematically receive more attention to enable appropriate early preventive strategies to be implemented.

  14. System certification: An alternative to package certification?

    International Nuclear Information System (INIS)

    Luna, R.E.; Jefferson, R.J.

    1992-01-01

    One precept of the current radioactive material transportation regulations is that the package is the primary protection for the public. A packaging is chosen to provide containment, shielding, and criticality control suitable to the quantity and characteristics of the radionuclide being transported. Occasionally, radioactive materials requiring transport are not of a mass or size that would allow the materials to be shipped in an appropriate packaging. This is a particular problem for materials that should be shipped in a Type B package, but because such packages are designed and certified for specific contents, the package is usually fairly expensive, available in relatively small numbers, and often requires a fairly long period to achieve certification or amended certification for new contents. Where the shipment to be made is relatively infrequent, there may be economic and time penalties that may hamper shipment or force the shipper into uneconomic or high risk options. However, there is recognition of such situations in the International Atomic Energy Agency (IAEA) regulations under the provisions for Special Arrangement

  15. Formal Methods and Safety Certification: Challenges in the Railways Domain

    DEFF Research Database (Denmark)

    Fantechi, Alessandro; Ferrari, Alessio; Gnesi, Stefania

    2016-01-01

    The railway signalling sector has historically been a source of success stories about the adoption of formal methods in the certification of software safety of computer-based control equipment.......The railway signalling sector has historically been a source of success stories about the adoption of formal methods in the certification of software safety of computer-based control equipment....

  16. Climate certificates

    International Nuclear Information System (INIS)

    1998-10-01

    Reduced emissions of climate gases at the lowest cost require international cooperation in order to ensure that the most cost-efficient measures are taken. A market for emission rights is one way of achieving this. However, creating the right conditions for such a market to operate requires an unambiguous definition of the product to be traded. In this PM, the Swedish Power Association sketches out how such a product could be defined, and how a market for the resulting unambiguously defined product could be operated internationally, in parallel with other markets for energy products. Trade in climate certificates could become a joint EU approach to achieving common results within the field of climate policy. The main features of the proposal are as follows: Electricity producers would be allowed to issue climate certificates for electricity produced without climate-affecting emissions, e.g. in wind power plants. 1 kWh of electricity produced without emissions would entitle the utility to issue a climate certificate for 1 kWh. Electricity from power stations having low emissions, e.g. modern natural gas-fired plants, would entitle the utility to issue certificates in proportion to how much lower their emissions were in comparison with those from conventional coal-fired power stations. The number of certificates would be reduced by an individual coefficient, related directly to the quantity of climate-affecting emissions from the plant concerned. They would be traded and noted on markets in the various member countries. The certificates would not be nationally restricted, but could be traded across borders. Exchanges would be authorised by national authorities, in accordance with overall EU directives. These authorised exchanges would act as certification bodies, checking that certificates had been properly issued in accordance with a corresponding volume of electricity production. Electricity and certificates could be purchased from different suppliers. The

  17. Recent developments of biofuels/bioenergy sustainability certification: A global overview

    International Nuclear Information System (INIS)

    Scarlat, Nicolae; Dallemand, Jean-Francois

    2011-01-01

    The objective of this paper is to provide a review on the latest developments on the main initiatives and approaches for the sustainability certification for biofuels and/or bioenergy. A large number of national and international initiatives lately experienced rapid development in the view of the biofuels and bioenergy targets announced in the European Union, United States and other countries worldwide. The main certification initiatives are analysed in detail, including certification schemes for crops used as feedstock for biofuels, the various initiatives in the European Union, United States and globally, to cover biofuels and/or biofuels production and use. Finally, the possible way forward for biofuel certification is discussed. Certification has the potential to influence positively direct environmental and social impact of bioenergy production. Key recommendations to ensure sustainability of biofuels/bioenergy through certification include the need of an international approach and further harmonisation, combined with additional measures for global monitoring and control. The effects of biofuels/bioenergy production on indirect land use change (ILUC) is still very uncertain; addressing the unwanted ILUC requires sustainable land use planning and adequate monitoring tools such as remote sensing, regardless of the end-use of the product. - Research highlights: → There is little harmonisation between certification initiatives. → Certification alone is probably not able to avoid certain indirect effects. → Sustainability standards should be applied globally to all agricultural commodities. → A critical issue to certification is implementation and verification. → Monitoring and control of land use changes through remote sensing are needed.

  18. A multinational case-control study on childhood brain tumours, anthropogenic factors, birth characteristics and prenatal exposures: A validation of interview data.

    Science.gov (United States)

    Vienneau, Danielle; Infanger, Denis; Feychting, Maria; Schüz, Joachim; Schmidt, Lisbeth Samsø; Poulsen, Aslak Harbo; Tettamanti, Giorgio; Klæboe, Lars; Kuehni, Claudia E; Tynes, Tore; Von der Weid, Nicolas; Lannering, Birgitta; Röösli, Martin

    2016-02-01

    Little is known about the aetiology of childhood brain tumours. We investigated anthropometric factors (birth weight, length, maternal age), birth characteristics (e.g. vacuum extraction, preterm delivery, birth order) and exposures during pregnancy (e.g. maternal: smoking, working, dietary supplement intake) in relation to risk of brain tumour diagnosis among 7-19 year olds. The multinational case-control study in Denmark, Sweden, Norway and Switzerland (CEFALO) included interviews with 352 (participation rate=83.2%) eligible cases and 646 (71.1%) population-based controls. Interview data were complemented with data from birth registries and validated by assessing agreement (Cohen's Kappa). We used conditional logistic regression models matched on age, sex and geographical region (adjusted for maternal age and parental education) to explore associations between birth factors and childhood brain tumour risk. Agreement between interview and birth registry data ranged from moderate (Kappa=0.54; worked during pregnancy) to almost perfect (Kappa=0.98; birth weight). Neither anthropogenic factors nor birth characteristics were associated with childhood brain tumour risk. Maternal vitamin intake during pregnancy was indicative of a protective effect (OR 0.75, 95%-CI: 0.56-1.01). No association was seen for maternal smoking during pregnancy or working during pregnancy. We found little evidence that the considered birth factors were related to brain tumour risk among children and adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Software Certification - Coding, Code, and Coders

    Science.gov (United States)

    Havelund, Klaus; Holzmann, Gerard J.

    2011-01-01

    We describe a certification approach for software development that has been adopted at our organization. JPL develops robotic spacecraft for the exploration of the solar system. The flight software that controls these spacecraft is considered to be mission critical. We argue that the goal of a software certification process cannot be the development of "perfect" software, i.e., software that can be formally proven to be correct under all imaginable and unimaginable circumstances. More realistically, the goal is to guarantee a software development process that is conducted by knowledgeable engineers, who follow generally accepted procedures to control known risks, while meeting agreed upon standards of workmanship. We target three specific issues that must be addressed in such a certification procedure: the coding process, the code that is developed, and the skills of the coders. The coding process is driven by standards (e.g., a coding standard) and tools. The code is mechanically checked against the standard with the help of state-of-the-art static source code analyzers. The coders, finally, are certified in on-site training courses that include formal exams.

  20. [Optimum approach to delivery for control of premature birth (author's transl)].

    Science.gov (United States)

    Nieder, J; Lattorff, E

    1980-01-01

    Foetal condition and neonatal mortality of 637 prematurely born children with birth weights below 2,501 g were analysed, depending on modes of delivery, such as spontaneous birth, speculum delivery, use of forceps, manual support, and caesarean section. The clinical condition of the newborn, assessed five minutes from parturition by Apgar score 1, was found to depend primarily on birth weight rather than on the mode of delivery. The average Apgar values were lower for less mature newborns. While Apgar scores were worst for newborns after caesarean section delivery, the differences between approaches to delivery could not be statistically secured. Neonatal mortality went up, according to expectation, along with dropping birth weight. The mortality rate of premature births below 1,501 g was not affected by delivery modes. Prophylactic use of Shute forceps and speculum delivery appeared to be superior to spontaneous birth in the medium weight class, between 1,501 g and 2,000 g. Yet, not even here were the differences between clear postnatal mortality rates statistically secured. -Lowest mortality figures were recorded from spontaneous birth in the weight class between 2,001 g and 2,500 g, but significant differences were established only to speculum delivery. Premature newborns after caesarean section had poorer prospects than all variants of vaginal birth, but among the latter premature births from breech presentation were more endangered than others. Decisions as to vaginal, abdominal, spontaneous proprophylactically surgical approaches to premature deliveries should be taken for every individual case and due consideration of many factors.

  1. Risk factors for pre-term birth in Iraq: a case-control study

    Directory of Open Access Journals (Sweden)

    Al-Dabbagh Samim A

    2006-04-01

    Full Text Available Abstract Background Preterm birth (PTBis a major clinical problem associated with perinatal mortality and morbidity. The aim of the present study is to identify risk factors associated with PTB in Mosul, Iraq. Methods A case-control study was conducted in Mosul, Iraq, from 1st September, 2003 to 28th February, 2004. Results A total of 200 cases of PTB and 200 controls of full-term births were screened and enrolled in the study. Forward logistic regression analysis was used in the analysis. Several significant risk associations between PTB and the following risk factors were identified: poor diet (OR = 4.33, heavy manual work (OR = 1.70, caring for domestic animals (OR = 5.06, urinary tract infection (OR = 2.85, anxiety (OR = 2.16, cervical incompetence (OR = 4.74, multiple pregnancies (OR = 7.51, direct trauma to abdomen (OR = 3.76 and abortion (OR = 6.36. Conclusion The main determinants of PTB in Iraq were low socio-economic status and factors associated with it, such as heavy manual work and caring for domestic animals, in addition to urinary tract infections and poor obstetric history.

  2. Correlates of Low Birth Weight

    Directory of Open Access Journals (Sweden)

    Ankur Barua MD, PhD

    2014-12-01

    Full Text Available Background. Low birth weight is the single most important factor that determines the chances of child survival. A recent annual estimation indicated that nearly 8 million infants are born with low birth weight in India. The infant mortality rate is about 20 times greater for all low birth weight babies. Methods. A matched case–control study was conducted on 130 low birth weight babies and 130 controls for 12 months (from August 1, 2007, to July 31, 2008 at the Central Referral Hospital, Tadong, East District of Sikkim, India. Data were analyzed using the Statistical Package for Social Sciences, version 10.0 for Windows. Chi-square test and multiple logistic regression were applied. A P value less than .05 was considered as significant. Results. In the first phase of this study, 711 newborn babies, borne by 680 mothers, were screened at the Central Referral Hospital of Sikkim during the 1-year study period, and the proportion of low birth weight babies was determined to be 130 (18.3%. Conclusion. Multiple logistic regression analysis, conducted in the second phase, revealed that low or middle socioeconomic status, maternal underweight, twin pregnancy, previous history of delivery of low birth weight babies, smoking and consumption of alcohol during pregnancy, and congenital anomalies had independent significant association with low birth weight in this study population.

  3. Birth order and sibship size: evaluation of the role of selection bias in a case-control study of non-Hodgkin's lymphoma.

    Science.gov (United States)

    Mensah, F K; Willett, E V; Simpson, J; Smith, A G; Roman, E

    2007-09-15

    Substantial heterogeneity has been observed among case-control studies investigating associations between non-Hodgkin's lymphoma and familial characteristics, such as birth order and sibship size. The potential role of selection bias in explaining such heterogeneity is considered within this study. Selection bias according to familial characteristics and socioeconomic status is investigated within a United Kingdom-based case-control study of non-Hodgkin's lymphoma diagnosed during 1998-2001. Reported distributions of birth order and maternal age are each compared with expected reference distributions derived using national birth statistics from the United Kingdom. A method is detailed in which yearly data are used to derive expected distributions, taking account of variability in birth statistics over time. Census data are used to reweight both the case and control study populations such that they are comparable with the general population with regard to socioeconomic status. The authors found little support for an association between non-Hodgkin's lymphoma and birth order or family size and little evidence for an influence of selection bias. However, the findings suggest that between-study heterogeneity could be explained by selection biases that influence the demographic characteristics of participants.

  4. The birth beliefs scale - a new measure to assess basic beliefs about birth.

    Science.gov (United States)

    Preis, Heidi; Benyamini, Yael

    2017-03-01

    Basic beliefs about birth as a natural and safe or a medical and risky process are central in the decisions on where and how to birth. Despite their importance, they have not been studied separately from other childbirth-related constructs. Our aim was to develop a measure to assess these beliefs. Pregnant Israeli women (N = 850, gestational week ≥14) were recruited in women's health centers, in online natural birth forums, and through home midwives. Participants filled in questionnaires including sociodemographic and obstetric background, the Birth Beliefs Scale (BBS), dispositional desire for control (DC) and planned mode of delivery. Factor analyses revealed that the BBS is composed of two factors: beliefs about birth as a natural process and beliefs about birth as a medical process. Both subscales showed good internal and test-retest reliability. They had good construct validity, predicted birth choices, and were weakly correlated with DC. Women's medical obstetric history was associated with the BBS, further supporting the validity of the scale. Beliefs about birth may be the building blocks that make up perceptions of birth and drive women's preferences. The new scale provides an easy way to distinctly assess them so they can be used to further understand planned birth behaviors. Additional studies are needed to comprehend how these beliefs form in different cultural contexts and how they evolve over time.

  5. Trends and characteristics of home births in the United States by race and ethnicity, 1990-2006.

    Science.gov (United States)

    MacDorman, Marian F; Declercq, Eugene; Menacker, Fay

    2011-03-01

    After a gradual decline from 1990 to 2004, the percentage of births occurring at home in the United States increased by 5 percent in 2005 and that increase was sustained in 2006. The purpose of the study was to analyze trends and characteristics in home births in United States by race and ethnicity from 1990 to 2006. U.S. birth certificate data on home births were analyzed and compared with hospital births for a variety of demographic and medical characteristics. From 1990 to 2006, both the number and percentage of home births increased for non-Hispanic white women, but declined for all other race and ethnic groups. In 2006, non-Hispanic white women were three to four times more likely to have a home birth than women of other race and ethnic groups. Home births were more likely than hospital births to occur to older, married women with singleton pregnancies and several previous children. For non-Hispanic white women, fewer home births than hospital births were born preterm, whereas for other race and ethnic groups a higher percentage of home births than hospital births were born preterm. For non-Hispanic white women, two-thirds of home births were delivered by midwives. In contrast, for other race and ethnic groups, most home births were delivered by either physicians or "other" attendants, suggesting that a higher proportion of these births may be unplanned home births because of emergency situations. Differences in the risk profile of home births by race and ethnicity are consistent with previous research, suggesting that, compared with non-Hispanic white women, a larger proportion of non-Hispanic black and Hispanic home births represent unplanned, emergency situations. © 2010, Copyright the Authors. Journal compilation © 2010, Wiley Periodicals, Inc.

  6. The birth control movement before Roe v. Wade.

    Science.gov (United States)

    Reed, J W

    1995-01-01

    This essay synthesizes the history of the birth control movement in the US and describes changes in sexual behavior, social values, and public policy in order to provide a context for the changes in human reproductive public policy. After an introduction, the essay outlines the history of contraception from the early nineteenth to the early twentieth centuries. Part 3 covers the period of World War I to the Depression when civil libertarians and eugenicists began to question the suppression of contraception and Margaret Sanger organized her clinics. The fourth part of the essay carries the history forward to the end of World War II, a period in which Dr. Clarence J. Gamble began to expose the marketing of defective contraceptive methods and to illustrate the willingness of poor women to accept contraceptives. The social changes which began in the 1950s are the subject of the fifth section of the essay. During this period, Roman Catholic opposition to contraception lessened, and social scientists began to focus world attention on overpopulation. Frank Notestein was appointed the first head of the Office of Population Research at Princeton, and John D. Rockefeller III founded the Population Council which conducted research into the IUD and began to attempt to influence population growth in nonindustrialized countries. This period also saw the development of the oral contraceptive. The changes of this era were institutionalized in 1967 when the federal government took a positive stance towards family planning in its Social Security Amendments. The decade of the 1970s is the subject of the last part of this essay. This period saw the Supreme Court assign a constitutionally protected right to abortion and Congress pass the Helms Amendment which denied the use of foreign aid funds for abortions. Challenges to the right to individual birth control practice continued during this period, and debate centered around the specter of overpopulation, the threat of adolescent

  7. Area-level poverty and preterm birth risk: A population-based multilevel analysis

    Science.gov (United States)

    DeFranco, Emily A; Lian, Min; Muglia, Louis A; Schootman, Mario

    2008-01-01

    Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997). We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990). Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty) was the reference group. Results PTB rate of PTB poverty and increased through the 4th quartile (4.9%), p poverty was significantly associated with PTB risk. PTB risk (poverty, adjusted odds ratio (adjOR) 1.18 (95% CI 1.03, 1.35), with a similar effect at earlier gestational ages (birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies. PMID:18793437

  8. Area-level poverty and preterm birth risk: A population-based multilevel analysis

    Directory of Open Access Journals (Sweden)

    Muglia Louis A

    2008-09-01

    Full Text Available Abstract Background Preterm birth is a complex disease with etiologic influences from a variety of social, environmental, hormonal, genetic, and other factors. The purpose of this study was to utilize a large population-based birth registry to estimate the independent effect of county-level poverty on preterm birth risk. To accomplish this, we used a multilevel logistic regression approach to account for multiple co-existent individual-level variables and county-level poverty rate. Methods Population-based study utilizing Missouri's birth certificate database (1989–1997. We conducted a multilevel logistic regression analysis to estimate the effect of county-level poverty on PTB risk. Of 634,994 births nested within 115 counties in Missouri, two levels were considered. Individual-level variables included demographics factors, prenatal care, health-related behavioral risk factors, and medical risk factors. The area-level variable included the percentage of the population within each county living below the poverty line (US census data, 1990. Counties were divided into quartiles of poverty; the first quartile (lowest rate of poverty was the reference group. Results PTB th quartile (4.9%, p adjOR 1.18 (95% CI 1.03, 1.35, with a similar effect at earlier gestational ages (adjOR 1.27 (95% CI 1.06, 1.52. Conclusion Women residing in socioeconomically deprived areas are at increased risk of preterm birth, above other underlying risk factors. Although the risk increase is modest, it affects a large number of pregnancies.

  9. Risk Factors for premature birth in a hospital

    Directory of Open Access Journals (Sweden)

    Margarita E. Ahumada-Barrios

    Full Text Available Abstract Objective: to determine the risk factors for premature birth. Methods: retrospective case-control study of 600 pregnant women assisted in a hospital, with 298 pregnant women in the case group (who gave birth prematurely <37 weeks and 302 pregnant women who gave birth to a full-term newborn in the control group. Stata software version 12.2 was used. The Chi-square test was used in bivariate analysis and logistic regression was used in multivariate analysis, from which Odds Ratios (OR and Confidence Intervals (CI of 95% were derived. Results: risk factors associated with premature birth were current twin pregnancy (adjusted OR= 2.4; p= 0.02, inadequate prenatal care (< 6 controls (adjusted OR= 3.2; p <0.001, absent prenatal care (adjusted OR= 3.0; p <0.001, history of premature birth (adjusted OR= 3.7; p <0.001 and preeclampsia (adjusted OR= 1.9; p= 0.005. Conclusion: history of premature birth, preeclampsia, not receiving prenatal care and receiving inadequate prenatal care were risk factors for premature birth.

  10. The New Rich and Their Unplanned Births: Stratified Reproduction under China's Birth-planning Policy.

    Science.gov (United States)

    Shi, Lihong

    2017-12-01

    This article explores the creation and ramifications of a stratified reproductive system under China's state control of reproduction. Within this system, an emerging group of "new rich" are able to circumvent birth regulations and have unplanned births because of their financial capabilities and social networks. While China's birth-planning policy is meant to be enforced equally for all couples, the unequal access to wealth and bureaucratic power as a result of China's widening social polarization has created disparate reproductive rights and experiences. This article identifies three ways in which reproductive privileges are created. It further explores how a stratified reproductive system under state population control reinforces social polarization. While many socially marginalized couples are unable to register their unplanned children for citizenship status and social benefits, the new rich are able to legitimate their births and transfer their privilege and status to their children, thus reproducing a new generation of elites. © 2016 by the American Anthropological Association.

  11. Human factors certification in the development of future air traffic control systems

    Science.gov (United States)

    Evans, Alyson E.

    1994-01-01

    If human factors certification of aviation technologies aims to encompass the wide range of issues which need to be addressed for any new system, then human factors involvement must be present throughout the whole design process in a manner which relates to final certification. A certification process cannot simply be applied to the final product of design. Standards and guidelines will be required by designers at the outset of design for reference in preparing for certification. The most effective use of human factors principles, methods, and measures is made as part of an iterative design process, leading to a system which reflects these as far as possible. This particularly applies where the technology is complex and may be represented by a number of components or sub-systems. Some aspects of the system are best certified during early prototyping, when there is still scope to make changes to software or hardware. At this stage in design, financial and/or time pressures will not rule out the possibility of necessary changes, as may be the case later. Other aspects of the system will be best certified during the final phases of design when the system is in a more complete form and in a realistic environment.

  12. A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes.

    Science.gov (United States)

    Jiang, Hong; Xiong, Xu; Su, Yi; Zhang, Yiming; Wu, Hongqiao; Jiang, Zhijun; Qian, Xu

    2013-12-09

    Evidence has suggested that periodontal disease is associated with an increased risk of various adverse pregnancy and birth outcomes. However, several large clinical randomized controlled trials failed to demonstrate periodontal therapy during pregnancy reduced the incidence of adverse pregnancy and birth outcomes. It has been suggested that the pre-conception period may be an optimal period for periodontal disease treatment rather than during pregnancy. To date, no randomized controlled trial (RCT) has examined if treating periodontal disease before pregnancy reduces adverse birth outcomes. This study aims to examine if the pre-conception treatment of periodontal disease will lead to improved periodontal status during late pregnancy and subsequent birth outcomes. A sample of 470 (235 in each arm of the study) pre-conception women who plan to conceive within one year and with periodontal disease will be recruited for the study. All participants will be randomly allocated to the intervention or control group. The intervention group will receive free therapy including dental scaling and root planning (the standard therapy), supragingival prophylaxis, and oral hygiene education. The control group will only receive supragingival prophylaxis and oral hygiene education. Women will be followed throughout their pregnancy and then to childbirth. The main outcomes include periodontal disease status in late pregnancy and birth outcomes measured such as mean birth weight (grams), and mean gestational age (weeks). Periodontal disease will be diagnosed through a dental examination by measuring probing depth, clinical attachment loss and percentage of bleeding on probing (BOP) between gestational age of 32 and 36 weeks. Local and systemic inflammatory mediators are also included as main outcomes. This will be the first RCT to test whether treating periodontal disease among pre-conception women reduces periodontal disease during pregnancy and prevents adverse birth outcomes. If

  13. Economic implications of home births and birth centers: a structured review.

    Science.gov (United States)

    Henderson, Jane; Petrou, Stavros

    2008-06-01

    It is widely perceived that home births and birth centers may help decrease the costs of maternity care for women with uncomplicated pregnancies and deliveries. This structured review examines the literature relating to the economic implications of home births and birth center care compared with hospital maternity care. The bibliographic databases MEDLINE (from 1950), CINAHL (from 1982), EMBASE (from 1980), and an "in-house" database, Econ2, were searched for relevant English language publications using MeSH and free text terms. Data were extracted with respect to the study design, inclusion criteria, clinical and cost results, and details of what was included in the cost calculations. Eleven studies were included from the United Kingdom, United States, Australia, and Canada. Two studies focused on home births versus other forms and locations of care, whereas nine focused on birth centers versus other forms and locations of care. Resource use was generally lower for women cared for at home and in birth centers due to lower rates of intervention, shorter lengths of stay, or both. However, this fact did not always translate into lower costs because, in the U.K. where many studies were conducted, more midwives of a higher grade were employed to manage the birth centers than are usually employed in maternity units, and because of costs of converting existing facilities into delivery rooms. The quality of much of the literature was poor, although no studies were excluded for this reason. Selection bias was likely to be a problem in those studies not based on randomized controlled trials because, even where birth center eligibility was applied throughout, women who choose to deliver at home or in a birth center are likely to be different in terms of expectations and approach from women choosing to deliver in hospital. This review highlights the paucity of economic literature relating to home births and birth centers. Differences in results between studies may be

  14. "Natural family planning": effective birth control supported by the Catholic Church.

    Science.gov (United States)

    Ryder, R E

    1993-09-18

    During 20-22 September Manchester is to host the 1993 follow up to last year's "earth summit" in Rio de Janeiro. At that summit the threat posed by world overpopulation received considerable attention. Catholicism was perceived as opposed to birth control and therefore as a particular threat. This was based on the notion that the only method of birth control approved by the church--natural family planning--is unreliable, unacceptable, and ineffective. In the 20 years since E L Billings and colleagues first described the cervical mucus symptoms associated with ovulation natural family planning has incorporated these symptoms and advanced considerably. Ultrasonography shows that the symptoms identify ovulation precisely. According to the World Health Organisation, 93% of women everywhere can identify the symptoms, which distinguish adequately between the fertile and infertile phases of the menstrual cycle. Most pregnancies during trials of natural family planning occur after intercourse at times recognised by couples as fertile. Thus pregnancy rates have depended on the motivation of couples. Increasingly studies show that rates equivalent to those with other contraceptive methods are readily achieved in the developed and developing worlds. Indeed, a study of 19,843 poor women in India had a pregnancy rate approaching zero. Natural family planning is cheap, effective, without side effects, and may be particularly acceptable to the efficacious among people in areas of poverty.

  15. The Relevance of Maternal Socioeconomic Characteristics for Low Birth Weight – a Case-Control Study

    Science.gov (United States)

    Altenhöner, T.; Köhler, M.; Philippi, M.

    2016-01-01

    Introduction: The number of children born underweight (low birth weight, LBW) is increasing despite extensive prevention and screening programmes. The cost is high for the health system, and affected children are burdened with health predictors that can affect them negatively throughout their lives. This study investigates to what extent socioeconomic factors, in addition to known medical causes and the health behaviour of pregnant women, influence LBW. Materials and Methods: In this case-control study 131 mothers of singletons with a birth weight ≤ 2500 g (cases) and 323 mothers of normal birth weight babies (controls) were interviewed with respect to socioeconomic status, health behaviour and stress in the workplace. Medical data were collected by specialist staff using a questionnaire. Results: Independent of medical diagnosis and health behaviour, women with lower level education (OR [95 % CI] = 2.24 [1.12; 4.51]) and those who were not working (OR [95 % CI] = 1.82 [1.10; 3.00]) were more likely to have an LBW baby. No effect was shown for immigrant background (OR [95 % CI] = 1.14 [0.59; 2.21]) or stress in the workplace (OR [95 % CI] = 1.17 [0.90; 1.51]). Discussion and Conclusion: These results show that the association between social and health inequalities starts from before birth. In order to reduce the rising number of babies born underweight, socioeconomic determinants in the care and supervision of pregnant women should systematically receive more attention to enable appropriate early preventive strategies to be implemented. PMID:27065486

  16. Birth outcomes of male and female patients with infantile hypertrophic pyloric stenosis--a population-based case-control study.

    Science.gov (United States)

    Vermes, Gabor; Mátrai, Ákos; Czeizel, Andrew E; Ács, Nándor

    2016-01-01

    Most of the patients are affected by isolated infantile hypertrophic pyloric stenosis (IHPS) beyond the polygenic predisposition, the other factors in the multifactorial etiology are largely unknown. The main characteristic of IHPS is the robust male predominance, thus the aim of this study was to analyze birth outcomes in males and females whether they are different or not. The study samples included 241 cases with IHPS, 357 matched, and 38,151 population controls without any defect in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. The findings of this case-control study confirmed the well-known strong male excess (85.5%). The mean gestational age was somewhat longer and it is associated with a lower rate of preterm births. Mean birth weight did not show significant differences among the study groups, but the rate of low birthweight was higher in cases with IHPS. However, these differences were found only in males. Thus, intrauterine fetal growth restriction is characteristic only for male cases with IHPS. Our study confirmed the well-known obvious male excess of cases with IHPS, but our findings suggest some differences in birth outcomes of male and female cases. Male cases with IHPS had intrauterine fetal growth restriction while females did not. These data may indicate some differences in the pathogenesis of IHPS in males and females.

  17. Tobacco control campaign in Uruguay: Impact on smoking cessation during pregnancy and birth weight.

    Science.gov (United States)

    Harris, Jeffrey E; Balsa, Ana Inés; Triunfo, Patricia

    2015-07-01

    We analyzed a nationwide registry of all pregnancies in Uruguay during 2007-2013 to assess the impact of three types of tobacco control policies: (1) provider-level interventions aimed at the treatment of nicotine dependence, (2) national-level increases in cigarette taxes, and (3) national-level non-price regulation of cigarette packaging and marketing. We estimated models of smoking cessation during pregnancy at the individual, provider and national levels. The rate of smoking cessation during pregnancy increased from 15.4% in 2007 to 42.7% in 2013. National-level non-price policies had the largest estimated impact on cessation. The price response of the tobacco industry attenuated the effects of tax increases. While provider-level interventions had a significant effect, they were adopted by relatively few health centers. Quitting during pregnancy increased birth weight by an estimated 188 g. Tobacco control measures had no effect on the birth weight of newborns of non-smoking women. Copyright © 2015 Elsevier B.V. All rights reserved.

  18. Professional Certification

    Science.gov (United States)

    WaterSense recognizes certification programs for irrigation professionals that meet the specification criteria. Certification programs cover three areas: irrigation system design, installation and maintenance, and system auditing.

  19. Genomics of Preterm Birth

    Science.gov (United States)

    Swaggart, Kayleigh A.; Pavlicev, Mihaela; Muglia, Louis J.

    2015-01-01

    The molecular mechanisms controlling human birth timing at term, or resulting in preterm birth, have been the focus of considerable investigation, but limited insights have been gained over the past 50 years. In part, these processes have remained elusive because of divergence in reproductive strategies and physiology shown by model organisms, making extrapolation to humans uncertain. Here, we summarize the evolution of progesterone signaling and variation in pregnancy maintenance and termination. We use this comparative physiology to support the hypothesis that selective pressure on genomic loci involved in the timing of parturition have shaped human birth timing, and that these loci can be identified with comparative genomic strategies. Previous limitations imposed by divergence of mechanisms provide an important new opportunity to elucidate fundamental pathways of parturition control through increasing availability of sequenced genomes and associated reproductive physiology characteristics across diverse organisms. PMID:25646385

  20. Low Birth Weight And Maternal Risk Factors

    Directory of Open Access Journals (Sweden)

    Secma Nigam

    2003-06-01

    Full Text Available Objectives : To study tile socio-economic and maternal risk factors associated with low birth weight babies and to measure the strength of association. Study Design : Hospital based case-control study. Setting : Shri Sayajirao General Hospital, Vadodara. Sample size : 312 cases and 312 controls. Participants : Cases Mothers who delivered single, live baby less than 2500 gms i.e. low birth weight. Controls:- Mothers who delivered single live baby more than 2500 gms. Study Variable : Maternal age, literacy, anaemia, outcome of last pregnancy. Statistical Analysis : Chi-square test and odd’s ratio. Result : Among cases, 14.5% mothers had age less titan 20 yrs as compared to 7.3% mothers in control group. 68.6% mothers amongst cases were illiterate against 46.5% mothers in control group. 53.8% mothers had haemoglobin level 10gm% or less amongst cases and no statistically significant difference was found between low birth weight and outcome of last pregnancy Conclusion : The maternal risk factors associated with low birth weight in mothers attending S.S.G. hospital age maternal anaemia (OR 2.66, illiteracy (OR 2.51, maternal age less than 20 yrs. (OR 2.OS. No association was found between low birth rate and outcome of last pregnancy

  1. Staying home to give birth: why women in the United States choose home birth.

    Science.gov (United States)

    Boucher, Debora; Bennett, Catherine; McFarlin, Barbara; Freeze, Rixa

    2009-01-01

    Approximately 1% of American women give birth at home and face substantial obstacles when they make this choice. This study describes the reasons that women in the United States choose home birth. A qualitative descriptive secondary analysis was conducted in a previously collected dataset obtained via an online survey. The sample consisted of 160 women who were US residents and planned a home birth at least once. Content analysis was used to study the responses from women to one essay question: "Why did you choose home birth?" Women who participated in the study were mostly married (91%) and white (87%). The majority (62%) had a college education. Our analysis revealed 508 separate statements about why these women chose home birth. Responses were coded and categorized into 26 common themes. The most common reasons given for wanting to birth at home were: 1) safety (n = 38); 2) avoidance of unnecessary medical interventions common in hospital births (n = 38); 3) previous negative hospital experience (n = 37); 4) more control (n = 35); and 5) comfortable, familiar environment (n = 30). Another dominant theme was women's trust in the birth process (n = 25). Women equated medical intervention with reduced safety and trusted their bodies' inherent ability to give birth without interference.

  2. A multinational case-control study on childhood brain tumours, anthropogenic factors, birth characteristics and prenatal exposures: A validation of interview data.

    OpenAIRE

    Vienneau Danielle; Infanger Denis; Feychting Maria; Schüz Joachim; Schmidt Lisbeth Samsø; Poulsen Aslak Harbo; Tettamanti Giorgio; Klæboe Lars; Kuehni Claudia E; Tynes Tore; Von der Weid Nicolas; Lannering Birgitta; Röösli Martin

    2016-01-01

    Little is known about the aetiology of childhood brain tumours. We investigated anthropometric factors (birth weight length maternal age) birth characteristics (e.g. vacuum extraction preterm delivery birth order) and exposures during pregnancy (e.g. maternal: smoking working dietary supplement intake) in relation to risk of brain tumour diagnosis among 7 19 year olds. The multinational case control study in Denmark Sweden Norway and Switzerland (CEFALO) included interviews with 352 (particip...

  3. Real-Time Reliability Verification for UAV Flight Control System Supporting Airworthiness Certification.

    Science.gov (United States)

    Xu, Haiyang; Wang, Ping

    2016-01-01

    In order to verify the real-time reliability of unmanned aerial vehicle (UAV) flight control system and comply with the airworthiness certification standard, we proposed a model-based integration framework for modeling and verification of time property. Combining with the advantages of MARTE, this framework uses class diagram to create the static model of software system, and utilizes state chart to create the dynamic model. In term of the defined transformation rules, the MARTE model could be transformed to formal integrated model, and the different part of the model could also be verified by using existing formal tools. For the real-time specifications of software system, we also proposed a generating algorithm for temporal logic formula, which could automatically extract real-time property from time-sensitive live sequence chart (TLSC). Finally, we modeled the simplified flight control system of UAV to check its real-time property. The results showed that the framework could be used to create the system model, as well as precisely analyze and verify the real-time reliability of UAV flight control system.

  4. Births: preliminary data for 2005.

    Science.gov (United States)

    Hamilton, Brady E; Martin, Joyce A; Ventura, Stephanie J

    2006-12-28

    This report presents preliminary data for 2005 on births in the United States. U.S. data on births are shown by age, live-birth order, race, and Hispanic origin of mother. Data on marital status, cesarean delivery, preterm births, and low birthweight (LBW) are also presented. Data in this report are based on 99.2 percent of births for 2005. The records are weighted to independent control counts of all births received in state vital statistics offices in 2005. Comparisons are made with 2004 data. The crude birth rate in 2005 was 14.0 births per 1,000 total population, unchanged from 2004. The general fertility rate, however, rose to 66.7 births per 1,000 women aged 15-44 years in 2005, the highest level since 1993. The birth rate for teenagers declined by 2 percent in 2005, falling to 40.4 births per 1,000 women aged 15-19 years, the lowest ever recorded in the 65 years for which a consistent series of rates are available. The rate declined for teenagers 15-17 years to 21.4 births per 1,000, but was essentially stable for older teenagers 18-19 years. The birth rate for women aged 20-24 years rose in 2005, whereas the rate for women aged 25-29 years was essentially unchanged. The birth rates for women aged 30 years and over rose to levels not seen in almost 40 years. Childbearing by unmarried women increased to record levels for the Nation in 2005. The birth rate rose 3 percent to 47.6 births per 1,000 unmarried women aged 15-44 years; the proportion of all births to unmarried women increased to 36.8 percent. The cesarean delivery rate rose by 4 percent in 2005 to 30.2 percent of all births, another record high for the Nation. The preterm birth rate continued to rise (to 12.7 percent in 2005) as did the rate for LBW births (8.2 percent).

  5. Revitalising the Metropolit 1953 Danish male birth cohort: background, aims and design

    DEFF Research Database (Denmark)

    Osler, Merete; Andersen, Anne-Marie Nybo; Lund, Rikke

    2004-01-01

    mobility. At age 12 years, 9537 of these cohort members completed a questionnaire in school, which included cognitive measures and information on social aspirations and leisure time activities. In 1966 educational performance tests were administered for these boys and, in 1968, mothers of 2890 cohort......Recent research indicates that factors operating during childhood are related to adult health. Thus, longitudinal studies with information on subsequent phases may be key to understanding later health outcomes. The main objective of this paper is to describe the history and design of a Danish birth...... cohort, and its revitalisation. In 1965, information from birth certificates for 11 591 of a total of 12 270 males born in 1953 in the Metropolitan area of Copenhagen, Denmark were traced. These boys were the study population of a sociological investigation conducted with the aim of describing social...

  6. Deconstructing Teacher Certification

    Science.gov (United States)

    Baines, Lawrence A.

    2006-01-01

    In this article, the author takes a close look at alternative certification programs and is convinced that, because they vary so extremely in their requirements, all of them cannot possibly be producing highly qualified teachers. Here, he talks about Non-University Certification Programs (NUCPs). These are alternative certification programs that…

  7. The APPLe study: a randomized, community-based, placebo-controlled trial of azithromycin for the prevention of preterm birth, with meta-analysis.

    Directory of Open Access Journals (Sweden)

    Nynke R van den Broek

    2009-12-01

    Full Text Available Premature birth is the major cause of perinatal mortality and morbidity in both high- and low-income countries. The causes of preterm labour are multiple but infection is important. We have previously described an unusually high incidence of preterm birth (20% in an ultrasound-dated, rural, pregnant population in Southern Malawi with high burdens of infective morbidity. We have now studied the impact of routine prophylaxis with azithromycin as directly observed, single-dose therapy at two gestational windows to try to decrease the incidence of preterm birth.We randomized 2,297 pregnant women attending three rural and one peri-urban health centres in Southern Malawi to a placebo-controlled trial of oral azithromycin (1 g given at 16-24 and 28-32 wk gestation. Gestational age was determined by ultrasound before 24 wk. Women and their infants were followed up until 6 wk post delivery. The primary outcome was incidence of preterm delivery, defined as 6,200 pregnancies shows no effect on preterm birth (relative risk 1.02, 95% confidence interval 0.86-1.22.This study provides no support for the use of antibiotics as routine prophylaxis to prevent preterm birth in high risk populations; prevention of preterm birth requires alternative strategies.Current Controlled Trials ISRCTN84023116

  8. Risk Factors for premature birth in a hospital 1

    Science.gov (United States)

    Ahumada-Barrios, Margarita E.; Alvarado, German F.

    2016-01-01

    Abstract Objective: to determine the risk factors for premature birth. Methods: retrospective case-control study of 600 pregnant women assisted in a hospital, with 298 pregnant women in the case group (who gave birth prematurely <37 weeks) and 302 pregnant women who gave birth to a full-term newborn in the control group. Stata software version 12.2 was used. The Chi-square test was used in bivariate analysis and logistic regression was used in multivariate analysis, from which Odds Ratios (OR) and Confidence Intervals (CI) of 95% were derived. Results: risk factors associated with premature birth were current twin pregnancy (adjusted OR= 2.4; p= 0.02), inadequate prenatal care (< 6 controls) (adjusted OR= 3.2; p <0.001), absent prenatal care (adjusted OR= 3.0; p <0.001), history of premature birth (adjusted OR= 3.7; p <0.001) and preeclampsia (adjusted OR= 1.9; p= 0.005). Conclusion: history of premature birth, preeclampsia, not receiving prenatal care and receiving inadequate prenatal care were risk factors for premature birth. PMID:27463110

  9. Laterality defects in the national birth defects prevention study 1998-2007 birth prevalence and descriptive epidemiology

    Science.gov (United States)

    Little is known epidemiologically about laterality defects. Using data from the National Birth Defects Prevention Study (NBDPS), a large multi-site case-control study of birth defects, we analyzed prevalence and selected characteristics in children born with laterality defects born from 1998 to 2007...

  10. Mobile medical and health apps: state of the art, concerns, regulatory control and certification

    Science.gov (United States)

    Boulos, Maged N. Kamel; Brewer, Ann C.; Karimkhani, Chante; Buller, David B.; Dellavalle, Robert P.

    2014-01-01

    This paper examines the state of the art in mobile clinical and health-related apps. A 2012 estimate puts the number of health-related apps at no fewer than 40,000, as healthcare professionals and consumers continue to express concerns about the quality of many apps, calling for some form of app regulatory control or certification to be put in place. We describe the range of apps on offer as of 2013, and then present a brief survey of evaluation studies of medical and health-related apps that have been conducted to date, covering a range of clinical disciplines and topics. Our survey includes studies that highlighted risks, negative issues and worrying deficiencies in existing apps. We discuss the concept of ‘apps as a medical device’ and the relevant regulatory controls that apply in USA and Europe, offering examples of apps that have been formally approved using these mechanisms. We describe the online Health Apps Library run by the National Health Service in England and the calls for a vetted medical and health app store. We discuss the ingredients for successful apps beyond the rather narrow definition of ‘apps as a medical device’. These ingredients cover app content quality, usability, the need to match apps to consumers’ general and health literacy levels, device connectivity standards (for apps that connect to glucometers, blood pressure monitors, etc.), as well as app security and user privacy. ‘Happtique Health App Certification Program’ (HACP), a voluntary app certification scheme, successfully captures most of these desiderata, but is solely focused on apps targeting the US market. HACP, while very welcome, is in ways reminiscent of the early days of the Web, when many “similar” quality benchmarking tools and codes of conduct for information publishers were proposed to appraise and rate online medical and health information. It is probably impossible to rate and police every app on offer today, much like in those early days of the Web

  11. Outcomes of planned home births with certified professional midwives: large prospective study in North America.

    Science.gov (United States)

    Johnson, Kenneth C; Daviss, Betty-Anne

    2005-06-18

    To evaluate the safety of home births in North America involving direct entry midwives, in jurisdictions where the practice is not well integrated into the healthcare system. Prospective cohort study. All home births involving certified professional midwives across the United States (98% of cohort) and Canada, 2000. All 5418 women expecting to deliver in 2000 supported by midwives with a common certification and who planned to deliver at home when labour began. Intrapartum and neonatal mortality, perinatal transfer to hospital care, medical intervention during labour, breast feeding, and maternal satisfaction. 655 (12.1%) women who intended to deliver at home when labour began were transferred to hospital. Medical intervention rates included epidural (4.7%), episiotomy (2.1%), forceps (1.0%), vacuum extraction (0.6%), and caesarean section (3.7%); these rates were substantially lower than for low risk US women having hospital births. The intrapartum and neonatal mortality among women considered at low risk at start of labour, excluding deaths concerning life threatening congenital anomalies, was 1.7 deaths per 1000 planned home births, similar to risks in other studies of low risk home and hospital births in North America. No mothers died. No discrepancies were found for perinatal outcomes independently validated. Planned home birth for low risk women in North America using certified professional midwives was associated with lower rates of medical intervention but similar intrapartum and neonatal mortality to that of low risk hospital births in the United States.

  12. Maternal characteristics and birth outcomes of pregnant women who had offspring with congenital ear abnormalities - a population-based case-control study.

    Science.gov (United States)

    Paput, László; Bánhidy, Ferenc; Czeizel, Andrew E

    2011-09-01

    To describe the maternal characteristics and birth outcomes of newborn infants affected with isolated ear congenital abnormalities (IECA), mainly isolated anotia/microtia and unclassified multiple congenital abnormalities (CAs) including anotia/microtia (UMAM). Cases with IECA and UMAM were compared with their matched controls and all controls without any defect and malformed controls affected with other defects in the population-based large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities. The mothers of 354 cases with IECA did not show significant difference in age, but their mean birth order was higher while their socio-economic status based on the maternal employment status was lower compared to the figures of their matched controls. There was a male excess among cases with microtia and mainly with UMAM. The evaluation of birth outcomes of newborns affected with IECA indicated intrauterine fetal growth retardation. Newborn infants with isolated microtia had intrauterine growth retardation and the association of this developmental defect localized for a small region of head with the general fetal development raises interesting theoretical question.

  13. Birth characteristics and childhood carcinomas.

    Science.gov (United States)

    Johnson, K J; Carozza, S E; Chow, E J; Fox, E E; Horel, S; McLaughlin, C C; Mueller, B A; Puumala, S E; Reynolds, P; Von Behren, J; Spector, L G

    2011-10-25

    Carcinomas in children are rare and have not been well studied. We conducted a population-based case-control study and examined associations between birth characteristics and childhood carcinomas diagnosed from 28 days to 14 years during 1980-2004 using pooled data from five states (NY, WA, MN, TX, and CA) that linked their birth and cancer registries. The pooled data set contained 57,966 controls and 475 carcinoma cases, including 159 thyroid and 126 malignant melanoma cases. We used unconditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (CIs). White compared with 'other' race was positively associated with melanoma (OR=3.22, 95% CI 1.33-8.33). Older maternal age increased the risk for melanoma (OR(per 5-year age increase)=1.20, 95% CI 1.00-1.44), whereas paternal age increased the risk for any carcinoma (OR=1.10(per 5-year age increase), 95% CI 1.01-1.20) and thyroid carcinoma (OR(per 5-year age increase)=1.16, 95% CI 1.01-1.33). Gestational age birth weight, and birth order were not significantly associated with childhood carcinomas. This exploratory study indicates that some birth characteristics including older parental age and low gestational age may be related to childhood carcinoma aetiology.

  14. Intelligence, birth order, and family size.

    Science.gov (United States)

    Kanazawa, Satoshi

    2012-09-01

    The analysis of the National Child Development Study in the United Kingdom (n = 17,419) replicates some earlier findings and shows that genuine within-family data are not necessary to make the apparent birth-order effect on intelligence disappear. Birth order is not associated with intelligence in between-family data once the number of siblings is statistically controlled. The analyses support the admixture hypothesis, which avers that the apparent birth-order effect on intelligence is an artifact of family size, and cast doubt on the confluence and resource dilution models, both of which claim that birth order has a causal influence on children's cognitive development. The analyses suggest that birth order has no genuine causal effect on general intelligence.

  15. Possible association of first and high birth order of pregnant women with the risk of isolated congenital abnormalities in Hungary - a population-based case-matched control study.

    Science.gov (United States)

    Csermely, Gyula; Susánszky, Éva; Czeizel, Andrew E; Veszprémi, Béla

    2014-08-01

    In epidemiological studies at the estimation of risk factors in the origin of specified congenital abnormalities in general birth order (parity) is considered as confounder. The aim of this study was to analyze the possible association of first and high (four or more) birth order with the risk of congenital abnormalities in a population-based case-matched control data set. The large dataset of the Hungarian Case-Control Surveillance of Congenital Abnormalities included 21,494 cases with different isolated congenital abnormality and their 34,311 matched controls. First the distribution of birth order was compared of 24 congenital abnormality groups and their matched controls. In the second step the possible association of first and high birth order with the risk of congenital abnormalities was estimated. Finally some subgroups of neural-tube defects, congenital heart defects and abdominal wall's defects were evaluated separately. A higher risk of spina bifida aperta/cystica, esophageal atresia/stenosis and clubfoot was observed in the offspring of primiparous mothers. Of 24 congenital abnormality groups, 14 had mothers with larger proportion of high birth order. Ear defects, congenital heart defects, cleft lip± palate and obstructive defects of urinary tract had a linear trend from a lower proportion of first born cases to the larger proportion of high birth order. Birth order showed U-shaped distribution of neural-tube defects and clubfoot, i.e. both first and high birth order had a larger proportion in cases than in their matched controls. Birth order is a contributing factor in the origin of some isolated congenital abnormalities. The higher risk of certain congenital abnormalities in pregnant women with first or high birth order is worth considering in the clinical practice, e.g. ultrasound scanning. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Agricultural chemical exposures and birth defects in the Eastern Cape Province, South Africa A case – control study

    Directory of Open Access Journals (Sweden)

    Tyler Joanne

    2003-10-01

    Full Text Available Abstract Background South Africa is one of the major users of pesticides on the African continent. The Eastern Cape is the second largest province in South Africa. There has been growing concern about the occurrence of certain birth defects which seemed to have increased in the past few years. In this paper we investigate associations between exposure to agricultural chemicals and certain birth defects. Few such studies have been undertaken in the developing world previously. Methods Between September 2000 and March 2001 a case – control study was conducted among rural women in the area of the Eastern cape to investigate the association between women's exposure to pesticides and the occurrence of birth defects. Information on birth defects was obtained from the register of the Paediatrics Department at the Cecilia Makiwane Hospital in Mdantsane, one of the largest referral hospitals in the province. The cases were children who were diagnosed with selected birth defects. The controls were children born in the same areas as the cases. Exposure information on the mothers was obtained by interview concerning from their activities in gardens and fields. Data were analysed using conditional logistic regression. Results A total of 89 case mothers and 178 control mothers was interviewed. Babies with birth defects were seven times more likely to be born to women exposed to chemicals used in gardens and fields compared to no reported exposure (Odds Ratio 7.18, 95% CI 3.99, 13.25; and were almost twice as likely to be born to women who were involved in dipping livestock used to prevent ticks (OR 1.92, 95% CI 1.15, 3.14. They were also 6.5 times more likely to be born to women who were using plastic containers for fetching water (OR 6.5, 95% CI 2.2, 27.9. Some of these containers had previously contained pesticides (OR 1.87, 95% CI 1.06, 3.31. Conclusions These findings suggest a link between exposure to pesticides and certain birth defects among the

  17. Folklore information from Assam for family planning and birth control.

    Science.gov (United States)

    Tiwari, K C; Majumder, R; Bhattacharjee, S

    1982-11-01

    The author collected folklore information on herbal treatments to control fertility from different parts of Assam, India. Temporary methods of birth control include Cissampelos pareira L. in combination with Piper nigrum L., root of Mimosa pudica L. and Hibiscus rosa-sinensis L. Plants used for permanent sterilization include Plumbago zeylanica L., Heliotropium indicum L., Salmalia malabrica, Hibiscus rosa-sinensis L., Plumeria rubra L., Bambusa rundinacea. Abortion is achieved through use of Osbeckia nepalensis or Carica papaya L. in combination with resin from Ferula narthex Boiss. It is concluded that there is tremendous scope for the collection of folklore about medicine, family planning agents, and other treatments from Assam and surrounding areas. Such a project requires proper understanding between the survey team and local people, tactful behavior, and a significant amount of time. Monetary rewards can also be helpful for obtaining information from potential respondents.

  18. Delaying second births among adolescent mothers: a randomized, controlled trial of a home-based mentoring program.

    Science.gov (United States)

    Black, Maureen M; Bentley, Margaret E; Papas, Mia A; Oberlander, Sarah; Teti, Laureen O; McNary, Scot; Le, Katherine; O'Connell, Melissa

    2006-10-01

    Rates of rapid second births among low-income black adolescent mothers range from 20% to 50%. Most efforts to prevent rapid second births have been unsuccessful. There were 4 objectives: (1) to examine whether a home-based mentoring intervention was effective in preventing second births within 2 years of the adolescent mother's first delivery; (2) to examine whether greater intervention participation increased the likelihood of preventing a second birth; (3) to examine whether second births were better predicted from a risk practice perspective or a family formation perspective, based on information collected at delivery; and (4) to examine how risk practices or family formation over the first 2 years of parenthood were related to a second birth. We conducted a randomized, controlled trial of a home-based intervention curriculum, based on social cognitive theory, and focused on interpersonal negotiation skills, adolescent development, and parenting. The curriculum was delivered biweekly until the infant's first birthday by college-educated, black, single mothers who served as mentors, presenting themselves as "big sisters." The control group received usual care. Follow-up evaluations were conducted in the homes 6, 13, and 24 months after recruitment. Participants were recruited from urban hospitals at delivery and were 181 first time, black adolescent mothers ( or = 2 intervention visits increased the odds of not having a second infant more than threefold. Only 1 mother who completed > or = 6 visits had a second infant. At delivery of their first infant, mothers who had a second infant were slightly older (16.7 vs 16.2 years) and were more likely to have been arrested (30% vs 14%). There were no differences in baseline contraceptive use or other measures of risk or family formation. At 24 months, mothers who had a second infant reported high self-esteem, positive life events, and romantic involvement and residence with the first infant's father. At 24 months, there

  19. [Outcomes after planned home births].

    Science.gov (United States)

    Blix, Ellen; Øian, Pål; Kumle, Merethe

    2008-11-06

    About 150 planned home births take place in Norway annually. Professionals have different opinions on whether such births are safe or not. The aim of the present study was to perform a systematic literature review on maternal and neonatal outcomes after planned home births. A review was performed of literature retrieved from searches in MEDLINE, PubMed, Embase, Cinahl and The Cochrane Library and relevant references found in the articles. The searches were limited to studies published in 1985 and later. 10 studies with data from 30 204 women who had planned and were selected to home birth at the onset of labour were included. Three of the studies had control groups including women with planned hospital births. All included studies were assessed to be of medium quality. Between 9.9 and 23.1 % of women and infants were transferred to hospital during labour or after birth. There were few caesarean sections, other interventions or complications in the studies assessed; the total perinatal mortality rate was 2.9/1000 and the intrapartum mortality rate 0.8/1000. There is no sound basis for discouraging low-risk women from planning a home birth. Results from the included studies do not directly apply to Norwegian conditions. Outcomes and transfers after planned home births should be systematically registered.

  20. The novice birthing: theorising first-time mothers' experiences of birth at home and in hospital in Australia.

    Science.gov (United States)

    Dahlen, Hannah G; Barclay, Lesley M; Homer, Caroline S E

    2010-02-01

    to explore first-time mothers' experiences of birth at home and in hospital in Australia. a grounded theory methodology was used. Data were generated from in-depth interviews with women in their own homes. Sydney, Australia. 19 women were interviewed. Seven women who gave in a public hospital and seven women who gave birth for the first time at home were interviewed and their experiences were contrasted with two mothers who gave birth for the first time in a birth centre, one mother who gave birth for the first time in a private hospital and two women who had given birth more than once. three categories emerged from the analysis: preparing for birth, the novice birthing and processing the birth. These women shared a common core experience of seeing that they gave birth as 'novices'. The basic social process running through their experience of birth, regardless of birth setting, was that, as novices, they were all 'reacting to the unknown'. The mediating factors that influenced the birth experiences of these first-time mothers were preparation, choice and control, information and communication, and support. The quality of midwifery care both facilitated and hindered these needs, contributing to the women's perceptions of being 'honoured'. The women who gave birth at home seemed to have more positive birth experiences. identifying the novice status of first-time mothers and understanding the way in which they experience birth better explains previous research that reports unrealistic expectations and fear that may be associated with first-time birthing. It demonstrates how midwives can contribute to positive birth experiences by being aware that first-time mothers, irrespective of birth setting, are essentially reacting to the unknown as they negotiate the experience of birth. Copyright 2008 Elsevier Ltd. All rights reserved.

  1. Energy saving certificates

    International Nuclear Information System (INIS)

    2005-11-01

    The French ministry of economy, finances and industry and the French agency of environment and energy mastery (Ademe) have organized on November 8, 2005, a colloquium for the presentation of the energy saving certificates, a new tool to oblige the energy suppliers to encourage their clients to make energy savings. This document gathers the transparencies presented at this colloquium about the following topics: state-of-the-art and presentation of the energy saving certificates system: presentation of the EEC system, presentation of the EEC standard operations; the energy saving certificates in Europe today: energy efficiency commitment in UK, Italian white certificate scheme, perspectives of the different European systems. (J.S.)

  2. Trainer certification

    International Nuclear Information System (INIS)

    Couser, S.; Moore, J.

    1988-01-01

    A DOE Technical Safety Appraisal in October 1986 found that training at the Portsmouth Gaseous Diffusion Plant was fragmented and lacked uniformity. Training was localized in departments and was more often handled by line supervisors, etc. - with no certification. The Trainer Certification Program has provided the means for applying standard guidelines to ensure that training is designed, applied, and evaluated in a consistent, effective, and efficient manner. The program is in a state of substantial change and a target date for compliance is set for 1989. Trainer certification will provide both current and future resources to ensure consistent and effective training. 22 figures

  3. Maternal Age at Child Birth, Birth Order, and Suicide at a Young Age: A Sibling Comparison

    OpenAIRE

    Bjørngaard, Johan Håkon; Bjerkeset, Ottar; Vatten, Lars Johan; Janszky, Imre; Gunnell, David; Romundstad, Pål Richard

    2013-01-01

    Previous studies have reported strong associations between birth order, maternal age, and suicide, but these results might have been confounded by socioeconomic and other factors. To control for such factors, we compared suicide risk between siblings and studied how maternal age at child birth and birth order influenced risk in a cohort study of 1,690,306 Norwegians born in 1967–1996 who were followed up until 2008. Using stratified Cox regression, we compared suicide risk within families wit...

  4. The relative proportion of preterm births complicated by premature rupture of membranes in multifetal gestations: a population-based study.

    Science.gov (United States)

    Pakrashi, Tarita; Defranco, Emily A

    2013-01-01

    To compare the relative contribution of premature rupture of membranes (PROM) to preterm births in singleton compared with multifetal gestations. A population-based retrospective cohort study of 291,782 nonanomalous live births in the state of Ohio from January 1, 2006, to December 31, 2007, identified through birth certificate data. Frequency of PROM was compared between singleton and multifetal gestations and then stratified by gestational age at birth. Multivariate regression analysis estimated the risk of PROM by plurality in each gestational age group, accounting for influential risk factors. The frequency of PROM increased with increasing plurality of gestation. The relative proportion of preterm birth < 37 weeks complicated by PROM increased with gestational plurality 13.2% singletons, 16.8% twins, 20.0% triplets, 19.6% quadruplets, and 100% for higher-order multiples (p < 0.001). The frequency of PROM increased with earlier gestational age at birth, regardless of plurality. The increased risk of PROM in multifetal gestation persisted even after adjustment for influential concomitant risk factors. The proportion of preterm birth attributable to PROM increases by plurality of gestation, with its most significant contribution in higher-order multiples and at earliest gestational ages when outcomes are the poorest. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. Social class at birth and risk of psychosis.

    Science.gov (United States)

    O'Donoghue, Brian; Fanning, Felicity; Lyne, John; Renwick, Laoise; Madigan, Kevin; Kinsella, Anthony; Lane, Abbie; Turner, Niall; O'Callaghan, Eadbhard; Clarke, Mary

    2015-12-01

    Individuals with psychotic disorders are represented more in the lower social classes, yet there is conflicting evidence to whether these individuals drift into the lower social classes or whether lower social class is a risk factor for developing psychosis. The aim of this study was to examine whether the social class at birth is a risk factor for developing psychosis. We included individuals with a first episode of psychosis (FEP) whose social class at birth was determined from birth records. We employed a case-control study design and also compared the distribution of the social classes at birth of the cases to that of the general population. A total of 380 individuals with an FEP and 760 controls were included in the case-control study. The odds ratio for developing an FEP associated with social class (low vs high) was .62 (95% confidence interval (CI): .46-.85, p social class at birth have a reduced risk of psychosis. Individuals born between 1961 and 1980 with an FEP were more likely to be from a higher social class at birth compared to the general population (60.8% vs 36.7%, χ(2) = 60.85, df = 1, p social class at birth is associated with a greater risk for developing a psychotic disorder; however, this effect may show temporal variation. © The Author(s) 2015.

  6. "Natural family planning": effective birth control supported by the Catholic Church.

    Science.gov (United States)

    Ryder, R E

    1993-01-01

    During 20-22 September Manchester is to host the 1993 follow up to last year's "earth summit" in Rio de Janeiro. At that summit the threat posed by world overpopulation received considerable attention. Catholicism was perceived as opposed to birth control and therefore as a particular threat. This was based on the notion that the only method of birth control approved by the church--natural family planning--is unreliable, unacceptable, and ineffective. In the 20 years since E L Billings and colleagues first described the cervical mucus symptoms associated with ovulation natural family planning has incorporated these symptoms and advanced considerably. Ultrasonography shows that the symptoms identify ovulation precisely. According to the World Health Organisation, 93% of women everywhere can identify the symptoms, which distinguish adequately between the fertile and infertile phases of the menstrual cycle. Most pregnancies during trials of natural family planning occur after intercourse at times recognised by couples as fertile. Thus pregnancy rates have depended on the motivation of couples. Increasingly studies show that rates equivalent to those with other contraceptive methods are readily achieved in the developed and developing worlds. Indeed, a study of 19,843 poor women in India had a pregnancy rate approaching zero. Natural family planning is cheap, effective, without side effects, and may be particularly acceptable to the efficacious among people in areas of poverty. Images p724-a p724-b p724-c p724-d p724-e p724-f p724-g PMID:8401097

  7. Case-control study on infant mortality in Southern Brazil

    Directory of Open Access Journals (Sweden)

    Mendes Karina Giane

    2006-01-01

    Full Text Available OBJECTIVE: To identify risk factors associated with infant mortality and, more specifically, with neonatal mortality. METHODS: A case-control study was carried out in the municipality of Caxias do Sul, Southern Brazil. Characteristics of prenatal care and causes of mortality were assessed for all live births in the 2001-2002 period with a completed live-birth certificate and whose mothers lived in the municipality. Cases were defined as all deaths within the first year of life. As controls, there were selected the two children born immediately after each case in the same hospital, who were of the same sex, and did not die within their first year of life. Multivariate analysis was performed using conditional logistic regression. RESULTS: There was a reduction in infant mortality, the greatest reduction was observed in the post-neonatal period. The variables gestational age (<36 weeks, birth weight (<2,500 g, and 5-minute Apgar (<6 remained in the final model of the multivariate analysis, after adjustment. CONCLUSIONS: Perinatal conditions comprise almost the totality of neonatal deaths, and the majority of deaths occur at delivery. The challenge for reducing infant mortality rate in the city is to reduce the mortality by perinatal conditions in the neonatal period.

  8. Developing an interdisciplinary certificate program in transportation planning, phase 2 : the eCertificate.

    Science.gov (United States)

    2011-11-01

    This proposal extends the delivery of the recently developed graduate Certificate in Transportation : Planning to a wider audience through the establishment of an Executive Certificate Program by distance : (eCertificate). While the need for an inter...

  9. [Relationship between air pollution exposure during pregnancy and birth weight of term singleton live-birth newborns].

    Science.gov (United States)

    Guo, L Q; Zhang, Q; Zhao, D D; Wang, L L; Chen, Y; Mi, B B; Dang, S N; Yan, H

    2017-10-10

    Objective: This study explored the association between air pollution exposure and birth weight by using the multilevel linear model, after controlling related meteorological factors and individual differences of both mothers and babies. Methods: Women of childbearing age who were pregnant in Xi'an from 2010 to 2013, were selected as objects of this study. Multistage random sampling method was used to select 4 631 subjects followed by a self-designed questionnaire survey. Data related to quality of air and meteorology were gathered from routine monitoring system. Gestational age and date of birth, together with the average levels of air pollution were calculated for each trimester on each mother, and then the impact of air pollution on birth weight was assessed. A multilevel linear model was employed to investigate the association between the levels of exposure to air pollution by birth weight. Confounding factors were under control. We established three models in this study: Model 1 which involving the variable of air pollution exposure. Model 2 was adjusted for variables in Model 1 plus some other individual differences of both mother and baby. Model 3 was adjusted for variables in Model 2 plus meteorological factors. Results: There were significant differences seen in birth weight within the subgroups of gender, gestational age, mother's reproductive age, maternal education, residential areas and family incomes ( P 0.05). Data from Model 3 indicated that a decrease of 13.3 g(10.9 g in Model 2) and 6.6 g (5.9 g in Model 2) in birth weight that were associated with an increase of 10 μg/m(3) in the average level of NO(2) and PM(10) during the second trimester; A decrease of 13.7 g (9.8 g in Model 2) in birth weight was associated with an increase of 10 μg/m(3) in the average level of NO(2) during the third trimester. Conclusion: After controlling for meteorological factors, the levels of exposure to NO(2) and PM(10) during the second trimester and NO(2) during the

  10. Birth Satisfaction Scale/Birth Satisfaction Scale-Revised (BSS/BSS-R): A large scale United States planned home birth and birth centre survey

    OpenAIRE

    Fleming, Susan E.; Donovan-Batson, Colleen.; Burduli, Ekaterina.; Barbosa-Leiker, Celestina.; Hollins Martin, Caroline J.; Martin, Colin R.

    2016-01-01

    Objective:\\ud to explore the prevalence of birth satisfaction for childbearing women planning to birth in their home or birth centers in the United States. Examining differences in birth satisfaction of the home and birth centers; and those who birthed in a hospital using the 30-item Birth Satisfaction Scale (BSS) and the 10-item Birth Satisfaction Scale-Revised (BSS-R).\\ud Study design:\\ud a quantitative survey using the BSS and BSS-R were employed. Additional demographic data were collected...

  11. The influence of birth weight and body mass in early adulthood on early coronary heart disease risk among Danish men born in 1953

    DEFF Research Database (Denmark)

    Osler, Merete; Lund, Rikke; Kriegbaum, Margit

    2009-01-01

    This study examines the joint and separate influence of birth weight and body mass in young adulthood on subsequent coronary heart disease (CHD) risk. A cohort of 9,143 men born in Copenhagen, Denmark, in 1953, for whom information on birth weight and body weight and height around age 19 years were...... retrieved from birth certificates and conscript records, respectively, were followed from 1978 until 2005 (between age 25 and 52 years) for incident fatal and non-fatal CHD. Data on CHD were obtained through record linkage to the Cause of Death Registry and the National Patient Registry. During follow......-up, a total of 475 men had a CHD diagnosis. Men with low birth weight, high body mass index (BMI) at age 19, a father from the working class, and low educational level at age 19 had an increased risk for CHD. Birth weight was inversely associated with CHD only in men with BMI of 25 kg/m(2) or above...

  12. Restaurant manager and worker food safety certification and knowledge.

    Science.gov (United States)

    Brown, Laura G; Le, Brenda; Wong, Melissa R; Reimann, David; Nicholas, David; Faw, Brenda; Davis, Ernestine; Selman, Carol A

    2014-11-01

    Over half of foodborne illness outbreaks occur in restaurants. To combat these outbreaks, many public health agencies require food safety certification for restaurant managers, and sometimes workers. Certification entails passing a food safety knowledge examination, which is typically preceded by food safety training. Current certification efforts are based on the assumption that certification leads to greater food safety knowledge. The Centers for Disease Control and Prevention conducted this study to examine the relationship between food safety knowledge and certification. We also examined the relationships between food safety knowledge and restaurant, manager, and worker characteristics. We interviewed managers (N=387) and workers (N=365) about their characteristics and assessed their food safety knowledge. Analyses showed that certified managers and workers had greater food safety knowledge than noncertified managers and workers. Additionally, managers and workers whose primary language was English had greater food safety knowledge than those whose primary language was not English. Other factors associated with greater food safety knowledge included working in a chain restaurant, working in a larger restaurant, having more experience, and having more duties. These findings indicate that certification improves food safety knowledge, and that complex relationships exist among restaurant, manager, and worker characteristics and food safety knowledge.

  13. Restaurant Manager and Worker Food Safety Certification and Knowledge

    Science.gov (United States)

    Brown, Laura G.; Le, Brenda; Wong, Melissa R.; Reimann, David; Nicholas, David; Faw, Brenda; Davis, Ernestine; Selman, Carol A.

    2017-01-01

    Over half of foodborne illness outbreaks occur in restaurants. To combat these outbreaks, many public health agencies require food safety certification for restaurant managers, and sometimes workers. Certification entails passing a food safety knowledge examination, which is typically preceded by food safety training. Current certification efforts are based on the assumption that certification leads to greater food safety knowledge. The Centers for Disease Control and Prevention conducted this study to examine the relationship between food safety knowledge and certification. We also examined the relationships between food safety knowledge and restaurant, manager, and worker characteristics. We interviewed managers (N = 387) and workers (N = 365) about their characteristics and assessed their food safety knowledge. Analyses showed that certified managers and workers had greater food safety knowledge than noncertified managers and workers. Additionally, managers and workers whose primary language was English had greater food safety knowledge than those whose primary language was not English. Other factors associated with greater food safety knowledge included working in a chain restaurant, working in a larger restaurant, having more experience, and having more duties. These findings indicate that certification improves food safety knowledge, and that complex relationships exist among restaurant, manager, and worker characteristics and food safety knowledge. PMID:25361386

  14. Multiple Sclerosis and Several Demographic Characteristics, Family History of MS, and Month of Birth: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Bagheri

    2015-09-01

    Full Text Available Background Several factors have been reported as risk factors for multiple sclerosis (MS; however, the main causes of the disease are still unknown. A geographical area with a low MS incidence is Ahvaz, Iran. Objectives The objective of this study was to evaluate the association of several demographic characteristics, family history, and birth month with MS in Ahvaz. Patients and Methods This was a case-control study including 155 MS cases and 155 controls matched for age, sex, and residential status. The participants were selected randomly, using a systematic method, from the MS patients referred to the MS Society of Khuzestan (Iran. The data collection tool was a standardized questionnaire designed by the authors to assess demographic characteristics. Data were analyzed using descriptive statistics including mean, frequency, and standard deviation and inferential statistical tests including χ2, Fisher’s exact test, and logistic regression using SPSS version 19. Results In both cases and controls, no significant associations were found between Arab ethnicity and incidence of MS, marital status and risk of MS in Ahvaz, or more than 15-year residency in Ahvaz, birth in Khuzestan, and month of birth and the risk of MS (P > 0.05. However, there was a marginally significant association between living from birth to age 15 years in Ahvaz and MS (P = 0.05. Furthermore, there was an association between a family history of MS and the risk of MS in Ahvaz (P = 0.02, which was significant in univariate logistic regression (P = 0.006. Conclusions The findings suggested that according to the ecological conditions of Ahvaz, a family history of MS may increase the risk of developing MS.

  15. 78 FR 64153 - Direct Certification and Certification of Homeless, Migrant and Runaway Children for Free School...

    Science.gov (United States)

    2013-10-28

    ...-0001] RIN 0584-AD60 Direct Certification and Certification of Homeless, Migrant and Runaway Children... interim rule entitled Direct Certification and Certification of Homeless, Migrant and Runaway Children for...

  16. A Study Of Risk Factors For Low Birth Weight

    Directory of Open Access Journals (Sweden)

    Deswal B S

    1999-01-01

    Full Text Available Research question: What is the extent of low weight babies born in hospitals and its association with some maternal factors? Objectives: 1. To find an overall prevalence of low birth weight babies amongst hospital births in Meerut city. 2. To identify and quantify the effects of some risk factors for low birth weight. Setting: District women Hospital of Meerut city of western U.P. Study Design: Hospital based matched case-control study. Sample size: 491 low birth weight babies as ‘cases’ and an equal number of babies of normal birth weight in ‘control’ group matched for maternal age, sex of baby, birth order and institution of delivery. Study variables: Socio-economic Status: maternal biological factors including obstetric history: antenatal factors: nutritional factors: history of abortion: toxaemia of pregnancy etc. Results: Overall proportion of low birth weight babies was found to be 21.8% amongst hospital live births and 30.9% born to mothers aged below 30 years of age. Low maternal weight, under nutrition, lack of antenatal care, short inter-pregnancy interval, toxacmia of pregnancy were independent factors increasing the risk of low birth weight significantly. Conclusions: The study suggested that a substantial proportion of low birth weight babies can be averted by improving maternal nutritional status including anemic condition, birth spacing and proper antenatal care.

  17. A Case-Control Study of Prenatal Thallium Exposure and Low Birth Weight in China.

    Science.gov (United States)

    Xia, Wei; Du, Xiaofu; Zheng, Tongzhang; Zhang, Bin; Li, Yuanyuan; Bassig, Bryan A; Zhou, Aifen; Wang, Youjie; Xiong, Chao; Li, Zhengkuan; Yao, Yuanxiang; Hu, Jie; Zhou, Yanqiu; Liu, Juan; Xue, Weiyan; Ma, Yue; Pan, Xinyun; Peng, Yang; Xu, Shunqing

    2016-01-01

    Thallium (Tl) is a highly toxic heavy metal widely present in the environment. Case reports have suggested that maternal exposure to high levels of Tl during pregnancy is associated with low birth weight (LBW), but epidemiological data are limited. This study was designed to evaluate whether prenatal Tl exposure is associated with an increased risk of LBW. This case-control study involving 816 study participants (204 LBW cases and 612 matched controls) was conducted in Hubei Province, China, in 2012-2014. Tl concentrations were measured in maternal urine collected at delivery, and associations with LBW were evaluated using conditional logistic regression. Higher maternal urinary Tl levels were significantly associated with increased risk of LBW [crude odds ratio (OR) = 1.52; 95% CI: 1.00, 2.30 for the highest vs. lowest tertile], and the association was similarly elevated after adjustment for potential confounders (adjusted OR = 1.90; 95% CI: 1.01, 3.58 for the highest vs. lowest tertile). Stratified analyses showed slightly higher risk estimates for LBW associated with higher Tl levels for mothers thallium exposure and low birth weight in China. Environ Health Perspect 124:164-169; http://dx.doi.org/10.1289/ehp.1409202.

  18. Birth order and risk of childhood cancer in the Danish birth cohort of 1973-2010.

    Science.gov (United States)

    Schüz, Joachim; Luta, George; Erdmann, Friederike; Ferro, Gilles; Bautz, Andrea; Simony, Sofie Bay; Dalton, Susanne Oksbjerg; Lightfoot, Tracy; Winther, Jeanette Falck

    2015-11-01

    Many studies have investigated the possible association between birth order and risk of childhood cancer, although the evidence to date has been inconsistent. Birth order has been used as a marker for various in utero or childhood exposures and is relatively straightforward to assess. Data were obtained on all children born in Denmark between 1973 and 2010, involving almost 2.5 million births and about 5,700 newly diagnosed childhood cancers before the age of 20 years. Data were analyzed using Poisson regression models. We failed to observe associations between birth order and risk of any childhood cancer subtype, including acute lymphoblastic leukemia; all rate ratios were close to one. Further analyses stratified by birth cohort (those born between 1973 and 1990, and those born between 1991 and 2010) also failed to show any associations. Considering stillbirths and/or controlling for birth weight and parental age in the analyses had no effect on the results. Analyses by years of birth (those born between 1973 and 1990, and those born between 1991 and 2010) did not show any changes in the overall pattern of no association. In this large cohort of all children born in Denmark over an almost 40-year period, we did not observe an association between birth order and the risk of childhood cancer.

  19. Maternal Residential Exposure to Agricultural Pesticides and Birth Defects in a 2003 to 2005 North Carolina Birth Cohort

    Science.gov (United States)

    Birth defects are responsible for a large proportion of disability and infant mortality. Exposure to a variety of pesticides have been linked to increased risk of birth defects. We conducted a case-control study to estimate the associations between a residence-based metric of agr...

  20. Home birth after hospital birth: women's choices and reflections.

    Science.gov (United States)

    Bernhard, Casey; Zielinski, Ruth; Ackerson, Kelly; English, Jessica

    2014-01-01

    The number of US women choosing home birth is increasing. Little is known about women who choose home birth after having experienced hospital birth; therefore, the purpose of this research was to explore reasons why these women choose home birth and their perceptions regarding their birth experiences. Qualitative description was the research design, whereby focus groups were conducted with women who had hospital births and subsequently chose home birth. Five focus groups were conducted (N = 20), recorded, and transcribed verbatim. Qualitative content analysis was undertaken allowing themes to emerge. Five themes emerged from the women's narratives: 1) choices and empowerment: with home birth, women felt they were given real choices rather than perceived choices, giving them feelings of empowerment; 2) interventions and interruptions: women believed things were done that were not helpful to the birth process, and there were interruptions associated with their hospital births; 3) disrespect and dismissal: participants believed that during hospital birth, providers were more focused on the laboring woman's uterus, with some experiencing dismissal from their hospital provider when choosing to birth at home; 4) birth space: giving birth in their own home, surrounded by people they chose, created a peaceful and calm environment; and 5) connection: women felt connected to their providers, families, newborns, and bodies during their home birth. For most participants, dissatisfaction with hospital birth influenced their subsequent decision to choose home birth. Despite experiencing challenges associated with this decision, women expressed satisfaction with their home birth. © 2014 by the American College of Nurse-Midwives.

  1. 75 FR 28235 - Export Trade Certificate of Review

    Science.gov (United States)

    2010-05-20

    ..., Dallas, TX (controlling entity: Sekisui America Corporation, Mt. Laurel, NJ); Thomas M. Johnson, Park... Members from USSA's Certificate: Atotech USA, Inc., Rockhill, SC; Bostik, Inc., Wauwatosa, WI; Cook...

  2. Association between antibiotic use among pregnant women with urinary tract infections in the first trimester and birth defects, National Birth Defects Prevention Study 1997 to 2011.

    Science.gov (United States)

    Ailes, Elizabeth C; Gilboa, Suzanne M; Gill, Simerpal K; Broussard, Cheryl S; Crider, Krista S; Berry, Robert J; Carter, Tonia C; Hobbs, Charlotte A; Interrante, Julia D; Reefhuis, Jennita

    2016-11-01

    Previous studies noted associations between birth defects and some antibiotics (e.g., nitrofurantoin, sulfonamides) but not others (e.g., penicillins). It is unclear if previous findings were due to antibiotic use, infections, or chance. To control for potential confounding by indication, we examined associations between antibiotic use and birth defects, among women reporting urinary tract infections (UTIs). The National Birth Defects Prevention Study is a multi-site, population-based case-control study. Case infants/fetuses have any of over 30 major birth defects and controls are live-born infants without major birth defects. We analyzed pregnancies from 1997 to 2011 to estimate the association between maternally reported periconceptional (month before conception through the third month of pregnancy) use of nitrofurantoin, trimethoprim-sulfamethoxazole, or cephalosporins and specific birth defects, among women with periconceptional UTIs. Women with periconceptional UTIs who reported penicillin use served as the comparator. Periconceptional UTIs were reported by 7.8% (2029/26,068) of case and 6.7% (686/10,198) of control mothers. Most (68.2% of case, 66.6% of control mothers) also reported antibiotic use. Among 608 case and 231 control mothers reporting at least one periconceptional UTI and certain antibiotic use, compared with penicillin, nitrofurantoin use was associated with oral clefts in the offspring (adjusted odds ratio, 1.97 [95% confidence interval, 1.10-3.53]), trimethoprim-sulfamethoxazole use with esophageal atresia (5.31 [1.39-20.24]) and diaphragmatic hernia (5.09 [1.20-21.69]), and cephalosporin use with anorectal atresia/stenosis (5.01 [1.34-18.76]). Periconceptional exposure to some antibiotics might increase the risk for certain birth defects. However, because individual birth defects are rare, absolute risks should drive treatment decisions.Birth Defects Research (Part A) 106:940-949, 2016.© 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals

  3. Birth Satisfaction Scale/Birth Satisfaction Scale-Revised (BSS/BSS-R): A large scale United States planned home birth and birth centre survey.

    Science.gov (United States)

    Fleming, Susan E; Donovan-Batson, Colleen; Burduli, Ekaterina; Barbosa-Leiker, Celestina; Hollins Martin, Caroline J; Martin, Colin R

    2016-10-01

    to explore the prevalence of birth satisfaction for childbearing women planning to birth in their home or birth centers in the United States. Examining differences in birth satisfaction of the home and birth centers; and those who birthed in a hospital using the 30-item Birth Satisfaction Scale (BSS) and the 10-item Birth Satisfaction Scale-Revised (BSS-R). a quantitative survey using the BSS and BSS-R were employed. Additional demographic data were collected using electronic linkages (Qualtrics ™ ). a convenience sample of childbearing women (n=2229) who had planned to birth in their home or birth center from the US (United States) participated. Participants were recruited via professional and personal contacts, primarily their midwives. the total 30-item BSS score mean was 128.98 (SD 16.92) and the 10-item BSS-R mean score was 31.94 (SD 6.75). Sub-scale mean scores quantified the quality of care provision, women's personal attributes, and stress experienced during labour. Satisfaction was higher for women with vaginal births compared with caesareans deliveries. In addition, satisfaction was higher for women who had both planned to deliver in a home or a birth centre, and who had actually delivered in a home or a birth center. total and subscale birth satisfaction scores were positive and high for the overall sample IMPLICATIONS FOR PRACTICE: the BSS and the BSS-R provide a robust tool to quantify women's experiences of childbirth between variables such as birth types, birth settings and providers. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. The origins of the birth control movement in England in the early nineteenth century.

    Science.gov (United States)

    Langer, W L

    1975-01-01

    The origins of the birth control movement in England in the 19th cen tury are discussed. The impact of Malthus's "Essay on the Principle of Population" and the activities of such thinkers and reformers as Jermy Bentham, James and John Stuart Mill, Francis Plance, Richard Carlile, Robert Dale Owen, and Charles Knowlton are discussed. The social debate that arose during the century is discussed.

  5. Certification Considerations for Adaptive Systems

    Science.gov (United States)

    Bhattacharyya, Siddhartha; Cofer, Darren; Musliner, David J.; Mueller, Joseph; Engstrom, Eric

    2015-01-01

    Advanced capabilities planned for the next generation of aircraft, including those that will operate within the Next Generation Air Transportation System (NextGen), will necessarily include complex new algorithms and non-traditional software elements. These aircraft will likely incorporate adaptive control algorithms that will provide enhanced safety, autonomy, and robustness during adverse conditions. Unmanned aircraft will operate alongside manned aircraft in the National Airspace (NAS), with intelligent software performing the high-level decision-making functions normally performed by human pilots. Even human-piloted aircraft will necessarily include more autonomy. However, there are serious barriers to the deployment of new capabilities, especially for those based upon software including adaptive control (AC) and artificial intelligence (AI) algorithms. Current civil aviation certification processes are based on the idea that the correct behavior of a system must be completely specified and verified prior to operation. This report by Rockwell Collins and SIFT documents our comprehensive study of the state of the art in intelligent and adaptive algorithms for the civil aviation domain, categorizing the approaches used and identifying gaps and challenges associated with certification of each approach.

  6. birth complications control between midwives among women in ...

    African Journals Online (AJOL)

    Method: The study adopted was survey design. The sample .... traditional midwives, policy makers, women in general, government and ... mal-presentation of the fetal head ii) ..... in minimizing maternal trauma and ensuring an optimal birth for ...

  7. Trends and characteristics of home vaginal birth after cesarean delivery in the United States and selected States.

    Science.gov (United States)

    Macdorman, Marian F; Declercq, Eugene; Mathews, T J; Stotland, Naomi

    2012-04-01

    To examine trends and characteristics of home vaginal birth after cesarean delivery (VBAC) in the United States and selected states from 1990-2008. Birth certificate data were used to track trends in home and hospital VBACs from 1990-2008. Data on planned home VBAC were analyzed by sociodemographic and medical characteristics for the 25 states reporting this information in 2008 and compared with hospital VBAC data. In 2008, there were approximately 42,000 hospital VBACs and approximately 1,000 home VBACs in the United States, up from 664 in 2003 and 656 in 1990. The percentage of home births that were VBACs increased from less than 1% in 1996 to 4% in 2008, whereas the percentage of hospital births that were VBACs decreased from 3% in 1996 to 1% in 2008. Planned home VBACs had a lower risk profile than hospital VBACs with fewer births to teenagers, unmarried women, or smokers; fewer preterm or low-birth-weight deliveries; and higher maternal education levels. Recent increases in the proportion of U.S. women with a prior cesarean delivery mean that an increasing number of women are faced with the choice and associated risks of either VBAC or repeat cesarean delivery. Recent restrictions in hospital VBAC availability have coincided with increases in home VBACs; however, home VBAC remains rare, with approximately 1,000 occurrences in 2008. II.

  8. Factors relating to pregnancy and birth and the risk of childhood brain tumors: results from an Australian case-control study.

    Science.gov (United States)

    Greenop, Kathryn R; Blair, Eve M; Bower, Carol; Armstrong, Bruce K; Milne, Elizabeth

    2014-03-01

    Childhood brain tumors (CBT) are the leading cause of cancer death in children, yet their causes are largely known. This study investigated the association between maternal and birth characteristics and risk of CBT. Cases families were recruited from all 10 Australian pediatric oncology centers between 2005 and 2010. Control families were recruited via random-digit dialing, frequency matched to cases on the basis of child's age, sex, and State of residence. Maternal and birth characteristics of children were ascertained by questionnaires. Odds ratios (ORs) and 95% confidence intervals (CI) were estimated using unconditional logistic regression, adjusting for relevant confounders. For this analysis, data on 319 case children and 1,079 control children were available. No association was found between risk of CBT and birth weight, fetal growth, birth order, gestational age, or maternal body mass index. The ORs for inadequate and excessive maternal gestational weight gain (GWG) (Institute of Medicine 2009 guidelines) were 1.8 (95% CI 1.2-2.6) and 1.4 (95% CI 1.0-2.1), respectively; similar findings for GWG were seen across categories of child's age, fetal growth, maternal body mass index and height, maternal smoking, and parental education. Risk of low grade glioma appeared increased with preterm birth (OR 1.6 (95% CI 0.8-3.1) and admission to neonatal intensive care (NICU) for >2 days (OR 1.7, 95% CI 0.9-3.6). We found little evidence of associations between risk of CBT and most birth characteristics. The associations we observed with GWG, prematurity and NICU admission require corroboration in other studies. © 2013 Wiley Periodicals, Inc.

  9. 75 FR 50747 - Export Trade Certificate of Review

    Science.gov (United States)

    2010-08-17

    ..., Dallas, TX (controlling entity: Sekisui America Corporation, Mt. Laurel, NJ); and Thomas M. Johnson, Park... Members from USSA's Certificate: Atotech USA, Inc., Rockhill, SC; Bostik, Inc., Wauwatosa, WI; Cook...

  10. Formulating evidence-based guidelines for certified nurse-midwives and certified midwives attending home births.

    Science.gov (United States)

    Cook, Elizabeth; Avery, Melissa; Frisvold, Melissa

    2014-01-01

    Implementing national home birth guidelines for certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States may facilitate a common approach to safe home birth practices. Guidelines are evidence-based care recommendations for specified clinical situations that can be modified by individual providers to meet specific client needs. Following a review of home birth guidelines from multiple countries, a set of home birth practices guidelines for US CNMs/CMs was drafted. Fifteen American Midwifery Certification Board, Inc. (AMCB)-certified home birth midwives who participate in the American College of Nurse-Midwives (ACNM) home birth electronic mailing list considered the use of such a document in their practices and reviewed and commented on the guidelines. The proposed guidelines addressed client screening, informed consent, antepartum care, routine intrapartum care, obstetric complications and hospital transports, postpartum care, neonatal care, gynecologic care, primary care, peer reviews, recordkeeping, and physician collaboration. The reviewers had varying assessments as to whether the guidelines reflected international standards and current best evidence. The primary concern expressed was that an adoption of national guidelines could compromise provider autonomy. Incorporation of evidence-based guidelines is an ACNM standard and was recommended by the Home Birth Consensus Summit. Clinical practice guidelines are informed by current evidence and supported by experts in a given discipline. Implementation of guidelines ensures optimal patient care and is becoming increasingly central to reimbursement and to medicolegal support. A set of practice guidelines based on current best evidence and internationally accepted standards was developed and reviewed by an interested group of US CNMs/CMs. Further discussion with home birth midwives and other stakeholders about the development and implementation of home birth guidelines is needed, especially in

  11. Trends and Characteristics of United States Out-of-Hospital Births 2004-2014: New Information on Risk Status and Access to Care.

    Science.gov (United States)

    MacDorman, Marian F; Declercq, Eugene

    2016-06-01

    Out-of-hospital births are increasing in the United States. Our purpose was to examine trends in out-of-hospital births from 2004 to 2014, and to analyze newly available data on risk status and access to care. Newly available data from the revised birth certificate for 47 states and Washington, DC, were used to examine out-of-hospital births by characteristics and to compare them with hospital births. Trends from 2004 to 2014 were also examined. Out-of-hospital births increased by 72 percent, from 0.87 percent of United States births in 2004 to 1.50 percent in 2014. Compared with mothers who had hospital births, those with out-of-hospital births had lower prepregnancy obesity (12.5% vs 25.0%) and smoking (2.8% vs 8.5%) rates, and higher college graduation (39.3% vs 30.0%) and breastfeeding initiation (94.3% vs 80.8%) rates. Among planned home births, 67.1 percent were self-paid, compared with 31.9 percent of birth center and 3.4 percent of hospital births. Vaginal births after cesarean (VBACs) comprised 4.6 percent of planned home births and 1.6 percent of hospital and birth center births. Sociodemographic and medical risk status of out-of-hospital births improved substantially from 2004 to 2014. Improvements in risk status of out-of-hospital births from 2004 to 2014 suggest that appropriate selection of low-risk women is improving. High rates of self-pay for the costs of out-of-hospital birth suggest serious gaps in insurance coverage, whereas higher-than-average rates of VBAC could reflect lack of access to hospital VBACs. Mandating private insurance and Medicaid coverage could substantially improve access to out-of-hospital births. Improving access to hospital VBACs might reduce the number of out-of-hospital VBACs. © 2016 Wiley Periodicals, Inc.

  12. Birth defects in children with newborn encephalopathy

    NARCIS (Netherlands)

    Felix, JF; Badawi, N; Kurinczuk, JJ; Bower, C; Keogh, JM; Pemberton, PJ

    2000-01-01

    This study was designed to investigate birth defects found in association with newborn encephalopathy. All possible birth defects were ascertained in a population-based study of 276 term infants with moderate or severe encephalopathy and 564 unmatched term control infants. A strong association

  13. Paternal effects on the human sex ratio at birth: evidence from interracial crosses.

    Science.gov (United States)

    Khoury, M J; Erickson, J D; James, L M

    1984-01-01

    The effects of interracial crossing on the human sex ratio at birth were investigated using United States birth-certificate data for 1972-1979. The sex ratio was 1.059 for approximately 14 million singleton infants born to white couples, 1.033 for 2 million born to black couples, and 1.024 for 64,000 born to American Indian couples. Paternal and maternal race influences on the observed racial differences in sex ratio were analyzed using additional data on approximately 97,000 singleton infants born to white-black couples and 60,000 born to white-Indian couples. After adjustment for mother's race, white fathers had significantly more male offspring than did black fathers (ratio of sex ratios [RSR] = 1.027) and Indian fathers (RSR = 1.022). On the other hand, after adjustment for father's race, white mothers did not have more male offspring than did black mothers (RSR = 0.998) or Indian mothers (RSR = 1.009). The paternal-race effect persisted after adjustment for parental ages, education, birth order, and maternal marital status. The study shows that the observed racial differences in the sex ratio at birth are due to the effects of father's race and not the mother's. The study points to paternal determinants of the human sex ratio at fertilization and/or of the prenatal differential sex survival. PMID:6496474

  14. Maternal Demographic and Psychosocial Factors Associated with Low Birth Weight in Eastern Taiwan

    Directory of Open Access Journals (Sweden)

    Yin-Ming Li

    2005-11-01

    Full Text Available The relationship between birth weight and maternal sociodemographic characteristics was examined in a sample from two teaching hospitals in eastern Taiwan. Using a structured questionnaire, we conducted face- to-face interviews with women at antenatal clinics between 1998 and 1999 in Hualien City. One year later, we took the outcome of pregnancy from medical records and birth certificates from the Public Health Bureau of Hualien County. Of the 1,128 single live births, 6.8% had low birth weight (LBW using the World Health Organization cut-off of 2,500 g. LBW was more common in teenage ( 30 years, first-time, and unmarried mothers; those with basic/intermediate educational attainment; and residents of aboriginal districts. Teenage pregnancies were more likely than those in adults to be unplanned, and such mothers had smoking or alcohol-drinking behavior. Prevention of teenage pregnancy is crucial to lower LBW rates in eastern Taiwan. For adult mothers, basic or intermediate educational attainment, residence in an aboriginal district, and first-term pregnancy were significant factors associated with LBW, after adjustment for other psychosocial attributes, such as psychologic distress and poor family support. Thus, we should pay more attention when caring for pregnant women with such sociodemographic characteristics, and ensure that they have adequate prenatal care and can adopt a healthy lifestyle.

  15. COSPAS-SARSAT Beacon Certification Facility

    Data.gov (United States)

    Federal Laboratory Consortium — EPG's COSPAS-SARSAT Beacon Certification Facility is one of five certification facilities in the world. Formal certifications are available for all beacon types and...

  16. Modifying effects of maternal Hb concentration on infant birth weight in women receiving prenatal iron-containing supplements: a randomised controlled trial.

    Science.gov (United States)

    Wang, Linlin; Mei, Zuguo; Li, Hongtian; Zhang, Yali; Liu, Jianmeng; Serdula, Mary K

    2016-02-28

    Concerns have been raised about the benefits of Fe-containing supplements on infant birth weight among women with normal/high Hb levels at baseline. Thus far, no clinical trials have examined whether the effects of prenatal Fe-containing supplements on birth weight vary by maternal Hb levels. We compared the effects of Fe-folic acid (IFA) or multiple micronutrients (MMN) with folic acid (FA) supplements on birth weight among pregnant women with mild/no anaemia or high Hb levels. A double-blind randomised controlled trial was conducted in 2006-2009. In total, 18 775 pregnant women with mild/no anaemia (145 g/l) baseline Hb levels, IFA and MMN supplements increased birth weight by 91·44 (95% CI 3·37, 179·51) g and 107·63 (95% CI 21·98, 193·28) g (PHb concentration. In conclusion, the effects of Fe-containing supplements on birth weight depended on baseline Hb concentrations. The Fe-containing supplements improved birth weight in women with very high Hb levels before 20 weeks of gestation.

  17. A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes

    OpenAIRE

    Jiang, Hong; Xiong, Xu; Su, Yi; Zhang, Yiming; Wu, Hongqiao; Jiang, Zhijun; Qian, Xu

    2013-01-01

    Background Evidence has suggested that periodontal disease is associated with an increased risk of various adverse pregnancy and birth outcomes. However, several large clinical randomized controlled trials failed to demonstrate periodontal therapy during pregnancy reduced the incidence of adverse pregnancy and birth outcomes. It has been suggested that the pre-conception period may be an optimal period for periodontal disease treatment rather than during pregnancy. To date, no randomized cont...

  18. Systemic sclerosis, birth order and parity.

    Science.gov (United States)

    Russo, Paul A J; Lester, Susan; Roberts-Thomson, Peter J

    2014-06-01

    A recent study identified increasing birth order to be a risk factor for the development of systemic sclerosis (SSc). This finding supports the theory that transplacental microchimerism may be a key pathological event in the initiation of SSc. We investigated the relationship between birth order and parity and the age of onset of SSc in South Australia. A retrospective analysis of patient data in the South Australian Scleroderma Register was performed. Data were obtained from a mailed questionnaire. Control data was collected prospectively using a similar questionnaire. The relationship between birth order, family size or parity and risk of subsequent development of SSc was analyzed by mixed effects logistic regression analysis. Three hundred and eighty-seven index probands were identified and compared with 457 controls. Controls were well matched for gender, but not for age. No statistically significant relationship was identified between SSc and birth order, parity in females, family size, age at first pregnancy in females or gender of first child in parous females. Our data suggests that parity, age at first pregnancy and the gender of the first child are not relevant factors in our understanding of the epidemiology and pathogenesis of SSc. Birth order and family size in both genders also appears irrelevant. These results argue against microchimerism as being relevant in the pathogenesis of SSc and add further support to the theory that stochastic events may be important in the etiopathogenesis of SSc. © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  19. Birth order and post-traumatic stress disorder.

    Science.gov (United States)

    Green, Ben; Griffiths, Emily C

    2014-01-01

    To compare the birth order of patients with post-traumatic stress disorder (PTSD) and adjustment disorder (AD) with population norms. 83 PTSD patients and 104 AD control patients from a psychiatric trauma clinic were diagnosed according to DCR-10 guidelines. A family history was taken as to number of siblings, and their birth order. We compared the distribution of birth order for each patient group against birth order distributions expected by chance for the same years of birth using UK population-level birth order from the Office for National Statistics. Psychiatric patients with PTSD were more likely to be from a large family, specifically to be the fifth child or later (OR 4.78, p birth order between AD patients and the general population. People with PTSD are more likely to be the youngest children from large families than expected from a random sample of people born in the same years. This association with birth order was not found for another psychiatric diagnosis AD from the same clinic. We discuss possible psychosocial and biological causes, and implications for further research.

  20. Progesterone for preterm birth prevention

    Directory of Open Access Journals (Sweden)

    Miha Lucovnik

    2015-10-01

    Full Text Available Background: Progesterone is important in maintaining pregnancy. Progesterone supplementation may reduce risk of preterm birth in certain populations of pregnant women. The objective of this review was to develop evidence-based clinical recommendation for progesterone treatment in the prevention of preterm birth.Methods: A search in the Medline database was performed using keywords: progesterone, pregnancy, preterm birth, preterm labour, preterm delivery, randomized trial, and randomized controlled trial. We only included studies of vaginal progesterone treatments for the prevention of preterm birth and excluded studies on 17-α-hydroksiprogesterone caproate.Results: We report findings from twelve randomized trials conducted since 2003. These trials differ regarding inclusion criteria, progesterone dose, vehicle used, and duration of treatment. Inclusion criteria were: short uterine cervix (two trials, history of previous preterm birth (two trials, signs and symptoms of preterm labour (three trials, twin pregnancies (three trials, and multiple risk factors (among these history of previous preterm birth was the most common (two trials. Six of these twelve trials showed a significant reduction in preterm birth in the progesterone groups.Conclusions: Based on current evidence we recommend treatment with 200 mg of micronized progesterone daily, administered vaginally, in pregnant women found to have a short cervix (≤ 25 mm at 19-24 weeks. The treatment should be continued until 37 weeks.

  1. Special Section: Creating a Profession of Teaching: The Role of National Board Certification.

    Science.gov (United States)

    American Educator: The Professional Journal of the American Federation of Teachers, 1990

    1990-01-01

    Outlines the broad standards for the proposed National Board Certification for teachers. This advanced certification will bring new status to teaching and has enormous potential to spur increased collaboration among teachers, reduced bureaucratic control, and more productive use of teachers' talents. (FMW)

  2. Disease control through fertility control: Secondary benefits of animal birth control in Indian street dogs.

    Science.gov (United States)

    Yoak, Andrew J; Reece, John F; Gehrt, Stanley D; Hamilton, Ian M

    2014-01-01

    We sought to (1) survey sexually intact street dogs for a wide range of diseases in three cities in Rajasthan, India and (2) evaluate links between the health of non-treated dogs and both the presence and duration of animal birth control (ABC) programs. ABC regimes sterilize and vaccinate stray dogs in an attempt to control their population and the spread of rabies. They are commonly suggested to improve the health of those dogs they serve, but here we provide evidence that these benefits also extend to untreated dogs in the community. Viral and bacterial disease seroprevalences were assessed in 240 sexually intact street dogs from Jaipur, Jodhpur, and Sawai Madhopur cities in October and September 2011. Those individuals and 50 additional dogs were assessed for the presence of ticks, fleas, fight wounds, and given body condition scores. Dogs in cities with an ABC program had with significantly (pdogs in cities with ABC programs had significantly higher prevalence of Brown Dog Tick (Rhipicephalus sanguineus) infestations. Canine parvovirus and Brucella canis prevalences were not significantly different between cities. This study is the first to demonstrate the health benefits of ABC on non-vaccinated diseases and non-treated individuals. Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  3. Epidemiologic characteristics of anophthalmia and bilateral microphthalmia among 2.5 million births in California, 1989-1997.

    Science.gov (United States)

    Shaw, Gary M; Carmichael, Suzan L; Yang, Wei; Harris, John A; Finnell, Richard H; Lammer, Edward J

    2005-08-15

    There is a paucity of epidemiologic information about the eye malformations anophthalmia and microphthalmia. Using data from a large population-based registry, we explored prevalences and maternal/infant characteristics associated with anophthalmia and bilateral microphthalmia. Data were derived from the California Birth Defects Monitoring Program, a population-based active surveillance system for collecting information on infants and fetuses with congenital malformations using multiple source ascertainment. Approximately 2.5 million births (liveborn and stillborn) occurred during the ascertainment period, 1989-1997. Information on maternal and infant/fetal characteristics was obtained from California birth certificate and fetal death files. The prevalence per 10,000 livebirths and stillbirths for anophthalmia was 0.18 and for bilateral microphthalmia was 0.22. These estimates reflect prevalences among births without chromosomal anomalies. Relative risks of anophthalmia were modestly higher among women aged 40 or more (relative risk = 2.0, 95% confidence interval 0.5-8.6). Risks were substantially lower for those mothers with >12 years of education, even after adjusting for other study factors, relative risk = 0.6 (0.2-1.7). The risk of anophthalmia was approximately twofold among multiple births compared to singletons. Similar to results for anophthalmia, decreased risks for bilateral microphthalmia were observed for maternal education of 12 years or more and increased risks observed for multiple births. These data show descriptive epidemiologic features of anophthalmia and bilateral microphthalmia. Copyright 2005 Wiley-Liss, Inc.

  4. Eczema, birth order, and infection.

    Science.gov (United States)

    Hughes, Ann Maree; Crouch, Simon; Lightfoot, Tracy; Ansell, Pat; Simpson, Jill; Roman, Eve

    2008-05-15

    The association between infections occurring in the first 2 years of life and development of eczema was investigated in 1,782 control children from a national population-based case-control study in the United Kingdom conducted over the period 1991-1996. Dates of eczema and infectious diagnoses were ascertained from contemporaneously collected primary care records. Children diagnosed with eczema before the age of 2 years had more prior clinically diagnosed infections recorded than did children without eczema (rate ratio = 1.26, 95% confidence interval (CI): 1.18, 1.36). The difference in infection rates between children with and without eczema was apparent from birth and throughout the first 2 years of life. As expected, compared with children of second or higher birth order, those firstborn were at increased risk of eczema (p = 0.020); however, the relation between eczema and prior infection was evident only among children of second or higher birth order and not among firstborn children (rate ratio = 1.45, 95% CI: 1.32, 1.59, and rate ratio = 1.08, 95% CI: 0.98, 1.20, respectively). The authors' results are consistent with the notion that the association between birth order and eczema is unlikely to be attributable to variations in early infectious exposure.

  5. Update on the Essure System for Permanent Birth Control.

    Science.gov (United States)

    Fantasia, Heidi Collins

    In 2002, the U.S. Food and Drug Administration approved the Essure system for permanent birth control. Implantation with this device offers a minimally invasive option for permanent female contraception that is placed during a brief office visit. Unlike laparoscopic tubal sterilization, the Essure procedure requires no hospitalization or general anesthesia, resulting in minimal recovery time. After a decade of stability in the report of adverse effects, the U.S. Food and Drug Administration noted a sharp increase in patient-reported adverse events, including chronic pelvic pain, irregular bleeding, allergic reactions, and autoimmune-like reactions. In response to this increase in complaints, the U.S. Food and Drug Administration issued updated guidelines for patient education and counseling. This article discusses those updates, as well as implications for nurses who provide health care to women seeking permanent contraception. © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  6. Maternal age at child birth, birth order, and suicide at a young age: a sibling comparison.

    Science.gov (United States)

    Bjørngaard, Johan Håkon; Bjerkeset, Ottar; Vatten, Lars; Janszky, Imre; Gunnell, David; Romundstad, Pål

    2013-04-01

    Previous studies have reported strong associations between birth order, maternal age, and suicide, but these results might have been confounded by socioeconomic and other factors. To control for such factors, we compared suicide risk between siblings and studied how maternal age at child birth and birth order influenced risk in a cohort study of 1,690,306 Norwegians born in 1967-1996 who were followed up until 2008. Using stratified Cox regression, we compared suicide risk within families with 2 or more children in which one died from suicide. Altogether, 3,005 suicides occurred over a mean follow-up period of 15 years; 2,458 of these suicides occurred among 6,741 siblings within families of 2 or more siblings. Among siblings, a higher position in the birth order was positively associated with risk; each increase in birth order was associated with a 46% (adjusted hazard ratio = 1.46, 95% confidence interval: 1.29, 1.66) higher risk of suicide. For each 10-year increase in maternal age at child birth, the offspring's suicide risk was reduced by 57% (adjusted hazard ratio = 0.43, 95% confidence interval: 0.30, 0.62). Our study suggests that confounding due to familial factors is not likely to explain the associations of birth order and maternal age at child birth with suicide risk.

  7. KSC Center Director Bridges accepts an ISO 9001 certificate from DNV

    Science.gov (United States)

    1998-01-01

    Center Director Roy Bridges displays the ISO 9001 certificate he was awarded by Det Norske Veritas (DNV), Inc., an international ISO certification organization, at a ceremony at KSC. Dalton Lyon of DNV made the presentation, which included a 2000th ISO Certificate Plaque. ISO 9001 comprises the most detailed, comprehensive set of standard requirements for quality programs established by the International Standards Organization. The presentation followed a successful independent audit by DNV of the KSC Management System in May of this year. The third-party auditors examined about 20 elements of KSC's system, including management responsibility, design control, documentation, test and inspection, and corrective action procedures. DNV found that KSC met or exceeded the stringent quality standards in all areas. KSC will use this certification as a tool to improve an already world-class team. All NASA centers are required by NASA Administrator Daniel S. Goldin to be ISO 9001 registered by September 1999. NASA is the first federal agency to seek the quality certification.

  8. Agricultural Compounds in Water and Birth Defects.

    Science.gov (United States)

    Brender, Jean D; Weyer, Peter J

    2016-06-01

    Agricultural compounds have been detected in drinking water, some of which are teratogens in animal models. The most commonly detected agricultural compounds in drinking water include nitrate, atrazine, and desethylatrazine. Arsenic can also be an agricultural contaminant, although arsenic often originates from geologic sources. Nitrate has been the most studied agricultural compound in relation to prenatal exposure and birth defects. In several case-control studies published since 2000, women giving birth to babies with neural tube defects, oral clefts, and limb deficiencies were more likely than control mothers to be exposed to higher concentrations of drinking water nitrate during pregnancy. Higher concentrations of atrazine in drinking water have been associated with abdominal defects, gastroschisis, and other defects. Elevated arsenic in drinking water has also been associated with birth defects. Since these compounds often occur as mixtures, it is suggested that future research focus on the impact of mixtures, such as nitrate and atrazine, on birth defects.

  9. The Medical Prenuptial Certificate in Antioquia (Colombia, 1933-1936

    Directory of Open Access Journals (Sweden)

    Natalia María Gutiérrez Urquijo

    2017-01-01

    Full Text Available Through the requirement of a medical certificate between 1933 and 1936, health authorities in the Colombian Antioquia department sought to regulate the physical and moral conditions of men and women who wanted to marry. The aim of this bureaucratic procedure was to prevent the birth of individuals who may become a burden to the State, and to promote the health and general welfare. Based on reports from physician and municipal health inspectors of the time, this article discusses the way in which this measure was unveiled to the population. It also highlights some of the challenges to enforce it due the disinterest of the Catholic Church, the low presence of physician in areas away from the municipalities, and the lack of infrastructure to carry out the required tests.

  10. An evaluation of the impact of maternity care coordination on Medicaid birth outcomes in North Carolina.

    Science.gov (United States)

    Buescher, P A; Roth, M S; Williams, D; Goforth, C M

    1991-12-01

    Care coordination is an important component of the enhanced prenatal care services provided under the recent expansions of the Medicaid program. The effect of maternity care coordination services on birth outcomes in North Carolina was assessed by comparing women on Medicaid who did and did not receive these services. Health program data files, including Medicaid claims paid for maternity care coordination, were linked to 1988 and 1989 live birth certificates. Simple comparisons of percentages and rates were supplemented by a logistic regression analysis. Among women on Medicaid who did not receive maternity care coordination services, the low birth weight rate was 21% higher, the very low birth weight rate was 62% higher, and the infant mortality rate was 23% higher than among women on Medicaid who did receive such services. It was estimated that, for each $1.00 spent on maternity care coordination, Medicaid saved $2.02 in medical costs for newborns up to 60 days of age. Among the women who did receive maternity care coordination, those receiving it for 3 or more months had better outcomes than those receiving it for less than 3 months. These results suggest that maternity care coordination can be effective in reducing low birth weight, infant mortality, and newborn medical care costs among babies born to women in poverty.

  11. A Case–Control Study of Prenatal Thallium Exposure and Low Birth Weight in China

    Science.gov (United States)

    Xia, Wei; Du, Xiaofu; Zheng, Tongzhang; Zhang, Bin; Li, Yuanyuan; Bassig, Bryan A.; Zhou, Aifen; Wang, Youjie; Xiong, Chao; Li, Zhengkuan; Yao, Yuanxiang; Hu, Jie; Zhou, Yanqiu; Liu, Juan; Xue, Weiyan; Ma, Yue; Pan, Xinyun; Peng, Yang; Xu, Shunqing

    2015-01-01

    Background Thallium (Tl) is a highly toxic heavy metal widely present in the environment. Case reports have suggested that maternal exposure to high levels of Tl during pregnancy is associated with low birth weight (LBW), but epidemiological data are limited. Objectives This study was designed to evaluate whether prenatal Tl exposure is associated with an increased risk of LBW. Methods This case–control study involving 816 study participants (204 LBW cases and 612 matched controls) was conducted in Hubei Province, China, in 2012–2014. Tl concentrations were measured in maternal urine collected at delivery, and associations with LBW were evaluated using conditional logistic regression. Results Higher maternal urinary Tl levels were significantly associated with increased risk of LBW [crude odds ratio (OR) = 1.52; 95% CI: 1.00, 2.30 for the highest vs. lowest tertile], and the association was similarly elevated after adjustment for potential confounders (adjusted OR = 1.90; 95% CI: 1.01, 3.58 for the highest vs. lowest tertile). Stratified analyses showed slightly higher risk estimates for LBW associated with higher Tl levels for mothers thallium exposure and low birth weight in China. Environ Health Perspect 124:164–169; http://dx.doi.org/10.1289/ehp.1409202 PMID:26009470

  12. The Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Olsen, Jørn

    2011-01-01

    , physical exercise, working conditions, medication and infections during pregnancy, and environmental possible toxins. The study designs cover straightforward cohort analyses, case-control studies and sub-cohort analyses with enriched data collection. CONCLUSION: So far, the Danish National Birth Cohort has......INTRODUCTION: In this review a selection of studies published during the period 2002-2010, based on data from the Danish National Birth Cohort linked with other health registers, is described. Illustrative examples of studies addressing perinatal health outcomes (pregnancy complications and fetal...... that this investment in epidemiologic infrastructure was well spent. The existence of the Danish National Birth Cohort together with other cohorts and national registers has given Denmark a leading position in reproductive epidemiology....

  13. Update of energy performance certificates in the residential sector and scenarios that consider the impact of automation, control and management systems: A case study of La Rioja

    International Nuclear Information System (INIS)

    López-González, Luis M.; López-Ochoa, Luis M.; Las-Heras-Casas, Jesús; García-Lozano, César

    2016-01-01

    Highlights: • A total of 9416 energy performance certificates in the residential sector were analyzed. • Approximately 40% of the energy performance certificates were incorrect. • The developed algorithms can be generalized for the remainder of Spain. • Introducing BACS and TBM systems can reduce building energy consumption by up to 26.36%. - Abstract: Energy performance certificates are considered to be tools for knowledge and energy planning in the residential sector. Although energy performance certificates describe primary energy consumption and the associated emissions of a home or building, they do not consider the influence of building automation control systems (BACS) or technical building management (TBM) systems on these parameters. The European Standard EN 15232 remedies this shortcoming and evaluates the savings in primary energy and the reduction of CO_2 emissions that can be achieved by these systems. This study investigates the energy performance certificates registered in the Autonomous Community of La Rioja and considers the policy changes in the Technical Building Code (Código Técnico de la Edificación) and, specifically, the Basic Document for Energy Saving (Documento Básico de Ahorro de Energía) (CTE-DB-HE). Due to this regulatory change, we corrected the certificates and outlined different scenarios based on the implementation of these systems in this study. These scenarios show the potential distribution of energy performance certificates and the improvements in the ratings obtained.

  14. 7 CFR 205.404 - Granting certification.

    Science.gov (United States)

    2010-01-01

    ... PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.404 Granting certification. (a) Within a reasonable... certified operation; (2) Effective date of certification; (3) Categories of organic operation, including... operation's organic certification continues in effect until surrendered by the organic operation or...

  15. Treatment of asymptomatic vaginal candidiasis in pregnancy to prevent preterm birth: an open-label pilot randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Rickard Kristen

    2011-03-01

    Full Text Available Abstract Background Although the connection between ascending infection and preterm birth is undisputed, research focused on finding effective treatments has been disappointing. However evidence that eradication of Candida in pregnancy may reduce the risk of preterm birth is emerging. We conducted a pilot study to assess the feasibility of conducting a large randomized controlled trial to determine whether treatment of asymptomatic candidiasis in early pregnancy reduces the incidence of preterm birth. Methods We used a prospective, randomized, open-label, blinded-endpoint (PROBE study design. Pregnant women presenting at Candida were randomized to 6-days of clotrimazole vaginal pessaries (100mg or usual care (screening result is not revealed, no treatment. The primary outcomes were the rate of asymptomatic vaginal candidiasis, participation and follow-up. The proposed primary trial outcome of spontaneous preterm birth Results Of 779 women approached, 500 (64% participated in candidiasis screening, and 98 (19.6% had asymptomatic vaginal candidiasis and were randomized to clotrimazole or usual care. Women were not inconvenienced by participation in the study, laboratory testing and medication dispensing were problem-free, and the follow-up rate was 99%. There was a tendency towards a reduction in spontaneous preterm birth among women with asymptomatic candidiasis who were treated with clotrimazole RR = 0.33, 95%CI 0.04-3.03. Conclusions A large, adequately powered, randomized trial of clotrimazole to prevent preterm birth in women with asymptomatic candidiasis is both feasible and warranted. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR: ACTRN12609001052224

  16. Cesarean Birth

    Science.gov (United States)

    ... QUESTIONS LABOR, DELIVERY, AND POSTPARTUM CARE FAQ006 Cesarean Birth (C-section) • What is cesarean birth? • What are the reasons for cesarean birth? • Is a cesarean birth necessary if I have ...

  17. A randomized, controlled trial of the effectiveness of an early-intervention program in reducing parenting stress after preterm birth.

    Science.gov (United States)

    Kaaresen, Per Ivar; Rønning, John A; Ulvund, Stein Erik; Dahl, Lauritz B

    2006-07-01

    Preterm birth has been associated with increased parenting stress in early infancy, and some reports have found this to be a risk factor for later behavioral problems. There are, however, few studies and conflicting results. Information about the fathers is scarce. Our goal was to study the effects of an early-intervention program on parenting stress after a preterm birth until 1 year corrected age. A randomized, controlled trial was conducted including infants with a birth weight effects of a modified version of the Mother-Infant Transaction Program on parenting stress measured by the Parenting Stress Index. A term control group was also recruited. The Parenting Stress Index was administered to the mothers at 6 and 12 months' corrected age and to the fathers at 12 months' corrected age. The intervention consisted of 8 sessions shortly before discharge and 4 home visits by specially trained nurses focusing on the infant's unique characteristics, temperament, and developmental potential and the interaction between the infant and the parents. Seventy-one infants were included in the preterm intervention group, and 69 were included in the preterm control group. The preterm groups were well balanced. Seventy-four infants were included in the term control group. Compared with the preterm controls, both the mothers and fathers in the preterm intervention group reported significant lower scores in child domain, parent domain, and total stress on all occasions except the mother-reported child domain at 12 months. These differences were not related to birth weight or gestational age. The level of stress among the preterm intervention group was comparable to their term peers. Both parents in the intervention group reported consistently lower scores within the distractibility/hyperactivity, reinforces parents, competence, and attachment subscales compared with the preterm control group. There were no differences in mean summary stress scores between the mothers and fathers in

  18. Dynamic complexities in a pest control model with birth pulse and harvesting

    International Nuclear Information System (INIS)

    Goel, A.; Gakkhar, S.

    2016-01-01

    In this paper, an impulsive model is discussed for an integrated pest management approach comprising of chemical and mechanical controls. The pesticides and harvesting are used to control the stage-structured pest population. The mature pest give birth to immature pest in pulses at regular intervals. The pest is controlled by spraying chemical pesticides affecting immature as well as mature pest. The harvesting of both immature and mature pest further reduce the pest population. The discrete dynamical system obtained from stroboscopic map is analyzed. The threshold conditions for stability of pest-free state as well as non-trivial period-1 solution is obtained. The effect of pesticide spray timing and harvesting on immature as well as mature pest are shown. Finally, by numerical simulation with MATLAB, the dynamical behaviors of the model is found to be complex. Above the threshold level there is a characteristic sequence of bifurcations leading to chaotic dynamics. Route to chaos is found to be period-doubling. Period halving bifurcations are also observed.

  19. Dynamic complexities in a pest control model with birth pulse and harvesting

    Energy Technology Data Exchange (ETDEWEB)

    Goel, A., E-mail: goelanju23@gmail.com; Gakkhar, S., E-mail: sungkfma@iitr.ernet.in [Department of Mathematics, Indian Institute of Technology, Roorkee, Uttarakhand 247667 (India)

    2016-04-06

    In this paper, an impulsive model is discussed for an integrated pest management approach comprising of chemical and mechanical controls. The pesticides and harvesting are used to control the stage-structured pest population. The mature pest give birth to immature pest in pulses at regular intervals. The pest is controlled by spraying chemical pesticides affecting immature as well as mature pest. The harvesting of both immature and mature pest further reduce the pest population. The discrete dynamical system obtained from stroboscopic map is analyzed. The threshold conditions for stability of pest-free state as well as non-trivial period-1 solution is obtained. The effect of pesticide spray timing and harvesting on immature as well as mature pest are shown. Finally, by numerical simulation with MATLAB, the dynamical behaviors of the model is found to be complex. Above the threshold level there is a characteristic sequence of bifurcations leading to chaotic dynamics. Route to chaos is found to be period-doubling. Period halving bifurcations are also observed.

  20. Savannah River Certification Plan for newly generated, contact-handled transuranic waste

    International Nuclear Information System (INIS)

    Wierzbicki, K.S.

    1986-01-01

    This Certification Plan document describes the necessary processes and methods for certifying unclassified, newly generated, contact-handled solid transuranic (TRU) waste at the Savannah River Plant and Laboratory (SRP, SRL) to comply with the Waste Isolation Pilot Plant Waste Acceptance Criteria (WIPP-WAC). Section 2 contains the organizational structure as related to waste certification including a summary of functional responsibilities, levels of authority, and lines of communication of the various organizations involved in certification activities. Section 3 describes general plant operations and TRU waste generation. Included is a description of the TRU Waste classification system. Section 4 contains the SR site TRU Waste Quality Assurance Program Plan. Section 5 describes waste container procurement, inspection, and certification prior to being loaded with TRU waste. Certification of waste packages, after package closure in the waste generating areas, is described in Section 6. The packaging and certification of individual waste forms is described in Attachments 1-5. Included in each attachment is a description of controls used to ensure that waste packages meet all applicable waste form compliance requirements for shipment to the WIPP. 3 figs., 3 tabs

  1. Thomas Scharping, Birth Control in China, 1949-2000. Population policy and demographic development

    OpenAIRE

    Allès, Élisabeth

    2007-01-01

    Family policy and the growth of the population in China have been the subject of continuous attention for many years, but there was no research which provided an overall view of the policies and outcomes for these areas. This remarkable work by the German demographer Thomas Scharping, on birth control and demography in China from 1949 to 2000, fills this gap. It recounts and analyses demographic growth, the policies of the Chinese state in this field and the reactions of the population over t...

  2. Space outside the market: implications of NTFP certification for subsistence use (US)

    Science.gov (United States)

    Marla R. Emery

    2002-01-01

    Non-timber forest product (NTFP) certification is a market mechanism that is advanced to attain the dual goals of protecting global forests and promoting economic development (Nepstad and Schwartzman, 1992; Pierce, 1999; Viana et al, 1996). Certification criteria and indicators emphasize the rationalization and control of each step of the NTFP process from forest to...

  3. Birth Characteristics and Childhood Leukemia Risk: Correlations With Genetic Markers.

    Science.gov (United States)

    Kennedy, Amy E; Kamdar, Kala Y; Lupo, Philip J; Okcu, Mehmet F; Scheurer, Michael E; Dorak, Mehmet T

    2015-07-01

    Birth characteristics such as birth order, birth weight, birth defects, and Down syndrome showed some of the first risk associations with childhood leukemia. Examinations of correlations between birth characteristics and leukemia risk markers have been limited to birth weight-related genetic polymorphisms. We integrated information on nongenetic and genetic markers by evaluating the relationship of birth characteristics, genetic markers for childhood acute lymphoblastic leukemia (ALL) susceptibility, and ALL risk together. The multiethnic study consisted of cases with childhood ALL (n=161) and healthy controls (n=261). Birth characteristic data were collected through questionnaires, and genotyping was achieved by TaqMan SNP Genotyping Assays. We observed risk associations for birth weight over 4000 g (odds ratios [OR]=1.93; 95% confidence interval [CI], 1.16-3.19), birth length (OR=1.18 per inch; 95% CI, 1.01-1.38), and with gestational age (OR=1.10 per week; 95% CI, 1.00-1.21). Only the HFE tag single-nucleotide polymorphism (SNP) rs9366637 showed an inverse correlation with a birth characteristic, gestational age, with a gene-dosage effect (P=0.005), and in interaction with a transferrin receptor rs3817672 genotype (Pinteraction=0.05). This correlation translated into a strong association for rs9366637 with preterm birth (OR=5.0; 95% CI, 1.19-20.9). Our study provides evidence for the involvement of prenatal events in the development of childhood ALL. The inverse correlation of rs9366637 with gestational age has implications on the design of HFE association studies in birth weight and childhood conditions using full-term newborns as controls.

  4. Is Halal Certification Process “Green”?

    Directory of Open Access Journals (Sweden)

    Mohd Rizal Razalli

    2012-09-01

    Full Text Available These days, the environmental perspective on operations is becoming more common. In fact, any effort in improving efficiency in the organization is closely related to sustainability of our environment. The Environmental Management System (EMS certification such as ISO 14001 has been accepted as the world standard. In addition to these ISO standards, there are other certifications such as Halal certification. There is no research that investigates the relationship between Halal Certification process and its effect on our environment. Hence, our main research question is that is Halal Certification process can be considered as environmental friendly? In this paper, we argue that Halal Certification also contributes towards green initiatives. We used EDC-UUM as our case study. EDC-UUM is actively seeking the Halal certification from Malaysian authority agency or JAKIM. In this study, we assessed the perception of the EDC-UUM staff on the issue of going green. The findings and implications are discussed in the paper. Keywords: halal certification, hotel operations, sustainability, green

  5. Home versus hospital birth--process and outcome.

    Science.gov (United States)

    Wax, Joseph R; Pinette, Michael G; Cartin, Angelina

    2010-02-01

    A constant small, but clinically important, number of American women choose to deliver at home. Contradictory professional and public policies reflect the polarization and politicization of the controversy surrounding this birth option. Women opting for home birth seek and often attain their goals of a nonmedicalized experience in comfortable, familiar surroundings wherein they maintain situational control. However, home deliveries in developed Western nations are often associated with excess perinatal and neonatal mortality, particularly among nonanomalous term infants. On the other hand, current home birth practices are, especially when birth attendants are highly trained and fully integrated into comprehensive health care delivery systems, associated with fewer cesareans, operative vaginal deliveries, episiotomies, infections, and third and fourth degree lacerations. Newborn benefits include less meconium staining, assisted ventilation, low birth weight, prematurity, and intensive care admissions. Existing data suggest areas of future research regarding the safety of home birth in the United States. Obstetricians & Gynecologists, Family Physicians. After completion of this educational activity, the participant should be better able to assess perinatal outcomes described in the reported literature associated with home births in developed countries, list potential advantages and disadvantages of planned home births, and identify confounders in current literature that impact our thorough knowledge of home birth outcomes.

  6. Birth Weight in Type 1 Diabetic Pregnancy

    Directory of Open Access Journals (Sweden)

    Jacquemyn Yves

    2010-01-01

    Full Text Available Our aim was to investigate whether birth weight in mothers with diabetes mellitus type 1 is higher as compared to nondiabetic controls. Methods. A retrospective study was performed using an existing database covering the region of Flanders, Belgium. Data included the presence of diabetes type 1, hypertension, parity, maternal age, the use artificial reproductive technology, fetal- neonatal death, congenital anomalies, admission to a neonatal intensive care unit, and delivery by Caesarean section or vaginally. Results. In the period studied, 354 women with diabetes type 1 gave birth and were compared with 177.471 controls. Women with type 1 diabetes more often had a maternal age of over 35 years (16.7% versus 12.0%, P=.008, OR 1.46; 95% CI 1.09–1.95. They more frequently suffered hypertension in pregnancy (19.5% versus 4.7%, P<.0001, OR 4.91; 95% CI 3.73–6.44. Perinatal death was significantly higher in the diabetes mellitus group (3.05% versus 0.73%, P<.0001, OR 4.28; 95% CI 2.22–8.01. Caesarean section was performed almost 5 times as frequently in the diabetes versus the control group (OR 4.57; 95% CI 3.70–5.65. Birth weight was significantly higher in diabetic pregnant women from 33 until 38 weeks included, but those reaching 39 weeks and later were not different with control groups. Conclusion. In Belgium, diabetic pregnancy still carries a high risk for fetal and maternal complications; in general birth weight is significantly higher but for those reaching term there is no significant difference in birth weight.

  7. Births: preliminary data for 2000.

    Science.gov (United States)

    Martin, J A; Hamilton, B E; Ventura, S J

    2001-07-24

    This report presents preliminary data for 2000 on births in the United States. U.S. data on births are shown by age, race, and Hispanic origin of mother. Data on marital status, prenatal care, cesarean delivery, and low birthweight are also presented. Data in this report are based on more than 96 percent of births for 2000. The records are weighted to independent control counts of births received in State vital statistics offices in 2000. Comparisons are made with 1999 final data. The number of births rose 3 percent between 1999 and 2000. The crude birth rate increased to 14.8 per 1,000 population in 2000, 2 percent higher than the 1999 rate. The fertility rate rose 3 percent to 67.6 per 1,000 women aged 15-44 years between 1999 and 2000. The birth rate for teenagers, which has been falling since 1991, declined 2 percent in 2000 to 48.7 births per 1,000 females aged 15-19 years, another historic low. The rate for teenagers 15-17 years fell 4 percent, and the rate for 18-19 year olds was down 1 percent. Since 1991, rates have fallen 29 percent for teenagers 15-17 years and 16 percent for teenagers 18-19 years. Birth rates for all of the older age groups increased for 1999-2000: 1 percent among women aged 20-24 years, 3 percent for women aged 25-29 years, and 5 percent for women in their thirties. Rates for women aged 40-54 years were also up for 2000. The birth rate for unmarried women increased 2 percent to 45.2 births per 1,000 unmarried women aged 15-44 years in 2000, but was still lower than the peak reached in 1994. The number of births to unmarried women was up 3 percent, the highest number ever reported in the United States. However, the number of births to unmarried teenagers declined. The proportion of women who began prenatal care in the first trimester of pregnancy (83.2 percent) did not improve for 2000, nor did the rate of low birthweight (7.6 percent). The total cesarean rate rose for the fourth consecutive year to 22.9 percent, the result of both a

  8. The influence of trade associations and group certification programs on the hardwood certification movement

    Science.gov (United States)

    Iris B. Montague

    2013-01-01

    Forest certification has gained momentum around the world over the past two decades. Although there are advantages to being certified, many forest landowners and forest products manufacturers consider forest certification of U.S. forest and forest products unnecessary. Many believe that U.S. forests are already sustainably managed, the current certification systems are...

  9. Green certificates causing inconvenience?

    International Nuclear Information System (INIS)

    Torgersen, Lasse

    2002-01-01

    From early 2002, producers of green energy in selected countries have been able to benefit from generous financial support in the Netherlands. Thus, there has been increased sale of green certificates from Norway and Sweden. But the condition that physical energy delivery should accompany the certificates has caused a marked rise in the price of energy in transit through Germany to the Netherlands. This article discusses the green certificate concept and the experience gained from the Netherlands. One conclusion is that if large-scale trade with green certificates is introduced in Europe without the condition of accompanying energy delivery, then producers of hydro-electric power in Norway and Sweden may be the losers

  10. The Whys and Hows of Certification. Public Librarian Certification Law.

    Science.gov (United States)

    Wisconsin State Dept. of Public Instruction, Madison. Div. of Library Services.

    Under Wisconsin state law (Administrative Code P1-6.03) any librarian employed in a public library system or any municipal public library, except in a city of the first class, supported in whole or in part by public funds, must hold state certification. Qualifications are delineated for three grades of certification: grade 1, for public libraries…

  11. 40 CFR 85.1410 - Changes after certification.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 18 2010-07-01 2010-07-01 false Changes after certification. 85.1410 Section 85.1410 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM MOBILE SOURCES Urban Bus Rebuild Requirements § 85.1410 Changes...

  12. Time from cervical conization to pregnancy and preterm birth.

    Science.gov (United States)

    Himes, Katherine P; Simhan, Hyagriv N

    2007-02-01

    To estimate whether the time interval between cervical conization and subsequent pregnancy is associated with risk of preterm birth. Our study is a case control study nested in a retrospective cohort. Women who underwent colposcopic biopsy or conization with loop electrosurgical excision procedure, large loop excision of the transformation zone, or cold knife cone and subsequently delivered at our hospital were identified with electronic databases. Variables considered as possible confounders included maternal race, age, marital status, payor status, years of education, self-reported tobacco use, history of preterm delivery, and dimensions of cone specimen. Conization was not associated with preterm birth or any subtypes of preterm birth. Among women who underwent conization, those with a subsequent preterm birth had a shorter conization-to-pregnancy interval (337 days) than women with a subsequent term birth (581 days) (P=.004). The association between short conization-to-pregnancy interval and preterm birth remained significant when controlling for confounders including race and cone dimensions. The effect of short conization-to-pregnancy interval on subsequent preterm birth was more persistent among African Americans when compared with white women. Women with a short conization-to-pregnancy interval are at increased risk for preterm birth. Women of reproductive age who must have a conization procedure can be counseled that conceiving within 2 to 3 months of the procedure may be associated with an increased risk of preterm birth. II.

  13. Birth Defects

    Science.gov (United States)

    A birth defect is a problem that happens while a baby is developing in the mother's body. Most birth defects happen during the first 3 months of ... in the United States is born with a birth defect. A birth defect may affect how the ...

  14. 40 CFR 745.89 - Firm certification.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Firm certification. 745.89 Section 745... § 745.89 Firm certification. (a) Initial certification. (1) Firms that perform renovations for compensation must apply to EPA for certification to perform renovations or dust sampling. To apply, a firm must...

  15. Male scarcity is associated with higher prevalence of premature gestation and low birth weight births across the United States.

    Science.gov (United States)

    Kruger, Daniel J; Clark, Jillian; Vanas, Sarah

    2013-01-01

    Modern adverse birth outcomes may partially result from mechanisms evolved to evaluate environmental conditions and regulate maternal investment trade-offs. Male scarcity in a population is associated with a cluster of characteristics related to higher mating effort and lower paternal investment. We predicted that modern populations with male scarcity would have shorter gestational times and lower birth weights on average. We compared US Centers for Disease Control and Prevention county-aggregated year 2000 birth records with US Decennial Census data. We combined these data in a path model with the degree of male scarcity and known socio-economic predictors of birth outcomes as exogenous predictors of prematurity and low birth weight, with single mother households as a proportion of families with children as a mediator (N = 450). Male scarcity was directly associated with higher rates of low birth weight. Male scarcity made significant indirect predictions of rates of prematurity and low birth weight, as mediated by the proportion of families headed by single mothers. Aggregate socio-economic status also indirectly predicted birth outcomes, as mediated by the proportion of families headed by single mothers, whereas the proportion African American retained both direct and indirect predictions of adverse birth outcomes. Male scarcity influences life history tradeoffs, with consequences for important social and public health issues such as adverse birth outcomes. Copyright © 2013 Wiley Periodicals, Inc.

  16. 40 CFR 85.1406 - Certification.

    Science.gov (United States)

    2010-07-01

    ... POLLUTION FROM MOBILE SOURCES Urban Bus Rebuild Requirements § 85.1406 Certification. (a) Certification... provide some level of particulate emission reduction, and will not cause the urban bus engine to fail to... urban bus engines. (c) Test equipment selection. Certification shall be based upon tests utilizing...

  17. Certification trails for data structures

    Science.gov (United States)

    Sullivan, Gregory F.; Masson, Gerald M.

    1993-01-01

    Certification trails are a recently introduced and promising approach to fault detection and fault tolerance. The applicability of the certification trail technique is significantly generalized. Previously, certification trails had to be customized to each algorithm application; trails appropriate to wide classes of algorithms were developed. These certification trails are based on common data-structure operations such as those carried out using these sets of operations such as those carried out using balanced binary trees and heaps. Any algorithms using these sets of operations can therefore employ the certification trail method to achieve software fault tolerance. To exemplify the scope of the generalization of the certification trail technique provided, constructions of trails for abstract data types such as priority queues and union-find structures are given. These trails are applicable to any data-structure implementation of the abstract data type. It is also shown that these ideals lead naturally to monitors for data-structure operations.

  18. Enforcement/certification program for appliance efficiency standards. Task II, report

    Energy Technology Data Exchange (ETDEWEB)

    1979-09-28

    The research and analysis program at Vitro Labs. in support of the appliance certification and enforcement program provides Vitro's recommended approach to appliance certification and enforcement (C/E). The approach established the C/E program framework, general criteria, and procedures for assuring a specified level of energy-efficiency performance for 13 categories of consumer products (furnaces, humidifiers, dehumidifiers, dishwashers, television, clothes washers, freezers, air conditioners, stoves, refrigerators, water heaters). Section 2 summarizes the recommended approach. Section 3 contains detailed evaluations and comparisons for four independent alternative approaches considered (minimal government intevention, strong certification control, strong enforcement audit, and mixed certification/enforcement). The fifth C/E approach (strong remedy/deterrent) involves the remedies available to the government should non-compliance be discovered and could affect the choice among the approaches, but this approach has not been evaluated. Section 4 summarizes the analysis methodology used to select the recommended approach. Additional information is provided in 6 appendices.

  19. Season of birth and multiple sclerosis in Tunisia.

    Science.gov (United States)

    Sidhom, Youssef; Kacem, Imen; Bayoudh, Lamia; Ben Djebara, Mouna; Hizem, Yosr; Ben Abdelfettah, Sami; Gargouri, Amina; Gouider, Riadh

    2015-11-01

    Recent studies on date of birth of multiple sclerosis (MS) patients showed an association between month of birth and the risk of developing MS. This association has not been investigated in an African country. We aimed to determine if the risk of MS is associated with month of birth in Tunisia. Data concerning date of birth for MS patients in Tunisia (n = 1912) was obtained. Birth rates of MS patients were compared with all births in Tunisia matched by year of birth (n = 11,615,912). We used a chi-squared analysis and the Hewitt's non-parametric test for seasonality. The distribution of births among MS patients compared with the control population was not different when tested by the chi-squared test. The Hewitt's test for seasonality showed an excess of births between May and October among MS patients (p = 0.03). The peak of Births of MS patients in Tunisia was in July and the nadir in December. Our data does support the seasonality hypothesis of month of birth as risk factor for MS in Tunisia. Low vitamin D levels during pregnancy could be a possible explanation that needs further investigation. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Very Low Birth Weight and Perinatal Periods of Risk: Disparities in St. Louis

    Directory of Open Access Journals (Sweden)

    Pamela Xaverius

    2014-01-01

    Full Text Available Objective. Very low birth weight (VLBW is a significant issue in St. Louis, Missouri. Our study evaluated risk factors associated with VLBW in this predominantly urban community. Methods. From 2000 to 2009, birth and fetal death certificates were evaluated (n=160, 189, and mortality rates were calculated for perinatal periods of risk. The Kitagawa method was used to explore fetoinfant mortality rates (FIMR in terms of birth weight distribution and birthweight specific mortality. Multivariable logistic regression was used to assess the magnitude of association of selected risk factors with VLBW. Results. VLBW contributes to 50% of the excess FIMR in St. Louis City and County. The highest proportion of VLBW can be attributed to black maternal race (40.6% in St. Louis City, inadequate prenatal care (19.8%, and gestational hypertension (12.0% among black women. Medicaid was found to have a protective effect for VLBW among black women (population attributable risk (PAR = −14.5. Discussion. Interventions targeting the health of women before and during conception may be most successful at reducing the disparities in VLBW in this population. Interventions geared towards smoking cessation and improvements in Medicaid and prenatal care access for black mothers and St. Louis City residents can greatly reduce VLBW rates.

  1. Identifying areas at risk of low birth weight using spatial epidemiology: A small area surveillance study.

    Science.gov (United States)

    Insaf, Tabassum Z; Talbot, Thomas

    2016-07-01

    To assess the geographic distribution of Low Birth Weight (LBW) in New York State among singleton births using a spatial regression approach in order to identify priority areas for public health actions. LBW was defined as birth weight less than 2500g. Geocoded data from 562,586 birth certificates in New York State (years 2008-2012) were merged with 2010 census data at the tract level. To provide stable estimates and maintain confidentiality, data were aggregated to yield 1268 areas of analysis. LBW prevalence among singleton births was related with area-level behavioral, socioeconomic and demographic characteristics using a Poisson mixed effects spatial error regression model. Observed low birth weight showed statistically significant auto-correlation in our study area (Moran's I 0.16 p value 0.0005). After over-dispersion correction and accounting for fixed effects for selected social determinants, spatial autocorrelation was fully accounted for (Moran's I-0.007 p value 0.241). The proportion of LBW was higher in areas with larger Hispanic or Black populations and high smoking prevalence. Smoothed maps with predicted prevalence were developed to identify areas at high risk of LBW. Spatial patterns of residual variation were analyzed to identify unique risk factors. Neighborhood racial composition contributes to disparities in LBW prevalence beyond differences in behavioral and socioeconomic factors. Small-area analyses of LBW can identify areas for targeted interventions and display unique local patterns that should be accounted for in prevention strategies. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  2. 7 CFR 253.7 - Certification of households.

    Science.gov (United States)

    2010-01-01

    ... savings accounts, savings certificates, stocks, or bonds, or other readily negotiable instruments exceeds... duration of the disqualification (that is, 12 months; 24 months; or permanent). The State agency must also... agency conference. (Approved by the Office of Management and Budget under control number 0584-0071) (44 U...

  3. Board Certification in Counseling Psychology

    Science.gov (United States)

    Crowley, Susan L.; Lichtenberg, James W.; Pollard, Jeffrey W.

    2012-01-01

    Although specialty board certification by the American Board of Professional Psychology (ABPP) has been a valued standard for decades, the vast majority of counseling psychologists do not pursue board certification in the specialty. The present article provides a brief history of board certification in general and some historical information about…

  4. Primary birthing attendants and birth outcomes in remote Inuit communities—a natural “experiment” in Nunavik, Canada

    Science.gov (United States)

    Simonet, F; Wilkins, R; Labranche, E; Smylie, J; Heaman, M; Martens, P; Fraser, W D; Minich, K; Wu, Y; Carry, C; Luo, Z-C

    2010-01-01

    Background There is a lack of data on the safety of midwife-led maternity care in remote or indigenous communities. In a de facto natural “experiment”, birth outcomes were assessed by primary birthing attendant in two sets of remote Inuit communities. Methods A geocoding-based retrospective birth cohort study in 14 Inuit communities of Nunavik, Canada, 1989–2000: primary birth attendants were Inuit midwives in the Hudson Bay (1529 Inuit births) vs western physicians in Ungava Bay communities (1197 Inuit births). The primary outcome was perinatal death. Secondary outcomes included stillbirth, neonatal death, post-neonatal death, preterm, small-for-gestational-age and low birthweight birth. Multilevel logistic regression was used to obtain the adjusted odds ratios (aOR) controlling for maternal age, marital status, parity, education, infant sex and plurality, community size and community-level random effects. Results The aORs (95% confidence interval) for perinatal death comparing the Hudson Bay vs Ungava Bay communities were 1.29 (0.63 to 2.64) for all Inuit births and 1.13 (0.48 to 2.47) for Inuit births at ≥28 weeks of gestation. There were no statistically significant differences in the crude or adjusted risks of any of the outcomes examined. Conclusion Risks of perinatal death were somewhat but not significantly higher in the Hudson Bay communities with midwife-led maternity care compared with the Ungava Bay communities with physician-led maternity care. These findings are inconclusive, although the results excluding extremely preterm births are more reassuring concerning the safety of midwife-led maternity care in remote indigenous communities. PMID:19286689

  5. Metabolomic profiling in blood from umbilical cords of low birth weight newborns

    Directory of Open Access Journals (Sweden)

    Ivorra Carmen

    2012-07-01

    Full Text Available Abstract Background Low birth weight has been linked to an increased risk to develop obesity, type 2 diabetes, and hypertension in adult life, although the mechanisms underlying the association are not well understood. The objective was to determine whether the metabolomic profile of plasma from umbilical cord differs between low and normal birth weight newborns. Methods Fifty healthy pregnant women and their infants were selected. The eligibility criteria were being born at term and having a normal pregnancy. Pairs were grouped according to their birth weight: low birth weight (LBW, birth weight th percentile, n = 20 and control (control, birth weight between the 75th-90th percentiles, n = 30. Nuclear Magnetic Resonance (NMR was used to generate metabolic fingerprints of umbilical cord plasma samples. Simultaneously, the metabolomic profiles of the mothers were analysed. The resulting data were subjected to chemometric, principal component and partial least squares discriminant analyses. Results Umbilical cord plasma from LBW and control newborns displayed a clearly differentiated metabolic profile. Seven metabolites were identified that discriminate the LBW from the control group. LBW newborns had lower levels of choline, proline, glutamine, alanine and glucose than did the control newborns, while plasma levels of phenylalanine and citrulline were higher in LBW newborns (p Conclusions Low birth weight newborns display a differential metabolomic profile than those of normal birth weight, a finding not present in the mothers. The meaning and the potential utility of the findings as biomarkers of risk need to be addressed in future studies.

  6. Cost-effectiveness of planned birth in a birth centre compared with alternative planned places of birth: Results of the Dutch Birth Centre study

    NARCIS (Netherlands)

    M.F. Hitzert (Marit); M.A.A. Hermus (Marieke A.A.); Boesveld, I.I.C. (Inge I.C.); A. Franx (Arie); K.M. van der Pal-De Bruin (Karin); E.A.P. Steegers (Eric); Van Den Akker-Van Marle, E.M.E. (Eiske M.E.)

    2017-01-01

    textabstractObjectives To estimate the cost-effectiveness of a planned birth in a birth centre compared with alternative planned places of birth for low-risk women. In addition, a distinction has been made between different types of locations and integration profiles of birth centres. Design

  7. Risk Factors for premature birth in a hospital 1

    OpenAIRE

    Ahumada-Barrios, Margarita E.; Alvarado, German F.

    2016-01-01

    Abstract Objective: to determine the risk factors for premature birth. Methods: retrospective case-control study of 600 pregnant women assisted in a hospital, with 298 pregnant women in the case group (who gave birth prematurely

  8. Are all immigrant mothers really at risk of low birth weight and perinatal mortality? The crucial role of socio-economic status.

    Science.gov (United States)

    Racape, Judith; Schoenborn, Claudia; Sow, Mouctar; Alexander, Sophie; De Spiegelaere, Myriam

    2016-04-08

    Increasing studies show that immigrants have different perinatal health outcomes compared to native women. Nevertheless, we lack a systematic examination of the combined effects of immigrant status and socioeconomic factors on perinatal outcomes. Our objectives were to analyse national Belgian data to determine 1) whether socioeconomic status (SES) modifies the association between maternal nationality and perinatal outcomes (low birth weight and perinatal mortality); 2) the effect of adopting the Belgian nationality on the association between maternal foreign nationality and perinatal outcomes. This study is a population-based study using the data from linked birth and death certificates from the Belgian civil registration system. Data are related to all singleton births to mothers living in Belgium between 1998 and 2010. Perinatal mortality and low birth weight (LBW) were estimated by SES (maternal education and parental employment status) and by maternal nationality (at her own birth and at her child's birth). We used logistic regression to estimate the odds ratios for the associations between nationality and perinatal outcomes after adjusting for and stratifying by SES. The present study includes, for the first time, all births in Belgium; that is 1,363,621 singleton births between 1998 and 2010. Compared to Belgians, we observed an increased risk of perinatal mortality in all migrant groups (p order to understand more fully the relationship between migration and perinatal outcomes. Further studies are needed to analyse more finely the impact of socio-economic characteristics on perinatal outcomes.

  9. Maternal residential proximity to chlorinated solvent emissions and birth defects in offspring: a case-control study.

    Science.gov (United States)

    Brender, Jean D; Shinde, Mayura U; Zhan, F Benjamin; Gong, Xi; Langlois, Peter H

    2014-11-19

    Some studies have noted an association between maternal occupational exposures to chlorinated solvents and birth defects in offspring, but data are lacking on the potential impact of industrial air emissions of these solvents on birth defects. With data from the Texas Birth Defects Registry for births occurring in 1996-2008, we examined the relation between maternal residential proximity to industrial air releases of chlorinated solvents and birth defects in offspring of 60,613 case-mothers and 244,927 control-mothers. Maternal residential exposures to solvent emissions were estimated with metrics that took into account residential distances to industrial sources and annual amounts of chemicals released. Logistic regression was used to generate odds ratios and 95% confidence intervals for the associations between residential proximity to emissions of 14 chlorinated solvents and selected birth defects, including neural tube, oral cleft, limb deficiency, and congenital heart defects. All risk estimates were adjusted for year of delivery and maternal age, education, race/ethnicity, and public health region of residence. Relative to exposure risk values of 0, neural tube defects were associated with maternal residential exposures (exposure risk values >0) to several types of chlorinated solvents, most notably carbon tetrachloride (adjusted odds ratio [aOR] 1.42, 95% confidence interval [CI] 1.09, 1.86); chloroform (aOR 1.40, 95% CI 1.04, 1.87); ethyl chloride (aOR 1.39, 95% CI 1.08, 1.79); 1,1,2-trichloroethane (aOR 1.56, 95% CI 1.11, 2.18); and 1,2,3-trichloropropane (aOR 1.49, 95% CI 1.08, 2.06). Significant associations were also noted between a few chlorinated solvents and oral cleft, limb deficiency, and congenital heart defects. We observed stronger associations between some emissions and neural tube, oral cleft, and heart defects in offspring of mothers 35 years or older, such as spina bifida with carbon tetrachloride (aOR 2.49, 95% CI 1.09, 5.72), cleft palate

  10. Cost-effectiveness of planned birth in a birth centre compared with alternative planned places of birth: results of the Dutch Birth Centre study

    NARCIS (Netherlands)

    Hitzert, M.; Hermus, M.M.; Boesveld, I.I.; Franx, A.; Pal-de Bruin, K.K. van der; Steegers, E.E.; Akker-van Marle, E.M. van den

    2017-01-01

    Objectives To estimate the cost-effectiveness of a planned birth in a birth centre compared with alternative planned places of birth for low-risk women. In addition, a distinction has been made between different types of locations and integration profiles of birth centres. Design Economic evaluation

  11. Cost-effectiveness of planned birth in a birth centre compared with alternative planned places of birth : Results of the Dutch Birth Centre study

    NARCIS (Netherlands)

    Hitzert, Marit F.; Hermus, Marieke A. A.; Boesveld, Inge I.C.; Franx, Arie; van der Pal-de Bruin, Karin M.; Steegers, Eric A. P.; Van Den Akker-Van Marle, Eiske M.E.

    2017-01-01

    Objectives To estimate the cost-effectiveness of a planned birth in a birth centre compared with alternative planned places of birth for low-risk women. In addition, a distinction has been made between different types of locations and integration profiles of birth centres. Design Economic evaluation

  12. Continuous training and certification in neonatal resuscitation in remote areas using a multi-platform information and communication technology intervention, compared to standard training: A randomized cluster trial study protocol [version 3; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Delgado

    2018-03-01

    Full Text Available Background: About 10% of all newborns may have difficulty breathing and require support by trained personnel. In Peru, 90% of deliveries occur in health facilities. However, there is not a national neonatal resuscitation and certification program for the public health sector. In addition, the Andes and the Amazon regions concentrate large rural remote areas, which further limit the implementation of training programs and the accomplishment of continuous certification. Neonatal resuscitation training through the use of information, communication and technology (ICT tools running on computers, tablets or mobile phones, may overcome such limitations. This strategy allows online and offline access to educational resources, paving the way to more frequent and efficient training and certification processes. Objective: To evaluate the effects of a neonatal resuscitation training and certification program that uses a multi-platform ICT (MP-ICT strategy on neonatal health care in remote areas. Methods: We propose to conduct the study through a cluster-randomized trial, where the study and analysis unit is the health care facility. Eligible facilities will include primary and secondary health care level facilities that are located in provinces with neonatal mortality rates higher than 15 per 1,000 live births. We will compare the proportion of newborns with a heart rate ≥100 beats per minute at two minutes after birth in health care facilities that receive MP-ICT training and certification implementation, with those that receive standard training and certification. Discussion: We expect that the intervention will be shown as more effective than the current standard of care. We are prepared to include it within a national neonatal resuscitation training and certification program to be implemented at national scale together with policymakers and other key stakeholders.  Trial registration: ClinicalTrials.gov Nº NCT03210194  Status of the study: This

  13. ENVIRONMENTAL MANAGEMENT SYSTEMS CERTIFICATION

    Directory of Open Access Journals (Sweden)

    Aniko Miler-Virc

    2012-12-01

    Full Text Available ISO 14001 prescribes the requirements for a system, not environmental performance itself. Similarly, certification is of the management system itself, not environmental performance. An audit is not conducted to ascertain whether your flue gas emissions are less than X part per million nitrous oxide or that your wastewater effluent contains less that Y milligrams of bacteria per litre. Consequently, the procces of auditing the system for compliance to the standard entails checking to see that all of the necessary components of a functioning system are present and working properly.           A company can have a complete and fully functional EMS as prescribed by ISO 14001 without being certified. As certification can add to the time and expense of EMS development, it is important for you to establish, in advance, whether certification is of net benefit to you. Although most companies that develop an EMS do in fact certify, there are cases where certification does not add immediate value. Certification is not always beneficial to small and medium sized companies. Certification is not always necessary for companies with one or two large clients with environmental demands who are satisfied that you have a functional EMS (second-party declaration. Whatever decision you make, it is important to remember that just as a driver′s licence does not automatically make you a good driver, ISO 14001 certification does not automatically make your company environmentally benign or ensure that you will continually improve environmental performance. The system is only as good as the people who operate it.

  14. What we don't know can hurt us: Nonresponse bias assessment in birth defects research.

    Science.gov (United States)

    Strassle, Paula D; Cassell, Cynthia H; Shapira, Stuart K; Tinker, Sarah C; Meyer, Robert E; Grosse, Scott D

    2015-07-01

    Nonresponse bias assessment is an important and underutilized tool in survey research to assess potential bias due to incomplete participation. This study illustrates a nonresponse bias sensitivity assessment using a survey on perceived barriers to care for children with orofacial clefts in North Carolina. Children born in North Carolina between 2001 and 2004 with an orofacial cleft were eligible for inclusion. Vital statistics data, including maternal and child characteristics, were available on all eligible subjects. Missing 'responses' from nonparticipants were imputed using assumptions based on the distribution of responses, survey method (mail or phone), and participant maternal demographics. Overall, 245 of 475 subjects (51.6%) responded to either a mail or phone survey. Cost as a barrier to care was reported by 25.0% of participants. When stratified by survey type, 28.3% of mail respondents and 17.2% of phone respondents reported cost as a barrier. Under various assumptions, the bias-adjusted estimated prevalence of cost as barrier to care ranged from 16.1% to 30.0%. Maternal age, education, race, and marital status at time of birth were not associated with subjects reporting cost as a barrier. As survey response rates continue to decline, the importance of assessing the potential impact of nonresponse bias has become more critical. Birth defects research is particularly conducive to nonresponse bias analysis, especially when birth defect registries and birth certificate records are used. Future birth defect studies which use population-based surveillance data and have incomplete participation could benefit from this type of nonresponse bias assessment. Birth Defects Research (Part A) 103:603-609, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  15. Certificate Transparency with Privacy

    Directory of Open Access Journals (Sweden)

    Eskandarian Saba

    2017-10-01

    Full Text Available Certificate transparency (CT is an elegant mechanism designed to detect when a certificate authority (CA has issued a certificate incorrectly. Many CAs now support CT and it is being actively deployed in browsers. However, a number of privacy-related challenges remain. In this paper we propose practical solutions to two issues. First, we develop a mechanism that enables web browsers to audit a CT log without violating user privacy. Second, we extend CT to support non-public subdomains.

  16. An original tool for checking energy performance and certification of buildings by means of Artificial Neural Networks

    International Nuclear Information System (INIS)

    Buratti, C.; Barbanera, M.; Palladino, D.

    2014-01-01

    Highlights: • ANN used as a tool for evaluating energy performance of buildings. • Training, validation, and testing of Neural Network with real energy certificates data. • Global energy performance index was chosen as a target of ANN. • A good correlation and a minimum error was found with certificates data. • A new energy index was defined in order to check the energy certificates. - Abstract: The Energy Performance Buildings Directive (EPBD) was issued to provide a common strategy for all European countries and to implement several actions for improving energy efficiency of buildings, responsible for 40% of energy consumption. Energy Performance Certificates are provided as a tool to evaluate the energy performance of buildings; however, costly and time-consuming controls are necessary to verify the accuracy of the set and declared data. Useful tools could be the Artificial Neural Networks (ANN), whereby it is possible to estimate the energy consumptions from specific parameters, to evaluate the accuracy of data in the energy certificates, and to identify the certificates needing accurate control. In this study, an Artificial Neural Network was developed based on approximately 6500 energy certificates (2700 are self-declaration) received by the Umbria Region (central Italy), in order to evaluate the global energy consumption of buildings from several and specific parameters reported in certificates. Data was checked in compliance with energy standards and only the correct certificates were used to train the Neural Network. The implemented Neural Network was tested with database data and a good correlation was found; in particular the energy performance calculated with the Neural Network presents an error greater than 15 kW h/m 2 year with respect to the real value of global energy performance index in only 3.6% of cases. Finally, a Neural Energy Performance Index (N.E.P.I.) was defined, in order to verify the accuracy of the energy certificates; the

  17. [Family planning programs and birth control in the third world].

    Science.gov (United States)

    Wohlschlagl, H

    1991-01-01

    The population explosion has been abating since the 2nd half of the 1960s. The birth rate of the 3rd World dropped from 45/1000 during 1950-55 to 31/1000 during 1985-90. From the 1st half of the 1960s to the 1st half of the 1980s the total fertility of such countries dropped from 6.1 to 4.2 children/woman. In Taiwan, Singapore, Hong Kong, South Korea, and Malaysia living standards improved as a result of industrialization, and fertility decreased significantly. In Sri Lanka, China, North Vietnam, and Thailand the drop of fertility is explained by cultural and religious factors. In 1982 about 78% of the population of developing countries lived in 39 states that followed an official policy aimed at reducing the population. Another 16% lived in countries supporting the concept of a desired family size. However, World Bank data showed that in the mid-1980s in 27 developing countries no state family planning (FP) programs existed. India adopted an official FP program in 1952, Pakistan followed suit in 1960, South Korea in 1961, and China in 1962. In Latin America a split policy manifested itself: in Brazil birth control was rejected, only Colombia had a FP policy. In 1986 the governments of 68 of 131 developing countries representing 3.1 billion people considered the number of children per woman too high. 31 of these countries followed concrete population control policies. On the other hand, in 1986 24 countries of Africa with 40% of the continent's population took no measures to influence population growth. In Latin America and the Caribbean 18 of 33 countries were idle, except for Mexico that had a massive state FP program. These programs also improve maternal and child health with birth spacing of at least 2 years, and the prevention of pregnancies of too young women or those over 40. The evaluation of rapidly spreading FP programs in the 1970s was carried out by the World Fertility Survey in 41 countries. The impact of FP programs was more substantial than

  18. Transit management certificate program.

    Science.gov (United States)

    2012-07-01

    TTI worked closely with the Landscape Architecture and Urban Planning Department : (LAUP) of Texas A&M University (TAMU) to develop a transit management certificate : focus for the current Graduate Certificate in Transportation Planning (CTP) housed ...

  19. Maternal employment and birth outcomes

    DEFF Research Database (Denmark)

    Wüst, Miriam

    selection of mothers between pregnancies drives the results, I focus on mothers whose change in employment status is likely not to be driven by underlying health (unemployed mothers and students). Given generous welfare bene ts and strict workplace regulations in Denmark, my findings support a residual......I use Danish survey and administrative data to examine the impact of maternal employment during pregnancy on birth outcomes. As healthier mothers are more likely to work and health shocks to mothers may impact employment and birth outcomes, I combine two strategies: First, I control extensively...... for time-varying factors that may correlate with employment and birth outcomes, such as pre-pregnancy family income and maternal occupation, pregnancy-related health shocks, maternal sick listing, and health behaviors (smoking and alcohol consumption). Second, to account for remaining time...

  20. Relationship between Maternal Serum Copper Level and Birth Weight Neonate

    Directory of Open Access Journals (Sweden)

    Mirzarahimi M

    2012-01-01

    Full Text Available Background and Objectives: Low birth weight (LBW is a major public health problem. LBW is associated with increased neonatal morbidity and mortality. There is no consensus in the literature as to whether maternal copper nutrition is associated with pregnancy outcome or fetal growth. Methods: This case-control study was carried out at Alavi Hospital in Ardabil between August 2008 and August 2009. 56 women who had delivered low-birth- weight infants (<2500gr were taken as the case group, and from the mothers who had delivered normal birth weight infants (≥2500gr, 56 were selected at random as the control group. Venous blood samples were obtained from the mothers. Serum zinc level was determined by the Atomic Absorption Spectrophotometer method.Results: Mean of birth weight in infants, maternal age, body mass index in mothers and socioeconomic or demographic factors did not differ between cases and control groups. Maternal copper concentration (μg/dl differed between Cases and Controls; 231.75±38.12μg/dl vs. 204.42±31.30μg/dl respectively. There is a significant difference (p<0.001 in the serum copper concentration between the two groups.Conclusion: There is a negative relation between low infant birth weight and maternal copper concentration.

  1. General practitioners' use of sickness certificates.

    Science.gov (United States)

    Roope, Richard; Parker, Gordon; Turner, Susan

    2009-12-01

    At present, sickness certification is largely undertaken by general practitioners (GPs). Guidance from the Department of Work and Pensions (DWP) is available to help with this task; however, there has been little formal evaluation of the DWP's guidance in relation to day-to-day general practice. To assess GPs' training, knowledge and application of the DWP's sickness certification guidelines. A structured questionnaire was sent to GPs within a (former) primary care trust (PCT). It probed demographics, training and knowledge of sickness certification guidelines. Case histories and structured questions were used to assess current practice. In this group of 113 GPs, there was a low awareness and use of the DWP's guidelines and Website relating to sickness certification. The majority of the GPs (63%) had received no training in sickness certification, and the mean length of time for those who had received training was 4.1 h. Most GPs also felt that patients and GPs have equal influence on the duration of sickness certification. This evidence of variable practice indicates that GPs should have more guidance and education in sickness certification. Closer sickness certification monitoring through existing GP computer systems may facilitate an improvement in practice that benefits patients and employers. The DWP, medical educators and PCTs may all have an additional role in further improving sickness certification practice.

  2. 5 CFR Appendix A to Part 2634 - Certificate of Independence (Form Approved: OMB Control No. 3209-0007)

    Science.gov (United States)

    2010-01-01

    ... GOVERNMENT ETHICS GOVERNMENT ETHICS EXECUTIVE BRANCH FINANCIAL DISCLOSURE, QUALIFIED TRUSTS, AND CERTIFICATES... submitted to the Office of Government Ethics for certification pursuant to the Ethics in Government Act of... interested party, and is not a partner of, or involved in any joint venture or other investment or business...

  3. Healthcare teams over the Internet: programming a certificate-based approach.

    Science.gov (United States)

    Georgiadis, Christos K; Mavridis, Ioannis K; Pangalos, George I

    2003-07-01

    Healthcare environments are a representative case of collaborative environments since individuals (e.g. doctors) in many cases collaborate in order to provide care to patients in a more proficient way. At the same time modern healthcare institutions are increasingly interested in sharing access of their information resources in the networked environment. Healthcare applications over the Internet offer an attractive communication infrastructure at worldwide level but with a noticeably great factor of risk. Security has, therefore, become a major concern. However, although an adequate level of security can be relied upon digital certificates, if an appropriate security model is used, additional security considerations are needed in order to deal efficiently with the above team-work concerns. The already known Hybrid Access Control (HAC) security model supports and handles efficiently healthcare teams with active security capabilities and is capable to exploit the benefits of certificate technology. In this paper we present the way for encoding the appropriate authoritative information in various types of certificates, as well as the overall operational architecture of the implemented access control system for healthcare collaborative environments over the Internet. A pilot implementation of the proposed methodology in a major Greek hospital has shown the applicability of the proposals and the flexibility of the access control provided.

  4. Healthcare teams over the Internet: towards a certificate-based approach.

    Science.gov (United States)

    Georgiadis, Christos K; Mavridis, Ioannis K; Pangalos, George I

    2002-01-01

    Healthcare environments are a representative case of collaborative environments since individuals (e.g. doctors) in many cases collaborate in order to provide care to patients in a more proficient way. At the same time modem healthcare institutions are increasingly interested in sharing access of their information resources in the networked environment. Healthcare applications over the Internet offer an attractive communication infrastructure at worldwide level but with a noticeably great factor of risk. Security has therefore become a major concern for healthcare applications over the Internet. However, although an adequate level of security can be relied upon digital certificates, if an appropriate security policy is used, additional security considerations are needed in order to deal efficiently with the above team-work concerns. The already known Hybrid Access Control security model supports and handles efficiently healthcare teams with active security capabilities and is capable to exploit the benefits of certificate technology. In this paper we present the way for encoding the appropriate authoritative information in various types of certificates, as well as the overall operational architecture of the implemented access control system for healthcare collaborative environments over the Internet. A pilot implementation of the proposed methodology in a major Greek hospital has shown the applicability of the proposals and the flexibility of the access control provided.

  5. Birth weight and stuttering: Evidence from three birth cohorts.

    Science.gov (United States)

    McAllister, Jan; Collier, Jacqueline

    2014-03-01

    Previous studies have produced conflicting results with regard to the association between birth weight and developmental stuttering. This study sought to determine whether birth weight was associated with childhood and/or adolescent stuttering in three British birth cohort samples. Logistic regression analyses were carried out on data from the Millenium Cohort Study (MCS), British Cohort Study (BCS70) and National Child Development Study (NCDS), whose initial cohorts comprised over 56,000 individuals. The outcome variables were parent-reported stuttering in childhood or in adolescence; the predictors, based on prior research, were birth weight, sex, multiple birth status, vocabulary score and mother's level of education. Birth weight was analysed both as a categorical variable (low birth weight, stuttering during childhood (age 3, 5 and 7 and MCS, BCS70 and NCDS, respectively) or at age 16, when developmental stuttering is likely to be persistent. None of the multivariate analyses revealed an association between birth weight and parent-reported stuttering. Sex was a significant predictor of stuttering in all the analyses, with males 1.6-3.6 times more likely than females to stutter. Our results suggest that birth weight is not a clinically useful predictor of childhood or persistent stuttering. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Birth spacing and neonatal mortality in India : Dynamics, frailty and fecundity

    NARCIS (Netherlands)

    Bhalotra, S.; van Soest, A.H.O.

    2008-01-01

    Using microdata on 30,000 child births in India and dynamic panel data models, we analyze causal effects of birth spacing on subsequent neonatal mortality and of mortality on subsequent birth intervals, controlling for unobserved heterogeneity. Right censoring is accounted for by jointly estimating

  7. Outcomes of independent midwifery attended births in birth centres and home births: a retrospective cohort study in Japan.

    Science.gov (United States)

    Kataoka, Yaeko; Eto, Hiromi; Iida, Mariko

    2013-08-01

    the objective of this study was to describe and compare perinatal and neonatal outcomes of women who received care from independent midwives practicing home births and at birth centres in Tokyo. a retrospective cohort study. birth centres and homes serviced by independent midwives in Tokyo. of the 43 eligible independent midwives 19 (44%) (10 assisted birth at birth centres, nine assisted home birth) participated in the study. A total of 5477 women received care during their pregnancy and gave birth assisted by these midwives between 2001 and 2006. researchers conducted a retrospective chart review of women's individual data. Collected data included demographic characteristics, process of pregnancy and perinatal and neonatal outcomes. We also collected data about independent midwives and their practice. of the 5477 women, 83.9% gave birth at birth centres and 16.1% gave birth at home. The average age was 31.7 years old and the majority (70.6%) were multiparas. All women had vaginal spontaneous deliveries, with no vacuum, forceps or caesarean section interventions. No maternal fatalities were reported, nor were breech or multiple births. The average duration of the first and second stages of labour was 14.9 hours for primiparas and 6.2 hours for multiparas. Most women (97.1%) gave birth within 24 hours of membrane rupture. Maternal position during labour varied and family attended birth was common. The average blood loss was 371.3mL, while blood loss over 500mL was 22.6% and over 1000mL was 3.6%. Nearly 60% of women had intact perinea. There were few preterm births (0.6%) and post mature births (1.3%). Infant's average birth weight was 3126g and 0.5% were low-birthweight-infants, while 3.3% had macrosomia. Among primiparas, the birth centre group had more women experiencing an excess of 500mL blood loss compared to the home birth group (27.2% versus 17.6% respectively; RR 1.54; 95%CI 1.10 to 2.16). Multiparas delivering at birth centres were more likely to have a

  8. Current experience concerning Romanian green certificates market functioning

    International Nuclear Information System (INIS)

    Vladescu, Gherghina; Lupului, Luminita; Vasilevschi, Constantin; Ghinea, Smaranda

    2006-01-01

    The renewable energy sources are promoted by their beneficial use, namely: - diversification of energy sources for producing electric power; - reduction of pollution produced by fossil fuel burning; - reduction of gas releases producing the greenhouse effects, etc. Currently, most of the renewable energy sources cannot concur on electric power free market because of the high costs of implied investments. To ensure an efficient use of renewable energy sources in electricity production and to maintain the installations implied on the electric power market, it is necessary to implement a system able to produce an output greater than that obtained from electric energy selling. The Romanian Government chose to promote the electric energy production by renewable energy sources by using the green certificate trading system. This system ensures the progress in developing the technologies employed in electric energy production from renewable energy sources and, at the same time the costs implied by their promotion can be adjusted by market mechanisms what will reduce the effects upon the electric energy consumers. The paper presents the legislation frame existing in Romania for promoting the electric energy produced from renewable energy sources, the green certificate trading system applied in Romania, as well as, the role shared by the entities implied in operation and development of the system. In November 2005, a first transaction with green certificates on controlled green certificate market in Romania took place. Analyzed is the evolution of the green certificate market registered so far from its inception, as well as, the lessons learned so far from the experience acquired

  9. Converse Barrier Certificate Theorem

    DEFF Research Database (Denmark)

    Wisniewski, Rafael; Sloth, Christoffer

    2013-01-01

    This paper presents a converse barrier certificate theorem for a generic dynamical system.We show that a barrier certificate exists for any safe dynamical system defined on a compact manifold. Other authors have developed a related result, by assuming that the dynamical system has no singular...... points in the considered subset of the state space. In this paper, we redefine the standard notion of safety to comply with generic dynamical systems with multiple singularities. Afterwards, we prove the converse barrier certificate theorem and illustrate the differences between ours and previous work...

  10. Low birth weight,very low birth weight rates and gestational age-specific birth weight distribution of korean newborn infants.

    Science.gov (United States)

    Shin, Son-Moon; Chang, Young-Pyo; Lee, Eun-Sil; Lee, Young-Ah; Son, Dong-Woo; Kim, Min-Hee; Choi, Young-Ryoon

    2005-04-01

    To obtain the low birth weight (LBW) rate, the very low birth weight (VLBW) rate, and gestational age (GA)-specific birth weight distribution based on a large population in Korea, we collected and analyzed the birth data of 108,486 live births with GA greater than 23 weeks for 1 yr from 1 January to 31 December 2001, from 75 hospitals and clinics located in Korea. These data included birth weight, GA, gender of the infants, delivery type, maternal age, and the presence of multiple pregnancy. The mean birth weight and GA of a crude population are 3,188 +/-518 g and 38.7+/-2.1 weeks, respectively. The LBW and the VLBW rates are 7.2% and 1.4%, respectively. The preterm birth rate (less than 37 completed weeks of gestation) is 8.4% and the very preterm birth rate (less than 32 completed weeks of gestation) is 0.7%. The mean birth weights for female infants, multiple births, and births delivered by cesarean section were lower than those for male, singletons, and births delivered vaginally. The risk of delivering LBW or VLBW infant was higher for the teenagers and the older women (aged 35 yr and more). We have also obtained the percentile distribution of GA-specific birth weight in infants over 23 weeks of gestation.

  11. 76 FR 22785 - Direct Certification and Certification of Homeless, Migrant and Runaway Children for Free School...

    Science.gov (United States)

    2011-04-25

    ... [FNS-2008-0001] RIN 0584-AD60 Direct Certification and Certification of Homeless, Migrant and Runaway... concerning the certification of certain children who are homeless, runaway, or migratory. This rule affects... children who are homeless, runaway, or migratory, as determined by the homeless coordinator for homeless or...

  12. Investigating weaknesses in Android certificate security

    Science.gov (United States)

    Krych, Daniel E.; Lange-Maney, Stephen; McDaniel, Patrick; Glodek, William

    2015-05-01

    Android's application market relies on secure certificate generation to establish trust between applications and their users; yet, cryptography is often not a priority for application developers and many fail to take the necessary security precautions. Indeed, there is cause for concern: several recent high-profile studies have observed a pervasive lack of entropy on Web-systems leading to the factorization of private keys.1 Sufficient entropy, or randomness, is essential to generate secure key pairs and combat predictable key generation. In this paper, we analyze the security of Android certificates. We investigate the entropy present in 550,000 Android application certificates using the Quasilinear GCD finding algorithm.1 Our results show that while the lack of entropy does not appear to be as ubiquitous in the mobile markets as on Web-systems, there is substantial reuse of certificates only one third of the certificates in our dataset were unique. In other words, we find that organizations frequently reuse certificates for different applications. While such a practice is acceptable under Google's specifications for a single developer, we find that in some cases the same certificates are used for a myriad of developers, potentially compromising Android's intended trust relationships. Further, we observed duplicate certificates being used by both malicious and non-malicious applications. The top 3 repeated certificates present in our dataset accounted for a total of 11,438 separate APKs. Of these applications, 451, or roughly 4%, were identified as malicious by antivirus services.

  13. Profile and birthing practices of Maranao traditional birth attendants

    Directory of Open Access Journals (Sweden)

    Maghuyop-Butalid R

    2015-10-01

    Full Text Available Roselyn Maghuyop-Butalid, Norhanifa A Mayo, Hania T Polangi College of Nursing, Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines Abstract: This study determined the profile and birthing practices in both modern and traditional ways among Maranao traditional birth attendants (TBAs in Lanao del Norte, Philippines. It employed a descriptive research design. The respondents were 50 Maranao TBAs selected through the snowball sampling technique. A questionnaire was developed by the researchers to identify the respondents’ modern birthing practices utilizing the Essential Intrapartum and Newborn Care (EINC Protocol. To determine their profile and traditional birthing practices, items from a previous study and the respondents’ personal claims were adapted. This study shows that Maranao TBAs have less compliance to the EINC Protocol and they often practice the traditional birthing interventions, thus increasing the risk of complications to both mother and newborn. Keywords: intrapartum and newborn care, modern birthing practices, traditional birthing practices 

  14. Risk of preterm birth by subtype among Medi-Cal participants with mental illness.

    Science.gov (United States)

    Baer, Rebecca J; Chambers, Christina D; Bandoli, Gretchen; Jelliffe-Pawlowski, Laura L

    2016-10-01

    Previous studies have demonstrated an association between mental illness and preterm birth (before 37 weeks). However, these investigations have not simultaneously considered gestation of preterm birth, the indication (eg, spontaneous or medically indicated), and specific mental illness classifications. The objective of the study was to examine the likelihood of preterm birth across gestational lengths and indications among Medi-Cal (California's Medicaid program) participants with a diagnostic code for mental illness. Mental illnesses were studied by specific illness classification. The study population was drawn from singleton live births in California from 2007 through 2011 in the birth cohort file maintained by the California Office of Statewide Health Planning and Development, which includes birth certificate and hospital discharge records. The sample was restricted to women with Medi-Cal coverage for prenatal care. Women with mental illness were identified using International Classification of Diseases, ninth revision, codes from their hospital discharge record. Women without a mental illness International Classification of Diseases, ninth revision, code were randomly selected at a 4:1 ratio. Adjusting for maternal characteristics and obstetric complications, relative risks and 95% confidence intervals were calculated for preterm birth comparing women with a mental illness diagnostic code with women without such a code. We identified 6198 women with a mental illness diagnostic code and selected 24,792 women with no such code. The risk of preterm birth in women with a mental illness were 1.2 times higher than women without a mental illness (adjusted relative risk, 1.2, 95% confidence interval, 1.1-1.3). Among the specific mental illnesses, schizophrenia, major depression, and personality disorders had the strongest associations with preterm birth (adjusted relative risks, 2.0, 2.0 and 3.3, respectively). Women receiving prenatal care through California's low

  15. Systematic review of progesterone for the prevention of preterm birth in singleton pregnancies

    DEFF Research Database (Denmark)

    Rode, Line; Langhoff-Roos, Jens; Andersson, Charlotte

    2009-01-01

    . SEARCH STRATEGY: A search in the PubMed, Embase, and Cochrane database was performed using the keywords: pregnancy, progesterone, preterm birth/preterm delivery, preterm labor, controlled trial, and randomized controlled trial. SELECTION CRITERIA: Studies on singleton pregnancies. DATA COLLECTION...... AND ANALYSIS: A meta-analysis was performed on randomized trials including singleton pregnancies with previous preterm birth. MAIN RESULTS: Two new randomized controlled trials of women with previous preterm birth were added to the four analyzed in the Cochrane review, and the meta-analysis of all six studies......BACKGROUND: A Cochrane review in 2006 concluded that further knowledge is required before recommendation can be made with regard to progesterone in the prevention of preterm birth. OBJECTIVE: To provide an update on the preventive effect of progesterone on preterm birth in singleton pregnancies...

  16. Knowledge, compliance with good clinical practices and barriers to effective control of postoperative pain among nurses from hospitals with and without a "Hospital without Pain" certificate.

    Science.gov (United States)

    Tomaszek, Lucyna; Dębska, Grażyna

    2018-04-01

    (i) To compare knowledge and compliance with good clinical practices regarding control of postoperative pain among nurses employed at hospitals with and without a "Hospital without Pain" certificate, (ii) to identify the determinants of nurses' knowledge and (iii) to define barriers to effective control of postoperative pain. Only a slight improvement in postoperative pain control has been observed recently, if any. Implementation of good clinical practices in the control of postoperative pain requires involvement of nurses. A cross-sectional study. The study included 257 nurses from hospitals with a "Hospital without Pain" certificate and 243 nurses from noncertified hospitals, with mean job seniority of 17.6 ± 9.6 years. All respondents answered 26 questions regarding postoperative pain control-related issues. Based on the answers, overall scores were calculated for (i) nurses' knowledge, (ii) compliance with good clinical practices and (iii) barriers to effective control of postoperative pain. Nurses from the certified hospitals presented with significantly higher levels of knowledge and compliance with good clinical practices and identified significantly more barriers to effective control of postoperative pain. Apart from certification of a hospital, better knowledge of postoperative pain control was determined by higher education, participation in postgraduate training programmes and other relevant courses, self-education from medical journals, employment at paediatric ward or intensive care unit. The most commonly reported barriers to effective control of pain included too low doses of painkillers prescribed by physicians and inability to modify the protocol of pain treatment by the nurse. Control of postoperative pain can be improved by enrolling nurses in various forms of continuous training and by providing them with greater autonomy in administering painkillers to surgical patients. Better quality of care offered to patients with postoperative pain

  17. [Home births].

    Science.gov (United States)

    Welffens, K; Kirkpatrick, C; Daelemans, C; Derisbourg, S

    In Belgium, very few women give birth outside the delivery room. In the United Kingdom and in the Netherlands, they are more numerous. Several studies evaluated obstetric and neonatal outcomes of home births compared with hospital births. We selected seven recent and large studies (with cohorts of more than 5.000 women) using PubMed, Science Direct and Cochrane Database of Systematic Reviews. Several questions were examined. Is there any difference in maternal and neonatal outcomes depending on the intended place of birth? Does parity affect outcomes ? What are the characteristics of women who choose to deliver at home ? We conclude that giving birth at home improves obstetric outcomes but is riskier for the baby, especially for the first one. The women delivering at home are mainly white Europeans, between 25 and 35 years old, in a relationship, multiparous and wealthier. In order to avoid this increased risk for the baby while preserving the obstetric advantages, alongside birth centers offer an intermediate solution. They combine the reassuring home-like atmosphere with the safety of the hospital. In Belgium, the first alongside birth center " Le Cocon " (a low technicity unit distinct from the delivery room) offers now this type of alternative place of birth for women in Hôpital Erasme in Brussels.

  18. 76 FR 5510 - Safety Enhancements Part 139, Certification of Airports

    Science.gov (United States)

    2011-02-01

    ... Control System (SMGCS) is a system of lighting, signs, and markings that allows an aircraft to operate to... also require a Surface Movement Guidance Control System (SMGCS) plan if the certificate holder conducts... time pressure, creates an environment for injuries and aircraft damage. Errors occur because of...

  19. 7 CFR 205.405 - Denial of certification.

    Science.gov (United States)

    2010-01-01

    ... PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.405 Denial of certification. (a) When the certifying... organic program. (e) An applicant for certification who has received a written notification of... 7 Agriculture 3 2010-01-01 2010-01-01 false Denial of certification. 205.405 Section 205.405...

  20. 7 CFR 205.401 - Application for certification.

    Science.gov (United States)

    2010-01-01

    ... PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.401 Application for certification. A person seeking... certification to a certifying agent. The application must include the following information: (a) An organic... 7 Agriculture 3 2010-01-01 2010-01-01 false Application for certification. 205.401 Section 205.401...

  1. 14 CFR 147.39 - Display of certificate.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Display of certificate. 147.39 Section 147...) SCHOOLS AND OTHER CERTIFICATED AGENCIES AVIATION MAINTENANCE TECHNICIAN SCHOOLS Operating Rules § 147.39 Display of certificate. Each holder of an aviation maintenance technician school certificate and ratings...

  2. 40 CFR 89.105 - Certificate of conformity.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Certificate of conformity. 89.105... and Certification Provisions § 89.105 Certificate of conformity. Every manufacturer of a new nonroad compression-ignition engine must obtain a certificate of conformity covering the engine family, as described...

  3. Public Health Data in Action: An Analysis of Using Louisiana Vital Statistics for Quality Improvement and Payment Reform.

    Science.gov (United States)

    Danilack, Valery A; Gee, Rebekah E; Berthelot, Danielle P; Gurvich, Rebecca; Muri, Janet H

    2017-05-01

    Introduction In 2012, the Louisiana (LA) Department of Health and Hospitals revised the LA birth certificate to include medical reasons for births before 39 completed weeks' gestation. We compared the completeness and validity of these data with hospital discharge records. Methods For births occurring 4/1/2012-9/30/2012 at Woman's Hospital of Baton Rouge, we linked maternal delivery and newborn birth data collected through the National Perinatal Information Center with LA birth certificates. Among early term births (37-38 completed weeks' gestation), we quantified the reasons for early delivery listed on the birth certificate and compared them with ICD-9-CM codes from Woman's discharge data. Results Among 4353 birth certificates indicating delivery at Woman's Hospital, we matched 99.8% to corresponding Woman's administrative data. Among 1293 early term singleton births, the most common reasons for early delivery listed on the birth certificate were spontaneous active labor (57.5%), gestational hypertensive disorders (15.3%), gestational diabetes (8.7%), and premature rupture of membranes (8.1%). Only 2.7% of births indicated "other reason" as the only reason for early delivery. Most reasons for early delivery had >80% correspondence with ICD-9-CM codes. Lower correspondence (35 and 72%, respectively) was observed for premature rupture of membranes and abnormal heart rate or fetal distress. Discussion There was near-perfect ability to match LA birth certificates with Woman's Hospital records, and the agreement between reasons for early delivery on the birth certificate and ICD-9-CM codes was high. A benchmark of 2.7% can be used as an attainable frequency of "other reason" for early delivery reported by hospitals. Louisiana implemented an effective mechanism to identify and explain early deliveries using vital records.

  4. KSC Center Director Bridges accepts an ISO 9001 certification plaque from DNV

    Science.gov (United States)

    1998-01-01

    Center Director Roy Bridges (right) displays the 2000th ISO Certificate Plaque he was given by Dalton Lyon (left) of Det Norske Veritas (DNV), Inc., an international ISO certification organization, at a ceremony at KSC. The plaque is a representation of the ISO 9001 certification awarded to KSC by DNV. ISO 9001 comprises the most detailed, comprehensive set of standard requirements for quality programs established by the International Standards Organization. The presentation followed a successful independent audit by DNV of the KSC Management System in May of this year. The third-party auditors examined about 20 elements of KSC's system, including management responsibility, design control, documentation, test and inspection, and corrective action procedures. DNV found that KSC met or exceeded the stringent quality standards in all areas. KSC will use this certification as a tool to improve an already world- class team. All NASA centers are required by NASA Administrator Daniel S. Goldin to be ISO 9001 registered by September 1999. NASA is the first federal agency to seek the quality certification.

  5. Converse Barrier Certificate Theorems

    DEFF Research Database (Denmark)

    Wisniewski, Rafael; Sloth, Christoffer

    2016-01-01

    This paper shows that a barrier certificate exists for any safe dynamical system. Specifically, we prove converse barrier certificate theorems for a class of structurally stable dynamical systems. Other authors have developed a related result by assuming that the dynamical system has neither...

  6. Infant Mortality Statistics From the 2013 Period Linked Birth/Infant Death Data Set.

    Science.gov (United States)

    Matthews, T J; MacDorman, Marian F; Thoma, Marie E

    2015-08-06

    This report presents 2013 period infant mortality statistics from the linked birth/infant death data set (linked file) by maternal and infant characteristics. The linked file differs from the mortality file, which is based entirely on death certificate data. Descriptive tabulations of data are presented and interpreted. The U.S. infant mortality rate was 5.96 infant deaths per 1,000 live births in 2013, similar to the rate of 5.98 in 2012. The number of infant deaths was 23,446 in 2013, a decline of 208 infant deaths from 2012. From 2012 to 2013, infant mortality rates were stable for most race and Hispanic origin groups; declines were reported for two Hispanic subgroups: Cuban and Puerto Rican. Since 2005, the most recent high, the U.S. infant mortality rate has declined 13% (from 6.86), with declines in both neonatal and postneonatal mortality overall and for most groups. In 2013, infants born at 37–38 weeks of gestation (early term) had mortality rates that were 63% higher than for full-term (39–40 week) infants. For multiple births, the infant mortality rate was 25.84, 5 times the rate of 5.25 for singleton births. In 2013, 36% of infant deaths were due to preterm-related causes of death, and an additional 15% were due to causes grouped into the sudden unexpected infant death category. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

  7. ECOTOURISM CERTIFICATION PROGRAMS: STANDARDS AND BENEFITS

    Directory of Open Access Journals (Sweden)

    Mariia Holub

    2015-11-01

    Full Text Available The problem of researching the ecotourism certification processes in the world is very up-to-date nowadays. The relevance of the research is stipulated by current state of environ-mental pollutants, the development of sustainable politics implementation and the fact that now people aware of real danger of environmental catastrophe that threatens the survival of civilization. That’s why the purpose of the article is conducting a complex analysis of foreign ecotourism certi-fication programs. Moreover, it is necessary to study the evolution of ecotourism development to understand the key issues of this problem. The object of this article is the analysis of ecotourism certification worldwide. The subject of the article is the detection of theoretical, methodological and practical aspects of implementation of effective ecotourism certification programs in Ukraine. To clarify all aspects of studying this issue it is necessary to use such theoretical and methodological basis as: modern theories of the genesis and evolution of ecological tourism, logical and analogy analysis, historical method, hypothetical method, classification and graphical method. Using such methods it was found that the development of ecotourism formation has taking three evolutionary steps, which affected the creation of its definition. This fact reveals the classification of different types of sustainable tourism and provides an impetus of ecotourism certification studies. Moreover, it was identified that there is a logical regularity in ecotourism certification programs all over the world. As the result, it was found that practically all the ecotourism certification processes are functioning successfully nowadays. By the way, it can be observed the rapid increase in the amount of ecocertified companies. Moreover, the programs which were analyzed in this article were divided into several steps (depends on the ecotourism certification program following which a company can

  8. 40 CFR 86.416-80 - Application for certification.

    Science.gov (United States)

    2010-07-01

    ...) An application for a certificate of conformity to the regulations in the English language applicable.... This shall include a detailed description of each auxiliary emission control device. Transmission gear... multiple copies as the Administrator may require. (4) For purposes of this section, “auxiliary emission...

  9. 40 CFR 90.106 - Certificate of conformity.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Certificate of conformity. 90.106... Standards and Certification Provisions § 90.106 Certificate of conformity. (a)(1) Except as provided in § 90... certificate of conformity covering such engines; however, engines manufactured during an annual production...

  10. 40 CFR 91.106 - Certificate of conformity.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Certificate of conformity. 91.106... Provisions § 91.106 Certificate of conformity. (a) Every manufacturer of a new marine SI engine produced... obtain a certificate of conformity covering each engine family. The certificate of conformity must be...

  11. 48 CFR 33.207 - Contractor certification.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Contractor certification... CONTRACTING REQUIREMENTS PROTESTS, DISPUTES, AND APPEALS Disputes and Appeals 33.207 Contractor certification. (a) Contractors shall provide the certification specified in paragraph (c) of this section when...

  12. Acupuncture and Clomiphene Citrate for Live Birth in Polycystic Ovary Syndrome: Study Design of a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Hongying Kuang

    2013-01-01

    Full Text Available Acupuncture is an alternative therapy to induce ovulation in women with polycystic ovary syndrome (PCOS, but there is no study reporting the live birth rate following ovulation induction by acupuncture or its potential as an adjuvant treatment to clomiphene citrate (CC. We assess the efficacy of acupuncture with or without CC in achieving live births among 1000 PCOS women in Mainland China. This paper reports the methodology of an ongoing multicenter randomized controlled trial. The randomization scheme is coordinated through the central mechanism and stratified by the participating sites. Participants will be randomized into one of the four treatment arms: (A true acupuncture and CC, (B control acupuncture and CC, (C true acupuncture and placebo CC, and (D control acupuncture and placebo CC. To ensure the quality and integrity of the trial we have developed a unique multinational team of investigators and Data and Safety Monitoring Board. Up to the end of April 2013, 326 subjects were recruited. In conclusion, the success of this trial will allow us to evaluate the additional benefit of acupuncture beyond the first line medicine for fertility treatment in PCOS women in an unbiased manner.

  13. Effect of kangaroo method on the risk of hypothermia and duration of birth weight regain in low birth weight infants: A randomized controlled trial

    OpenAIRE

    I G. A. P. Eka Pratiwi; Soetjiningsih Soetjiningsih; I Made Kardana

    2009-01-01

    Background In Indonesia, the infant mortality rate in 2001 was 50 per 1000 live births, with 34.7% due to perinatal death. This perinatal death was associated with low birth weight (LBW) newborn, which was caused by prematurity, infection, birth asphyxia, hypothermia, and inadequate breast feeding. In developing countries, lack of facilities of LBW infant care leads to the utilization of kangaroo method as care to prevent hypothermia in LBW newborn. Objective To evaluate the differences of...

  14. Preterm birth-associated cost of early intervention services: an analysis by gestational age.

    Science.gov (United States)

    Clements, Karen M; Barfield, Wanda D; Ayadi, M Femi; Wilber, Nancy

    2007-04-01

    Characterizing the cost of preterm birth is important in assessing the impact of increasing prematurity rates and evaluating the cost-effectiveness of therapies to prevent preterm delivery. To assess early intervention costs that are associated with preterm births, we estimated the program cost of early intervention services for children who were born in Massachusetts, by gestational age at birth. Using the Pregnancy to Early Life Longitudinal Data Set, birth certificates for infants who were born in Massachusetts between July 1999 and June 2000 were linked to early intervention claims through 2003. We determined total program costs, in 2003 dollars, of early intervention and mean cost per surviving infant by gestational age. Costs by plurality, eligibility criteria, provider discipline, and annual costs for children's first 3 years also were examined. Overall, 14,033 of 76,901 surviving infants received early intervention services. Program costs totaled almost $66 million, with mean cost per surviving infant of $857. Mean cost per infant was highest for children who were 24 to 31 weeks' gestational age ($5393) and higher for infants who were 32 to 36 weeks' gestational age ($1578) compared with those who were born at term ($725). Cost per surviving infant generally decreased with increasing gestational age. Among children in early intervention, mean cost per child was higher for preterm infants than for term infants. At each gestational age, mean cost per surviving infant was higher for multiples than for singletons, and annual early intervention costs were higher for toddlers than for infants. Compared with their term counterparts, preterm infants incurred higher early intervention costs. This information along with data on birth trends will inform budget forecasting for early intervention programs. Costs that are associated with early childhood developmental services must be included when considering the long-term costs of prematurity.

  15. Epigenetic signature of birth weight discordance in adult twins

    DEFF Research Database (Denmark)

    Tan, Qihua; Nielsen, Morten Frost Munk; Heijmans, Bastiaan T

    2014-01-01

    between birth weight and adult life health while controlling for not only genetics but also postnatal rearing environment. We performed an epigenome-wide profiling on blood samples from 150 pairs of adult monozygotic twins discordant for birth weight to look for molecular evidence of epigenetic signatures...... profiling did not reveal epigenetic signatures of birth weight discordance although some sites displayed age-dependent intra-pair differential methylation in the extremely discordant twin pairs....

  16. The Effect of Activity Restriction on Infant's Birth Weight and Gestational Age at Birth: PRAMS Data Analysis.

    Science.gov (United States)

    Omar, Abeer

    2018-01-01

    Activity restriction is extensively prescribed for pregnant women with major comorbidities despite the lack of evidence to support its effectiveness in preventing preterm birth or low birth weight. To determine the moderation effect of home activity restriction for more than a week on infant's birth weight and gestational age at birth for high-risk women with obstetrical and medical comorbidities. A secondary analysis of 2004-2008 New York Pregnancy Risk Assessment Monitoring System was conducted with 1426 high-risk women. High-risk group included 41% of women treated with activity restriction and 59% of those not treated with activity restriction. Women with preterm premature rupture of membrane (PPROM) who were treated with activity restriction had a lower infant birth weight ( b = -202.85, p = ≤.001) and gestational age at birth ( b = -.91, p = ≤.001) than those without activity restriction. However, women with preterm labor and hypertensive disorders of pregnancy who were not treated with activity restriction had lower infant gestational age at birth ( b = -96, p = ≤.01) and ( b = -92, p = ≤.001), respectively, compared to those who were treated with activity restriction. Findings suggest a contrary effect of activity restriction on infants born to women with PPROM, which is a major reason for prescribing activity restriction. The current study results may trigger the need to conduct randomized control trials to determine the effect of severity of activity restriction on maternal and infant outcomes.

  17. Employment certificates on HRT

    CERN Multimedia

    HR Department

    2008-01-01

    As part of the ongoing drive to simplify and streamline administrative procedures and processes, the IT and HR Departments have made employment certificates available on a self-service basis on the HRT application, in the main menu under "My self services". All members of the personnel can thus obtain a certificate of employment or association, in French or in English, for the present or past contractual period. The HR Department’s Records Office remains responsible for issuing any special certificates that might be required. IT-AIS (Administrative Information Services) HR-SPS (Services, Procedures & Social) Records Office – Tel. 73700

  18. Out-of-hospital births, U.S., 1978: birth weight and Apgar scores as measures of outcome.

    OpenAIRE

    Declercq, E R

    1984-01-01

    An examination of 1978 natality data for the United States disclosed that low birth weight was less common among 30,819 infants born out of hospital than among 3,294,101 infants born in hospital in that year. When controls were applied for birth attendant, infants' race, and mothers' education, age, nativity, and parity, the data revealed that white, well-educated women between 25 and 39 years of age, who were having their second babies and were attended by midwives out of hospital, were at l...

  19. EAS Telecommunications Certification Bodies (TCB)

    Data.gov (United States)

    Federal Communications Commission — EAS (Equipment Authorization System). A Telecommunication Certification Body (TCB) is an accredited product certification body with the authority to issue Grants of...

  20. Young males' perspectives on pregnancy, fatherhood and condom use: Where does responsibility for birth control lie?

    Science.gov (United States)

    Smith, Jennifer L; Fenwick, Jennifer; Skinner, Rachel; Merriman, Gareth; Hallett, Jonathan

    2011-01-01

    To improve our understanding of males' role in contraceptive practices, this paper explores the relationship between young males' perspectives on pregnancy and fatherhood and their attitudes, beliefs and practices in relation to condom use and birth control. Semi-structured interviews were conducted with a sample of 42 males aged 15-25 years. A systematic process of thematic analysis was used to reduce and organise the narrative data around the focus areas of relationships, sex, condom use, STIs and pregnancy/fatherhood. To facilitate the emergence of key patterns in the data, new data was constantly compared with existing ideas to formulate and refine codes and descriptive categories. The analysis revealed a clear discrepancy between young males' desire to prevent pregnancy and the level of control they assumed over this. Despite pregnancy emerging as the overriding concern for participants, this failed to motivate continued use of condoms when STI risk was perceived as low and a partner was using birth control. Reliance on a partner's use of hormonal contraceptives and in several cases, beliefs of low personal responsibility for pregnancy prevention reduced young males' participation in fertility control. Young males' unfavourable attitudes toward immediate pregnancy and fatherhood provide a unique opportunity for safe sex promotion by encouraging greater ownership over sexual and reproductive health outcomes. However, this requires a shift in the meanings associated with condoms, from a disease prevention only orientation to one that promotes condom use as a positive act for self and partner protection. Copyright © 2010 Elsevier B.V. All rights reserved.

  1. Efficacy of Saccharomyces boulardii on necrotizing enterocolitis or sepsis in very low birth weight infants: a randomised controlled trial.

    Science.gov (United States)

    Serce, Ozge; Benzer, Derya; Gursoy, Tugba; Karatekin, Guner; Ovali, Fahri

    2013-12-01

    Probiotics have strain specific effects and the effects of fungi in preventing diseases in preterm infants have been investigated poorly. Saccharomyces boulardii is a yeast which acts both as a probiotic and a polyamine producer. The objective of this study was to investigate the efficacy of S. boulardii in preventing necrotizing enterocolitis (NEC) or sepsis in very low birth weight infants. A prospective, double blind, placebo controlled trial was conducted in preterm infants (≤ 32 GWs, ≤ 1500 g birth weight). They were randomized either to receive feeding supplementation with S. boulardii 50 mg/kg every 12 h or placebo, starting with the first feed until discharged. Necrotizing enterocolitis (NEC) or sepsis and NEC or death. Birth weight and gestational age of the study (n = 104) and the control (n = 104) groups were 1126 ± 232 vs 1162 ± 216 g and 28.8 ± 2.2 vs 28.7 ± 2.1 weeks, respectively. Neither the incidence of stage ≥ 2 NEC or death nor stage ≥ 2 NEC or late onset culture proven sepsis was significantly lower in the study group when compared with the control group (9.6% vs 7.7%, p = 0.62; 28.8% vs 23%, p = 0.34). Time to reach 100 mL/kg/day of enteral feeding (11.9 ± 7 vs 12.6 ± 7 days, p = 0.37) was not different between the groups. Saccharomyces boulardii did not decrease the incidence of NEC or sepsis. © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Underlying causes of neonatal deaths in term singleton pregnancies: home births versus hospital births in the United States.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Dudenhausen, Joachim; Orosz, Brooke; Chervenak, Frank A

    2017-04-01

    The objective of this study was to evaluate the underlying causes of neonatal mortality (NNM) in midwife-attended home births and compare them to hospital births attended by a midwife or a physician in the United States (US). A retrospective cohort study of the Centers for Disease Control (CDC) linked birth/infant death data set (linked files) for 2008 through 2012 of singleton, term (≥37 weeks) births and normal newborn weights (≥2500 grams). Midwife-attended home births had the highest rate of neonatal deaths [122/95,657 neonatal mortality (NNM) 12.75/10,000; relative risk (RR): 3.6, 95% confidence interval (CI) 3-4.4], followed by hospital physician births (8695/14,447,355 NNM 6.02/10,000; RR: 1.7 95% CI 1.6-1.9) and hospital midwife births (480/1,363,199 NNM 3.52/10,000 RR: 1). Among midwife-assisted home births, underlying causes attributed to labor and delivery caused 39.3% (48/122) of neonatal deaths (RR: 13.4; 95% CI 9-19.9) followed by 29.5% due to congenital anomalies (RR: 2.5; 95% CI 1.8-3.6), and 12.3% due to infections (RR: 4.5; 95% CI 2.5-8.1). There are significantly increased risks of neonatal deaths among midwife-attended home births associated with three underlying causes: labor and delivery issues, infections, and fetal malformations. This analysis of the causes of neonatal death in planned home birth shows that it is consistently riskier for newborns to deliver at home than at the hospital. Physicians, midwives, and other health care providers have a professional responsibility to share information about the clinical benefits and risks of clinical management.

  3. 46 CFR 107.211 - Original Certificate of Inspection.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Original Certificate of Inspection. 107.211 Section 107... INSPECTION AND CERTIFICATION Inspection and Certification § 107.211 Original Certificate of Inspection. (a) The owner or builder of a unit applies for an inspection for an original Certificate of Inspection by...

  4. The role of progesterone in prevention of preterm birth

    Directory of Open Access Journals (Sweden)

    Jodie M Dodd

    2009-07-01

    Full Text Available Jodie M Dodd, Caroline A CrowtherDiscipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia, AustraliaAbstract: Preterm birth continues to provide an enormous challenge in the delivery of perinatal health care, and is associated with considerable short and long-term health consequences for surviving infants. Progesterone has a role in maintaining pregnancy, by suppression of the calcium–calmodulin–myosin light chain kinase system. Additionally, progesterone has recognized anti-inflammatory properties, raising a possible link between inflammatory processes, alterations in progesterone receptor expression and the onset of preterm labor. Systematic reviews of randomized controlled trials evaluating the use of intramuscular and vaginal progesterone in women considered to be at increased risk of preterm birth have been published, with primary outcomes of perinatal death, preterm birth <34 weeks, and neurodevelopmental handicap in childhood. Eleven randomized controlled trials were included in the systematic review, involving 2714 women and 3452 infants, with results presented according to the reason women were considered to be at increased risk of preterm birth. While there is a potential beneficial effect in the use of progesterone for some women considered to be at increased risk of preterm birth, primarily in the reduction in the risk of preterm birth before 34 weeks gestation, it remains unclear if the observed prolongation of pregnancy translates into improved health outcomes for the infant.Keywords: progesterone, preterm birth, systematic review, randomized trial

  5. 16 CFR 1207.9 - Product certification.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Product certification. 1207.9 Section 1207.9 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT SAFETY ACT REGULATIONS SAFETY STANDARD FOR SWIMMING POOL SLIDES § 1207.9 Product certification. (a) Certification shall be in accordance...

  6. [A co-twin control study on birth weight, overweight and obesity among children younger than 18 years old in China].

    Science.gov (United States)

    Liu, Qingqing; Yu, Canqing; Gao, Wenjing; Cao, Weihua; Lyu, Jun; Wang, Shengfeng; Pang, Zengchang; Cong, Liming; Dong, Zhong; Wu, Fan; Wang, Hua; Wu, Xianping; Wang, Dezheng; Wang, Binyou; Li, Liming

    2016-04-01

    To analyze the associations between birth weight and overweight/obesity among children. A total of 8 267 twin pairs younger than 18 years old from the Chinese National Twin Registry were included in the study. Associations between birth weight, childhood BMI and overweight/obesity were explored by this co-twin control study. After adjusting for sex and zygosity, when birth weight had an increase of 0.5 kg per fold, the OR values for overweight and obesity were 1.87(95%CI: 1.40-2.48) for 2-6 year olds, 1.69 (95%CI: 1.16-2.46) for 6-12 year olds and 1.28 (95%CI: 0.80-2.07) for 12-18 year olds. from the stratified analysis in the 2-6 year-olds, statistically significant differences were seen. When birth weight increased 0.5 kg per fold, the risk of overweight and obesity increased by 0.87 times among the dizygotic twins, more than that of the monozygotic twins (OR=1.86, 95%CI:1.24-2.81). The risk for male twins was 1.12 times higher than that of female twins (OR=1.65, 95%CI:1.11-2.44). Birth weight seemed associated with overweight and obesity for kids at early childhood or at age for schools. However, guidance on the implementation of public health interventions is still needed on these children.

  7. Perceived value of national certification for pediatric nurses.

    Science.gov (United States)

    Messmer, Patricia R; Hill-Rodriguez, Deborah; Williams, Arthur R; Ernst, Mary E; Tahmooressi, Jill

    2011-09-01

    This study evaluated whether pediatric nurses who were certified valued national certifications to a greater degree than those who were not certified. The Gaberson, Schroeter, Killen, and Valentine (2003) Perceived Value of Certification Tool (PVCT) was used to measure nurses' perceptions of certification. The PVCT includes 18 certification-related value statements, using a five-point Likert scale response ranging from strongly agree to strongly disagree. A principal factor analysis was performed to identify clusters of related variables. Certified pediatric nurses valued national certifications to a greater degree than those who were not certified. More favorable views of certification were moderately associated with favorable views of the effects of certification on salary. The PVCT was found to have one factor, not two, as previously reported in the literature. Lower perceived relationships were reported between certification and salary, clinical competence, and consumer confidence compared with feelings of professionalism and personal satisfaction. Efforts to improve the relationship between certification and its perceived value at one institution were addressed. More attention may be needed to strengthen relationships, perceived or otherwise, between certification and competency skills, public awareness, and compensation of nurses for holding national certification. Copyright 2011, SLACK Incorporated.

  8. Birth weight classification in gestational diabetes: is there an ideal chart?

    Directory of Open Access Journals (Sweden)

    Livia Silveira Mastella

    2017-01-01

    Full Text Available Introduction: Gestational diabetes mellitus (GDM is associated to increased rates of large for gestational age newborns and macrosomia. Several charts are used to classify birth weight. Is there an ideal chart to classify newborns of GDM mothers? Methods: We evaluated adequacy of birth weight of 332 neonates born to GDM mothers at Hospital de Clínicas de Porto Alegre, Brazil. Newborns were classified according to gestational age as small (SGA, adequate or large (LGA based on four charts: Alexander, Pedreira, INTERGROWTH 21st Project and SINASC-2012. The latter was built using data from a large national registry of 2012, the Born Alive National Surveillance System (Sistema de Informações de Nascidos Vivos – SINASC, which included 2.905,789 birth certificates. Frequencies of SGA and LGA and Kappa agreement were calculated. Results: In non-gender adjusted curves, SGA rates (95% confidence interval varied from 8% (5-11 to 9% (6-13; LGA rates, from 11% (8-15 to 17% (13-21. For males, SGA rates varied from 3% (1-6% to 6% (3-11%, and LGA rates, from 18% (13-24% to 31% (24-38%; for female, SGA rates were from 3% (1-7% to 10% (6-16% and LGA rates, from 11% (6-16% to 19% (13-26%. Kappa results were: ALEXANDER vs. SINASC-2012: 0.80 (0.73-0.88; INTERGROWTH 21st vs. SINASC-2012 (adjusted by sex: 0.62 (0.53-0.71; INTERGROWTH 21st vs. PEDREIRA: 0.71 (0.62-0.79; SINASC-2012 (by sex vs. PEDREIRA: 0.86 (0.79-0.93. Conclusions: Misclassification has to be taken into account when evaluating newborns of GDM mothers, as LGA rates can almost double depending on the chart used to classify birth weight.

  9. 14 CFR 125.7 - Display of certificate.

    Science.gov (United States)

    2010-01-01

    ... OR MORE; AND RULES GOVERNING PERSONS ON BOARD SUCH AIRCRAFT General § 125.7 Display of certificate. (a) The certificate holder must display a true copy of the certificate in each of its aircraft. (b... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Display of certificate. 125.7 Section 125.7...

  10. The electricity certificate system, 2008

    Energy Technology Data Exchange (ETDEWEB)

    2008-07-01

    The electricity certificate system is now in its sixth year. Since the start, both the system and the market have developed, and have undergone a number of changes. In January 2007, the Swedish Energy Agency published a report on the system, 'The electricity certificate system, 2006', to provide easily accessible information on the development of the system and to improve general understanding of it. With the passing of another year, it is now time for the third edition, 'The electricity certificate system, 2008', describing the market status of the electricity certificate system, with statistics from 2003 to 2007. This year's special theme chapter describes current support systems for renewable electricity production throughout the EU. The report also contains expanded information and statistics on biofuels, together with a new chapter that describes planned expansion of renewable electricity production up to 2012. The chapter on consumers' contribution to renewable electricity production has also been updated. A new feature this year is provided in the form of a number of tables at the end of the report, complementing the text. Through annual publication of the report, we hope to create a means of continuously developing the statistical material and analyses, in order to assist those involved in the market, and all other interested persons, to follow achievement of the objectives set out in the Government's Bill No. 205/06:154, 'Renewable electricity with green certificates'. We welcome views on the content and presentation of the report in order further to improve it. The target for the certificate system is to increase, by 2016, the annual production of electricity from renewable sources by 17 TWh relative to its production in 2002. So far, the actual production of renewable electricity is less than the indicative stage target for 2007. Nevertheless, progress is regarded as good, as there are many planned projects

  11. Birth outcomes of planned home births in Missouri: a population-based study.

    Science.gov (United States)

    Chang, Jen Jen; Macones, George A

    2011-08-01

    We evaluated the birth outcomes of planned home births. We conducted a retrospective cohort study using Missouri vital records from 1989 to 2005 to compare the risk of newborn seizure and intrapartum fetal death in planned home births attended by physicians/certified nurse midwives (CNMs) or non-CNMs with hospitals/birthing center births. The study sample included singleton pregnancies between 36 and 44 weeks of gestation without major congenital anomalies or breech presentation ( N = 859,873). The adjusted odds ratio (aOR) of newborn seizures in planned home births attended by non-CNMs was 5.11 (95% confidence interval [CI]: 2.52, 10.37) compared with deliveries by physicians/CNMs in hospitals/birthing centers. For intrapartum fetal death, aORs were 11.24 (95% CI: 1.43, 88.29), and 20.33 (95% CI: 4.98, 83.07) in planned home births attended by non-CNMs and by physicians/CNMs, respectively, compared with births in hospitals/birthing centers. Planned home births are associated with increased likelihood of adverse birth outcomes. © Thieme Medical Publishers.

  12. Hypnotherapy for labor and birth.

    Science.gov (United States)

    Beebe, Kathleen R

    2014-01-01

    Hypnotherapy is an integrative mind-body technique with therapeutic potential in various health care applications, including labor and birth. Evaluating the efficacy of this modality in controlled studies can be difficult, because of methodologic challenges, such as obtaining adequate sample sizes and standardizing experimental conditions. Women using hypnosis techniques for childbirth in hospital settings may face barriers related to caregiver resistance or institutional policies. The potential anxiolytic and analgesic effects of clinical hypnosis for childbirth merit further study. Nurses caring for women during labor and birth can increase their knowledge and skills with strategies for supporting hypnotherapeutic techniques. © 2014 AWHONN.

  13. Certification and the Branding of HRD

    Science.gov (United States)

    Carliner, Saul

    2012-01-01

    Although calls continue to establish certification, several certifications for human resource development (HRD) practitioners already exist, although none use the name HRD. This Forum explores what those certification programs are and what their availability means to the development of the HRD "brand" (the impressions of the service derived from…

  14. Cervical mucus properties stratify risk for preterm birth.

    Directory of Open Access Journals (Sweden)

    Agatha S Critchfield

    Full Text Available Ascending infection from the colonized vagina to the normally sterile intrauterine cavity is a well-documented cause of preterm birth. The primary physical barrier to microbial ascension is the cervical canal, which is filled with a dense and protective mucus plug. Despite its central role in separating the vaginal from the intrauterine tract, the barrier properties of cervical mucus have not been studied in preterm birth.To study the protective function of the cervical mucus in preterm birth we performed a pilot case-control study to measure the viscoelasticity and permeability properties of mucus obtained from pregnant women at high-risk and low-risk for preterm birth. Using extensional and shear rheology we found that cervical mucus from women at high-risk for preterm birth was more extensible and forms significantly weaker gels compared to cervical mucus from women at low-risk of preterm birth. Moreover, permeability measurements using fluorescent microbeads show that high-risk mucus was more permeable compared with low-risk mucus.Our findings suggest that critical biophysical barrier properties of cervical mucus in women at high-risk for preterm birth are compromised compared to women with healthy pregnancy. We hypothesize that impaired barrier properties of cervical mucus could contribute to increased rates of intrauterine infection seen in women with preterm birth. We furthermore suggest that a robust association of spinnbarkeit and preterm birth could be an effectively exploited biomarker for preterm birth prediction.

  15. Navajo birth outcomes in the Shiprock uranium mining area

    International Nuclear Information System (INIS)

    Shields, L.M.; Wiese, W.H.; Skipper, B.J.; Charley, B.; Benally, L.

    1992-01-01

    The role of environmental radiation in the etiology of birth defects, stillbirths, and other adverse outcomes of pregnancy was evaluated for 13,329 Navajos born at the Public Health Service/Indian Health Service Hospital in the Shiprock, NM, uranium mining area (1964-1981). More than 320 kinds of defective congenital conditions were abstracted from hospital records. Using a nested case-control design, families of 266 pairs of index and control births were interviewed. The only statistically significant association between uranium operations and unfavorable birth outcome was identified with the mother living near tailings or mine dumps. Among the fathers who worked in the mines, those of the index cases had histories of more years of work exposure but not necessarily greater gonadal dosage of radiation. Also, birth defects increased significantly when either parent worked in the Shiprock electronics assembly plant. Overall, the associations between adverse pregnancy outcome and exposure to radiation were weak and must be interpreted with caution with respect to implying a biogenetic basis

  16. Profile and birthing practices of Maranao traditional birth attendants.

    Science.gov (United States)

    Maghuyop-Butalid, Roselyn; Mayo, Norhanifa A; Polangi, Hania T

    2015-01-01

    This study determined the profile and birthing practices in both modern and traditional ways among Maranao traditional birth attendants (TBAs) in Lanao del Norte, Philippines. It employed a descriptive research design. The respondents were 50 Maranao TBAs selected through the snowball sampling technique. A questionnaire was developed by the researchers to identify the respondents' modern birthing practices utilizing the Essential Intrapartum and Newborn Care (EINC) Protocol. To determine their profile and traditional birthing practices, items from a previous study and the respondents' personal claims were adapted. This study shows that Maranao TBAs have less compliance to the EINC Protocol and they often practice the traditional birthing interventions, thus increasing the risk of complications to both mother and newborn.

  17. Just-in-time characterization and certification of DOE-generated wastes

    Energy Technology Data Exchange (ETDEWEB)

    Arrenholz, D.A.; Primozic, F.J. [Benchmark Environmental Corp., Albuquerque, NM (United States); Robinson, M.A. [Los Alamos National Lab., NM (United States)

    1995-12-31

    Transportation and disposal of wastes generated by Department of Energy (DOE) activities, including weapons production and decontamination and decommissioning (D&D) of facilities, require that wastes be certified as complying with various regulations and requirements. These certification requirements are typically summarized by disposal sites in their specific waste acceptance criteria. Although a large volume of DOE wastes have been generated by past activities and are presently in storage awaiting disposal, a significant volume of DOE wastes, particularly from D&D projects. have not yet been generated. To prepare DOE-generated wastes for disposal in an efficient manner. it is suggested that a program of just-in-time characterization and certification be adopted. The goal of just-in-time characterization and certification, which is based on the just-in-time manufacturing process, is to streamline the certification process by eliminating redundant layers of oversight and establishing pro-active waste management controls. Just-in-time characterization and certification would rely on a waste management system in which wastes are characterized at the point of generation, precertified as they are generated (i.e., without iterative inspections and tests subsequent to generation and storage), and certified at the point of shipment, ideally the loading dock of the building from which the wastes are generated. Waste storage would be limited to accumulating containers for cost-efficient transportation.

  18. Just-in-time characterization and certification of DOE-generated wastes

    International Nuclear Information System (INIS)

    Arrenholz, D.A.; Primozic, F.J.; Robinson, M.A.

    1995-01-01

    Transportation and disposal of wastes generated by Department of Energy (DOE) activities, including weapons production and decontamination and decommissioning (D ampersand D) of facilities, require that wastes be certified as complying with various regulations and requirements. These certification requirements are typically summarized by disposal sites in their specific waste acceptance criteria. Although a large volume of DOE wastes have been generated by past activities and are presently in storage awaiting disposal, a significant volume of DOE wastes, particularly from D ampersand D projects. have not yet been generated. To prepare DOE-generated wastes for disposal in an efficient manner. it is suggested that a program of just-in-time characterization and certification be adopted. The goal of just-in-time characterization and certification, which is based on the just-in-time manufacturing process, is to streamline the certification process by eliminating redundant layers of oversight and establishing pro-active waste management controls. Just-in-time characterization and certification would rely on a waste management system in which wastes are characterized at the point of generation, precertified as they are generated (i.e., without iterative inspections and tests subsequent to generation and storage), and certified at the point of shipment, ideally the loading dock of the building from which the wastes are generated. Waste storage would be limited to accumulating containers for cost-efficient transportation

  19. Facilitating home birth.

    Science.gov (United States)

    Finigan, Valerie; Chadderton, Diane

    2015-06-01

    The birth of a baby is a family experience. However, in the United Kingdom birth often occurs outside the family environment, in hospital. Both home and hospital births have risks and benefits, but research shows that, for most women, it is as safe to give birth at home as it is in hospital. Women report home-birth to be satisfying with lowered risks of intervention and less likelihood of being separated from their family. It is also more cost effective for the National Health Service. Yet, whilst midwives are working hard to promote home birth as an option, it remains controversial. The aim of this paper is to raise awareness of the safety of home birth and the needs of women and midwives when a home birth is chosen. It provides an overview of care required and the role of the midwife in the ensuring care is woman-centred and personalised.

  20. Low Birth Weight, Very Low Birth Weight Rates and Gestational Age-Specific Birth Weight Distribution of Korean Newborn Infants

    OpenAIRE

    Shin, Son-Moon; Chang, Young-Pyo; Lee, Eun-Sil; Lee, Young-Ah; Son, Dong-Woo; Kim, Min-Hee; Choi, Young-Ryoon

    2005-01-01

    To obtain the low birth weight (LBW) rate, the very low birth weight (VLBW) rate, and gestational age (GA)-specific birth weight distribution based on a large population in Korea, we collected and analyzed the birth data of 108,486 live births with GA greater than 23 weeks for 1 yr from 1 January to 31 December 2001, from 75 hospitals and clinics located in Korea. These data included birth weight, GA, gender of the infants, delivery type, maternal age, and the presence of multiple pregnancy. ...

  1. Modeling landowner behavior regarding forest certification

    Science.gov (United States)

    David C. Mercker; Donald G. Hodges

    2008-01-01

    Nonindustrial private forest owners in western Tennessee were surveyed to assess their awareness, acceptance, and perceived benefits of forest certification. More than 80 percent of the landowners indicated a willingness to consider certification for their lands. A model was created to explain landowner behavior regarding their willingness to consider certification....

  2. 40 CFR 82.161 - Technician certification.

    Science.gov (United States)

    2010-07-01

    ... shall address the subject areas listed in appendix D. (c) Program Approval. Persons may seek approval of... the closed-book certification exam, within 30 days. Programs providing Type I certification using the... percent or higher on the certification exam, no later than 30 days after the program has received the exam...

  3. 77 FR 24960 - Agency Forms Undergoing Paperwork Reduction Act Review

    Science.gov (United States)

    2012-04-26

    ... themselves and their infants for DNA testing. The collection of cheek cells by the mother, father, and infant... questionnaire. 3,600 1 1 Mothers, fathers, infants Cheek Cell Specimen 10,800 1 10/60 Collection. [[Page 24961... from birth certificates or birth hospital records. Mothers of case and control infants are interviewed...

  4. 76 FR 67559 - Proposed Information Collection (Monthly Certification of On-the-Job and Apprenticeship Training...

    Science.gov (United States)

    2011-11-01

    ... (Monthly Certification of On-the- Job and Apprenticeship Training) Activity: Comment Request AGENCY... techniques or the use of other forms of information technology. Title: Monthly Certification of On-the-Job and Apprenticeship Training, VA Forms 22-6553d and 22-6553d-1. OMB Control Number: 2900-0178. Type of...

  5. Radiation protection supervisors certification in Brazil

    International Nuclear Information System (INIS)

    Mendonca Costa, Eduardo; Arraes Monteiro, Iara

    2008-01-01

    In order to accomplish its legal assignments CNEN certifies the qualification of radiation protection supervisors. The current certification process is presented and discussed in this paper. This paper discusses the main points of the certification process including: knowledge tests, stake holder's communication, standards, supervisor responsibilities and profiles. The importance of safety certification of nuclear facilities and radiation protection of public individuals and workers are also discussed. Taking into account the characteristics of the Brazilian Nuclear program, the future improvements and goals in the certification process is also presented. (author)

  6. Distribution of maternal age and birth order groups in cases with unclassified multiple congenital abnormalities according to the number of component abnormalities: a national population-based case-control study.

    Science.gov (United States)

    Csermely, Gyula; Czeizel, Andrew E; Veszprémi, Béla

    2015-02-01

    Multiple congenital abnormalities are caused by chromosomal aberrations, mutant major genes and teratogens. A minor proportion of these patients are identified as syndromes but the major part belonging to the group of unclassified multiple CAs (UMCAs). The main objective of this study was to evaluate the maternal age and birth order in pregnant women who had offspring affected with UMCA. The strong association between numerical chromosomal aberrations, e.g., Down syndrome and advanced maternal age is well-known and tested here. The Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980 to 1996, yielded a large population-based national data set with 22,843 malformed newborns or fetuses ("informative cases") included 1349 UMCA cases with their 2407 matched controls. Case-control comparison of maternal age and birth order was made for cases with UMCA, stratified by component numbers and their controls. In addition, 834 cases with Down syndrome were compared to 1432 matched controls. The well-known advanced maternal age with the higher risk for Down syndrome was confirmed. The findings of the study suggest that the young age of mothers associates with the higher risk of UMCA, in addition birth order 4 or more associates with the higher risk for UMCA with 2 and 3 component CAs. This study was the first to analyze the possible maternal and birth order effect for cases with UMCA, and the young age and higher birth order associated with a higher risk for UMCA. © 2014 Wiley Periodicals, Inc.

  7. System 80+trademark Standard Design: CESSAR design certification

    International Nuclear Information System (INIS)

    1990-01-01

    This report, entitled Combustion Engineering Standard Safety Analysis Report -- Design Certification (CESSAR-DC), has been prepared in support of the industry effort to standardize nuclear plant designs. These volumes describe the Combustion Engineering, Inc. System 80 + trademark Standard Design. This volume 8 provides a description of instrumentation and controls

  8. Modeling of a green certificate market

    International Nuclear Information System (INIS)

    Marchenko, O.V.

    2008-01-01

    The paper considers one of the economic mechanisms, stimulating the introduction of renewable energy sources (RES) - a green certificate market. A mathematical model was developed to describe a supply and demand balance in the electricity and green certificate markets simultaneously. The sellers of certificates are RES owners, who obtain certificates for each unit of electricity produced, and the buyers are consumers, who are obliged by law to buy a certain share of this electricity. Equilibrium structures of the power system including RES with stochastic operation conditions are calculated. The prices of electricity and certificates, as well as the total economic effect of the system are determined taking into account external costs (environmental damages). The paper shows that a mechanism of green certificates is not an ideal means for minimizing the impact of energy on the environment: the economic effect turns out to be smaller than the maximum possible one. However, this deviation is relatively small, therefore the green certificate market allows the external effects to be partially taken into account. Such a market creates incentives for investors, electricity producers and consumers to make power sources mix, modes of electricity production and consumption closer to the optimum ones in terms of the economy as a whole. (author)

  9. Maintenance of Certification for Radiation Oncology

    International Nuclear Information System (INIS)

    Kun, Larry E.; Ang, Kian; Erickson, Beth; Harris, Jay; Hoppe, Richard; Leibel, Steve; Davis, Larry; Hattery, Robert

    2005-01-01

    Maintenance of Certification (MOC) recognizes that in addition to medical knowledge, several essential elements involved in delivering quality care must be developed and maintained throughout one's career. The MOC process is designed to facilitate and document professional development of American Board of Radiology (ABR) diplomates in the essential elements of quality care in Radiation Oncology and Radiologic Physics. ABR MOC has been developed in accord with guidelines of the American Board of Medical Specialties. All Radiation Oncology certificates issued since 1995 are 10-year, time-limited certificates; diplomates with time-limited certificates who wish to maintain specialty certification must complete specific requirements of the American Board of Radiology MOC program. Diplomates with lifelong certificates are not required to participate but are strongly encouraged to do so. Maintenance of Certification is based on documentation of participation in the four components of MOC: (1) professional standing, (2) lifelong learning and self-assessment, (3) cognitive expertise, and (4) performance in practice. Through these components, MOC addresses six competencies-medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Details of requirements for components 1, 2, and 3 of MOC are outlined along with aspects of the fourth component currently under development

  10. Alternative Certification Pathways: Filling a Gap?

    Science.gov (United States)

    Ludlow, Carlyn

    2013-01-01

    The purpose of this article is to examine the proliferation of alternative certification pathways through an analysis of the role and history of teacher certification and supply followed by a synthesis of national, regional, and state research studies on alternative routes to certification programs and a review of studies conducted on well-known…

  11. Exercise during pregnancy in normal-weight women and risk of preterm birth: a systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Di Mascio, Daniele; Magro-Malosso, Elena Rita; Saccone, Gabriele; Marhefka, Gregary D; Berghella, Vincenzo

    2016-11-01

    Preterm birth is the major cause of perinatal mortality in the United States. In the past, pregnant women have been recommended to not exercise because of presumed risks of preterm birth. Physical activity has been theoretically related to preterm birth because it increases the release of catecholamines, especially norepinephrine, which might stimulate myometrial activity. Conversely, exercise may reduce the risk of preterm birth by other mechanisms such as decreased oxidative stress or improved placenta vascularization. Therefore, the safety of exercise regarding preterm birth and its effects on gestational age at delivery remain controversial. The objective of the study was to evaluate the effects of exercise during pregnancy on the risk of preterm birth. MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID, and Cochrane Library were searched from the inception of each database to April 2016. Selection criteria included only randomized clinical trials of pregnant women randomized before 23 weeks to an aerobic exercise regimen or not. Types of participants included women of normal weight with uncomplicated, singleton pregnancies without any obstetric contraindication to physical activity. The summary measures were reported as relative risk or as mean difference with 95% confidence intervals. The primary outcome was the incidence of preterm birth exercise group and 1037 (50.4%) to the control group. Aerobic exercise lasted about 35-90 minutes 3-4 times per week. Women who were randomized to aerobic exercise had a similar incidence of preterm birth of exercise group had a significantly higher incidence of vaginal delivery (73.6% vs 67.5%; relative risk, 1.09, 95% confidence interval, 1.04-1.15) and a significantly lower incidence of cesarean delivery (17.9% vs 22%; relative risk, 0.82, 95% confidence interval, 0.69-0.97) compared with controls. The incidence of operative vaginal delivery (12.9% vs 16.5%; relative risk, 0.78, 95% confidence interval, 0

  12. Obstetric History and Likelihood of Preterm Birth of Twins.

    Science.gov (United States)

    Easter, Sarah Rae; Little, Sarah E; Robinson, Julian N; Mendez-Figueroa, Hector; Chauhan, Suneet P

    2018-01-05

     The objective of this study was to investigate the relationship between preterm birth in a prior pregnancy and preterm birth in a twin pregnancy.  We performed a secondary analysis of a randomized controlled trial evaluating 17-α-hydroxyprogesterone caproate in twins. Women were classified as nulliparous, multiparous with a prior term birth, or multiparous with a prior preterm birth. We used logistic regression to examine the odds of spontaneous preterm birth of twins before 35 weeks according to past obstetric history.  Of the 653 women analyzed, 294 were nulliparas, 310 had a prior term birth, and 49 had a prior preterm birth. Prior preterm birth increased the likelihood of spontaneous delivery before 35 weeks (adjusted odds ratio [aOR]: 2.44, 95% confidence interval [CI]: 1.28-4.66), whereas prior term delivery decreased these odds (aOR: 0.55, 95% CI: 0.38-0.78) in the current twin pregnancy compared with the nulliparous reference group. This translated into a lower odds of composite neonatal morbidity (aOR: 0.38, 95% CI: 0.27-0.53) for women with a prior term delivery.  For women carrying twins, a history of preterm birth increases the odds of spontaneous preterm birth, whereas a prior term birth decreases odds of spontaneous preterm birth and neonatal morbidity for the current twin pregnancy. These results offer risk stratification and reassurance for clinicians. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. AutoCAD 2014 review for certification official certification preparation

    CERN Document Server

    ASCENT center for technical knowledge

    2014-01-01

    The AutoCAD® 2014 Review for Certification book is intended for users of AutoCAD® preparing to complete the AutoCAD 2014 Certified Professional exam. This book contains a collection of relevant instructional topics, practice exercises, and review questions from the Autodesk Official Training Guides (AOTG) from ASCENT - Center for Technical Knowledge pertaining specifically to the Certified Professional exam topics and objectives. This book is intended for experienced users of AutoCAD in preparation for certification. New users of AutoCAD should refer to the AOTG training guides from ASCENT, such as AutoCAD/AutoCAD LT 2014 Fundamentals, for more comprehensive instruction.

  14. How the pill became a lifestyle drug: the pharmaceutical industry and birth control in the United States since 1960.

    Science.gov (United States)

    Watkins, Elizabeth Siegel

    2012-08-01

    Marketing decisions, rather than scientific innovations, have guided the development and positioning of contraceptive products in recent years. I review the stalled progress in contraceptive development in the decades following the advent of the Pill in 1960 and then examine the fine-tuning of the market for oral contraceptives in the 1990s and 2000s. Although birth control has been pitched in the United States as an individual solution, rather than a public health strategy, the purpose of oral contraceptives was understood by manufacturers, physicians, and consumers to be the prevention of pregnancy, a basic health care need for women. Since 1990, the content of that message has changed, reflecting a shift in the drug industry's view of the contraception business. Two factors contributed to bring about this change: first, the industry's move away from research and development in birth control and second, the growth of the class of medications known as lifestyle drugs.

  15. System certification progress in concept recognition in IAEA regulation

    International Nuclear Information System (INIS)

    Luna, R.E.; Pollog, T.

    1995-01-01

    System Certification is a regulatory concept which is intended to expand the scope of radioactive material transport regulations by allowing alternative means for proving compliance with the requisite standards of safety set out in transport regulations. In practice it may allow more stringent requirements in one aspect of the regulations to be substituted for less stringent application in other areas so long as the safety standard provided by regulation is preserved. The concept is widely perceived as the imposition of operational controls in exchange for relaxation of packaging standards, but that is only one possibility in the spectrum of potential actions under a System Certification provision in IAEA or national regulations

  16. Certification of Markets, Markets of Certificates: Tracing Sustainability in Global Agro-Food Value Chains

    NARCIS (Netherlands)

    Mol, A.P.J.; Oosterveer, P.J.M.

    2015-01-01

    There is a blossoming of voluntary certification initiatives for sustainable agro-food products and production processes. With these certification initiatives come traceability in supply chains, to guarantee the sustainability of the products consumed. No systematic analysis exists of traceability

  17. [Percentage of births and fertility rates in adolescents in Mexico (2008-2012): stratification and priorization of municipalities with high risk].

    Science.gov (United States)

    Reyes-Pablo, Adelmo Eloy; Navarrete-Hernández, Eduardo; Canún-Serrano, Sonia; Valdés-Hernández, Javier

    2015-12-01

    Mexico in 2008 was designed as the first place of adolescent pregnancy at the Organization for Economic Cooperation and Development, with specific fertility rate (SFR) for 15-1 9years of age of 64.2/1,000 woman at the same age. Estimate of percentage births and SFR in adolescent population at national, state and municipal level in Mexico in 2008-2012 at the total group of adolescents 10 to 1 9 years old and by subgroups of 10-14 and 15 tol 9 years old, identifying the priority municipalities with adolescence pregnancies. Data bases of certificates of live birth and fetal death with gestational age of 22-45 weeks were joined in 2008-2012. A data base of 1 0'585,032 births in 2008-2012 was obtained, 98.9% were live births and 1.1% was stillbirths. The SFR nationwide for the period 2008-2012 were of the order of 3.l for the group of 10-1 4years, 75.3 for 15-19, 39.6 for the total group of 10-19 years and 66.1 for 20 to 49 years per 1000 women for the same age. In the last decade it has increased teen pregnancy as well as the percentage of births and the fertility rate in this age group, worrying situation for the high risk of biological, psychological and social damage that pregnancy early.

  18. Esophageal cancer among Brazilian agricultural workers: case-control study based on death certificates.

    Science.gov (United States)

    Meyer, Armando; Alexandre, Pedro Celso Braga; Chrisman, Juliana de Rezende; Markowitz, Steven B; Koifman, Rosalina Jorge; Koifman, Sergio

    2011-03-01

    Several studies suggest that agricultural workers are at higher risk to develop and die by certain types of cancer. Esophageal cancer is not commonly listed among these types. However, some recent studies indicated that if there is an association between agricultural working and esophageal cancer, it s more likely to be observed among workers highly exposed to pesticides. In the present study, the magnitude of the association between agricultural working and esophageal cancer mortality was evaluated in a high pesticide use area in Brazil, through a death certificate-based case-control study. Cases were individuals from both genders, 30-59 years old, for whom basic cause of death was ascertained as cancer of the esophagus. For each case, one control was randomly selected from all possible controls for which the basic cause of death was ascertained as different from neoplasm and diseases of the digestive system. In addition, controls matched their cases by sex, age, year of death, and state of residence. Crude and adjusted odds ratios were then calculated to estimate the magnitude of the risk. Results showed that, in general, agricultural workers were at significantly higher risk to die by esophageal cancer, when compared to non-agricultural workers. Stratified analysis also revealed that the magnitude of such risk was slightly higher among illiterate agricultural workers, and simultaneous adjustment for several covariates showed that the risk was quantitatively higher among younger southern agricultural workers. These results suggest the esophageal cancer may be included among those types of cancer etiologically associated to agricultural working. Copyright © 2010 Elsevier GmbH. All rights reserved.

  19. Risk factors and birth prevalence of birth defects and inborn errors of ...

    African Journals Online (AJOL)

    raoul

    2011-02-23

    Feb 23, 2011 ... methylmalonic aciduria, and maple syrup urine disease (MSUD) had their diagnoses confirmed by enzyme assay. The diagnosis of all ... Personal information like date of birth, sex, area of residence, mother's age at birth, father's age, order of birth, birth weight, gestational age on birth, medical history and ...

  20. Birth Territory: a theory for midwifery practice.

    Science.gov (United States)

    Fahy, Kathleen M; Parratt, Jenny Anne

    2006-07-01

    The theory of Birth Territory describes, explains and predicts the relationships between the environment of the individual birth room, issues of power and control, and the way the woman experiences labour physiologically and emotionally. The theory was synthesised inductively from empirical data generated by the authors in their roles as midwives and researchers. It takes a critical post-structural feminist perspective and expands on some of the ideas of Michel Foucault. Theory synthesis was also informed by current research about the embodied self and the authors' scholarship in the fields of midwifery, human biology, sociology and psychology. In order to demonstrate the significance of the theory, it is applied to two clinical stories that both occur in hospital but are otherwise different. This analysis supports the central proposition that when midwives use 'midwifery guardianship' to create and maintain the ideal Birth Territory then the woman is most likely to give birth naturally, be satisfied with the experience and adapt with ease in the post-birth period. These benefits together with the reduction in medical interventions also benefit the baby. In addition, a positive Birth Territory is posited to have a broader impact on the woman's partner, family and society in general.

  1. Links between environmental geochemistry and rate of birth defects: Shanxi Province, China

    Energy Technology Data Exchange (ETDEWEB)

    Yu Haiying [State Key Laboratory of Earth Surface Processes and Resource Ecology, School of Geography, Beijing Normal University, Beijing 100875 (China); College of Resources and Environmental Sciences, Sichuan Agricultural University, Ya' an, Sichuan 625014 (China); Zhang Keli, E-mail: keli@bnu.edu.cn [State Key Laboratory of Earth Surface Processes and Resource Ecology, School of Geography, Beijing Normal University, Beijing 100875 (China)

    2011-01-01

    The rate of birth defects in Shanxi Province is among the highest worldwide. In order to identify the impacts of geochemical and environmental factors on birth defect risk, samples of soil, water and food were collected from an area with an unusually high rate of birth defects (study area) and an area with a low rate of birth defects (control area) in Shanxi Province, China. Element contents were determined by ICP-OES, and the results were analyzed using a non-parametric test and stepwise regression. Differences in the level and distribution of 14 geochemical elements, namely arsenic (As), selenium (Se), molybdenum (Mo), zinc (Zn), strontium (Sr), iron (Fe), tin (Sn), magnesium (Mg), vanadium (V), calcium (Ca), copper (Cu), aluminum (Al), potassium (K) and sulfur (S) were thus compared between the study and control areas. The results reveal that the geochemical element contents in soil, water and food show a significant difference between the study area and control area, and suggest that the study area was characterized by higher S and lower Sr and Al contents. These findings, based on statistical analysis, may be useful in directing further epidemiological investigations identifying the leading causes of birth defects. - Research Highlights: {yields} Environmental geochemistry has an significant impact on birth defects in the regions with an unusually high rate of birth defects. {yields} An excess of S and deficiency of Sr and Al are the distinctive environmental features associated with the high rate of birth defects in the Shanxi Province of China. {yields} Geochemical anomalies is a non-medical basis for effective prevention and cure of birth defects.

  2. Links between environmental geochemistry and rate of birth defects: Shanxi Province, China

    International Nuclear Information System (INIS)

    Yu Haiying; Zhang Keli

    2011-01-01

    The rate of birth defects in Shanxi Province is among the highest worldwide. In order to identify the impacts of geochemical and environmental factors on birth defect risk, samples of soil, water and food were collected from an area with an unusually high rate of birth defects (study area) and an area with a low rate of birth defects (control area) in Shanxi Province, China. Element contents were determined by ICP-OES, and the results were analyzed using a non-parametric test and stepwise regression. Differences in the level and distribution of 14 geochemical elements, namely arsenic (As), selenium (Se), molybdenum (Mo), zinc (Zn), strontium (Sr), iron (Fe), tin (Sn), magnesium (Mg), vanadium (V), calcium (Ca), copper (Cu), aluminum (Al), potassium (K) and sulfur (S) were thus compared between the study and control areas. The results reveal that the geochemical element contents in soil, water and food show a significant difference between the study area and control area, and suggest that the study area was characterized by higher S and lower Sr and Al contents. These findings, based on statistical analysis, may be useful in directing further epidemiological investigations identifying the leading causes of birth defects. - Research Highlights: → Environmental geochemistry has an significant impact on birth defects in the regions with an unusually high rate of birth defects. → An excess of S and deficiency of Sr and Al are the distinctive environmental features associated with the high rate of birth defects in the Shanxi Province of China. → Geochemical anomalies is a non-medical basis for effective prevention and cure of birth defects.

  3. 7 CFR 205.400 - General requirements for certification.

    Science.gov (United States)

    2010-01-01

    ...) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.400 General requirements for certification. A person seeking to receive or maintain organic certification under the... 7 Agriculture 3 2010-01-01 2010-01-01 false General requirements for certification. 205.400...

  4. BIX Certificates: Cryptographic Tokens for Anonymous Transactions Based on Certificates Public Ledger

    Directory of Open Access Journals (Sweden)

    Sead Muftic

    2016-12-01

    Full Text Available With the widespread use of Internet, Web, and mobile technologies, a new category of applications and transactions that requires anonymity is gaining increased interest and importance. Examples of such new applications are innovative payment systems, digital notaries, electronic voting, documents sharing, electronic auctions, medical applications, and many others. In addition to anonymity, these applications and transactions also require standard security services: identification, authentication, and authorization of users and protection of their transactions. Providing those services in combination with anonymity is an especially challenging issue, because all security services require explicit user identification and authentication. To solve this issue and enable applications with security and also anonymity we introduce a new type of cryptographically encapsulated objects called BIX certificates. “BIX” is an abbreviation for “Blockchain Information Exchange.” Their purpose is equivalent to X.509 certificates: to support security services for users and transactions, but also enhanced with anonymity. This paper describes the structure and attributes of BIX certificate objects and all related protocols for their creation, distribution, and use. The BIX Certification Infrastructure (BCI as a distributed public ledger is also briefly described.

  5. 78 FR 49758 - Proposed Data Collections Submitted for Public Comment and Recommendations

    Science.gov (United States)

    2013-08-15

    ... collection of saliva cells by the mother, father and infant takes about 15 minutes per person. For the infant..., control infants will be randomly selected from birth certificates or birth hospital records; mothers of... asked to swab a total of 5 sponges per infant. The infant's mother and father will be asked to provide...

  6. A Pleasing Birth

    NARCIS (Netherlands)

    Vries, De Raymond

    2005-01-01

    Women have long searched for a pleasing birth-a birth with a minimum of fear and pain, in the company of supportive family, friends, and caregivers, a birth that ends with a healthy mother and baby gazing into each other's eyes. For women in the Netherlands, such a birth is defined as one at home

  7. 40 CFR 90.511 - Suspension and revocation of certificates of conformity.

    Science.gov (United States)

    2010-07-01

    ... KILOWATTS Selective Enforcement Auditing § 90.511 Suspension and revocation of certificates of conformity... proposed quality control and/or quality assurance measures to be taken by the manufacturer to prevent...

  8. 40 CFR 89.511 - Suspension and revocation of certificates of conformity.

    Science.gov (United States)

    2010-07-01

    ... ENGINES Selective Enforcement Auditing § 89.511 Suspension and revocation of certificates of conformity... proposed quality control and/or quality assurance measures to be taken by the manufacturer to prevent...

  9. 78 FR 30273 - Export Trade Certificate of Review

    Science.gov (United States)

    2013-05-22

    ... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 84-24A12] Export Trade Certificate of Review ACTION: Notice of Application to Amend the Export Trade Certificate of Review Issued to... application to amend an Export Trade Certificate of Review (``Certificate''). This notice summarizes the...

  10. 78 FR 62585 - Export Trade Certificate of Review

    Science.gov (United States)

    2013-10-22

    ... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 89-5A018] Export Trade Certificate of Review ACTION: Notice of Application to amend the Export Trade Certificate of Review Issued to... received an application to amend an Export Trade Certificate of Review (``Certificate''). This notice...

  11. 78 FR 36747 - Export Trade Certificate of Review

    Science.gov (United States)

    2013-06-19

    ... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 89-4A018] Export Trade Certificate of Review ACTION: Notice of Application to amend the Export Trade Certificate of Review Issued to... received an application to amend an Export Trade Certificate of Review (``Certificate''). This notice...

  12. 78 FR 72865 - Export Trade Certificate of Review

    Science.gov (United States)

    2013-12-04

    ... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 92-12A001] Export Trade Certificate of Review ACTION: Notice of application to amend the Export Trade Certificate of Review issued to..., has received an application to amend an Export Trade Certificate of Review (``Certificate''). This...

  13. 78 FR 36745 - Export Trade Certificate of Review

    Science.gov (United States)

    2013-06-19

    ... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 87-9A001] Export Trade Certificate of Review ACTION: Notice of Application to amend the Export Trade Certificate of Review Issued to..., has received an application to amend an Export Trade Certificate of Review (``Certificate''). This...

  14. Protocol for a randomised controlled trial of treatment of asymptomatic candidiasis for the prevention of preterm birth [ACTRN12610000607077

    Directory of Open Access Journals (Sweden)

    Rickard Kristen R

    2011-03-01

    Full Text Available Abstract Background Prevention of preterm birth remains one of the most important challenges in maternity care. We propose a randomised trial with: a simple Candida testing protocol that can be easily incorporated into usual antenatal care; a simple, well accepted, treatment intervention; and assessment of outcomes from validated, routinely-collected, computerised databases. Methods/Design Using a prospective, randomised, open-label, blinded-endpoint (PROBE study design, we aim to evaluate whether treating women with asymptomatic vaginal candidiasis early in pregnancy is effective in preventing spontaneous preterm birth. Pregnant women presenting for antenatal care The study protocol draws on the usual antenatal care schedule, has been pilot-tested and the intervention involves only a minor modification of current practice. Women who agree to participate will self-collect a vaginal swab and those who are culture positive for Candida will be randomised (central, telephone to open-label treatment or usual care (screening result is not revealed, no treatment, routine antenatal care. Outcomes will be obtained from population databases. A sample size of 3,208 women with Candida colonisation (1,604 per arm is required to detect a 40% reduction in the spontaneous preterm birth rate among women with asymptomatic candidiasis from 5.0% in the control group to 3.0% in women treated with clotrimazole (significance 0.05, power 0.8. Analyses will be by intention to treat. Discussion For our hypothesis, a placebo-controlled trial had major disadvantages: a placebo arm would not represent current clinical practice; knowledge of vaginal colonisation with Candida may change participants' behaviour; and a placebo with an alcohol preservative may have an independent affect on vaginal flora. These disadvantages can be overcome by the PROBE study design. This trial will provide definitive evidence on whether screening for and treating asymptomatic candidiasis in

  15. Directory of certificates of compliance for radioactive materials packages. Certificates of compliance

    International Nuclear Information System (INIS)

    1979-10-01

    This volume contains all Certificates of Compliance for radioactive material packages effective September 14, 1979. Purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance number is included at the back of each volume of the directory

  16. Birth characteristics and Wilms tumors in children in the Nordic countries

    DEFF Research Database (Denmark)

    Schüz, Joachim; Schmidt, Lisbeth Samsø; Kogner, Per

    2011-01-01

    Little is known about causes of Wilms tumor. Because of the young age at diagnosis, several studies have looked at various birth characteristics. We conducted a registry-based case-control study involving 690 cases of Wilms tumor aged 0-14 years, occurring in Denmark, Finland, Norway or Sweden...... during 1985-2006, individually matched to five controls drawn randomly from the Nordic childhood population. Information on birth characteristics was obtained from the population-based medical birth registries. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic......-for-gestational age girls also had a higher risk (2.48, 1.51-4.05), whereas no effect was seen for boys (1.12, 0.60-2.07). An association was seen with Apgar score at 5 min birth order. In our large-scale, registry...

  17. Parental bonding after preterm birth: child and parent perspectives in the Helsinki study of very low birth weight adults.

    Science.gov (United States)

    Pyhälä, Riikka; Räikkönen, Katri; Pesonen, Anu-Katriina; Heinonen, Kati; Lahti, Jari; Hovi, Petteri; Strang-Karlsson, Sonja; Andersson, Sture; Eriksson, Johan G; Järvenpää, Anna-Liisa; Kajantie, Eero

    2011-02-01

    To examine whether parenting behavior recalled by very low birth weight (VLBW) adults or their parents differs from that of term-born control subjects or their parents. A total of 164 VLBW and 172 control adults (mean age 22.5 years, SD 2.2) assessed retrospectively the parenting behavior of their parents by the Parental Bonding Instrument, which includes dimensions of care, protectiveness, and authoritarianism. A subgroup of 190 mothers and 154 fathers assessed their own parenting behavior by the Parent Behavior Inventory, which includes dimensions of supportive and hostile parenting. The VLBW women assessed their mothers as more protective and authoritarian than the control women. The VLBW and control men did not differ from each other. Both mothers and fathers of the VLBW adults assessed their own parenting as more supportive than those of the control subjects. Preterm birth at VLBW may promote a more protective, as well as more supportive, parenting style. Copyright © 2011 Mosby, Inc. All rights reserved.

  18. Randomized trial of BCG vaccination at birth to low-birth-weight children

    DEFF Research Database (Denmark)

    Aaby, Peter; Roth, Adam Anders Edvin; Ravn, Henrik

    2011-01-01

    Observational studies have suggested that BCG may have nonspecific beneficial effects on survival. Low-birth-weight (LBW) children are not given BCG at birth in Guinea-Bissau; we conducted a randomized trial of BCG at birth (early BCG) vs delayed BCG.......Observational studies have suggested that BCG may have nonspecific beneficial effects on survival. Low-birth-weight (LBW) children are not given BCG at birth in Guinea-Bissau; we conducted a randomized trial of BCG at birth (early BCG) vs delayed BCG....

  19. Small-for-gestational age and preterm birth across generations: a population-based study of Illinois births.

    Science.gov (United States)

    Castrillio, Stephanie M; Rankin, Kristin M; David, Richard J; Collins, James W

    2014-12-01

    Small for gestational age (weight for gestational age mothers (1956-1976) with appended US census income information. Former SGA White mothers (N = 8,993) had a twofold greater infant SGA frequency than former non-SGA White mothers (N = 101,312); 14.4 versus 6.9 %, RR = 2.1 (2.0-2.2). Former SGA African American (N = 4,861) mothers had a SGA birth frequency of 25.7 % compared to 16.1 % for former non-SGA mothers (N = 28,090); RR = 1.5 (1.5-1.6). The adjusted (controlling for maternal age, education, marital status, parity, prenatal care usage, cigarette smoking, and hypertension) RR (95 % CI) of infant SGA for former SGA (compared to non-SGA) White and African-American mothers equaled 2.0 (1.9-2.1 and 1.5 (1.5-1.6), respectively. The adjusted RR (95 % CI) of infant preterm birth for former preterm (compared to term) White and African-American mothers were 1.1 (1.0-1.2). The findings were minimally changed among mothers with a lifelong residence in impoverished or affluent neighborhoods. In both races, approximately 8 % of SGA births were attributable to maternal SGA. There is a transgenerational association of SGA but not preterm birth among non-Hispanic Whites and African-Americans. In both races, a similar proportion of SGA births are attributable to maternal SGA.

  20. Birth characteristics of women with Marfan syndrome, obstetric and neonatal outcomes of their pregnancies-A nationwide cohort and case-control study.

    Science.gov (United States)

    Kernell, Kristina; Sydsjö, Gunilla; Bladh, Marie; Josefsson, Ann

    2017-08-01

    The aim was to investigate birth characteristics, obstetric and neonatal outcomes of the first childbirth in women with Marfan syndrome by use of Swedish national registers since pregnancy-related outcomes in women with Marfan syndrome have only been sparsely investigated. In this national population-based cohort study and matched case-control study of Swedish women born 1973-1993, women with Marfan syndrome (n=273) were compared to women without the condition (n=1 017 265). The study population was followed until 2013. A total of 364 553 mother-firstborn-offspring pairs were analyzed. Sixty-one women with Marfan syndrome became mothers. Women with Marfan syndrome were also compared to 543 healthy controls. Women with Marfan syndrome were more often born preterm (pMarfan syndrome had no increased risk of giving birth by cesarean section (p=0.079). No increased neonatal risks in their children were found. Women with Marfan syndrome were less likely to give birth than those without (pMarfan syndrome were more likely to be born preterm, SGA and by cesarean section. These increased risks of preterm birth and SGA babies were not found in connection with their own first childbirth. Pregnancies with known fetal Marfan syndrome have to be carefully monitored. The results are important for obstetricians giving preconception counseling and treating women with Marfan syndrome. Further studies are needed to evaluate risks during pregnancy and long-term effects of pregnancy on the cardiovascular status of women with Marfan syndrome. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. 77 FR 12562 - Export Trade Certificate of Review

    Science.gov (United States)

    2012-03-01

    ... DEPARTMENT OF COMMERCE International Trade Administration [Application No. 10-2A001] Export Trade Certificate of Review ACTION: Notice of Application (10-2A001) to Amend the Export Trade Certificate of Review..., has received an application to amend an Export Trade Certificate of Review (``Certificate''). This...

  2. Planned hospital birth versus planned home birth

    DEFF Research Database (Denmark)

    Olsen, O.; Clausen, J.A.

    2012-01-01

    Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications. This is an update of a Cochrane review first published in 1998....

  3. [Risk factors associated with preterm birth in a second level hospital].

    Science.gov (United States)

    Escobar-Padilla, Beatriz; Gordillo-Lara, Limberg Darinel; Martínez-Puon, Horacio

    2017-01-01

    Preterm birth is one of the biggest problems in obstetrics and gynecology, given that it has an incidence of 10-11%. The objective was to identify the risk factors associated with a preterm birth. A retrospective, observational, transversal and analytic case-control study was made. All premature birth incidences were determined as study objects and controls were integrated with term deliveries. A sample size of 344 patients with a control per case was calculated. A total of 688 patients were studied. Statistical analysis was descriptive, univariate and bivariate and we used the Pearson chi square test, with a p preclampsia, PROM, twin pregnancy, placenta praevia, cervicovaginitis, previous preterm delivery and UTI are risk factors with statistical significance associated with preterm delivery.

  4. Architect’s Certification: A Problem?

    Directory of Open Access Journals (Sweden)

    Yong Kum Weng

    2015-01-01

    Full Text Available Currently the problems of some architects issuing fraudulent progress certificates for Malaysia’s housing projects result in many house buyers losing their life savings. Unfortunately, these house buyers still remain contractually responsible for all the associated, present and future financial obligations such as their bank loans. Fraudulent certification is the most frequent incident of complaints amongst the range of problems complained about to the Board of Architects, Malaysia or Lembaga Arkitek Malaysia (LAM. This paper highlights the underlying pertinent issues such as when an architect does not fully understand the ramifications, or exercise due care when performing the certifier’s role with its inherent responsibilities under the Housing Development Act (HDA and Housing Development Regulations (HDR. Also at what stage the architect is legally required to issue progressive work completion certificates, particularly the scope ranging from the inception stage through to the completion stage. This includes the relevant housing laws and regulations that enshrine the architects’ professional status and confers legal certification duties. This is designed to protect the public interest, yet many architects fail to perform this duty inde-pendently, or impartially and fairly to the new house buyers and the public at-large. Recognizing the systemic weakness, the elements that contribute to the fraudulent certification and illustrates how the fraudulent certification exploits the trust of house buyers. In the analysis, a quantitative framework was used to measure, quantify and discuss the best all round outcomes.

  5. Young, low-birth-weight men are not more susceptible to the diabetogenic effects of a prolonged free fatty acid exposure than matched controls

    DEFF Research Database (Denmark)

    Jensen, Christine B; Storgaard, Heidi; Holst, Jens Juul

    2005-01-01

    a prolonged physiological lipid load could unmask or augment existing metabolic defects in otherwise healthy young LBW subjects. Forty 19-year-old men (LBW [n = 20], controls [normal birth weight, NBW] [n = 20]) without a family history of diabetes underwent an intravenous glucose tolerance test (0.3 g kg(-1......Low birth weight (LBW) is associated with increased risk of developing type 2 diabetes later in life. Progression from normal to impaired glucose tolerance and overt diabetes may depend, to some extent, on elevation of plasma free fatty acids (FFAs). We undertook this study to elucidate whether...... with normal glucose tolerance and in NBW controls. We reproduced our previous finding of lower insulin-stimulated glycolysis in this population....

  6. 46 CFR 91.60-40 - Duration of Convention certificates.

    Science.gov (United States)

    2010-10-01

    ... VESSELS INSPECTION AND CERTIFICATION Certificates Under International Convention for Safety of Life at Sea... period of not more than 60 months. (1) A Cargo Ship Safety Construction Certificate. (2) A Cargo Ship Safety Equipment Certificate. (3) A Safety Management Certificate. (4) A Cargo Ship Safety Radio...

  7. Certification Manual for Wisconsin Public Librarians. Bulletin No. 94111.

    Science.gov (United States)

    Lamb, Donald K.

    This manual contains the guidelines and procedures for public librarian certification and certification renewal in Wisconsin. Certification is not required for library personnel other than administrators, but nonadministrators may apply for certification at the level for which they are eligible. Requirements for voluntary library certification are…

  8. Tradable green certificates in Flanders (Belgium)

    International Nuclear Information System (INIS)

    Verbruggen, Aviel

    2004-01-01

    The paper provides details on green certificate systems in Belgium. The Flemish region has established a system and the Walloon region is preparing a slightly different one. The lack of uniformity and consequently of transparency in one country emphasises the need for more EU leadership in the field. The main part of the article analyses the established Flemish system. Green certificates are complementary to other instruments that promote renewable electricity, e.g. direct subventions on the feed-in price of green electricity or direct subventions on capital investments. Certificates execute a forcing effect on the actual development of green power if the imposed shares of green power in total sales are significant and if the fine level is at the height to enforce the quota. If the fine is too low the incentive effect turns into a financing tax effect. When the green certificate system does the job it is designed for, i.e. operating at the edge of the RES-E development and organise the transition from a non-sustainable to a sustainable power system, certificate prices will be high and reduce end-use consumption of electricity. A segmentation of the RES-E sector along the various RES-E technologies is a necessity to keep any certificate system affordable, effective and efficient. One can segment the tradable certificate market or one can assign a different number of certificates to a different RES-E technology project. Both solutions require an intensive follow-up of cost structures and of other policy measures (subventions), but given the infant state of understanding and experience segmenting markets may be best in the nearby years. (Author)

  9. Design and implementation of PKI-based certification authority

    Science.gov (United States)

    Zheng, Ying; Bai, Qinghai; Zhao, Linna; Chun, Hua; Chen, Jing

    2015-12-01

    PKI achieves the management of public key by certificates. It combines the user's public key and his or her identification formation through a trusted third-party organization CA, in order to authenticate the user's identity on the Internet, thus ensuring the authenticity, integrity, confidentiality, and non- repudiation of the information transmitted on the Internet. CA is the most critical agency in the PKI system, mainly responsible for issuing and managing certificates. On the basis of the actual needs of an enterprise, in this paper the author designs and develops a small-sized PKI-based Certification Authority equipped with the functions of root CA initialization, certificate application, certificate issuance, certificate revocation, and the generation of certificate revocation list. The author also points out the problems that need to be mentioned in the design and development.

  10. 46 CFR 153.15 - Conditions under which the Coast Guard issues a Certificate of Inspection or Certificate of...

    Science.gov (United States)

    2010-10-01

    ... Certificate of Inspection required under § 153.900 for a United States ship to carry a hazardous material or... Certificate of Inspection or Certificate of Compliance. 153.15 Section 153.15 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SHIPS CARRYING BULK LIQUID, LIQUEFIED...

  11. Beating Birth Defects

    Centers for Disease Control (CDC) Podcasts

    Each year in the U.S., one in 33 babies is affected by a major birth defect. Women can greatly improve their chances of giving birth to a healthy baby by avoiding some of the risk factors for birth defects before and during pregnancy. In this podcast, Dr. Stuart Shapira discusses ways to improve the chances of giving birth to a healthy baby.

  12. Experiences of women who planned birth in a birth centre compared to alternative planned places of birth. Results of the Dutch Birth Centre Study

    NARCIS (Netherlands)

    Hitzert, M.; Hermes, M.A.; Scheerhagen, M.; Boesveld, L.C.; Wiegers, T.A.; Akker-van Marle, M.E.; Dommelen, P. van; Pal-de Bruin, K.M. de; Graaf, J.P. de

    2016-01-01

    Objective to assess the experiences with maternity care of women who planned birth in a birth centre and to compare them to alternative planned places of birth, by using the responsiveness concept of the World Health Organization. Design this study is a cross-sectional study using the ReproQ

  13. Experiences of women who planned birth in a birth centre compared to alternative planned places of birth. Results of the Dutch Birth Centre Study.

    NARCIS (Netherlands)

    Hitzert, M.; Hermus, M.; Scheerhagen, M.; Boesveld, I.C.; Wiegers, T.; Akker-van Marle, M.E. van den; Dommelen, P. van; Pal-de Bruin, K.M. van der; Graal, J. P. de

    2016-01-01

    Objective: to assess the experiences with maternity care of women who planned birth in a birth centre and to compare them to alternative planned places of birth, by using the responsiveness concept of the World Health Organization. Design: this study is a cross-sectional study using the ReproQ

  14. Impact of short-term high-fat feeding and insulin-stimulated FGF21 levels in subjects with low birth weight and controls

    DEFF Research Database (Denmark)

    Vienberg, Sara Gry; Brøns, Charlotte; Nilsson, Emma

    2012-01-01

    of type 2 diabetes and 26 control (normal birth weight (NBW)) young men were subjected to 5 days of high-fat (HF) overfeeding (+50%). Basal and clamp insulin-stimulated serum FGF21 levels were examined before and after the diet, and FGF21 mRNA expression was measured in muscle and fat biopsies......OBJECTIVE: Fibroblast growth factor 21 (FGF21) is a metabolic factor involved in glucose and lipid metabolism. However, little is known about the physiological role of FGF21 during a dietary challenge in humans. RESEARCH DESIGN AND METHODS: Twenty healthy low birth weight (LBW) with known risk...

  15. 76 FR 24956 - 30-Day Notice of Proposed Information Collection: Certificate of Eligibility for Exchange Visitor...

    Science.gov (United States)

    2011-05-03

    ...: Certificate of Eligibility for Exchange Visitor (J-1) Status; Form DS-2019, OMB No. 1405-0119. ACTION: Notice... Management and Budget (OMB) for approval in accordance with the Paperwork Reduction Act of 1995. Title of Information Collection: Certificate of Eligibility for Exchange Visitor (J-1) Status OMB Control Number: 1405...

  16. Analysis of the green certificate market

    International Nuclear Information System (INIS)

    Storeboe, Inger Oeydis

    2001-04-01

    This report studies the advantages and disadvantages of a separate financial market for the environmental advantages in the production of electricity from renewable energy sources. This market solution is evaluated against other financial systems used to promote the production of green electricity. By starting from a general equilibrium model for the green certificate market, the report discusses how the adaptation in the certificate market is influenced by changes in the market conditions. The certificate market is combined with a quota market for carbon dioxide, with and without international trade with electricity and certificate and market power in the production of electricity from renewable energy sources

  17. The incidence of histological chorioamnionitis in IVF/GIFT preterm births.

    Science.gov (United States)

    Williams, H; Jeffery, H

    1994-08-01

    A retrospective case control study was designed to investigate the role of subclinical infection as a risk factor for the high rate of preterm deliveries in IVF/GIFT pregnancies. The cases and the controls were identified from the records of consecutive livebirths of preclampsia and antepartum haemorrhage. As a marker of subclinical infection, the incidence of histological chorioamnionitis (HCA) in the 2 groups (as defined by the standardized, semiquantitative method of Benirschke) was compared. The matched variables did not differ significantly between the IVF/GIFT group and the control group. No significant difference in the incidence of HCA was detected between IVF/GIFT and control groups for singletons or twins. Overall 24% of IVF/GIFT and 30% of controls showed evidence of HCA, odds ratio (95% confidence intervals), 0.72 (0.40-1.31). This study showed no evidence that the incidence of HCA, is significantly increased in IVF/GIFT preterm births compared with other matched, preterm births. Therefore, we conclude that subclinical infection/inflammation cannot explain the 4-fold increase in preterm births in the IVF/GIFT population.

  18. 7 CFR 205.406 - Continuation of certification.

    Science.gov (United States)

    2010-01-01

    ..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) ORGANIC FOODS PRODUCTION ACT PROVISIONS NATIONAL ORGANIC PROGRAM Certification § 205.406 Continuation of certification. (a) To continue... 7 Agriculture 3 2010-01-01 2010-01-01 false Continuation of certification. 205.406 Section 205.406...

  19. 7 CFR 1421.110 - Commodity certificate exchanges.

    Science.gov (United States)

    2010-01-01

    ... commodity certificate for the marketing assistance loan collateral. (b) The exchange rate is the lesser of... assistance loan collateral. (3) Immediately exchanging the purchased commodity certificate for the outstanding loan collateral. (e) The authority to make commodity certificates available to the producer will...

  20. A software product certification model

    NARCIS (Netherlands)

    Heck, P.M.; Klabbers, M.D.; van Eekelen, Marko

    2010-01-01

    Certification of software artifacts offers organizations more certainty and confidence about software. Certification of software helps software sales, acquisition, and can be used to certify legislative compliance or to achieve acceptable deliverables in outsourcing. In this article, we present a

  1. Symptoms of anxiety and depression during pregnancy and their association with low birth weight in Chinese women: a nested case control study.

    Science.gov (United States)

    Yang, Shaoping; Yang, Rong; Liang, Shengwen; Wang, Jing; Weaver, Nancy L; Hu, Ke; Hu, Ronghua; Trevathan, Edwin; Huang, Zhen; Zhang, Yiming; Yin, Ting; Chang, Jen Jen; Zhao, Jinzhu; Shen, Longjiao; Dong, Guanghui; Zheng, Tongzhang; Xu, Shunqing; Qian, Zhengmin; Zhang, Bin

    2017-04-01

    This study is a nested case control study from a population-based cohort study conducted in Wuhan, China. The aim is to estimate the association between symptoms of depression during pregnancy (DDP), anxiety during pregnancy(ADP), and depression with anxiety during pregnancy (DADP) and low birth weight (LBW) and to examine the extent to which preterm birth (PTB) moderates these associations. Logistic regression analyses were used to model associations between DDP, ADP, and DADP and LBW. Models were stratified by the presence or absence of PTB to examine moderating effects. From the cohort study, 2853 had a LBW baby (cases); 5457 pregnant women served as controls. Women with DDP or ADP only were not at higher risk of having a LBW baby, but DADP was associated with increased risk of LBW (crude OR 1.41, 95% CI 1.17-1.70; adjusted OR 1.29, 95% CI 1.07-1.57), and the significant association was particularly evident between DADP and LBW in PTB, but not in full-term births. Our data suggests that DADP is related to an increased risk of LBW and that this association is most present in PTBs.

  2. Review of utility staff training and certification

    International Nuclear Information System (INIS)

    1999-04-01

    The Advisory Committee on Nuclear Safety (ACNS) has reviewed the nuclear utility training programs in Canada and the Atomic Energy Control Board (AECB) certification program, to determine their effectiveness in meeting current and future needs. It has also looked briefly at the practices in other countries and in the aviation industry in Canada, by way of comparison. While a quantitative measure of effectiveness was beyond the scope of this review, on a purely qualitative basis the ACNS concludes that the current training and certification regime produces qualified operators, but not necessarily in the most effective way. The report makes five recommendations. The thrust of these recommendations is towards a more effective and streamlined training and certification regime based on strict adherence to the Systematic Approach to Training (SAT) methodology combined with independent verification through a peer review and accreditation process. The Committee believes that training and qualification of nuclear power plant operating staff is the complete responsibility of the utilities and that the role of the AECB is to audit the process to ensure that the utilities discharge their responsibility appropriately. In other words, the AECB should deal with operator training and certification in the same way that it deals with other aspects of nuclear power plant operation that are important to health, safety, security and the environment - by inspections and audits. The Committee believes that the proposed regulatory requirement for recertification of certain nuclear power plant operating staff, which would come into effect when the new Regulations are promulgated, is not consistent with the government's thrust and with how the AECB regulates other aspects of nuclear power plant operations. (author)

  3. Antihypertensive treatment and control according to gender, education, country of birth and psychiatric disorder: the Swedish Primary Care Cardiovascular Database (SPCCD).

    Science.gov (United States)

    Ljungman, C; Kahan, T; Schiöler, L; Hjerpe, P; Wettermark, B; Boström, K B; Manhem, K

    2015-06-01

    The reasons why women and men are treated with different antihypertensive drugs are not clear. Whether socioeconomic factors influence prescription patterns and blood pressure control differently in women and men has not been investigated. This cross-sectional study performed in a cohort of hypertensive patients from the Swedish Primary Care Cardiovascular Database (SPCCD) examined the influence of educational level, country of birth, gender and concomitant psychiatric disorder on prescription pattern and blood pressure control in 40,825 hypertensive patients. Men were more often than women treated with calcium channel blocker and angiotensin-converting enzyme inhibitor (ACEI), irrespective of education, country of birth and psychiatric disorder. Educational level influenced the prescription pattern to some extent, where the gender differences were reduced in patients with a higher educational level. In women, but not in men, high educational level and concomitant psychiatric disorder were associated with a higher proportion reaching target blood pressure. The predominant use of ACEI and calcium channel blockers in men is not influenced by educational level, country of birth or psychiatric disorder. Thus other explanations must be considered such as gender differences in side effects. Educational level seems to have a greater impact on reaching target blood pressure in women compared with men.

  4. Preparation procedure and certification of uranous-uranic oxide and nitric acid solution of neptunium as standard specimens of plant

    International Nuclear Information System (INIS)

    Bulyanitsa, L.S.; Lipovskij, A.A.; Ryzhinskij, M.V.; Preobrazhensskaya, L.D.; Aleksandruk, V.M.; Alekseeva, N.A.; Gromova, E.A.; Solntseva, L.F.; Shereshevskaya, I.I.

    1981-01-01

    Two techniques of certification of standard specimens of plant (SSP) are considered. The first technique-comparison with initial SS-metallic uranium NBS-960 - is used for certification of uranium. protoxide-oxide. The mass part of the sum of analyzed impurities in prepared initial SS is (8.4+-0.8)x10 -3 %. For certification according to mass uranium part the method of gravimetric potentiometric titration with semiautomatic titrator is used; the mean quadratic deviation of the method is s=0.0002-0.0003, certified value of uranium mass part in SSP (taking account of the error of initial SS) is (84.80+-0.02)%. The second technigue - a simplified circular experiment - is used for certification of SSP-nitric acid solution of neptunium as to Np mass part. Coulometry at controlled potential and coulometry at controlled current and two variants of potentiometric titration are used as certification methods of analysis. Relative mean quadratic deviations of the methods are ssub(r)=0.0014-0.0023. When calculating total error of certified value of neptunium mass part constituents of both accidental and unremoved systematic errors of the methods were included. The final certification result of SSP is (5.707+-0.018)% [ru

  5. CDC WONDER: Births

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Births (Natality) online databases in CDC WONDER report birth rates, fertility rates and counts of live births occurring within the United States to U.S....

  6. 13 CFR 120.644 - Transfers of Certificates.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Transfers of Certificates. 120.644 Section 120.644 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Secondary Market Miscellaneous Provisions § 120.644 Transfers of Certificates. (a) General rule. Certificates are...

  7. The impact of the legalisation of abortion on birth outcomes in Uruguay.

    Science.gov (United States)

    Antón, José-Ignacio; Ferre, Zuleika; Triunfo, Patricia

    2018-04-18

    This study investigates the short-term impact on the quantity and quality of births of an abortion reform in Uruguay that legalised termination of pregnancy until the 12 th week of pregnancy in the short run. We employ a differences-in-differences approach, comprehensive administrative records of births, and a novel identification strategy based on the planned or unplanned nature of pregnancies that came to term. Our results suggest that this policy change has led to an 8% decline in the number of births from unplanned pregnancies, driven by the group of mothers aged between 20 and 34 years old who have secondary education. This decline has triggered an increase in the average quality of births in terms of more intensive prenatal control care and a lower probability of births among single mothers. Furthermore, we document a positive selection process of births because of the reform, as adequate prenatal control care and Apgar scores rose among the affected demographic group. Copyright © 2018 John Wiley & Sons, Ltd.

  8. [Cornea bank of Lyon: from quality diagnosis to ISO 9001 certification].

    Science.gov (United States)

    Pascal, P; Chalochet, A; Damour, O

    2001-12-01

    The tissue and cell bank of the HCL (Hospices Civils de Lyon) has, since 10 June 1999, consisted of two sections with related activities: cell culture for the Skin Substitutes Laboratory (Laboratoire des Substituts Cutanés, LSC) and preservation of corneas at 31 degrees C for the Cornea Bank. As the LSC had been ISO 9001 certified since March 1997 our aim, since merger, was to raise the Cornea Bank to the same level of quality as the LSC, so as to coincide with the renewal of the LSC certificate in February 2000. The methods we used (project, quality control, analysis and process optimization) led us to receive official certification only nine months after the merger. The procedure started with a program of quality control at the Cornea Bank from February 1999 onwards, in order to list the work and equipment required, evaluate its documentation system and what was needed to incorporate this new activity into the existing system of quality assurance at the LSC. On the 7th March 2000, the Tissue and Cell Bank of the HCL obtained an ISO 9001 certificate for its combined functions. As well as achieving our objectives and the strong points highlighted by the auditor during the renewal process, this quality assessment revealed many advantages: improvements in the conservation of corneas, economies in staff replacement and reductions in both the cost of maintaining quality, the cost of the corneas themselves, etc. The decree 'Banque' no. 99-741 of 30th August 1999, which put in place the system of authorization of tissue banks in France, demands quality control. Our application for certification which started in early 1999 had anticipated this regulation. This helped us enormously when compiling the dossier accompanying the official request and was an essential element in obtaining the favourable response of the ASSAPS on 21 June 2000.

  9. Vaginal birth after cesarean: neonatal outcomes and United States birth setting.

    Science.gov (United States)

    Tilden, Ellen L; Cheyney, Melissa; Guise, Jeanne-Marie; Emeis, Cathy; Lapidus, Jodi; Biel, Frances M; Wiedrick, Jack; Snowden, Jonathan M

    2017-04-01

    Women who seek vaginal birth after cesarean delivery may find limited in-hospital options. Increasing numbers of women in the United States are delivering by vaginal birth after cesarean delivery out-of-hospital. Little is known about neonatal outcomes among those who deliver by vaginal birth after cesarean delivery in- vs out-of-hospital. The purpose of this study was to compare neonatal outcomes between women who deliver via vaginal birth after cesarean delivery in-hospital vs out-of-hospital (home and freestanding birth center). We conducted a retrospective cohort study using 2007-2010 linked United States birth and death records to compare singleton, term, vertex, nonanomolous, and liveborn neonates who delivered by vaginal birth after cesarean delivery in- or out-of-hospital. Descriptive statistics and multivariate regression analyses were conducted to estimate unadjusted, absolute, and relative birth-setting risk differences. Analyses were stratified by parity and history of vaginal birth. Sensitivity analyses that involved 3 transfer status scenarios were conducted. Of women in the United States with a history of cesarean delivery (n=1,138,813), only a small proportion delivered by vaginal birth after cesarean delivery with the subsequent pregnancy (n=109,970; 9.65%). The proportion of home vaginal birth after cesarean delivery births increased from 1.78-2.45%. A pattern of increased neonatal morbidity was noted in unadjusted analysis (neonatal seizures, Apgar score birthing their second child by vaginal birth after cesarean delivery in out-of-hospital settings had higher odds of neonatal morbidity and death compared with women of higher parity. Women who had not birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery had higher odds of neonatal morbidity and mortality compared with women who had birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery. Sensitivity analyses generated distributions of plausible

  10. Gestational age, birth weight, and the risk of hyperkinetic disorder

    DEFF Research Database (Denmark)

    Linnet, Karen M; Wisborg, Kirsten; Agerbo, Esben

    2006-01-01

    AIMS: To study the association between gestational age and birth weight and the risk of clinically verified hyperkinetic disorder. METHODS: Nested case-control study of 834 cases and 20 100 controls with incidence density sampling. RESULTS: Compared with children born at term, children born...... with gestational ages of 34-36 completed weeks had a 70% increased risk of hyperkinetic disorder (rate ratio (RR) 1.7, 95% confidence interval (CI) 1.2 to 2.5). Children with gestational ages below 34 completed weeks had an almost threefold increased risk (RR 2.7, 95% CI 1.8 to 4.1). Children born at term...... with birth weights of 1500-2499 g had a 90% increased risk of hyperkinetic disorder (RR 1.9, 95% CI 1.2 to 2.9), and children with birth weights of 2500-2999 g had a 50% increased risk (RR 1.5, 95% CI 1.2 to 1.8) compared with children born at term with birth weights above 2999 g. The results were adjusted...

  11. Malaria has no effect on birth weight in Rwanda

    Directory of Open Access Journals (Sweden)

    Karema Corine

    2009-08-01

    Full Text Available Abstract Background Malaria has a negative effect on pregnancy outcome, causing low birth weight, premature birth and stillbirths, particularly in areas with high malaria transmission. In Rwanda, malaria transmission intensity ranges from high to nil, probably associated with variable altitudes. Overall, the incidence decreased over the last six years (2002–2007. Therefore, the impact of malaria on birth outcomes is also expected to vary over time and space. Methods Obstetric indicators (birth weight and pregnancy outcome and malaria incidence were compared and analyzed to their association over time (2002–2007 and space. Birth data from 12,526 deliveries were collected from maternity registers of 11 different primary health centers located in different malaria endemic areas. Malaria data for the same communities were collected from the National Malaria Control Programme. Associations were sought with mixed effects models and logistic regression. Results In all health centres, a significant increase of birth weight over the years was observed (p Conclusion In Rwanda, birth weight and pregnancy outcome are not directly influenced by malaria, which is in contrast to many other studied areas. Although malaria incidence overall has declined and mean birth weight increased over the studied period, no direct association was found between the two. Socio-economic factors and improved nutrition could be responsible for birth weight changes in recent years.

  12. Certification of building thermographers: experiences after three courses

    Science.gov (United States)

    Kauppinen, Timo; Hekkanen, Martti; Paloniitty, Sauli; Krankka, Juha

    2006-04-01

    The certification procedure of building thermographers was started in 2003, even though thermography has been used in Finland in building survey since late 70's. There has been about a 25 years' unorganized and more or less wild period, without any generally accepted rules for interpretation, as well as how to order thermography services, how to report the results, how to do the practical work in the buildings etc. The service was provided by consultants with varied backgrounds. More operators have come into the market and building developers and contractors have begun to use thermography for quality control in new building and in renovation planning. In the year 2004 various organizations in building trade launched a pilot project to certificate building thermographers. The structure and the topics of the course were introduced in Thermosense 2005. By the end of the year 2005 the third course was completed. From the beginning of the procedure to the end of the third course about 40 persons have received a certificate. During the certification process, two guidelines have been published, as part of RT (Building Information) - files: instructions for ordering, for practical field work and for reporting of thermography survey in buildings. The guidelines also contain basics for interpretation. The interpretation is consistent with the other existing directions (building codes etc). At the turn of 2005 - 2006 a new book of building thermography was published. There is still lack of comprehensive as well as unambiguous rules for interpretation. In the paper we will present experiences on the courses, the main problems posed to the participants and findings during the last two - three years' field work. We will also introduce briefly the structure and content of the guidelines and an example how to use thermography as a tool of quality control in new building. The case studies are new one-family houses in a housing fair and exhibition area in the city of Oulu.

  13. Maternal risk factors associated with low birth weight

    International Nuclear Information System (INIS)

    Khan, N.; Jamal, M.

    2003-01-01

    Objective: To determine the association of socio-demographic, maternal, medical and obstetric risk factors with low birth weight. Results: The mean weight of cases was 2.08 kg as compared to 3.1 in controls. Forty-sixty percent of cases were preterm. The factors like maternal malnutrition, young age of the mothers, poverty, close birth spacing, hypertension and antenatal per vagamin (p/v) bleeding during pregnancy have independent effect in causing low birth weight (LBW). Conclusion: Maternal bio social, medical and obstetric factors have strong association with LBW. To overcome this problem, special attention is required to strengthen the mother and child health care services in the community. (author)

  14. [The new policies of natural birth control].

    Science.gov (United States)

    Johnson, J H; Reich, J

    1986-01-01

    International agency donors have in recent years become increasingly interested in natural family planning (NFP). The US Agency for International Development (USAID) has made an increasing amount of funds available annually for NFP, and at 1 point, in the case of NFP, relaxed the requirement that donor agencies offer more than 1 contraceptive method, despite the argument that developing country populations do not benefit from enough information for informed consent to be guaranteeable by 1-method agency. NFP has evolved from simple counting of days to observation of changes in cervical mucus and body temperature. The self-observation and learning generally required contribute to difficulties experienced in recruitment and retention of acceptors. At a 1986 meeting in Ottawa, Canada, sponsored by the International Federation for Family Life Promotion, it was revealed that calendar (but not the more effective sympto-thermal) method of NFP is fairly common in some developing countries (it is used by 41% of Peruvian and 24% of Filipino and Sri Lankan women), and even in developed countries. The hypothesized connection between the phenomenon of "old gametes" and birth defects, feared to be a side effect of NFP, was touched on, as was the possibility of using NFP to control the sex of the fetus. It was stressed that the effect of breastfeeding on fecundability constituted NFP in many countries. Other speakers cited religious and moral reasons for promotion of NFP, adding that NFP aids marital communication. It is possible increased popularity of NFP could depend in the near future on medical and legal problems associated with artificial methods as well as the US political situation.

  15. Planned and unplanned home births and hospital births in Calgary, Alberta, 1984-87.

    Science.gov (United States)

    Abernathy, T J; Lentjes, D M

    1989-01-01

    Information collected on all home births in Calgary (Canada) between the years 1984 and 1987, was examined and analyzed according to whether the home birth environment had been planned or unplanned. The two groups were compared to each other and to all hospital births according to demographic characteristics of mothers, indicators of prenatal care, and birth outcome. Mothers who had planned their home birth were more likely to be primiparous, attend prenatal classes, obtain regular prenatal care from a physician, and have babies with a higher birth weight than either the unplanned or hospital group. Of particular concern, however, were the subset of unplanned home births who were primiparous. These mothers attended prenatal classes less frequently than any other group, reported the lowest number of physician visits, were youngest, and least likely to be married. In addition their babies averaged the shortest gestational age and the lowest birth weight. Findings in general show that planned and unplanned home births must be considered as heterogeneous groups in any comparison of risk factors and of birth outcome between home and hospital births. Further, within the unplanned group, multiparous women differ from primiparous women. Given the limitations inherent in this and similar studies, the apparent better outcome in the planned home birth group, as measured by birth weight, must be viewed with caution.

  16. Obtaining your annual internal taxation certificate

    CERN Document Server

    2006-01-01

    (cf. Article R IV 2.04 of the Staff Regulations) Your annual internal taxation certificate will state the taxable amount of your CERN remuneration, payments and other financial benefits and the amount of tax levied by the Organization during the previous financial year. In France, your tax return must be accompanied by this certificate. Current Members of the Personnel (including Members of the Personnel participating in a pre-retirement programme): - You will receive an e-mail containing a link to your printable annual certificate, which will be stored together with your pay and leave statements (e-Payslips). - You can also access your annual certificate via https://hrt.cern.ch (open 'My Payslips' at the bottom of the main menu.) - If you experience any technical difficulties in accessing your annual certificate (e.g. invalid AIS login or password), please contact CERN's AIS support team at ais.support@cern.ch. Former Members of the Personnel:- If you remember your AIS login and password, you can acc...

  17. 40 CFR 1051.335 - How do I ask EPA to reinstate my suspended certificate?

    Science.gov (United States)

    2010-07-01

    ... (CONTINUED) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM RECREATIONAL ENGINES AND VEHICLES Testing Production-Line Vehicles and Engines § 1051.335 How do I ask EPA to reinstate my suspended certificate? (a...

  18. 7 CFR 946.60 - Inspection and certification.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Inspection and certification. 946.60 Section 946.60... WASHINGTON Order Regulating Handling Inspection and Certification § 946.60 Inspection and certification. (a... this subpart, each handler who first ships potatoes shall, prior to making shipment, cause each...

  19. Prenatal and childhood antecedents of suicide: 50-year follow-up of the 1958 British Birth Cohort study.

    Science.gov (United States)

    Geoffroy, M-C; Gunnell, D; Power, C

    2014-04-01

    We aimed to elucidate early antecedents of suicide including possible mediation by early child development. Using the 1958 birth cohort, based on British births in March 1958, individuals were followed up to adulthood. We used data collected at birth and at age 7 years from various informants. Suicides occurring up to 31 May 2009 were identified from linked national death certificates. Multivariable Cox proportional hazard models were used to investigate risk factors. Altogether 12399 participants (n = 44 suicides) had complete data. The strongest prenatal risk factors for suicide were: birth order, with risk increasing in later-born children [p trend = 0.063, adjusted hazard ratio (HR)], e.g. for fourth- or later-born children [HR = 2.27, 95% confidence interval (CI) 0.90-5.75]; young maternal age (HR = 1.18, 95% CI 0.34-4.13 for ⩽19 years and HR = 0.41, 95% CI 0.19-0.91 for >29 years, p trend = 0.034); and low (birth weight (HR = 2.48, 95% CI 1.03-5.95). The strongest risk factors at 7 years were externalizing problems in males (HR = 2.96, 95% CI 1.03-8.47, p trend = 0.050) and number of emotional adversities (i.e. parental death, neglected appearance, domestic tension, institutional care, contact with social services, parental divorce/separation and bullying) for which there was a graded association with risk of suicide (p trend = 0.033); the highest (HR = 3.12, 95% CI 1.01-9.62) was for persons with three or more adversities. Risk factors recorded at birth and at 7 years may influence an individual's long-term risk of suicide, suggesting that trajectories leading to suicide have roots in early life. Some factors are amenable to intervention, but for others a better understanding of causal mechanisms may provide new insights for intervention to reduce suicide risk.

  20. Extremely Preterm Birth

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Extremely Preterm Birth Home For Patients Search FAQs Extremely Preterm Birth ... Spanish FAQ173, June 2016 PDF Format Extremely Preterm Birth Pregnancy When is a baby considered “preterm” or “ ...

  1. 47 CFR 76.1502 - Certification.

    Science.gov (United States)

    2010-10-01

    ... sufficient time to comply with the Commission's notification requirements. (b) Certifications must be... certification in its cable franchise area, a statement that the applicant is qualified to operate an open video... that the applicant will comply with the Commission's notice and enrollment requirements for...

  2. 40 CFR 68.185 - Certification.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Certification. 68.185 Section 68.185 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL... certification that, to the best of the signer's knowledge, information, and belief formed after reasonable...

  3. Emergency Teacher Certification. ERIC Digest.

    Science.gov (United States)

    Ashburn, Elizabeth A.

    Emergency certification involves the issuance of teaching licenses to individuals who have not completed a traditional college or university teacher education program. This two-page information review examines the problems arising from emergency certification and its relationship to student achievement. Some alternatives to emergency certification…

  4. The Study of Mothers’ Periodontal Status and Newborn’s Low Birth Weight

    Directory of Open Access Journals (Sweden)

    M. Shirinzad

    2006-10-01

    Full Text Available Introduction & Objective: Recent studies have presented evidence that periodontal disease in pregnant women may be a determining factor for newborn’s low birth weight. The present investigation was carried out to verify whether there is an association between maternal periodontal disease and low birth weight of newborns.Materials and Methods: This was a case-control study on 330 women, containing 110 mothers having live newborns with weight 2500 g (control group. The existence of an association between periodontal disease and newborn’s low birth weight was evaluated by means of analytic statistics that considered other risk factors for low weight. The two groups were compared with regard to urinary infection, preeclampsia, premature rupture of membrane, placenta previa, primiparous, smoking, age, height, socioeconomic status and periodontal disease.Results: There were no statistically significant differences between the case and control groups for any of the covariables (P>0.05, but there was significant differences for principal independent variable (periodontal disease P<0.05.Conclusion: Results indicated a positive association between periodontal disease and newborn’s low birth weight. Thus periodontal disease is a possible risk factor for low birth weight.

  5. Birth order and risk of non-hodgkin lymphoma--true association or bias?

    Science.gov (United States)

    Grulich, Andrew E; Vajdic, Claire M; Falster, Michael O; Kane, Eleanor; Smedby, Karin Ekstrom; Bracci, Paige M; de Sanjose, Silvia; Becker, Nikolaus; Turner, Jenny; Martinez-Maza, Otoniel; Melbye, Mads; Engels, Eric A; Vineis, Paolo; Costantini, Adele Seniori; Holly, Elizabeth A; Spinelli, John J; La Vecchia, Carlo; Zheng, Tongzhang; Chiu, Brian C H; Franceschi, Silvia; Cocco, Pierluigi; Maynadié, Marc; Foretova, Lenka; Staines, Anthony; Brennan, Paul; Davis, Scott; Severson, Richard K; Cerhan, James R; Breen, Elizabeth C; Birmann, Brenda; Cozen, Wendy

    2010-09-15

    There is inconsistent evidence that increasing birth order may be associated with risk of non-Hodgkin lymphoma (NHL). The authors examined the association between birth order and related variables and NHL risk in a pooled analysis (1983-2005) of 13,535 cases and 16,427 controls from 18 case-control studies within the International Lymphoma Epidemiology Consortium (InterLymph). Overall, the authors found no significant association between increasing birth order and risk of NHL (P-trend = 0.082) and significant heterogeneity. However, a significant association was present for a number of B- and T-cell NHL subtypes. There was considerable variation in the study-specific risks which was partly explained by study design and participant characteristics. In particular, a significant positive association was present in population-based studies, which had lower response rates in cases and controls, but not in hospital-based studies. A significant positive association was present in higher-socioeconomic-status (SES) participants only. Results were very similar for the related variable of sibship size. The known correlation of high birth order with low SES suggests that selection bias related to SES may be responsible for the association between birth order and NHL.

  6. Grand multiparae's evolving experiences of birthing and technology in U.S. hospitals.

    Science.gov (United States)

    Fleming, Susan E; Vandermause, Roxanne

    2011-01-01

    To explore the nature of birthing in United States (U.S.) hospitals from 1973-2007 and to explicate and interpret common, often overlooked, birthing experiences and nursing care. A Heideggerian phenomenological approach utilizing in-depth interviews. Participants' homes in Washington, Idaho, and Oregon. A purposive sample of grand multiparaes (N = 14). Data were collected via open conversational interviews of 60-90 minutes recorded on digital media and completion of a demographic and birth attribute form. Field notes and interpretive commentary were used as additional data sources and were analyzed using an established Heideggerian approach. The participants came from diverse religious and ethical backgrounds and experienced 116 births (8.29 births per woman, 79% unmedicated), a Cesarean rate of 6%, and a breastfeeding rate of 99% with a mean duration of 12 months. Two overarching patterns emerged: pursuing the "'good birth": a safe passage for baby and being in-and-out of control: body, technology, others. Each pattern subsumed several overlapping themes. The first pattern revealed that women often desire a good birth in the safety of a hospital by navigating their options prior to and during the birth. The second pattern revealed a common, yet often unachievable, desire by all of those involved in the process to control birth. Harmonizing an exchange of ideas in a technologically advanced environment prevalent in hospitals today can increase the quality of intrapartum care. Encouraging anchored companions and promoting normal physiological birth will make hospitals places where women can experience a good birth and feel safe. © 2011 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  7. KSC Center Director Bridges addresses the audience at an ISO 9001 certification ceremony

    Science.gov (United States)

    1998-01-01

    Center Director Roy Bridges speaks to KSC employees at the ISO certification ceremony held at the Training Auditorium. Bridges was presented an ISO 9001 certificate and plaque awarded to KSC by Det Norske Veritas (DNV), Inc., an international ISO certification organization. ISO 9001 comprises the most detailed, comprehensive set of standard requirements for quality programs established by the International Standards Organization. The presentation followed a successful independent audit by DNV of the KSC Management System in May of this year. The third-party auditors examined about 20 elements of KSC's system, including management responsibility, design control, documentation, test and inspection, and corrective action procedures. DNV found that KSC met or exceeded the stringent quality standards in all areas. KSC will use this certification as a tool to improve an already world- class team. All NASA centers are required by NASA Administrator Daniel S. Goldin to be ISO 9001 registered by September 1999. NASA is the first federal agency to seek the quality certification. Next to Bridges is Heidi Hollingsworth, with the Center for Independent Living, who uses American Sign Language for any hearing-impaired employees in the audience.

  8. 12 CFR 563.74 - Mutual capital certificates.

    Science.gov (United States)

    2010-01-01

    ... the funds for redemption are raised by the issuance of mutual capital certificates approved pursuant... 12 Banks and Banking 5 2010-01-01 2010-01-01 false Mutual capital certificates. 563.74 Section 563...-OPERATIONS Securities and Borrowings § 563.74 Mutual capital certificates. (a) General. No savings...

  9. 19 CFR 191.10 - Certificate of delivery.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Certificate of delivery. 191.10 Section 191.10... TREASURY (CONTINUED) DRAWBACK General Provisions § 191.10 Certificate of delivery. (a) Purpose; when... other party a certificate of delivery, certified by the importer or other party through whose possession...

  10. Probing Birth-Order Effects on Narrow Traits Using Specification-Curve Analysis.

    Science.gov (United States)

    Rohrer, Julia M; Egloff, Boris; Schmukle, Stefan C

    2017-12-01

    The idea that birth-order position has a lasting impact on personality has been discussed for the past 100 years. Recent large-scale studies have indicated that birth-order effects on the Big Five personality traits are negligible. In the current study, we examined a variety of more narrow personality traits in a large representative sample ( n = 6,500-10,500 in between-family analyses; n = 900-1,200 in within-family analyses). We used specification-curve analysis to assess evidence for birth-order effects across a range of models implementing defensible yet arbitrary analytical decisions (e.g., whether to control for age effects or to exclude participants on the basis of sibling spacing). Although specification-curve analysis clearly confirmed the previously reported birth-order effect on intellect, we found no meaningful effects on life satisfaction, locus of control, interpersonal trust, reciprocity, risk taking, patience, impulsivity, or political orientation. The lack of meaningful birth-order effects on self-reports of personality was not limited to broad traits but also held for more narrowly defined characteristics.

  11. Population-based estimate of sibling risk for preterm birth, preterm premature rupture of membranes, placental abruption and pre-eclampsia.

    Science.gov (United States)

    Plunkett, Jevon; Borecki, Ingrid; Morgan, Thomas; Stamilio, David; Muglia, Louis J

    2008-07-08

    Adverse pregnancy outcomes, such as preterm birth, preeclampsia and placental abruption, are common, with acute and long-term complications for both the mother and infant. Etiologies underlying such adverse outcomes are not well understood. As maternal and fetal genetic factors may influence these outcomes, we estimated the magnitude of familial aggregation as one index of possible heritable contributions. Using the Missouri Department of Health's maternally-linked birth certificate database, we performed a retrospective population-based cohort study of births (1989-1997), designating an individual born from an affected pregnancy as the proband for each outcome studied. We estimated the increased risk to siblings compared to the population risk, using the sibling risk ratio, lambdas, and sibling-sibling odds ratio (sib-sib OR), for the adverse pregnancy outcomes of preterm birth, preterm premature rupture of membranes (PPROM), placental abruption, and pre-eclampsia. Risk to siblings of an affected individual was elevated above the population prevalence of a given disorder, as indicated by lambdaS (lambdaS (95% CI): 4.3 (4.0-4.6), 8.2 (6.5-9.9), 4.0 (2.6-5.3), and 4.5 (4.4-4.8), for preterm birth, PPROM, placental abruption, and pre-eclampsia, respectively). Risk to siblings of an affected individual was similarly elevated above that of siblings of unaffected individuals, as indicated by the sib-sib OR (sib-sib OR adjusted for known risk factors (95% CI): 4.2 (3.9-4.5), 9.6 (7.6-12.2), 3.8 (2.6-5.5), 8.1 (7.5-8.8) for preterm birth, PPROM, placental abruption, and pre-eclampsia, respectively). These results suggest that the adverse pregnancy outcomes of preterm birth, PPROM, placental abruption, and pre-eclampsia aggregate in families, which may be explained in part by genetics.

  12. Using new satellite based exposure methods to study the association between pregnancy PM₂.₅ exposure, premature birth and birth weight in Massachusetts.

    Science.gov (United States)

    Kloog, Itai; Melly, Steven J; Ridgway, William L; Coull, Brent A; Schwartz, Joel

    2012-06-18

    Adverse birth outcomes such as low birth weight and premature birth have been previously linked with exposure to ambient air pollution. Most studies relied on a limited number of monitors in the region of interest, which can introduce exposure error or restrict the analysis to persons living near a monitor, which reduces sample size and generalizability and may create selection bias. We evaluated the relationship between premature birth and birth weight with exposure to ambient particulate matter (PM₂.₅) levels during pregnancy in Massachusetts for a 9-year period (2000-2008). Building on a novel method we developed for predicting daily PM₂.₅ at the spatial resolution of a 10x10 km grid across New-England, we estimated the average exposure during 30 and 90 days prior to birth as well as the full pregnancy period for each mother. We used linear and logistic mixed models to estimate the association between PM₂.₅ exposure and birth weight (among full term births) and PM₂.₅ exposure and preterm birth adjusting for infant sex, maternal age, maternal race, mean income, maternal education level, prenatal care, gestational age, maternal smoking, percent of open space near mothers residence, average traffic density and mothers health. Birth weight was negatively associated with PM₂.₅ across all tested periods. For example, a 10 μg/m³ increase of PM₂.₅ exposure during the entire pregnancy was significantly associated with a decrease of 13.80 g [95% confidence interval (CI) = -21.10, -6.05] in birth weight after controlling for other factors, including traffic exposure. The odds ratio for a premature birth was 1.06 (95% confidence interval (CI) = 1.01-1.13) for each 10 μg/m3 increase of PM₂.₅ exposure during the entire pregnancy period. The presented study suggests that exposure to PM₂.₅ during the last month of pregnancy contributes to risks for lower birth weight and preterm birth in infants.

  13. Relationship between birth order and birth weight of the pig

    OpenAIRE

    Charneca, Rui; Freitas, Amadeu; Nunes, José; Le Dividich, Jean

    2013-01-01

    The objective of this study was to determine whether birth weight of the pig is related to its birth order. The study involved 292 sows from 2 genotypes (Large White x Landrace crossbred (LL), n= 247 and Alentejano (AL), n=45) of mixed parity and their piglets. Most sows farrowed naturally. Each piglet was identified, weighed (± 1g) (mummies excepted) and its birth order (BO) recorded within 2 min of birth. A total of 3418 LL and 375 AL piglets were born of which 43 and 7 were mummified, a...

  14. A NEW FOOD CHAIN APPROACH: UNI EN ISO 22005:2008 VOLUNTARY CERTIFICATION

    Directory of Open Access Journals (Sweden)

    E. Guidi

    2011-01-01

    Full Text Available This work summarize an experience of auditing according to new UNI EN ISO 22005:2008. This new food chain certification scheme, arisen from two different European schemes of internal and external traceability certification, requires companies to build up their own check plans considering all components in food chain processing. This new approach, also derived from the European legislation, wants to verify if traceability system is under control and to verify if corrective actions to warrant hygienic production standards are built up.

  15. Parental investments in child health - maternal health behaviours and birth outcomes

    DEFF Research Database (Denmark)

    Wüst, Miriam

    consumption, exercise and diet during pregnancy on birth outcomes and considers the problem of identifying the causal effect of these endogenous maternal health behaviours. The analysis controls for a wide range of covariates and exploits sibling variation in the Danish National Birth Cohort. The paper...... the ways in which child health is generated, and - for children of higher birth order - earlier children's outcomes will shape parental investments in child health....

  16. DGNB Building Certification Companion

    DEFF Research Database (Denmark)

    Møller, Renate Skovgaard; Rhodes, Michael K.; Larsen, Tine Steen

    2017-01-01

    for sustainable buildings. The literature describes several barriers of entry preventing actors in the industry from seeking sustainability certifications and prioritizing design methods, supporting sustainability in greater numbers. In the newly developed tool, “DGNB building certification companion: Sustainable......-language, easily digestible summaries of various topics regarding sustainability and the DGNB certification scheme. The identified barriers are described in the tool followed by a solution to overcome them. The tool, tested at multiple stages of development and moulded by many individuals both within and outside...... was that this is a desired product on the market. This new approach is expected to dramatically reduce misunderstandings, conflicts, and mistakes during a sustainable design process, helping the design team plan a project to possibly obtain the highest DGNB score if desired and properly documented....

  17. DGNB BUILDING CERTIFICATION COMPANION

    DEFF Research Database (Denmark)

    Møller, Renate Skovgaard; Rhodes, Michael K.; Larsen, Tine Steen

    2018-01-01

    for sustainable buildings. The literature describes several barriers of entry preventing actors in the industry from seeking sustainability certifications and prioritizing design methods, supporting sustainability in greater numbers. In the newly developed tool, “DGNB building certification companion: Sustainable......-language, easily digestible summaries of various topics regarding sustainability and the DGNB certification scheme. The identified barriers are described in the tool followed by a solution to overcome them. The tool, tested at multiple stages of development and moulded by many individuals both within and outside...... was that this is a desired product on the market. This new approach is expected to dramatically reduce misunderstandings, conflicts, and mistakes during a sustainable design process, helping the design team plan a project to possibly obtain the highest DGNB score if desired and properly documented....

  18. Soy production and certification

    DEFF Research Database (Denmark)

    Tomei, Julia; Semino, Stella Maris; Paul, Helena

    2010-01-01

    With the rising emphasis on biofuels as a potential solution to climate change, this paper asks whether certification schemes, developed to promote sustainable feedstock production, are able to deliver genuine sustainability benefits. The Round Table on Responsible Soy (RTRS) is a certification...... the social and environmental impacts of soybean production can be mitigated by the RTRS. It concludes that at present certification schemes are unlikely to be able to address either the institutional challenges associated with their implementation or the detrimental impacts of the additional demand generated...... scheme that aims to promote responsible soy production through the development of principles and criteria. However, can and does this initiative address the negative impacts associated with the intensive production of soy? Taking the example of soy biodiesel produced in Argentina, this paper asks whether...

  19. 12 CFR 411.110 - Certification and disclosure.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Certification and disclosure. 411.110 Section 411.110 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES NEW RESTRICTIONS ON LOBBYING General § 411.110 Certification and disclosure. (a) Each person shall file a certification, and a disclosure...

  20. Planned home births: the need for additional contraindications.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Sapra, Katherine J; Arabin, Birgit; Chervenak, Frank A

    2017-04-01

    Planned home births in the United States are associated with fewer interventions but with increased adverse neonatal outcomes such as perinatal and neonatal deaths, neonatal seizures or serious neurologic dysfunction, and low 5-minute Apgar scores. The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice states that, to reduce perinatal death and to improve outcomes at planned home births, strict criteria are necessary to guide the selection of appropriate candidates for planned home birth. The committee lists 3 absolute contraindications for a planned home birth: fetal malpresentation, multiple gestations, and a history of cesarean delivery. The aim of this study was to evaluate whether there are risk factors that should be considered contraindications to planned home births in addition to the 3 that are listed by the American College of Obstetricians and Gynecologists. We conducted a population-based, retrospective cohort study of all term (≥37 weeks gestation), normal weight (≥2500 grams), singleton, nonanomalous births from 2009-2013 using the Centers for Disease Control and Prevention's period-linked birth-infant death files that allowed for identification of intended and unintended home births. We examined neonatal deaths (days 0-27 after birth) across 3 groups (hospital-attended births by certified nurse midwives, hospital-attended births by physicians, and planned home births) for 5 risk factors: 2 of the 3 absolute contraindications to home birth listed by the American College of Obstetricians and Gynecologists (breech presentation and previous cesarean delivery) and 3 additional risk factors (parity [nulliparous and multiparous], maternal age [women home births (12.1 neonatal death/10,000 deliveries; Pbirths by certified nurse midwives (3.08 neonatal death/10,000 deliveries) or physicians (5.09 neonatal death/10,000 deliveries). Neonatal mortality rates were increased significantly at planned home births, with the

  1. Green certificates and carbon trading in the Netherlands

    International Nuclear Information System (INIS)

    Boots, M.

    2003-01-01

    The combination of trading schemes for green certificates and for carbon, as they are implemented and planned in the Netherlands, imply a complete separation of green certificates and CO 2 markets. This means that the costs of CO 2 reduction will be reflected in the spot price of electricity and that the price of green certificates only reflects the additional cost of RE development. However, since the green certificate scheme is already implemented, while the carbon trading scheme is not, it is unclear if currently the green certificate value includes the CO 2 reduction value of RE production. It is important that buyers and sellers in the market for green certificates agree on what they are trading, therefore this issue should be clarified

  2. 40 CFR 92.208 - Certification.

    Science.gov (United States)

    2010-07-01

    ... the construction of a locomotive or locomotive engine, where such step may reasonably be expected to... POLLUTION FROM LOCOMOTIVES AND LOCOMOTIVE ENGINES Certification Provisions § 92.208 Certification. (a) This paragraph (a) applies to manufacturers of new locomotives and new locomotive engines. If, after a review of...

  3. Maternal dietary intake of nitrates, nitrites and nitrosamines and selected birth defects in offspring: a case-control study.

    Science.gov (United States)

    Huber, John C; Brender, Jean D; Zheng, Qi; Sharkey, Joseph R; Vuong, Ann M; Shinde, Mayura U; Griesenbeck, John S; Suarez, Lucina; Langlois, Peter H; Canfield, Mark A; Romitti, Paul A; Weyer, Peter J

    2013-03-21

    Dietary intake of nitrates, nitrites, and nitrosamines can increase the endogenous formation of N-nitroso compounds in the stomach. Results from animal studies suggest that these compounds might be teratogenic. We examined the relationship between maternal dietary intake of nitrates, nitrites (including plant and animal sources as separate groups), and nitrosamines and several types of birth defects in offspring. For this population-based case-control study, data from a 58-question food frequency questionnaire, adapted from the short Willett Food Frequency Questionnaire and administered as part of the National Birth Defects Prevention Study (NBDPS), were used to estimate daily intake of dietary nitrates, nitrites, and nitrosamines in a sample of 6544 mothers of infants with neural tube defects (NTD)s, oral clefts (OC)s, or limb deficiencies (LD)s and 6807 mothers of unaffected control infants. Total daily intake of these compounds was divided into quartiles based on the control mother distributions. Odds ratios (OR)s and 95% confidence intervals (CI)s were estimated using logistic regression; estimates were adjusted for maternal daily caloric intake, maternal race-ethnicity, education, dietary folate intake, high fat diet (>30% of calories from fat), and state of residence. While some unadjusted ORs for NTDS had 95% (CI)s that excluded the null value, none remained significant after adjustment for covariates, and the effect sizes were small (adjusted odds ratios [aOR]nitrate, nitrite, and nitrosamines.

  4. Maternal residential exposure to agricultural pesticides and birth defects in a 2003 to 2005 North Carolina birth cohort.

    Science.gov (United States)

    Rappazzo, Kristen M; Warren, Joshua L; Meyer, Robert E; Herring, Amy H; Sanders, Alison P; Brownstein, Naomi C; Luben, Thomas J

    2016-04-01

    Birth defects are responsible for a large proportion of disability and infant mortality. Exposure to a variety of pesticides have been linked to increased risk of birth defects. We conducted a case-control study to estimate the associations between a residence-based metric of agricultural pesticide exposure and birth defects. We linked singleton live birth records for 2003 to 2005 from the North Carolina (NC) State Center for Health Statistics to data from the NC Birth Defects Monitoring Program. Included women had residence at delivery inside NC and infants with gestational ages from 20 to 44 weeks (n = 304,906). Pesticide exposure was assigned using a previously constructed metric, estimating total chemical exposure (pounds of active ingredient) based on crops within 500 meters of maternal residence, specific dates of pregnancy, and chemical application dates based on the planting/harvesting dates of each crop. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals for four categories of exposure (90(th) percentiles) compared with unexposed. Models were adjusted for maternal race, age at delivery, education, marital status, and smoking status. We observed elevated ORs for congenital heart defects and certain structural defects affecting the gastrointestinal, genitourinary and musculoskeletal systems (e.g., OR [95% confidence interval] [highest exposure vs. unexposed] for tracheal esophageal fistula/esophageal atresia = 1.98 [0.69, 5.66], and OR for atrial septal defects: 1.70 [1.34, 2.14]). Our results provide some evidence of associations between residential exposure to agricultural pesticides and several birth defects phenotypes. Birth Defects Research (Part A) 106:240-249, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  5. 20 CFR 656.24 - Labor certification determinations.

    Science.gov (United States)

    2010-04-01

    ... certification applications. (2) If the labor certification presents a special or unique problem, the Director of... opportunity as a college or university teacher, the U.S. worker must be at least as qualified as the alien. (3... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Labor certification determinations. 656.24...

  6. 32 CFR 537.20 - Certification to Congress.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Certification to Congress. 537.20 Section 537.20... BEHALF OF THE UNITED STATES § 537.20 Certification to Congress. Admiralty claims, including claims for... of the Army for approval and if in excess of $500,000 for certification to Congress for final...

  7. From institutionalized birth to home birth

    Directory of Open Access Journals (Sweden)

    Clara Fróes de Oliveira Sanfelice

    2014-06-01

    Full Text Available The study aimed to describe the experiences of a group of nurse-midwives from the city of Campinas, SP, Brasil, regarding the transition process from attending institutionalized births to attending home births, in the period 2011 – 2013. The study is of the experience report type; the reflections, perceptions and challenges experienced in this process were collected using the technique of brainstorming. Content analysis, as proposed by Bardin, was used, which yielded four thematic categories: a the hospital experience; b living with obstetric violence; c returning home and d the challenges of home care. It is concluded that attending home births offers greater satisfaction to the nurses, even in the face of various obstacles, as it is possible to offer a care to the woman and new-born which covers both the concept of comprehensiveness and the current scientific recommendations.

  8. How much market do market-based instruments create? An analysis for the case of 'white' certificates

    International Nuclear Information System (INIS)

    Langniss, Ole

    2003-01-01

    Discussions about 'green' certificates for renewable energy forms are under way for some time now. In contrast, tradable 'white' certificates have only lately been celebrated as a market-based tool to foster energy efficiency. Theoretically, there is little doubt about this. In practice, however, some fundamental problems and doubts about the usefulness of certificates arise: How 'competitive' are markets for certificates in reality? Is a 'white' certificate scheme only a new name for an old hat rooted in control and command regulation? With this suspicion, a number of questions and aspects arise: - Market mechanism: Which criteria guarantee that an - artificial - market for certificates really becomes competitive? Will trading be characterized by spot markets or by rather anti-competitive long-term over-the-counter contracts? Which minimum market size is needed, and which are the conditions regarding the tradability of the certificate that have to be met? - Target group: Who should be obliged to purchase certificates? Are electricity suppliers the right target group, or should fuel and heat suppliers be addressed, or the consumer himself? - Additionality and measurability: Which efficiency technologies should be eligible for certificates? What exactly is an efficient technology? A narrow definition might ease measuring problems but at the same time reduce innovation incentives. We use the theoretical framework of Transaction Cost Economics to discuss these issues. A brief review of the design of tradable certificate schemes in Italy and the UK is given. Lessons can also be learned from renewable portfolio standards recently implemented in a number of countries

  9. Mothers with alcoholic liver disease and the risk for preterm and small-for-gestational-age birth.

    Science.gov (United States)

    Stokkeland, Knut; Ebrahim, Fereshte; Hultcrantz, Rolf; Ekbom, Anders; Stephansson, Olof

    2013-01-01

    To study pregnancy outcome in women with alcoholic liver disease (ALD). Using the Swedish nation-wide Patient and Medical Birth Registers, we investigated risk of adverse pregnancy outcome in 720 women diagnosed with ALD before and 1720 diagnosed after birth and compared them with 24 460 population-based control births. Women with ALD diagnosed before or after birth were generally of higher age and body mass index, more likely to smoke cigarettes during pregnancy and to have a low socio-economic status compared with controls. Women diagnosed with ALD before birth had an increased risk of moderately and very preterm birth, adjusted odd ratio (OR) = 1.53 (95% confidence interval (CI): 1.37-1.72 and 1.15-2.06 95%), respectively. Infants of mothers with ALD before birth were more often small-for-gestational age, adjusted OR = 1.22 (95% CI: 1.05-1.43), and were at increased risk for low Apgar scores (<7) at 5 min, adjusted OR = 1.49 (95% CI: 1.15-1.92) compared with controls. Similar associations with slightly lower-risk estimates were found among women diagnosed with ALD after birth. ALD is associated with adverse-birth outcomes, highlighting the importance of screening women for alcohol dependence in antenatal care.

  10. Defeitos congênitos no Município do Rio de Janeiro, Brasil: uma avaliação através do SINASC (2000-2004 Birth defects in Rio de Janeiro, Brazil: an evaluation through birth certificates (2000-2004

    Directory of Open Access Journals (Sweden)

    Fernando Antônio Ramos Guerra

    2008-01-01

    Full Text Available Avaliou-se a ocorrência de defeitos congênitos em nascidos vivos no Município do Rio de Janeiro, Brasil, com base no Sistema de Informações sobre Nascidos Vivos (SINASC, no período de 1º de janeiro de 2000 a 31 de dezembro de 2004. Através de um estudo seccional e descritivo, estudaram-se as variáveis relativas aos defeitos congênitos (presença e aparelho ou sistema acometido, aos serviços de saúde, às mães, às gestações, aos recém-natos e aos partos. Constatou-se uma prevalência de defeitos congênitos de 83/10 mil nascidos vivos. Os sistemas orgânicos mais afetados foram o osteomuscular, nervoso central, genital, as fendas lábio-palatinas e as anomalias cromossômicas. A maioria dos casos nasceu nas maternidades municipais e na rede privada, e maior prevalência de defeitos congênitos ocorreu no Instituto Fernandes Figueira da Fundação Oswaldo Cruz. Os defeitos congênitos foram mais prevalentes entre os filhos de mulheres mais velhas e menos instruídas. O percentual de casos ignorados foi alto, chegando a 21% em algumas maternidades. Uma maior divulgação das informações do SINASC sobre defeitos congênitos deveria ser estimulada. Estudos de confiabilidade são recomendados para melhor aproveitamento das informações.To evaluate the occurrence of birth defects in the city of Rio de Janeiro, Brazil, using the Live Birth Information System (SINASC, we performed a cross-sectional study on all live newborns with birth defects from January 1, 2000, to December 31, 2004. The variables referred to birth defects (presence and system affected, type of health service, mothers, gestations, live births, and deliveries. Prevalence of birth defects was 83/10,000 live births. The most frequent birth defects involved the musculoskeletal system, central nervous system, cleft lip and palate, and chromosomal anomalies. The majority of cases were born in public (municipal and private maternity hospitals, with the highest prevalence

  11. 9 CFR 156.6 - Certificates.

    Science.gov (United States)

    2010-01-01

    ... products, if the inspector finds that the requirements as stated in the certification have been met. The... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Certificates. 156.6 Section 156.6 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE...

  12. An economic evaluation of planned immediate versus delayed birth for preterm prelabour rupture of membranes: findings from the PPROMT randomised controlled trial.

    Science.gov (United States)

    Lain, S J; Roberts, C L; Bond, D M; Smith, J; Morris, J M

    2017-03-01

    This study is an economic evaluation of immediate birth compared with expectant management in women with preterm prelabour rupture of the membranes near term (PPROMT). A cost-effectiveness analysis alongside the PPROMT randomised controlled trial. Obstetric departments in 65 hospitals across 11 countries. Women with a singleton pregnancy with ruptured membranes between 34 +0 and 36 +6 weeks gestation. Women were randomly allocated to immediate birth or expectant management. Costs to the health system were identified and valued. National hospital costing data from both the UK and Australia were used. Average cost per recruit in each arm was calculated and 95% confidence intervals were estimated using bootstrap re-sampling. Averages costs during antenatal care, delivery and postnatal care, and by country were estimated. Total mean cost difference between immediate birth and expectant management arms of the trial. From 11 countries 923 women were randomised to immediate birth and 912 were randomised to expectant management. Total mean costs per recruit were £8852 for immediate birth and £8740 for expectant delivery resulting in a mean difference in costs of £112 (95% CI: -431 to 662). The expectant management arm had significantly higher antenatal costs, whereas the immediate birth arm had significantly higher delivery and neonatal costs. There was large variation between total mean costs by country. This economic evaluation found no evidence that expectant management was more or less costly than immediate birth. Outpatient management may offer opportunities for cost savings for those women with delayed delivery. For women with preterm prelabour rupture of the membranes, the relative benefits and harms of immediate and expectant management should inform counselling as costs are similar. © 2016 Royal College of Obstetricians and Gynaecologists.

  13. Introduction of China's Compulsory Product Certification System (Ⅰ)

    Institute of Scientific and Technical Information of China (English)

    无

    2004-01-01

    @@ Why does China establish a new Compulso-ry Product Certification System? For a long time, our compulsory product certification system has had problems such as lack of a unified management department, repeated assessments,repeated charging and no separation between certification activities and behaviors of law enforcement.The most obvious problem is that two certification management systems exist respectively for domestic products and imported products.

  14. Periodontal Disease And Risk For Pre-Term Birth: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Andonova Irena

    2015-03-01

    Full Text Available Maternal periodontal infection has been recognizsed as a risk factor for preterm and low birth weight infants. It is hypothesized that pathogens causing periodontal disease might translocate to the amniotic cavity and contribute to triggering an adverse pregnancy outcome. The growing evidence that an infection remote from the foetal-placental unit might have a role in preterm delivery has led to an increased awareness of the potential role of chronic bacterial infections in the body. The aim of this study was to evaluate whether the presence of chronic periodontitis might influence the incidence of preterm labour and preterm birth.

  15. [Birthing institutions and births in Norwegian counties in the early 1990s].

    Science.gov (United States)

    Bergsjø, P; Daltveit, A K

    1996-05-20

    Between 1972 and 1993 the number of hospitals and maternity homes providing obstetric help in Norway fell from 158 to 67. Most of the decline is explained by the closing down of maternity homes and obstetrical units in small hospitals, partly due to a reduction in number of births and partly to a deliberate drive towards giving birth in larger units. 16 of the 19 counties of Norway contained four or fewer obstetric institutions in 1993. Nevertheless, most of the 60,000 births took place in institutions with between 500 and 2,999 births annually. Births at home accounted for 0.3%, and births during transport for 0.2% of the total in 1990 and 1993.

  16. Converse Theorems for Safety and Barrier Certificates

    OpenAIRE

    Ratschan, Stefan

    2017-01-01

    An important tool for proving safety of dynamical systems is the notion of a barrier certificate. In this paper we prove that every robustly safe ordinary differential equation has a barrier certificate. Moreover, we show a construction of such a barrier certificate based on a set of states that is reachable in finite time.

  17. Combating pharmacist shortage through labor certification.

    Science.gov (United States)

    Maswoswe, J J; Stewart, K R; Enigbokan, M; Egbunike, I; Jackson, D M

    1994-06-01

    Several solutions, ranging from increased technician duties to salary raises, automation, and increasing job satisfaction, have been presented in the literature as methods of assuaging the pharmacist shortage. Although a significant portion of pharmacy graduates from American pharmacy colleges are foreign nationals, no marketing strategies have been elucidated in the retention and recruitment of foreign nationals through labor certification. Labor certifications are generally approved by the Secretary of Labor if the following factors have been verified: 1) there are not sufficient United States workers who are able, willing, qualified, and available for employment; and 2) the employment of the foreign national will not adversely affect the wages and working conditions of U.S. workers similarly employed. When properly understood, the labor certification process is a test of the job market where foreigners, by virtue of their skills and qualifications, attain certification which subsequently leads to permanent residency (green card). The objective of this report is to elucidate the tedious yet effective method of retaining American-educated foreign nationals through labor certification.

  18. Implementation of thermographers' certification in Brazil

    Science.gov (United States)

    dos Santos, Laerte; Alves, Luiz M.; da Costa Bortoni, Edson

    2011-05-01

    In recent years Brazil has experienced extraordinary growth despite the recent economic global crisis. The demand for infrared thermography products and services has accompanied this growth. Like other non-destructive testing and inspection, the results obtained by thermography are highly dependent on the skills of thermographer. Therefore, it is very important to establish a serious and recognized process of certification to assess thermographers' qualifications and help services suppliers to establish credibility with their customers and increase the confidence of these costumers on the quality of these services. The Brazilian Society of Non-Destructive Testing and Inspection, ABENDI, a non-profitable, private technical-scientific entity, recognized nationally and internationally, has observed the necessity of starting a process for certification of thermographers in Brazil. With support of a work group composed by experts from oil and energy industries, transportation, universities and manufactures, the activities started in 2005. This paper describes the economic background required for installation of the certification process, its initial steps, the main characteristics of the Brazilian certification and the expectation for initiating the certification process.

  19. Software Quality Certification: identifying the real obstacles

    Directory of Open Access Journals (Sweden)

    Megan Baker

    1996-05-01

    Full Text Available A case study of software certification reveals the real difficulty of certifying quality beyond superficial assessment - readers are invited to form their own conclusions. AS 3563 Software Quality Management System is the Australian version of ISO 9001, developed specifically for the software industry. For many Australian software houses, gaining certification with AS 3563 is a priority since certification has become a prerequisite to doing business with government departments and major corporations. However, the process of achieving registration with this standard is a lengthy and resource intensive process, and may have little impact on actual software quality. This case study recounts the experience of the consulting arm of one of Australia's accounting firms in its quest for certification. By using a number of specific management strategies this company was able to successfully implement AS 3563 in less than half the time usually taken to achieve certification - a feat for which its management should be congratulated. However, because the focus of the project was on gaining certification, few internal benefits have been realised despite the successful implementation of the standard.

  20. Breech birth

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000623.htm Breech birth To use the sharing features on this page, ... safer for your baby to pass through the birth canal. In the last weeks of pregnancy, your ...

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