WorldWideScience

Sample records for birth control policy

  1. [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.

  2. 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 ...

  3. 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.

  4. 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 ...

  5. 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...

  6. 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 ...

  7. 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 ...

  8. Birth Control Shot

    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 Shot KidsHealth / For Teens / Birth Control Shot What's ...

  9. 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 ...

  10. 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 ...

  11. 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 ...

  12. 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 ...

  13. 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 ...

  14. 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- ...

  15. 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 ...

  16. Contraception and Birth Control

    Science.gov (United States)

    ... of Legislation and Public Policy (OLPP) Office of Science Policy, Reporting, and Program Analysis (OSPRA) Division of Extramural Research (DER) Extramural Scientific Branches Grants Management Branch (GMB) Office of Committee Management ( ...

  17. 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 ...

  18. 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.

  19. 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 ...

  20. 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...

  1. 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 ...

  2. Birth Control: How to Use Your Diaphragm

    Science.gov (United States)

    ... 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) ...

  3. Micro-blogs, online forums, and the birth-control policy: social media and the politics of reproduction in China.

    Science.gov (United States)

    Shi, Lihong

    2014-03-01

    In June 2012, the news of a Chinese woman's forced late-term abortion quickly spread across the internet in China. Graphic photos of the woman with the aborted fetus provoked public outrage and widespread condemnation on social media sites. In the aftermath, local authorities apologized, seven officials were given demerits, and the couple received monetary compensation. This case was put under the spotlight mainly because of the exposure of the story by family members of the woman through social media and the resulting public outcry in cyberspace. Following the disclosure of this story and public reactions online, this article explores the complex interplays among different layers of state power, the individual, and the public in reproductive politics, and discusses the ways in which social media has been utilized to resist state control of reproduction. By delving into the nuanced interactions among layers of state authorities, this article sheds light on the study of state-society relations in reproductive politics. It also calls attention to the role that social media plays in reproductive issues.

  4. Giving Birth to a Good Policy

    Science.gov (United States)

    Untener, Joseph

    2008-01-01

    In this article, the author talks about the need for sound policies to help faculty members balance family life with career issues. Many human-resource policies--for example, those governing conflicts of interest--can be developed almost independently of other policies and have a high degree of transferability from one campus to the next. A…

  5. 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)

  6. 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

  7. 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 ...

  8. roles of traditional birth attendants and perceptions on the policy

    African Journals Online (AJOL)

    2014-03-01

    Mar 1, 2014 ... the perceptions of TBAs and Skilled Birth Attendants (SBAs) towards the policy discouraging home ... improve maternal health, with the targets of reducing maternal ... Asia, where the majority of maternal deaths occur (3). These two ..... The SBA, with an attitude of cultural humility, could learn from the.

  9. Social policies, separation, and second birth spacing in Western Europe

    Directory of Open Access Journals (Sweden)

    Michaela Kreyenfeld

    2017-10-01

    Full Text Available Objective: This paper studies postseparation fertility behavior. The aim is to investigate whether, and if so how, separation affects second birth spacing in Western European countries. Methods: This analysis makes use of rich survey data from Belgium, France, Germany, Italy, Spain, and the United Kingdom, as well as from Finnish register data. We thus cover the behavior of a large proportion of the population of Western Europe. We also use descriptive measures, such as Kaplan‒Meier survival functions and cumulative incidence curves. In the multivariate analysis, we employ event history modeling to show how education relates to postseparation fertility behavior. Results: There are large differences in postseparation fertility behavior across European countries. For Spain and Italy, we find that only a negligibly small proportion of the population have a second child after separating from the other parent of the firstborn child. The countries with the highest proportion of second children with a new partner are the United Kingdom, Germany, and Finland. In all countries, separation after first birth leads to a sharp increase in the birth interval between first and second births. Contribution: Our study is a contribution to the demographic literature that aims at understanding birth spacing patterns in Western Europe. Furthermore, we draw attention to the role of postseparation policies in explaining country differences in fertility behavior in contemporary societies.

  10. [Tobacco control policies and perinatal health].

    Science.gov (United States)

    Peelen, M J; Sheikh, A; Kok, M; Hajenius, P; Zimmermann, L J; Kramer, B W; Hukkelhoven, C W; Reiss, I K; Mol, B W; Been, J V

    2017-01-01

    Study the association between the introduction of tobacco control policies in the Netherlands and changes in perinatal outcomes. National quasi-experimental study. We used Netherlands Perinatal Registry data (now called Perined) for the period 2000-2011. We studied whether the introduction of smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign in January 2004, and extension of the smoke-free law to the hospitality industry accompanied by another tax increase and media campaign in July 2008, was associated with changes in perinatal outcomes. We studied all singleton births (gestational age: 24+0 to 42+6 weeks). Our primary outcome measures were: perinatal mortality, preterm birth and being small-for-gestational-age (SGA). Interrupted time series logistic regression analyses were performed to investigate changes in these outcomes occurred after the introduction of the aforementioned tobacco control policies (ClinicalTrials.gov: NCT02189265). Among 2,069,695 singleton births, 13,027 (0.6%) perinatal deaths, 116,043 (5.6%) preterm live-births and 187,966 (9.1%) SGA live-births were observed. The policies introduced in January 2004 were not associated with significant changes in any of the primary outcome measures. A -4.4% (95% CI: -6.4 to -2.4; p hospitality industry, a further tax increase and another media campaign. This translates to an estimated over 500 cases of SGA being averted per year. A reduction in SGA births, but not preterm birth or perinatal mortality, was observed in the Netherlands after extension of the smoke-free workplace law to include bars and restaurants, in conjunction with a tax increase and media campaign in 2008.

  11. 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.

  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. 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.

  14. 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 ...

  15. 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…

  16. [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.

  17. 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

  18. 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 ...

  19. Energy control policy

    International Nuclear Information System (INIS)

    Moisan, F.; Bosseboeuf, D.

    1995-01-01

    The report 'energy efficiency policies' shows the evolution of energy efficiency for different countries since the first petroleum crisis. The countries concerned by this study are European countries, North America ones, Japan, Eastern Asia countries and some out of OECD such Brazil, Chile, Poland. The results are presented in a global way and then by industry sectors, transports and tertiary and residential sectors. 8 tabs

  20. Immigration policy and birth weight: Positive externalities in Italian law.

    Science.gov (United States)

    Salmasi, Luca; Pieroni, Luca

    2015-09-01

    A decade ago, the political party of the Italian center-right voted a law restricting immigration. The law became effective in early 2005, when the Italian parliament approved the decree for its application, but one of its articles, granting amnesty for illegal immigrant workers, became immediately effective in July 2002. As a result, 650,000 immigrants were granted the status of foreign nationals in Italy. In this paper, we examine whether the increase in the prevalence of "regular immigrants" has led to an improvement in health outcomes of babies born to migrant women, measured in terms of birth weight. Two hitherto unexploited birth sample surveys published by Italian Institute of Statistics were used for this study. Our estimates show that regularized immigration reduced the probability of low birth weight. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Traditional Birth Attendants in Rural Northern Uganda: Policy, Practice, and Ethics.

    Science.gov (United States)

    Rudrum, Sarah

    2016-01-01

    The current emphasis on skilled attendants as a means to reduce maternal mortality contributes to a discouraging policy environment for traditional birth attendants (TBAs). They continue to attend a significant number of births, however, such that their role and the policies and practices affecting their work remain important to understanding maternity health care and maternal health in the global South. In this article, I examine the policies and practices governing community elders practicing as TBAs in rural northern Uganda. This discussion is relevant to health workers in developing countries and to scholars in fields such as women's studies, sociology, and public health.

  2. [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

  3. Nuclear power hazard control policy

    Energy Technology Data Exchange (ETDEWEB)

    Chicken, J C

    1982-01-01

    This study presents an analysis of the factors that appear to have influenced the formation and form of nuclear power hazard control policy in Britain. A simple account is given of the technical nature of nuclear hazards and of the legal and administrative framework that has been constructed to control them. The subsequent analysis concentrates primarily on the influence exerted by social and political factors. Particular attention is directed to those political groups which have developed a special interest in the problems of nuclear power, and to the interplay between organised groupings and public opinion generally. The metamorphosis of these groupings is traced from the origins of the nuclear industry in the Second World War to their prominent role during the Windscale Inquiry. Attention is given to the policy constraint imposed by increased expectations in the form of demands for higher standards of living, and improvements in the quality of the environment. The study is concerned with both policy-making and with policy implementation; with interest articulation as well as with the functioning of formal institutions. The evolution of policy takes place in an atmosphere of keen economic debate and conflicting moral perceptions. A model of the policy-making system is postulated.

  4. Nuclear power hazard control policy

    International Nuclear Information System (INIS)

    Chicken, J.C.

    1982-01-01

    This study presents an analysis of the factors that appear to have influenced the formation and form of nuclear power hazard control policy in Britain. A simple account is given of the technical nature of nuclear hazards and of the legal and administrative framework that has been constructed to control them. The subsequent analysis concentrates primarily on the influence exerted by social and political factors. Particular attention is directed to those political groups which have developed a special interest in the problems of nuclear power, and to the interplay between organised groupings and public opinion generally. The metamorphosis of these groupings is traced from the origins of the nuclear industry in the Second World War to their prominent role during the Windscale Inquiry. Attention is given to the policy constraint imposed by increased expectations in the form of demands for higher standards of living, and improvements in the quality of the environment. The study is concerned with both policy-making and with policy implementation; with interest articulation as well as with the functioning of formal institutions. The evolution of policy takes place in an atmosphere of keen economic debate and conflicting moral perceptions. A model of the policy-making system is postulated. (author)

  5. Family planning, population policy and declining birth rates in Yugoslavia.

    Science.gov (United States)

    Malacic, J

    1989-01-01

    Although Yugoslavia has below-replacement fertility (a net reproduction rate in 1986 of 0.92), there are vast regional differentials. In the less developed autonomous province of Kosovo, for example, the population has doubled in the past 30 years. By region, the net reproduction rate ranges from a low of 0.83 in Croatia to a high of 1.80 in Kosovo. Until the late 1970s, when pronatalism and centralized economic planning had weakened in influence, there was an avoidance of demographic planning and policy. In 1975, the Federal Assembly issued a document on the country's demographic patterns and goals and called on republics and autonomous provinces to adapt the document to local situations--a step that was not taken. By the 1980s, the deteriorating political, economic, and demographic situation in regions with high fertility forced more explicit attention to the formulation of a national population policy. The 1989 Resolution on Population Development Policy and Family Planning sets the goal of replacement- level fertility for both high and low fertility regions and calls for an integrated approach to population issues and socioeconomic development. Decentralization, however, has represented a major obstacle to the execution of federal policy at the republic and lower local levels. While this is a chronic problem that must be addressed on the macro level, some progress could be achieved in problematic regions such as Kosovo through educational campaigns aimed at convincing individual couples of the advantages of family size of 2-3 children.

  6. The birth of mindpolitics : Understanding nudging in public health policy

    NARCIS (Netherlands)

    Peeters, Rik; Schuilenburg, Marc

    2017-01-01

    This article addresses the question: 'In what ways have nudging and other behavioural techniques entered the realm of policymaking for public health and what does that mean for the way contemporary society is governed?' In our genealogy of Dutch public health policy, we have identified four periods:

  7. The birth of mindpolitics: Understanding nudging in public health policy

    NARCIS (Netherlands)

    Peeters, Rik; Schuilenburg, Marc

    This article addresses the question: 'In what ways have nudging and other behavioural techniques entered the realm of policymaking for public health and what does that mean for the way contemporary society is governed?' In our genealogy of Dutch public health policy, we have identified four periods:

  8. Starting Young: Massachusetts Birth-3rd Grade Policies That Support Children's Literacy Development

    Science.gov (United States)

    Cook, Shayna; Bornfreund, Laura

    2015-01-01

    Massachusetts is one of a handful of states that is often recognized as a leader in public education, and for good reason. The Commonwealth consistently outperforms most states on national reading and math tests and often leads the pack in education innovations. "Starting Young: Massachusetts Birth-3rd Grade Policies that Support Children's…

  9. Impact of the Jamaican birth cohort study on maternal, child and adolescent health policy and practice.

    Science.gov (United States)

    McCaw-Binns, A; Ashley, D; Samms-Vaughan, M

    2010-01-01

    The Jamaica Perinatal Morbidity and Mortality Survey (JPMMS) was a national study designed to identify modifiable risk factors associated with poor maternal and perinatal outcome. Needing to better understand factors that promote or retard child development, behaviour and academic achievement, we conducted follow-up studies of the birth cohort. The paper describes the policy developments from the JPMMS and two follow-up rounds. The initial study (1986-87) documented 94% of all births and their outcomes on the island over 2 months (n = 10 508), and perinatal (n = 2175) and maternal deaths (n = 62) for a further 10 months. A subset of the birth cohort, identified by their date of birth through school records, was seen at ages 11-12 (n = 1715) and 15-16 years (n = 1563). Findings from the initial survey led to, inter alia, clinic-based screening for syphilis, referral high-risk clinics run by visiting obstetricians, and the redesign and construction of new labour wards at referral hospitals. The follow-up studies documented inadequate academic achievement among boys and children attending public schools, and associations between under- and over-nutrition, excessive television viewing (>20 h/week), inadequate parental supervision and behavioural problems. These contributed to the development of a television programming code for children, a National Parenting Policy, policies aimed at improving inter-sectoral services to children from birth to 5 years (Early Childhood Commission) and behavioural interventions of the Violence Prevention Alliance (an inter-sectoral NGO) and the Healthy Lifestyles project (Ministry of Health). Indigenous maternal and child health research provided a local evidence base that informed public policy. Collaboration, good communication, being vigilant to opportunities to influence policy, and patience has contributed to our success.

  10. 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 ...

  11. 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.

  12. 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 ...

  13. Do State-Based Policies Have an Impact on Teen Birth Rates and Teen Abortion Rates in the United States?

    Science.gov (United States)

    Chevrette, Marianne; Abenhaim, Haim Arie

    2015-10-01

    The United States has one of the highest teen birth rates among developed countries. Interstate birth rates and abortion rates vary widely, as do policies on abortion and sex education. The objective of our study is to assess whether US state-level policies regarding abortion and sexual education are associated with different teen birth and teen abortion rates. We carried out a state-level (N = 51 [50 states plus the District of Columbia]) retrospective observational cross-sectional study, using data imported from the National Vital Statistics System. State policies were obtained from the Guttmacher Institute. We used descriptive statistics and regression analysis to study the association of different state policies with teen birth and teen abortion rates. The state-level mean birth rates, when stratifying between policies protective and nonprotective of teen births, were not statistically different-for sex education policies, 39.8 of 1000 vs 45.1 of 1000 (P = .2187); for mandatory parents' consent to abortion 45 of 1000, vs 38 of 1000 when the minor could consent (P = .0721); and for deterrents to abortion, 45.4 of 1000 vs 37.4 of 1000 (P = .0448). Political affiliation (35.1 of 1000 vs 49.6 of 1000, P births. Lower teen abortion rates were, however, associated with restrictive abortion policies, specifically lower in states with financial barriers, deterrents to abortion, and requirement for parental consent. While teen birth rates do not appear to be influenced by state-level sex education policies, state-level policies that restrict abortion appear to be associated with lower state teen abortion rates. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  14. ROLES OF TRADITIONAL BIRTH ATTENDANTS AND PERCEPTIONS ON THE POLICY DISCOURAGING HOME DELIVERY IN COASTAL KENYA.

    Science.gov (United States)

    Wanyua, S; Kaneko, S; Karama, M; Makokha, A; Ndemwa, M; Kisule, A; Changoma, M; Goto, K; Shimada, M

    2014-03-01

    To describe the roles of Traditional Birth Attendants (TBAs), to determine the perceptions of TBAs and Skilled Birth Attendants (SBAs) towards the policy discouraging home delivery by TBAs and to establish the working relationship between TBAs and SBAs in Kwale, Kenya. Community based cross-sectional study. Mwaluphamba, Kinango and Golini locations of Kwale County, Kenya. Fifty eight participants were involved in the study. Interviews were conducted with 22 TBAs and 8 SBAs as well as 3 FGDs with 28 TBAs were carried out in July 2012. Roles of TBAs, policy awareness and support as well as the working relationship between TBAs and SBAs. Before delivery, the main role of TBAs was checking position of the baby in the womb (86%) while during delivery, the main role was stomach massage (64%). However, majority (95%) of the TBAs did not provide any after delivery. All SBAs and 59% of TBAs were aware of the policy while 88% SBAs and 36% of TBAs supported it. The working relationship between TBAs and SBAs mainly involved the referral of women to health facilities (HFs). Sometimes, TBAs accompanied women to the HF offering emotional support until after delivery. TBAs in Kwale have a big role to play especially during pregnancy and delivery periods. Awareness and support of the policy as well as the collaboration between SBAs and TBAs should be enhanced in Kwale.

  15. 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.

  16. 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.

  17. 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.

  18. Maternity waiting homes and institutional birth in Nicaragua: policy options and strategic implications.

    Science.gov (United States)

    García Prado, Ariadna; Cortez, Rafael

    2012-01-01

    With the aim of promoting institutional births and reducing the high maternal and child mortality rates in rural and poor zones, the government of Nicaragua is supporting the creation of maternity waiting homes. This study analyzes that strategy and examines the factors associated with the use of maternity waiting homes and institutional birth. To that end, we apply a quantitative approach, by means of an econometric analysis of the data extracted from surveys conducted in 2006 on a sample of women and parteras or traditional birth attendants, as well as a qualitative approach based on interviews with key informants. Results indicate that although the operation of the maternity waiting homes is usually satisfactory, there is still room for improvement along the following lines: (i) disseminating information about the homes to both women and men, as the latter frequently decide the course of women's healthcare, and to parteras, who can play an important role in referring women; (ii) strengthening the postpartum care; (iii) ensuring financial sustainability by obtaining regular financial support from the government to complement contributions from the community; and (iv) strengthening the local management and involvement of the regional government. These measures might be useful for health policy makers in Nicaragua and in other developing countries that are considering this strategy. Copyright © 2011 John Wiley & Sons, Ltd.

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. Control Structures and Payout Policy

    NARCIS (Netherlands)

    Renneboog, L.D.R.; Trojanowski, G.

    2005-01-01

    This paper examines the payout policies of UK firms listed on the London Stock Exchange during the 1990s.It complements the existing literature by analyzing the trends in both dividends and total payouts (including share repurchases).In a dynamic panel data regression setting, we relate target

  4. 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.

  5. Signalling, wage controls and monetary disinflation policy

    NARCIS (Netherlands)

    van Wijnbergen, S.J.G.; Persson, T.

    1993-01-01

    Focuses on wage control and monetary disinflation policy. How the crucial variable to control is the money supply and wage and price controls should be avoided because of their macroeconomic costs; The two types of government as being low-inflation governments and high-inflation governments; How

  6. Time dependent policy-based access control

    DEFF Research Database (Denmark)

    Vasilikos, Panagiotis; Nielson, Flemming; Nielson, Hanne Riis

    2017-01-01

    also on other attributes of the environment such as the time. In this paper, we use systems of Timed Automata to model distributed systems and we present a logic in which one can express time-dependent policies for access control. We show how a fragment of our logic can be reduced to a logic......Access control policies are essential to determine who is allowed to access data in a system without compromising the data's security. However, applications inside a distributed environment may require those policies to be dependent on the actual content of the data, the flow of information, while...... that current model checkers for Timed Automata such as UPPAAL can handle and we present a translator that performs this reduction. We then use our translator and UPPAAL to enforce time-dependent policy-based access control on an example application from the aerospace industry....

  7. 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

  8. 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

  9. The emergence of the vertical birth in Ecuador: an analysis of agenda setting and policy windows for intercultural health

    Science.gov (United States)

    Llamas, Ana; Mayhew, Susannah

    2016-01-01

    Maternal mortality continues to claim the lives of thousands of women in Latin America despite the availability of effective treatments to avert maternal death. In the past, efforts to acknowledge cultural diversity in birth practices had not been clearly integrated into policy. However, in Otavalo (Ecuador) a local hospital pioneered the implementation of the ‘Vertical Birth’—a practical manifestation of an intercultural health policy aimed at increasing indigenous women’s access to maternity care. Drawing on agenda-setting theory, this qualitative research explores how the vertical birth practice made it onto the local policy agenda and the processes that allowed actors to seize a window of opportunity allowing the vertical birth practice to emerge. Our results show that the processes that brought about the vertical birth practice took place over a prolonged period of time and resulted from the interplay between various factors. Firstly, a maternal health policy community involving indigenous actors played a key role in identifying maternal mortality as a policy problem, defining its causes and framing it as an indigenous rights issue. Secondly, previous initiatives to address maternal mortality provided a wealth of experience that gave these actors the knowledge and experience to formulate a feasible policy solution and consolidate support from powerful actors. Thirdly, the election of a new government that had incorporated the demands of the indigenous movement opened up a window of opportunity to push intercultural health policies such as the vertical birth. We conclude that the socioeconomic and political changes at both national and local level allowed the meaningful participation of indigenous actors that made a critical contribution to the emergence of the vertical birth practice. These findings can help us advance our knowledge of strategies to set the agenda for intercultural maternal health policy and inform future policy in similar settings

  10. Control of the population growth and women in Mexico: international organizations, civil society and public policies

    Directory of Open Access Journals (Sweden)

    María Ileana García Gossio

    2015-07-01

    subjects of the public demographic policies. For their part, the international organizations considered them, at first, as the key factor in birth control, but also as a beginning of development. Later, women were identified in public discourse according to feminist demands: as subjects with rights and with positions with a generic perspective.

  11. 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…

  12. 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...

  13. Gun Control: The Debate and Public Policy.

    Science.gov (United States)

    Watkins, Christine

    1997-01-01

    Provides an overview and background information on the debate over gun control, as well as several teaching ideas. Handouts include a list of related topics drawn from various disciplines (economics, U.S. history), seven arguments for and against gun control, and a set of policy evaluation guidelines. (MJP)

  14. 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...

  15. Reasons for and challenges of recent increases in teen birth rates: a study of family planning service policies and demographic changes at the state level.

    Science.gov (United States)

    Yang, Zhou; Gaydos, Laura M

    2010-06-01

    After declining for over a decade, the birth rate in the United States for adolescents aged 15-19 years increased by 3% in 2006 and 1% again in 2007. We examined demographic and policy reasons for this trend at state level. With data merged from multiple sources, descriptive analysis was used to detect state-level trends in birth rate and policy changes from 2000 to 2006, and variations in the distribution of teen birth rates, sex education, and family planning service policies, and demographic features across each state in 2006. Regression analysis was then conducted to estimate the effect of several reproductive health policies and demographic features on teen birth rates at the state level. Instrument variable was used to correct possible bias in the regression analysis. Medicaid family planning waivers were found to reduce teen birth rates across all ages and races. Abstinence-only education programs were found to cause an increase in teen birth rates among white and black teens. The increasing Hispanic population is another driving force for high teen birth rates. Both demographic factors and policy changes contributed to the increase in teen birth rates between 2000 and 2006. Future policy and behavioral interventions should focus on promoting and increasing access to contraceptive use. Family planning policies should be crafted to address the special needs of teens from different cultural backgrounds, especially Hispanics. Copyright 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Adoptees in Search of Their Past: Policy Induced Strain on Adoptive Families and Birth Parents.

    Science.gov (United States)

    Simpson, Mark; And Others

    1981-01-01

    Explores the impact of Minnesota's Open Birth Record Law. Studied adoptees in search of information and contact with their birth parents. Caseworkers were relatively successful in the searches, but personal contacts were achieved for only 35 percent of the adoptees. Supports the value of the Open Birth Record law. (Author)

  17. Tobacco control policies and perinatal health: a national quasi-experimental study.

    Science.gov (United States)

    Peelen, Myrthe J; Sheikh, Aziz; Kok, Marjolein; Hajenius, Petra; Zimmermann, Luc J; Kramer, Boris W; Hukkelhoven, Chantal W; Reiss, Irwin K; Mol, Ben W; Been, Jasper V

    2016-04-22

    We investigated whether changes in perinatal outcomes occurred following introduction of key tobacco control policies in the Netherlands: smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign (January-February 2004); and extension of the smoke-free law to the hospitality industry, accompanied by another tax increase and mass media campaign (July 2008). This was a national quasi-experimental study using Netherlands Perinatal Registry data (2000-2011; registration: ClinicalTrials.gov NCT02189265). Primary outcome measures were: perinatal mortality, preterm birth, and being small-for-gestational age (SGA). The association with timing of the tobacco control policies was investigated using interrupted time series logistic regression analyses with adjustment for confounders. Among 2,069,695 singleton births, there were 13,027 (0.6%) perinatal deaths, 116,043 (5.6%) preterm live-births and 187,966 (9.1%) SGA live-births. The 2004 policies were not associated with significant changes in the odds of developing any of the primary outcomes. After the 2008 policy change, a -4.4% (95% CI -2.4; -6.4, p law to bars and restaurants in conjunction with a tax increase and mass media campaign.

  18. 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...

  19. 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.

  20. 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...

  1. 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.

  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. Improving Skilled Birth Attendance in Ghana: An Evidence-Based Policy Brief.

    Science.gov (United States)

    Apanga, Paschal Awingura; Awoonor-Williams, John Koku

    2017-01-01

    This commentary has the objective of improving skilled birth attendance in Ghana to reduce maternal and neonatal mortality and morbidity. We have provided evidence of causes of low-skilled birth attendance in Ghana. Physical accessibility of health care, sociocultural factors, economic factors and health care system delivery problems were found as the main underlying causes of low levels of skilled birth attendance in Ghana. The paper provides potential strategies in addressing maternal and child health issues in Ghana.

  4. The OPL Access Control Policy Language

    Science.gov (United States)

    Alm, Christopher; Wolf, Ruben; Posegga, Joachim

    Existing policy languages suffer from a limited ability of directly and elegantly expressing high-level access control principles such as history-based separation of duty [22], binding of duty [26], context constraints [24], Chinese wall properties [10], and obligations [20]. It is often difficult to extend a language in order to retrofit these features once required or it is necessary to use complicated and complex language constructs to express such concepts. The latter, however, is cumbersome and error-prone for humans dealing with policy administration.

  5. Who has the right to advise children on birth control?

    Science.gov (United States)

    Gerber, P; Rahemtula, A

    1986-04-14

    recognized that there was some age below which a child was incapable, as a matter of law, of giving a valid consent or making a valid decision for itself in regard to its custody or upbringing, and the provisions of the criminal law showed that, in the matter of sexual intercourse, that age was 16 years for a girl; and that the circular which had been issued by the Department that stated a doctor could prescribe contraceptive agents for a girl 16 years of age without first informing her parents was illegal. A majority of the House of Lords concluded that the question of birth control for minors was essentially a medicosocial issue which, in exceptional circumstances, was best left to the clinical judgment of the appropriate health professionals, and that there was nothing in any statutory enactment which vested the exclusive right in a parent or guardian to permit or prohibit a girl below the age of 16 years to obtain professional advice or treatment relating to contraception. As the position in Australia remains fluid, and the decisions of the House of Lords are not binding, it is still possible that the statute-by-statute approach adopted by the Court of Appeal may find favor in Australia. A table sets out the relevant position on a State-by-State basis. It is concluded that the "right" to contraceptive advice and treatment involves the decision whether or not to have a child, and if the right of privacy means anything, it is the right of the individual to be free of unwarranted governmental intrusion in these matters, as held in a 1972 US Supreme Court decision.

  6. Facts about Birth Defects

    Science.gov (United States)

    ... label> Information For… Media Policy Makers Facts about Birth Defects Language: English (US) Español (Spanish) Recommend on ... having a baby born without a birth defect. Birth Defects Are Common Every 4 ½ minutes, a ...

  7. 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.

  8. European healthcare policies for controlling drug expenditure.

    Science.gov (United States)

    Ess, Silvia M; Schneeweiss, Sebastian; Szucs, Thomas D

    2003-01-01

    In the last 20 years, expenditures on pharmaceuticals - as well as total health expenditures - have grown faster than the gross national product in all European countries. The aim of this paper was to review policies that European governments apply to reduce or at least slow down public expenditure on pharmaceutical products. Such policies can target the industry, the wholesalers and retailers, prescribers, and patients. The objectives of pharmaceutical policies are multidimensional and must take into account issues relating to public health, public expenditure and industrial incentives. Both price levels and consumption patterns determine the level of total drug expenditure in a particular country, and both factors vary greatly across countries. Licensing and pricing policies intend to influence the supply side. Three types of pricing policies can be recognised: product price control, reference pricing and profit control. Profit control is mainly used in the UK. Reference pricing systems were first used in Germany and The Netherlands and are being considered in other countries. Product price control is still the most common method for establishing the price of drugs. For the aim of fiscal consolidation, price-freeze and price-cut measures have been frequently used in the 1980s and 1990s. They have affected all types of schemes. For drug wholesalers and retailers, most governments have defined profit margins. The differences in price levels as well as the introduction of a Single European Pharmaceutical Market has led to the phenomenon of parallel imports among member countries of the European Union. This may be facilitated by larger and more powerful wholesalers and the vertical integration between wholesalers and retailers. To control costs, the use of generic drugs is encouraged in most countries, but only few countries allow pharmacists to substitute generic drugs for proprietary brands. Various interventions are used to reduce the patients' demand for drugs by

  9. 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.

  10. 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

  11. Estimating the Potential Impact of Tobacco Control Policies on Adverse Maternal and Child Health Outcomes in the United States Using the SimSmoke Tobacco Control Policy Simulation Model.

    Science.gov (United States)

    Levy, David; Mohlman, Mary Katherine; Zhang, Yian

    2016-05-01

    Numerous studies document the causal relationship between prenatal smoking and adverse maternal and child health (MCH) outcomes. Studies also reveal the impact that tobacco control policies have on prenatal smoking. The purpose of this study is to estimate the effect of tobacco control policies on prenatal smoking prevalence and adverse MCH outcomes. The US SimSmoke simulation model was extended to consider adverse MCH outcomes. The model estimates prenatal smoking prevalence and, applying standard attribution methods, uses estimates of MCH prevalence and relative smoking risks to estimate smoking-attributable MCH outcomes over time. The model then estimates the effect of tobacco control policies on adverse birth outcomes averted. Different tobacco control policies have varying impacts on the number of smoking-attributable adverse MCH birth outcomes. Higher cigarette taxes and comprehensive marketing bans individually have the biggest impact with a 5% to 10% reduction across all outcomes for the period from 2015 to 2065. The policies with the lowest impact (2%-3% decrease) during this period are cessation treatment, health warnings, and complete smoke-free laws. Combinations of all policies with each tax level lead to 23% to 28% decreases across all outcomes. Our findings demonstrate the substantial impact of strong tobacco control policies for preventing adverse MCH outcomes, including long-term health implications for children exposed to low birth weight and preterm birth. These benefits are often overlooked in discussions of tobacco control. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  12. 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.

  13. 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.

  14. Optimal pulse fishing policy in stage-structured models with birth pulses

    International Nuclear Information System (INIS)

    Gao Shujing; Chen Lansun; Sun Lihua

    2005-01-01

    In this paper, we propose exploited models with stage structure for the dynamics in a fish population for which periodic birth pulse and pulse fishing occur at different fixed time. Using the stroboscopic map, we obtain an exact cycle of system, and obtain the threshold conditions for its stability. Bifurcation diagrams are constructed with the birth rate (or pulse fishing time or harvesting effort) as the bifurcation parameter, and these are observed to display complex dynamic behaviors, including chaotic bands with period windows, period-doubling, multi-period-halving and incomplete period-doubling bifurcation, pitch-fork and tangent bifurcation, non-unique dynamics (meaning that several attractors or attractor and chaos coexist) and attractor crisis. This suggests that birth pulse and pulse fishing provide a natural period or cyclicity that make the dynamical behaviors more complex. Moreover, we show that the pulse fishing has a strong impact on the persistence of the fish population, on the volume of mature fish stock and on the maximum annual-sustainable yield. An interesting result is obtained that, after the birth pulse, the population can sustain much higher harvesting effort if the mature fish is removed as early as possible

  15. 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.

  16. 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

  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. Projecting the effects of tobacco control policies in the USA through microsimulation: a study protocol

    Science.gov (United States)

    Levy, David T; Jeon, Jihyoun; Clarke, John; Gilkeson, Scott; Hall, Tim; Holford, Theodore R; Meza, Rafael

    2018-01-01

    Introduction Smoking remains the leading cause of preventable death in the USA but can be reduced through policy interventions. Computational models of smoking can provide estimates of the projected impact of tobacco control policies and can be used to inform public health decision making. We outline a protocol for simulating the effects of tobacco policies on population health outcomes. Methods and analysis We extend the Smoking History Generator (SHG), a microsimulation model based on data from the National Health Interview Surveys, to evaluate the effects of tobacco control policies on projections of smoking prevalence and mortality in the USA. The SHG simulates individual life trajectories including smoking initiation, cessation and mortality. We illustrate the application of the SHG policy module for four types of tobacco control policies at the national and state levels: smoke-free air laws, cigarette taxes, increasing tobacco control programme expenditures and raising the minimum age of legal access to tobacco. Smoking initiation and cessation rates are modified by age, birth cohort, gender and years since policy implementation. Initiation and cessation rate modifiers are adjusted for differences across age groups and the level of existing policy coverage. Smoking prevalence, the number of population deaths avoided, and life-years gained are calculated for each policy scenario at the national and state levels. The model only considers direct individual benefits through reduced smoking and does not consider benefits through reduced exposure to secondhand smoke. Ethics and dissemination A web-based interface is being developed to integrate the results of the simulations into a format that allows the user to explore the projected effects of tobacco control policies in the USA. Usability testing is being conducted in which experts provide feedback on the interface. Development of this tool is under way, and a publicly accessible website is available at http

  19. Health policies for the reduction of obstetric interventions in singleton full-term births in Catalonia.

    Science.gov (United States)

    Pueyo, Maria-Jesus; Escuriet, Ramon; Pérez-Botella, M; de Molina, I; Ruíz-Berdun, D; Albert, S; Díaz, S; Torres-Capcha, P; Ortún, V

    2018-04-01

    To explore the effect of hospital's characteristics in the proportion of obstetric interventions (OI) performed in singleton fullterm births (SFTB) in Catalonia (2010-2014), while incentives were employed to reduce C-sections. Data about SFTB assisted at 42 public hospitals were extracted from the dataset of hospital discharges. Hospitals were classified according to the level of complexity, the volume of births attended, and the adoption of a non-medicalized delivery (NMD) strategy. The annual average change in the percentage for OI was calculated based on Poisson regression models. The rate of OI (35% of all SFTB) including C-sections (20.6%) remained stable through the period. Hospitals attending less complex cases had a lower average of OI, while hospitals attending lower volumes had the highest average. Higher levels of complexity increased the use of C-sections (+4% yearly) and forceps (+16%). The adoption of the NMD strategy decreased the rate of C-sections. The proportion of OI, including C-sections, remained stable in spite of public incentives to reduce them. The adoption of the NMD strategy could help in decreasing the rate of OI. To reduce the OI rate, new strategies should be launched as the development of low-risk pregnancies units, alignment of incentives and hospital payment, increased value of incentives and encouragement of a cultural shift towards non-medicalized births. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. 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.

  1. Policy means of control in the climate policy

    International Nuclear Information System (INIS)

    2003-01-01

    Using the MARKAL simulation tool, different economic incentives in climate mitigation policy such as tradable emission permits, green certificates and carbon dioxide taxes have been analyzed. The analysis shows that there is an important advantage in applying the emission reductions internationally compared to a national policy, due to the varying marginal costs for the measures in different countries. The analysis also reveals at which price levels the Nordic countries as a whole become net sellers or net buyers of emission permits. The effects of combining emission permits with green certificates are analyzed, e.g. the inverse relation between permit and certificate prices. An appendix to the report gives a description of the Swedish energy system, emissions world-wide and examples of cost-effective mitigation measures for Sweden

  2. Prevalence of Low Birth Weight before and after Policy Change to IPTp-SP in Two Selected Hospitals in Southern Nigeria: Eleven-Year Retrospective Analyses

    Directory of Open Access Journals (Sweden)

    Nneka U. Igboeli

    2018-01-01

    Full Text Available Background. In 2005, Nigeria changed its policy on prevention of malaria in pregnancy to intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP. Indicators of impact of effective prevention and control of malaria on pregnancy (MIP are low birth weight (LBW and maternal anaemia by parity. This study determined the prevalence of LBW for different gravidity groups during periods of pre- and postpolicy change to IPTp-SP. Methods. Eleven-year data were abstracted from the delivery registers of two hospitals. Study outcomes calculated for both pre- (2000–2004 and post-IPTp-SP-policy (2005–2010 years were prevalence of LBW for different gravidity groups and risk of LBW in primigravidae compared to multigravidae. Results. Out of the 11,496 singleton deliveries recorded within the 11-year period, the prevalence of LBW was significantly higher in primigravidae than in multigravidae for both prepolicy (6.3% versus 4% and postpolicy (8.6% versus 5.1% years. The risk of LBW in primigravidae compared to multigravidae increased from 1.62 (1.17–2.23 in the prepolicy years to 1.74 (1.436–2.13 during the postpolicy years. Conclusion. The study demonstrated that both the prevalence and risk of LBW remained significantly higher in primigravidae even after the change in policy to IPTp-SP.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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…

  5. 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).

  6. 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 ...

  7. Air pollution control policy in Switzerland

    Energy Technology Data Exchange (ETDEWEB)

    Leutert, G. [Forests and Landscape, Berne (Switzerland). Federal Office of Environment

    1995-12-31

    The legal basis of the Swiss air pollution control policy is set by the Federal Law on the Protection of the Environment, which came into force in 1985. It aims to protect human beings, animals and plants, their biological communities and habitats against harmful effects or nuisances and to maintain the fertility of the soil. The law is source-oriented (by emission standards) as well as effect-oriented (by ambient air quality standards). To link both elements a two-stage approach is applied. In the first stage preventive measures are taken at the emitting sources, irrespective of existing air pollution levels. Emissions have to be limited by early preventive measures as much as technical and operational conditions allow and as far as economically acceptable (prevention principle). By this, air pollution shall be kept as low as possible as a matter of principle, without the environment having to be in danger first. In a second stage the measures are strengthened or backed up by additional measures if ambient air quality standards laid down in the Ordinance on Air Pollution Control are exceeded. At this second stage, protection of man and his environment has priority over economic considerations. (author)

  8. Air pollution control policy in Switzerland

    Energy Technology Data Exchange (ETDEWEB)

    Leutert, G [Forests and Landscape, Berne (Switzerland). Federal Office of Environment

    1996-12-31

    The legal basis of the Swiss air pollution control policy is set by the Federal Law on the Protection of the Environment, which came into force in 1985. It aims to protect human beings, animals and plants, their biological communities and habitats against harmful effects or nuisances and to maintain the fertility of the soil. The law is source-oriented (by emission standards) as well as effect-oriented (by ambient air quality standards). To link both elements a two-stage approach is applied. In the first stage preventive measures are taken at the emitting sources, irrespective of existing air pollution levels. Emissions have to be limited by early preventive measures as much as technical and operational conditions allow and as far as economically acceptable (prevention principle). By this, air pollution shall be kept as low as possible as a matter of principle, without the environment having to be in danger first. In a second stage the measures are strengthened or backed up by additional measures if ambient air quality standards laid down in the Ordinance on Air Pollution Control are exceeded. At this second stage, protection of man and his environment has priority over economic considerations. (author)

  9. Divergent trends in abortion and birth control practices in belarus, Russia and Ukraine.

    Directory of Open Access Journals (Sweden)

    Boris P Denisov

    Full Text Available CONTEXT: The last decade witnessed growing differences in abortion dynamics in Belarus, Russia, and Ukraine despite demographic, social, and historical similarities of these nations. This paper investigates changes in birth control practices in the three countries and searches for an explanation of the diverging trends in abortion. METHODS: Official abortion and contraceptive use statistics, provided by national statistical agencies, were analysed. Respective laws and other legal documents were examined and compared between the three countries. To disclose inter-country differences in prevalence of the modern methods of contraception and its association with major demographic and social factors, an analysis of data from national sample surveys was performed, including binary logistic regression. RESULTS: The growing gap in abortion rate in Belarus, Russia, and Ukraine is a genuine phenomenon, not a statistical artefact. The examination of abortion and prevalence of contraception based on official statistics and three national sample surveys did not reveal any unambiguous factors that could explain differences in abortion dynamics in Belarus, Russia, and Ukraine. However, it is very likely that the cause of the inter-country discrepancies lies in contraceptive behavior itself, in adequacies of contraceptive knowledge and practices. Additionally, large differences in government policies, which are very important in shaping contraceptive practices of the population, were detected. CONCLUSION: Since the end of the 1990s, the Russian government switched to archaic ideology in the area of reproductive health and family planning and neglects evidence-based arguments. Such an extreme turn in the governmental position is not observed in Belarus or Ukraine. This is an important factor contributing to the slowdown in the decrease of abortion rates in Russia.

  10. Divergent Trends in Abortion and Birth Control Practices in Belarus, Russia and Ukraine

    Science.gov (United States)

    Denisov, Boris P.; Sakevich, Victoria I.; Jasilioniene, Aiva

    2012-01-01

    Context The last decade witnessed growing differences in abortion dynamics in Belarus, Russia, and Ukraine despite demographic, social, and historical similarities of these nations. This paper investigates changes in birth control practices in the three countries and searches for an explanation of the diverging trends in abortion. Methods Official abortion and contraceptive use statistics, provided by national statistical agencies, were analysed. Respective laws and other legal documents were examined and compared between the three countries. To disclose inter-country differences in prevalence of the modern methods of contraception and its association with major demographic and social factors, an analysis of data from national sample surveys was performed, including binary logistic regression. Results The growing gap in abortion rate in Belarus, Russia, and Ukraine is a genuine phenomenon, not a statistical artefact. The examination of abortion and prevalence of contraception based on official statistics and three national sample surveys did not reveal any unambiguous factors that could explain differences in abortion dynamics in Belarus, Russia, and Ukraine. However, it is very likely that the cause of the inter-country discrepancies lies in contraceptive behavior itself, in adequacies of contraceptive knowledge and practices. Additionally, large differences in government policies, which are very important in shaping contraceptive practices of the population, were detected. Conclusion Since the end of the 1990s, the Russian government switched to archaic ideology in the area of reproductive health and family planning and neglects evidence-based arguments. Such an extreme turn in the governmental position is not observed in Belarus or Ukraine. This is an important factor contributing to the slowdown in the decrease of abortion rates in Russia. PMID:23349656

  11. 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.

  12. Alcohol Control and Harm Reduction Policies in Lebanon | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Findings will document the current national alcohol policy and identify the direct and indirect influences of policy-relevant factors and psychosocial mediators on alcohol consumption and purchasing. Researchers will also assess the potential impact of specific alcohol-control policy packages. The results should help to ...

  13. The birth and spread of IWRM - A case study of global policy diffusion and translation

    Directory of Open Access Journals (Sweden)

    Jeremy Allouche

    2016-10-01

    Full Text Available How did the idea of IWRM emerge at the global level? Why has IWRM become so popular and so resilient, at least in discourse and policy? What has caused IWRM policies to diffuse across time and space? The principal goal of this article is to identify a set of concepts and mechanisms to study the global diffusion and translation of IWRM through coercion, cooperation, or learning from the ground. The article will also highlight the extent to which this global diffusion was contested and translated into different meanings in terms of policy orientation. Overall, IWRM was a mindset of a particular period where the water policy paradigm was evolving in the same direction as sustainable development and other related paradigms in a post-Rio moment. There were no clear alternatives at the time but now IWRM is being questioned. This IWRM fatigue is leading to other framings and discourses around the water-food-energy nexus and the green economy.

  14. Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012

    DEFF Research Database (Denmark)

    Bonet, Mercedes; Cuttini, M; Piedvache, A

    2017-01-01

    OBJECTIVE: to investigate changes in maternity and neonatal unit policies towards extremely preterm infants (EPTI) between 2003 and 2012 and concurrent trends in their mortality and morbidity in ten European regions. DESIGN: population-based cohort studies in 2003 (MOSAIC study) and 2011/12 (EPIC...

  15. Conviviality-driven access control policy

    NARCIS (Netherlands)

    El Kateb, Donia; Zannone, N.; Moawad, Assaad; Caire, Patrice; Nain, Grégory; Mouelhi, Tejeddine; Le Traon, Yves

    2015-01-01

    Nowadays many organizations experience security incidents due to unauthorized access to information. To reduce the risk of such incidents, security policies are often employed to regulate access to information. Such policies, however, are often too restrictive, and users do not have the rights

  16. 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

  17. Increasingly heterogeneous ages at first birth by education in Southern-European and Anglo-American family-policy regimes: A seven-country comparison

    Science.gov (United States)

    Rendall, Michael; Aracil, Encarnacion; Bagavos, Christos; Couet, Christine; DeRose, Alessandra; DiGiulio, Paola; Lappegard, Trude; Robert-Bobée, Isabelle; Rønsen, Marit; Smallwood, Steve; Verropoulou, Georgia

    2010-01-01

    Family-policy regimes unfavourable to combining employment with motherhood have been claimed to increase socio-economic differentials in fertility as combining employment and motherhood has become more normative. This claim has to date been explored mainly in reference to ‘liberal’ Anglo-American regimes. Comparing education differentials in age at first birth among native-born women of 1950s and 1960s birth cohorts in seven countries representing three regime types, we find persistence in early first births among low-educated women not only in Britain and the United States but also in Greece, Italy, and Spain. Shifts towards later first births, however, were more extreme in Southern Europe and involved to some extent women at all education levels. The educationally-heterogeneous changes in age patterns of first births seen in the Southern European and Anglo-American family-policy regimes contrast with educationally-homogeneous changes across birth cohorts seen in the study’s two ‘universalistic’ countries, Norway and France. PMID:20954097

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. Alcohol Control Policies in 46 African Countries: Opportunities for Improvement.

    Science.gov (United States)

    Ferreira-Borges, Carina; Esser, Marissa B; Dias, Sónia; Babor, Thomas; Parry, Charles D H

    2015-07-01

    There is little information on the extent to which African countries are addressing alcohol consumption and alcohol-related harm, which suggests that evaluations of national alcohol policies are needed in this region. The aim of this article is to examine the strength of a mix of national alcohol control policies in African countries, as well as the relationship between alcohol policy restrictiveness scores and adult alcohol per capita consumption (APC) among drinkers at the national level. We examined national alcohol policies of 46 African countries, as of 2012, in four regulatory categories (price, availability, marketing and drink-driving), and analyzed the restrictiveness of national alcohol policies using an adapted Alcohol Policy Index (API). To assess the validity of the policy restrictiveness scores, we conducted correlational analyses between policy restrictiveness scores and APC among drinkers in 40 countries. Countries attained a mean score of 44.1 of 100 points possible, ranging from 9.1 (Sao Tomé and Principe) to 75.0 (Algeria), with low scores indicating low policy restrictiveness. Policy restrictiveness scores were negatively correlated with and APC among drinkers (rs = -0.353, P = 0.005). There is great variation in the strength of alcohol control policies in countries throughout the African region. Tools for comparing the restrictiveness of alcohol policies across countries are available and are an important instrument to monitor alcohol policy developments. The negative correlation between policy restrictiveness and alcohol consumption among drinkers suggests the need for stronger alcohol policies as well as increased training and capacity building at the country level. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  5. Analysis on policies text of air pollution control in Beijing

    Science.gov (United States)

    ZHANG, Yujuan; WANG, Wen; ZHANG, Wei

    2017-04-01

    Air pollution is one of the most serious environmental problems, and it is also the inevitable result of the extensive economic development mode. The matter of air pollution in Beijing is becoming more and more serious since 2010, which has a great impact on the normal social production, living and human health. These hazards have been highly valued by the whole society. More than 30 years have been pasted since controlling the air pollution and the system of policies was relatively complete. These policies have improved the quality of atmospheric and prevented environment further deterioration. The policies performance is not obvious. It is urgent trouble to improve policy performance. This paper analyzes the 103 policies text of air pollution control in Beijing, and researches status, history and problems, and put forward suggestions on policy improvement and innovation at last.

  6. Air Pollution Control Policies in China: A Retrospective and Prospects

    OpenAIRE

    Jin, Yana; Andersson, Henrik; Zhang, Shiqiu

    2016-01-01

    With China’s significant role on pollution emissions and related health damage, deep and up-to-date understanding of China’s air pollution policies is of worldwide relevance. Based on scientific evidence for the evolution of air pollution and the institutional background of environmental governance in China, we examine the development of air pollution control policies from the 1980s and onwards. We show that: (1) The early policies, until 2005, were ineffective at reducing emissions; (2) Duri...

  7. Asymmetric forecasting and commitment policy in a robust control problem

    OpenAIRE

    Taro Ikeda

    2013-01-01

    This paper provides a piece of results regarding asymmetric forecasting and commitment monetary policy with a robust control algorithm. Previous studies provide no clarification of the connection between asymmetric preference and robust commitment policy. Three results emerge from general equilibrium modeling with asymmetric preference: (i) the condition for system stability implies an average inflation bias with respect to asymmetry (ii) the effect of asymmetry can be mitigated if policy mak...

  8. 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

  9. 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.

  10. Tobacco control, global health policy and development: towards policy coherence in global governance

    Science.gov (United States)

    Collin, Jeff

    2015-01-01

    The WHO Framework Convention on Tobacco Control (FCTC) demonstrates the international political will invested in combating the tobacco pandemic and a newfound prominence for tobacco control within the global health agenda. However, major difficulties exist in managing conflicts with foreign and trade policy priorities, and significant obstacles confront efforts to create synergies with development policy and avoid tensions with other health priorities. This paper uses the concept of policy coherence to explore congruence and inconsistencies in objectives, policy, and practice between tobacco control and trade, development and global health priorities. Following the inability of the FCTC negotiations to satisfactorily address the relationship between trade and health, several disputes highlight the challenges posed to tobacco control policies by multilateral and bilateral agreements. While the work of the World Bank has demonstrated the potential contribution of tobacco control to development, the absence of non-communicable diseases from the Millennium Development Goals has limited scope to offer developing countries support for FCTC implementation. Even within international health, tobacco control priorities may be hard to reconcile with other agendas. The paper concludes by discussing the extent to which tobacco control has been pursued via a model of governance very deliberately different from those used in other health issues, in what can be termed ‘tobacco exceptionalism’. The analysis developed here suggests that non-communicable disease (NCD) policies, global health, development and tobacco control would have much to gain from re-examining this presumption of difference. PMID:22345267

  11. Increased Utilization of Primary Health Care Centers for Birthing Care in Tamil Nadu, India: A Visible Impact of Policies, Initiatives, and Innovations

    Science.gov (United States)

    Pandian, Jayanthi; Suresh, Saradha; Desikachari, B. R.; Padmanaban, P.

    2013-01-01

    Background: Tamil Nadu has been showing an increasing trend in institutional deliveries since early 1990's and has now achieved near 100%. Among the institutional deliveries, a change was observed since 2006, wherein primary health centers (PHCs) showed a four-fold increase in deliveries, while other public and private health facilities showed a decline, despite equal access to all categories of health facilities. What led to this increased utilization of PHCs for birthing care? Material and Methods: Policies, documents, and published reports of the Government of Tamil Nadu (GoTN) were reviewed and interviews were conducted with the various stakeholders involved in providing birthing care in the PHCs. This study analyzes the impact of the policies and supply side initiatives and innovations which led to increase utilization of the PHCs for birthing care. Results: Scaling up of 24 × 7 services in all PHCs, upgrading PHCs with good infrastructure, human resources, and women friendly services have helped to boost the image of the PHCs. Pro-women policies like maternity benefit schemes, birth companionship, providing food, and compulsory stay for 48 h following delivery have attracted women towards PHC. Innovative strategies like maternity picnics and use of expected date of delivery (EDD) chart for follow-up have made women choose PHCs, while periodic reviews and support to staff has improved service delivery. Conclusion: Women centered policies, efficient managerial systems, quality care, and innovative marketing of services have together contributed to increased utilization of PHCs for birthing. Other states could explore the possibility of replicating this model to make optimal use the PHC facilities. PMID:26664836

  12. Understanding tobacco control policy at the national level: bridging the gap between public policy and tobacco control advocacy

    Directory of Open Access Journals (Sweden)

    Marc C. Willemsen

    2018-03-01

    Full Text Available Background While some countries have advanced tobacco control policies, other countries struggle to adopt and implement FCTC's measures. This presentation uncovers the main factors that explain such variations, taking insights from public policy and political science as a starting point for a case study. Methods A case study of tobacco control policy making in the Netherlands, covering the period from the 1960s until the present. The study consisted of a systematic search and analysis of documents and proceedings of parliamentary debates on tobacco policy, supplemented with 22 interviews with key informants from the government, health organisations, politicians, and the tobacco industry. In addition, documents from the Truth Tobacco Industry Documents database, pertaining to the influence of the tobacco industry on Dutch policy making, were analysed. Results The Dutch government started relatively late to regulate tobacco. The choices in tobacco control policy making at the national level and the tempo in which they are made are explained by the interaction of the five main elements of the tobacco control policy making process: Relatively stable context factors (constitutional structures, 'rules of the policy making game', national cultural values Relatively dynamic context factors (regime changes, EU regulation and FCTC guidelines, changing social norms, public support Transfer of ideas (availability and interpretation of scientific evidence Pro and anti-tobacco control networks and coalitions (their organisational and lobby strength Agenda-setting (changes in problem definition, issue framing, media advocacy Conclusions Despite worldwide convergence of tobacco control policies, accelerated by the ratification of the FCTC treaty by most nations, governments develop approaches to tobacco control in line with cultural values, ideological preferences and specific national institutional arrangements. There is no one-size-fits-all approach. The

  13. Expanding Fiscal Policies for Global and National Tobacco Control ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project aims to accelerate the adoption of effective fiscal policies for public ... control and/or innovative financing mechanisms in low- and middle-income ... from the health sciences, medicine, chemistry and engineering departments.

  14. Better Monetary Control may Increase the Inflationary Bias of Policy

    NARCIS (Netherlands)

    O.H. Swank (Otto)

    1994-01-01

    textabstractExplores the implications of imperfect monetary control and uncertainty about the trade-off between output and inflation to discretionary policy. Impact of imperfect control of money growth on policymakers' incentive to create surprises; Consequences of imperfect control of money growth

  15. Prioritizing congenital syphilis control in south China: a decision analytic model to inform policy implementation.

    Directory of Open Access Journals (Sweden)

    Nicholas X Tan

    Full Text Available Syphilis is a major public health problem in many regions of China, with increases in congenital syphilis (CS cases causing concern. The Chinese Ministry of Health recently announced a comprehensive 10-y national syphilis control plan focusing on averting CS. The decision analytic model presented here quantifies the impact of the planned strategies to determine whether they are likely to meet the goals laid out in the control plan.Our model incorporated data on age-stratified fertility, female adult syphilis cases, and empirical syphilis transmission rates to estimate the number of CS cases associated with prenatal syphilis infection on a yearly basis. Guangdong Province was the focus of this analysis because of the availability of high-quality demographic and public health data. Each model outcome was simulated 1,000 times to incorporate uncertainty in model inputs. The model was validated using data from a CS intervention program among 477,656 women in China. Sensitivity analyses were performed to identify which variables are likely to be most influential in achieving Chinese and international policy goals. Increasing prenatal screening coverage was the single most effective strategy for reducing CS cases. An incremental increase in prenatal screening from the base case of 57% coverage to 95% coverage was associated with 106 (95% CI: 101, 111 CS cases averted per 100,000 live births (58% decrease. The policy strategies laid out in the national plan led to an outcome that fell short of the target, while a four-pronged comprehensive syphilis control strategy consisting of increased prenatal screening coverage, increased treatment completion, earlier prenatal screening, and improved syphilis test characteristics was associated with 157 (95% CI: 154, 160 CS cases averted per 100,000 live births (85% decrease.The Chinese national plan provides a strong foundation for syphilis control, but more comprehensive measures that include earlier and more

  16. Urban stormwater source control policies: why and how?

    Directory of Open Access Journals (Sweden)

    G. Petrucci

    2014-09-01

    Full Text Available Stormwater source control is becoming a common strategy for urban stormwater management in many countries. It relies on regulations or other policy instruments compelling or inciting implementation, for each new urban development, of small-scale facilities to locally store and manage stormwater. Local authorities that pioneered source control since the 1980s have already observed that small-scale facilities systematically implemented over a catchment are able to influence its hydrological behaviour. This capability is the main strength of source control, as it allows compensation for the negative effects of urbanization. Yet, it also represents its main risk: if initial decision-making is not sufficiently accurate, source control can produce long-term negative effects. Because of its current spreading, source control will acquire an increasing role as a driver of hydrological changes in urban catchments, and the directions of these changes depend on current policy-making practices. This paper presents an analysis and a critical discussion of the main objectives that policy-makers attribute to stormwater source control. The investigation is based on a sample of French case studies, completed by a literature review for international comparison. It identifies four main objectives, some typical of urban stormwater management and some more innovative: flood reduction, receiving waters protection, sustainable development, costs reduction. The discussion focuses on how current policy-making practices are able to translate these objectives in concrete policy instruments, and on which knowledge and tools could improve this process. It is shown that for some objectives, basic knowledge is available, but the creation of policy instruments which are effective at the catchment scale and adapted to local conditions is still problematic. For other objectives, substantial lacks of knowledge exist, casting doubts on long-term effectiveness of current policy

  17. 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

  18. 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.

  19. "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

  20. 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.

  1. 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

  2. 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.

  3. "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.

  4. 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.

  5. Empoderamiento juvenil y control policial informal

    Directory of Open Access Journals (Sweden)

    Luis Gerardo Gabaldón

    2015-01-01

    Full Text Available El artículo discute la aplicación de mecanismos altamentecoactivos de control social informal sobre la población juvenilpercibida como desviada o incluso rebelde, utilizando comomarco referencial la noción de vulnerabilidad vinculada acarencias asociadas a la indefinición de identidades, laatenuación de controles informales benignos, la insuficiencia oineficacia del control social formal, las debilidadessocioeconómicas y la exclusión social. Los datos empíricosprovienen, fundamentalmente, de estudios y diagnósticosvenezolanos de las últimas dos décadas, contextualizadosdentro de la perspectiva internacional sobre la vulnerabilidadjuvenil. Se sugieren mecanismos para reducir la aplicación de lacoacción informal con base en el empoderamiento juvenilasociado al incremento de la respetabilidad y reconocimientode identidades legítimas, particularmente frente a la policía que,como agencia de control social con amplias facultades deintervención situacional, estaría mayormente propensa a aplicarmedidas informales altamente coactivas para lograr suafirmación frente al desafío y obtener sometimiento.

  6. Cross-Layer Admission Control Policy for CDMA Beamforming Systems

    Directory of Open Access Journals (Sweden)

    Sheng Wei

    2007-01-01

    Full Text Available A novel admission control (AC policy is proposed for the uplink of a cellular CDMA beamforming system. An approximated power control feasibility condition (PCFC, required by a cross-layer AC policy, is derived. This approximation, however, increases outage probability in the physical layer. A truncated automatic retransmission request (ARQ scheme is then employed to mitigate the outage problem. In this paper, we investigate the joint design of an AC policy and an ARQ-based outage mitigation algorithm in a cross-layer context. This paper provides a framework for joint AC design among physical, data-link, and network layers. This enables multiple quality-of-service (QoS requirements to be more flexibly used to optimize system performance. Numerical examples show that by appropriately choosing ARQ parameters, the proposed AC policy can achieve a significant performance gain in terms of reduced outage probability and increased system throughput, while simultaneously guaranteeing all the QoS requirements.

  7. Air Pollution Control Policies in China: A Retrospective and Prospects

    Science.gov (United States)

    Jin, Yana; Andersson, Henrik; Zhang, Shiqiu

    2016-01-01

    With China’s significant role on pollution emissions and related health damage, deep and up-to-date understanding of China’s air pollution policies is of worldwide relevance. Based on scientific evidence for the evolution of air pollution and the institutional background of environmental governance in China, we examine the development of air pollution control policies from the 1980s and onwards. We show that: (1) The early policies, until 2005, were ineffective at reducing emissions; (2) During 2006–2012, new instruments which interact with political incentives were introduced in the 11th Five-Year Plan, and the national goal of reducing total sulfur dioxide (SO2) emissions by 10% was achieved. However, regional compound air pollution problems dominated by fine particulate matter (PM2.5) and ground level ozone (O3) emerged and worsened; (3) After the winter-long PM2.5 episode in eastern China in 2013, air pollution control policies have been experiencing significant changes on multiple fronts. In this work we analyze the different policy changes, the drivers of changes and key factors influencing the effectiveness of policies in these three stages. Lessons derived from the policy evolution have implications for future studies, as well as further reforming the management scheme towards air quality and health risk oriented directions. PMID:27941665

  8. Air Pollution Control Policies in China: A Retrospective and Prospects.

    Science.gov (United States)

    Jin, Yana; Andersson, Henrik; Zhang, Shiqiu

    2016-12-09

    With China's significant role on pollution emissions and related health damage, deep and up-to-date understanding of China's air pollution policies is of worldwide relevance. Based on scientific evidence for the evolution of air pollution and the institutional background of environmental governance in China, we examine the development of air pollution control policies from the 1980s and onwards. We show that: (1) The early policies, until 2005, were ineffective at reducing emissions; (2) During 2006-2012, new instruments which interact with political incentives were introduced in the 11th Five-Year Plan, and the national goal of reducing total sulfur dioxide (SO₂) emissions by 10% was achieved. However, regional compound air pollution problems dominated by fine particulate matter (PM 2.5 ) and ground level ozone (O₃) emerged and worsened; (3) After the winter-long PM 2.5 episode in eastern China in 2013, air pollution control policies have been experiencing significant changes on multiple fronts. In this work we analyze the different policy changes, the drivers of changes and key factors influencing the effectiveness of policies in these three stages. Lessons derived from the policy evolution have implications for future studies, as well as further reforming the management scheme towards air quality and health risk oriented directions.

  9. Air Pollution Control Policies in China: A Retrospective and Prospects

    Directory of Open Access Journals (Sweden)

    Yana Jin

    2016-12-01

    Full Text Available With China’s significant role on pollution emissions and related health damage, deep and up-to-date understanding of China’s air pollution policies is of worldwide relevance. Based on scientific evidence for the evolution of air pollution and the institutional background of environmental governance in China, we examine the development of air pollution control policies from the 1980s and onwards. We show that: (1 The early policies, until 2005, were ineffective at reducing emissions; (2 During 2006–2012, new instruments which interact with political incentives were introduced in the 11th Five-Year Plan, and the national goal of reducing total sulfur dioxide (SO2 emissions by 10% was achieved. However, regional compound air pollution problems dominated by fine particulate matter (PM2.5 and ground level ozone (O3 emerged and worsened; (3 After the winter-long PM2.5 episode in eastern China in 2013, air pollution control policies have been experiencing significant changes on multiple fronts. In this work we analyze the different policy changes, the drivers of changes and key factors influencing the effectiveness of policies in these three stages. Lessons derived from the policy evolution have implications for future studies, as well as further reforming the management scheme towards air quality and health risk oriented directions.

  10. Exposure to tobacco marketing and support for tobacco control policies.

    Science.gov (United States)

    Hammond, David; Costello, Mary-Jean; Fong, Geoffrey T; Topham, Jennifer

    2006-01-01

    To examine the salience of tobacco marketing on postsecondary campuses and student support for tobacco control policies. Face-to-face surveys were conducted with 1690 students at 3 universities in southwestern Ontario. Virtually all (97%) students reported noticing tobacco marketing in the past year, and 35% reported noticing marketing on campus. There was strong support for smoke-free restrictions on campus, including restaurants and bars (82%), and for prohibitions on campus marketing. The presence of campus policies was associated with reduced exposure to marketing and increased policy support. There is strong support among students to remove tobacco marketing from campus and to introduce comprehensive smoke-free restrictions.

  11. Evaluation of Tobacco Control Policies in Bangladesh | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Evaluation of Tobacco Control Policies in Bangladesh. Bangladesh introduced its first comprehensive tobacco control act in 2005, in an attempt to address the country's high prevalence of tobacco use. ... Institution. University of Dhaka. Pays d' institution. Bangladesh. Site internet. http://www.univdhaka.edu ...

  12. Analysis of Access Control Policies in Operating Systems

    Science.gov (United States)

    Chen, Hong

    2009-01-01

    Operating systems rely heavily on access control mechanisms to achieve security goals and defend against remote and local attacks. The complexities of modern access control mechanisms and the scale of policy configurations are often overwhelming to system administrators and software developers. Therefore, mis-configurations are common, and the…

  13. Impact of Scheduling Policies on Control System Performance

    DEFF Research Database (Denmark)

    Schiøler, Henrik; Ravn, Anders Peter; Nielsen, Jens Frederik Dalsgaard

    2003-01-01

    It is well known that jitter has an impact on control system performance, and this is often used as an argument for static scheduling policies, e.g. a time triggered architecture. However, it is only completion jitter that seriously disturbs standard linear control algorithms in a way similar to ...

  14. Relaxation of the one child policy and trends in caesarean section rates and birth outcomes in China between 2012 and 2016: observational study of nearly seven million health facility births.

    Science.gov (United States)

    Liang, Juan; Mu, Yi; Li, Xiaohong; Tang, Wen; Wang, Yanping; Liu, Zheng; Huang, Xiaona; Scherpbier, Robert W; Guo, Sufang; Li, Mingrong; Dai, Li; Deng, Kui; Deng, Changfei; Li, Qi; Kang, Leni; Zhu, Jun; Ronsmans, Carine

    2018-03-05

    To examine how the relaxation of the one child policy and policies to reduce caesarean section rates might have affected trends over time in caesarean section rates and perinatal and pregnancy related mortality in China. Observational study. China's National Maternal Near Miss Surveillance System (NMNMSS). 6 838 582 births at 28 completed weeks or more of gestation or birth weight ≥1000 g in 438 hospitals in the NMNMSS between 2012 and 2016. Obstetric risk was defined using a modified Robson classification. The main outcome measures were changes in parity and age distributions and relative frequency of each Robson group, crude and adjusted trends over time in caesarean section rates within each risk category (using Poisson regression with a robust variance estimator), and trends in perinatal and pregnancy related mortality over time. Caesarean section rates declined steadily between 2012 and 2016 (crude relative risk 0.91, 95% confidence interval 0.89 to 0.93), reaching an overall hospital based rate of 41.1% in 2016. The relaxation of the one child policy was associated with an increase in the proportion of multiparous births (from 34.1% in 2012 to 46.7% in 2016), and births in women with a uterine scar nearly doubled (from 9.8% to 17.7% of all births). Taking account of these changes, the decline in caesarean sections was amplified over time (adjusted relative risk 0.82, 95% confidence interval 0.81 to 0.84). Caesarean sections declined noticeably in nulliparous women (0.75, 0.73 to 0.77) but also declined in multiparous women without a uterine scar (0.65, 0.62 to 0.77). The decrease in caesarean section rates was most pronounced in hospitals with the highest rates in 2012, consistent with the government's policy of targeting hospitals with the highest rates. Perinatal mortality declined from 10.1 to 7.2 per 1000 births over the same period (0.87, 0.83 to 0.91), and there was no change in pregnancy related mortality over time. China is the only country that

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. The right to have a family: 'legal trafficking of children', adoption and birth control in Brazil.

    Science.gov (United States)

    Cardarello, Andrea

    2012-01-01

    This paper focuses on one of the 'child-trafficking scandals' that occurred in Brazil in the 1990s. Ethnographic research was carried out between 2000 and 2001 within a movement of poor families formed in São Paulo to put pressure on the authorities to review the legal procedures that had led to their children being placed for national and international adoption. Fieldwork was supplemented by other data, including reports by legislative bodies, articles in the press, and case files involving the termination of parental rights. This paper explores views on international adoption among members of the Brazilian elites such as judges, agents in the field of child protection and journalists, in the context of old but persistent neo-Malthusian ideas. Although the Brazilian birth rate is now below the replacement level, it is still common to blame 'irresponsible' reproduction among the urban poor for violence in large cities. Drawing a parallel with the routine sterilization of women that prevailed for decades and was encouraged by Brazilian physicians, the paper examines how, in a 'struggle against poverty', judicial agents took it upon themselves to enforce 'birth control' through adoption, bypassing family consent and the law in the process. The paper concludes by arguing that discrimination against poor families who are viewed as disorganized, immoral and irresponsible - characteristics frequently associated with criminality by a sector of the elites - has contributed to the view that lower-class families do not have the right to bear children, or to keep them.

  20. 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.

  1. Bangladesh policy on prevention and control of non-communicable diseases: a policy analysis.

    Science.gov (United States)

    Biswas, Tuhin; Pervin, Sonia; Tanim, Md Imtiaz Alam; Niessen, Louis; Islam, Anwar

    2017-06-19

    This paper is aimed at critically assessing the extent to which Non-Communicable Disease NCD-related policies introduced in Bangladesh align with the World Health Organization's (WHO) 2013-2020 Action Plan for the Global Strategy for the Prevention and Control of NCDs. The authors reviewed all relevant policy documents introduced by the Government of Bangladesh since its independence in 1971. The literature review targeted scientific and grey literature documents involving internet-based search, and expert consultation and snowballing to identify relevant policy documents. Information was extracted from the documents using a specific matrix, mapping each document against the six objectives of the WHO 2013-2020 Action Plan for the Global Strategy for the Prevention and Control of NCDs. A total of 51 documents were identified. Seven (14%) were research and/or surveys, nine were on established policies (17%), while seventeen (33%) were on action programmes. Five (10%) were related to guidelines and thirteen (25%) were strategic planning documents from government and non-government agencies/institutes. The study covered documents produced by the Government of Bangladesh as well as those by quasi-government and non-government organizations irrespective of the extent to which the intended policies were implemented. The policy analysis findings suggest that although the government has initiated many NCD-related policies or programs, they lacked proper planning, implementation and monitoring. Consequently, Bangladesh over the years had little success in effectively addressing the growing burden of non-communicable diseases. It is imperative that future research critically assess the effectiveness of national NCD policies by monitoring their implementation and level of population coverage.

  2. Ancillary effects of selected acid deposition control policies

    Energy Technology Data Exchange (ETDEWEB)

    Moe, R.J.; Lyke, A.J.; Nesse, R.J.

    1986-08-01

    NAPAP is examining a number of potential ways to reduce the precursors (sulfur dioxide and nitrogen oxides) to acid deposition. However, the policies to reduce acid deposition will have other physical, biological and economic effects unrelated to acid deposition. For example, control policies that reduce sulfur dioxide emissions may also increase visibility. The effects of an acid deposition policy that are unrelated to acid deposition are referred to as ''ancillary'' effects. This reserch identifies and characterizes the principle physical and economic ancillary effects associated with acid deposition control and mitigation policies. In this study the ancillary benefits associated with four specific acid deposition policy options were investigated. The four policy options investigated are: (1) flue gas desulfurization, (2) coal blending or switching, (3) reductions in automobile emissions of NO/sub x/, and (4) lake liming. Potential ancillary benefits of each option were identified and characterized. Particular attention was paid to the literature on economic valuation of potential ancillary effects.

  3. Radiological assessment of placement of the hysteroscopically inserted Essure permanent birth control device.

    Science.gov (United States)

    Lorente Ramos, R M; Azpeitia Armán, J; Aparicio Rodríguez-Miñón, P; Salazar Arquero, F J; Albillos Merino, J C

    2015-01-01

    Essure is a permanent birth control device that is inserted through the cervix by hysteroscopy. The device is placed in the fallopian tubes, where it causes occlusion by stimulating fibrosis. Patients can be followed up with plain-film X-rays, hysterosalpingography, and ultrasonography, although the devices can also be identified incidentally on CT and MRI. The follow-up of Essure is based on checking the criteria for appropriate positioning and correct functioning (tubal occlusion) and on diagnosing complications. The most common complications are perforation, migration (toward the uterine or peritoneal cavity), and occlusion failure. In hysterosalpingography, vascular intravasation is the most common cause of diagnostic error. Radiologists need to know how to recognize the device on different imaging techniques, how to check that it is correctly placed and functioning, and how to diagnose complications. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  4. Intraventricular hemorrhage risk factors in very low birth weight newborns: a case-control study

    Directory of Open Access Journals (Sweden)

    Laura Martins

    2009-09-01

    Full Text Available Objective: Identification of variables that affect the risk of severe intraventricular hemorrhage (IVH in very low birth weight (VLBW newborns. Methods: Analytic case-control study, in a population consisting of all VLBW newborns admitted to the Neonatal Intensive Care Unit of a maternity hospital, between January 2002 and December 2007. The authors considered as cases all VLBW newborns with severe IVH (grade ≥ 3, and control all VLBW newborns without IVH. Independent variables included obstetric, perinatal and neonatal diagnosis and therapy. Bivariate analysis and multivariate logistic regression analysis were performed. Rresults: During this period, of the 864 VLBW newborns admitted to the Neonatal Intensive Care Unit, 9.7% had severe IVH. With bivariate analysis an association between severe IVH, gestational age and birth weight was found. Prenatal care and pre-eclampsia were associated with a decrease in the incidence of severe IVH. Amnionitis, being outborn, vaginal delivery, male gender, intubation in the delivery room, surfactant, hyaline membrane disease, pneumothorax, necrotizing enterocolitis (NEC perforation and oscillatory high frequency ventilation were associated with an increased incidence of severe IVH. By multivariate logistic regression, the variables associated with increased risk of severe IVH were: pneumothorax (OR = 3.8; 95%CI = 1.7-8.3, NEC with perforation (OR = 8.8; 95%CI = 1.7-45.0, vaginal delivery (OR = 2.0; 95%CI = 1.0-4.1 and high frequency ventilation (OR = 4.8; 95%CI = 1.3-17.3. The following were protective of severe IVH: gestational age (OR = 0.61; 95%CI = 0.52-0.72, patent ductus arteriosus treatment with indomethacin (OR = 0.26; 95%CI = 0.11-0.6 and fertility treatment (OR = 0.24; 95%CI = 0.06-0.94. Cconclusion: These data outline the importance of improvement of pre and neonatal care to reduce severe IVH.

  5. 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.

  6. UNPACKING THE DIFFERENTIAL IMPACT OF FAMILY PLANNING POLICIES IN CHINA: ANALYSIS OF PARITY PROGRESSION RATIOS FROM RETROSPECTIVE BIRTH HISTORY DATA, 1971-2005.

    Science.gov (United States)

    Qin, Min; Falkingham, Jane; Padmadas, Sabu S

    2018-01-10

    Although China's family planning programme is often referred to in the singular, most notably the One-Child policy, in reality there have been a number of different policies in place simultaneously, targeted at different sub-populations characterized by region and socioeconomic conditions. This study attempted to systematically assess the differential impact of China's family planning programmes over the past 40 years. The contribution of Parity Progression Ratios to fertility change among different sub-populations exposed to various family planning policies over time was assessed. Cross-sectional birth history data from six consecutive rounds of nationally representative population and family planning surveys from the early 1970s until the mid-2000s were used, covering all geographical regions of China. Four sub-populations exposed to differential family planning regimes were identified. The analyses provide compelling evidence of the influential role of family planning policies in reducing higher Parity Progression Ratios across different sub-populations, particularly in urban China where fertility dropped to replacement level even before the implementation of the One-Child policy. The prevailing socioeconomic conditions in turn have been instrumental in adapting and accelerating family planning policy responses to reducing fertility levels across China.

  7. Tobacco control policies and perinatal and child health: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Timor Faber

    2018-03-01

    Full Text Available Background Tobacco smoking and smoke exposure during pregnancy and childhood cause considerable childhood morbidity and mortality. We aimed to determine whether implementation of the World Health Organization's recommended tobacco control policies (MPOWER were of benefit to perinatal and child health. Methods We searched 19 electronic databases, hand-searched references and citations, and consulted experts to identify (quasi-experimental studies assessing the association between implementation of MPOWER policies and child health. Our primary outcomes of interest were: perinatal mortality, preterm birth, hospital attendance for asthma exacerbations, and hospital attendance for respiratory tract infections (RTIs. Where possible and appropriate, we combined data from different studies in random-effects meta-analyses. Results We identified 41 eligible studies that assessed (combinations of MPOWER policies: smoke-free legislation (n=35, tobacco taxation (n=11, and smoking cessation services (n=3. Following implementation of smoke-free legislation, rates of preterm birth decreased by -3.77% (10 studies, 27,530,183 individuals; 95%CI -6.37 to -1.16, hospital attendance for asthma exacerbations decreased by -9.83% (five studies, 684,826 events; 95%CI -16.62 to -3.04, and hospital attendance for RTIs decreased by -3.45% (two studies, 1,681,020 events; 95%CI -4.64, -2.25 for all RTIs, and by -18.48% (three studies, 887,414 events; 95%CI -32.79 to -4.17 for lower RTIs. Associations appeared to be stronger when comprehensive smoke-free laws were implemented. Among two studies assessing the association between smoke-free legislation and perinatal mortality, one demonstrated significant reductions in stillbirth and neonatal mortality. Meta-analysis of studies on other MPOWER policies was not possible; all four studies on increasing tobacco taxation and one of two on offering disadvantaged pregnant women help to quit smoking that reported on our primary

  8. CSchema: A Downgrading Policy Language for XML Access Control

    Institute of Scientific and Technical Information of China (English)

    Dong-Xi Liu

    2007-01-01

    The problem of regulating access to XML documents has attracted much attention from both academic and industry communities.In existing approaches, the XML elements specified by access policies are either accessible or inac-cessible according to their sensitivity.However, in some cases, the original XML elements are sensitive and inaccessible, but after being processed in some appropriate ways, the results become insensitive and thus accessible.This paper proposes a policy language to accommodate such cases, which can express the downgrading operations on sensitive data in XML documents through explicit calculations on them.The proposed policy language is called calculation-embedded schema (CSchema), which extends the ordinary schema languages with protection type for protecting sensitive data and specifying downgrading operations.CSchema language has a type system to guarantee the type correctness of the embedded calcula-tion expressions and moreover this type system also generates a security view after type checking a CSchema policy.Access policies specified by CSchema are enforced by a validation procedure, which produces the released documents containing only the accessible data by validating the protected documents against CSchema policies.These released documents are then ready tobe accessed by, for instance, XML query engines.By incorporating this validation procedure, other XML processing technologies can use CSchema as the access control module.

  9. Smoking inequalities and tobacco control policies in Europe

    NARCIS (Netherlands)

    Kuipers, M.A.G.

    2016-01-01

    Smoking is the worlds’ leading avoidable cause of mortality and kills 6 million people each year. Individuals of lower socioeconomic status are more likely to initiate smoking and less likely to quit smoking. Tobacco control policies have been implemented in the last decades, but although smoking

  10. Evaluation of Tobacco Control Policies in Bangladesh | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The three-year evaluation is expected to shed light on such issues as the price ... the effects of tobacco control policies; and changes in the form of tobacco use. ... Minister Bibeau announces appointments of IDRC's President and new ...

  11. Environmental advertisement: An alternative policy to control consumption pollution

    OpenAIRE

    Sartzetakis, Eftichios Sophocles; Xepapadeas, Anastasios P.

    1998-01-01

    This paper examines the efficiency enhancing potential of supplementing existing policies of controlling consumption pollution with environmental advertisement. Our definition of environmental advertisement includes both information dissemination and persuasion. While incentive-based regulations that are based on coercion are effective immediately, environmental advertisement that is based on inducing voluntary action requires time. We formalise this argument by assuming that the shift of con...

  12. Optimal Control via Reinforcement Learning with Symbolic Policy Approximation

    NARCIS (Netherlands)

    Kubalìk, Jiřì; Alibekov, Eduard; Babuska, R.; Dochain, Denis; Henrion, Didier; Peaucelle, Dimitri

    2017-01-01

    Model-based reinforcement learning (RL) algorithms can be used to derive optimal control laws for nonlinear dynamic systems. With continuous-valued state and input variables, RL algorithms have to rely on function approximators to represent the value function and policy mappings. This paper

  13. Situation Analysis of Alcohol Control Policy in Five African Countries ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Alcohol use is a major risk factor for premature deaths and disabilities in low and middle-income countries. This research will evaluate alcohol control policy and legislation in five African countries to provide evidence-based research to policymakers, researchers, and lobby groups working to reduce alcohol use.

  14. Tobacco Control in Africa: People, Politics and Policies | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    15 oct. 2011 ... Tobacco use in Sub-Saharan Africa is growing rapidly as a result of strong economic growth and the aggressive marketing tactics of tobacco multinationals. Although the policy interventions are well understood, the political economy of tobacco control in Sub-Saharan Africa is not, and this volume is a timely ...

  15. International trade agreements challenge tobacco and alcohol control policies.

    Science.gov (United States)

    Zeigler, Donald W

    2006-11-01

    This report reviews aspects of trade agreements that challenge tobacco and alcohol control policies. Trade agreements reduce barriers, increase competition, lower prices and promote consumption. Conversely, tobacco and alcohol control measures seek to reduce access and consumption, raise prices and restrict advertising and promotion in order to reduce health and social problems. However, under current and pending international agreements, negotiated by trade experts without public health input, governments and corporations may challenge these protections as constraints on trade. Advocates must recognise the inherent conflicts between free trade and public health and work to exclude alcohol and tobacco from trade agreements. The Framework Convention on Tobacco Control has potential to protect tobacco policies and serve as a model for alcohol control.

  16. Nuclear Export Control Policy in Korea - Present and future

    International Nuclear Information System (INIS)

    Kim, Jongsook

    2008-01-01

    The International community has been facing with the continued challenges for possession and proliferation of WMD over the past years. In addition, it is known that the terrorist groups are interested in acquiring WMD. The black market of WMD related materials and technologies show also the one of seriousness of our challenges. A number of international treaties, agreements and initiatives to control the proliferation of weapons of N, B, C and their delivery system have been existed to deal with these challenges, but their missions are challenged greatly in recent a series of nuclear issues by Iran and North Korea. The paper reviews the current international export control status and Korea export control system and policy. It also addresses some agenda to be done as future export control policy in Korea

  17. Off-policy reinforcement learning for H∞ control design.

    Science.gov (United States)

    Luo, Biao; Wu, Huai-Ning; Huang, Tingwen

    2015-01-01

    The H∞ control design problem is considered for nonlinear systems with unknown internal system model. It is known that the nonlinear H∞ control problem can be transformed into solving the so-called Hamilton-Jacobi-Isaacs (HJI) equation, which is a nonlinear partial differential equation that is generally impossible to be solved analytically. Even worse, model-based approaches cannot be used for approximately solving HJI equation, when the accurate system model is unavailable or costly to obtain in practice. To overcome these difficulties, an off-policy reinforcement leaning (RL) method is introduced to learn the solution of HJI equation from real system data instead of mathematical system model, and its convergence is proved. In the off-policy RL method, the system data can be generated with arbitrary policies rather than the evaluating policy, which is extremely important and promising for practical systems. For implementation purpose, a neural network (NN)-based actor-critic structure is employed and a least-square NN weight update algorithm is derived based on the method of weighted residuals. Finally, the developed NN-based off-policy RL method is tested on a linear F16 aircraft plant, and further applied to a rotational/translational actuator system.

  18. 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.

  19. 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....

  20. 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.

  1. 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.

  2. The long, slow birth of a U.S. emissions trading regime. Recent developments in U.S. climate policy

    Energy Technology Data Exchange (ETDEWEB)

    Freestone, D.; Frenkil, D.J. [George Washington University Law School, Washington D.C. (United States)

    2010-11-15

    Representatives back to the Republicans by a majority of more than 40 members (with several races still pending at time of writing) and reduced the Democratic hold in the Senate to a paper-thin majority. Although it remains to be seen how the Republicans will govern once they take control of Congress in January 2011, the incoming House leadership will likely back-peddle on the progress enjoyed in U.S. climate policy since the end of the fossil fuel-happy Bush Administration, because the Republicans campaigned fiercely against 'cap-and-trade' policies and promised to investigate the Obama Administration's recent EPA GHG regulations. Even in the race of such regulatory uncertainty, an overview of recent federal, state and regional approaches to reducing GHG emissions provides an indication of where U.S. climate policy will ultimately be headed once the so-called 'political pendulum' inevitably swings back in the direction of environmentally-responsible leadership.

  3. 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 ...

  4. The ERS role on Tobacco Control Policy in Europe

    Directory of Open Access Journals (Sweden)

    Christina Gratziou

    2016-03-01

    Full Text Available The European Respiratory Society is an international medical organisation that brings together physicians, healthcare professionals, scientists and other experts working in respiratory medicine. Its aim is to alleviate suffering from respiratory diseases and promote lung health globally through science, education and advocacy. ERS has since its founding in 1990 demonstrated strong commitment to tobacco control. Through scientific assemblies, education courses, various alliances and collaboration (Framework Convention Alliance, European Chronic Disease Alliance, World Health Organisation etc. As well as a Tobacco Control Committee (TCC dedicated to advocacy, ERS constantly strives to promote strong and evidence-based policies to reduce the burden of tobacco related diseases. One of the main outcome of the TCC is the creation of Smokehaz, a website aimed at providing policy-makers with scientific information on the Health hazards associated with smoking. Recently, ERS created the Latin-America Working Group which aims at strengthening tobacco control activities in Spain, Portugal and Latin-American countries.

  5. Birth planning and sterilization in China.

    Science.gov (United States)

    Short, S E; Linmao, M; Wentao, Y

    2000-11-01

    Sterilization is the most prevalent method of contraception in China. Approximately half of all women of reproductive age report that they or their husbands are sterilized. Using data from the China Health and Nutrition Survey we describe patterns of sterilization in eight Chinese provinces. With a discrete-time event history model we investigate the link between characteristics of local birth planning policy and the risk of sterilization. After controlling for parity, the risk of sterilization is highest in communities where birth planning policy is least strong as measured by exceptions to the one-child policy. These results suggest that couples with more flexibility in family building may have less control over contraceptive method use. Other factors affecting the risk of sterilization are a woman's age, parity, and whether or not she has a son. Our results emphasize the importance of taking into account multiple dimensions of reproductive behaviour when assessing one-child policy changes.

  6. Computational Models Used to Assess US Tobacco Control Policies.

    Science.gov (United States)

    Feirman, Shari P; Glasser, Allison M; Rose, Shyanika; Niaura, Ray; Abrams, David B; Teplitskaya, Lyubov; Villanti, Andrea C

    2017-11-01

    Simulation models can be used to evaluate existing and potential tobacco control interventions, including policies. The purpose of this systematic review was to synthesize evidence from computational models used to project population-level effects of tobacco control interventions. We provide recommendations to strengthen simulation models that evaluate tobacco control interventions. Studies were eligible for review if they employed a computational model to predict the expected effects of a non-clinical US-based tobacco control intervention. We searched five electronic databases on July 1, 2013 with no date restrictions and synthesized studies qualitatively. Six primary non-clinical intervention types were examined across the 40 studies: taxation, youth prevention, smoke-free policies, mass media campaigns, marketing/advertising restrictions, and product regulation. Simulation models demonstrated the independent and combined effects of these interventions on decreasing projected future smoking prevalence. Taxation effects were the most robust, as studies examining other interventions exhibited substantial heterogeneity with regard to the outcomes and specific policies examined across models. Models should project the impact of interventions on overall tobacco use, including nicotine delivery product use, to estimate preventable health and cost-saving outcomes. Model validation, transparency, more sophisticated models, and modeling policy interactions are also needed to inform policymakers to make decisions that will minimize harm and maximize health. In this systematic review, evidence from multiple studies demonstrated the independent effect of taxation on decreasing future smoking prevalence, and models for other tobacco control interventions showed that these strategies are expected to decrease smoking, benefit population health, and are reasonable to implement from a cost perspective. Our recommendations aim to help policymakers and researchers minimize harm and

  7. 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.

  8. Maternal Locus of Control and Perception of Family Status at Entry and Exit of Birth to Three Early Intervention

    Science.gov (United States)

    Coffaro, Ann

    2009-01-01

    Birth to three early intervention is unique time in the life of a family of a child with a disability in that confidence and competence of the parents can be addressed as part of the intervention goals and objectives. Locus of control is a quality measure of a parent's perception of their ability to be their child's teacher, advocate, and champion…

  9. Ethnicity, smoking status, and preterm birth as predictors of maternal locus of control.

    Science.gov (United States)

    Ashford, Kristin B; Rayens, Mary Kay

    2015-04-01

    A woman's psychological health can affect prenatal behaviors. The purpose of this study was to examine the relationship between maternal beliefs, prenatal behaviors, and preterm birth (PTB) in a multiethnic population. This was a planned secondary analysis of a cross-sectional trial of postpartum women with singleton gestation. In all, 210 participants were given the Fetal Health Locus of Control (FHLC) scale to measure three primary maternal beliefs that influenced their prenatal behaviors (Internal Control, Chance, Powerful Others). Women who experienced preterm delivery and those who smoked during pregnancy scored the Chance category significantly higher than those who delivered term infants (p = .05; p = .004, respectively). This suggests those who smoked during pregnancy had a greater degree of belief that Chance influenced their infant's health status. Cultural differences also emerged specific to the impact of health care providers on PTB; with Hispanic women scoring Powerful Others the highest among the groups (p = .02). Nurses can plan a critical role in identifying at-risk women (smoking, strong Chance beliefs) while providing a clear message that taking action and modifying high-risk behaviors can reduce risk for adverse pregnancy outcome. © The Author(s) 2013.

  10. Why Have Tobacco Control Policies Stalled? Using Genetic Moderation to Examine Policy Impacts

    Science.gov (United States)

    Fletcher, Jason M.

    2012-01-01

    Background Research has shown that tobacco control policies have helped produce the dramatic decline in use over the decades following the 1964 surgeon general’s report. However, prevalence rates have stagnated during the past two decades in the US, even with large tobacco taxes and expansions of clean air laws. The observed differences in tobacco control policy effectiveness and why policies do not help all smokers are largely unexplained. Objective The aim of this study was to determine the importance of genetics in explaining response to tobacco taxation policy by testing the potential of gene-policy interaction in determining adult tobacco use. Methods A moderated regression analysis framework was used to test interactive effects between genotype and tobacco policy in predicting tobacco use. Cross sectional data of US adults from the National Health and Nutrition Examination Survey (NHANES) linked with genotype and geocodes were used to identify tobacco use phenotypes, state-level taxation rates, and variation in the nicotinic acetylcholine receptor (CHRNA6) genotype. Tobacco use phenotypes included current use, number of cigarettes smoked per day, and blood serum cotinine measurements. Results Variation in the nicotinic acetylcholine receptor was found to moderate the influence of tobacco taxation on multiple measures of tobacco use. Individuals with the protective G/G polymorphism (51% of the sample) responded to taxation while others had no response. The estimated differences in response by genotype were C/C genotype: b = −0.016 se  = 0.018; G/C genotype: b = 0.014 se  = 0.017; G/G genotype: b = −0.071 se 0.029. Conclusions This study provides novel evidence of “gene-policy” interaction and suggests a genetic mechanism for the large differences in response to tobacco policies. The inability for these policies to reduce use for individuals with specific genotypes suggests alternative methods may be needed to further reduce use

  11. 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

  12. Phase and gain control policies for robust active vibration control of flexible structures

    International Nuclear Information System (INIS)

    Zhang, K; Ichchou, M N; Scorletti, G; Mieyeville, F

    2013-01-01

    The interest of this paper is to develop a general and systematic robust control methodology for active vibration control of flexible structures. For this purpose, first phase and gain control policies are proposed to impose qualitative frequency-dependent requirements on the controller to consider a complete set of control objectives. Then the proposed control methodology is developed by employing phase and gain control policies in the dynamic output feedback H ∞  control: according to the set of control objectives, phase and gain control policies incorporate necessary weighting functions and determine them in a rational and systematic way; on the other hand, with the appropriate weighting functions efficient H ∞  control algorithms can automatically realize phase and gain control policies and generate a satisfactory H ∞  controller. The proposed control methodology can be used for both SISO and MIMO systems with collocated or non-collocated sensors and actuators. In this paper, it is validated on a non-collocated piezoelectric cantilever beam. Both numerical simulations and experimental results demonstrate the effectiveness of the proposed control methodology. (paper)

  13. Prioritizing Congenital Syphilis Control in South China: A Decision Analytic Model to Inform Policy Implementation

    Science.gov (United States)

    Tan, Nicholas X.; Rydzak, Chara; Yang, Li-Gang; Vickerman, Peter; Yang, Bin; Peeling, Rosanna W.; Hawkes, Sarah; Chen, Xiang-Sheng; Tucker, Joseph D.

    2013-01-01

    Background Syphilis is a major public health problem in many regions of China, with increases in congenital syphilis (CS) cases causing concern. The Chinese Ministry of Health recently announced a comprehensive 10-y national syphilis control plan focusing on averting CS. The decision analytic model presented here quantifies the impact of the planned strategies to determine whether they are likely to meet the goals laid out in the control plan. Methods and Findings Our model incorporated data on age-stratified fertility, female adult syphilis cases, and empirical syphilis transmission rates to estimate the number of CS cases associated with prenatal syphilis infection on a yearly basis. Guangdong Province was the focus of this analysis because of the availability of high-quality demographic and public health data. Each model outcome was simulated 1,000 times to incorporate uncertainty in model inputs. The model was validated using data from a CS intervention program among 477,656 women in China. Sensitivity analyses were performed to identify which variables are likely to be most influential in achieving Chinese and international policy goals. Increasing prenatal screening coverage was the single most effective strategy for reducing CS cases. An incremental increase in prenatal screening from the base case of 57% coverage to 95% coverage was associated with 106 (95% CI: 101, 111) CS cases averted per 100,000 live births (58% decrease). The policy strategies laid out in the national plan led to an outcome that fell short of the target, while a four-pronged comprehensive syphilis control strategy consisting of increased prenatal screening coverage, increased treatment completion, earlier prenatal screening, and improved syphilis test characteristics was associated with 157 (95% CI: 154, 160) CS cases averted per 100,000 live births (85% decrease). Conclusions The Chinese national plan provides a strong foundation for syphilis control, but more comprehensive measures

  14. International trade agreements: a threat to tobacco control policy.

    Science.gov (United States)

    Shaffer, E R; Brenner, J E; Houston, T P

    2005-08-01

    International covenants establish a role for governments in ensuring the conditions for human health and wellbeing, which has been recognised as a central human right. International trade agreements, conversely, prioritize the rights of corporations over health and human rights. International trade agreements are threatening existing tobacco control policies and restrict the possibility of implementing new controls. This situation is unrecognised by many tobacco control advocates in signatory nations, especially those in developing countries. Recent agreements on eliminating various trade restrictions, including those on tobacco, have expanded far beyond simply international movement of goods to include internal tobacco distribution regulations and intellectual property rules regulating advertising and labelling. Our analysis shows that to the extent trade agreements protect the tobacco industry, in itself a deadly enterprise, they erode human rights principles and contribute to ill health. The tobacco industry has used trade policy to undermine effective barriers to tobacco importation. Trade negotiations provide an unwarranted opportunity for the tobacco industry to assert its interests without public scrutiny. Trade agreements provide the industry with additional tools to obstruct control policies in both developed and developing countries and at every level. The health community should become involved in reversing these trends, and help promote additional measures to protect public health.

  15. Historical analysis of SO2 pollution control policies in China.

    Science.gov (United States)

    Gao, Cailing; Yin, Huaqiang; Ai, Nanshan; Huang, Zhengwen

    2009-03-01

    Coal is not only an important energy source in China but also a major source of air pollution. Because of this, China's national sulfur dioxide (SO(2)) emissions have been the highest in the world for many years, and since the 1990s, the territory of China's south and southwest has become the third largest acid-rain-prone region in the world. In order to control SO(2) emissions, the Chinese government has formulated and promulgated a series of policies and regulations, but it faces great difficulties in putting them into practice. In this retrospective look at the history of SO(2) control in China, we found that Chinese SO(2) control policies have become increasingly strict and rigid. We also found that the environmental policies and regulations are more effective when central officials consistently give environmental protection top priority. Achieving China's environmental goals, however, has been made difficult by China's economic growth. Part of this is due to the practice of environmental protection appearing in the form of an ideological "campaign" or "storm" that lacks effective economic measures. More recently, better enforcement of environmental laws and regulations has been achieved by adding environmental quality to the performance assessment metrics for leaders at all levels. To continue making advances, China needs to reinforce the economic and environmental assessments for pollution control projects and work harder to integrate economic measures into environmental protection. Nonetheless, China has a long way to go before economic growth and environmental protection are balanced.

  16. [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.

  17. The second great wall of China: evolution of a successful policy of population control.

    Science.gov (United States)

    Stycos, J M

    1989-10-01

    In 1949, Mao Tse-tung professed that overpopulation could not occur under communism and more people and socialist organization leads only to more wealth and power. Yet 3 decades later communist China has adopted Malthusian population policies claiming them as socialist with a Chinese approach. This shift is ideology came about due to rapid population growth, concomitant food shortages, and insufficient economic growth. Since 1982 China has added 13 million persons/year to its population of 1 billion. In 1963, urban fertility began to decline from 6 children/woman to 3 at the end of the decade. The early 1970s marked the beginning of the politicization of birth control. Unlike Western nations and other developing countries that emphasize the health of mothers and children in their family planning campaigns, China emphasizes political goals. For example, the Chinese purports that family planning can speed world revolution by reducing family size. The Chinese prefer to persuade others to use contraceptives rather than coercing them to do so. Actually Chinese prefer very small families (2 in urban areas and 2 in rural areas). This persuasion and the introduction of oral contraceptives (OCs) and a simpler technique for female sterilization (minilaparotomy) contributed to the high contraceptive usage of 70% for couples of childbearing age and a high abortion rate of 318/1000 live birth by the end of the 1970s. The Chinese constitution states that family planning is the duty of each couple rather than a right. Further, the government has a 1 child/couple population policy. Even though China has had many successes, it has not reached a below replacement level (1989 total fertility rate=2.4), however.

  18. The influence of cold pack on labour pain relief and birth outcomes: a randomised controlled trial.

    Science.gov (United States)

    Shirvani, Marjan Ahmad; Ganji, Zhila

    2014-09-01

    (1) To evaluate the influence of local cold on severity of labour pain and (2) to identify the effect of local cold on maternal and neonatal outcomes. Fear of labour pain results in an increase in pain and duration of labour, maternal discontent and demand for caesarean section. Regarding maternal and foetal complications of analgesic medications, the attention to application of nonpharmacological methods including cold therapy is increased. Randomised controlled trial. Sixty-four pregnant women, at initiation of active phase of labour, were allocated randomly to cold therapy and control groups (n = 64). Null parity, term pregnancy, presence of single foetus, cephalic presentation and completing informed consent were considered as inclusion criteria. Administration of analgesic and anaesthesia, foetal distress, skin lesions in regions of cold therapy and high-risk pregnancy provided exclusion criteria. Cold pack was applied over abdomen and back, for 10 minutes every 30 minutes during first phase of labour. Additionally, cold pack was placed over perineum, for 5 minutes every 15 minutes during second phase. Pain severity was assessed based on the visual analogue scale. The two groups were not significantly different considering demographic data, gestational age, foetal weight, rupture of membranes and primary severity of pain. Degree of pain was lower in cold therapy group during all parts of active phase and second stage. Duration of all phases was shorter in cold therapy group in all phases. Foetal heart rate, perineal laceration, type of birth, application of oxytocin and APGAR score were not significantly different between two groups. Labour pain is probably reduced based on gate theory using cold. Pain control by cold maybe improves labour progression without affecting mother and foetus adversely. Local cold therapy could be included in labour pain management. © 2013 John Wiley & Sons Ltd.

  19. Control of mercury emissions: policies, technologies, and future trends

    OpenAIRE

    Rhee, Seung-Whee

    2015-01-01

    Seung-Whee Rhee Department of Environmental Engineering, Kyonggi University, Suwon, Republic of Korea Abstract: Owing to the Minamata Convention on Mercury and the Global Mercury Partnership, policies and regulations on mercury management in advanced countries were intensified by a mercury phaseout program in the mercury control strategy. In developing countries, the legislative or regulatory frameworks on mercury emissions are not established specifically, but mercury management is designed...

  20. A policy of routine umbilical cord blood gas analysis decreased missing samples from high-risk births.

    Science.gov (United States)

    Ahlberg, M; Elvander, C; Johansson, S; Cnattingius, S; Stephansson, O

    2017-01-01

    This study compared obstetric units practicing routine or selective umbilical cord blood gas analysis, with respect to the risk of missing samples in high-risk deliveries and in infants with birth asphyxia. This was a Swedish population-based cohort study that used register data for 155 235 deliveries of live singleton infants between 2008 and 2014. Risk ratios and 95% confidence intervals were calculated to estimate the association between routine and selective umbilical cord blood gas sampling strategies and the risk of missing samples. Selective sampling increased the risk ratios when routine sampling was used as the reference, with a value of 1.0, and these were significant in high-risk deliveries and birth asphyxia. The risk ratios for selective sampling were large-for-gestational age (9.07), preterm delivery at up to 36 weeks of gestation (8.24), small-for-gestational age (7.94), two or more foetal scalp blood samples (5.96), an Apgar score of less than seven at one minute (2.36), emergency Caesarean section (1.67) and instrumental vaginal delivery (1.24). Compared with routine sampling, selective umbilical cord blood gas sampling significantly increased the risks of missing samples in high-risk deliveries and in infants with birth asphyxia. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  1. The control of environmental tobacco smoke: a policy review.

    LENUS (Irish Health Repository)

    McNabola, Aonghus

    2009-02-01

    According to World Health Organisation figures, 30% of all cancer deaths, 20% of all coronary heart diseases and strokes and 80% of all chronic obstructive pulmonary disease are caused by cigarette smoking. Environmental Tobacco Smoke (ETS) exposure has also been shown to be associated with disease and premature death in non-smokers. In response to this environmental health issue, several countries have brought about a smoking ban policy in public places and in the workplace. Countries such as the U.S., France, Italy, Ireland, Malta, the Netherlands, Sweden, Scotland, Spain, and England have all introduced policies aimed at reducing the population exposure to ETS. Several investigations have monitored the effectiveness of these smoking ban policies in terms of ETS concentrations, human health and smoking prevalence, while others have also investigated a number of alternatives to smoking ban policy measures. This paper reviews the state of the art in research, carried out in the field of ETS, smoking bans and Tobacco Control to date and highlights the need for future research in the area.

  2. XACML to build access control policies for Internet of Things

    OpenAIRE

    Atlam, Hany F.; Alassafi, Madini, Obad; Alenezi, Ahmed; Walters, Robert; Wills, Gary

    2018-01-01

    Although the Internet of things (IoT) brought unlimited benefits, it also brought many security issues. The access control is one of the main elements to address these issues. It provides the access to system resources only to authorized users and ensures that they behave in an authorized manner during their access sessions. One of the significant components of any access control model is access policies. They are used to build the criteria to permit or deny any access request. Building an ef...

  3. 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...

  4. 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

  5. Month of birth, vitamin D and risk of immune-mediated disease: a case control study

    Directory of Open Access Journals (Sweden)

    Disanto Giulio

    2012-07-01

    Full Text Available Abstract Background A season of birth effect in immune-mediated diseases (ID such as multiple sclerosis and type 1 diabetes has been consistently reported. We aimed to investigate whether season of birth influences the risk of rheumatoid arthritis, Crohn's disease, ulcerative colitis and systemic lupus erythematosus in addition to multiple sclerosis, and to explore the correlation between the risk of ID and predicted ultraviolet B (UVB light exposure and vitamin D status during gestation. Methods The monthly distribution of births of patients with ID from the UK (n = 115,172 was compared to that of the general population using the Cosinor test. Predicted UVB radiation and vitamin D status in different time windows during pregnancy were calculated for each month of birth and correlated with risk of ID using the Spearman's correlation coefficient. Results The distributions of ID births significantly differed from that of the general population (P = 5e-12 with a peak in April (odds ratio = 1.045, 95% confidence interval = 1.024, 1.067, P P P = 0.00005 and third trimester vitamin D status (Spearman's rho = -0.44, P = 0.0003. Conclusions The risk of different ID in the UK is significantly influenced by the season of birth, suggesting the presence of a shared seasonal risk factor or factors predisposing to ID. Gestational UVB and vitamin D exposure may be implicated in the aetiology of ID.

  6. 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...

  7. 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...

  8. 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

  9. Framing risk in pandemic influenza policy and control.

    Science.gov (United States)

    Seetoh, Theresa; Liverani, Marco; Coker, Richard

    2012-01-01

    This article explores differing understandings of 'risk' in relation to pandemic influenza policy and control. After a preliminary overview of methodological and practical problems in risk analysis, ways in which risk was framed and managed in three historical cases were examined. The interdependence between scientific empiricism and political decision-making led to the mismanagement of the 1976 swine influenza scare in the USA. The 2004 H5N1 avian influenza outbreak in Thailand, on the other hand, was undermined by questions of national economic interest and concerns over global health security. Finally, the recent global emergency of pandemic influenza H1N1 in 2009 demonstrated the difficulties of risk management under a context of pre-established perceptions about the characteristics and inevitability of a pandemic. Following the analysis of these cases, a conceptual framework is presented to illustrate ways in which changing relationships between risk assessment, risk perception and risk management can result in differing policy strategies.

  10. Reproductive health policy affecting low-income women: historical precedents and current need for social work action.

    Science.gov (United States)

    Averitt Taylor, Jessica

    2014-01-01

    This article provides an overview of the historical arguments surrounding reproductive health policy and current policy initiatives. Because reproductive policy itself is a vast subject matter with sometimes blurry boundaries, the struggle concerning the advent of birth control is used to illustrate the historic complexities of policy affecting such a wide array of individuals. The battle over introduction of the birth control pill is pertinent because the very same arguments are used today in debates over reproductive health policy.

  11. 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.

  12. Are Tobacco Control Policies Effective in Reducing Young Adult Smoking?

    Science.gov (United States)

    Farrelly, Matthew C.; Loomis, Brett R.; Kuiper, Nicole; Han, Beth; Gfroerer, Joseph; Caraballo, Ralph S.; Pechacek, Terry F.; Couzens, G. Lance

    2015-01-01

    Purpose We examined the influence of tobacco control program funding, smoke-free air laws, and cigarette prices on young adult smoking outcomes. Methods We use a natural experimental design approach that uses the variation in tobacco control policies across states and over time to understand their influence on tobacco outcomes. We combine individual outcome data with annual state-level policy data to conduct multivariable logistic regression models, controlling for an extensive set of sociodemographic factors. The participants are 18- to 25-year-olds from the 2002–2009 National Surveys on Drug Use and Health. The three main outcomes are past-year smoking initiation, and current and established smoking. A current smoker was one who had smoked on at least 1 day in the past 30 days. An established smoker was one who had smoked 1 or more cigarettes in the past 30 days and smoked at least 100 cigarettes in his or her lifetime. Results Higher levels of tobacco control program funding and greater smoke-free-air law coverage were both associated with declines in current and established smoking (p smoke-free air laws was associated with lower past year initiation with marginal significance (p = .058). Higher cigarette prices were not associated with smoking outcomes. Had smoke-free-air law coverage and cumulative tobacco control funding remained at 2002 levels, current and established smoking would have been 5%–7% higher in 2009. Conclusions Smoke-free air laws and state tobacco control programs are effective strategies for curbing young adult smoking. PMID:24268360

  13. 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.

  14. Legislators' beliefs on tobacco control policies in Nevada.

    Science.gov (United States)

    York, Nancy L; Pritsos, Chris A; Gutierrez, Antonio P

    2012-02-01

    The purpose of this study was to identify Nevada legislators' views on comprehensive smoke-free (SF) policy development. The Nevada Clean Indoor Air Act (NCIAA) is a weak law that prohibits smoking in most indoor public places, excluding stand-alone bars and casino gaming areas. Nevada's state senators and assembly members were contacted to participate in the study. A literature review guided modifications of an instrument previously used to measure county-level officials' policy views in Kentucky. Descriptive statistics were conducted for selected variables, while independent t tests and one-way analysis of variance were used to examine differences between various groups. 23 of 63 legislators participated. Even though the majority of officials recognized smoking as a health hazard and nicotine as addictive, there was not overwhelming support for strengthening the NCIAA, raising cigarette excise taxes or providing cessation benefits to citizens. Officials believed that the NCIAA was having a negative economic impact on smaller gaming businesses, but not on the casino industry. Democrats were more likely than Republicans to agree that raising the excise tax by $1 is important for needed state revenues. 63% of legislators believed that they would be persuaded to strengthen the NCIAA regardless of its financial impact on small businesses, if their constituents supported such a move. No other state relies on gaming revenues as much as Nevada. Given that legislators are strongly influenced by their constituents' views, policy advocates need to establish grassroots support for strengthening the current NCIAA and also tobacco control laws in general.

  15. 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

  16. 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.

  17. 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

  18. 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.

  19. Effectiveness of tax and price policies in tobacco control.

    Science.gov (United States)

    Chaloupka, Frank J; Straif, Kurt; Leon, Maria E

    2011-05-01

    Over 20 experts on economics, epidemiology, public policy and tobacco control were asked by the International Agency for Research on Cancer (IARC) to evaluate the strength of the available evidence on the effects of tax and price policies to prevent and reduce tobacco use. Draft papers presenting and assessing the evidence on the following topics were developed by the experts in an 8-month period prior to the meeting: tobacco industry pricing strategies and tax related lobbying; tax, price and aggregate demand for tobacco; tax, price and adult tobacco use, use among young people and use among the poor; tax avoidance and tax evasion; and the economic and health impact of tobacco taxation. Subsequently, papers were peer reviewed, revised and resubmitted for final discussion at a 6-day meeting at IARC in Lyon, France, where a consensus evaluation of 18 concluding statements using the pre-established criteria of the IARC Cancer Prevention Handbooks took place. Studies published (or accepted for publication) in the openly available scientific literature were the main source of evidence for the review and evaluation; other types of publications were included when appropriate. In support of 12 of the 18 conclusions, the experts agreed that there was sufficient evidence of effectiveness of increased tobacco excise taxes and prices in reducing overall tobacco consumption and prevalence of tobacco use and improvement of public health, including by preventing initiation and uptake among young people, promoting cessation among current users and lowering consumption among those who continue to use. For the remaining six concluding statements the evidence was strong (four statements) or limited (two statements). The evidence presented and assessed in IARC Handbook volume 14 documents the effectiveness of tax and price policies in the control of tobacco use and improvement of public health.

  20. The impact of tobacco control policies in Albania.

    Science.gov (United States)

    Zaloshnja, Eduard; Ross, Hana; Levy, David T

    2010-12-01

    To assess the impact of a tobacco control law adopted in Albania in 2007 and to estimate the share of illicit cigarettes on the market. Comparative analysis of two waves of a nationally representative household survey, one conducted before the new law went into effect and the other after 2 years. Official sales data were contrasted with the consumption estimate based on the survey. Smoking prevalence, quit attempts, exposure to cigarette advertising, exposure to second-hand smoke, total cigarette consumption, share of illicit packs among packs possessed by smokers. Despite the adoption of strong smoke-free policies and adverting restrictions, smoking prevalence in Albania has risen. The increase in prevalence has been driven by higher smoking rates among females (18.9% in 2007 vs 29.3% in 2009) and young adults (23.2% in 2007 vs 38.5% in 2009 among 18-19 year olds). Self-reported exposure to second-hand smoke and cigarette advertising have been reduced since 2007. The majority of respondents are still exposed to second-hand smoke and more than half are exposed to tobacco advertising. Nevertheless, there are signs that the consumption of illicit cigarettes is declining. The impacts of smoke-free policies and an advertising ban have been limited due to lack of enforcement and failure to adopt a comprehensive set of tobacco control measures. These measures should include sizeable and regular tobacco tax increases in excess of the general level of inflation and income growth. The decline in the share of illicit cigarettes should improve the effectiveness of the cigarette tax policy.

  1. Nifedipine versus atosiban for threatened preterm birth (APOSTEL III): a multicentre, randomised controlled trial

    NARCIS (Netherlands)

    van Vliet, Elvira O. G.; Nijman, Tobias A. J.; Schuit, Ewoud; Heida, Karst Y.; Opmeer, Brent C.; Kok, Marjolein; Gyselaers, Wilfried; Porath, Martina M.; Woiski, Mallory; Bax, Caroline J.; Bloemenkamp, Kitty W. M.; Scheepers, Hubertina C. J.; Jacquemyn, Yves; van Beek, Erik; Duvekot, Johannes J.; Franssen, Maureen T. M.; Papatsonis, Dimitri N.; Kok, Joke H.; van der Post, Joris A. M.; Franx, Arie; Mol, Ben W.; Oudijk, Martijn A.

    2016-01-01

    In women with threatened preterm birth, delay of delivery by 48 h allows antenatal corticosteroids to improve neonatal outcomes. For this reason, tocolytics are often administered for 48 h; however, there is no consensus about which drug results in the best maternal and neonatal outcomes. In the

  2. Nifedipine versus atosiban for threatened preterm birth (APOSTEL III) : A multicentre, randomised controlled trial

    NARCIS (Netherlands)

    Van Vliet, Elvira O G; Nijman, Tobias A J; Schuit, Ewoud; Heida, Karst Y.; Opmeer, Brent C.; Kok, Marjolein; Gyselaers, Wilfried; Porath, Martina M.; Woiski, Mallory; Bax, Caroline J.; Bloemenkamp, Kitty W M; Scheepers, Hubertina C J; Jacquemyn, Yves; Beek, Erik Van; Duvekot, Johannes J.; Franssen, Maureen T M; Papatsonis, Dimitri N.; Kok, Joke H.; Van Der Post, Joris A M; Franx, Arie; Mol, Ben W.; Oudijk, Martijn A.

    2016-01-01

    Background In women with threatened preterm birth, delay of delivery by 48 h allows antenatal corticosteroids to improve neonatal outcomes. For this reason, tocolytics are often administered for 48 h; however, there is no consensus about which drug results in the best maternal and neonatal outcomes.

  3. Nifedipine versus atosiban for threatened preterm birth (APOSTEL III) : a multicentre, randomised controlled trial

    NARCIS (Netherlands)

    van Vliet, Elvira O. G.; Nijman, Tobias A. J.; Schuit, Ewoud; Heida, Karst Y.; Opmeer, Brent C.; Kok, Marjolein; Gyselaers, Wilfried; Porath, Martina M.; Woiski, Mallory; Bax, Caroline J.; Bloemenkamp, Kitty W. M.; Scheepers, Hubertina C. J.; Jacquemyn, Yves; van Beek, Erik; Duvekot, Johannes J.; Franssen, Maureen T. M.; Papatsonis, Dimitri N.; Kok, Joke H.; van der Post, Joris A. M.; Franx, Arie; Mol, Ben W.; Oudijk, Martijn A.

    2016-01-01

    Background In women with threatened preterm birth, delay of delivery by 48 h allows antenatal corticosteroids to improve neonatal outcomes. For this reason, tocolytics are often administered for 48 h; however, there is no consensus about which drug results in the best maternal and neonatal outcomes.

  4. Nifedipine versus atosiban for threatened preterm birth (APOSTEL III): a multicentre, randomised controlled trial

    NARCIS (Netherlands)

    Vliet, E.O. van; Nijman, T.A.; Schuit, E.; Heida, K.Y.; Opmeer, B.C.; Kok, M. de; Gyselaers, W.; Porath, M.M.; Woiski, M.D.; Bax, C.J.; Bloemenkamp, K.W.; Scheepers, H.C.; Jacquemyn, Y.; Beek, E. van; Duvekot, J.J.; Franssen, M.T.; Papatsonis, D.N.; Kok, J.H.; Post, J.A. van der; Franx, A.; Mol, B.W.; Oudijk, M.A.

    2016-01-01

    BACKGROUND: In women with threatened preterm birth, delay of delivery by 48 h allows antenatal corticosteroids to improve neonatal outcomes. For this reason, tocolytics are often administered for 48 h; however, there is no consensus about which drug results in the best maternal and neonatal

  5. Acidification policy - control of acidifying emissions in Germany

    International Nuclear Information System (INIS)

    Schaerer, B.

    1992-01-01

    Since the mid-eighties total annual acidifying emissions have started to decline in West Germany. There was considerable impact on this positive trend in air pollution by the control of SO 2 and NO x emissions from large boilers, which were reduced by more than 80%. Corresponding control programmes have been established for other groups of sources as well as other pollutants and - with unification - for East Germany. The driving force behind this development was and still is first of all the legal principle of anticipatory action or precaution which means in practical terms 'emission minimization'. This cornerstone of German clean air legislation is the most powerful components of Germany's 'acidification policy', as it requires policy-makers to draw up new or review existing regulations for emission reduction based on requirements according to the state of the art and forces operators to apply the most modern ways and means of operation. This paper describes the system used in Germany to deal with air pollution, the emission minimization strategy, and the actions against acidifying emissions based thereon. In addition, an outlook on what might be necessary to cope with the challenges of a sustainable development concerning acidification is given. 1 ref., 1 fig., 2 tabs

  6. El Control Policial-Medico-Securitario Brasileño

    Directory of Open Access Journals (Sweden)

    Thayara Silva Castelo Branco

    2016-10-01

    Full Text Available El artículo trata de los contornos del nuevo modelo de gobierno medico-policial, introducido en Brasil a finales del siglo XIX , en los cuales tenía como objetivo promover la salud básica a través de la vía policialesca conectada al control y normalización de los peligrosos e indeseables. Así, cuestiona la medicalización y policialización de las acciones del gobierno que empiezó a conectar el concepto de "enfermedad" a la lógica de la anticipación del peligro, la delincuencia, el control, la exclusión e inocuização, cumpliendo así, la política de seguridad que allí sobresalía y que dejó graves consecuencias en el Brasil.

  7. 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 ...

  8. 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 ...

  9. Food Service Guideline Policies on State Government-Controlled Properties.

    Science.gov (United States)

    Zaganjor, Hatidza; Bishop Kendrick, Katherine; Warnock, Amy Lowry; Onufrak, Stephen; Whitsel, Laurie P; Ralston Aoki, Julie; Kimmons, Joel

    2016-09-13

    Food service guideline (FSG) policies can impact millions of daily meals sold or provided to government employees, patrons, and institutionalized persons. This study describes a classification tool to assess FSG policy attributes and uses it to rate FSG policies. Quantitative content analysis. State government facilities in the United States. Participants were from 50 states and District of Columbia in the United States. Frequency of FSG policies and percentage alignment to tool. State-level policies were identified using legal research databases to assess bills, statutes, regulations, and executive orders proposed or adopted by December 31, 2014. Full-text reviews were conducted to determine inclusion. Included policies were analyzed to assess attributes related to nutrition, behavioral supports, and implementation guidance. A total of 31 policies met the inclusion criteria; 15 were adopted. Overall alignment ranged from 0% to 86%, and only 10 policies aligned with a majority of the FSG policy attributes. Western states had the most FSG policies proposed or adopted (11 policies). The greatest number of FSG policies were proposed or adopted (8 policies) in 2011, followed by the years 2013 and 2014. The FSG policies proposed or adopted through 2014 that intended to improve the food and beverage environment on state government property vary considerably in their content. This analysis offers baseline data on the FSG landscape and information for future FSG policy assessments. © The Author(s) 2016.

  10. Food Service Guideline Policies on State Government Controlled Properties

    Science.gov (United States)

    Zaganjor, Hatidza; Bishop Kendrick, Katherine; Warnock, Amy Lowry; Onufrak, Stephen; Whitsel, Laurie P.; Ralston Aoki, Julie; Kimmons, Joel

    2017-01-01

    Purpose Food service guidelines (FSG) policies can impact millions of daily meals sold or provided to government employees, patrons, and institutionalized persons. This study describes a classification tool to assess FSG policy attributes and uses it to rate FSG policies. Design Quantitative content analysis. Setting State government facilities in the U.S. Subjects 50 states and District of Columbia. Measures Frequency of FSG policies and percent alignment to tool. Analysis State-level policies were identified using legal research databases to assess bills, statutes, regulations, and executive orders proposed or adopted by December 31, 2014. Full-text reviews were conducted to determine inclusion. Included policies were analyzed to assess attributes related to nutrition, behavioral supports, and implementation guidance. Results A total of 31 policies met inclusion criteria; 15 were adopted. Overall alignment ranged from 0% to 86%, and only 10 policies aligned with a majority of FSG policy attributes. Western States had the most FSG policy proposed or adopted (11 policies). The greatest number of FSG policies were proposed or adopted (8 policies) in 2011, followed by the years 2013 and 2014. Conclusion FSG policies proposed or adopted through 2014 that intended to improve the food and beverage environment on state government property vary considerably in their content. This analysis offers baseline data on the FSG landscape and information for future FSG policy assessments. PMID:27630113

  11. Effect of a policy to reduce user fees on the rate of skilled birth attendance across socioeconomic strata in Burkina Faso.

    Science.gov (United States)

    Langlois, Étienne V; Karp, Igor; Serme, Jean De Dieu; Bicaba, Abel

    2016-05-01

    In Sub-Saharan Africa, maternal and neonatal morbidity and mortality rates are associated with underutilization of skilled birth attendance (SBA). In 2007, Burkina Faso introduced a subsidy scheme for SBA fees. The objective of this study was to evaluate the effect of Burkina Faso's subsidy policy on SBA rate across socioeconomic status (SES) strata. We used a quasi-experimental design. The data sources were two representative surveys (n = 1408 and n = 1403) of women from Houndé and Ziniaré health districts of Burkina Faso, and a survey of health centres assessing structural quality of care. Multilevel Poisson regression models were used with robust variance estimators. We estimated adjusted rate ratios (RR) and rate differences (RD) as a function of time and SES. For lowest-SES women, immediately upon the introduction of the subsidy policy, the rate of SBA was 45% higher (RR = 1.45, 95% confidence interval (CI): 1.19-1.77) than expected in the absence of subsidy introduction. The results indicated a sustained effect after introduction of the subsidy policy, based on RR estimate (95% CI) of 1.48 (1.21-1.81) at 2 years. For middle-SES women, the RR estimates were 1.28 (1.09-1.49) immediately after introduction of the subsidy policy and 1.30 (1.11-1.51) at 2 years, respectively. For highest-SES women, the RR estimates were 1.19 (1.02-1.38) immediately after subsidy introduction and 1.21 (1.06-1.38) at 2 years, respectively. The RD (95% CI) was 14% (3-24%) for lowest-SES women immediately after introduction of the policy, and the effect was sustained at 14% (4-25%) at 2 years. Our study suggests that the introduction of a user-fee subsidy in Burkina Faso resulted in increased rates of SBA across all SES strata. The increase was sustained over time and strongest among the poorest women. These findings have important implications for evidence-informed policy making in Burkina Faso and other countries in Sub-Saharan Africa. © The Author 2015. Published by

  12. Religious beliefs and alcohol control policies: a Brazilian nationwide study

    Directory of Open Access Journals (Sweden)

    Giancarlo Lucchetti

    2014-03-01

    Full Text Available Objective: The connection between lower alcohol use and religiousness has been extensively examined. Nevertheless, few studies have assessed how religion and religiousness influence public policies. The present study seeks to understand the influence of religious beliefs on attitudes toward alcohol use. Methods: A door-to-door, nationwide, multistage population-based survey was carried out. Self-reported religiousness, religious attendance, and attitudes toward use of alcohol policies (such as approval of public health interventions, attitudes about drinking and driving, and attitudes toward other alcohol problems and their harmful effects were examined. Multiple logistic regression was used to control for confounders and to assess explanatory variables. Results: The sample was composed of 3,007 participants; 57.3% were female and mean age was 35.7 years. Religiousness was generally associated with more negative attitudes toward alcohol, such as limiting hours of sale (p < 0.01, not having alcohol available in corner shops (p < 0.01, prohibiting alcohol advertisements on TV (p < 0.01, raising the legal drinking age (p < 0.01, and raising taxes on alcohol (p < 0.05. Higher religious attendance was associated with less alcohol problems (OR: 0.61, 95%CI 0.40-0.91, p = 0.017, and self-reported religiousness was associated with less harmful effects of drinking (OR: 0.61, 95%CI 0.43-0.88, p = 0.009. Conclusions: Those with high levels of religiousness support more restrictive alcohol policies. These findings corroborate previous studies showing that religious people consume less alcohol and have fewer alcohol-related problems.

  13. 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

  14. A Logic for Reasoning About Time-Dependent Access Control Policies

    National Research Council Canada - National Science Library

    DeYoung, Henry

    2008-01-01

    .... Because of the number and complexity of authorization policies in access control systems, it is clear that ad hoc methods for specifying and enforcing policies cannot inspire a high degree of trust...

  15. Public policy for the control of tobacco-related disease.

    Science.gov (United States)

    Bierer, M F; Rigotti, N A

    1992-03-01

    Public policies concerning tobacco shape the environment of the smoker and nonsmoker alike. These policies use diverse means to achieve the common goal of reducing tobacco use and its attendant health consequences. Educational interventions such as warning labels, school curricula, and public service announcements serve to inform the public about the hazards of tobacco smoke. These are countered by the pervasive marketing of tobacco products by the tobacco industry, despite a ban on tobacco advertising on radio and television. Further restrictions on tobacco advertising and promotion have been proposed and await action. Cigarette excise taxes and smoker-nonsmoker insurance premium differentials discourage smoking by making it more costly to purchase cigarettes. Conversely, health insurance reimbursement for smoking cessation programs could reduce the cost of giving up the habit and might encourage cessation. Restricting or banning smoking in public places and workplaces decreases a smoker's opportunities to smoke, further inhibiting this behavior. Reducing the availability of cigarettes to children and adolescents may help to prevent them from starting to smoke. The environment of the smoker is conditioned by this pastiche of influences. Physicians who become involved in tobacco-control issues have the opportunity to alter the environmental influences on their patients. This is likely to be synergistic with physicians' efforts inside the office to encourage individual smokers to quit. As a first step toward advocacy outside the office, physicians can help to create a smoke-free health-care facility in their own institution. Beyond that, advocacy groups or the voluntary health organizations (e.g., American Lung Association) provide avenues for physicians to take a stand on community issues relevant to tobacco control. Physicians who take these steps to alter the environment of smokers beyond the office are likely to magnify the effect of their work with individual

  16. Public attitudes towards smoking and tobacco control policy in Russia.

    Science.gov (United States)

    Danishevski, K; Gilmore, A; McKee, M

    2008-08-01

    Since the political transition in 1991, Russia has been targeted intensively by the transnational tobacco industry. Already high smoking rates among men have increased further; traditionally low rates among women have more than doubled. The tobacco companies have so far faced little opposition as they shape the discourse on smoking in Russia. This paper asks what ordinary Russians really think about possible actions to reduce smoking. A representative sample of the Russian population (1600 respondents) was interviewed face to face in November 2007. Only 14% of respondents considered tobacco control in Russia adequate, while 37% thought that nothing was being done at all. There was support for prices keeping pace with or even exceeding inflation. Over 70% of all respondents favoured a ban on sales from street kiosks, while 56% believed that existing health warnings (currently 4% of front and back of packs) were inadequate. The current policy of designating a few tables in bars and restaurants as non-smoking was supported by less than 10% of respondents, while almost a third supported a total ban, with 44% supporting provision of equal space for smokers and non-smokers. Older age, non-smoking status and living in a smaller town all emerged as significantly associated with the propensity to support antismoking measures. The tobacco companies were generally viewed as behaving like most other companies in Russia, with three-quarters of respondents believing that these companies definitely or maybe bribe politicians. Knowledge of impact of smoking on health was limited with significant underestimation of dangers and addictive qualities of tobacco. A third believed that light cigarettes are safer than normal cigarettes. The majority of the Russian population would support considerable strengthening of tobacco control policies but there is also a need for effective public education campaigns.

  17. Public attitudes towards smoking and tobacco control policy in Russia

    Science.gov (United States)

    Danishevski, Kirill; Gilmore, Anna; McKee, Martin

    2014-01-01

    Background Since the political transition in 1991, Russia has been targeted intensively by the transnational tobacco industry. Already high smoking rates among men have increased further; traditionally low rates among women have more than doubled. The tobacco companies have so far faced little opposition as they shape the discourse on smoking in Russia. This paper asks what ordinary Russians really think about possible actions to reduce smoking. Methods A representative sample of the Russian population (1600 respondents) was interviewed face-to-face in November 2007. Results Only 14% of respondents considered tobacco control in Russia adequate, while 37% felt that nothing was being done at all. There was support for prices keeping pace with or even exceeding inflation. Over 70% of all respondents favoured a ban on sales from street kiosks, while 56% believed that existing health warnings (currently 4% of front and back of packs) were inadequate. The current policy of designating a few tables in bars and restaurants as non-smoking was supported by less than 10% of respondents, while almost a third supported a total ban, with 44% supporting provision of equal space for smokers and non-smokers. Older age, non-smoking status and living a smaller town all emerged as significantly associated with the propensity to support of antismoking measures. The tobacco companies were generally viewed as behaving like most other companies in Russia, with three-quarters believing that they definitely or maybe bribe politicians. Knowledge of impact of smoking on health was limited with significant underestimation of dangers and addictive qualities of tobacco. A third believed that light cigarettes are safer than normal. Conclusion The majority of the Russian population would support considerable strengthening of tobacco control policies but there is also a need for effective public education campaigns. PMID:18653793

  18. Recommendations for Infant Feeding Policy and Programs in Dzimauli Region, South Africa: Results From the MAL-ED Birth Cohort.

    Science.gov (United States)

    Mushaphi, Lindelani Fhumudzani; Mahopo, Tjale Cloupas; Nesamvuni, Cebisa Noxolo; Baloyi, Brenda; Mashau, Ellen; Richardson, Jeniata; Dillingham, Rebecca; Guerrant, Richard; Ambikapathi, Ramya; Bessong, Pascal

    2017-09-01

    There is strong evidence that exclusive breastfeeding (EBF) in the first 6 months of life reduces the risk of diseases in infancy and in later life. To understand the maternal reasoning that influences optimum infant feeding practices of caregivers in semirural communities of Limpopo province. Nested qualitative study among mothers in an ongoing birth cohort study was conducted; structured and semi-structured interviews were used to collect data. Data from 234 infants after 6 months of follow-up was included for quantitative analysis. Four focus discussion groups comprising 7 to 10 caregivers were used to obtain perception of mothers on breastfeeding. A semi-structured interview guide was used to stimulate discussions. Thematic content analyses were conducted to identify the main themes that influence breastfeeding practices of caregivers. Over 90% of the caregivers initiated breastfeeding after delivery. However, less than 1% of mothers practiced EBF by 3 months, and none of the children were exclusively breastfed for up to 6 months. All caregivers introduced non-breast milk liquids and solids by the second month of child's life. Common reasons for introducing non-breast milk foods included insufficiency of breast milk production, going back to work or school, and influence by elderly women (mothers/mothers-in-law) and church members. Exclusive breastfeeding was not practiced in this community due to cultural and religious beliefs and misinformation. The involvement of elderly women and church members in infant feeding education and promotion programs and the dissemination of breastfeeding information through mobile phones to younger mothers are recommended.

  19. 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

  20. Assessing Segregation under a New Generation of Controlled Choice Policies

    Science.gov (United States)

    Frankenberg, Erica

    2017-01-01

    Student assignment policies (SAPs) in K-12 schools can either reproduce or help ameliorate existing inequality. Some districts are trying to maintain voluntarily adopted integration policies despite the Supreme Court's recent 2007 decision in "Parents Involved," which prohibited most race-conscious school choice policies that were…

  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. Obstacles to condom use: the combination of other forms of birth control and short-term monogamy.

    Science.gov (United States)

    Critelli, J W; Suire, D M

    1998-03-01

    Two hundred thirty-seven college students involved in heterosexual relationships were surveyed to determine the effects of relationship type and use of forms of contraception other than condoms on condom use. Findings indicated that in the context of a short-term, monogamous relationship, the use of another form of birth control was associated with decreased condom use. In addition, 20% of the participants reported that they had wanted to use a condom for disease prevention on at least one occasion but had decided not to do so because they were using another form of contraception. Implications for preventive health are discussed.

  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. 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.

  5. Acupuncture to improve live birth rates for women undergoing in vitro fertilization: a protocol for a randomized controlled trial

    Science.gov (United States)

    2012-01-01

    Background IVF is a costly treatment option for women, their partners, and the public. Therefore new therapies that improve reproductive and health outcomes are highly desirable. There is a growing body of research evaluating the effect of acupuncture administered during IVF, and specifically on the day of embryo transfer (ET). Many trials are heterogeneous and results inconsistent. There remains insufficient evidence to determine if acupuncture can enhance live birth rates when used as an adjunct to IVF treatment. The study will determine the clinical effectiveness of acupuncture with improving the proportion of women undergoing IVF having live births. Other objectives include: determination of the cost effectiveness of IVF with acupuncture; and examination of the personal and social context of acupuncture in IVF patients, and examining the reasons why the acupuncture may or may not have worked. Methods We will conduct a randomized controlled trial of acupuncture compared to placebo acupuncture. Inclusion criteria include: women aged less than 43 years; undergoing a fresh IVF or ICSI cycle; and restricted to women with the potential for a lower live birth rate defined as two or more previous unsuccessful ETs; and unsuccessful clinical pregnancies of quality embryos deemed by the embryologist to have been suitable for freezing by standard criteria. Women will be randomized to acupuncture or placebo acupuncture. Treatment is administered on days 6 to 8 of the stimulated cycle and two treatments on the day of ET. A non-randomized cohort of women not using acupuncture will be recruited to the study. The primary study outcome is the proportion of women reporting a live birth. Secondary outcomes include the proportion of women reporting a clinical pregnancy miscarriage prior to 12 weeks, quality of life, and self-efficacy. The sample size of the study is 1,168 women, with the aim of detecting a 7% difference in live births between groups (P = 0.05, 80% power

  6. Acupuncture to improve live birth rates for women undergoing in vitro fertilization: a protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Smith Caroline A

    2012-05-01

    Full Text Available Abstract Background IVF is a costly treatment option for women, their partners, and the public. Therefore new therapies that improve reproductive and health outcomes are highly desirable. There is a growing body of research evaluating the effect of acupuncture administered during IVF, and specifically on the day of embryo transfer (ET. Many trials are heterogeneous and results inconsistent. There remains insufficient evidence to determine if acupuncture can enhance live birth rates when used as an adjunct to IVF treatment. The study will determine the clinical effectiveness of acupuncture with improving the proportion of women undergoing IVF having live births. Other objectives include: determination of the cost effectiveness of IVF with acupuncture; and examination of the personal and social context of acupuncture in IVF patients, and examining the reasons why the acupuncture may or may not have worked. Methods We will conduct a randomized controlled trial of acupuncture compared to placebo acupuncture. Inclusion criteria include: women aged less than 43 years; undergoing a fresh IVF or ICSI cycle; and restricted to women with the potential for a lower live birth rate defined as two or more previous unsuccessful ETs; and unsuccessful clinical pregnancies of quality embryos deemed by the embryologist to have been suitable for freezing by standard criteria. Women will be randomized to acupuncture or placebo acupuncture. Treatment is administered on days 6 to 8 of the stimulated cycle and two treatments on the day of ET. A non-randomized cohort of women not using acupuncture will be recruited to the study. The primary study outcome is the proportion of women reporting a live birth. Secondary outcomes include the proportion of women reporting a clinical pregnancy miscarriage prior to 12 weeks, quality of life, and self-efficacy. The sample size of the study is 1,168 women, with the aim of detecting a 7% difference in live births between groups (P

  7. Russia SimSmoke: the long-term effects of tobacco control policies on smoking prevalence and smoking-attributable deaths in Russia.

    Science.gov (United States)

    Maslennikova, Galina Ya; Oganov, Rafael G; Boytsov, Sergey A; Ross, Hana; Huang, An-Tsun; Near, Aimee; Kotov, Alexey; Berezhnova, Irina; Levy, David T

    2014-11-01

    Russia has high smoking rates and weak tobacco control policies. A simulation model is used to examine the effect of tobacco control policies on past and future smoking prevalence and premature mortality in Russia. The Russia model was developed using the SimSmoke tobacco control model previously developed for the USA and other nations. The model inputs population size, birth, death and smoking rates specific to Russia. It assesses, individually and in combination, the effect of seven types of policies consistent with the WHO Framework Convention on Tobacco Control (FCTC): taxes, smoke-free air, mass media campaign, advertising bans, warning labels, cessation treatment and youth access policies. Outcomes are smoking prevalence and the number of smoking-attributable deaths by age and gender from 2009 to 2055. Increasing cigarette taxes to 70% of retail price, stronger smoke-free air laws, a high-intensity media campaign and comprehensive treatment policies are each potent policies to reduce smoking prevalence and smoking-attributable premature deaths in Russia. With the stronger set of policies, the model estimates that, relative to the status quo trend, smoking prevalence can be reduced by as much as 30% by 2020, with a 50% reduction projected by 2055. This translates into 2 684 994 male and 1 011 985 female premature deaths averted from 2015-2055. SimSmoke results highlight the relative contribution of policies to reducing the tobacco health burden in Russia. Significant inroads to reducing smoking prevalence and premature mortality can be achieved through strengthening tobacco control policies in line with FCTC recommendations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. 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 ...

  9. 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.

  10. Development of an omnibus policy for tobacco control in the Philippine department of health

    Directory of Open Access Journals (Sweden)

    Lee Edson Yarcia

    2018-03-01

    Tobacco control regime complexes and regulatory gaps result from the difficulty of determining issuance provisions that have been impliedly repealed. The analytical tool developed threshed out repealed provisions, which would allow actors and stakeholders to fulfil individual mandates. Both Omnibus Policy on Tobacco Control and 2017-2030 Policy Development Plan on Tobacco Control would guide the DOH in formulating policies that strengthen the Philippines´ compliance with the FCTC.

  11. The effect of participatory women's groups on birth outcomes in Bangladesh: does coverage matter? Study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Fottrell Edward F

    2011-09-01

    Full Text Available Abstract Background Progress on neonatal survival has been slow in most countries. While there is evidence on what works to reduce newborn mortality, there is limited knowledge on how to deliver interventions effectively when health systems are weak. Cluster randomized trials have shown strong reductions in neonatal mortality using community mobilisation with women's groups in rural Nepal and India. A similar trial in Bangladesh showed no impact. A main hypothesis is that this negative finding is due to the much lower coverage of women's groups in the intervention population in Bangladesh compared to India and Nepal. For evidence-based policy making it is important to examine if women's group coverage is a main determinant of their impact. The study aims to test the effect on newborn and maternal health outcomes of a participatory women's group intervention with a high population coverage of women's groups. Methods A cluster randomised trial of a participatory women's group intervention will be conducted in 3 districts of rural Bangladesh. As we aim to study a women's group intervention with high population coverage, the same 9 intervention and 9 control unions will be used as in the 2005-2007 trial. These had been randomly allocated using the districts as strata. To increase coverage, 648 new groups were formed in addition to the 162 existing groups that were part of the previous trial. An open cohort of women who are permanent residents in the union in which their delivery or death was identified, is enrolled. Women and their newborns are included after birth, or, if a woman dies during pregnancy, after her death. Excluded are women who are temporary residents in the union in which their birth or death was identified. The primary outcome is neonatal mortality in the last 24 months of the study. A low cost surveillance system will be used to record all birth outcomes and deaths to women of reproductive age in the study population. Data on home

  12. Birth weight differences between those offered financial voucher incentives for verified smoking cessation and control participants enrolled in the Cessation in Pregnancy Incentives Trial (CPIT), employing an intuitive approach and a Complier Average Causal Effects (CACE) analysis.

    Science.gov (United States)

    McConnachie, Alex; Haig, Caroline; Sinclair, Lesley; Bauld, Linda; Tappin, David M

    2017-07-20

    The Cessation in Pregnancy Incentives Trial (CPIT), which offered financial incentives for smoking cessation during pregnancy showed a clinically and statistically significant improvement in cessation. However, infant birth weight was not seen to be affected. This study re-examines birth weight using an intuitive and a complier average causal effects (CACE) method to uncover important information missed by intention-to-treat analysis. CPIT offered financial incentives up to £400 to pregnant smokers to quit. With incentives, 68 women (23.1%) were confirmed non-smokers at primary outcome, compared to 25 (8.7%) without incentives, a difference of 14.3% (Fisher test, p financial incentives to quit. Viewed in this way, the overall birth weight gain with incentives is attributable only to potential quitters. We compared an intuitive approach to a CACE analysis. Mean birth weight of potential quitters in the incentives intervention group (who therefore quit) was 3338 g compared with potential quitters in the control group (who did not quit) 3193 g. The difference attributable to incentives, was 3338 - 3193 = 145 g (95% CI -617, +803). The mean difference in birth weight between the intervention and control groups was 21 g, and the difference in the proportion who managed to quit was 14.3%. Since the intervention consisted of the offer of incentives to quit smoking, the intervention was received by all women in the intervention group. However, "compliance" was successfully quitting with incentives, and the CACE analysis yielded an identical result, causal birth weight increase 21 g ÷ 0.143 = 145 g. Policy makers have great difficulty giving pregnant women money to stop smoking. This study indicates that a small clinically insignificant improvement in average birth weight is likely to hide an important clinically significant increase in infants born to pregnant smokers who want to stop but cannot achieve smoking cessation without the addition of financial

  13. 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...

  14. Heredity, pet ownership, and confounding control in a population-based birth cohort.

    Science.gov (United States)

    Almqvist, Catarina; Egmar, Ann-Charlotte; van Hage-Hamsten, Marianne; Berglind, Niklas; Pershagen, Göran; Nordvall, S Lennart; Svartengren, Magnus; Hedlin, Gunilla; Wickman, Magnus

    2003-04-01

    The association between pet ownership in childhood and subsequent allergic disease is controversial. Bias related to selection of pet exposure has been suggested as a reason for contradictory study results. The purpose of this investigation was to elucidate how pet exposure depends on family history of allergic disease, smoking, and socioeconomic factors in a prospective birth cohort. Parents of 4089 two-month-old children answered a questionnaire that included detailed questions about family history of asthma (maternal, paternal, and sibling), rhinoconjunctivitis, atopic eczema/dermatitis syndrome, pollen and pet allergy, smoking habits, parental occupation, and family pet ownership (cat and dog). Dust samples collected from the mothers' beds were analyzed for Fel d 1 and Can f 1 in a subgroup of the cohort. Cats were less frequently kept in families with parental asthma, rhinoconjunctivitis, or pet or pollen allergy (3.5% to 5.8%) than in families without parental allergic disease (10.8% to 11.8%). Dogs were less common in families with (3.3%) than in families without (5.9%) parental atopic eczema/dermatitis syndrome. Families with smoking mothers and those with low socioeconomic index kept cats and dogs more frequently. Cat allergen levels were lower in homes with than in homes without maternal pet allergy, and this tended to hold true even for homes without a cat. Cat ownership decreased from birth to 2 years of age, especially in families with parental history of allergic diseases. There seems to be a selection of pet exposure based on parental history of allergy, maternal smoking, and socioeconomic factors. This has to be taken into consideration in evaluations of risk associations between pet exposure and allergic disease in childhood.

  15. How Drug Control Policy and Practice Undermine Access to Controlled Medicines.

    Science.gov (United States)

    Burke-Shyne, Naomi; Csete, Joanne; Wilson, Duncan; Fox, Edward; Wolfe, Daniel; Rasanathan, Jennifer J K

    2017-06-01

    Drug conventions serve as the cornerstone for domestic drug laws and impose a dual obligation upon states to prevent the misuse of controlled substances while ensuring their adequate availability for medical and scientific purposes. Despite the mandate that these obligations be enforced equally, the dominant paradigm enshrined in the drug conventions is an enforcement-heavy criminal justice response to controlled substances that prohibits and penalizes their misuse. Prioritizing restrictive control is to the detriment of ensuring adequate availability of and access to controlled medicines, thereby violating the rights of people who need them. This paper argues that the drug conventions' prioritization of criminal justice measures-including efforts to prevent non-medical use of controlled substances-undermines access to medicines and infringes upon the right to health and the right to enjoy the benefits of scientific progress. While the effects of criminalization under drug policy limit the right to health in multiple ways, we draw on research and documented examples to highlight the impact of drug control and criminalization on access to medicines. The prioritization and protection of human rights-specifically the right to health and the right to enjoy the benefits of scientific progress-are critical to rebalancing drug policy.

  16. 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.

  17. Promoting Implementation of Tobacco Control Laws and Policies in ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Following an analysis of six possible areas for action, the government chose smoke-free initiatives and taxation disincentives as priorities. This grant will support enforcement of an existing smoke-free policy in Abuja State and its introduction in Osun State, and initiate policy discussion on the use of taxation as a tool for ...

  18. Sterilization and birth control in the shadow of eugenics: married, middle-class women in Alberta, 1930-1960s.

    Science.gov (United States)

    Dyck, Erika

    2014-01-01

    The history of eugenic sterilization connotes draconian images of coerced and involuntary procedures robbing men and women of their reproductive health. While eugenics programs often fit this characterization, there is another, smaller, and less obvious legacy of eugenics that arguably contributed to a more empowering image of reproductive health. Sexual sterilization surgeries as a form of contraception began to gather momentum alongside eugenics programs in the middle of the 20th century and experiences among prairie women serve as an illustrative example. Alberta maintained its eugenics program from 1929 to 1972 and engaged in thousands of eugenic sterilizations, but by the 1940s middle-class married women pressured their Albertan physicians to provide them with sterilization surgeries to control fertility, as a matter of choice. The multiple meanings and motivations behind this surgery introduced a moral quandary for physicians, which encourages medical historians to revisit the history of eugenics and its relationship to the contemporaneous birth control movement.

  19. 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.

  20. Involving traditional birth attendants in emergency obstetric care in Tanzania: policy implications of a study of their knowledge and practices in Kigoma Rural District.

    Science.gov (United States)

    Vyagusa, Dismas B; Mubyazi, Godfrey M; Masatu, Melchiory

    2013-10-14

    Access to quality maternal health services mainly depends on existing policies, regulations, skills, knowledge, perceptions, and economic power and motivation of service givers and target users. Critics question policy recommending involvement of traditional birth attendants (TBAs) in emergency obstetric care (EmoC) services in developing countries. This paper reports about knowledge and practices of TBAs on EmoC in Kigoma Rural District, Tanzania and discusses policy implications on involving TBAs in maternal health services. 157 TBAs were identified from several villages in 2005, interviewed and observed on their knowledge and practice in relation to EmoC. Quantitative and qualitative techniques were used for data collection and analysis depending on the nature of the information required. Among all 157 TBAs approached, 57.3% were aged 50+ years while 50% had no formal education. Assisting mothers to deliver without taking their full pregnancy history was confessed by 11% of all respondents. Having been attending pregnant women with complications was experienced by 71.2% of all respondents. Only 58% expressed adequate knowledge on symptoms and signs of pregnancy complications. Lack of knowledge on possible risk of HIV infections while assisting childbirth without taking protective gears was claimed by 5.7% of the respondents. Sharing the same pair of gloves between successful deliveries was reported to be a common practice by 21.1% of the respondents. Use of unsafe delivery materials including local herbs and pieces of cloth for protecting themselves against HIV infections was reported as being commonly practiced among 27.6% of the respondents. Vaginal examination before and during delivery was done by only a few respondents. TBAs in Tanzania are still consulted by people living in underserved areas. Unfortunately, TBAs' inadequate knowledge on EmOC issues seems to have contributed to the rising concerns about their competence to deliver the recommended maternal

  1. Birth Defects Data and Statistics

    Science.gov (United States)

    ... Submit" /> Information For… Media Policy Makers Data & Statistics Recommend on Facebook Tweet Share Compartir On This ... and critical. Read below for the latest national statistics on the occurrence of birth defects in the ...

  2. Traditional vs. Contemporary Management Control Practices for Developing Public Health Policies.

    Science.gov (United States)

    Naranjo-Gil, David; Sánchez-Expósito, María Jesús; Gómez-Ruiz, Laura

    2016-07-14

    Public health policies must address multiple goals and complex community health needs. Recently, management control practices have emerged to provide a broader type of information for evaluating the effectiveness of healthcare policies, and relate activities and processes to multiple strategic outcomes. This study compares the effect of traditional and contemporary management control practices on the achievement of public health policies. It is also analyzed how two different uses of such practices (enabling vs. coercive) facilitate the achievement of public health policies. Relationships are explored using data collected from managers from public health agencies and public hospitals in Spain. The findings show that contemporary management control practices are more suitable than traditional practices to achieve public health policies. Furthermore, results show that public health policies are better achieved when managers use management control practices in an enabling way rather than in a coercive way.

  3. 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

  4. Early traumatic life events, parental attitudes, family history, and birth risk factors in patients with depressive disorder and healthy controls.

    Science.gov (United States)

    Bandelow, Borwin; Gutermann, Julia; Peter, Helmut; Wedekind, Dirk

    2013-02-01

    Only few studies have compared the frequency of traumatic life events during childhood in inpatients with depression with a healthy control group. Consecutively admitted inpatients with depression (n = 79), most of whom belonged to the melancholic subtype (n = 73; 92.4%), and healthy controls (n = 110) were investigated using a comprehensive retrospective interview with 203 questions regarding childhood traumatic life events, parental attitudes, family history of psychiatric disorders and birth risk factors. Depressed patients had significantly more severe traumatic events (mean score 1.33; SD 1.4) than control subjects (0.85; SD 1.2) on a 0-10 point "severe trauma scale". 70.9% (n = 56) of the depressed patients, but only 48.2% (n = 53) of the controls reported at least one severe traumatic event. When looking at single events, only few differences were found between patients and controls. Compared to controls, patients described significantly higher rates of psychiatric disorders in their families, in particular depression. Parental rearing styles were rated as more unfavorable in the patient group. In a logistic regression model, of all possible etiological factors examined, only a family history of psychiatric disorders showed a significant influence (OR = 3.6). Melancholic depression seems to be less associated with traumatic events than other psychiatric disorders.

  5. 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

  6. The Impact of State Abortion Policies on Teen Pregnancy Rates

    Science.gov (United States)

    Medoff, Marshall

    2010-01-01

    The availability of abortion provides insurance against unwanted pregnancies since abortion is the only birth control method which allows women to avoid an unwanted birth once they are pregnant. Restrictive state abortion policies, which increase the cost of obtaining an abortion, may increase women's incentive to alter their pregnancy avoidance…

  7. Tobacco Control in Africa: People, Politics and Policies | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2011-10-15

    Oct 15, 2011 ... Although the policy interventions are well understood, the political economy ... case studies – representing diverse linguistic, geographic, political, legal and ... Addressing Africa's unmet need for family planning by intensifying ...

  8. The passage of tobacco control law 174 in Lebanon: reflections on the problem, policies and politics.

    Science.gov (United States)

    Nakkash, R T; Torossian, L; El Hajj, T; Khalil, J; Afifi, R A

    2018-06-01

    Progress in tobacco control policy making has occurred worldwide through advocacy campaigns involving multiple players- civil society groups, activists, academics, media and policymakers. The Framework Convention on Tobacco Control (FCTC)-the first ever global health treaty-outlines evidence-based tobacco control policies. Lebanon ratified the FCTC in 2005, but until 2011, tobacco control policies remained rudimentary and not evidence-based. Beginning in 2009, a concerted advocacy campaign was undertaken by a variety of stakeholders with the aim of accelerating the process of adopting a strong tobacco control policy. The campaign was successful, and Law 174 passed the Lebanese Parliament in August 2011. In this article, we analyse the policy making process that led to the adoption of Law 174 using Kingdon's model. The analysis relies on primary and secondary data sources including historical records of key governmental decisions, documentation of the activities of the concerted advocacy campaign and in-depth interviews with key stakeholders. We describe the opening of a window of opportunity as a result of the alignment of the problem, policy and politics streams. Furthermore, findings revealed that despite the challenge of persistent tobacco industry interference and established power relations between the industry, its allies and policymakers; policy entrepreneurs succeeded in supporting the alignment of the streams, and influencing the passage of the law. Kingdon's multiple stream approach was useful in explaining how tobacco control became an emerging policy issue at the front of the policy agenda in Lebanon.

  9. Control policies impact on commercial trade in nuclear sector

    International Nuclear Information System (INIS)

    Vatamanu, Mariana; Bugeag, Elena; Ignat Irina

    2004-01-01

    The restructuring of the economic sectors, improvement of the business environment and, implicitly, the development of the appropriate legislative framework correspond to the main objectives of the Work Programme issued by the Government of Romania with view to fulfil the criteria imposed by the European Commission for the accession of Romania to European Union planned for the year 2007. One of the legislative package section, being under revision of the Legislative Chamber of Romania, is referring to power sector, where remarkable efforts are made in connection with energy and gas market liberalization towards 40% opening, correction applied to the thermal and electric power and gas tariffs, with a view to get fully cover of the production costs, start up of the privatisation process for some of the distribution companies and all these represent part of the main priorities of the Romanian government for the restructuring of the power sector. SN Nuclearelectrica SA - SNN SA - has as domain of its main activities the development of the nuclear program in Romania regarding: Cernavoda Unit 1 operation for production and delivery of electric power to the National Grid (since 1996), the nuclear fuel fabrication at Nuclear Fuel Plant in Pitesti, the completion and commissioning of the Cernavoda Unit 2 and start up, in the near future, of the work for Unit 3 completion. The trade activity within the power production sector using nuclear fuel is governed, due to its specific, by the rules and laws of Romania and are also subject of the international rules related to the foreign trade and, particularly to the policy of transaction of the special materials on international market. This category of special materials, named strategic materials with dual use, are under the control of the National Agency for Export Control - ANCEX, as well as other specialised and dedicated Romanian authorities, as: National Commission for the Nuclear Activities Control - CNCAN, specialized

  10. Tobacco control policy development in the European Union: do political factors matter?

    NARCIS (Netherlands)

    Bosdriesz, Jizzo R.; Willemsen, Marc C.; Stronks, Karien; Kunst, Anton E.

    2015-01-01

    There has been much variation between European countries in the development of tobacco control policy. Not much is known about the factors that shape this variation. This study aimed to assess the role of political factors in tobacco control policy development. We used data from 11 European

  11. Tobacco control policies and perinatal and child health: A systematic review and meta-analysis protocol

    NARCIS (Netherlands)

    J.V. Been (Jasper V.); J.P. Mackenbach (Johan); C. Millett (Christopher); S. Basu (Sanjay); A. Sheikh (Aziz)

    2015-01-01

    textabstractIntroduction: Children experience considerable morbidity and mortality due to tobacco smoke exposure. Tobacco control policies may benefit child health by reducing this exposure. We aim to comprehensively assess the effects of the range of tobacco control policies advocated by the WHO on

  12. Status of infection control policies and organisation in European hospitals, 2001: the ARPAC study.

    NARCIS (Netherlands)

    Struelens, M.J.; Wagner, D.; Bruce, J.; MacKenzie, F.M.; Cookson, B.; Voss, A.; Broek, P.J.J.A. van den; Gould, I.

    2006-01-01

    Patient safety in hospital care depends on effective infection control (IC) programmes. The Antimicrobial Resistance Prevention and Control (ARPAC) study assessed the organisation, components and human resources of IC programmes in European hospitals. A questionnaire survey of policies and

  13. Toward Effective Water Pipe Tobacco Control Policy in the United States: Synthesis of Federal, State, and Local Policy Texts.

    Science.gov (United States)

    Colditz, Jason B; Ton, Jessica N; James, A Everette; Primack, Brian A

    2017-07-01

    Water pipe tobacco smoking (WTS) is growing in popularity among U.S. young adults and is associated with health risks similar to those of cigarette smoking. The purpose of this study is to examine existing tobacco control policies (TCPs) in order to investigate how they engage WTS. A systematic synthesis of content and legal interactions among federal, state, and local TCP documents. Pennsylvania, which represents a politically and demographically diverse microcosm of the United States. No human subjects. Federal and state TCPs were retrieved via public legal repositories. Local policy searches were conducted via county/municipal Web sites, inclusive of 13 localities that had autonomous health departments or existing TCPs based on a National Cancer Institute report. Full-text TCPs were double coded within a grounded theory framework for health policy analysis. Emergent codes were used to compare and contrast policy texts and to examine legal interactions among TCPs. Examination of policy categories including youth access, use restrictions, and taxation revealed WTS as largely omitted from current TCPs. WTS was sometimes addressed as an "other" tobacco product under older TCPs, though ambiguities in language led to questionable enforceability. State preemptions have rolled back or prevented well-tailored reforms at the local level. Federal preemptions have likewise constrained state TCPs. Outdated, preempted, and unclear policies limit the extent to which TCPs engage WTS. Health advocates might target these aspects of TCP reform.

  14. 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.

  15. 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.

  16. Sibling Variation and Family Language Policy: The Role of Birth Order in the Spanish Proficiency and First Names of Second-Generation Latinos

    Science.gov (United States)

    Parada, Maryann

    2013-01-01

    The effects of birth order have been debated in many disciplines and have been shown to be important for a number of outcomes. However, studies examining the significance of birth order in language development and practices, particularly with regard to minority languages, are few. This article reports on two sets of data collected among Spanish…

  17. The economics of tobacco control: evidence from the International Tobacco Control (ITC) Policy Evaluation Project.

    Science.gov (United States)

    Tauras, John A; Chaloupka, Frank J; Quah, Anne Chiew Kin; Fong, Geoffrey T

    2014-03-01

    Over the past few decades, the importance of economic research in advancing tobacco control policies has become increasingly clear. Extensive research has demonstrated that increasing tobacco taxes and prices is the single most cost-effective tobacco control measure. The research contained in this supplement adds to this evidence and provides new insights into how smokers respond to tax and price changes using the rich data on purchase behaviours, brand choices, tax avoidance and evasion, and tobacco use collected systematically and consistently across countries and over time by the International Tobacco Control (ITC) Project. The findings from this research will help inform policymakers, public health professionals, advocates, and others seeking to maximise the public health and economic benefits from higher taxes.

  18. 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.

  19. 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.

  20. Older teen attitudes toward birth control access in pharmacies: a qualitative study.

    Science.gov (United States)

    Wilkinson, Tracey A; Miller, Courtney; Rafie, Samantha; Landau, Sharon Cohen; Rafie, Sally

    2018-03-01

    To examine adolescent attitudes toward accessing contraception through a new pharmacist prescribing model in the State of California. In-depth telephone interviews were conducted in summer 2015 with 30 females ages 18 to 19 in California. Participants were recruited using a social media advertisement. Semi-structured interviews utilized open-ended questions to understand teens' experiences with pharmacies, experiences obtaining contraception, and views on pharmacist prescribing of contraception. Responses were transcribed and qualitatively analyzed using an independent-coder method to identify salient themes. Participants were ethnically diverse and primarily living in suburban areas. All participants had completed high school and many had completed one year of college. Nearly all participants were supportive of California's new law allowing pharmacist prescribing of contraception. Thematic analyses revealed that while participants were satisfied with traditional service providers and valued those relationships, they appreciated the benefit of increased access and convenience of going directly to a pharmacy. Participants expected increased access to contraception in pharmacies would lead to both personal and societal benefits. They expressed concerns regarding parental involvement, as well as confidentiality in the pharmacy environment and with insurance disclosures. Older teens in California are very supportive of pharmacies and pharmacists as direct access points for contraception, but confidentiality concerns were noted. Policy makers and pharmacies can incorporate study findings when designing policies, services, and physical pharmacy spaces to better serve teens. Further research is warranted after pharmacies implement this new service to assess teen utilization and satisfaction as well as outcomes. Several states recently passed legislation enabling pharmacists to prescribe contraception and other states are considering similar legislation. Older teens are

  1. Controle social e políticas de saúde Social control over health policies

    Directory of Open Access Journals (Sweden)

    Aldaíza Sposati

    1992-12-01

    Full Text Available Na história de democratização das políticas de saúde, um dos campos que construiu visibilidade aos movimentos de saúde, quer pela denúncia das "ausências e omissões" dos serviços instalados, quer pela luta no sentido de construir um espaço regular para o exercício do controle nos serviços e nas burocracias da gestão da saúde, foi o controle social da coisa pública. No início da década de 80, a experiência marcante na região leste da cidade de São Paulo foi a de criar os conselhos de saúde como representação popular no controle do Estado. Nesta reflexão, as autoras não pretendem discutir a composição da representação, mas sim avançar para novos problemas. Na conjuntura pós Constituição de 1988, vivemos um novo momento democrático. As leis, a princípio, amparam a participação da população nas políticas de saúde e são defensoras dos direitos sociais. Como, então, é entendido o campo do controle social? Este restringe-se aos serviços de saúde ou é mais ampliado, englobando a política de saúde? Como é que as leis passam da sua formulação para a sua aplicação? Busca-se, no texto, mapear questões que se colocam quando o controle social se orienta para constituir uma pressão pela mudança/alteração da situação.As the democratization of health policies develops, social control over public interests has been of help in providing health movements with prominence, not only by denouncing cases of "negligence and omission" by established services, but also by struggling to create regular, favourable conditions by which to exercise control over services and governmental management of public health policies. In the early 1980s, a remarkable experience occurred in the "Zona Leste" or eastern burrough of the city of São Paulo, consisting of the emergence of Health Councils as a means of popular representation in the control over the state. Through their analysis of these issues, the authors' intent is

  2. Birthing Classes

    Science.gov (United States)

    ... management options. Breastfeeding basics. Caring for baby at home. Birthing classes are not just for new parents, though. ... midwife. Postpartum care. Caring for your baby at home, including baby first aid. Lamaze One of the most popular birthing techniques in the U.S., Lamaze has been around ...

  3. [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.

  4. Alcohol Control and Harm Reduction Policies in Lebanon | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Currently alcohol prices are low (with very low excise taxes) and illegal sales to minors are high. This research project aims to generate ... The results should help to identify an optimum policy approach most likely to influence alcohol consumption behaviours among youth. Project findings will be publicly shared, with the ...

  5. Consequences of Inconsistency in Air Force Tobacco Control Policy.

    Science.gov (United States)

    Lando-King, Elizabeth A; Malone, Ruth E; Haddock, Christopher K; Poston, Walker S Carlos; Lando, Harry A; Jahnke, Sara A; Hawk, Nita; Smith, Elizabeth A

    2017-04-01

    Although the United States Air Force (USAF) has been a leader in efforts to reduce tobacco use among service members, tobacco continues to be a problem and initiatives to decrease tobacco use further require buy-in from leadership. We explored line leaderships' perspectives on tobacco. A diverse group of 10 senior commissioned and 10 non-commissioned personnel were interviewed. Respondents reported substantial changes in the culture of tobacco use during their years of service, from near ubiquity to restricted use areas. They also perceived mixed messages coming from the USAF, including simultaneous discouragement of and accommodations for tobacco use, and variability in policies and enforcement. Many respondents indicated that allowing tobacco use creates conflict and undermines military discipline and suggested that a tobacco-free policy would be the best way to eliminate these contradictions. Although there has been substantial movement away from a culture of tobacco in the USAF, current policies and variable enforcement of these policies create unnecessary contradictions. Establishing a tobacco-free service would resolve these issues in addition to improving the health of service members and veterans.

  6. Association between birth order and emergency room visits and acute hospital admissions following pediatric vaccination: a self-controlled study.

    Science.gov (United States)

    Hawken, Steven; Kwong, Jeffrey C; Deeks, Shelley L; Crowcroft, Natasha S; Ducharme, Robin; Manuel, Douglas G; Wilson, Kumanan

    2013-01-01

    We investigated the association between a child's birth order and emergency room (ER) visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. We included all children born in Ontario between April 1(st), 2006 and March 31(st), 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI) of events among 1(st)-born and later-born children using relative incidence ratios (RIR). For the 2-month vaccination, the RIR for 1(st)-borns versus later-born children was 1.37 (95% CI: 1.19-1.57), which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1(st)-borns vs. later-borns was 1.70 (95% CI: 1.45-1.99), representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1(st) vs. later-borns was 1.27 (95% CI: 1.09-1.48), or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02-1.21), or 249 excess events/100,000 vaccinated. Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1(st)-born children had significantly higher relative incidence of events compared to later-born children.

  7. Association between birth order and emergency room visits and acute hospital admissions following pediatric vaccination: a self-controlled study.

    Directory of Open Access Journals (Sweden)

    Steven Hawken

    Full Text Available OBJECTIVE: We investigated the association between a child's birth order and emergency room (ER visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. METHODS: We included all children born in Ontario between April 1(st, 2006 and March 31(st, 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI of events among 1(st-born and later-born children using relative incidence ratios (RIR. RESULTS: For the 2-month vaccination, the RIR for 1(st-borns versus later-born children was 1.37 (95% CI: 1.19-1.57, which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1(st-borns vs. later-borns was 1.70 (95% CI: 1.45-1.99, representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1(st vs. later-borns was 1.27 (95% CI: 1.09-1.48, or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02-1.21, or 249 excess events/100,000 vaccinated. CONCLUSIONS: Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1(st-born children had significantly higher relative incidence of events compared to later-born children.

  8. Maternal oral health status and preterm low birth weight at Muhimbili National Hospital, Tanzania: a case-control study

    Directory of Open Access Journals (Sweden)

    Manji Karim P

    2007-06-01

    Full Text Available Abstract Background The study examined the relationship between oral health status (periodontal disease and carious pulpal exposure (CPE and preterm low-birth-weight (PTLBW infant deliveries among Tanzanian-African mothers at Muhimbili National Hospital (MNH, Tanzania. Methods A retrospective case-control study was conducted, involving 373 postpartum mothers aged 14–44 years (PTLBW – 150 cases and at term normal-birth-weight (TNBW – 223 controls, using structured questionnaire and full-mouth examination for periodontal and dentition status. Results The mean number of sites with gingival bleeding was higher in PTLBW than in TNBW (P = 0.026. No significant differences were observed for sites with plaque, calculus, teeth with decay, missing, filling (DMFT between PTLBW and TNBW. Controlling for known risk factors in all post-partum (n = 373, and primiparaous (n = 206 mothers, no significant differences were found regarding periodontal disease diagnosis threshold (PDT (four sites or more that had probing periodontal pocket depth 4+mm and gingival bleeding ≥ 30% sites, and CPE between cases and controls. Significant risk factors for PTLBW among primi- and multiparous mothers together were age ≤ 19 years (adjusted Odds Ratio (aOR = 2.09, 95% Confidence interval (95% CI: 1.18 – 3.67, P = 0.011, hypertension (aOR = 2.44, (95% CI: 1.20 – 4.93, P = 0.013 and being un-married (aOR = 1.59, (95% CI: 1.00 – 2.53, P = 0.049. For primiparous mothers significant risk factors for PTLBW were age ≤ 19 years (aOR = 2.07, 95% CI: 1.13 – 3.81, P = 0.019, and being un-married (aOR = 2.58, 95% CI: 1.42 – 4.67, P = 0.002. Conclusions These clinical findings show no evidence for periodontal disease or carious pulpal exposure being significant risk factors in PTLBW infant delivery among Tanzanian-Africans mothers at MNH, except for young age, hypertension, and being unmarried. Further research incorporating periodontal pathogens is recommended.

  9. A controlled community-based trial to promote smoke-free policy in rural communities.

    Science.gov (United States)

    Hahn, Ellen J; Rayens, Mary Kay; Adkins, Sarah; Begley, Kathy; York, Nancy

    2015-01-01

    Rural, tobacco-growing areas are disproportionately affected by tobacco use, secondhand smoke, and weak tobacco control policies. The purpose was to test the effects of a stage-specific, tailored policy-focused intervention on readiness for smoke-free policy, and policy outcomes in rural underserved communities. A controlled community-based trial including 37 rural counties. Data were collected annually with community advocates (n = 330) and elected officials (n = 158) in 19 intervention counties and 18 comparison counties over 5 years (average response rate = 68%). Intervention communities received policy development strategies from community advisors tailored to their stage of readiness and designed to build capacity, build demand, and translate and disseminate science. Policy outcomes were tracked over 5 years. Communities receiving the stage-specific, tailored intervention had higher overall community readiness scores and better policy outcomes than the comparison counties, controlling for county-level smoking rate, population size, and education. Nearly one-third of the intervention counties adopted smoke-free laws covering restaurants, bars, and all workplaces compared to none of the comparison counties. The stage-specific, tailored policy-focused intervention acted as a value-added resource to local smoke-free campaigns by promoting readiness for policy, as well as actual policy change in rural communities. Although actual policy change and percent covered by the policies were modest, these areas need additional resources and efforts to build capacity, build demand, and translate and disseminate science in order to accelerate smoke-free policy change and reduce the enormous toll from tobacco in these high-risk communities. © 2014 National Rural Health Association.

  10. 21 CFR 1401.2 - The Office of National Drug Control Policy-organization and functions.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false The Office of National Drug Control Policy-organization and functions. 1401.2 Section 1401.2 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY PUBLIC AVAILABILITY OF INFORMATION § 1401.2 The Office of National Drug Control Policy—organization and functions. (a) The Office of National Drug...

  11. Local Support for Alcohol Control Policies and Perceptions of Neighborhood Issues in Two College Communities.

    Science.gov (United States)

    Fairlie, Anne M; DeJong, William; Wood, Mark D

    2015-01-01

    Although valuable, national opinion surveys on alcohol policy may be less informative for policy development at the local level. Using samples of adult residents in 2 college communities, the present study: (1) measured public support for local alcohol control policies to stem underage drinking and alcohol overservice in on-premise outlets, (2) assessed residents' opinions regarding neighborhood problems, and (3) identified factors associated with strong policy support. We administered random-sample telephone surveys to residents aged 21 years and older in college communities located in Community 1 (N = 501; mean age = 57.4 years, SD = 14.7) and Community 2 (N = 505; mean age = 56.0 years, SD = 15.2). The response rates were typical of telephone surveys (Community 1: 33.5%; Community 2: 29.9%). We assessed support for 16 alcohol control policies and the occurrence of specific types of neighborhood incidents (e.g., witnessing intoxicated people). We used multiple regression analyses to determine factors associated with policy support. Residents in Community 1 reported significantly higher weekly alcohol use, a greater number of witnessed neighborhood incidents, and a higher level of perceived neighborhood problems than did residents in Community 2. Residents in Community 1 perceived local alcohol control policies and their enforcement to be significantly stricter. Overall, policy support was high and did not differ between the communities. In both communities, higher policy support was significantly associated with being female, being older, less weekly alcohol use, and lower perceived strictness of alcohol control policies and enforcement. It is important for campus officials and community leaders to be aware of and publicize favorable public opinion when advocating for policy change, especially at the local level. Information on residents' perceptions of the neighborhood issues they face can also inform local policy and enforcement efforts.

  12. Selection of controls in case-control studies on maternal medication use and risk of birth defects

    NARCIS (Netherlands)

    Bakker, M.K.; de Walle, H.E.; Dequito, A.; van den Berg, P.B.; de Jong-van den Berg, L.T.

    BACKGROUND:: In case-control studies on teratogenic risks of maternal drug use during pregnancy, the use of normal or malformed controls may lead to recall-bias or selection bias. This can be avoided by using controls with a genetic disorder. However, researchers are hesitant to use these as

  13. Off-policy integral reinforcement learning optimal tracking control for continuous-time chaotic systems

    International Nuclear Information System (INIS)

    Wei Qing-Lai; Song Rui-Zhuo; Xiao Wen-Dong; Sun Qiu-Ye

    2015-01-01

    This paper estimates an off-policy integral reinforcement learning (IRL) algorithm to obtain the optimal tracking control of unknown chaotic systems. Off-policy IRL can learn the solution of the HJB equation from the system data generated by an arbitrary control. Moreover, off-policy IRL can be regarded as a direct learning method, which avoids the identification of system dynamics. In this paper, the performance index function is first given based on the system tracking error and control error. For solving the Hamilton–Jacobi–Bellman (HJB) equation, an off-policy IRL algorithm is proposed. It is proven that the iterative control makes the tracking error system asymptotically stable, and the iterative performance index function is convergent. Simulation study demonstrates the effectiveness of the developed tracking control method. (paper)

  14. Effect of consanguinity on birth defects in Saudi women; results from a nested case-control study

    DEFF Research Database (Denmark)

    Majeed-Saidan, Muhammad Ali; Ammari, Amer N; AlHashem, Amal M

    2015-01-01

    BACKGROUND: The role of consanguinity in the etiology of structural birth defects outside of chromosomal and inherited disorders has always been debated. We studied the independent role of consanguinity on birth defects in Saudi women with a high prevalence of consanguineous marriages. METHODS: T...

  15. Arms Control and Proliferation Challenges to the Reset Policy

    Science.gov (United States)

    2011-11-01

    Sunshine Policy and economic transfers to the North.185 While it is impos- sible to determine conclusively which of these analy- ses of the DPRK’s motives...induce a return to some agreeable forum for negotiations. But it is quite unlikely that in the present configuration, North Korea will renounce its...engage North Ko- rea directly within the Six-Party framework, as China and others have recommended. Then it might be pos- sible to resume

  16. Environmental Pollution Control Policy-Making: An Analysis of Elite Perceptions and Preferences

    Science.gov (United States)

    Althoff, Phillip; Greig, William H.

    1974-01-01

    This article is based on an analysis of the perceptions and preferences of elite groups concerning environmental pollution control policy making. Results showed that although the groups agreed that present methods were inadequate, they were, nevertheless, unable to agree upon the nature of a future policy-making system. (MA)

  17. ANTI-FERTILITY EFFECTS OF SOME PLANTS USED BY THE STREET HERBAL VENDORS FOR BIRTH CONTROL

    OpenAIRE

    Sinha, Rajiv K.; Nathawat, G.S.

    1989-01-01

    The Herbal Vendors are the descendants of ancient mobile tribal medicine men. Now –a –days they sell crude Herbal Drugs on the streets of India. They have knowledge of medicinal plants – a skill which inherited from their forefathers. Also they are aware of the medicinal value of certain locally growing plants which are administered and control fertility and, do help family planning.

  18. 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.

  19. Policy environment for prevention, control and management of cardiovascular diseases in primary health care in Kenya.

    Science.gov (United States)

    Asiki, Gershim; Shao, Shuai; Wainana, Carol; Khayeka-Wandabwa, Christopher; Haregu, Tilahun N; Juma, Pamela A; Mohammed, Shukri; Wambui, David; Gong, Enying; Yan, Lijing L; Kyobutungi, Catherine

    2018-05-09

    In Kenya, cardiovascular diseases (CVDs) accounted for more than 10% of total deaths and 4% of total Disability-Adjusted Life Years (DALYs) in 2015 with a steady increase over the past decade. The main objective of this paper was to review the existing policies and their content in relation to prevention, control and management of CVDs at primary health care (PHC) level in Kenya. A targeted document search in Google engine using keywords "Kenya national policy on cardiovascular diseases" and "Kenya national policy on non-communicable diseases (NCDs)" was conducted in addition to key informant interviews with Kenyan policy makers. Relevant regional and international policy documents were also included. The contents of documents identified were reviewed to assess how well they aligned with global health policies on CVD prevention, control and management. Thematic content analysis of the key informant interviews was also conducted to supplement the document reviews. A total of 17 documents were reviewed and three key informants interviewed. Besides the Tobacco Control Act (2007), all policy documents for CVD prevention, control and management were developed after 2013. The national policies were preceded by global initiatives and guidelines and were similar in content with the global policies. The Kenya health policy (2014-2030), The Kenya Health Sector Strategic and Investment Plan (2014-2018) and the Kenya National Strategy for the Prevention and Control of Non-communicable diseases (2015-2020) had strategies on NCDs including CVDs. Other policy documents for behavioral risk factors (The Tobacco Control Act 2007, Alcoholic Drinks Control (Licensing) Regulations (2010)) were available. The National Nutrition Action Plan (2012-2017) was available as a draft. Although Kenya has a tiered health care system comprising primary healthcare, integration of CVD prevention and control at PHC level was not explicitly mentioned in the policy documents. This review revealed

  20. 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...

  1. Birth of a megaproject: Political economy of flood control in bangladesh

    Science.gov (United States)

    Boyce, James K.

    1990-07-01

    A major flood control initiative has been launched in Bangladesh under the coordination of the World Bank. The bank's five-year Action Plan is intended to initiate a long-term investment program, the specifics of which remain to be determined. Long-term proposals under consideration include the construction of massive embankments along the great rivers of the Bangladesh delta. The wisdom of such a “structural solution” to Bangladesh's flood problems can be questioned on economic, environmental, and technical grounds. Regrettably, the decision-making process has not encouraged wide debate on these questions.

  2. School-based obesity policy, social capital, and gender differences in weight control behaviors.

    Science.gov (United States)

    Zhu, Ling; Thomas, Breanca

    2013-06-01

    We examined the associations among school-based obesity policies, social capital, and adolescents' self-reported weight control behaviors, focusing on how the collective roles of community and adopted policies affect gender groups differently. We estimated state-level ecologic models using 1-way random effects seemingly unrelated regressions derived from panel data for 43 states from 1991 to 2009, which we obtained from the Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance System. We used multiplicative interaction terms to assess how social capital moderates the effects of school-based obesity policies. School-based obesity policies in active communities were mixed in improving weight control behaviors. They increased both healthy and unhealthy weight control behaviors among boys but did not increase healthy weight control behaviors among girls. Social capital is an important contextual factor that conditions policy effectiveness in large contexts. Heterogeneous behavioral responses are associated with both school-based obesity policies and social capital. Building social capital and developing policy programs to balance outcomes for both gender groups may be challenging in managing childhood obesity.

  3. Promoting Evidence to Policy Link on the Control of Infectious Diseases of Poverty in Nigeria: Outcome of A Multi-Stakeholders Policy Dialogue

    Science.gov (United States)

    Uneke, Chigozie Jesse; Ebeh Ezeoha, Abel; Uro-Chukwu, Henry; Ezeonu, Chinonyelum Thecla; Ogbu, Ogbonnaya; Onwe, Friday; Edoga, Chima

    2015-01-01

    Background: In Nigeria, malaria, schistosomiasis and lymphatic filariasis are among infectious diseases of poverty (IDP) with severe health burden and require effective policy strategies for their control. In this study, we investigated the value of policy brief and policy dialogue as excellent policymaking mechanisms that enable policymakers to adapt effective evidence informed policy for IDP control. Methods: A policy brief was developed on the control of malaria, schistosomiasis and lymphatic filariasis and subjected to deliberations in a one-day multi-stakeholder policy dialogue held in Ebonyi State Nigeria. A modified cross sectional intervention study design was used in this investigation. Structured pre-tested questionnaires were used to evaluate the policy brief document and policy dialogue process at the end of the policy dialogue. Results: Forty-seven policymakers participated in the dialogue. An analysis of the response on the policy brief regarding context, different features of the problem; policy options and key implementation considerations indicated the mean ratings (MNRs) mostly ranged from 6.40-6.85 on 7 point scale. The over-all assessment of the policy brief had MNR at 6.54. The analysis of the response on the policy dialogue regarding the level of priority of policy issue, opportunity to discuss different features of the problem and options for addressing the problem, and the MNRs mostly ranged from 6.50-6.82. The overall assessment of the policy dialogue had MNR at 6.72. Conclusion: Policy dialogues can allow research evidence to be considered together with views, experiences and tacit knowledge of policymakers and can enhance evidence-to-policy link. PMID:26290826

  4. [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.

  5. A Randomized, Controlled Trial of Behavioral Voice Therapy for Dysphonia Related to Prematurity of Birth.

    Science.gov (United States)

    Reynolds, Victoria; Meldrum, Suzanne; Simmer, Karen; Vijayasekaran, Shyan; French, Noel

    2017-03-01

    Dysphonia is a potential complication of prematurity. Preterm children may sustain iatrogenic laryngeal damage from medical intervention in the neonatal period, and further, adopt compensatory, maladaptive voicing behaviors. This pilot study aimed to evaluate the effects of a voice therapy protocol on voice quality in school-aged, very preterm (VP) children. Twenty-seven VP children with dysphonia were randomized to an immediate intervention group (n = 7) or a delayed-intervention, waiting list control group (n = 14). Following analysis of these data, a secondary analysis was conducted on the pooled intervention data (n = 21). Six participants did not complete the trial. Change to voice quality was measured via pre- and posttreatment assessments using the Consensus Auditory Perceptual Evaluation of Voice. The intervention group did not demonstrate statistically significant improvements in voice quality, whereas this was observed in the control group (P = 0.026). However, when intervention data were pooled including both the immediate and delayed groups following intervention, dysphonia severity was significantly lower (P = 0.026) in the treatment group. Dysphonia in most VP children in this cohort was persistent. These pilot data indicate that some participants experienced acceptable voice outcomes on spontaneous recovery, whereas others demonstrated a response to behavioral intervention. Further research is needed to identify the facilitators of and barriers to intervention success, and to predict those who may experience spontaneous recovery. Copyright © 2017 The Voice Foundation. All rights reserved.

  6. Preterm Birth

    Science.gov (United States)

    ... for Health Care Providers For Health Care Providers: Electronic Nicotine Delivery Systems and Pregnancy CDC Activities Resources ... births and improving neonatal outcomes. View the archived presentation and publication Related Links Is It Worth It? ...

  7. Engaging China in the International Export Control Process: Options for U.S. Policy

    National Research Council Canada - National Science Library

    Goldman, Charles

    1995-01-01

    This documented briefing is intended to provide options for U.S. policy that will enhance China's participation in the control of international transfers of destabilizing military or dual use technology...

  8. Gambling on the Protestants: the Pathfinder Fund and birth control in Peru, 1958-1965.

    Science.gov (United States)

    López, L Necochea

    2014-01-01

    Among the agencies involved in population control activities in the mid-twentieth century, none scored as many early victories in Latin America as did the Pathfinder Fund, founded by Procter & Gamble scion Clarence Gamble. This article analyzes a style in the delivery of family planning assistance in the developing world through the work of the Pathfinder Fund in Peru, the organization's hub in South America, and shows how Pathfinder personnel collaborated with local Protestant institutions. Its Protestant allies helped Pathfinder set up and manage rapid interventions such as the production of pamphlets, the smuggling of contraceptives, and the enrollment of physicians as advocates of the use of intrauterine devices. Although these rapid interventions helped quickly disseminate information and certain technologies among a fortunate few, they also weakened legitimate state agencies, neglected the monitoring of the safety of the drugs supplied, and alienated allies with their high-handed boldness.

  9. 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.

  10. 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.

  11. Environmental control policy change in the EU between ideas and reality; Umweltpolitischer Steuerungswechsel in der EU zwischen Ideen und Realitaet

    Energy Technology Data Exchange (ETDEWEB)

    Heumader, Katja

    2014-07-01

    The study on the environmental policy change in the EU covers the following issues: theoretical frame work: the scientific policy debate on political control and governance; boom of ideas: development in the discussion on European environmental policy; discrepancies: the change of political control between intention and realization; case studies: EU policy concerning the enhancement of energy efficiency, the groundwater guideline, waste policy and waste stream priorities, the European emission trading system, access to jurisdiction for environmental issues, the soil protection guideline.

  12. Influence of recent tobacco control policies and campaigns on Quitline call volume in Korea

    Directory of Open Access Journals (Sweden)

    Jin-Ju Park

    2018-03-01

    It appears that the continuous efforts to add up of tobacco control policies in the context of a nationwide anti-tobacco mass media campaign that includes the Quitline number is the most effective approach to maintaining the upward trend in smoking cessation intentions. Based on the Korean experience, Quitline data may be useful for measuring the impact of tobacco control policies and campaigns in Asian Pacific countries.

  13. Postnational or National Europe? European Asylum Policies and Immigration Controls

    Directory of Open Access Journals (Sweden)

    Vedrana Baričević

    2011-01-01

    Full Text Available The paper deals with the theories of the transformation of the modern functions of the nation state and the immigrant membership associated with the (legally defined status of community members exemplified by asylum policies. In the process, two fundamental approaches to the issue are distinguished: the first one emphasizing changes in the institution of the traditional national citizenship and competences of the nation state, while stressing a predominantly national character of the institution of citizenship, and the second one, which emphasizes the transformation of traditional citizenships, stressing the weakening of the role of the nation state. Therefore, in the latter case, there is increasingly more talk about postnationalism, which is a term denoting the transformation of the substantive aspects of citizenship in the EU countries. The mentioned theoretical approaches are applied to three groups of issues. First, the impact of the EU on the processes of the globalisation of the rights of asylum migrants are examined. Second, the paper works out the details of the way of formulating the policy of asylum membership in the EU member states. Third, the question of whether universal postnational inclusion of asylum migrants is at work in the EU member states, or whether the status of this group of immigrants should be found within the limits of the traditional theory of state membership and national sovereignty is addressed

  14. Pollution control through innovation and technological development. Environmental policy concepts of the BDI

    Energy Technology Data Exchange (ETDEWEB)

    Meller, E

    1987-02-01

    Increasing acceptance of pollution control tasks call for enhanced innovative power both of industry and politics. One pre-requisite of boosting innovation is an environmental policy concept fit into the framework of the economic policy: A clear environmental strategy stating priorities and foreseeable, fixed data for the required adjustment of industry, selection of pollution control measures by means of verifiable cost-benefit analyses in cooperation with industry, embedding environmental policy in the context of the free market system and harmonization of means and methods on an international level. (orig./HSCH).

  15. Promoting Implementation of Tobacco Control Laws and Policies in ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The looming tobacco epidemic and its potential for thwarting development has prompted most governments in sub-Saharan Africa to ratify the World Health Organization's Framework Convention on Tobacco Control (WHO-FCTC). Ratifying countries must design and implement a national tobacco control action plan and ...

  16. 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

  17. Soviet declaratory policy regarding the controllability of escalation

    International Nuclear Information System (INIS)

    Prewitt, J.L.

    1991-01-01

    Three variables were examined for their affect on Soviet views regarding the controllability of escalation. The first was bureaucratic affiliation. It was hypothesized that individuals affiliated with groups which directly controlled weapons would be more likely to support the controllability of escalation than those who were members of groups which did not control weapons. This hypothesis could not be rejected. The second variable was a commentator's rank. It was hypothesized that rank would act in two ways: (1) ideas regarding controlled escalation would appear at lower ranks first; and (2) unique views would be produced by specialized ranks within groups. The rank hypothesis could not be rejected. Certain escalation themes appeared to be presented first by military and civilian writers before being presented by the political leadership. The third variable, image of the West, did not appear to function as theorized. It was hypothesized that hard images of the West would be associated with the rejection of controlled escalation, whereas soft images would be associated with positions suggesting that escalation was controlled through joint US-Soviet cooperation

  18. Influence of export control policy on the competitiveness of machine tool producing organizations

    Science.gov (United States)

    Ahrstrom, Jeffrey D.

    The possible influence of export control policies on producers of export controlled machine tools is examined in this quantitative study. International market competitiveness theories hold that market controlling policies such as export control regulations may influence an organization's ability to compete (Burris, 2010). Differences in domestic application of export control policy on machine tool exports may impose throttling effects on the competitiveness of participating firms (Freedenberg, 2010). Commodity shipments from Japan, Germany, and the United States to the Russian market will be examined using descriptive statistics; gravity modeling of these specific markets provides a foundation for comparison to actual shipment data; and industry participant responses to a user developed survey will provide additional data for analysis using a Kruskal-Wallis one-way analysis of variance. There is scarce academic research data on the topic of export control effects within the machine tool industry. Research results may be of interest to industry leadership in market participation decisions, advocacy arguments, and strategic planning. Industry advocates and export policy decision makers could find data of interest in supporting positions for or against modifications of export control policies.

  19. Digital Distributed Control System Design: Control Policy for Shared Objects in HTR-PM

    International Nuclear Information System (INIS)

    Zhou Shuqiao; Huang Xiaojin

    2014-01-01

    HTR-PM is an HTR demonstration plant with a structure of two modules feeding one steam turbine. Compared with the structure of one single reactor feeding one turbine, there are more devices shared between these two modules. When they are operated, the shared components are prone to introduce collisions or even logical deadlocks for different technical processes. The future commercial HTR-PM plants are supposed to comprise more modules for a larger turbine, thus the collision problem introduced by the shared components may become severer. Therefore, how to design suitable policies in the distributed control system (DCS) to relieve the collisions during using these shared devices is a new and also a very important problem. In this paper, the classifications of the shared devices are first addressed, and then how to identify the shared objects of an NPP is proposed. Furthermore, a general model for the control logic design is proposed, taking into consideration the collision avoidance, time delay and fairness. The example of how to apply the schemes to relieve the conflicts and deadlocks in the processes of using the shared devices in fuel element cycling system is illustrated. (author)

  20. 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...

  1. Radioactive wastes and residues: government participation in a control policy

    International Nuclear Information System (INIS)

    Gelli, Guido

    1993-01-01

    This paper discusses the politic aspects of the State participation in inspection and control of the radioactive wastes residues with the supervise of Brazilian Nuclear Energy Commission (CNEN), by a national program

  2. 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.

  3. 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).

  4. Precipitous Birth

    Directory of Open Access Journals (Sweden)

    Jennifer Yee

    2017-09-01

    Full Text Available Audience: This scenario was developed to educate emergency medicine residents on the management of a precipitous birth in the emergency department (ED. The case is also appropriate for teaching of medical students and advanced practice providers, as well as reviewing the principles of crisis resource management, teamwork, and communication. Introduction: Patients with precipitous birth require providers to manage two patients simultaneously with limited time and resources. Crisis resource management skills will be tested once baby is delivered, and the neonate will require assessment for potential neonatal resuscitation. Objectives: At the conclusion of the simulation session, learners will be able to manage women who have precipitous deliveries, as well as perform neonatal assessment and management. Method: This session was conducted using high-fidelity simulation, followed by a debriefing session and lecture on precipitous birth management and neonatal evaluation.

  5. Feedback control policies employed by people using intracortical brain-computer interfaces

    Science.gov (United States)

    Willett, Francis R.; Pandarinath, Chethan; Jarosiewicz, Beata; Murphy, Brian A.; Memberg, William D.; Blabe, Christine H.; Saab, Jad; Walter, Benjamin L.; Sweet, Jennifer A.; Miller, Jonathan P.; Henderson, Jaimie M.; Shenoy, Krishna V.; Simeral, John D.; Hochberg, Leigh R.; Kirsch, Robert F.; Bolu Ajiboye, A.

    2017-02-01

    Objective. When using an intracortical BCI (iBCI), users modulate their neural population activity to move an effector towards a target, stop accurately, and correct for movement errors. We call the rules that govern this modulation a ‘feedback control policy’. A better understanding of these policies may inform the design of higher-performing neural decoders. Approach. We studied how three participants in the BrainGate2 pilot clinical trial used an iBCI to control a cursor in a 2D target acquisition task. Participants used a velocity decoder with exponential smoothing dynamics. Through offline analyses, we characterized the users’ feedback control policies by modeling their neural activity as a function of cursor state and target position. We also tested whether users could adapt their policy to different decoder dynamics by varying the gain (speed scaling) and temporal smoothing parameters of the iBCI. Main results. We demonstrate that control policy assumptions made in previous studies do not fully describe the policies of our participants. To account for these discrepancies, we propose a new model that captures (1) how the user’s neural population activity gradually declines as the cursor approaches the target from afar, then decreases more sharply as the cursor comes into contact with the target, (2) how the user makes constant feedback corrections even when the cursor is on top of the target, and (3) how the user actively accounts for the cursor’s current velocity to avoid overshooting the target. Further, we show that users can adapt their control policy to decoder dynamics by attenuating neural modulation when the cursor gain is high and by damping the cursor velocity more strongly when the smoothing dynamics are high. Significance. Our control policy model may help to build better decoders, understand how neural activity varies during active iBCI control, and produce better simulations of closed-loop iBCI movements.

  6. More appropriate disease control policies for the developing world : policy and trade issues

    Directory of Open Access Journals (Sweden)

    J.C. Mariner

    2009-09-01

    Full Text Available Investment in disease control should be targeted to critical points that provide the greatest benefit to the livelihoods of livestock-dependent stakeholders. Risk-based targeting should balance the impacts of diseases against the feasibility of their control. This requires sensitive and specific surveillance systems that provide representative overviews of the animal health situation for accurate assessment of disease impact and transmission patterns. Assessment of impact should include household and market effects. The key in surveillance is involving livestock owners using active methods that ensure their disease priorities are addressed. Epidemiological targeting of interventions to critical points in disease transmission cycles should be done to obtain maximal disease reduction. Interventions should be delivered in full partnership with both private and community-based stakeholders to assure high uptake and sustainability. In developing countries, approaches such as participatory disease surveillance and community-based animal health programs have been effective and comply with international animal health standards.

  7. Analysis and control design of sustainable policies for greenhouse gas emissions

    International Nuclear Information System (INIS)

    Chu, Bing; Duncan, Stephen; Papachristodoulou, Antonis; Hepburn, Cameron

    2013-01-01

    Reducing greenhouse gas emissions is now an urgent priority. Systems control theory, and in particular feedback control, can be helpful in designing policies that achieve sustainable levels of emissions of CO 2 (and other greenhouse gases) while minimizing the impact on the economy, and at the same time explicitly addressing the high levels of uncertainty associated with predictions of future emissions. In this paper, we describe preliminary results for an approach where model predictive control (MPC) is applied to a model of the UK economy (UK 4see model) as a test bed to design sustainable policies for greenhouse gas emissions. Using feedback control, the policies are updated on the basis of the actual emissions, rather than on the predicted level of emissions. The basic structure and principle of the UK 4see model is described and its implementation in Simulink is presented. A linearized state space model is obtained and model predictive control is applied to design policies for CO 2 emissions. Simulation results are presented to demonstrate the effectiveness of the proposed method. The preliminary results obtained in this paper illustrate the strength of the proposed design approach and form the basis for future research on using systems control theory to design optimal sustainable policies

  8. Birth control pill - slideshow

    Science.gov (United States)

    ... Duplication for commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow us Disclaimers Copyright ...

  9. Birth control methods (image)

    Science.gov (United States)

    ... t allow egg implantation. The hormones in oral contraceptives and hormone implants fool the ovaries into refraining ... egg, pregnancy will not occur. IUDs and oral contraceptives and hormones may be used as emergency contraception ...

  10. Birth Control Methods

    Science.gov (United States)

    ... federal government website managed by the Office on Women's Health in the Office of the Assistant Secretary for Health at the U.S. Department of Health and Human Services . 200 Independence Avenue, S.W., Washington, DC 20201 1-800-994- ...

  11. Tobacco Taxes and Tobacco Control Policies in Brazil, Mexico, and ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    However, research has yet to explore differences in cigarette smoking rates ... Meanwhile, existing studies on the impact of tobacco taxes are based on ... Associação de Controle do Tabagismo, Promoção da Saúde e dos Direitos Humanos.

  12. Impact of Scheduling Policies on Control System Performance

    DEFF Research Database (Denmark)

    Schiøler, Henrik; Ravn, Anders Peter; Nielsen, Jens Frederik Dalsgaard

    in the deterministic case and under white noise disturbances. The conclusion is that under very reasonable assumptions about robustness of control algorithms,they are insensitive to relase jitter, albeit strongly sensitive to completion jitter, thus priority based scheduling without preemption is may be preferable...

  13. Probing into the effectiveness of self-isolation policies in epidemic control

    International Nuclear Information System (INIS)

    Crokidakis, Nuno; Duarte Queirós, Sílvio M

    2012-01-01

    In this work, we inspect the reliability of controlling and quelling an epidemic disease mimicked by a susceptible–infected–susceptible (SIS) model defined on a complex network by means of current and implementable quarantine and isolation policies. Specifically, we consider that each individual in the network is originally linked to individuals of two types: members of the same household and acquaintances. The topology of this network evolves, taking into account a probability q that aims at representing the quarantine or isolation process in which the connection with acquaintances is severed according to standard policies of control of epidemics. Within current policies of self-isolation and standard infection rates, our results show that the propagation is either only controllable for hypothetical rates of compliance or not controllable at all

  14. Socioeconomic inequalities in the impact of tobacco control policies on adolescent smoking

    DEFF Research Database (Denmark)

    Pförtner, Timo-Kolja; Hublet, Anne; Schnohr, Christina Warrer

    2016-01-01

    INTRODUCTION: There are concerns that tobacco control policies may be less effective in reducing smoking among disadvantaged socioeconomic groups and thus may contribute to inequalities in adolescent smoking. This study examines how the association between tobacco control policies and smoking of 15...... regression analyses were conducted to assess the association of weekly smoking with components of the Tobacco Control Scale (TCS), and to assess whether this association varied according to family affluence (FAS). Analyses were carried out per gender and adjusted for national wealth and general smoking rate...

  15. Nuclear controls and its correlation with the energy policy in two Koreas

    International Nuclear Information System (INIS)

    Choi, G. G.; Choi, Y. M.; Ahn, J. S.; Kim, J. S.

    2003-01-01

    The purpose of this paper is to analyse how the nuclear controls, main tools of implementation for the international NPT regime, have been understood and taken by two Koreas, and also what kind of influence it has on the energy policies of two Koreas as a national energy resources. Even though two Koreas have shown different position in their understanding and their reactions for the nuclear controls, there exist a close correlation between the nuclear controls and energy policies in the sense that they approach nuclear energy question as an essential way to make sure energy resources for industrial and social development

  16. CERN’s Computing rules updated to include policy for control systems

    CERN Multimedia

    IT Department

    2008-01-01

    The use of CERN’s computing facilities is governed by rules defined in Operational Circular No. 5 and its subsidiary rules of use. These rules are available from the web site http://cern.ch/ComputingRules. Please note that the subsidiary rules for Internet/Network use have been updated to include a requirement that control systems comply with the CNIC(Computing and Network Infrastructure for Control) Security Policy. The security policy for control systems, which was approved earlier this year, can be accessed at https://edms.cern.ch/document/584092 IT Department

  17. Security, development and human rights: normative, legal and policy challenges for the international drug control system.

    Science.gov (United States)

    Barrett, Damon

    2010-03-01

    This commentary addresses some of the challenges posed by the broader normative, legal and policy framework of the United Nations for the international drug control system. The 'purposes and principles' of the United Nations are presented and set against the threat based rhetoric of the drug control system and the negative consequences of that system. Some of the challenges posed by human rights law and norms to the international drug control system are also described, and the need for an impact assessment of the current system alongside alternative policy options is highlighted as a necessary consequence of these analyses. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  18. Impact of California air quality control policies on the use and demand for natural gas

    International Nuclear Information System (INIS)

    Boyd, J.D.

    1992-01-01

    This paper discusses the impact of California's air quality control policies on the use of natural gas. In this paper the author would like to briefly review the regulatory structure for air pollution control in California, summarize the requirement of the California Clean Air Act of 1988, and discuss the impacts of our regulatory programs on the use and demand for natural gas

  19. Can early intervention policies improve wellbeing? Evidence from a randomized controlled trial

    OpenAIRE

    Michael Daly; Liam Delaney; Orla Doyle; Nick Fitzpatrick; Christine O'Farrelly

    2014-01-01

    Many authors have proposed incorporating measures of well-being into evaluations of public policy. Yet few evaluations use experimental design or examine multiple aspects of well-being, thus the causal impact of public policies on well-being is largely unknown. In this paper we examine the effect of an intensive early intervention program on maternal well-being in a targeted disadvantaged community. Using a randomized controlled trial design we estimate and compare treatment effects on global...

  20. Can Early Intervention Policies Improve Well-being? Evidence from a randomized controlled trial

    OpenAIRE

    Daly, Michael; Delaney, Liam; Doyle, Orla; Fitzpatrick, Nick; O'Farrelly, Christine

    2014-01-01

    Many authors have proposed incorporating measures of well-being into evaluations of public policy. Yet few evaluations use experimental design or examine multiple aspects of wellbeing, thus the causal impact of public policies on well-being is largely unknown. In this paper we examine the effect of an intensive early intervention program on maternal wellbeing in a targeted disadvantaged community. Using a randomized controlled trial design we estimate and compare treatment effects on global w...

  1. 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

  2. Impact of tobacco control policy on teenager population in Uruguay

    Directory of Open Access Journals (Sweden)

    Winston Abascal

    2017-03-01

    Full Text Available Objective. To analyze the evolution of the prevalence of tobacco use, comparing data obtained from the Global Youth Tobacco Survey in 2007 and 2014 editions. Materials and methods. Data from the World Youth Tobacco Survey 2007 and 2014 were compared. Tobacco control measures implemented in the period under review were also analyzed. Results. Data shows a decrease in 30-day cigarette consumption in population aged 13 to 15 years: from 20.2% in 2007 to 8.2% in 2014. No significant differences were found between the sexes. Susceptibility to become a smoker in the next year decreased from 25.8% in 2007 to 16.6% in 2014. Conclusions. The implementation, almost simultaneously, of measures included in WHO Framework Convention for Tobacco Control, is an effective strategy to achieve the objectives of reducing the prevalence of tobacco use.

  3. [Impact of tobacco control policy on teenager population in Uruguay].

    Science.gov (United States)

    Abascal, Winston; Lorenzo, Ana

    2017-01-01

    To analyze the evolution of the prevalence of tobacco use, comparing data obtained from the Global Youth Tobacco Survey in 2007 and 2014 editions. Data from the World Youth Tobacco Survey 2007 and 2014 were compared. Tobacco control measures implemented in the period under review were also analyzed. Data shows a decrease in 30-day cigarette consumption in population aged 13 to 15 years: from 20.2% in 2007 to 8.2% in 2014. No significant differences were found between the sexes. Susceptibility to become a smoker in the next year decreased from 25.8% in 2007 to 16.6% in 2014. The implementation, almost simultaneously, of measures included in WHO Framework Convention for Tobacco Control, is an effective strategy to achieve the objectives of reducing the prevalence of tobacco use.

  4. Technology in the policy process - controlling nuclear power

    International Nuclear Information System (INIS)

    Collingridge, D.

    1983-01-01

    The discussion in this book is built around nuclear power. The technology of nuclear power is shown to have features which make it inflexible in the sense that, once built, it is difficult and expensive to control. If inflexible technology is to be avoided, it is crucially important to be able to identify this failing at an early stage in the technology's development, before it has acquired an immunity to political control. Again, this problem is approached through the example of nuclear power, in particular the breeder reactor. The breeder is shown to be even less flexible than today's nuclear technology, because it will have higher capital costs, be of greater capital intensity, longer lead time, larger unit size, and will require more infrastructure for its operation. If this is developed, the breeder will be even less open to political control than the nuclear plant of the present. To put it another way, its planning will be even more open to errors and whatever errors are made will be even more costly than for existing nuclear technology. It is therefore even less of a socially and economically acceptable technology than today's nuclear power. (author)

  5. Air Pollution Prevention and Control Policy in China.

    Science.gov (United States)

    Huang, Cunrui; Wang, Qiong; Wang, Suhan; Ren, Meng; Ma, Rui; He, Yiling

    2017-01-01

    With rapid urbanization and development of transport infrastructure, air pollution caused by multiple-pollutant emissions and vehicle exhaust has been aggravated year by year in China. In order to improve air quality, the Chinese authorities have taken a series of actions to control air pollution emission load within a permissible range. However, although China has made positive progress on tackling air pollution, these actions have not kept up with its economy growth and fossil-fuel use. The traditional single-pollutant approach is far from enough in China now, and in the near future, air pollution control strategies should move in the direction of the multiple-pollutant approach. In addition, undesirable air quality is usually linked with the combination of high emissions and adverse weather conditions. However, few studies have been done on the influence of climate change on atmospheric chemistry in the global perspective. Available evidence suggested that climate change is likely to exacerbate certain kinds of air pollutants including ozone and smoke from wildfires. This has become a major public health problem because the interactions of global climate change, urban heat islands, and air pollution have adverse effects on human health. In this chapter, we first review the past and current circumstances of China's responses to air pollution. Then we discuss the control challenges and future options for a better air quality in China. Finally, we begin to unravel links between air pollution and climate change, providing new opportunities for integrated research and actions in China.

  6. 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....

  7. Barriers to adopting and implementing local-level tobacco control policies.

    Science.gov (United States)

    Satterlund, Travis D; Cassady, Diana; Treiber, Jeanette; Lemp, Cathy

    2011-08-01

    Although California communities have been relatively successful in adopting and implementing a wide range of local tobacco control policies, the process has not been without its setbacks and barriers. Little is known about local policy adoption, and this paper examines these processes related to adopting and implementing outdoor smoke-free policies, focusing on the major barriers faced by local-level tobacco control organizations in this process. Ninety-six projects funded by the California Tobacco Control Program submitted final evaluation reports pertaining to an outdoor smoking objective, and the reports from these projects were analyzed. The barriers were grouped in three primary areas: politically polarizing barriers, organizational barriers, and local political orientation. The barriers identified in this study underscore the need for an organized action plan in adopting local tobacco policy. The authors also suggest potential strategies to offset the barriers, including: (1) having a "champion" who helps to carry an objective forward; (2) tapping into a pool of youth volunteers; (3) collecting and using local data as a persuasive tool; (4) educating the community in smoke-free policy efforts; (5) working strategically within the local political climate; and (6) demonstrating to policymakers the constituent support for proposed policy.

  8. The politics of drug control in Nigeria: Exclusion, repression and obstacles to policy change.

    Science.gov (United States)

    Klantschnig, Gernot

    2016-04-01

    International agencies have viewed West Africa as a major player in the global trade in cocaine and heroin and in efforts to control that trade, as there have been reports of escalating arrests of drug smugglers, large-scale drug seizures and 'narco-states' in the subregion. It is claimed that a substantial share of the drugs available in Western markets transit through West Africa today and are increasingly used there as well. Notwithstanding this growing alarm, there is little serious scholarship addressing the issue of drugs and drug policy in West Africa. The article assesses and challenges some of the existing depictions of drugs and drug policy in West Africa through an empirical case study of drug control in Nigeria - one of West Africa's most notorious 'drug hubs' and recently hailed as a policy model by international experts. Based on previously inaccessible government documents, interviews with key officials in Nigeria, as well as ethnographic work at Nigeria's key drug agency, the article provides a unique insight into the politics of drug policy-making and implementation in West Africa. After describing the dominant official narratives of Nigeria's drug control, the article shows how the key political dynamics underlying drug policy remain obscured by these narratives. Nigerian drug policy has been characterised by a highly exclusive policy-making process, repression as the sole means of implementation and a strong bond with international drug agencies. This policy emerged in the 1980s and 1990s and has remained the unchallenged norm until today. The political processes underlying Nigerian drug policy also explain why policy reform has been and will be difficult to accomplish. These domestic political processes have largely been ignored in the existing depictions of drugs in West Africa, as they have mainly focused on externally driven drug threats and foreign policy responses. Most importantly, they have ignored the role played by the state. Rather

  9. 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

  10. Sweden SimSmoke: the effect of tobacco control policies on smoking and snus prevalence and attributable deaths

    OpenAIRE

    Near, Aimee M.; Blackman, Kenneth; Currie, Laura M.; Levy, David T.

    2013-01-01

    Background: This study examines the effect of past tobacco control policies and projects the effect of future policies on smoking and snus use prevalence and associated premature mortality in Sweden. Methods: The established SimSmoke model was adapted with population, smoking rates and tobacco control policy data from Sweden. SimSmoke evaluates the effect of taxes, smoke-free air, mass media, marketing bans, warning labels, cessation treatment and youth access policies on smoking and snus pre...

  11. Risk factors for low birth-weight in areas with varying malaria transmission in Korogwe, Tanzania: implications for malaria control

    DEFF Research Database (Denmark)

    Mmbando, Bruno Paul; Cole-Lewis, H; Sembuche, S

    2008-01-01

    Low birth weight (LBW) is a risk factor for infant mortality, morbidity, growth retardation, poor cognitive development, and chronic diseases. Maternal exposure to diseases such as malaria, HIV, and syphilis has been shown to have a significant impact on birth weight (BW). This study was aimed...... babies compared to first parity women (OR=0.44, 95% CI 0.19-0.98, P=0.045). Similarly, the risk of LBW was higher in women who had delayed MCH gestational booking and in women who conceived during high malaria transmission seasons. There was high degree of preference of digits ending with 0...

  12. Progesterone for the prevention of preterm birth in twin pregnancy (STOPPIT): a randomised, double-blind, placebo-controlled study and meta-analysis.

    Science.gov (United States)

    Norman, Jane E; Mackenzie, Fiona; Owen, Philip; Mactier, Helen; Hanretty, Kevin; Cooper, Sarah; Calder, Andrew; Mires, Gary; Danielian, Peter; Sturgiss, Stephen; MacLennan, Graeme; Tydeman, Graham; Thornton, Steven; Martin, Bill; Thornton, James G; Neilson, James P; Norrie, John

    2009-06-13

    Women with twin pregnancy are at high risk for spontaneous preterm delivery. Progesterone seems to be effective in reducing preterm birth in selected high-risk singleton pregnancies, albeit with no significant reduction in perinatal mortality and little evidence of neonatal benefit. We investigated the use of progesterone for prevention of preterm birth in twin pregnancy. In this double-blind, placebo-controlled trial, 500 women with twin pregnancy were recruited from nine UK National Health Service clinics specialising in the management of twin pregnancy. Women were randomised, by permuted blocks of randomly mixed sizes, either to daily vaginal progesterone gel 90 mg (n=250) or to placebo gel (n=250) for 10 weeks from 24 weeks' gestation. All study personnel and participants were masked to treatment assignment for the duration of the study. The primary outcome was delivery or intrauterine death before 34 weeks' gestation. Analysis was by intention to treat. Additionally we undertook a meta-analysis of published and unpublished data to establish the efficacy of progesterone in prevention of early (<34 weeks' gestation) preterm birth or intrauterine death in women with twin pregnancy. This study is registered, number ISRCTN35782581. Three participants in each group were lost to follow-up, leaving 247 analysed per group. The combined proportion of intrauterine death or delivery before 34 weeks of pregnancy was 24.7% (61/247) in the progesterone group and 19.4% (48/247) in the placebo group (odds ratio [OR] 1.36, 95% CI 0.89-2.09; p=0.16). The rate of adverse events did not differ between the two groups. The meta-analysis confirmed that progesterone does not prevent early preterm birth in women with twin pregnancy (pooled OR 1.16, 95% CI 0.89-1.51). Progesterone, administered vaginally, does not prevent preterm birth in women with twin pregnancy. Chief Scientist Office of the Scottish Government Health Directorate.

  13. Periodontal disease and oral health-related behavior as factors associated with preterm birth: a case-control study in south-eastern Brazil.

    Science.gov (United States)

    Macedo, J F; Ribeiro, R A; Machado, F C; Assis, N M S P; Alves, R T; Oliveira, A S; Ribeiro, L C

    2014-08-01

    Several studies have suggested a link between periodontal disease and preterm birth, but the mechanism of how this occurs remains controversial. Therefore, this study aimed to investigate whether periodontal disease, defined according to two commonly used clinical definitions, is associated with preterm birth and to examine the association regarding oral health-related behaviors during pregnancy. This case-control study included women 18-40 years of age. Demographic and socio-economic data, information on current and previous pregnancies, and data on dental health-related behaviors and periodontal clinical parameters were collected within 48 h postpartum. Periodontal disease was assessed according to two definitions: four or more teeth with at least one site showing a probing depth of ≥ 4 mm and clinical attachment level of ≥ 3 mm (Definition 1); or at least one site with probing depth and clinical attachment level of ≥ 4 mm (Definition 2). The chi-square test was used to examine differences in the proportion of categorical variables. Bivariate analysis was performed to analyze the proportion of preterm births with respect to independent variables. Multiple logistic regression analyses were used to assess the association between periodontal disease and preterm birth. Odds ratios (ORs) were calculated with a 95% confidence interval (95% CI). A total of 296 postpartum women met the inclusion criteria. The case group included 74 women who delivered a preterm neonate (Periodontal disease according to Definition 1 was not associated with fewer weeks of gestation (adjusted OR (OR adjusted ) = 1.62; 95% CI = 0.80-3.29; p = 0.178). However, a significant association was found between periodontal disease, according to Definition 2, and preterm birth (OR adjusted = 1.98; 95% CI = 1.14-3.43; p = 0.015). Increased appetite and a low number of daily toothbrushings were associated with preterm birth, regardless of the definition of periodontal disease used. Periodontal

  14. Association between tobacco control policies and smoking behaviour among adolescents in 29 European countries

    DEFF Research Database (Denmark)

    Hublet, Anne; Schmid, Holger; Clays, Els

    2009-01-01

    AIMS: To investigate the associations between well-known, cost-effective tobacco control policies at country level and smoking prevalence among 15-year-old adolescents. DESIGN: Multi-level modelling based on the 2005-06 Health Behaviour in School-aged Children Study, a cross-national study...... at individual level, and with country-level variables from the Tobacco Control Scale and published country-level databases. SETTING: Twenty-nine European countries. PARTICIPANTS: A total of 25 599 boys and 26 509 girls. MAIN OUTCOME MEASURES: Self-reported regular smoking defined as at least weekly smoking...... vending machines) = -0.372, P = 0.06]. CONCLUSIONS: For boys, some of the currently recommended tobacco control policies may help to reduce smoking prevalence. However, the model is less suitable for girls, indicating gender differences in the potential efficacy of smoking policies. Future research should...

  15. IMPACTS OF GROUP-BASED SIGNAL CONTROL POLICY ON DRIVER BEHAVIOR AND INTERSECTION SAFETY

    Directory of Open Access Journals (Sweden)

    Keshuang TANG

    2008-01-01

    Full Text Available Unlike the typical stage-based policy commonly applied in Japan, the group-based control (often called movement-based in the traffic control industry in Japan refers to such a control pattern that the controller is capable of separately allocating time to each signal group instead of stage based on traffic demand. In order to investigate its applicability at signalized intersections in Japan, an intersection located in Yokkaichi City of Mie Prefecture was selected as an experimental application site by the Japan Universal Traffic Management Society (UTMS. Based on the data collected at the intersection before and after implementing the group-based control policy respectively, this study evaluated the impacts of such a policy on driver behavior and intersection safety. To specify those impacts, a few models utilizing cycle-based data were first developed to interpret the occurrence probability and rate of red-light-running (RLR. Furthermore, analyses were performed on the yellow-entry time (Ye of the last cleared vehicle and post encroachment time (PET during the phase switching. Conclusions supported that the group-based control policy, along with certain other factors, directly or indirectly influenced the RLR behavior of through and right-turn traffics. Meanwhile, it has potential safety benefits as well, indicated by the declined Ye and increased PET values.

  16. A New Regulation Policy for Accounting and Control of Nuclear Material

    Energy Technology Data Exchange (ETDEWEB)

    Kim, K. H.; Kim, M. S.; Ahn, S. H. [Korea Institute of Nuclear nonproliferation and Control, Daejeon (Korea, Republic of)

    2016-05-15

    Nuclear Safety and Security Commission(NSSC) has amended two public notices about the regulation of nuclear material accounting and control(NMAC). Those notices were declared in November 2014 and entry into force since 2015. According to this legislation, a new type of NMAC inspection system was introduced and facility rules for NMAC approved by the government should be revised subsequently. These changes were one of the preemptive actions to cope with the emergence of new international safeguards policy and increasing demand on advanced nuclear technology. Generally, the regulation policy affects the nuclear business including research and development. Therefore, understanding of the new policy and its making process may help stakeholders to minimize unnecessary financial and operational burden. This study describes background, features, and institutionalization of the new regulation policy for NMAC. The new regulation policy for NMAC was established and institutionalized to preemptively cope with the internal and external demand on 'better' national system of accounting and control of nuclear material. This new policy and regulation system may call not only the regulator but also nuclear business operators for new works to make their system more effective and efficient.

  17. A New Regulation Policy for Accounting and Control of Nuclear Material

    International Nuclear Information System (INIS)

    Kim, K. H.; Kim, M. S.; Ahn, S. H.

    2016-01-01

    Nuclear Safety and Security Commission(NSSC) has amended two public notices about the regulation of nuclear material accounting and control(NMAC). Those notices were declared in November 2014 and entry into force since 2015. According to this legislation, a new type of NMAC inspection system was introduced and facility rules for NMAC approved by the government should be revised subsequently. These changes were one of the preemptive actions to cope with the emergence of new international safeguards policy and increasing demand on advanced nuclear technology. Generally, the regulation policy affects the nuclear business including research and development. Therefore, understanding of the new policy and its making process may help stakeholders to minimize unnecessary financial and operational burden. This study describes background, features, and institutionalization of the new regulation policy for NMAC. The new regulation policy for NMAC was established and institutionalized to preemptively cope with the internal and external demand on 'better' national system of accounting and control of nuclear material. This new policy and regulation system may call not only the regulator but also nuclear business operators for new works to make their system more effective and efficient

  18. 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.

  19. International Guidelines on Human Rights and Drug Control: A Tool for Securing Women's Rights in Drug Control Policy.

    Science.gov (United States)

    Schleifer, Rebecca; Pol, Luciana

    2017-06-01

    Discrimination and inequality shape women's experiences of drug use and in the drug trade and the impact of drug control efforts on them, with disproportionate burdens faced by poor and otherwise marginalized women. In recent years, UN member states and UN drug control and human rights entities have recognized this issue and made commitments to integrate a 'gender perspective' into drug control policies, with 'gender' limited to those conventionally deemed women. But the concept of gender in international law is broader, rooted in socially constructed and culturally determined norms and expectations around gender roles, sex, and sexuality. Also, drug control policies often fail to meaningfully address the specific needs and circumstances of women (inclusively defined), leaving them at risk of recurrent violations of their rights in the context of drugs. This article explores what it means to 'mainstream' this narrower version of gender into drug control efforts, using as examples various women's experiences as people who use drugs, in the drug trade, and in the criminal justice system. It points to international guidelines on human rights and drug control as an important tool to ensure attention to women's rights in drug control policy design and implementation.

  20. 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.

  1. 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.

  2. Converging research needs across framework convention on tobacco control articles: making research relevant to global tobacco control practice and policy.

    Science.gov (United States)

    Leischow, Scott J; Ayo-Yusuf, Olalekan; Backinger, Cathy L

    2013-04-01

    Much of the research used to support the ratification of the WHO Framework Convention on Tobacco Control (FCTC) was conducted in high-income countries or in highly controlled environments. Therefore, for the global tobacco control community to make informed decisions that will continue to effectively inform policy implementation, it is critical that the tobacco control community, policy makers, and funders have updated information on the state of the science as it pertains to provisions of the FCTC. Following the National Cancer Institute's process model used in identifying the research needs of the U.S. Food and Drug Administration's relatively new tobacco law, a core team of scientists from the Society for Research on Nicotine and Tobacco identified and commissioned internationally recognized scientific experts on the topics covered within the FCTC. These experts analyzed the relevant sections of the FCTC and identified critical gaps in research that is needed to inform policy and practice requirements of the FCTC. This paper summarizes the process and the common themes from the experts' recommendations about the research and related infrastructural needs. Research priorities in common across Articles include improving surveillance, fostering research communication/collaboration across organizations and across countries, and tracking tobacco industry activities. In addition, expanding research relevant to low- and middle-income countries (LMIC), was also identified as a priority, including identification of what existing research findings are transferable, what new country-specific data are needed, and the infrastructure needed to implement and disseminate research so as to inform policy in LMIC.

  3. Telecommuting, Control, and Boundary Management: Correlates of Policy Use and Practice, Job Control, and Work-Family Effectiveness

    Science.gov (United States)

    Kossek, Ellen Ernst; Lautsch, Brenda A.; Eaton, Susan C.

    2006-01-01

    We examine professionals' use of telecommuting, perceptions of psychological job control, and boundary management strategies. We contend that work-family research should distinguish between descriptions of flexibility use (formal telecommuting policy user, amount of telecommuting practiced) and how the individual psychologically experiences…

  4. Policy Gradient Adaptive Dynamic Programming for Data-Based Optimal Control.

    Science.gov (United States)

    Luo, Biao; Liu, Derong; Wu, Huai-Ning; Wang, Ding; Lewis, Frank L

    2017-10-01

    The model-free optimal control problem of general discrete-time nonlinear systems is considered in this paper, and a data-based policy gradient adaptive dynamic programming (PGADP) algorithm is developed to design an adaptive optimal controller method. By using offline and online data rather than the mathematical system model, the PGADP algorithm improves control policy with a gradient descent scheme. The convergence of the PGADP algorithm is proved by demonstrating that the constructed Q -function sequence converges to the optimal Q -function. Based on the PGADP algorithm, the adaptive control method is developed with an actor-critic structure and the method of weighted residuals. Its convergence properties are analyzed, where the approximate Q -function converges to its optimum. Computer simulation results demonstrate the effectiveness of the PGADP-based adaptive control method.

  5. MIGRATION POLICIES AND STATE CONTROL IN ARGENTINA: EXPERIENCES OF VULNERABLE BOLIVIAN WOMEN WHO CROSS THE BORDERS

    Directory of Open Access Journals (Sweden)

    Cynthia Pizarro

    2015-01-01

    Full Text Available This paper analyzes the way in which migration policies impact in the trajectories of Bolivian women who live and work in the outskirts of the main cities of Argentina. It focuses on three cases representative of the experiences of women laborers who, coming from the poorest rural areas of Bolivia, crossed the international border when Argentine migration policy was very restrictive. It shows that symbolic and socio-economic borders keep on excluding them, as well as other labor migrants, within the Argentine territory even when the current Migration Law enacted in 2004 is more inclusive, since it grants human and social rights to the migrants. It highlights the way in which particular state control mechanisms operate nowadays both at the international border and within the Argentine territory, and analyses the difficulties that these women experience due to their positions of class, ethnic, gender, nationality and migratory status. It remarks that despite the changes in the immigration policy of Argentina, state policies keep on controlling labor migrations in accordance with the paradigm of the governance of migration. It also analyses the strategies that these women develop in order to sort out state control policies. Therefore, it considers that they are active agents even though they still have feelings of fear and trauma associated with the crossing of borders.

  6. Teaching attachment behaviors to pregnant women: a randomized controlled trial of effects on infant mental health from birth to the age of three months.

    Science.gov (United States)

    Akbarzadeh, Marzieh; Dokuhaki, Akram; Joker, Azam; Pishva, Narges; Zare, Najaf

    2016-01-01

    Maternal-fetal attachment, which forms as soon as pregnancy starts, is essential to an infant's mental development. This study aimed to explore the effect of teaching attachment behaviors to pregnant women on infant mental health from birth to 3 months of age. Randomized controlled trial. Hafiz Hospital, Shiraz University of Medical Sciences, Iran, from February to November 2014. The participants were randomly divided into an intervention and a control group at 28-34 weeks gestation. The participants in the intervention group attended six educational sessions each lasting for 60-90 minutes. After delivery, the infants of mothers in each group were compared in terms of mental health indexes (total mean scores and scores derived from a checklist of questions for infant mental health with results categorized as low, average and high). Maternal anxiety levels were also recorded at birth and at 3 months. Infant mental health index. In 190 pregnant women (96 in the intervention group and 94 in the control group), the total mean (SD) scores for infant mental health at birth were 16.66 (1.51) in the intervention group and 16.07 (1.74) in the control group (P=.013). At 3 months, the total mental health scores infants were 31.05 (1.88) in the intervention group and 30.25 (2.10) in the control group (P=.007). Differences in checklist scores between the groups at 3 months were not statistically significant, except for crying intensity at 3 months (P=.021). Women in the control group had higher anxiety levels at 3 months (P=.01). Teaching attachment skills to mothers increased the attachment between the mothers and their infants, and consequently, improved infant mental health. Thus, teaching attachment skills should be incorporated into routine prenatal care. Use of phone calls by the researcher to assess mental health.

  7. Traditional Birth Attendant Training and Local Birthing Practices in India

    Science.gov (United States)

    Saravanan, Sheela; Turrell, Gavin; Johnson, Helen; Fraser, Jenny; Patterson, Carla

    2011-01-01

    Training birth attendants (TBAs) to provide essential maternal and infant health care services during delivery and ongoing community care in developing countries. Despite inadequate evidence of relevance and effectiveness of TBA training programmes, there has been a policy shift since the 1990s in that many donor agencies funding TBA training…

  8. Fine-grained policy control in U.S. Army Research Laboratory (ARL) multimodal signatures database

    Science.gov (United States)

    Bennett, Kelly; Grueneberg, Keith; Wood, David; Calo, Seraphin

    2014-06-01

    The U.S. Army Research Laboratory (ARL) Multimodal Signatures Database (MMSDB) consists of a number of colocated relational databases representing a collection of data from various sensors. Role-based access to this data is granted to external organizations such as DoD contractors and other government agencies through a client Web portal. In the current MMSDB system, access control is only at the database and firewall level. In order to offer finer grained security, changes to existing user profile schemas and authentication mechanisms are usually needed. In this paper, we describe a software middleware architecture and implementation that allows fine-grained access control to the MMSDB at a dataset, table, and row level. Result sets from MMSDB queries issued in the client portal are filtered with the use of a policy enforcement proxy, with minimal changes to the existing client software and database. Before resulting data is returned to the client, policies are evaluated to determine if the user or role is authorized to access the data. Policies can be authored to filter data at the row, table or column level of a result set. The system uses various technologies developed in the International Technology Alliance in Network and Information Science (ITA) for policy-controlled information sharing and dissemination1. Use of the Policy Management Library provides a mechanism for the management and evaluation of policies to support finer grained access to the data in the MMSDB system. The GaianDB is a policy-enabled, federated database that acts as a proxy between the client application and the MMSDB system.

  9. Political economy of tobacco control policy on public health in Japan.

    Science.gov (United States)

    Desapriya, E B R; Iwase, Nobutada; Shimizu, Shinji

    2003-02-01

    Tobacco use, particularly smoking, remains the number one cause of preventable disease and mortality in Japan. This review of the tobacco control policy and public health is the first to offer a composite review of the subject within Japan. This review attempts to evaluate the most important aspects of the current political economy of the tobacco control policy, and concludes that more effective control policies must be employed to minimize the impact of smoking on the public's health in Japan. Further the article attempts to place the approaches in the larger context of tobacco control, providing a vision for the future of tobacco prevention and control based on current knowledge. Tobacco use will remain the leading cause of preventable illness and death in Japan, until tobacco prevention and control efforts are commensurate with the harm caused by tobacco. Taken together, the results of various studies have clearly shown that control measures can influence tobacco smoking patterns, and in turn, the rate of tobacco-related problems. Government tobacco taxes have not kept pace with inflation for years. Availability of tobacco is virtually unlimited with easy access and the prices being very low due to the strong currency of Japan. Thus Japan must be one of the most tobacco accessible countries. It is important to ensure that people are not conditioned to smoke tobacco by an unduly favourable economic and commercial environment. For that reason, prevention advocates have called for substantial regulation of tobacco products and appeal for both tobacco tax increases and tobacco taxes to be indexed to inflation. In this review, present tobacco related public health policies in Japan are discussed with implication for prevention of tobacco related problems. Continued research in this area will be necessary to determine the most effective policies of reducing tobacco related problems in Japan.

  10. [Population policy: the legacy of Greek thought].

    Science.gov (United States)

    Elgegren Reategui, F

    1994-01-01

    The author "explains that the Greek philosophy and scientific thought developed elements of what is known today as population policies. These include roles and gender relationships, the population volume, the family, sexuality, birth control, eugenics, abortion and [quality of life]....The first part of the article reviews issues on family and women's roles. The second part is related to aspects associated with sexuality and...population policy." (SUMMARY IN ENG) excerpt

  11. 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.

  12. Population policy.

    Science.gov (United States)

    1987-03-01

    Participants in the Seminar on Population Policies for Top-level Policy Makers and Program Managers, meeting in Thailand during January 1987, examined the challenges now facing them regarding the implementation of fertility regulation programs in their respective countries -- Bangladesh, China, India, Indonesia, Malaysia, Nepal, Pakistan, the Philippines, the Republic of Korea, and Thailand. This Seminar was organized to coincide with the completion of an Economic and Social Commission for Asia and the Pacific (ESCAP) study investigating the impact and efficiency of family planning programs in the region. Country studies were reviewed at the Seminar along with policy issues about the status of women, incentive and disincentive programs, and socioeconomic factors affecting fertility. In Bangladesh the government recognizes population growth as its top priority problem related to the socioeconomic development of the country and is working to promote a reorientation strategy from the previous clinic-oriented to a multidimensional family welfare program. China's family planning program seeks to postpone marraige, space the births of children between 3-5 years, and promote the 1-child family. Its goal is to reduce the rate of natural increase from 12/1000 in 1978 to 5/1000 by 1985 and 0 by 2000. India's 7th Five-Year-Plan (1986-90) calls for establishing a 2-child family norm by 2000. In Indonesia the government's population policy includes reducing the rate of population growth, achieving a redistribution of the population, adjusting economic factors, and creating prosperous families. The government of Indonesia reversed its policy to reduce the population growth rate in 1984 and announced its goal of achieving a population of 70 million by 2100 in order to support mass consumption industries. It has created an income tax deduction system favoring large families and maternity benefits for women who have up to 5 children as incentives. Nepal's official policy is to

  13. China's Population Policy at the Crossroads: Social Impacts and Prospects

    OpenAIRE

    Jiang, Quanbao; Li, Shuzhuo; Feldman, Marcus W.

    2013-01-01

    China's total fertility rate fell below replacement level in the 1990s. From the 1970s the fertility rate declined dramatically, mainly as a consequence of the national population policy whose aim has been to limit birth numbers, control population growth and boost economic growth. Having achieved such a low fertility rate, how will China's population policy evolve in the future? This paper first reviews the history of China's population policy since 1970 in terms of three stages: 1970-1979; ...

  14. Efficacy of Probiotics Versus Placebo in the Prevention of Necrotizing Enterocolitis in Preterm Very Low Birth Weight Infants: A Double-blind Randomized Controlled Trial

    International Nuclear Information System (INIS)

    Chowdhury, T.; Ali, M.M.; Hossain, M. M.

    2016-01-01

    Objective: To evaluate the efficacy of orally administered probiotics in preventing necrotizing enterocolitis (NEC) in preterm very low birth weight (VLBW) infants. Study Design: Arandomized double blind controlled trial. Place and Duration of Study: The Paediatrics Department of Sylhet M.A.G. Osmani Medical College Hospital, Sylhet Bangladesh, from July 2012 to June 2015. Methodology: Preterm (28 - 33 weeks gestation) VLBW (birth weight 1000 - 1499 g) neonates were enrolled. The study group was fed with probiotics once daily with breast milk from first feeding, and the control group with only breast milk without the addition of probiotics. Both the groups received other standard care. The primary outcome was the development of NEC (stage II and III), categorized by modified Bell's classification. Result: In 108 neonates, development of NEC was significantly lower in the study group than that of control group [1 (1.9 percent) vs. 6 (11.5 percent); p=0.044]. Age of achievement of full oral feeding was significantly earlier in the study group than that in the control group (14.88 ±3.15 and 18.80 ±4.32 days; p < 0.001). Duration of hospital stay was significantly short in the study group compared to the control group (15.82 ±2.94 days vs. 19.57 ±4.26 days; p < 0.001). Conclusion: Probiotic supplementation reduces the frequency of necrotising enterocolitis in preterm neonates with very low birth weight. It is also associated with faster achievement of full oral feeding and short duration of hospital stay. (author)

  15. Women's social networks and use of facility delivery services for uncomplicated births in North West Ethiopia: a community-based case-control study.

    Science.gov (United States)

    Asrese, Kerebih; Adamek, Margaret E

    2017-12-28

    High maternal mortality has remained an unmet public health challenge in the developing world. Maternal mortality in Ethiopia is among the highest in the world. Since most maternal deaths occur during labor, delivery, and the immediate postpartum period, facility delivery with skilled birth attendants is recommended to reduce maternal mortality. Nonetheless, the majority of women in Ethiopia give birth at home. Individual attributes and availability and accessibility of services deter service utilization. The role of social networks that may facilitate or constrain service use is not well studied. Community-based case-control study was conducted between February and March 2014 in Jabi Tehinan District, North West Ethiopia. Retrospective data were collected from 134 women who had uncomplicated births at health facilities and 140 women who had uncomplicated births at home within a year preceding the survey. Interviews were held with eight women who had uncomplicated births at health facilities and 11 who had uncomplicated births at home. The quantitative data were entered and analyzed using SPSS for Windows versions 16.0 and hierarchical logistic regression model was used for analysis. The qualitative data were transcribed verbatim and data were used to substantiate the quantitative data. The results indicated that social network variables were significantly associated with the use of health facilities for delivery. Taking social networks into account improved the explanation of facility use for delivery services over women's individual attributes. Women embedded within homogeneous network members (Adjusted OR 2.53; 95% CI: 1.26-5.06) and embedded within high SBA endorsement networks (Adjusted OR 7.97; 95% CI: 4.07-12.16) were more likely to deliver at health facilities than their counterparts. Women living in urban areas (Adjusted OR 3.32; 95% CI: 1.37-8.05) and had better knowledge of obstetric complications (Adjusted OR 3.01; 95% CI: 1.46-6.18) were more likely to

  16. Association of School Nutrition Policy and Parental Control with Childhood Overweight

    Science.gov (United States)

    Seo, Dong-Chul; Lee, Chung Gun

    2012-01-01

    Background: Schools and parents may play important roles in preventing childhood obesity by affecting children's behaviors related to energy balance. This study examined how school nutrition policy and parental control over children's eating and physical activity habits are associated with the children's overweight/obesity (hereafter overweight)…

  17. Tobacco control policies and perinatal health: A national quasi-experimental study

    NARCIS (Netherlands)

    M. Peelen (Myrthe); A. Sheikh (Aziz); M. Kok (Marjolein); P.J. Hajenius (Petra); L.J.I. Zimmermann (Luc); B.W. Kramer (Boris); C.W.P.M. Hukkelhoven (Chantal); I.K.M. Reiss (Irwin); B.W. Mol (Ben W.); J.V. Been (Jasper V.)

    2016-01-01

    textabstractWe investigated whether changes in perinatal outcomes occurred following introduction of key tobacco control policies in the Netherlands: smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign (January-February 2004); and extension of the smoke-free law

  18. Tobacco control policies and perinatal health: a national quasi-experimental study

    NARCIS (Netherlands)

    Peelen, Myrthe J.; Sheikh, Aziz; Kok, Marjolein; Hajenius, Petra; Zimmermann, Luc J.; Kramer, Boris W.; Hukkelhoven, Chantal W.; Reiss, Irwin K.; Mol, Ben W.; Been, Jasper V.

    2016-01-01

    We investigated whether changes in perinatal outcomes occurred following introduction of key tobacco control policies in the Netherlands: smoke-free legislation in workplaces plus a tobacco tax increase and mass media campaign (January-February 2004); and extension of the smoke-free law to the

  19. Soviet Education Policy 1917-1935: From Ideology to Bureaucratic Control.

    Science.gov (United States)

    Lauglo, Jon

    1988-01-01

    Examining early Soviet educational policy, Lauglo analyzes the initial expression of Marxist humanist values, popular participation, and the value of productive work for general education. Discusses the routinization into a Stalinist pattern of bureaucratically controlled utilitarianism and comments briefly on recent indications of change in…

  20. Mandatory Production Controls. Issues in Agricultural Policy. Agriculture Information Bulletin Number 520.

    Science.gov (United States)

    Economic Research Service (USDA), Washington, DC.

    Mandatory restrictions on agricultural production continue to be suggested as an alternative policy for reducing price-depressing surplus production, increasing farm income, and cutting farm program costs. A mandatory production control program (MPCP) can be implemented through two methods: (1) acreage allotments, which restrict individual farmers…

  1. A policy iteration approach to online optimal control of continuous-time constrained-input systems.

    Science.gov (United States)

    Modares, Hamidreza; Naghibi Sistani, Mohammad-Bagher; Lewis, Frank L

    2013-09-01

    This paper is an effort towards developing an online learning algorithm to find the optimal control solution for continuous-time (CT) systems subject to input constraints. The proposed method is based on the policy iteration (PI) technique which has recently evolved as a major technique for solving optimal control problems. Although a number of online PI algorithms have been developed for CT systems, none of them take into account the input constraints caused by actuator saturation. In practice, however, ignoring these constraints leads to performance degradation or even system instability. In this paper, to deal with the input constraints, a suitable nonquadratic functional is employed to encode the constraints into the optimization formulation. Then, the proposed PI algorithm is implemented on an actor-critic structure to solve the Hamilton-Jacobi-Bellman (HJB) equation associated with this nonquadratic cost functional in an online fashion. That is, two coupled neural network (NN) approximators, namely an actor and a critic are tuned online and simultaneously for approximating the associated HJB solution and computing the optimal control policy. The critic is used to evaluate the cost associated with the current policy, while the actor is used to find an improved policy based on information provided by the critic. Convergence to a close approximation of the HJB solution as well as stability of the proposed feedback control law are shown. Simulation results of the proposed method on a nonlinear CT system illustrate the effectiveness of the proposed approach. Copyright © 2013 ISA. All rights reserved.

  2. Cost-effectiveness of tobacco control policies and programmes targeting adolescents: a systematic review

    NARCIS (Netherlands)

    Leão, Teresa; Kunst, Anton E.; Perelman, Julian

    2018-01-01

    Consistent evidence shows the importance of preventing smoking at young ages, when health behaviours are formed, with long-term consequences on health and survival. Although tobacco control policies and programmes targeting adolescents are widely promoted, the cost-effectiveness of such

  3. School Autonomy and Government Control: School Leaders' Views on a Changing Policy Landscape in England

    Science.gov (United States)

    Higham, Rob; Earley, Peter

    2013-01-01

    The Conservative-Liberal Democrat Coalition government elected in 2010 has argued contemporary reform will increase the autonomy of schools in England. Given the complexities that exist, however, in the balance between autonomy and control, we explore how school leaders view autonomy as it exists within the wider policy framework. The article…

  4. Cabbage compression early breast care on breast engorgement in primiparous women after cesarean birth: a controlled clinical trial

    Science.gov (United States)

    Lim, A-Reum; Song, Ji-Ah; Hur, Myung-Haeng; Lee, Mi-Kyoung; Lee, Myeong Soo

    2015-01-01

    This study aimed to compare the effects of cabbage compression early breast care (CCEBC) and early breast care (EBC) on breast pain, breast hardness with general nursing breast care (GNBC) in primiparous women after cesarean birth. Sixty participants were divided to three groups including CCEBC, EBC and GNBC. Each group was treated with its intervention respectively more than 10 minutes before breast feeding from day two to day four after delivery. The primary outcomes were breast pain and breast hardness. Both CCEBC and EBC showed significantly lower pain level than GNBC at day 4 after delivery. There are significant differences of breast hardness among three groups. CCEBC group showed significantly lower breast hardness compared with EBC and GNBC. Neither core body temperature nor breast skin temperature was significantly different among the three groups. In conclusion, CCEBC may effective in relieving breast pain and breast hardness compared with EBC alone and GNBC in primiparous women after a cesarean birth. PMID:26885074

  5. Risk factors for low birth-weight in areas with varying malaria transmission in Korogwe, Tanzania: implications for malaria control

    DEFF Research Database (Denmark)

    Mmbando, Bruno Paul; Cole-Lewis, H; Sembuche, S

    2008-01-01

    Low birth weight (LBW) is a risk factor for infant mortality, morbidity, growth retardation, poor cognitive development, and chronic diseases. Maternal exposure to diseases such as malaria, HIV, and syphilis has been shown to have a significant impact on birth weight (BW). This study was aimed...... at determining whether there was a difference in rates of LBW in areas of varying malaria transmission intensity in Korogwe, Tanzania. Retrospective data for one year (June 2004-May 2005) in three maternal and child health (MCH) clinics in the district were analysed. Villages were stratified into three strata...... babies compared to first parity women (OR=0.44, 95% CI 0.19-0.98, P=0.045). Similarly, the risk of LBW was higher in women who had delayed MCH gestational booking and in women who conceived during high malaria transmission seasons. There was high degree of preference of digits ending with 0...

  6. Off-Policy Actor-Critic Structure for Optimal Control of Unknown Systems With Disturbances.

    Science.gov (United States)

    Song, Ruizhuo; Lewis, Frank L; Wei, Qinglai; Zhang, Huaguang

    2016-05-01

    An optimal control method is developed for unknown continuous-time systems with unknown disturbances in this paper. The integral reinforcement learning (IRL) algorithm is presented to obtain the iterative control. Off-policy learning is used to allow the dynamics to be completely unknown. Neural networks are used to construct critic and action networks. It is shown that if there are unknown disturbances, off-policy IRL may not converge or may be biased. For reducing the influence of unknown disturbances, a disturbances compensation controller is added. It is proven that the weight errors are uniformly ultimately bounded based on Lyapunov techniques. Convergence of the Hamiltonian function is also proven. The simulation study demonstrates the effectiveness of the proposed optimal control method for unknown systems with disturbances.

  7. Plans, preferences or going with the flow: An online exploration of women's views and experiences of birth plans.

    Science.gov (United States)

    Divall, Bernie; Spiby, Helen; Nolan, Mary; Slade, Pauline

    2017-11-01

    To explore women's views of birth plans, and experiences of their completion and use. A qualitative, descriptive study, using Internet-mediated research methods. The discussion boards of two well-known, UK-based, online parenting forums, where a series of questions relating to birth plans were posted. Members of the selected parenting forums who had written and used, or who had chosen not to write or use, a birth plan. Women responded with a range of views and experiences relating to the completion and use of birth plans. The benefits of birth plans were described in terms of communication with healthcare professionals, potentially enhancing awareness of available options, and maintaining a sense of control during labour and birth. However, many respondents believed the idea of 'planning' birth was problematic, and described a reluctance to write a formal plan. The support of healthcare professionals, particularly midwives, was considered essential to the success of both writing and using birth plans. Our findings show a continued debate among women on the benefits and challenges involved in writing and using birth plans, suggesting problems for a 'one size fits all' approach often seen in the use of birth plan templates. In the context of maternity policy supporting women's choice and personalised care, and as a way of acknowledging perceived problems of 'planning' for birth, a flexible approach to birth plans is required, including the consideration of employing alternative nomenclature. Birth plans remain a point of contention in care contexts around the world. Midwives and other healthcare providers play a central role in supporting women to discuss available options, whether or not they decide to complete a formal birth plan. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Energy-related carbon dioxide emissions: control targets and long term policy strategies

    International Nuclear Information System (INIS)

    Haites, E.

    1993-01-01

    A number of countries have unilaterally committed themselves to limit emissions of greenhouse gases. Other countries have resisted such commitments; they prefer to engage in further climate research to determine the extent of any emissions reduction that may be necessary before committing themselves to significant costs to implement controls. This paper examines the costs of alternative policies including immediate action to limit emissions and climate research followed by controls if necessary. (Author)

  9. Racism, Gun Ownership and Gun Control: Biased Attitudes in US Whites May Influence Policy Decisions

    OpenAIRE

    O?Brien, Kerry; Forrest, Walter; Lynott, Dermot; Daly, Michael

    2013-01-01

    OBJECTIVE: Racism is related to policies preferences and behaviors that adversely affect blacks and appear related to a fear of blacks (e.g., increased policing, death penalty). This study examined whether racism is also related to gun ownership and opposition to gun controls in US whites. METHOD: The most recent data from the American National Election Study, a large representative US sample, was used to test relationships between racism, gun ownership, and opposition to gun control in US wh...

  10. Growth and Neurodevelopmental Outcomes of Early, High-Dose Parenteral Amino Acid Intake in Very Low Birth Weight Infants: A Randomized Controlled Trial.

    Science.gov (United States)

    Balakrishnan, Maya; Jennings, Alishia; Przystac, Lynn; Phornphutkul, Chanika; Tucker, Richard; Vohr, Betty; Stephens, Bonnie E; Bliss, Joseph M

    2017-03-01

    Administration of high-dose parenteral amino acids (AAs) to premature infants within hours of delivery is currently recommended. This study compared the effect of lower and higher AA administration starting close to birth on short-term growth and neurodevelopmental outcomes at 18-24 months corrected gestational age (CGA). Infants Toddler Development, Third Edition at 18-24 months CGA. Secondary outcomes were growth parameters at 36 weeks CGA among infants surviving to hospital discharge, serum bicarbonate, serum urea nitrogen, creatinine, AA profiles in the first week of life, and incidence of major morbidities and mortality. No differences in neurodevelopmental outcome were detected between the high and low AA groups. Infants in the high AA group had significantly lower mean weight, length, and head circumference percentiles than those in the standard AA group at 36 weeks CGA and at hospital discharge. These differences did not persist after controlling for birth growth parameters, except for head circumference. Infants in the high AA group had higher mean serum urea nitrogen than the standard group on each day throughout the first week. Current recommendations for high-dose AA starting at birth are not associated with improved growth or neurodevelopmental outcomes.

  11. Towards understanding the drivers of policy change: a case study of infection control policies for multi-drug resistant tuberculosis in South Africa.

    Science.gov (United States)

    Saidi, Trust; Salie, Faatiema; Douglas, Tania S

    2017-05-30

    Explaining policy change is one of the central tasks of contemporary policy analysis. In this article, we examine the changes in infection control policies for multi-drug resistant tuberculosis (MDR-TB) in South Africa from the time the country made the transition to democracy in 1994, until 2015. We focus on MDR-TB infection control and refer to decentralised management as a form of infection control. Using Kingdon's theoretical framework of policy streams, we explore the temporal ordering of policy framework changes. We also consider the role of research in motivating policy changes. Policy documents addressing MDR-TB in South Africa over the period 1994 to 2014 were extracted. Literature on MDR-TB infection control in South Africa was extracted from PubMed using key search terms. The documents were analysed to identify the changes that occurred and the factors driving them. During the period under study, five different policy frameworks were implemented. The policies were meant to address the overwhelming challenge of MDR-TB in South Africa, contextualised by high prevalence of HIV infection, that threatened to undermine public health programmes and the success of antiretroviral therapy rollouts. Policy changes in MDR-TB infection control were supported by research evidence and driven by the high incidence and complexity of the disease, increasing levels of dissatisfaction among patients, challenges of physical, human and financial resources in public hospitals, and the ideologies of the political leadership. Activists and people living with HIV played an important role in highlighting the importance of MDR-TB as well as exerting pressure on policymakers, while the mass media drew public attention to infection control as both a cause of and a solution to MDR-TB. The critical factors for policy change for infection control of MDR-TB in South Africa were rooted in the socioeconomic and political environment, were supported by extensive research, and can be framed

  12. Birth of Industry 5.0: Making Sense of Big Data with Artificial Intelligence, "The Internet of Things" and Next-Generation Technology Policy.

    Science.gov (United States)

    Özdemir, Vural; Hekim, Nezih

    2018-01-01

    Driverless cars with artificial intelligence (AI) and automated supermarkets run by collaborative robots (cobots) working without human supervision have sparked off new debates: what will be the impacts of extreme automation, turbocharged by the Internet of Things (IoT), AI, and the Industry 4.0, on Big Data and omics implementation science? The IoT builds on (1) broadband wireless internet connectivity, (2) miniaturized sensors embedded in animate and inanimate objects ranging from the house cat to the milk carton in your smart fridge, and (3) AI and cobots making sense of Big Data collected by sensors. Industry 4.0 is a high-tech strategy for manufacturing automation that employs the IoT, thus creating the Smart Factory. Extreme automation until "everything is connected to everything else" poses, however, vulnerabilities that have been little considered to date. First, highly integrated systems are vulnerable to systemic risks such as total network collapse in the event of failure of one of its parts, for example, by hacking or Internet viruses that can fully invade integrated systems. Second, extreme connectivity creates new social and political power structures. If left unchecked, they might lead to authoritarian governance by one person in total control of network power, directly or through her/his connected surrogates. We propose Industry 5.0 that can democratize knowledge coproduction from Big Data, building on the new concept of symmetrical innovation. Industry 5.0 utilizes IoT, but differs from predecessor automation systems by having three-dimensional (3D) symmetry in innovation ecosystem design: (1) a built-in safe exit strategy in case of demise of hyperconnected entrenched digital knowledge networks. Importantly, such safe exists are orthogonal-in that they allow "digital detox" by employing pathways unrelated/unaffected by automated networks, for example, electronic patient records versus material/article trails on vital medical information; (2) equal

  13. Effectiveness of hospital-wide methicillin-resistant Staphylococcus aureus (MRSA infection control policies differs by ward specialty.

    Directory of Open Access Journals (Sweden)

    Rosemarie Sadsad

    Full Text Available Methicillin-resistant Staphylococcus aureus (MRSA is a major cause of preventable nosocomial infections and is endemic in hospitals worldwide. The effectiveness of infection control policies varies significantly across hospital settings. The impact of the hospital context towards the rate of nosocomial MRSA infections and the success of infection control is understudied. We conducted a modelling study to evaluate several infection control policies in surgical, intensive care, and medical ward specialties, each with distinct ward conditions and policies, of a tertiary public hospital in Sydney, Australia. We reconfirm hand hygiene as the most successful policy and find it to be necessary for the success of other policies. Active screening for MRSA, patient isolation in single-bed rooms, and additional staffing were found to be less effective. Across these ward specialties, MRSA transmission risk varied by 13% and reductions in the prevalence and nosocomial incidence rate of MRSA due to infection control policies varied by up to 45%. Different levels of infection control were required to reduce and control nosocomial MRSA infections for each ward specialty. Infection control policies and policy targets should be specific for the ward and context of the hospital. The model we developed is generic and can be calibrated to represent different ward settings and pathogens transmitted between patients indirectly through health care workers. This can aid the timely and cost effective design of synergistic and context specific infection control policies.

  14. A system dynamics feedback control model study of population of "India 2001" and policies for stabilizing growth.

    Science.gov (United States)

    Patil, M K; Janahanlal, P S

    1978-06-01

    A mathematical population model is presented and diagrammed. The model is a nonlinear, higher order, self-regulating, goal-seeking system. In other words, the model treats the population system like a biological system which has positive and negative feedbacks. The model incorporates the effects of important economic factors that influence human birth and death rates. It calculates the total population size, which is a determinant of resource usage. It also indicates the demographic response, through a changing birth and death rate, to a changing resource supply. The model is illustrated with Indian population data, disaggregated by age into 15 levels each of which is, in turn, divided into 4 income levels. The effect on population growth of various alternative population policies is analyzed with the goal of stabilizing the population growth quickly without causing undue hardship. Different computer runs of the model are conducted, using different levels of family planning practice, different ages at marriage, and different distributions of income throughout the country. The policy which would result in the lowest population for the year 2001 is 1 in which family planning acceptance levels would increase from 15% in 1975 to 60% in 1980 and 100% from 1990 on. However, there is widespread opposition to this policy. It is felt that a much slower rise in family planning acceptance would be a more acceptable policy for stabilizing population in India.

  15. Generating news media interest in tobacco control; challenges in an advanced policy environment.

    Science.gov (United States)

    MacKenzie, Ross; Chapman, Simon

    2012-08-01

    To determine the efficacy of using media releases for tobacco control advocacy in Australia's advanced policy environment. Between February and August 2010, news releases that summarised either newly published but unpublicized research findings, or local developments in tobacco control, were sent to NSW media outlets. Reports arising from the releases were tracked using commercial services Media Monitors and Factiva, as well as Google and Google News. Other tobacco control related news items during the same period were also tracked and recorded. Twenty-one news releases generated 93 news items across all news media, with a quarter of these related to a story of porcine haemoglobin in cigarette filters. By comparison, 'live' policy issues (especially plain packaging and a significant tobacco tax increase) covered in this period attracted 1,033 news stories in the Australian media. Press releases describing recently published, but underpublicized research were issued in weeks where no major competing tobacco control news occurred. Results of this project indicate that in environments with advanced tobacco policy, media opportunities related to tobacco control advocacy are limited, as many objectives have been achieved. The media can still play a key advocacy role in such environments, and advocates need to be particularly vigilant for opportunities that do arise. The paper also highlights the increasingly important role of internet-based media, including opportunities presented by social media for tobacco control.

  16. Results from an evaluation of tobacco control policies at the 2010 Shanghai World Expo.

    Science.gov (United States)

    Li, Xiang; Zheng, PinPin; Fu, Hua; Berg, Carla; Kegler, Michelle

    2013-09-01

    Large-scale international events such as World Expos and Olympic Games have the potential to strengthen smoke-free norms globally. The Shanghai 2010 World Expo was one of the first large-scale events to implement and evaluate the adoption of strict tobacco control policies. To evaluate implementation of tobacco control policies at the 2010 World Expo in Shanghai, China. This mixed methods evaluation was conducted from July to October 2010. Observations were conducted in all 155 pavilions and outdoor queuing areas, all 45 souvenir shops, a random sample of restaurants (51 of 119) and selected outdoor non-smoking areas in all sections of the Expo. In addition, intercept surveys were completed with 3022 visitors over a 4-month period. All pavilions and souvenir shops were smoke-free. Restaurants were smoke-free, with only 0.1% of customers observed smoking. Smoking was more common in outdoor non-smoking areas, but still relatively rare overall with only 4.5% of visitors observed smoking. Tobacco products were not sold or marketed in any public settings except for three pavilions that had special exemptions from the policy. Overall, 80.3% of visitors were aware of the smoke-free policy at the World Expo, 92.5% of visitors supported the policy and 97.1% of visitors were satisfied with the smoke-free environment. Tobacco control policies at the World Expo sites were generally well-enforced and accepted although compliance was not 100%, particularly in outdoor non-smoking areas.

  17. Smoking habits, awareness of risks, and attitude towards tobacco control policies among medical students in Lagos, Nigeria.

    Science.gov (United States)

    Dania, Michelle G; Ozoh, Obianuju B; Bandele, Emmanuel O

    2015-01-01

    This study aimed to assess the prevalence of cigarette smoking among medical students, and to determine their level of knowledge regarding risk associated with cigarette smoking and their attitude and behavior towards tobacco control strategies and policies. A stratified random sampling approach was used to select participants. A modified version of the the Global Health Professional Students Survey questionnaire was self-administered. Descriptive statistics were applied and comparisons were done using chi-square test. Multivariate logistic regression was used to obtain the significant determinants of smoking. A P smoking and current smoking was 9.6 and 1.2%, respectively. Age > 21, having a smoking father, and use of alcohol were significantly associated with ever smoking. Knowledge of smoking as a risk for emphysema was 72.8%, coronary artery disease 82.8%, stroke 68.8%, and low birth weight 76.4%. There were 103 (41.2%) students aware of antidepressant usage in smoking cessation. One hundred and ninety-five (78%) offered smoking cessation advice if a smoker had no smoking-related disease and did not seek their opinion about smoking, 68.8% affirmed to having adequate knowledge on smoking cessation, and 56.8% had received formal training on smoking cessation techniques. The ban on cigarette smoking in enclosed public places was supported by 92.4%. The prevalence of current cigarette smoking among medical students in Lagos is relatively low. Gaps exist in the level of knowledge of the students regarding risks of cigarette smoking, tobacco cessation strategies, and in their attitude and behavior towards offering tobacco cessation advice. There is need therefore to include formal training on tobacco control strategies at an early stage in the medical curriculum.

  18. FISCAL POLICY OF THE REPUBLIC OF MOLDOVA: ACHIEVEMENTS OF THE FISCAL CONTROL AND ENTITY BEHAVIOR

    Directory of Open Access Journals (Sweden)

    Olimpiu GHERMAN

    2015-12-01

    Full Text Available It is an actual theme, determined by achievements of tax control in Moldova and its impact on the behaviour of the entity as important elements of fiscal policy. There are examined different methods for differentiating the problem, supplemented by deduction, induction, synthesis, analysis of defining phenomena of fiscal policy and its elements. The methodology used in this study is based on assessments of the theory, studies and interpretations of specialized literature and analyzes the practical activities specific for taxation at national, European and international levels, depending on which some opinions, conclusions and proposals were founded and formulated, to minimize the impact of tax evasion and fraud.

  19. Association between tobacco control policies and smoking behaviour among adolescents in 29 European countries.

    Science.gov (United States)

    Hublet, Anne; Schmid, Holger; Clays, Els; Godeau, Emmanuelle; Gabhainn, Saoirse Nic; Joossens, Luk; Maes, Lea

    2009-11-01

    To investigate the associations between well-known, cost-effective tobacco control policies at country level and smoking prevalence among 15-year-old adolescents. Multi-level modelling based on the 2005-06 Health Behaviour in School-aged Children Study, a cross-national study at individual level, and with country-level variables from the Tobacco Control Scale and published country-level databases. Twenty-nine European countries. A total of 25 599 boys and 26 509 girls. Self-reported regular smoking defined as at least weekly smoking, including daily smoking (dichotomous). Interaction effects between gender and smoking policies were identified, therefore boys and girls were analysed separately. Large cross-national differences in smoking prevalence were documented. Intraclass correlations (ICC) of 0.038 (boys) and 0.035 (girls) were found. In the final multi-level model for boys, besides the significance of the individual variables such as family affluence, country-level affluence and the legality of vending machines were related significantly to regular smoking [b(country affluence) = -0.010; b(partial restriction vending machines) = -0.366, P vending machines had a borderline significance in the final model [b(total ban vending machines) = -0.372, P = 0.06]. For boys, some of the currently recommended tobacco control policies may help to reduce smoking prevalence. However, the model is less suitable for girls, indicating gender differences in the potential efficacy of smoking policies. Future research should address this issue.

  20. Policy reconciliation for access control in dynamic cross-enterprise collaborations

    Science.gov (United States)

    Preuveneers, D.; Joosen, W.; Ilie-Zudor, E.

    2018-03-01

    In dynamic cross-enterprise collaborations, different enterprises form a - possibly temporary - business relationship. To integrate their business processes, enterprises may need to grant each other limited access to their information systems. Authentication and authorization are key to secure information handling. However, access control policies often rely on non-standardized attributes to describe the roles and permissions of their employees which convolutes cross-organizational authorization when business relationships evolve quickly. Our framework addresses the managerial overhead of continuous updates to access control policies for enterprise information systems to accommodate disparate attribute usage. By inferring attribute relationships, our framework facilitates attribute and policy reconciliation, and automatically aligns dynamic entitlements during the evaluation of authorization decisions. We validate our framework with a Industry 4.0 motivating scenario on networked production where such dynamic cross-enterprise collaborations are quintessential. The evaluation reveals the capabilities and performance of our framework, and illustrates the feasibility of liberating the security administrator from manually provisioning and aligning attributes, and verifying the consistency of access control policies for cross-enterprise collaborations.

  1. IMPLEMENTATION OF TRADE LAWS: IMPLICATIONS IN THE PRICE CONTROL POLICY OF COMMUNITY NEEDS

    Directory of Open Access Journals (Sweden)

    Engkus Engkus

    2018-01-01

    Full Text Available [Implementation Of Trade Laws: Implications In The Price Control Policy Of Community Needs] Issuing the act no 7 year 2014 about tade, Indonesia has new hope to design the obscene of social basic requirements were going on all this time. The main problem in the research that “increasing and decreasing pricefluctuatively” has became repeatedly in Ramadhan. It has been caused by some factors: Unbalancing Supply and demand not done optimally yet. The aim of the research to collect data, facta and problems analyses them and directly or indirectlywe want to know and increase for academic nuance as theorital, also who want to know about them deeply. The research is qualitative research, using the technical of theresearch are observation, interview, documental history and documental audio visual. The results of research, before, at the moment, after Ramadhan, the price of social basic requirements still increasely and fluctuatively. Government intervention, by short term policy not touched social basic requirements continously yet. So piling them were not clearness of official. Raring supply, increasing demand, It has been caused by social increasing consumption, Finally high increasing price. Conclusion: The price control social basic requirements policy, complately by redesign comprehensive, transparancy, participative and continuosly policy, from central government to local government towards nation autonomy in food. Keywords: Increasing Price, clearness of official, Control.

  2. The economic impact of emission peaking control policies and China's sustainable development

    Directory of Open Access Journals (Sweden)

    Yi Wang

    2014-12-01

    Full Text Available To achieve the goals of national sustainable development, the peaking control of CO2 emissions is pivotal, as well as other pollutants. In this paper, we build a Chinese inter-regional CGE model and simulate 13 policies and their combinations. By analyzing the energy consumptions, coal consumptions, relating emissions and their impacts on GDP, we found that with the structure adjustment policy, the proportion of coal in primary fossil fuels in 2030 will decrease from 53% to 48% and CO2 emissions will decrease by 11.3%–22.8% compared to the baseline scenario. With the energy intensity reduction policy, CO2 emissions will decrease by 33.3% in 2030 and 47.8% in 2050 than baseline scenario. Other pollutants will also be controlled as synergetic effects. In this study we also find that although the earlier the peaking time the better for emission amounts control, the economic costs can not be ignored. The GDP will decrease by 2.96%–8.23% under different scenarios. Therefore, integrated policy solutions are needed for realizing the peaks package and more targeted measures are required to achieve the peaks of other pollutants earlier.

  3. Domestic politics, citizen activism, and U.S. nuclear arms control policy

    International Nuclear Information System (INIS)

    Knopf, J.W.

    1991-01-01

    The author seeks to ascertain whether and how citizens' movements concerning nuclear arms control and disarmament affect US arms control policy. The author employs a comparative case study methodology. He examines cases of the Eisenhower and Kennedy Administrations during the period of protest against nuclear testing, and the Reagan Administration during the nuclear weapons freeze campaign and the subsequent campaign for a comprehensive test ban. He hows there are four mechanisms through which public advocacy efforts can influence arms control policy, identifies the conditions under which each can be effective, and details the type of impact each mechanism has. Domestic activism interacts with broader public opinion in a way that creates electoral pressure; with elite-level debates in a way that removes a consensus behind presidential policy or changes the winning coalition in Congress; with bureaucratic politics, by generating ideas that have utility for some agents within the Executive; or with the public diplomacy of foreign governments, especially the Soviet Union. Citizens' movements had an impact on policy in each of the cases studied. The type and extent of impact, and the mechanisms involved in giving activism influence, are different for each case

  4. Cost analysis of the Dutch obstetric system: low-risk nulliparous women preferring home or short-stay hospital birth--a prospective non-randomised controlled study.

    Science.gov (United States)

    Hendrix, Marijke Jc; Evers, Silvia Maa; Basten, Marloes Cm; Nijhuis, Jan G; Severens, Johan L

    2009-11-19

    In the Netherlands, pregnant women without medical complications can decide where they want to give birth, at home or in a short-stay hospital setting with a midwife. However, a decrease in the home birth rate during the last decennium may have raised the societal costs of giving birth. The objective of this study is to compare the societal costs of home births with those of births in a short-stay hospital setting. This study is a cost analysis based on the findings of a multicenter prospective non-randomised study comparing two groups of nulliparous women with different preferences for where to give birth, at home or in a short-stay hospital setting. Data were collected using cost diaries, questionnaires and birth registration forms. Analysis of the data is divided into a base case analysis and a sensitivity analysis. In the group of home births, the total societal costs associated with giving birth at home were euro3,695 (per birth), compared with euro3,950 per birth in the group for short-stay hospital births. Statistically significant differences between both groups were found regarding the following cost categories 'Cost of contacts with health care professionals during delivery' (euro138.38 vs. euro87.94, -50 (2.5-97.5 percentile range (PR)-76;-25), p home' (euro1,551.69 vs. euro1,240.69, -311 (PR -485; -150), p home birth are euro4,364 per birth, and euro4,541 per birth for short-stay hospital births. The total costs associated with pregnancy, delivery, and postpartum care are comparable for home birth and short-stay hospital birth. The most important differences in costs between the home birth group and the short-stay hospital birth group are associated with maternity care assistance, hospitalisation, and travelling costs.

  5. Tobacco control policy in France: from war to compromise and collaboration

    Directory of Open Access Journals (Sweden)

    Alain Braillon

    2012-09-01

    Full Text Available BACKGROUND: Absence of an effective tobacco control policy costs lives and tobacco prevention is policy-sensitive. We describe the historical record of tobacco control in France. METHODS: Public policies and main decisions (laws, regulations, health plans for tobacco control were considered from 1950 to 2010. Data for cigarette sales and relative price of cigarettes were obtained from official databases. Sales are expressed in number of cigarettes. The relative price of cigarettes is the nominal price divided by the Consumer Price Index. RESULTS: The first step Veil Law (1976 blunted the steady increase in cigarette sales observed since World War II. The second period began with the Evin Law (1991. This law banned tobacco advertising and withdrew tobacco from the Consumer Price Index allowing for marked and repeated increases in taxes. Sales decreased over the next 6 years, from 97.1 billion to 83.0 billion in 1997 but then remained steady for 5 years (83.5 billion in 2001. The first Cancer Plan (2003 imposed three tax increases in a year (39% increase in price. Cigarette sales decreased to 54.9 billion in 2004. This period ended in 2004 when a moratorium on tobacco taxes was announced. The policies which have been implemented since President Sarkozy was elected in 2007 were flawed and protected the interests of the tobacco industry: prevalence of smoking is now increasing, mainly among the younger generation. Since 1991, the cigarette market has nearly halved but the decline has been a stop-and-go erratic process. The two 5-year periods (1997-2002 and 2005 -2010 during which consumption leveled off seem to demonstrate that government-driven health policies could have been influenced by commercial interests. CONCLUSION: Tobacco control efforts, especially tobacco tax increases, need to be sustained and shielded from the influence of the tobacco industry.

  6. Tobacco-control policies in tobacco-growing states: where tobacco was king.

    Science.gov (United States)

    Fallin, Amanda; Glantz, Stanton A

    2015-06-01

    POLICY POINTS: The tobacco companies prioritized blocking tobacco-control policies in tobacco-growing states and partnered with tobacco farmers to oppose tobacco-control policies. The 1998 Master Settlement Agreement, which settled state litigation against the cigarette companies, the 2004 tobacco-quota buyout, and the companies' increasing use of foreign tobacco led to a rift between the companies and tobacco farmers. In 2003, the first comprehensive smoke-free local law was passed in a major tobacco-growing state, and there has been steady progress in the region since then. Health advocates should educate the public and policymakers on the changing reality in tobacco-growing states, notably the major reduction in the volume of tobacco produced. The 5 major tobacco-growing states (Kentucky, North Carolina, South Carolina, Tennessee, and Virginia) are disproportionately affected by the tobacco epidemic, with higher rates of smoking and smoking-induced disease. These states also have fewer smoke-free laws and lower tobacco taxes, 2 evidence-based policies that reduce tobacco use. Historically, the tobacco farmers and hospitality associations allied with the tobacco companies to oppose these policies. This research is based on 5 detailed case studies of these states, which included key informant interviews, previously secret tobacco industry documents (available at http://legacy.library.ucsf.edu), and media articles. This was supplemented with additional tobacco document and media searches specifically for this article. The tobacco companies were particularly concerned about blocking tobacco-control policies in the tobacco-growing states by promoting a pro-tobacco culture, beginning in the late 1960s. Nevertheless, since 2003, there has been rapid progress in the tobacco-growing states' passage of smoke-free laws. This progress came after the alliance between the tobacco companies and the tobacco farmers fractured and hospitality organizations stopped opposing smoke

  7. A Comprehensive Examination of the Influence of State Tobacco Control Programs and Policies on Youth Smoking

    Science.gov (United States)

    Loomis, Brett R.; Han, Beth; Gfroerer, Joe; Kuiper, Nicole; Couzens, G. Lance; Dube, Shanta; Caraballo, Ralph S.

    2013-01-01

    Objectives. We examined the influence of tobacco control policies (tobacco control program expenditures, smoke-free air laws, youth access law compliance, and cigarette prices) on youth smoking outcomes (smoking susceptibility, past-year initiation, current smoking, and established smoking). Methods. We combined data from the 2002 to 2008 National Surveys on Drug Use and Health with state and municipality population data from the US Census Bureau to assess the associations between state tobacco control policy variables and youth smoking outcomes, focusing on youths aged 12 to 17 years. We also examined the influence of policy variables on youth access when these variables were held at 2002 levels. Results. Per capita funding for state tobacco control programs was negatively associated with all 4 smoking outcomes. Smoke-free air laws were negatively associated with all outcomes except past-year initiation, and cigarette prices were associated only with current smoking. We found no association between these outcomes and retailer compliance with youth access laws. Conclusions. Smoke-free air laws and state tobacco control programs are effective strategies for curbing youth smoking. PMID:23327252

  8. Improvement of Inventory Control Using Continuous Review Policy in A Local Hospital at Bandung City, Indonesia

    Directory of Open Access Journals (Sweden)

    Fina Hafnika

    2016-12-01

    Full Text Available Abstract. This research was aimed to analyze the excess inventories issue in pharmacy and medical equipment unit at a local hospital in Bandung which affected the service level of the hospital. As one of the busy hospital in Java, proven by the higher amount of the patient/year than in other average Java typical hospital, the hospital needs to concern about the pharmaceutical and medical equipment inventories in order to fulfill patients’ needs and in the same time keeping the inventory level under control. Therefore, an inventory control evaluation was conducted to determine the appropriate number of inventories and time of order to avoid the excessive goods in central warehouse of the hospital. By using probabilistic inventory model and continuous review policy, the pharmaceutical inventory in the hospital was calculated to compare the ideal and actual amount of the average inventory level (AIL. ABC (Always, Better, Control classification also classified in this research to identify the proper item which potentially can be reduced from the inventory. From the analysis, we have discovered that the hospital potentially able to reduce almost Rp 830 million or 57% from the overstock inventory level by using continuous review policy as the basis of inventory control calculation system. Keywords: Continuous review policy, inventory control, EOQ, ROP, AIL

  9. The need for a formalised system of Quality Control for environmental policy-science.

    Science.gov (United States)

    Larcombe, Piers; Ridd, Peter

    2018-01-01

    Research science used to inform public policy decisions, herein defined as "Policy-Science", is rarely subjected to rigorous checking, testing and replication. Studies of biomedical and other sciences indicate that a considerable fraction of published peer-reviewed scientific literature, perhaps half, has significant flaws. To demonstrate the potential failings of the present approaches to scientific Quality Control (QC), we describe examples of science associated with perceived threats to the Great Barrier Reef (GBR), Australia. There appears a serious risk of efforts to improve the health of the GBR being directed inefficiently and/or away from the more serious threats. We suggest the need for a new organisation to undertake quality reviews and audits of important scientific results that underpin government spending decisions on the environment. Logically, such a body could also examine policy science in other key areas where governments rely heavily upon scientific results, such as education, health and criminology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Institutional Control Policies and Implementation for the Area 5 and Area 3 Radioactive Waste Management Sites

    International Nuclear Information System (INIS)

    Vefa Yucel; Greg Shott; Denise Wieland

    2007-01-01

    The U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) has implemented varying institutional control policies in performance assessment/composite analysis (PA/CA) calculations for the Area 5 and Area 3 Radioactive Waste Management Sites (RWMSs) (Shott et al., 1998; 2000; Bechtel Nevada [BN] and Neptune and Company Inc. [Neptune], 2006). The facilities are within the actively maintained boundaries of the Nevada Test Site (NTS) that are enforced by NNSA/NSO. Under current policies, access required for exposure of the member of public (MOP) or the inadvertent human intruder (IHI) is prohibited. Uncertainties affecting institutional control policies are the duration and effectiveness of the controls during the post-closure period. Implementing a uniform set of institutional control policies for the RWMSs that encompasses waste management and environmental restoration programs and is consistent with the end-state vision for the environmental management programs for the NTS (DOE, 2006) is a primary goal of the maintenance program. The NNSA/NSO Performance Management Plan (DOE, 2002) complies with DOE Policy P455.1, 'Use of Risk-Based End States' (DOE, 2003a). Expected future land uses are a driver in selecting acceptable end state conditions and clean-up goals for the NTS. NNSA/NSO Environmental Management's (EM's) land management assumptions and framework for Environmental Management activities are as follows: The NTS will remain under federal control in perpetuity as an NNSA test site, and the large buffer zone surrounding the NTS (the Nevada Test and Training Range) is assumed to remain under the control of the U.S. Air Force. There are no plans for transfer of any NTS lands to other agencies or public entities. Access will continue to be restricted to the NTS and the surrounding areas. For management purposes, NNSA/NV EM activities have been established based on the source of contamination and type of waste

  11. Institutional Control Policies and Implementation for the Area 5 and Area 3 Radioactive Waste Management Sites

    Energy Technology Data Exchange (ETDEWEB)

    Vefa Yucel, Greg Shott, Denise Wieland, et al.

    2007-11-01

    The U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) has implemented varying institutional control policies in performance assessment/composite analysis (PA/CA) calculations for the Area 5 and Area 3 Radioactive Waste Management Sites (RWMSs) (Shott et al., 1998; 2000; Bechtel Nevada [BN] and Neptune and Company Inc. [Neptune], 2006). The facilities are within the actively maintained boundaries of the Nevada Test Site (NTS) that are enforced by NNSA/NSO. Under current policies, access required for exposure of the member of public (MOP) or the inadvertent human intruder (IHI) is prohibited. Uncertainties affecting institutional control policies are the duration and effectiveness of the controls during the post-closure period. Implementing a uniform set of institutional control policies for the RWMSs that encompasses waste management and environmental restoration programs and is consistent with the end-state vision for the environmental management programs for the NTS (DOE, 2006) is a primary goal of the maintenance program. The NNSA/NSO Performance Management Plan (DOE, 2002) complies with DOE Policy P455.1, 'Use of Risk-Based End States' (DOE, 2003a). Expected future land uses are a driver in selecting acceptable end state conditions and clean-up goals for the NTS. NNSA/NSO Environmental Management's (EM's) land management assumptions and framework for Environmental Management activities are as follows: The NTS will remain under federal control in perpetuity as an NNSA test site, and the large buffer zone surrounding the NTS (the Nevada Test and Training Range) is assumed to remain under the control of the U.S. Air Force. There are no plans for transfer of any NTS lands to other agencies or public entities. Access will continue to be restricted to the NTS and the surrounding areas. For management purposes, NNSA/NV EM activities have been established based on the source of contamination and

  12. Access Control with Delegated Authorization Policy Evaluation for Data-Driven Microservice Workflows

    Directory of Open Access Journals (Sweden)

    Davy Preuveneers

    2017-09-01

    Full Text Available Microservices offer a compelling competitive advantage for building data flow systems as a choreography of self-contained data endpoints that each implement a specific data processing functionality. Such a ‘single responsibility principle’ design makes them well suited for constructing scalable and flexible data integration and real-time data flow applications. In this paper, we investigate microservice based data processing workflows from a security point of view, i.e., (1 how to constrain data processing workflows with respect to dynamic authorization policies granting or denying access to certain microservice results depending on the flow of the data; (2 how to let multiple microservices contribute to a collective data-driven authorization decision and (3 how to put adequate measures in place such that the data within each individual microservice is protected against illegitimate access from unauthorized users or other microservices. Due to this multifold objective, enforcing access control on the data endpoints to prevent information leakage or preserve one’s privacy becomes far more challenging, as authorization policies can have dependencies and decision outcomes cross-cutting data in multiple microservices. To address this challenge, we present and evaluate a workflow-oriented authorization framework that enforces authorization policies in a decentralized manner and where the delegated policy evaluation leverages feature toggles that are managed at runtime by software circuit breakers to secure the distributed data processing workflows. The benefit of our solution is that, on the one hand, authorization policies restrict access to the data endpoints of the microservices, and on the other hand, microservices can safely rely on other data endpoints to collectively evaluate cross-cutting access control decisions without having to rely on a shared storage backend holding all the necessary information for the policy evaluation.

  13. Birthweight, parental age, birth order and breast cancer risk in African-American and white women: a population-based case–control study

    Science.gov (United States)

    Hodgson, M Elizabeth; Newman, Beth; Millikan, Robert C

    2004-01-01

    Introduction Much recent work has focused on hypotheses that very early life exposures influence adult cancer risk. For breast cancer it has been hypothesized that high in utero estrogen exposure may increase risk. Methods We used data from the Carolina Breast Cancer Study, a population-based case–control study of incident breast cancer in North Carolina, to examine associations for three possible surrogates of high prenatal estrogen exposure: weight at birth, maternal age, and birth order. We also examined paternal age. Birthweight analyses were conducted for white and African-American women born in North Carolina on or after 1949 (196 cases, 167 controls). Maternal age was analyzed for US born participants younger than 49 years of age (280 cases, 236 controls). Results There was a weak inverse association between birthweight in the highest tertile and breast cancer overall (odds ratio [OR] 0.7, 95% confidence interval [CI] 0.4–1.2), although associations differed by race (OR 0.5, 95% CI 0.2–1.0, and OR 1.0, 95% CI 0.5–2.1 for African-American and white women, respectively). For maternal age there was an approximately threefold increase in risk in women whose mothers were older than 22 years of age, relative to 19–22 years of age, when the women were born. After adjustment for maternal age, older paternal age increased risk in the oldest and youngest age categories (relative to 23–27 years of age at the woman's birth: OR 1.6, 95% CI 0.8–3.1 for age 15–22 years; OR 1.2, 95% CI 0.7–2.2 for age 28–34 years; and OR 1.5, 95% CI 0.7–3.2 for age 35–56 years). There was no association with older paternal age for white women alone. After adjustment for maternal age (265 cases, 224 controls), a birth order of fifth or higher relative to first had an inverse association with breast cancer for women younger than 49 years old (OR 0.6, 95% CI 0.3–1.3). Conclusion Although the CIs are wide, these results lend support to the possibility that the prenatal

  14. [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.

  15. 21 CFR 1404.610 - What procedures does the Office of National Drug Control Policy use in suspension and debarment...

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false What procedures does the Office of National Drug Control Policy use in suspension and debarment actions? 1404.610 Section 1404.610 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) General Principles Relating to Suspension and Debarment...

  16. 21 CFR 1404.635 - May the Office of National Drug Control Policy settle a debarment or suspension action?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false May the Office of National Drug Control Policy settle a debarment or suspension action? 1404.635 Section 1404.635 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) General Principles Relating to Suspension and Debarment Actions § 1404.635...

  17. 21 CFR 1404.630 - May the Office of National Drug Control Policy impute conduct of one person to another?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false May the Office of National Drug Control Policy impute conduct of one person to another? 1404.630 Section 1404.630 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) General Principles Relating to Suspension and Debarment Actions § 1404.630...

  18. 21 CFR 1404.135 - May the Office of National Drug Control Policy exclude a person who is not currently...

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false May the Office of National Drug Control Policy exclude a person who is not currently participating in a nonprocurement transaction? 1404.135 Section 1404.135 Food and Drugs OFFICE OF NATIONAL DRUG CONTROL POLICY GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) General § 1404.135 May the...

  19. Effect of Tobacco Control Policies on Information Seeking for Smoking Cessation in the Netherlands: A Google Trends Study

    NARCIS (Netherlands)

    Troelstra, Sigrid A.; Bosdriesz, Jizzo R.; de Boer, Michiel R.; Kunst, Anton E.

    2016-01-01

    Background The impact of tobacco control policies on measures of smoking cessation behaviour has often been studied, yet there is little information on their precise magnitude and duration. This study aims to measure the magnitude and timing of the impact of Dutch tobacco control policies on the

  20. Effect of Tobacco Control Policies on Information Seeking for Smoking Cessation in the Netherlands : A Google Trends Study

    NARCIS (Netherlands)

    Troelstra, Sigrid A; Bosdriesz, Jizzo R; de Boer, Michiel R; Kunst, Anton E

    2016-01-01

    BACKGROUND: The impact of tobacco control policies on measures of smoking cessation behaviour has often been studied, yet there is little information on their precise magnitude and duration. This study aims to measure the magnitude and timing of the impact of Dutch tobacco control policies on the

  1. Socioeconomic inequalities in the impact of tobacco control policies on adolescent smoking. A multilevel study in 29 European countries

    NARCIS (Netherlands)

    Pförtner, Timo-Kolja; Hublet, Anne; Schnohr, Christina Warrer; Rathmann, Katharina; Moor, Irene; de Looze, Margaretha; Baška, Tibor; Molcho, Michal; Kannas, Lasse; Kunst, Anton E.; Richter, Matthias

    2016-01-01

    There are concerns that tobacco control policies may be less effective in reducing smoking among disadvantaged socioeconomic groups and thus may contribute to inequalities in adolescent smoking. This study examines how the association between tobacco control policies and smoking of 15-year-old boys

  2. Safety and immunogenicity of RV3-BB human neonatal rotavirus vaccine administered at birth or in infancy: a randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Bines, Julie E; Danchin, Margaret; Jackson, Pamela; Handley, Amanda; Watts, Emma; Lee, Katherine J; West, Amanda; Cowley, Daniel; Chen, Mee-Yew; Barnes, Graeme L; Justice, Frances; Buttery, Jim P; Carlin, John B; Bishop, Ruth F; Taylor, Barry; Kirkwood, Carl D

    2015-12-01

    Despite the success of rotavirus vaccines, suboptimal vaccine efficacy in regions with a high burden of disease continues to present a challenge to worldwide implementation. A birth dose strategy with a vaccine developed from an asymptomatic neonatal rotavirus strain has the potential to address this challenge and provide protection from severe rotavirus disease from birth. This phase 2a randomised, double-blind, three-arm, placebo-controlled safety and immunogenicity trial was undertaken at a single centre in New Zealand between Jan 13, 2012, and April 17, 2014. Healthy, full-term (≥36 weeks gestation) babies, who weighed at least 2500 g, and were 0-5 days old at the time of randomisation were randomly assigned (1:1:1; computer-generated; telephone central allocation) according to a concealed block randomisation schedule to oral RV3-BB vaccine with the first dose given at 0-5 days after birth (neonatal schedule), to vaccine with the first dose given at about 8 weeks after birth (infant schedule), or to placebo. The primary endpoint was cumulative vaccine take (serum immune response or stool shedding of vaccine virus after any dose) after three doses. The immunogenicity analysis included all randomised participants with available outcome data. This trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611001212943. 95 eligible participants were randomised, of whom 89 were included in the primary analysis. A cumulative vaccine take was detected in 27 (90%) of 30 participants in the neonatal schedule group after three doses of RV3-BB vaccine compared with four (13%) of 32 participants in the placebo group (difference in proportions 0·78, 95% CI 0·55-0·88; pvaccine take after three doses compared with eight (25%) of 32 participants in the placebo group (difference in proportions 0·68, 0·44-0·81; pvaccine was not associated with an increased frequency of fever or gastrointestinal symptoms compared with placebo. RV3-BB vaccine was

  3. Lessons from an evaluation of a provincial-level smoking control policy in Shanghai, China.

    Science.gov (United States)

    Li, Xiang; Gao, Junling; Zhang, Zhixing; Wei, Minqi; Zheng, Pinpin; Nehl, Eric J; Wong, Frank Y; Berg, Carla J

    2013-01-01

    The Shanghai Public Places Smoking Control Legislation was implemented in March 2010 as the first provincial-level legislation promoting smoke-free public places in China. To evaluate the compliance with this policy as well as its impact on exposure to secondhand smoke (SHS), respiratory symptoms, and related attitudes among employees in five kinds of workplaces (schools, kindergartens, hospitals, hotels, and shopping malls). A cross-sectional survey was conducted six months before and then six months after the policy was implemented. Five types of occupational employees from 52 work settings were surveyed anonymously using multistage stratified cluster sampling. Six months after implementation, 82% of the participants agreed that "legislation is enforced most of the time". The percentage of self-reported exposure to secondhand smoke declined from round up to 49% to 36%. High compliance rates were achieved in schools and kindergartens (above 90%), with less compliance in hotels and shopping malls (about 70%). Accordingly, prevalence of exposure to SHS was low in schools and kindergartens (less than 10%) and high in hotels and shopping malls (40% and above). The prevalence of respiratory and sensory symptoms (e.g., red or irritated eyes) among employees decreased from 83% to 67%. Initial positive effects were achieved after the implementation of Shanghai Smoking Control legislation including decreased exposure to SHS. However, compliance with the policies was a considerable problem in some settings. Further evaluation of such policy implementation should be conducted to inform strategies for increasing compliance in the future.

  4. Modelling and Analysing Access Control Policies in XACML 3.0

    DEFF Research Database (Denmark)

    Ramli, Carroline Dewi Puspa Kencana

    (c.f. GM03,Mos05,Ris13) and manual analysis of the overall effect and consequences of a large XACML policy set is a very daunting and time-consuming task. In this thesis we address the problem of understanding the semantics of access control policy language XACML, in particular XACML version 3.0....... The main focus of this thesis is modelling and analysing access control policies in XACML 3.0. There are two main contributions in this thesis. First, we study and formalise XACML 3.0, in particular the Policy Decision Point (PDP). The concrete syntax of XACML is based on the XML format, while its standard...... semantics is described normatively using natural language. The use of English text in standardisation leads to the risk of misinterpretation and ambiguity. In order to avoid this drawback, we define an abstract syntax of XACML 3.0 and a formal XACML semantics. Second, we propose a logic-based XACML analysis...

  5. Cesarean Outcomes in US Birth Centers and Collaborating Hospitals: A Cohort Comparison.

    Science.gov (United States)

    Thornton, Patrick; McFarlin, Barbara L; Park, Chang; Rankin, Kristin; Schorn, Mavis; Finnegan, Lorna; Stapleton, Susan

    2017-01-01

    High rates of cesarean birth are a significant health care quality issue, and birth centers have shown potential to reduce rates of cesarean birth. Measuring this potential is complicated by lack of randomized trials and limited observational comparisons. Cesarean rates vary by provider type, setting, and clinical and nonclinical characteristics of women, but our understanding of these dynamics is incomplete. We sought to isolate labor setting from other risk factors in order to assess the effect of birth centers on the odds of cesarean birth. We generated low-risk cohorts admitted in labor to hospitals (n = 2527) and birth centers (n = 8776) using secondary data obtained from the American Association of Birth Centers (AABC). All women received prenatal care in the birth center and midwifery care in labor, but some chose hospital admission for labor. Analysis was intent to treat according to site of admission in spontaneous labor. We used propensity score adjustment and multivariable logistic regression to control for cohort differences and measured effect sizes associated with setting. There was a 37% (adjusted odds ratio [OR], 0.63; 95% confidence interval [CI], 0.50-0.79) to 38% (adjusted OR, 0.62; 95% CI, 0.49-0.79) decreased odds of cesarean in the birth center cohort and a remarkably low overall cesarean rate of less than 5% in both cohorts. These findings suggest that low rates of cesarean in birth centers are not attributable to labor setting alone. The entire birth center care model, including prenatal preparation and relationship-based midwifery care, should be studied, promoted, and implemented by policy makers interested in achieving appropriate cesarean rates in the United States. © 2016 by the American College of Nurse-Midwives.

  6. Smoking behaviors and attitudes during adolescence prospectively predict support for tobacco control policies in adulthood.

    Science.gov (United States)

    Macy, Jonathan T; Chassin, Laurie; Presson, Clark C

    2012-07-01

    Several cross-sectional studies have examined factors associated with support for tobacco control policies. The current study utilized a longitudinal design to test smoking status and attitude toward smoking measured in adolescence as prospective predictors of support for tobacco control policies measured in adulthood. Participants (N = 4,834) were from a longitudinal study of a Midwestern community-based sample. Hierarchical multiple regression analyses tested adolescent smoking status and attitude toward smoking as prospective predictors (after controlling for sociodemographic factors, adult smoking status, and adult attitude toward smoking) of support for regulation of smoking in public places, discussion of the dangers of smoking in public schools, prohibiting smoking in bars, eliminating smoking on television and in movies, prohibiting smoking in restaurants, and increasing taxes on cigarettes. Participants who smoked during adolescence demonstrated more support for discussion of the dangers of smoking in public schools and less support for increasing taxes on cigarettes but only among those who smoked as adults. Those with more positive attitudes toward smoking during adolescence demonstrated less support as adults for prohibiting smoking in bars and eliminating smoking on television and in movies. Moreover, a significant interaction indicated that those with more positive attitudes toward smoking as adolescents demonstrated less support as adults for prohibiting smoking in restaurants, but only if they became parents as adults. This study's findings suggest that interventions designed to deter adolescent smoking may have future benefits in increasing support for tobacco control policies.

  7. Preterm birth

    Science.gov (United States)

    2010-01-01

    Introduction Preterm birth occurs in about 5% to 10% of all births in resource-rich countries, but in recent years the incidence seems to have increased in some countries, particularly in the USA. We found little reliable evidence for incidence in resource-poor countries. The rate in northwestern Ethiopia has been reported to vary from 11% to 22%, depending on the age group of mothers studied, and is highest in teenage mothers. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of preventive interventions in women at high risk of preterm delivery? What are the effects of interventions to improve neonatal outcome after preterm rupture of membranes? What are the effects of treatments to stop contractions in preterm labour? What are the effects of elective compared with selective caesarean delivery for women in preterm labour? What are the effects of interventions to improve neonatal outcome in preterm delivery? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 58 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review, we present information relating to the effectiveness and safety of the following interventions: amnioinfusion for preterm rupture of membranes; antenatal corticosteroids; antibiotic treatment; bed rest; beta mimetics; calcium-channel blockers; elective caesarean; enhanced antenatal care programmes; magnesium sulphate; oxytocin receptor antagonists (atosiban); progesterone

  8. The Impact of Family Control on Dividend Policy: Evidence from Indonesia

    Directory of Open Access Journals (Sweden)

    Lukas Setia Atmaja

    2016-12-01

    Full Text Available This paper examines the relationship between family control and dividend policy in Indonesia. There are three possible explanations for the relationship. The expropriation hypothesis predicts that family control has a negative impact on dividend payouts. Meanwhile the reputation hypothesis and the family income hypothesis predict that family control has a positive impact on dividend payouts. Using a panel data of Indonesian publicly listed firms in the period of 2003-2009, the results shows that family control has a significant negative impact on dividend payouts, dividend yields and likelyhood to pay dividends. The results control for other variables that may potentially affect dividend payments such as growth opportunity, debt, profitability, firm size and firm age. From agency theory perspective, the finding is consistent with the argument that family controlling shareholders prefer lower dividends, in order to preserve cash flows that they can potentially expropriate (the expropriation hypothesis.

  9. The impact of low-dose aspirin on preterm birth: secondary analysis of a randomized controlled trial.

    Science.gov (United States)

    Allshouse, A A; Jessel, R H; Heyborne, K D

    2016-06-01

    The objective of this study is to determine whether low-dose aspirin (LDA) reduced the rate of preterm birth (PTB) in a cohort of women at high risk for preeclampsia. Secondary analysis of the Maternal-Fetal Medicine Units High-Risk Aspirin trial. Preterm births were categorized by phenotype: indicated, spontaneous or due to preterm premature rupture of membranes (PPROMs). Of 1789 randomized women, 30.5% delivered before 37 weeks (18.5% indicated, 5.8% spontaneous and 6.2% following preterm PPROMs). Among women randomized to LDA, we observed a trend favoring fewer PTBs due to spontaneous preterm labor and preterm PPROMs, odds ratio (OR: 0.826 (0.620, 1.099)); the incidence of indicated PTBs appeared unchanged, OR: 0.999 (0.787, 1.268). Although not reaching significance, we observed an effect size similar to other studies of both low- and high-risk women. These results support findings from other studies assessing LDA as a PTB prevention strategy.

  10. 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.

  11. Off-Policy Reinforcement Learning: Optimal Operational Control for Two-Time-Scale Industrial Processes.

    Science.gov (United States)

    Li, Jinna; Kiumarsi, Bahare; Chai, Tianyou; Lewis, Frank L; Fan, Jialu

    2017-12-01

    Industrial flow lines are composed of unit processes operating on a fast time scale and performance measurements known as operational indices measured at a slower time scale. This paper presents a model-free optimal solution to a class of two time-scale industrial processes using off-policy reinforcement learning (RL). First, the lower-layer unit process control loop with a fast sampling period and the upper-layer operational index dynamics at a slow time scale are modeled. Second, a general optimal operational control problem is formulated to optimally prescribe the set-points for the unit industrial process. Then, a zero-sum game off-policy RL algorithm is developed to find the optimal set-points by using data measured in real-time. Finally, a simulation experiment is employed for an industrial flotation process to show the effectiveness of the proposed method.

  12. The Brazil SimSmoke policy simulation model: the effect of strong tobacco control policies on smoking prevalence and smoking-attributable deaths in a middle income nation.

    Science.gov (United States)

    Levy, David; de Almeida, Liz Maria; Szklo, Andre

    2012-01-01

    Brazil has reduced its smoking rate by about 50% in the last 20 y. During that time period, strong tobacco control policies were implemented. This paper estimates the effect of these stricter policies on smoking prevalence and associated premature mortality, and the effect that additional policies may have. The model was developed using the SimSmoke tobacco control policy model. Using policy, population, and smoking data for Brazil, the model assesses the effect on premature deaths of cigarette taxes, smoke-free air laws, mass media campaigns, marketing restrictions, packaging requirements, cessation treatment programs, and youth access restrictions. We estimate the effect of past policies relative to a counterfactual of policies kept to 1989 levels, and the effect of stricter future policies. Male and female smoking prevalence in Brazil have fallen by about half since 1989, which represents a 46% (lower and upper bounds: 28%-66%) relative reduction compared to the 2010 prevalence under the counterfactual scenario of policies held to 1989 levels. Almost half of that 46% reduction is explained by price increases, 14% by smoke-free air laws, 14% by marketing restrictions, 8% by health warnings, 6% by mass media campaigns, and 10% by cessation treatment programs. As a result of the past policies, a total of almost 420,000 (260,000-715,000) deaths had been averted by 2010, increasing to almost 7 million (4.5 million-10.3 million) deaths projected by 2050. Comparing future implementation of a set of stricter policies to a scenario with 2010 policies held constant, smoking prevalence by 2050 could be reduced by another 39% (29%-54%), and 1.3 million (0.9 million-2.0 million) out of 9 million future premature deaths could be averted. Brazil provides one of the outstanding public health success stories in reducing deaths due to smoking, and serves as a model for other low and middle income nations. However, a set of stricter policies could further reduce smoking and save

  13. Two different doses of supplemental vitamin A did not affect mortality of normal-birth-weight neonates in Guinea-Bissau in a randomized controlled trial

    DEFF Research Database (Denmark)

    Benn, Christine Stabell; Diness, Birgitte R; Balde, Ibraima

    2014-01-01

    Whether neonatal vitamin A supplementation (NVAS) should be policy in areas with vitamin A deficiency is debated. We observed that a smaller dose of vitamin A may decrease mortality more than a larger dose and conducted a randomized, double-blind, placebo-controlled trial in Guinea-Bissau with th...

  14. A case-control study to examine the association between breastfeeding during late pregnancy and risk of a small-for-gestational-age birth in Lima, Peru.

    Science.gov (United States)

    Pareja, Rossina G; Marquis, Grace S; Penny, Mary E; Dixon, Philip M

    2015-04-01

    Excessive demands on maternal nutritional status may be a risk factor for poor birth outcomes. This study examined the association between breastfeeding during late pregnancy (≥ 28 weeks) and the risk of having a small-for-gestational-age (SGA) newborn, using a matched case-control design (78 SGA cases: birthweight project midwives visited daily three government hospitals in Lima, Peru and identified cases and matched controls based on hospital, gestational age, and inter-gestational period. Mothers were interviewed and clinical chart extractions were completed. Factors associated with risk of SGA were assessed by their adjusted odds ratios (aOR) from conditional logistic regression. Exposure to an overlap of breastfeeding during late pregnancy was not associated with an increased risk of having a SGA newborn [aOR=0.58, 95% confidence interval (CI): 0.10-3.30]. However, increased risk was associated with having a previous low-birthweight birth (aOR=6.53; 95% CI: 1.43-29.70) and a low intake of animal source foods (power are needed to definitively examine this possible association and clarify whether there are other risks to the new baby, the toddler and the pregnant woman. © 2012 Blackwell Publishing Ltd.

  15. Association of stress and depression with chronic facial pain: A case-control study based on the Northern Finland 1966 Birth Cohort.

    Science.gov (United States)

    Nevalainen, Netta; Lähdesmäki, Raija; Mäki, Pirjo; Ek, Ellen; Taanila, Anja; Pesonen, Paula; Sipilä, Kirsi

    2017-05-01

    The aim was to study the association between stress level and chronic facial pain, while controlling for the effect of depression on this association, during a three-year follow-up in a general population-based birth cohort. In the general population-based Northern Finland 1966 Birth Cohort, information about stress level, depression and facial pain were collected using questionnaires at the age of 31 years. Stress level was measured using the Work Ability Index. Depression was assessed using the 13-item depression subscale in the Hopkins Symptom Checklist-25. Three years later, a subsample of 52 subjects (42 women) with chronic facial pain and 52 pain-free controls (42 women) was formed. Of the subjects having high stress level at baseline, 73.3% had chronic facial pain, and 26.7% were pain-free three years later. The univariate logistic regression analysis showed that high stress level at 31 years increased the risk for chronic facial pain (crude OR 6.1, 95%, CI 1.3-28.7) three years later. When including depression in a multivariate model, depression associated statistically significantly with chronic facial pain (adjusted OR 2.5, 95%, CI 1.0-5.8), whereas stress level did not (adjusted OR 2.3, 95%, CI 0.6-8.4). High stress level is connected with increased risk for chronic facial pain. This association seems to mediate through depression.

  16. 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

  17. Smoke-free policies and the social acceptability of smoking in Uruguay and Mexico: findings from the International Tobacco Control Policy Evaluation Project.

    Science.gov (United States)

    Thrasher, James F; Boado, Marcelo; Sebrié, Ernesto M; Bianco, Eduardo

    2009-06-01

    Little research has been conducted to determine the psychosocial and behavioral impacts of smoke-free policies in middle-income countries. Cross-sectional data were analyzed from the 2006 waves of the International Tobacco Control Policy Evaluation. Survey comparing adult smokers in Mexico (n = 1,080), where smoke-free legislation at that time was weak, and Uruguay (n = 1,002), where comprehensive smoke-free legislation was implemented. Analyses aimed to determine whether exposure to smoke-free policies and perceived antismoking social norms were associated with smokers' receiving cues about the bothersome nature of secondhand smoke (SHS), with smokers' reactance against such cues, and with smokers' level of support for smoke-free policies in different venues. In bivariate analyses, Uruguayan smokers were more likely than Mexican smokers to experience verbal anti-SHS cues, lower reactance against anti-SHS cues, stronger antismoking societal norms, and stronger support for 100% smoke-free policies in enclosed workplaces, restaurants, and bars. In multivariate models for both countries, the strength of voluntary smoke-free policies at home was independently associated with support for smoke-free policies across all venues queried, except for in bars among Uruguayans. Perceived strength of familial antismoking norms was consistently associated with all indicators of the social acceptability of smoking in Uruguay but only with the frequency of receiving anti-SHS verbal cues in Mexico. These results are generally consistent with previous research indicating that comprehensive smoke-free policies are likely to increase the social unacceptability of smoking and that resistance against such policies is likely to diminish once such policies are in place.

  18. Mexico SimSmoke: how changes in tobacco control policies would impact smoking prevalence and smoking attributable deaths in Mexico.

    Science.gov (United States)

    Fleischer, Nancy L; Thrasher, James F; Reynales-Shigematsu, Luz Myriam; Cummings, K Michael; Meza, Rafael; Zhang, Yian; Levy, David T

    2017-07-01

    We examined the effect of tobacco control policies in Mexico on smoking prevalence and smoking-related deaths using the Mexico SimSmoke model. The model is based on the previously developed SimSmoke simulation model of tobacco control policy, and uses population size, smoking rates and tobacco control policy data for Mexico. It assesses, individually, and in combination, the effect of six tobacco control policies on smoking prevalence and smoking-related deaths. Policies included: cigarette excise taxes, smoke-free laws, anti-smoking public education campaigns, marketing restrictions, access to tobacco cessation treatments and enforcement against tobacco sales youth. The model estimates that, if Mexico were to adopt strong tobacco control policies compared to current policy levels, smoking prevalence could be reduced by 30% in the next decade and by 50% by 2053; an additional 470,000 smoking-related premature deaths could be averted over the next 40 years. The greatest impact on smoking and smoking-related deaths would be achieved by raising excise taxes on cigarettes from 55% to at least 70% of the retail price, followed by strong youth access enforcement and access to cessation treatments. Implementing tobacco control policies in Mexico could reduce smoking prevalence by 50%, and prevent 470,000 smoking-related deaths by 2053.

  19. Soviet Marxism and population policy.

    Science.gov (United States)

    Vonfrank, A

    1984-01-01

    American demographers have maintained that Marxism, notably Soviet Marxism, is consistently pronatalist. The Soviet view is said to be that population growth is not a problem and that birth control policies in either developed or developing societies are to be rejected; the "correct" (i.e., socialist) socioeconomic structure is the true solution to alleged population problems. Such representations of Soviet thought greatly oversimplify the Soviet position as well as fail to discern the changes in Soviet thought that have been occurring. Since the 1960s Soviet writers have increasingly acknowledged that population growth is, to a considerable degree, independent of the economic base of society and that conscious population policies may be needed to either increase or decrease the rate of population growth. Even socialist societies can have population problems. And where population growth is too rapid, as in the developing countries, policies to slow such growth are needed because of the threat to economic development. However, the Soviets continue to stress that birth control policies must go hand-in-hand with social and economic development policies if they are to be effective.

  20. Racism, gun ownership and gun control: biased attitudes in US whites may influence policy decisions.

    Science.gov (United States)

    O'Brien, Kerry; Forrest, Walter; Lynott, Dermot; Daly, Michael

    2013-01-01

    Racism is related to policies preferences and behaviors that adversely affect blacks and appear related to a fear of blacks (e.g., increased policing, death penalty). This study examined whether racism is also related to gun ownership and opposition to gun controls in US whites. The most recent data from the American National Election Study, a large representative US sample, was used to test relationships between racism, gun ownership, and opposition to gun control in US whites. Explanatory variables known to be related to gun ownership and gun control opposition (i.e., age, gender, education, income, conservatism, anti-government sentiment, southern vs. other states, political identification) were entered in logistic regression models, along with measures of racism, and the stereotype of blacks as violent. Outcome variables included; having a gun in the home, opposition to bans on handguns in the home, support for permits to carry concealed handguns. After accounting for all explanatory variables, logistic regressions found that for each 1 point increase in symbolic racism there was a 50% increase in the odds of having a gun at home. After also accounting for having a gun in the home, there was still a 28% increase in support for permits to carry concealed handguns, for each one point increase in symbolic racism. The relationship between symbolic racism and opposition to banning handguns in the home (OR1.27 CI 1.03,1.58) was reduced to non-significant after accounting for having a gun in the home (OR1.17 CI.94,1.46), which likely represents self-interest in retaining property (guns). Symbolic racism was related to having a gun in the home and opposition to gun control policies in US whites. The findings help explain US whites' paradoxical attitudes towards gun ownership and gun control. Such attitudes may adversely influence US gun control policy debates and decisions.

  1. Racism, gun ownership and gun control: biased attitudes in US whites may influence policy decisions.

    Directory of Open Access Journals (Sweden)

    Kerry O'Brien

    Full Text Available OBJECTIVE: Racism is related to policies preferences and behaviors that adversely affect blacks and appear related to a fear of blacks (e.g., increased policing, death penalty. This study examined whether racism is also related to gun ownership and opposition to gun controls in US whites. METHOD: The most recent data from the American National Election Study, a large representative US sample, was used to test relationships between racism, gun ownership, and opposition to gun control in US whites. Explanatory variables known to be related to gun ownership and gun control opposition (i.e., age, gender, education, income, conservatism, anti-government sentiment, southern vs. other states, political identification were entered in logistic regression models, along with measures of racism, and the stereotype of blacks as violent. Outcome variables included; having a gun in the home, opposition to bans on handguns in the home, support for permits to carry concealed handguns. RESULTS: After accounting for all explanatory variables, logistic regressions found that for each 1 point increase in symbolic racism there was a 50% increase in the odds of having a gun at home. After also accounting for having a gun in the home, there was still a 28% increase in support for permits to carry concealed handguns, for each one point increase in symbolic racism. The relationship between symbolic racism and opposition to banning handguns in the home (OR1.27 CI 1.03,1.58 was reduced to non-significant after accounting for having a gun in the home (OR1.17 CI.94,1.46, which likely represents self-interest in retaining property (guns. CONCLUSIONS: Symbolic racism was related to having a gun in the home and opposition to gun control policies in US whites. The findings help explain US whites' paradoxical attitudes towards gun ownership and gun control. Such attitudes may adversely influence US gun control policy debates and decisions.

  2. Racism, Gun Ownership and Gun Control: Biased Attitudes in US Whites May Influence Policy Decisions

    Science.gov (United States)

    O’Brien, Kerry; Forrest, Walter; Lynott, Dermot; Daly, Michael

    2013-01-01

    Objective Racism is related to policies preferences and behaviors that adversely affect blacks and appear related to a fear of blacks (e.g., increased policing, death penalty). This study examined whether racism is also related to gun ownership and opposition to gun controls in US whites. Method The most recent data from the American National Election Study, a large representative US sample, was used to test relationships between racism, gun ownership, and opposition to gun control in US whites. Explanatory variables known to be related to gun ownership and gun control opposition (i.e., age, gender, education, income, conservatism, anti-government sentiment, southern vs. other states, political identification) were entered in logistic regression models, along with measures of racism, and the stereotype of blacks as violent. Outcome variables included; having a gun in the home, opposition to bans on handguns in the home, support for permits to carry concealed handguns. Results After accounting for all explanatory variables, logistic regressions found that for each 1 point increase in symbolic racism there was a 50% increase in the odds of having a gun at home. After also accounting for having a gun in the home, there was still a 28% increase in support for permits to carry concealed handguns, for each one point increase in symbolic racism. The relationship between symbolic racism and opposition to banning handguns in the home (OR1.27 CI 1.03,1.58) was reduced to non-significant after accounting for having a gun in the home (OR1.17 CI.94,1.46), which likely represents self-interest in retaining property (guns). Conclusions Symbolic racism was related to having a gun in the home and opposition to gun control policies in US whites. The findings help explain US whites’ paradoxical attitudes towards gun ownership and gun control. Such attitudes may adversely influence US gun control policy debates and decisions. PMID:24204867

  3. 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....

  4. 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 “ ...

  5. Traditional birth attendants in an endemic area of tetanus neonatorum in Thailand: pitfalls in the control program.

    Science.gov (United States)

    Chongsuvivatwong, V; Bucharkorn, L; Treetrong, R

    1991-12-01

    A survey of the characteristics of traditional birth attendants in Krabi Province, Thailand, where the incidence rate of tetanus neonatorum was the highest in the country, was conducted in order to obtain background information necessary for planning a training curriculum and to evaluate previous training courses. Five second year medical students were used as research assistants. After the questionnaire was constructed and tested, the students went to visit a sample of 116 traditional birth attendants (TBAs) to interview them about their personal backgrounds, techniques and practices in delivery and beliefs and attitudes towards midwifery. The study revealed that these TBAs were a mixture of Buddhist and Islamic females whose literacy rate was 53 percent. Ninety-one per cent knew about the availability of an injection for antenatal care at the health center, but only about half knew that it was for tetanus prevention. More than half provided antenatal care at their own home but 85 per cent conducted delivery at the client's home. About eighty per cent of the TBAs claimed that sterilization of instruments was performed. However, dressing of the umbilical cord was done inappropriately using various kinds of powders by about 40 per cent. The majority of TBAs had experience with complicated labors but only 30 per cent were referred, perhaps, due to excessive self-confidence and supernatural beliefs. The trained TBAs possessed a higher level of knowledge of immunization and sterile techniques for cord cutting and dressing of the stumps of the umbilical cord than the untrained group. However, knowledge of sterilization of instruments was not significantly different, indicating a need to improve teaching in this area.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Reasons Why Women Choose Home Birth

    Directory of Open Access Journals (Sweden)

    Mary Angelie P. Andrino

    2016-11-01

    Full Text Available Maternal deaths in the Philippines remain high. These deaths are mostly due to the large proportion of home births, complications of pregnancy and delivery, and lack of access to facilities and competently trained staff. Utilizing a descriptive, one-shot survey design, the study aimed to determine the reasons why women in a municipality in Iloilo prefer home birth. The respondents were interviewed using a validated questionnaire. Descriptive statistics were used to analyze and interpret the findings. The study revealed that the proportion of home births progressively declined from 2012 to 2014. Birth being imminent or inevitable is the number one reason that supports home birth. Autonomy, safety, affordability, readily available birthing equipment and supplies, accessibility of birth attendant, remote access by going to the birthing center, lack of transportation, and bad weather conditions also led women to give birth at home. Women from the rural areas of the municipality utilized available resources in the community which prompted the predominance of home deliveries assisted by traditional birth attendants (TBAs and even midwives, who were readily available nearby. This study recommends continuous improvement in existing maternal health interventions and strategies through engagement of women in policy planning, improvement of health service delivery, infrastructural enhancement, better care practices and continuous health education.

  7. The influence of fish-oil lipid emulsions on retinopathy of prematurity in very low birth weight infants: a randomized controlled trial.

    Science.gov (United States)

    Beken, Serdar; Dilli, Dilek; Fettah, Nurdan Dinlen; Kabataş, Emrah Utku; Zenciroğlu, Ayşegül; Okumuş, Nurullah

    2014-01-01

    To compare the effect of two lipid emulsions on the development of retinopathy of prematurity in very low birth weight infants. Randomized controlled study. Eighty very low birth weight infants receiving parenteral nutrition from the first day of life were evaluated. One of the two lipid emulsions were used in the study infants: Group 1 (n=40) received fish-oil based lipid emulsion (SmofLipid®) and Group 2 (n=40) soybean oil based lipid emulsion (Intralipid®). The development of retinopathy of prematurity and the need for laser photocoagulation were assessed. The maternal and perinatal characteristics were similar in both groups. The median (range) duration of parenteral nutrition [14days (10-28) vs 14 (10-21)] and hospitalization [34days (20-64) vs 34 (21-53)] did not differ between the groups. Laboratory data including complete blood count, triglyceride level, liver and kidney function tests recorded before and after parenteral nutrition also did not differ between the two groups. In Group 1, two patients (5.0%) and in Group 2, 13 patients (32.5%) were diagnosed with retinopathy of prematurity (OR: 9.1, 95% CI 1.9-43.8, p=0.004). One patient in each group needed laser photocoagulation, without significant difference. Multivariate analysis showed that only receiving fish-oil emulsion in parenteral nutrition decreased the risk of development of retinopathy of prematurity [OR: 0.76, 95% CI (0.06-0.911), p=0.04]. Premature infants with very low birth weight receiving an intravenous fat emulsion containing fish oil developed less retinopathy of prematurity. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Economic policy instruments for the control of air pollution in Poland

    International Nuclear Information System (INIS)

    Bates, R.W.

    1993-01-01

    The World Bank is analyzing the role of economic policy instruments for the control of air pollution in Poland, in cooperation with Polish and international experts. The first stage, covering Poland as a whole, was recently completed, jointly financed with the U.S. E.P.A. and the Government of the Netherlands. The second stage, now under way, will extend the analysis into a specific regional framework. Stage 2 is financed by the World Bank, the Polish Government, and the U.K. Environment Know-How Fund. Air Pollution in Poland is overwhelmingly caused by energy production and uses, due to the fact that the Polish economy depends heavily on coal and lignite. At present, vehicles contribute less to total emissions than do coal burning and industrial processes, although they account for 25-35% of nitrogen oxides, carbon monoxide, hydrocarbons and lead; and the concentrated in areas of high population density. The paper shows how economic, technical and meteorological modelling can be used, to reach conclusions about cost-effective strategies for the control of emissions and the improvement of ambient air quality. A simulation approach is presented, to compare alternative policy instruments, in terms of their impact on emissions and control costs for Poland as a whole. The main instruments considered are open-quotes command-and-controlclose quotes regimes (C ampersand C) and economic incentives, namely fuel taxes, emissions taxes and emissions trading. Next, the paper describes how the analysis is being extended, to link emissions with ambient air quality, using air dispersion modelling, based on a case study for Krakow. Finally, some conclusions are drawn on the importance of sound economic policies for air quality management, the costs of alternative standards, C ampersand C approaches versus economic incentives, a practical strategy to develop an effective role for emissions taxes and trading, and the regional differentiation of policy instruments

  9. Cost Analysis of the Dutch Obstetric System: low-risk nulliparous women preferring home or short-stay hospital birth - a prospective non-randomised controlled study

    Directory of Open Access Journals (Sweden)

    Nijhuis Jan G

    2009-11-01

    Full Text Available Abstract Background In the Netherlands, pregnant women without medical complications can decide where they want to give birth, at home or in a short-stay hospital setting with a midwife. However, a decrease in the home birth rate during the last decennium may have raised the societal costs of giving birth. The objective of this study is to compare the societal costs of home births with those of births in a short-stay hospital setting. Methods This study is a cost analysis based on the findings of a multicenter prospective non-randomised study comparing two groups of nulliparous women with different preferences for where to give birth, at home or in a short-stay hospital setting. Data were collected using cost diaries, questionnaires and birth registration forms. Analysis of the data is divided into a base case analysis and a sensitivity analysis. Results In the group of home births, the total societal costs associated with giving birth at home were €3,695 (per birth, compared with €3,950 per birth in the group for short-stay hospital births. Statistically significant differences between both groups were found regarding the following cost categories 'Cost of contacts with health care professionals during delivery' (€138.38 vs. €87.94, -50 (2.5-97.5 percentile range (PR-76;-25, p Conclusion The total costs associated with pregnancy, delivery, and postpartum care are comparable for home birth and short-stay hospital birth. The most important differences in costs between the home birth group and the short-stay hospital birth group are associated with maternity care assistance, hospitalisation, and travelling costs.

  10. "How to have healthy children". Responses to the falling birth rate in Norway, c. 1900-1940.

    Science.gov (United States)

    Blom, Ida

    2008-01-01

    This paper focuses on initiatives to improve infant health, as they developed in Norway especially during the interwar period. Falling birth rates were felt as a menace to the survival of the nation and specific initiatives were taken to oppose it. But crises engendered by the reduction in fertility strengthened opportunities for introducing policies to help the fewer children born survive and grow up to become healthy citizens. Legislation supporting mothers started in 1892 increased in the interwar years including economic features. Healthy mother and baby stations and hygienic clinics, aimed at controlling births were developed by voluntary organisations inspired from France and England respectively. A sterilization law (1934) paralleled some German policies.

  11. Associations of neonatal high birth weight with maternal pre-pregnancy body mass index and gestational weight gain: a case-control study in women from Chongqing, China.

    Science.gov (United States)

    Xie, Yao Jie; Peng, Rong; Han, Lingli; Zhou, Xiaoli; Xiong, Zhengai; Zhang, Yuan; Li, Junnan; Yao, Ruoxue; Li, Tingyu; Zhao, Yong

    2016-08-16

    To examine the associations of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with neonatal high birth weight (HBW) in a sample of Chinese women living in southwest China. A hospital-based case-control study was conducted in Chongqing, China. A total of 221 mothers who delivered HBW babies (>4.0 kg) were recruited as cases and 221 age-matched (2-year interval) mothers with normal birth weight babies (2.5-4.0 kg) were identified as controls. ORs were estimated using conditional logistic regression analysis. For the analysis, pre-pregnancy BMI was categorised as underweight/normal weight/overweight and obesity and GWG was categorised as inadequate/appropriate/excessive. Among the cases, mean pre-pregnancy BMI was 21.8±2.8 kg/m(2), mean GWG was 19.7±5.1 kg and mean neonatal birth weight was 4.2±0.2 kg. In the controls, the corresponding values were 21.1±3.1 kg/m(2), 16.4±5.0 kg and 3.3±0.4 kg, respectively. More cases than controls gained excessive weight during pregnancy (80.1% vs 48.4%, p0.05). GWG was positively related to HBW after adjustment for gravidity, gestational age, newborns' gender and family income (OR=1.18, 95% CI 1.12 to 1.25; pweight women (OR=10.27, 95% CI 3.20 to 32.95; p<0.001). Overall, the findings suggest a significantly positive association between GWG and HBW. However, pre-pregnancy BMI shows no independent relationship with HBW. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. 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.

  13. 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 ...

  14. Policy-based secure communication with automatic key management for industrial control and automation systems

    Science.gov (United States)

    Chernoguzov, Alexander; Markham, Thomas R.; Haridas, Harshal S.

    2016-11-22

    A method includes generating at least one access vector associated with a specified device in an industrial process control and automation system. The specified device has one of multiple device roles. The at least one access vector is generated based on one or more communication policies defining communications between one or more pairs of devices roles in the industrial process control and automation system, where each pair of device roles includes the device role of the specified device. The method also includes providing the at least one access vector to at least one of the specified device and one or more other devices in the industrial process control and automation system in order to control communications to or from the specified device.

  15. Combining Correlation-Based and Reward-Based Learning in Neural Control for Policy Improvement

    DEFF Research Database (Denmark)

    Manoonpong, Poramate; Kolodziejski, Christoph; Wörgötter, Florentin

    2013-01-01

    Classical conditioning (conventionally modeled as correlation-based learning) and operant conditioning (conventionally modeled as reinforcement learning or reward-based learning) have been found in biological systems. Evidence shows that these two mechanisms strongly involve learning about...... associations. Based on these biological findings, we propose a new learning model to achieve successful control policies for artificial systems. This model combines correlation-based learning using input correlation learning (ICO learning) and reward-based learning using continuous actor–critic reinforcement...... learning (RL), thereby working as a dual learner system. The model performance is evaluated by simulations of a cart-pole system as a dynamic motion control problem and a mobile robot system as a goal-directed behavior control problem. Results show that the model can strongly improve pole balancing control...

  16. Cost-effectiveness of tobacco control policies and programmes targeting adolescents: a systematic review.

    Science.gov (United States)

    Leão, Teresa; Kunst, Anton E; Perelman, Julian

    2018-02-01

    Consistent evidence shows the importance of preventing smoking at young ages, when health behaviours are formed, with long-term consequences on health and survival. Although tobacco control policies and programmes targeting adolescents are widely promoted, the cost-effectiveness of such interventions has not been systematically documented. We performed a systematic review on the cost-effectiveness of policies and programmes preventing tobacco consumption targeting adolescents. We systematically reviewed literature on the (i) cost and effectiveness of (ii) prevention policies targeting (iii) smoking by (iv) adolescents. PubMed, Web of Science, Cochrane, CEA-TUFTS, Health Economic Evaluations, Wiley Online Library, Centre for Reviews and Dissemination Database, the National Institute for Health and Care Excellence and Google Scholar databases were used, and Google search engine was used for other grey literature review. We obtained 793 full-text papers and 19 grey literature documents, from which 16 studies fulfilled the inclusion criteria. Of these, only one was published in the last 5 years, and 15 were performed in high-income countries. Eight analyzed the cost-effectiveness of school-based programmes, five focused on media campaigns and three on legal bans. Policies and programmes were found to be cost-effective in all studies, and both effective and cost-saving in about half of the studies. Evidence is scarce and relatively obsolete, and rarely focused on the evaluation of legal bans. Moreover, no comparisons have been made between different interventions or across different contexts and implementation levels. However, all studies conclude that smoking prevention policies and programmes amongst adolescents are greatly worth their costs. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association.

  17. Harmonisation of European Migration Policies: The Failure of Immigration Control Policies in the Seventh and Eighth Decades of the 20th Century

    Directory of Open Access Journals (Sweden)

    Milan Mesić

    2003-12-01

    Full Text Available Until the middle of the 1970s, the migration policies of developed European countries were based on the assumption that controlling immigration was possible. Due to various reasons discussed in this article, such policies proved unsuccessful. The result was an increase in the total number of foreigners and a change in the composition of immigrant communities, i.e. the proportion of supported family members increased. During the 1980s there was increasing convergence in the migration policies of European immigration countries and traditional overseas emigration countries. Policies were more and more oriented towards preventing illegal migration flows, on regulating refugee flows and on balancing labour migration with family migration. The turning-point in the direction of “harmonising” West European migration policies was marked by the Schengen agreement (1985 on gradual elimination of border controls between the signing parties (France, Germany and the Benelux countries. Fear in the face of a possible invasion of Eastern Europeans after the collapse of socialism in 1989 was a further strong stimulus towards the harmonisation of migration policies in the developing EU. As opposed to migration control, the integration of immigrants has remained so far the prerogative of nation-states. The text further presents an overview of migration policy reforms in individual member states of the EU and of multilateral actions. The post-1989 migration regime in Europe has four major traits: 1 an extension of the agenda; 2 an accent on joint actions; 3 defensiveness; 4 confusion and an overload of issues. While on the one hand the EU continues to seek ways of protecting itself from undesired external migration, on the other hand the process of regional integration continues to “erase” its internal borders.

  18. 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.

  19. Predicting the effect of maternal docosahexaenoic acid (DHA) supplementation to reduce early preterm birth in Australia and the United States using results of within country randomized controlled trials

    Science.gov (United States)

    Yelland, LN; Gajewski, BJ; Colombo, J; Gibson, RA; Makrides, M; Carlson, SE

    2016-01-01

    SUMMARY The DHA to Optimize Mother Infant Outcome (DOMInO) and Kansas DHA Outcomes Study (KUDOS) were randomized controlled trials that supplemented mothers with 800 and 600 mg DHA/day, respectively, or a placebo during pregnancy. DOMInO was conducted in Australia and KUDOS in the United States. Both trials found an unanticipated and statistically significant reduction in early preterm birth (ePTB; i.e., birth before 34 weeks gestation). However, in each trial, the number of ePTBs were small. We used a novel Bayesian approach and an arbitrary sample of 120,000 pregnancies to estimate statistically derived low, moderate or high risk for ePTB, and to test for differences between the DHA and placebo groups. In both trials, the model predicted DHA would significantly reduce the expected proportion of deliveries in the high risk group under the trial conditions of the parent studies. From these proportions we estimated the number of ePTB that could be prevented. PMID:27637340

  20. Maternal and fetal insulin levels at birth in women with polycystic ovary syndrome: data from a randomized controlled study on metformin.

    Science.gov (United States)

    Helseth, Ragnhild; Vanky, Eszter; Stridsklev, Solhild; Vogt, Christina; Carlsen, Sven M

    2014-05-01

    Metformin is suggested to reduce pregnancy complications in women with polycystic ovary syndrome (PCOS). Metformin crosses the placenta and therapeutic concentrations are measured in the fetal circulation. Whether metformin treatment in pregnant PCOS women affects maternal and fetal insulin concentrations at birth is not clarified. To investigate the possible effect of metformin on insulin concentrations in umbilical cord blood and the possible association between maternal and fetal insulin concentrations. Post-hoc analysis of a subgroup of PCOS women participating in a double-blind randomized controlled trial. University hospital setting. Women with PCOS (n=118), aged 19-39 years. Maternal and umbilical cord insulin concentrations immediately after birth. At delivery women randomized to metformin had lower insulin concentrations than those randomized to placebo (259±209 vs 361±261 pmol/l; P=0.020). No difference was found in insulin concentrations in umbilical venous (P=0.95) and arterial (P=0.39) blood between the metformin and placebo groups. The arteriovenous difference was also equal between the groups (P=0.38). Insulin concentrations were higher in the umbilical vein than in the umbilical artery independent of randomization (70±51 vs 45±48 pmol/l; Pmetformin treatment during pregnancy resulted in lower maternal insulin concentrations at delivery. Metformin treatment did not affect fetal insulin concentrations. Higher insulin concentrations in the umbilical vein indicate that the placenta somehow secretes insulin to the fetus. The possibility of placental insulin secretion to the fetus deserves further investigations.

  1. Tobacco Control and Treatment for the Pediatric Clinician: Practice, Policy, and Research Updates.

    Science.gov (United States)

    Jenssen, Brian P; Wilson, Karen M

    2017-04-01

    Tobacco use is the leading cause of preventable death in the United States, and exposure to tobacco smoke harms children from conception forward. There is no safe level of tobacco exposure. Although overall smoking rates have declined, the advent of new products, such as electronic cigarettes, threatens to perpetuate nicotine addiction without clear health benefits. In addition to reviewing traditional and new tobacco products, we discuss the unique role that pediatricians should play in tobacco treatment and control efforts. New policies and technologies can empower pediatric clinicians and pediatric health care systems to help parent smokers quit, and new policies outside of the health care setting might help prevent smoking initiation as well as improve cessation treatments. Future research is needed to continue to study the consequences of tobacco use exposure as well as the best ways to help patients and parents stop tobacco use. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  2. Evaluating Tobacco Control Policies in 28 Countries (including 9 EU countries: The ITC Project

    Directory of Open Access Journals (Sweden)

    Geoffrey Fong

    2016-03-01

    Full Text Available Since its start in 2002, the ITC Project has been conducting evaluation studies of tobacco control policies via prospective cohort surveys of tobacco users in 28 countries, including 9 EU countries. This presentation will focus on the design of the ITC Project and how it differs from and complements existing evidence-gathering systems (monitoring and surveillance systems in measuring and understanding the impact of FCTC policies. The presentation will also describe the ITC Project's most recent initiatives: (1 the EUREST-PLUS study focusing on measuring the impact of the Tobacco Products Directive, and (2 a large-scale international cohort study of e-cigarettes starting in the United States, Canada, England, and Australia.

  3. Cost Analysis of the Dutch Obstetric System: low-risk nulliparous women preferring home or short-stay hospital birth - a prospective non-randomised controlled study

    OpenAIRE

    Hendrix, Marijke JC; Evers, Silvia MAA; Basten, Marloes CM; Nijhuis, Jan G; Severens, Johan L

    2009-01-01

    Abstract Background In the Netherlands, pregnant women without medical complications can decide where they want to give birth, at home or in a short-stay hospital setting with a midwife. However, a decrease in the home birth rate during the last decennium may have raised the societal costs of giving birth. The objective of this study is to compare the societal costs of home births with those of births in a short-stay hospital setting. Methods This study is a cost analysis based on the finding...

  4. Lessons from an evaluation of a provincial-level smoking control policy in Shanghai, China.

    Directory of Open Access Journals (Sweden)

    Xiang Li

    Full Text Available BACKGROUND: The Shanghai Public Places Smoking Control Legislation was implemented in March 2010 as the first provincial-level legislation promoting smoke-free public places in China. OBJECTIVE: To evaluate the compliance with this policy as well as its impact on exposure to secondhand smoke (SHS, respiratory symptoms, and related attitudes among employees in five kinds of workplaces (schools, kindergartens, hospitals, hotels, and shopping malls. METHODS: A cross-sectional survey was conducted six months before and then six months after the policy was implemented. Five types of occupational employees from 52 work settings were surveyed anonymously using multistage stratified cluster sampling. RESULTS: Six months after implementation, 82% of the participants agreed that "legislation is enforced most of the time". The percentage of self-reported exposure to secondhand smoke declined from round up to 49% to 36%. High compliance rates were achieved in schools and kindergartens (above 90%, with less compliance in hotels and shopping malls (about 70%. Accordingly, prevalence of exposure to SHS was low in schools and kindergartens (less than 10% and high in hotels and shopping malls (40% and above. The prevalence of respiratory and sensory symptoms (e.g., red or irritated eyes among employees decreased from 83% to 67%. CONCLUSIONS: Initial positive effects were achieved after the implementation of Shanghai Smoking Control legislation including decreased exposure to SHS. However, compliance with the policies was a considerable problem in some settings. Further evaluation of such policy implementation should be conducted to inform strategies for increasing compliance in the future.

  5. Lessons from an Evaluation of a Provincial-Level Smoking Control Policy in Shanghai, China

    Science.gov (United States)

    Li, Xiang; Gao, Junling; Zhang, Zhixing; Wei, Minqi; Zheng, Pinpin; Nehl, Eric J.; Wong, Frank Y.; Berg, Carla J.

    2013-01-01

    Background The Shanghai Public Places Smoking Control Legislation was implemented in March 2010 as the first provincial-level legislation promoting smoke-free public places in China. Objective To evaluate the compliance with this policy as well as its impact on exposure to secondhand smoke (SHS), respiratory symptoms, and related attitudes among employees in five kinds of workplaces (schools, kindergartens, hospitals, hotels, and shopping malls). Methods A cross-sectional survey was conducted six months before and then six months after the policy was implemented. Five types of occupational employees from 52 work settings were surveyed anonymously using multistage stratified cluster sampling. Results Six months after implementation, 82% of the participants agreed that “legislation is enforced most of the time”. The percentage of self-reported exposure to secondhand smoke declined from round up to 49% to 36%. High compliance rates were achieved in schools and kindergartens (above 90%), with less compliance in hotels and shopping malls (about 70%). Accordingly, prevalence of exposure to SHS was low in schools and kindergartens (less than 10%) and high in hotels and shopping malls (40% and above). The prevalence of respiratory and sensory symptoms (e.g., red or irritated eyes) among employees decreased from 83% to 67%. Conclusions Initial positive effects were achieved after the implementation of Shanghai Smoking Control legislation including decreased exposure to SHS. However, compliance with the policies was a considerable problem in some settings. Further evaluation of such policy implementation should be conducted to inform strategies for increasing compliance in the future. PMID:24058544

  6. Overview of systematic reviews on the health-related effects of government tobacco control policies.

    Science.gov (United States)

    Hoffman, Steven J; Tan, Charlie

    2015-08-05

    Government interventions are critical to addressing the global tobacco epidemic, a major public health problem that continues to deepen. We systematically synthesize research evidence on the effectiveness of government tobacco control policies promoted by the Framework Convention on Tobacco Control (FCTC), supporting the implementation of this international treaty on the tenth anniversary of it entering into force. An overview of systematic reviews was prepared through systematic searches of five electronic databases, published up to March 2014. Additional reviews were retrieved from monthly updates until August 2014, consultations with tobacco control experts and a targeted search for reviews on mass media interventions. Reviews were assessed according to predefined inclusion criteria, and ratings of methodological quality were either extracted from source databases or independently scored. Of 612 reviews retrieved, 45 reviews met the inclusion criteria and 14 more were identified from monthly updates, expert consultations and a targeted search, resulting in 59 included reviews summarizing over 1150 primary studies. The 38 strong and moderate quality reviews published since 2000 were prioritized in the qualitative synthesis. Protecting people from tobacco smoke was the most strongly supported government intervention, with smoke-free policies associated with decreased smoking behaviour, secondhand smoke exposure and adverse health outcomes. Raising taxes on tobacco products also consistently demonstrated reductions in smoking behaviour. Tobacco product packaging interventions and anti-tobacco mass media campaigns may decrease smoking behaviour, with the latter likely an important part of larger multicomponent programs. Financial interventions for smoking cessation are most effective when targeted at smokers to reduce the cost of cessation products, but incentivizing quitting may be effective as well. Although the findings for bans on tobacco advertising were

  7. People's responses to risks of electromagnetic fields and trust in government policy: the role of perceived risk, benefits and control

    NARCIS (Netherlands)

    Dongen, D.; Claassen, L.; Smid, T.; Timmermans, D.R.M.

    2013-01-01

    Trust in government policy affects the way people perceive and handle risks. In our study, we investigated the relationships between trust in government policy regarding electromagnetic fields (EMF), perceived risk and perceived benefits of public and personal EMF sources, perceived control over

  8. Effect of nationwide tobacco control policies on smoking cessation in high and low educated groups in 18 European countries

    NARCIS (Netherlands)

    Schaap, M. M.; Kunst, A. E.; Leinsalu, M.; Regidor, E.; Ekholm, O.; Dzurova, D.; Helmert, U.; Klumbiene, J.; Santana, P.; Mackenbach, J. P.

    2008-01-01

    BACKGROUND: Recently a scale was introduced to quantify the implementation of tobacco control policies at country level. Our study used this scale to examine the potential impact of these policies on quit ratios in European countries. Special attention was given to smoking cessation among lower

  9. Disparities in Birth Weight and Gestational Age by Ethnic Ancestry in South American countries

    Science.gov (United States)

    Wehby, George L.; Gili, Juan A.; Pawluk, Mariela; Castilla, Eduardo E.; López-Camelo, Jorge S.

    2015-01-01

    Objective We examine disparities in birth weight and gestational age by ethnic ancestry in 2000–2011 in eight South American countries. Methods The sample included 60480 singleton live-births. Regression models were estimated to evaluate differences in birth outcomes by ethnic ancestry controlling for time trends. Results Significant disparities were found in seven countries. In four countries – Brazil, Ecuador, Uruguay, and Venezuela – we found significant disparities in both low birth weight and preterm birth. Disparities in preterm birth alone were observed in Argentina, Bolivia, and Colombia. Several differences in continuous birth weight, gestational age, and fetal growth rate were also observed. There were no systematic patterns of disparities between the evaluated ethnic ancestry groups across the study countries, in that no racial/ethnic group consistently had the best or worst outcomes in all countries. Conclusions Racial/ethnic disparities in infant health are common in several South American countries. Differences across countries suggest that racial/ethnic disparities are driven by social and economic mechanisms. Researchers and policymakers should acknowledge these disparities and develop research and policy programs to effectively target them. PMID:25542227

  10. Maternal urinary bisphenol A levels and infant low birth weight: A nested case-control study of the Health Baby Cohort in China.

    Science.gov (United States)

    Huo, Wenqian; Xia, Wei; Wan, Yanjian; Zhang, Bin; Zhou, Aifen; Zhang, Yiming; Huang, Kai; Zhu, Yingshuang; Wu, Chuansha; Peng, Yang; Jiang, Minmin; Hu, Jie; Chang, Huailong; Xu, Bing; Li, Yuanyuan; Xu, Shunqing

    2015-12-01

    Exposure to bisphenol A (BPA), a known endocrine disruptor, has been demonstrated to affect fetal development in animal studies, but findings in human studies have been inconsistent. We investigated whether maternal exposure to BPA during pregnancy is associated with an increased risk of infant low birth weight (LBW). A total 452 mother-infant pairs (113 LBW cases and 339 matched controls) were selected from the participants enrolled in the prospective Health Baby Cohort (HBC) in Wuhan city, China, during 2012-2014. BPA concentrations were measured in maternal urine samples collected at delivery, and the information of birth outcomes was retrieved from the medical records. A conditional logistic regression was used to evaluate the relationship between urinary BPA levels and LBW. Mothers with LBW infants had significantly higher urinary BPA levels (median: 4.70μg/L) than the control mothers (median: 2.25μg/L) (p<0.05). Increased risk of LBW was associated with higher maternal urinary levels of BPA [adjusted odds ratio (OR)=3.13 for the medium tertile, 95% confidence interval (CI): 1.21, 8.08; adjusted OR=2.49 for the highest tertile, 95% CI: 0.98, 6.36]. The association was more pronounced among female infants than among male infants, with a statistical evidence of heterogeneity in risk (p=0.03). Prenatal exposure to higher levels of BPA may potentially increase the risk of delivering LBW infants, especially for female infants. This is the first case-control study to examine the association in China. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. How do policy advisors and practitioners prioritise the protection of children from secondhand smoke exposure in a country with advanced tobacco control policy?

    Science.gov (United States)

    Ritchie, Deborah Doreen; Amos, Amanda; Shaw, April; O'Donnell, Rachel; Semple, Sean; Turner, Steve; Martin, Claudia

    2015-01-01

    The aim is to extend understanding of the policy and practice discourses that inform the development of national tobacco control policy to protect children from secondhand smoke exposure (SHSE) in the home, particularly in a country with successful implementation of smoke-free public places legislation. The Scottish experience will contribute to the tobacco control community, particularly those countries at a similar level of tobacco control, as normalising discourses about protecting children from SHSE are becoming more widespread. Case study design using qualitative interviews and focus groups (FGs) with policy makers, health and childcare practitioners during which they were presented with the findings of the Reducing Families' Exposure to Secondhand Smoke (REFRESH) intervention and discussed the implications for their policy and practice priorities. Scotland, UK PARTICIPANTS: Qualitative interviews and FGs were conducted with 30 policy makers and practitioners who were purposively recruited. Participants accepted the harm of SHSE to children; however, action is limited by political expedience due to-the perception of a shift of the public health priority from smoking to alcohol, current financial constraints, more immediate child protection concerns and continuing unresolved ethical arguments. In a country, such as Scotland, with advanced tobacco control strategies, there continue to be challenges to policy and practice development in the more contentious arena of the home. Children's SHSE in their homes is unequivocally accepted as an important health priority, but it is not currently perceived to be a top public health priority in Scotland. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Competing with big business: a randomised experiment testing the effects of messages to promote alcohol and sugary drink control policy.

    Science.gov (United States)

    Scully, Maree; Brennan, Emily; Durkin, Sarah; Dixon, Helen; Wakefield, Melanie; Barry, Colleen L; Niederdeppe, Jeff

    2017-12-28

    Evidence-based policies encouraging healthy behaviours are often strongly opposed by well-funded industry groups. As public support is crucial for policy change, public health advocates need to be equipped with strategies to offset the impact of anti-policy messages. In this study, we aimed to investigate the effectiveness of theory-based public health advocacy messages in generating public support for sugary drink/alcohol policies (increased taxes; sport sponsorship bans) and improving resistance to subsequent anti-policy messages typical of the sugary drink/alcohol industry. We conducted a two-wave randomised online experiment assigning Australian adults to one of four health policies (sugary drink tax; sugary drink industry sports sponsorship ban; alcohol tax; alcohol industry sports sponsorship ban). Within each health policy, we randomised participants to one of five message conditions: (i) non-advocacy based message about the size and seriousness of the relevant health issue (control); (ii) standard pro-policy arguments alone; (iii) standard pro-policy arguments combined with an inoculation message (forewarning and directly refuting anti-policy arguments from the opposition); (iv) standard pro-policy arguments combined with a narrative message (a short, personal story about an individual's experience of the health issue); or (v) standard pro-policy arguments combined with a composite inoculation and narrative message. At time 1, we exposed participants (n = 6000) to their randomly assigned message. Around two weeks later, we re-contacted participants (n = 3285) and exposed them to an anti-policy message described as being from a representative of the sugary drink/alcohol industry. Generalised linear models tested for differences between conditions in policy support and anti-industry beliefs at both time points. Only the standard argument plus narrative message increased policy support relative to control at time 1. The standard argument plus narrative

  13. School-Based Obesity-Prevention Policies and Practices and Weight-Control Behaviors among Adolescents.

    Science.gov (United States)

    Larson, Nicole; Davey, Cynthia S; Caspi, Caitlin E; Kubik, Martha Y; Nanney, Marilyn S

    2017-02-01

    The promotion of healthy eating and physical activity within school settings is an important component of population-based strategies to prevent obesity; however, adolescents may be vulnerable to weight-related messages, as rapid development during this life stage often leads to preoccupation with body size and shape. This study examines secular trends in secondary school curricula topics relevant to the prevention of unhealthy weight-control behaviors; describes cross-sectional associations between weight-related curricula content and students' use of weight-control behaviors; and assesses whether implementation of school-based obesity-prevention policies/practices is longitudinally related to students' weight-control behaviors. The Minnesota School Health Profiles and Minnesota Student Survey (grades 9 and 12) data were used along with National Center for Education Statistics data to examine secular trends, cross-sectional associations (n=141 schools), and longitudinal associations (n=42 schools). Students self-reported their height and weight along with past-year use of healthy (eg, exercise), unhealthy (eg, fasting), and extreme (eg, use laxatives) weight-control behaviors. Descriptive statistics, generalized estimating equations, and generalized linear regression models accounting for school-level demographics. There was no observable pattern during the years 2008 to 2014 in the mean number of curricula topics addressing unhealthy weight-control behaviors, despite an increase in the prevalence of curricula addressing acceptance of body-size differences. Including three vs fewer weight-control topics and specifically including the topic of eating disorders in the curricula was related to a lower school-level percent of students using any extreme weight-control behaviors. In contrast, an overall measure of implementing school-based obesity-prevention policies/practices (eg, prohibited advertising) was unrelated to use of unhealthy or extreme behaviors

  14. The evolution of HIV policy in Vietnam: from punitive control measures to a more rights-based approach.

    Science.gov (United States)

    Nguyen Ha, Pham; Pharris, Anastasia; Huong, Nguyen Thanh; Chuc, Nguyen Thi Kim; Brugha, Ruairi; Thorson, Anna

    2010-08-28

    Policymaking in Vietnam has traditionally been the preserve of the political elite, not open to the scrutiny of those outside the Communist Party. This paper aims to analyse Vietnam's HIV policy development in order to describe and understand the policy content, policy-making processes, actors and obstacles to policy implementation. Nine policy documents on HIV were analysed and 17 key informant interviews were conducted in Hanoi and Quang Ninh Province, based on a predesigned interview guide. Framework analysis, a type of qualitative content analysis, was applied for data analysis. Our main finding was that during the last two decades, developments in HIV policy in Vietnam were driven in a top-down way by the state organs, with support and resources coming from international agencies. Four major themes were identified: HIV policy content, the policy-making processes, the actors involved and human resources for policy implementation. Vietnam's HIV policy has evolved from one focused on punitive control measures to a more rights-based approach, encompassing harm reduction and payment of health insurance for medical costs of patients with HIV-related illness. Low salaries and staff reluctance to work with patients, many of whom are drug users and female sex workers, were described as the main barriers to low health staff motivation. Health policy analysis approaches can be applied in a traditional one party state and can demonstrate how similar policy changes take place, as those found in pluralistic societies, but through more top-down and somewhat hidden processes. Enhanced participation of other actors, like civil society in the policy process, is likely to contribute to policy formulation and implementation that meets the diverse needs and concerns of its population.

  15. The evolution of HIV policy in Vietnam: from punitive control measures to a more rights-based approach

    Directory of Open Access Journals (Sweden)

    Pham Nguyen Ha

    2010-08-01

    Full Text Available Aim: Policymaking in Vietnam has traditionally been the preserve of the political elite, not open to the scrutiny of those outside the Communist Party. This paper aims to analyse Vietnam's HIV policy development in order to describe and understand the policy content, policy-making processes, actors and obstacles to policy implementation. Methods: Nine policy documents on HIV were analysed and 17 key informant interviews were conducted in Hanoi and Quang Ninh Province, based on a predesigned interview guide. Framework analysis, a type of qualitative content analysis, was applied for data analysis. Results: Our main finding was that during the last two decades, developments in HIV policy in Vietnam were driven in a top-down way by the state organs, with support and resources coming from international agencies. Four major themes were identified: HIV policy content, the policy-making processes, the actors involved and human resources for policy implementation. Vietnam's HIV policy has evolved from one focused on punitive control measures to a more rights-based approach, encompassing harm reduction and payment of health insurance for medical costs of patients with HIV-related illness. Low salaries and staff reluctance to work with patients, many of whom are drug users and female sex workers, were described as the main barriers to low health staff motivation. Conclusion: Health policy analysis approaches can be applied in a traditional one party state and can demonstrate how similar policy changes take place, as those found in pluralistic societies, but through more top-down and somewhat hidden processes. Enhanced participation of other actors, like civil society in the policy process, is likely to contribute to policy formulation and implementation that meets the diverse needs and concerns of its population.

  16. [A case-control study on association between OAS1 polymorphism and susceptibility to spontaneous preterm birth and preterm premature rupture of membranes].

    Science.gov (United States)

    Yang, Xiao; Zhang, Xiao-Ai; Wu, Zhi-Hao; Peng, Wei; Zhu, Li-Na; Wang, Yan

    2015-09-01

    To investigate the association between the genetic polymorphism of 2',5'-oligoadenylate synthetase 1 (OAS1) and susceptibility to spontaneous preterm birth (SPTB) and preterm premature rupture of membranes (PPROM). The case-control study consisted of 599 preterm infants including 171 cases of PPROM, and 673 full-term infants without maternal histories of SPTB and PPROM as controls. The single nucleotide polymorphism (SNP) at OAS1 intron 5, rs10774671, was analyzed by polymerase chain reaction-restriction fragment length polymorphism. No significant differences were observed between the case and control groups in the frequencies of genotypes (AA, GA, and GG) and alleles (A and G) of OAS1 rs10774671. When the case group was divided into two subgroups with or without PPROM, no significant differences in the genotype and allele frequencies were found between each subgroup and the control group. When the case group was divided into three subgroups with different gestational ages at SPTB, no significant differences in the genotype and allele frequencies were detected between each subgroup and the control group. No association is identified between OAS1 SNP and susceptibility to SPTB and PPROM.

  17. Sweden SimSmoke: the effect of tobacco control policies on smoking and snus prevalence and attributable deaths.

    Science.gov (United States)

    Near, Aimee M; Blackman, Kenneth; Currie, Laura M; Levy, David T

    2014-06-01

    This study examines the effect of past tobacco control policies and projects the effect of future policies on smoking and snus use prevalence and associated premature mortality in Sweden. The established SimSmoke model was adapted with population, smoking rates and tobacco control policy data from Sweden. SimSmoke evaluates the effect of taxes, smoke-free air, mass media, marketing bans, warning labels, cessation treatment and youth access policies on smoking and snus prevalence and the number of deaths attributable to smoking and snus use by gender from 2010 to 2040. Sweden SimSmoke estimates that significant inroads to reducing smoking and snus prevalence and premature mortality can be achieved through tax increases, especially when combined with other policies. Smoking prevalence can be decreased by as much as 26% in the first few years, reaching a 37% reduction within 30 years. Without effective tobacco control policies, almost 54 500 lives will be lost in Sweden due to tobacco use by the year 2040. Besides presenting the benefits of a comprehensive tobacco control strategy, the model identifies gaps in surveillance and evaluation that can help better focus tobacco control policy in Sweden. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  18. CONSOLIDATION POLICY: PAST, PRESENT AND FUTURE APPROACHES TO THE CONCEPT OF CONTROL

    Directory of Open Access Journals (Sweden)

    Ienciu Alin Ionel

    2010-07-01

    Full Text Available Preparing consolidated financial statements has been a common practice for groups of companies around the world for a relatively long time, going back one century in the USA and tens of years in different European countries.A far-reaching issue regarding consolidation accounting policy is the concept of control, as it holds a crucial role in determining the basis of consolidation and the applicable method of consolidation and subsequently in influencing the content of the group financial statements. We focus in our article on the concept of exclusive control as it is approached by the relevant International, American and European standards, casting light also on possible future developments of this concept. The objective of our study is to acknowledge the differences and similarities between the approaches to the control concept, closing with the presentation of the influences of these approaches on the basis of consolidation.

  19. 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

  20. 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.

  1. Control-limit preventive maintenance policies for components subject to imperfect preventive maintenance and variable operational conditions

    International Nuclear Information System (INIS)

    You Mingyi; Li Hongguang; Meng Guang

    2011-01-01

    This paper develops two component-level control-limit preventive maintenance (PM) policies for systems subject to the joint effect of partial recovery PM acts (imperfect PM acts) and variable operational conditions, and investigates the properties of the proposed policies. The extended proportional hazards model (EPHM) is used to model the system failure likelihood influenced by both factors. Several numerical experiments are conducted for policy property analysis, using real lifetime and operational condition data and typical characterization of imperfect PM acts and maintenance durations. The experimental results demonstrate the necessity of considering both factors when they do exist, characterize the joint effect of the two factors on the performance of an optimized PM policy, and explore the influence of the loading sequence of time-varying operational conditions on the performance of an optimized PM policy. The proposed policies extend the applicability of PM optimization techniques.

  2. Notification: Audit of EPA's Adherence to Policies, Procedures and Oversight Controls Pertaining to the Administrator’s Travel

    Science.gov (United States)

    Project #OA-FY17-0382, August 28, 2017. The EPA OIG plans to begin preliminary research on the EPA’s adherence to policies, procedures and oversight controls pertaining to the Administrator’s travel to Oklahoma.

  3. Controlling liver cancer internationally: A qualitative study of clinicians' perceptions of current public policy needs.

    Science.gov (United States)

    Bridges, John Fp; Gallego, Gisselle; Blauvelt, Barri M

    2011-07-28

    Liver cancer is the fifth most common cancer in men and the seventh for women. Usually because of late diagnosis, the prognosis for liver cancer remains poor, resulting in liver cancer being the third most common cause of death from cancer. While some countries have treatment guidelines, little is known or understood about the strategies needed for liver cancer control internationally. To explore leading liver cancer clinician's perceptions of the current public policy needs to control liver cancer internationally. Key informant interviews were conducted with a range of liver cancer clinicians involved in policy in eleven countries. Interviews were digitally recorded, transcribed verbatim, translated (where necessary), de-identified and analyzed by two researchers using a constant comparative method. Twenty in-depth semi-structured interviews were conducted in: Australia, China, France, Germany, Italy, Japan, Spain, South Korea, Taiwan, Turkey and the United States. Nine themes were identified and cluster into three groups: 1) Promoting prevention via early risk assessment, focusing on viral hepatitis and other lifestyle factors; 2) Increasing political, public and medical community awareness; and 3) Improving funding for screening, liver cancer surveillance and treatment. This study is an important step towards developing an evidence-based approach to assessing preparedness for implementing comprehensive liver cancer control strategies. Evaluation mechanisms to assess countries' performance on the needs described are needed. Future research will concentrate of understanding how these needs vary across countries and the optimal strategies to improve the diagnosis and prognosis of patients with liver cancer internationally.

  4. The importance of peer effects, cigarette prices and tobacco control policies for youth smoking behavior.

    Science.gov (United States)

    Powell, Lisa M; Tauras, John A; Ross, Hana

    2005-09-01

    This paper expands the youth cigarette demand literature by undertaking an examination of the determinants of smoking among high school students incorporating the importance of peer effects and allowing cigarette prices (taxes) and tobacco control policies to have a direct effect and an indirect effect (via the peer effect) on smoking behavior. To control for the potential endogeneity of our school-based peer measure we implement a two-stage generalized least squares estimator for a dichotomous dependent variable and implement a series of diagnostic tests. The key finding is that peer effects play a significant role in youth smoking decisions: moving a high-school student from a school where no children smoke to a school where one quarter of the youths smoke is found to increase the probability that the youth smokes by about 14.5 percentage points. The results suggest that there is a potential for social multiplier effects with respect to any exogenous change in cigarette taxes or tobacco control policies.

  5. Family control, institutional environment and cash dividend policy: Evidence from China

    Directory of Open Access Journals (Sweden)

    Zhihua Wei

    2011-06-01

    Full Text Available Using a sample of 1486 Chinese A-share listed companies for the period 2004–2008, this study empirically tests the impact of family control, institutional environment and their interaction on the cash dividend policy of listed companies. Our results indicate that (1 family firms have a lower cash dividend payout ratio and propensity to pay dividends than non-family firms; (2 a favorable regional institutional environment has a significant positive impact on the cash dividend payout ratio and propensity to pay dividends of listed companies; and (3 the impact of the regional institutional environment on cash dividends is stronger in family firms than in non-family firms. Somewhat surprisingly, we find that controlling family shareholders in China may intensify Agency Problem I (the owner–manager conflict rather than Agency Problem II (the controlling shareholder–minority shareholder conflict, and thus have a significant negative impact on cash dividend policy. In contrast, a favorable regional institutional environment plays a positive corporate governance role in mitigating Agency Problem I and encouraging family firms to pay cash dividends.

  6. Adaptive optimal control of unknown constrained-input systems using policy iteration and neural networks.

    Science.gov (United States)

    Modares, Hamidreza; Lewis, Frank L; Naghibi-Sistani, Mohammad-Bagher

    2013-10-01

    This paper presents an online policy iteration (PI) algorithm to learn the continuous-time optimal control solution for unknown constrained-input systems. The proposed PI algorithm is implemented on an actor-critic structure where two neural networks (NNs) are tuned online and simultaneously to generate the optimal bounded control policy. The requirement of complete knowledge of the system dynamics is obviated by employing a novel NN identifier in conjunction with the actor and critic NNs. It is shown how the identifier weights estimation error affects the convergence of the critic NN. A novel learning rule is developed to guarantee that the identifier weights converge to small neighborhoods of their ideal values exponentially fast. To provide an easy-to-check persistence of excitation condition, the experience replay technique is used. That is, recorded past experiences are used simultaneously with current data for the adaptation of the identifier weights. Stability of the whole system consisting of the actor, critic, system state, and system identifier is guaranteed while all three networks undergo adaptation. Convergence to a near-optimal control law is also shown. The effectiveness of the proposed method is illustrated with a simulation example.

  7. Breastfeeding Trends Among Very Low Birth Weight, Low Birth Weight, and Normal Birth Weight Infants.

    Science.gov (United States)

    Campbell, Angela G; Miranda, Patricia Y

    2018-05-18

    To examine the change in breastfeeding behaviors over time, among low birth weight (LBW), very low birth weight (VLBW), and normal birth weight (NBW) infants using nationally representative US data. Univariate statistics and bivariate logistic models were examined using the Early Child Longitudinal Study-Birth Cohort (2001) and National Study of Children's Health (2007 and 2011/2012). Breastfeeding behaviors improved for infants of all birth weights from 2007 to 2011/2012. In 2011/2012, a higher percentage of VLBW infants were ever breastfed compared with LBW and NBW infants. In 2011/2012, LBW infants had a 28% lower odds (95% CI, 0.57-0.92) of ever breastfeeding and a 52% lower odds (95% CI, 0.38-0.61) of breastfeeding for ≥6 months compared with NBW infants. Among black infants, a larger percentage of VLBW infants were breastfed for ≥6 months (26.2%) compared with LBW infants (14.9%). Breastfeeding rates for VLBW and NBW infants have improved over time. Both VLBW and NBW infants are close to meeting the Healthy People 2020 ever breastfeeding goal of 81.9%. LBW infants are farther from this goal than VLBW infants. The results suggest a need for policies that encourage breastfeeding specifically among LBW infants. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Enrichment from birth accelerates the functional and cellular development of a motor control area in the mouse.

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    Teresa Simonetti

    Full Text Available BACKGROUND: There is strong evidence that sensory experience in early life has a profound influence on the development of sensory circuits. Very little is known, however, about the role of experience in the early development of striatal networks which regulate both motor and cognitive function. To address this, we have investigated the influence of early environmental enrichment on motor development. METHODOLOGY/PRINCIPAL FINDINGS: Mice were raised in standard or enriched housing from birth. For animals assessed as adults, half of the mice had their rearing condition reversed at weaning to enable the examination of the effects of pre- versus post-weaning enrichment. We found that exclusively pre-weaning enrichment significantly improved performance on the Morris water maze compared to non-enriched mice. The effects of early enrichment on the emergence of motor programs were assessed by performing behavioural tests at postnatal day 10. Enriched mice traversed a significantly larger region of the test arena in an open-field test and had improved swimming ability compared to non-enriched cohorts. A potential cellular correlate of these changes was investigated using Wisteria-floribunda agglutinin (WFA staining to mark chondroitin-sulfate proteoglycans (CSPGs. We found that the previously reported transition of CSPG staining from striosome-associated clouds to matrix-associated perineuronal nets (PNNs is accelerated in enriched mice. CONCLUSIONS/SIGNIFICANCE: This is the first demonstration that the early emergence of exploratory as well as coordinated movement is sensitive to experience. These behavioural changes are correlated with an acceleration of the emergence of striatal PNNs suggesting that they may consolidate the neural circuits underlying these behaviours. Finally, we confirm that pre-weaning experience can lead to life long changes in the learning ability of mice.

  9. Program, policy, and price interventions for tobacco control: quantifying the return on investment of a state tobacco control program.

    Science.gov (United States)

    Dilley, Julia A; Harris, Jeffrey R; Boysun, Michael J; Reid, Terry R

    2012-02-01

    We examined health effects associated with 3 tobacco control interventions in Washington State: a comprehensive state program, a state policy banning smoking in public places, and price increases. We used linear regression models to predict changes in smoking prevalence and specific tobacco-related health conditions associated with the interventions. We estimated dollars saved over 10 years (2000-2009) by the value of hospitalizations prevented, discounting for national trends. Smoking declines in the state exceeded declines in the nation. Of the interventions, the state program had the most consistent and largest effect on trends for heart disease, cerebrovascular disease, respiratory disease, and cancer. Over 10 years, implementation of the program was associated with prevention of nearly 36,000 hospitalizations, at a value of about $1.5 billion. The return on investment for the state program was more than $5 to $1. The combined program, policy, and price interventions resulted in reductions in smoking and related health effects, while saving money. Public health and other leaders should continue to invest in tobacco control, including comprehensive programs.

  10. Randomized controlled trial of skin-to-skin contact from birth versus conventional incubator for physiological stabilization in 1200- to 2199-gram newborns.

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    Bergman, N J; Linley, L L; Fawcus, S R

    2004-06-01

    Conventional care of prematurely born infants involves extended maternal-infant separation and incubator care. Recent research has shown that separation causes adverse effects. Maternal-infant skin-to-skin contact (SSC) provides an alternative habitat to the incubator, with proven benefits for stable prematures; this has not been established for unstable or newborn low-birthweight infants. SSC from birth was therefore compared to incubator care for infants between 1200 and 2199 g at birth. This was a prospective, unblinded, randomized controlled clinical trial; potential subjects were identified before delivery and randomized by computerized minimization technique at 5 min if eligible. Standardized care and observations were maintained for 6 h. Stability was measured in terms of a set of pre-determined physiological parameters, and a composite cardio-respiratory stabilization score (SCRIP). 34 infants were analysed in comparable groups: 3/18 SSC compared to 12/13 incubator babies exceeded the pre-determined parameters (p incubator (maximum 78), mean difference 2.88 (95% CI: 0.3-5.46, p = 0.031). All 18 SSC subjects were stable in the sixth hour, compared to 6/13 incubator infants. Eight out of 13 incubator subjects experienced hypothermia. Newborn care provided by skin-to-skin contact on the mother's chest results in better physiological outcomes and stability than the same care provided in closed servo-controlled incubators. The cardio-respiratory instability seen in separated infants in the first 6 h is consistent with mammalian "protest-despair" biology, and with "hyper-arousal and dissociation" response patterns described in human infants: newborns should not be separated from their mothers.

  11. Public attitudes towards alcohol control policies in Scotland and England: Results from a mixed-methods study.

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    Li, Jessica; Lovatt, Melanie; Eadie, Douglas; Dobbie, Fiona; Meier, Petra; Holmes, John; Hastings, Gerard; MacKintosh, Anne Marie

    2017-03-01

    The harmful effects of heavy drinking on health have been widely reported, yet public opinion on governmental responsibility for alcohol control remains divided. This study examines UK public attitudes towards alcohol policies, identifies underlying dimensions that inform these, and relationships with perceived effectiveness. A cross-sectional mixed methods study involving a telephone survey of 3477 adult drinkers aged 16-65 and sixteen focus groups with 89 adult drinkers in Scotland and England was conducted between September 2012 and February 2013. Principal components analysis (PCA) was used to reduce twelve policy statements into underlying dimensions. These dimensions were used in linear regression models examining alcohol policy support by demographics, drinking behaviour and perceptions of UK drinking and government responsibility. Findings were supplemented with a thematic analysis of focus group transcripts. A majority of survey respondents supported all alcohol policies, although the level of support varied by type of policy. Greater enforcement of laws on under-age sales and more police patrolling the streets were strongly supported while support for pricing policies and restricting access to alcohol was more divided. PCA identified four main dimensions underlying support on policies: alcohol availability, provision of health information and treatment services, alcohol pricing, and greater law enforcement. Being female, older, a moderate drinker, and holding a belief that government should do more to reduce alcohol harms were associated with higher support on all policy dimensions. Focus group data revealed findings from the survey may have presented an overly positive level of support on all policies due to differences in perceived policy effectiveness. Perceived effectiveness can help inform underlying patterns of policy support and should be considered in conjunction with standard measures of support in future research on alcohol control policies

  12. Visual memory and learning in extremely low-birth-weight/extremely preterm adolescents compared with controls: a geographic study.

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    Molloy, Carly S; Wilson-Ching, Michelle; Doyle, Lex W; Anderson, Vicki A; Anderson, Peter J

    2014-04-01

    Contemporary data on visual memory and learning in survivors born extremely preterm (EP; Visual learning and memory data were available for 221 (74.2%) EP/ELBW subjects and 159 (60.7%) controls. EP/ELBW adolescents exhibited significantly poorer performance across visual memory and learning variables compared with controls. Visual learning and delayed visual memory were particularly problematic and remained so after controlling for visual-motor integration and visual perception and excluding adolescents with neurosensory disability, and/or IQ visual memory and learning outcomes compared with controls, which cannot be entirely explained by poor visual perceptual or visual constructional skills or intellectual impairment.

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

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    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.

  14. The Relationship between Maternal Diseases during Pregnancy and Low Birth Weight: a Nested Case-Control Study in Rural Areas of Kurdistan Province (West of Iran

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    Ghobad Moradi

    2017-08-01

    Full Text Available Background: Low birth weight (LBW is considered as one of the important health indicators in evaluating prenatal care as well as determining scale of infants' health in the society. The study aimed to investigate maternal diseases during pregnancy and its impact on LBW in rural areas of Kurdistan province, Iran. Materials and Methods: This study was conducted in nested case-control study method in rural areas of Kurdistan province- Iran in 2015-2016. In this study, 182 infants less than 2,500gr as case and 364 infants weighing 2,500 g and more as control were entered the study. Information about case and control groups was extracted by investigating records of pregnant women care. Data was analyzed using software Stata-12 with point and interval estimation of odds ratio (OR using conditional logistic regression. Results: The results of single-variable analysis of conditional logistic regression showed that there is a statistical relationship between blood pressure during pregnancy, iron deficiency anemia, mother's thyroid problems, oral and dental problems, and history of bleeding during pregnancy in case and control groups (P

  15. Global and Regional Patterns of Tobacco Smoking and Tobacco Control Policies.

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    Islami, Farhad; Stoklosa, Michal; Drope, Jeffrey; Jemal, Ahmedin

    2015-08-01

    Tobacco smoking is a major worldwide cause of morbidity and mortality from various diseases, including urologic diseases. We reviewed, at global and regional levels, the prevalence and trends of tobacco smoking and legislative and regulatory efforts around tobacco control. We also provided information about electronic cigarette (e-cigarette) use. We used several sources to present the most up-to-date information from national surveys, including the Global Adult Tobacco Survey, the Global Tobacco Control Report, and the Global Youth Tobacco Survey. Smoking prevalence has been decreasing globally, although trends in smoking vary substantially across countries and by gender. Among men, smoking prevalence in most high-income countries started to decrease in the mid-1990s, followed after a few decades by generally smaller decreases in some low- and middle-income countries (LMICs). However, there has been no change, or there has even been an increase, in smoking prevalence in many other LMICs. Countries with the highest male smoking prevalence are located in East Asia, Southeast Asia, and Eastern Europe. Similar to men, smoking prevalence for women has been decreasing in most high-income countries and some LMICs, although the decrease began later and was slower than that for men. Except in a few countries, smoking is much less common for women than for men. Most countries with the highest smoking prevalence in women are in Europe. Countries that have implemented the best practices for tobacco control, including monitoring, smoke-free policies, cessation programs, health warnings, advertising bans, and taxation, have been able to reduce smoking rates and related harms. E-cigarette use has rapidly increased since its introduction to the market. Health care providers should advise smoking patients about quitting smoking. Countries must improve the implementation and enforcement of tobacco control policies. Particular attention should be paid to preventing an increase in

  16. Effects of tobacco control policies on smoking prevalence and tobacco-attributable deaths in Mexico: the SimSmoke model

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    Luz Myriam Reynales-Shigematsu

    Full Text Available OBJECTIVE: To examine how policies adopted in Mexico in response to the Framework Convention on Tobacco Control affected smoking prevalence and smoking-attributable deaths. METHODS: The SimSmoke simulation model of tobacco control policy is applied to Mexico. This discrete time, first-order Markov model uses data on population size, smoking rates and tobacco control policy for Mexico. It assesses, individually and jointly, the effects of seven types of policies: cigarette taxes, smoke-free air laws, mass media campaigns, advertising bans, warning labels, cessation treatment, and youth tobacco access policies. RESULTS: The Mexico SimSmoke model estimates that smoking rates have been reduced by about 30% as a result of policies implemented since 2002, and that the number of smoking-attributable deaths will have been reduced by about 826 000 by 2053. Increases in cigarette prices are responsible for over 60% of the reductions, but health warnings, smoke-free air laws, marketing restrictions and cessation treatments also play important roles. CONCLUSIONS: Mexico has shown steady progress towards reducing smoking prevalence in a short period of time, as have other Latin American countries, such as Brazil, Panama and Uruguay. Tobacco control policies play an important role in continued efforts to reduce tobacco use and associated deaths in Mexico.

  17. 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.

  18. Chronic viral hepatitis: policy, regulation, and strategies for its control and elimination in Ethiopia

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    Fassil Shiferaw

    2016-08-01

    categories. The World Health Organization (WHO global hepatitis response framework was used to organize the analysis. Results Ethiopia is in the process of preparing strategic plan and guidelines for viral hepatitis. However, the country still lacks the required partnerships, and resource mobilization as a national health response is limited. Community awareness on the disease transmission and its sequel is poor. Viral hepatitis screening services are not widely available except for the occasional mandatory medical checkups for work or travel purposes. Healthcare providers often take no further action after diagnosing patients with viral hepatitis due to lack of treatment guidelines and strategic frameworks for screening, diagnosis, and treatment. Besides, drugs that are effective in the treatment of viral hepatitis are not available, mainly due to regulatory challenges. Conclusions Viral hepatitis and its disease burden are getting little attention in Ethiopia and many low-income countries. The levels of technical guidance and financial support from the international community are low. To date, the response to the infections in Ethiopia is patchy. Thus, the country needs to formulate policy and strategies in the areas of disease surveillance, risk group identification and screening, use of the birth dose of hepatitis B vaccine, and care and treatment. Improving availability of data on viral hepatitis, access to low-cost generic drugs and developing and dissemination of treatment guidelines are also critical. Leveraging the successful Health Extension Program for a hepatitis response, and exploring ways to learn from and integrate into the HIV/AIDS program should also be considered.

  19. Chronic viral hepatitis: policy, regulation, and strategies for its control and elimination in Ethiopia.

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    Shiferaw, Fassil; Letebo, Mekitew; Bane, Abate

    2016-08-11

    hepatitis response framework was used to organize the analysis. Ethiopia is in the process of preparing strategic plan and guidelines for viral hepatitis. However, the country still lacks the required partnerships, and resource mobilization as a national health response is limited. Community awareness on the disease transmission and its sequel is poor. Viral hepatitis screening services are not widely available except for the occasional mandatory medical checkups for work or travel purposes. Healthcare providers often take no further action after diagnosing patients with viral hepatitis due to lack of treatment guidelines and strategic frameworks for screening, diagnosis, and treatment. Besides, drugs that are effective in the treatment of viral hepatitis are not available, mainly due to regulatory challenges. Viral hepatitis and its disease burden are getting little attention in Ethiopia and many low-income countries. The levels of technical guidance and financial support from the international community are low. To date, the response to the infections in Ethiopia is patchy. Thus, the country needs to formulate policy and strategies in the areas of disease surveillance, risk group identification and screening, use of the birth dose of hepatitis B vaccine, and care and treatment. Improving availability of data on viral hepatitis, access to low-cost generic drugs and developing and dissemination of treatment guidelines are also critical. Leveraging the successful Health Extension Program for a hepatitis response, and exploring ways to learn from and integrate into the HIV/AIDS program should also be considered.

  20. Electronic Cigarettes Among Priority Populations: Role of Smoking Cessation and Tobacco Control Policies.

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    Huang, Jidong; Kim, Yoonsang; Vera, Lisa; Emery, Sherry L

    2016-02-01

    The electronic cigarette (e-cigarette) market has evolved rapidly in recent years, with exploding growth in brands and product types; however, e-cigarette use among priority (sexual minority and low-income) populations and its relationship with smoking-cessation and tobacco control policies have yet to be fully characterized. The authors conducted a nationally representative online survey of 17,522 U.S. adults in 2013. Participants were drawn from GfK's KnowledgePanel. Logistic regression models were used to analyze relationships between e-cigarettes (awareness, ever use, current use) and cigarette smoking and cessation behaviors, tobacco control policies, and demographics. Analyses were conducted in 2014. Approximately 15% of participants reported ever use of e-cigarettes, 5.1% reported current use, and 34.5% of ever users reported current use. E-cigarette awareness was lower among women, minorities, and those with low education. Ever and current use of e-cigarettes was higher among current cigarette smokers, young adults, and those with low SES; both ever use and current use were correlated with current cigarette smoking status, particularly when combined with quit intentions or attempts. Lesbian/gay/bisexual/transgender respondents had higher rates of ever use and current use. Ever use was lower in states with comprehensive smoking bans. No significant relationship between cigarette price and e-cigarette use was detected. Ongoing surveillance of e-cigarette use among subpopulation groups and monitoring their use for combustible cigarette cessation are needed. Important variations in the patterns and correlates of e-cigarette awareness and use exist among priority populations. These findings have implications for future e-cigarette policy decisions. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.