WorldWideScience

Sample records for birth control policy

  1. 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.

  2. 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...

  3. 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.

  4. 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 ...

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

    Science.gov (United States)

    Critchlow, D T

    1995-01-01

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

  6. [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.

  7. 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 ...

  8. 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 ...

  9. 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 ...

  10. 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 ...

  11. 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 ...

  12. 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 ...

  13. 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 ...

  14. 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.

  15. 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 ...

  16. 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.

  17. 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...

  18. 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.

  19. 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) ...

  20. 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.

  1. [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.

  2. 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 ...

  3. 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.

  4. 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...

  5. 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.

  6. [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.

  7. 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 ...

  8. 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)

  9. 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- ...

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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

  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. 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 ...

  17. 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 ...

  18. 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 ...

  19. [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

  20. 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.

  1. 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

  2. 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…

  3. 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 ...

  4. 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 ...

  5. 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.

  6. 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 ...

  7. 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 ...

  8. 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.

  9. 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.

  10. 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.

  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. 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.

  13. 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

  14. 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

  15. 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

  16. 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.

  17. 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

  18. 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.

  19. World population growth, family planning, and American foreign policy.

    Science.gov (United States)

    Sharpless, J

    1995-01-01

    The US decision since the 1960s to link foreign policy with family planning and population control is noteworthy for its intention to change the demographic structure of foreign countries and the magnitude of the initiative. The current population ideologies are part of the legacy of 19th century views on science, morality, and political economy. Strong constraints were placed on US foreign policy since World War II, particularly due to presumptions about the role of developing countries in Cold War ideology. Domestic debates revolved around issues of feminism, birth control, abortion, and family political issues. Since the 1960s, environmental degradation and resource depletion were an added global dimension of US population issues. Between 1935 and 1958 birth control movements evolved from the ideologies of utopian socialists, Malthusians, women's rights activists, civil libertarians, and advocates of sexual freedom. There was a shift from acceptance of birth control to questions about the role of national government in supporting distribution of birth control. Immediately postwar the debates over birth control were outside political circles. The concept of family planning as a middle class family issue shifted the focus from freeing women from the burdens of housework to making women more efficient housewives. Family planning could not be taken as a national policy concern without justification as a major issue, a link to national security, belief in the success of intervention, and a justifiable means of inclusion in public policy. US government involvement began with agricultural education, technological assistance, and economic development that would satisfy the world's growing population. Cold War politics forced population growth as an issue to be considered within the realm of foreign policy and diplomacy. US government sponsored family planning was enthusiastic during 1967-74 but restrained during the 1980s. The 1990s has been an era of redefinition of

  20. 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…

  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. 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.

  3. 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.

  4. 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

  5. "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...

  6. 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.

  7. 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

  8. 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.

  9. The politics of home birth in the United States.

    Science.gov (United States)

    Declercq, Eugene

    2012-12-01

    Home birth has emerged as a political issue in several states in the United States, and this essay examines two aspects of home births politics. First, legislative battles over home birth policy do not conform to our typical models of partisan (i.e., Democratic vs Republican) politics, and attempts at advocacy cannot rely on classical strategies of alignment with a dominant party in a state. Second, the debates over home birth have increasingly begun to parallel current partisan battles in their emotion and intensity with the related gridlock and reluctance to consider compromises that are often necessary to achieve policy goals. This essay calls for a greater willingness for all sides to approach home birth less as an ideological mission and more as a health policy challenge to support consumers interested in an integrated system of care. © 2012, Copyright the Authors Journal compilation © 2012, Wiley Periodicals, Inc.

  10. 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.

  11. 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 ...

  12. 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…

  13. 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

  14. 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

  15. 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

  16. 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.

  17. Fertility and Public Policies - Evidence from Norway and Finland

    Directory of Open Access Journals (Sweden)

    2004-05-01

    Full Text Available The relatively high and rising fertility rates of Nordic countries in the late 1980s and early 1990s sparked a renewed research interest in the possible pronatalistic effects of generous family policy programs. Several studies have addressed this issue, but few have tried to model policy effects explicitly. The existing evidence so far is mainly from Sweden, where policy indicators have been incorporated in economic fertility models that also control for female wages. This paper complements previous Swedish analyses with evidence from Norway and Finland. The results corroborate earlier findings of a negative effect of female wages. There are also indications of a positive policy impact, as maternity leave extensions are estimated to raise birth rates, although mainly higher parity births and mainly in Finland.

  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. 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

  20. 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 ...

  1. 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

  2. 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...

  3. 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…

  4. 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.

  5. 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…

  6. Born too soon: preterm birth matters.

    Science.gov (United States)

    Howson, Christopher P; Kinney, Mary V; McDougall, Lori; Lawn, Joy E

    2013-01-01

    Urgent action is needed to address preterm birth given that the fi rst country-level estimates show that globally 15 million babies are born too soon and rates are increasing in most countries with reliable time trend data. As the fi rst in a supplement entitled “Born Too Soon”, this paper focuses on the global policy context. Preterm birth is critical for progress on Millennium Development Goal 4 (MDG) for child survival by 2015 and beyond, and gives added value to maternal health (MDG 5) investments also linking to non-communicable diseases. For preterm babies who survive, the additional burden of prematurity-related disability may aff ect families and health systems. Prematurity is an explicit priority in many high-income settings; however, more attention is needed especially in low- and middle-income countries where the invisibility of preterm birth as well as its myths and misconceptions have slowed action on prevention and care. Recent global attention to preterm birth hit a tipping point in 2012, with the May 2 publication of Born Too Soon: The Global Action Report on Preterm Birth and with the 2nd annual World Prematurity Day on November 17 which mobilised the actions of partners in many countries to address preterm birth and newborn health. Interventions to strengthen preterm birth prevention and care span the continuum of care for reproductive, maternal, newborn and child health. Both prevention of preterm birth and implementation of care of premature babies require more research, as well as more policy attention and programmatic investment.

  7. 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.

  8. [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

  9. 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.

  10. The Birth Satisfaction Scale-Revised Indicator (BSS-RI).

    Science.gov (United States)

    Martin, Colin R; Hollins Martin, Caroline; Redshaw, Maggie

    2017-08-29

    The current study sought to develop a short birth satisfaction indicator utilising items from the Birth Satisfaction Scale-Revised (BSS-R) for use as a brief measure of birth satisfaction and as a possible key performance indicator for perinatal service delivery evaluation. Building on the recently developed BSS-R, the study aimed to develop a simplified version of the instrument to assess birth satisfaction easily that could work as a short evaluative measure of clinical service delivery for labour and birth that is consistent with policy documents, placing women at the centre of the birth experience. The six item Birth Satisfaction Scale-Revised Indicator (BSS-RI) was embedded within the 2014 National Maternity Survey for England. A random selection of mothers who had given birth in a two week period in England were surveyed three months after the birth. Using a two-stage design and split-half dataset, exploratory factor analysis, confirmatory factor analysis, internal consistency, convergent, divergent and known-groups discriminant validity evaluation were conducted in a secondary analysis of the survey data. Using this large population based survey of recent mothers the short revised measure was found to comprise two distinct domains of birth satisfaction, 'stress and emotional response to labour and birth' and 'quality of care'. The psychometric qualities of the tool were robust as were the indices of validity and reliability evaluated. The BSS-RI represents a short easily administered and scored measure of women's satisfaction with care and the experience of labour and birth. The instrument is potentially useful for researchers, service evaluation and policy makers.

  11. 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.

  12. 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.

  13. 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…

  14. 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.

  15. 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

  16. "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.

  17. 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.

  18. 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.

  19. 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.

  20. 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)

  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. 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....

  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. 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

  5. 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...

  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. 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).

  8. 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.

  9. State policy and teen childbearing: a review of research studies.

    Science.gov (United States)

    Beltz, Martha A; Sacks, Vanessa H; Moore, Kristin A; Terzian, Mary

    2015-02-01

    Teen childbearing is affected by many individual, family, and community factors; however, another potential influence is state policy. Rigorous studies of the relationship between state policy and teen birth rates are few in number but represent a body of knowledge that can inform policy and practice. This article reviews research assessing associations between state-level policies and teen birth rates, focusing on five policy areas: access to family planning, education, sex education, public assistance, and access to abortion services. Overall, several studies have found that measures related to access to and use of family planning services and contraceptives are related to lower state-level teen birth rates. These include adolescent enrollment in clinics, minors' access to contraception, conscience laws, family planning expenditures, and Medicaid waivers. Other studies, although largely cross-sectional analyses, have concluded that policies and practices to expand or improve public education are also associated with lower teen birth rates. These include expenditures on education, teacher-to-student ratios, and graduation requirements. However, the evidence regarding the role of public assistance, abortion access, and sex education policies in reducing teen birth rates is mixed and inconclusive. These conclusions must be viewed as tentative because of the limited number of rigorous studies that examine the relationship between state policy and teen birth rates over time. Many specific policies have only been analyzed by a single study, and few findings are based on recent data. As such, more research is needed to strengthen our understanding of the role of state policies in teen birth rates. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  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. Dealing with China's future population decline: a proposal for replacing low birth rates with sustainable rates.

    Science.gov (United States)

    Cao, Shixiong; Wang, Xiuqing

    2009-09-01

    Decreasing population levels due to declining birth rates are becoming a potentially serious social problem in developed and rapidly developing countries. China urgently needed to reduce birth rates so that its population would decline to a sustainable level, and the family planning policy designed to achieve this goal has largely succeeded. However, continuing to pursue this policy is leading to serious, unanticipated problems such as a shift in the country's population distribution towards the elderly and increasing difficulty supporting that elderly population. Social and political changes that promoted low birth rates and the lack of effective policies to encourage higher birth rates suggest that mitigating the consequences of the predicted population decline will depend on a revised approach based on achieving sustainable birth rates.

  16. 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; ...

  17. 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.

  18. 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.

  19. Investigating recent trends in the U.S. teen birth rate.

    Science.gov (United States)

    Kearney, Melissa S; Levine, Phillip B

    2015-05-01

    We investigate trends in the U.S. rate of teen childbearing between 1981 and 2010, focusing specifically on the sizable decline since 1991. We focus on establishing the role of state-level demographic changes, economic conditions, and targeted policies in driving recent aggregate trends. We offer three main observations. First, the recent decline cannot be explained by the changing racial and ethnic composition of teens. Second, the only targeted policies that have had a statistically discernible impact on aggregate teen birth rates are declining welfare benefits and expanded access to family planning services through Medicaid, but these policies can account for only 12.6 percent of the observed decline since 1991. Third, higher unemployment rates lead to lower teen birth rates and can account for 16 percent of the decline in teen birth rates since the Great Recession began. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. 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

  1. 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.

  2. 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

  3. 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

  4. 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)

  5. 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 ...

  6. 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.

  7. 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.

  8. 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...

  9. The impact of women's education, workforce experience, and the One Child Policy on fertility in China: a census study in Guangdong, China.

    Science.gov (United States)

    Lan, Manyu; Kuang, Yaoqiu

    2016-01-01

    The impact of women's education on fertility is of interest to researchers, particularly in China. However, few studies have provided well-founded assessments of how women's education, workforce experience, and birth control policy jointly affect fertility in China. This study, conducted in Guangdong Province, aimed to analyze how these three factors influenced the timing of births and affected women at different stages of their reproductive lives. We used census data for Guangdong Province (1990, 2000, and 2010) to make cross-sectional age-specific comparisons to examine the effects of women's education and workforce participation on fertility outcomes under China's One Child Policy. We found that: (1) under circumstances of low fertility, women tend to have more children with greater educational attainment; (2) the impact of women's education and workforce experience on fertility varied across age groups, with the effect of education showing a bimodal curve peaking at 25-29 years and 40-44 years, and a workforce experience effect at 25-34 years; and (3) the fertility time-squeeze effect by educational attainment was relatively small, the effect by workforce participation was larger, and the most important effect was birth control policy and its implementation. These results suggest that educational attainment and workforce experience have a substantial effect on women's fertility, and a tradeoff between them is unavoidable. China's 2015 birth control policy adjustment should be considered in planning future services to accommodate anticipated increases in the birth rate. More attention should be directed to the causal mechanism (women's preference and selection effects) behind the factors analyzed in this study.

  10. 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.

  11. 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

  12. 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 ( ...

  13. 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 ...

  14. 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.

  15. 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.

  16. 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

  17. 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.

  18. 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.

  19. 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...

  20. 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.

  1. 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…

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

    Science.gov (United States)

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

    2017-11-01

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

  4. 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....

  5. 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

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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

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

    Science.gov (United States)

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

    2013-09-01

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

  12. 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.

  13. From home deliveries to health care facilities: establishing a traditional birth attendant referral program in Kenya.

    Science.gov (United States)

    Tomedi, Angelo; Stroud, Sophia R; Maya, Tania Ruiz; Plaman, Christopher R; Mwanthi, Mutuku A

    2015-07-16

    To assess the effectiveness of a traditional birth attendant (TBA) referral program on increasing the number of deliveries overseen by skilled birth attendants (SBA) in rural Kenyan health facilities before and after the implementation of a free maternity care policy. In a rural region of Kenya, TBAs were recruited to educate pregnant women about the importance of delivering in healthcare facilities and were offered a stipend for every pregnant woman whom they brought to the healthcare facility. We evaluated the percentage of prenatal care (PNC) patients who delivered at the intervention site compared with the percentage of PNC patients who delivered at rural control facilities, before and after the referral program was implemented, and before and after the Kenya government implemented a policy of free maternity care. The window period of the study was from July of 2011 through September 2013, with a TBA referral intervention conducted from March to September 2013. The absolute increases from the pre-intervention period to the TBA referral intervention period in SBA deliveries were 5.7 and 24.0% in the control and intervention groups, respectively (p facility significantly increased compared to control health facilities when TBAs educated women about the need to deliver with a SBA and when TBAs received a stipend for bringing women to local health facilities to deliver. Furthermore, this TBA referral program proved to be far more effective in the target region of Kenya than a policy change to provide free obstetric care.

  14. 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.

  15. 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.

  16. Two decades of maternity care fee exemption policies in Ghana: have they benefited the poor?

    Science.gov (United States)

    Johnson, Fiifi Amoako; Frempong-Ainguah, Faustina; Padmadas, Sabu S

    2016-02-01

    To investigate, the impact of maternity-related fee payment policies on the uptake of skilled birth care amongst the poor in Ghana. Population data representing 12 288 births between November 1990 and October 2008 from four consecutive rounds of the Ghana demographic and health surveys were used to examine the impact of four major maternity-related payment policies: the full-cost recovery 'cash and carry' scheme; 'antenatal care fee exemption'; 'delivery care fee exemption' and the 'National Health Insurance Scheme (NHIS)'. Concentration curves were used to analyse the rich-poor gap in the use of skilled birth care by the four policy interventions. Multilevel logistic regression was used to examine the effect of the policies on the uptake of skilled birth care, adjusting for relevant predictors and clustering within communities and districts. The uptake of skilled birth care over the policy periods for the poorest women was trivial when compared with their non-poor counterparts. The rich-poor gap in skilled birth care use was highly pronounced during the 'cash and carry' and 'free antenatal care' policies period. The benefits during the 'free delivery care' and ' NHIS' policy periods accrued more for the rich than the poor. There exist significant differences in skilled birth care use between and within communities and districts, even after adjusting for policy effects and other relevant predictors. The maternal care fee exemption policies specifically targeted towards the poorest women had limited impact on the uptake of skilled birth care. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. Birth rates and pregnancy complications in adolescent pregnant women giving birth in the hospitals of Thailand.

    Science.gov (United States)

    Butchon, Rukmanee; Liabsuetrakul, Tippawan; McNeil, Edward; Suchonwanich, Yolsilp

    2014-08-01

    To determine the rates of births in adolescent pregnant women in diferent regions of Thailand and assess the rates of complications occurring at pregnancy, childbirth, and postpartum in women admitted in the hospitals ofThailand. The secondary analysis of data from pregnant women aged 10 to 49 years, who were admitted to hospitals and recorded in the National Health Security Office database between October 2010 and September 2011 was carried out. Adolescent birth rate by the regions and rate of complications ofpregnancy, delivery, and postpartum by age groups were analyzed. Highest birth rate was found among women aged 19 years (58.3 per 1, 000 population). The distribution of adolescent births varied across regions of Thailand, which was high in central region. Rate of preterm delivery was highest (10%) in adolescent aged 10 to 14 years. Rate of diabetes mellitus (6%), preeclampsia (4%), and postpartum hemorrhage (3%) among women aged 35 to 49 years were substantially higher than those among women aged 34 years or less. Adolescent birth rate varied across regions of Thailand. Complications occurred differently by ages of women. Holistic policy and planning strategies for proper prevention and management among pregnant women in different age groups are needed

  2. 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.

  3. Companion of choice at birth: factors affecting implementation.

    Science.gov (United States)

    Kabakian-Khasholian, Tamar; Portela, Anayda

    2017-08-31

    Two recent recommendations made by the World Health Organization confirm the benefits of companion of choice at birth on labour outcomes; however institutional practices and policies do not always support its implementation in different settings around the world. We conducted a review to determine factors that affect implementation of this intervention considering the perspectives and experiences of different stakeholders and other institutional, systemic barriers and facilitators. Forty one published studies were included in this review. Thirty one publications were identified from a 2013 Cochrane review on the effectiveness of companion of choice at birth. We also reviewed 10 qualitative studies conducted alongside the trials or other interventions on labour and birth companionship identified through electronic searches. The SURE (Supporting the Use of Research Evidence) framework was used to guide the thematic analysis of implementation factors. Women and their families expressed appreciation for the continuous presence of a person to provide support during childbirth. Health care providers were concerned about the role of the companion and possible interference with activities in the labour ward. Allocation of resources, organization of care, facility-related constraints and cultural inclinations were identified as implementation barriers. Prior to introducing companion of choice at birth, understanding providers' attitudes and sensitizing them to the evidence is necessary. The commitment of the management of health care facilities is also required to change policies, including allocation of appropriate physical space that respects women's privacy. Implementation research to develop models for different contexts which could be scaled up would be useful, including documentation of factors that affected implementation and how they were addressed. Future research should also focus on documenting the costs related to implementation, and on measuring the impact of

  4. 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

  5. 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.

  6. [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.

  7. 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.

  8. 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.

  9. 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.

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

    Science.gov (United States)

    Preis, Heidi; Benyamini, Yael

    2017-03-01

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

  11. 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)

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

    Science.gov (United States)

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

    2010-02-01

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

  13. Risk Factors for premature birth in a hospital

    Directory of Open Access Journals (Sweden)

    Margarita E. Ahumada-Barrios

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

  14. 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

  15. Associations of hospital staff training and policies with early breastfeeding practices.

    Science.gov (United States)

    Li, Chuan-Ming; Li, Ruowei; Ashley, Cindy G; Smiley, Janice M; Cohen, Jennifer H; Dee, Deborah L

    2014-02-01

    In 2009, the Centers for Disease Control and Prevention implemented the Maternity Practices in Infant Nutrition and Care (mPINC) survey in all US birth facilities to assess breastfeeding-related maternity practices. Maternity practices and hospital policies are known to influence breastfeeding, and Alabama breastfeeding rates are very low. Our objective was to assess whether staff training and structural-organizational aspects of care, such as policies, were associated with infants' breastfeeding behaviors 24 to 48 hours postpartum. We linked 2009 mPINC data from 48 Alabama hospitals with birth certificate and newborn screening databases. We used data collected 24 to 48 hours postpartum to classify 41 536 healthy, term, singleton infants as breastfed (any breast milk) or completely formula fed and examined associations with hospitals' mPINC scores in comparison with the state mean. We conducted multilevel analyses to assess infants' likelihood of being breastfed if their birth hospital scores were lower versus at least equal to the Alabama mean, accounting for hospital clustering, demographics, payment method, and prenatal care. The odds of breastfeeding were greater in hospitals with a higher-than-state-mean score on the following: new employees' breastfeeding education, nurses' receipt of breastfeeding education in the past year, prenatal breastfeeding classes offered, having a lactation coordinator, and having a written breastfeeding policy. The number of recommended elements included in hospitals' written breastfeeding policies was positively associated with newborn breastfeeding rates. Educating hospital staff to improve breastfeeding-related knowledge, attitudes, and skills; implementing a written hospital breastfeeding policy; and ensuring continuity of prenatal and postnatal breastfeeding education and support may improve newborn breastfeeding rates.

  16. 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 ...

  17. 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

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

    Science.gov (United States)

    Henderson, Jane; Petrou, Stavros

    2008-06-01

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

  19. The Australian baby bonus maternity payment and birth characteristics in Western Australia.

    Directory of Open Access Journals (Sweden)

    Kristjana Einarsdóttir

    Full Text Available BACKGROUND: The Australian baby bonus maternity payment introduced in 2004 has been reported to have successfully increased fertility rates in Australia. We aimed to investigate the influence of the baby bonus on maternal demographics and birth characteristics in Western Australia (WA. METHODS AND FINDINGS: This study included 200,659 birth admissions from WA during 2001-2008, identified from administrative birth and hospital data-systems held by the WA Department of Health. We estimated average quarterly birth rates after the baby bonus introduction and compared them with expected rates had the policy not occurred. Rate and percentage differences (including 95% confidence intervals were estimated separately by maternal demographics and birth characteristics. WA birth rates increased by 12.8% following the baby bonus implementation with the greatest increase being in mothers aged 20-24 years (26.3%, 95%CI = 22.0,30.6, mothers having their third (1.6%, 95%CI = 0.9,2.4 or fourth child (2.2%, 95%CI = 2.1,2.4, mothers living in outer regional and remote areas (32.4%, 95%CI = 30.2,34.6, mothers giving birth as public patients (1.5%, 95%CI = 1.3,1.8, and mothers giving birth in public hospitals (3.5%, 95%CI = 2.6,4.5. Interestingly, births to private patients (-4.3%, 95%CI = -4.8,-3.7 and births in private hospitals (-6.3%, 95%CI = -6.8,-5.8 decreased following the policy implementation. CONCLUSIONS: The introduction of the baby bonus maternity payment may have served as an incentive for women in their early twenties and mothers having their third or fourth child and may have contributed to the ongoing pressure and staff shortages in Australian public hospitals, particularly those in outer regional and remote areas.

  20. "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.

  1. 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

  2. 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.

  3. Dimensions of population policy in India: the psycho-social implications.

    Science.gov (United States)

    Shariff, A; Mouli, A S

    1978-01-01

    All population policies, while seemingly identical in their formulation, differ in terms of their veritable ulterior objective. This is due to the fact that the formulation is done by a selected group of planning agencies and the health ministry. As the purport of the population policy rests more or less with the manipulation of the demographic variables, the important components of the population influencing policies should be discussed, as the population-influencing policies intend to impact on the population directly. The important components are fertility regulation, reductions in mortality and morbidity, and migration and population distribution. In India fertility regulations are directed toward achieving a reduced birth rate of 25 by 1984 or a growth rate of 1.25. While India has successfully reduced the mortality rate and the birth rate, the reduction in the rates are not proportional. This has led to a higher growth rate. Consequently, the pressure on the nation at this time is to reduce the birth rate. India has felt the strains of realizing this goal despite her concerted efforts for various reasons. First, birth control programs failed to gain as much acceptance as anticipated, whereas the plans designed to reduce mortality were moderately well received. Additionally, the birth control schemes came to have a cultural taboo, possibly attributable to inadequate and vague propaganda on the part of program administrators as well as illiteracy. Economic pro and con factors also contributed. The extent of migration in India is insignificant for various socioeconomic reasons. First, India is a country where illiteracy is predominant, and this has restrained the scope for migration. Secondly, as 80% of Indians depend on agriculture, they feel satisfied at home with whatever they earn. Regarding in-migration, India, as a developing country experiencing the ills of poverty, unemployment, low capital formation, and a slow pace of technological development, has not

  4. The effects of maternity leave on children's birth and infant health outcomes in the United States.

    Science.gov (United States)

    Rossin, Maya

    2011-03-01

    This paper evaluates the impacts of unpaid maternity leave provisions of the 1993 Family and Medical Leave Act (FMLA) on children's birth and infant health outcomes in the United States. My identification strategy uses variation in pre-FMLA maternity leave policies across states and variation in which firms are covered by FMLA provisions. Using Vital Statistics data and difference-in-difference-in-difference methodology, I find that maternity leave led to small increases in birth weight, decreases in the likelihood of a premature birth, and substantial decreases in infant mortality for children of college-educated and married mothers, who were most able to take advantage of unpaid leave. My results are robust to the inclusion of numerous controls for maternal, child, and county characteristics, state, year, and month fixed effects, and state-year interactions, as well as across several different specifications. Copyright © 2011 Elsevier B.V. All rights reserved.

  5. 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.

  6. Schooling, marriage, and age at first birth in Madagascar.

    Science.gov (United States)

    Glick, Peter; Handy, Christopher; Sahn, David E

    2015-01-01

    The low school attainment, early marriage, and low age at first birth of females are major policy concerns in less developed countries. This study jointly estimated the determinants of educational attainment, marriage age, and age at first birth among females aged 12-25 in Madagascar, explicitly accounting for the endogeneities that arose from modelling these related outcomes simultaneously. An additional year of schooling results in a delay to marriage of 1.5 years and marrying 1 year later delays age at first birth by 0.5 years. Parents' education and wealth also have important effects on schooling, marriage, and age at first birth, with a woman's first birth being delayed by 0.75 years if her mother had 4 additional years of schooling. Overall, our results provide rigorous evidence for the critical role of education-both individual women's own and that of their parents-in delaying the marriage and fertility of young women.

  7. Risk factors for preterm birth in five Maternal and Child Health hospitals in Beijing.

    Directory of Open Access Journals (Sweden)

    Yun-Ping Zhang

    Full Text Available BACKGROUND: Preterm birth, the birth of an infant prior to 37 completed weeks of gestation, is the leading cause of perinatal morbidity and mortality. Preterm infants are at greater risk of respiratory, gastrointestinal and neurological diseases. Despite significant research in developed countries, little is known about the causes of preterm birth in many developing countries, especially China. This study investigates the association between sciodemographic data, obstetric risk factor, and preterm birth in five Maternal and Child Health hospitals in Beijing, China. METHODS AND FINDINGS: A case-control study was conducted on 1391 women with preterm birth (case group and 1391 women with term delivery (control group, who were interviewed within 48 hours of delivery. Sixteen potential factors were investigated and statistical analysis was performed by univariate analysis and logistic regression analysis. Univariate analysis showed that 14 of the 16 factors were associated with preterm birth. Inter-pregnancy interval and inherited diseases were not risk factors. Logistic regression analysis showed that obesity (odds ratio (OR = 3.030, 95% confidence interval (CI 1.166-7.869, stressful life events (OR = 5.535, 95%CI 2.315-13.231, sexual activity (OR = 1.674, 95%CI 1.279-2.191, placenta previa (OR 13.577, 95%CI 2.563-71.912, gestational diabetes mellitus (OR = 3.441, 95%CI1.694-6.991, hypertensive disorder complicating pregnancy (OR = 6.034, 95%CI = 3.401-10.704, history of preterm birth (OR = 20.888, 95%CI 2.519-173.218 and reproductive abnormalities (OR = 3.049, 95%CI 1.010-9.206 were independent risk factors. Women who lived in towns and cities (OR = 0.603, 95%CI 0.430-0.846, had a balanced diet (OR = 0.533, 95%CI 0.421-0.675 and had a record of prenatal care (OR = 0.261, 95%CI 0.134-0.510 were less likely to have preterm birth. CONCLUSIONS: Obesity, stressful life events, sexual activity, placenta previa

  8. 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

  9. Low Birth Weight And Maternal Risk Factors

    Directory of Open Access Journals (Sweden)

    Secma Nigam

    2003-06-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

  11. Selective versus routine use of episiotomy for vaginal birth

    Science.gov (United States)

    Jiang, Hong; Qian, Xu; Carroli, Guillermo; Garner, Paul

    2017-01-01

    Background Some clinicians believe that routine episiotomy, a surgical cut of the vagina and perineum, will prevent serious tears during childbirth. On the other hand, an episiotomy guarantees perineal trauma and sutures. Objectives To assess the effects on mother and baby of a policy of selective episiotomy ('only if needed') compared with a policy of routine episiotomy ('part of routine management') for vaginal births. Search methods We searched Cochrane Pregnancy and Childbirth's Trials Register (14 September 2016) and reference lists of retrieved studies. Selection criteria Randomised controlled trials (RCTs) comparing selective versus routine use of episiotomy, irrespective of parity, setting or surgical type of episiotomy. We included trials where either unassisted or assisted vaginal births were intended. Quasi-RCTs, trials using a cross-over design or those published in abstract form only were not eligible for inclusion in this review. Data collection and analysis Two authors independently screened studies, extracted data, and assessed risk of bias. A third author mediated where there was no clear consensus. We observed good practice for data analysis and interpretation where trialists were review authors. We used fixed-effect models unless heterogeneity precluded this, expressed results as risk ratios (RR) and 95% confidence intervals (CI), and assessed the certainty of the evidence using GRADE. Main results This updated review includes 12 studies (6177 women), 11 in women in labour for whom a vaginal birth was intended, and one in women where an assisted birth was anticipated. Two were trials each with more than 1000 women (Argentina and the UK), and the rest were smaller (from Canada, Germany, Spain, Ireland, Malaysia, Pakistan, Columbia and Saudi Arabia). Eight trials included primiparous women only, and four trials were in both primiparous and multiparous women. For risk of bias, allocation was adequately concealed and reported in nine trials; sequence

  12. 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...

  13. 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.

  14. 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...

  15. 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).

  16. 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.

  17. 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)

  18. 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

  19. 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.

  20. Risk Factors for premature birth in a hospital 1

    Science.gov (United States)

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

    2016-01-01

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

  1. Setting research priorities to reduce global mortality from preterm birth and low birth weight by 2015.

    Science.gov (United States)

    Bahl, Rajiv; Martines, Jose; Bhandari, Nita; Biloglav, Zrinka; Edmond, Karen; Iyengar, Sharad; Kramer, Michael; Lawn, Joy E; Manandhar, D S; Mori, Rintaro; Rasmussen, Kathleen M; Sachdev, H P S; Singhal, Nalini; Tomlinson, Mark; Victora, Cesar; Williams, Anthony F; Chan, Kit Yee; Rudan, Igor

    2012-06-01

    This paper aims to identify health research priorities that could improve the rate of progress in reducing global neonatal mortality from preterm birth and low birth weight (PB/LBW), as set out in the UN's Millennium Development Goal 4. We applied the Child Health and Nutrition Research Initiative (CHNRI) methodology for setting priorities in health research investments. In the process coordinated by the World Health Organization in 2007-2008, 21 researchers with interest in child, maternal and newborn health suggested 82 research ideas that spanned across the broad spectrum of epidemiological research, health policy and systems research, improvement of existing interventions and development of new interventions. The 82 research questions were then assessed for answerability, effectiveness, deliverability, maximum potential for mortality reduction and the effect on equity using the CHNRI method. The top 10 identified research priorities were dominated by health systems and policy research questions (eg, identification of LBW infants born at home within 24-48 hours of birth for additional care; approaches to improve quality of care of LBW infants in health facilities; identification of barriers to optimal home care practices including care seeking; and approaches to increase the use of antenatal corticosteriods in preterm labor and to improve access to hospital care for LBW infants). These were followed by priorities for improvement of the existing interventions (eg, early initiation of breastfeeding, including feeding mode and techniques for those unable to suckle directly from the breast; improved cord care, such as chlorhexidine application; and alternative methods to Kangaroo Mother Care (KMC) to keep LBW infants warm in community settings). The highest-ranked epidemiological question suggested improving criteria for identifying LBW infants who need to be cared for in a hospital. Among the new interventions, the greatest support was shown for the development of

  2. 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

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

    Science.gov (United States)

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

  4. Women's persistent utilisation of unskilled birth attendants in ...

    African Journals Online (AJOL)

    ... facilities to address the discrepancy between antenatal attendance and delivery by skilled birth attendance. We hope that the information generated from this study will be used by the policy makers leading to appropriate interventions or strategies which will reduce the number of home deliveries and maternal deaths.

  5. The associations of birth intervals with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis

    Science.gov (United States)

    2013-01-01

    Background Short and long birth intervals have previously been linked to adverse neonatal outcomes. However, much of the existing literature uses cross-sectional studies, from which deriving causal inference is complex. We examine the association between short/long birth intervals and adverse neonatal outcomes by calculating and meta-analyzing associations using original data from cohort studies conducted in low-and middle-income countries (LMIC). Methods We identified five cohort studies. Adjusted odds ratios (aOR) were calculated for each study, with birth interval as the exposure and small-for-gestational-age (SGA) and/or preterm birth, and neonatal and infant mortality as outcomes. The associations were controlled for potential confounders and meta-analyzed. Results Birth interval of shorter than 18 months had statistically significant increased odds of SGA (pooled aOR: 1.51, 95% CI: 1.31-1.75), preterm (pooled aOR: 1.58, 95% CI: 1.19-2.10) and infant mortality (pooled aOR: 1.83, 95% CI: 1.19-2.81) after controlling for potential confounding factors (reference 36-gestational-age, and preterm-SGA. Birth interval over 60 months had increased risk of SGA (pooled aOR: 1.22, 95% CI: 1.07-1.39) and term-SGA (pooled aOR: 1.14, 95% CI: 1.03-1.27), but was not associated with other outcomes. Conclusions Birth intervals shorter than 18 months are significantly associated with SGA, preterm birth and death in the first year of life. Lack of access to family planning interventions thus contributes to the burden of adverse birth outcomes and infant mortality in LMICs. Programs and policies must assess ways to provide equitable access to reproductive health interventions to mothers before or soon after delivering a child, but also address underlying socioeconomic factors that may modify and worsen the effect of short intervals. PMID:24564484

  6. Fertility targets and policy options in Asia.

    Science.gov (United States)

    Bulatao, R A

    1984-11-01

    The 3rd Asian and Pacific Population Conference in Colombo in 1982 recommended that countries review and modify existing demographic targets and goals for reducing birth and death rates in order to attain low levels as early as possible and to attain replacement level by the year 2000. The demographic goals of selected Asian countries (Bangladesh, Indonesia, Korea, Thailand, India, Pakistan, and the Philippines are assessed and compared to World Bank population projections. It also discusses the underlying rationale for setting fertility targets, and considers what government actions could make them more achievable. 6 stages for controlling population are distinguished: 1) collection and publication of reliable demographic data; 2) enunciation of an official policy to reduce population growth; 3) development of appropriate institutions to integrate demographic projections into economic plans; 4) promotion of family planning; 5) provision of incentives and disincentives, including elimination of all implicit and explicit subsidies for child bearing; and 6) restitution of birth quotas requiring permission for each child born. Principles to maintain and accelerate fertility declines to meet demographic targets include creating appropriate and equitable development policies, increasing the standard of family planning programs, confronting organizational problems, providing easier and more equal access to contraceptive methods, exploring innovative approaches to encourage smaller families and making a firm political commitment to population control. Rapid fertility decline will also require financial commitment. Willingness to spend the necessary amounts, and the capacity to spend them as well, will determine whether the countries of Asia enter the next century in control of their population.

  7. 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.

  8. Birth characteristics and childhood carcinomas.

    Science.gov (United States)

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

    2011-10-25

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

  9. Intelligence, birth order, and family size.

    Science.gov (United States)

    Kanazawa, Satoshi

    2012-09-01

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

  10. 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.

  11. 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

  12. 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

  13. 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.

  14. 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.

  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. [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.

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

    Science.gov (United States)

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

    2010-02-01

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

  18. 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.

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

    OpenAIRE

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

    2013-01-01

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

  20. Reducing one million child deaths from birth asphyxia – a survey of health systems gaps and priorities

    Directory of Open Access Journals (Sweden)

    Manandhar Ananta

    2007-05-01

    Full Text Available Abstract Background Millions of child deaths and stillbirths are attributable to birth asphyxia, yet limited information is available to guide policy and practice, particularly at the community level. We surveyed selected policymakers, programme implementers and researchers to compile insights on policies, programmes, and research to reduce asphyxia-related deaths. Method A questionnaire was developed and pretested based on an extensive literature review, then sent by email (or airmail or fax, when necessary to 453 policymakers, programme implementers, and researchers active in child health, particularly at the community level. The survey was available in French and English and employed 5-point scales for respondents to rate effectiveness and feasibility of interventions and indicators. Open-ended questions permitted respondents to furnish additional details based on their experience. Significance testing was carried out using chi-square, F-test and Fisher's exact probability tests as appropriate. Results 173 individuals from 32 countries responded (44%. National newborn survival policies were reported to exist in 20 of 27 (74% developing countries represented, but respondents' answers were occasionally contradictory and revealed uncertainty about policy content, which may hinder policy implementation. Respondents emphasized confusing terminology and a lack of valid measurement indicators at community level as barriers to obtaining accurate data for decision making. Regarding interventions, birth preparedness and essential newborn care were considered both effective and feasible, while resuscitation at community level was considered less feasible. Respondents emphasized health systems strengthening for both supply and demand factors as programme priorities, particularly ensuring wide availability of skilled birth attendants, promotion of birth preparedness, and promotion of essential newborn care. Research priorities included operationalising

  1. Birth Asphyxia in a Nigerian Mission Hospital in Benin City ...

    African Journals Online (AJOL)

    Background: Although birth asphyxia is a leading cause of neonatal morbidity and mortality in ... limited attention in terms of policy and funding priority partly because of lack robust perinatal statistics. ... Overall case fatality rate was 15.7%.

  2. Social class at birth and risk of psychosis.

    Science.gov (United States)

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

    2015-12-01

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

  3. "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

  4. 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.

  5. 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.

  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. 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...

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

    Science.gov (United States)

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

    2017-10-10

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

  9. 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 ...

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

    OpenAIRE

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

    2016-01-01

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

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. Technologies of birth and models of midwifery care

    Directory of Open Access Journals (Sweden)

    Christine McCourt

    2014-08-01

    Full Text Available This article is based on a study of a reform in the organisation of maternity services in the United Kingdom, which aimed towards developing a more woman-centred model of care. After decades of fragmentation and depersonalisation of care, associated with the shift of birth to a hospital setting, pressure by midwives and mothers prompted government review and a relatively radical turnaround in policy. However, the emergent model of care has been profoundly influenced by concepts and technologies of monitoring. The use of such technologies as ultrasound scans, electronic foetal monitoring and oxytocic augmentation of labour, generally supported by epidural anaesthesia for pain relief, have accompanied the development of a particular ecological model of birth – often called active management –, which is oriented towards the idea of an obstetric norm. Drawing on analysis of women’s narrative accounts of labour and birth, this article discusses the impact on women’s embodiment in birth, and the sources of information they use about the status of their own bodies, their labour and that of the child. It also illustrates how the impact on women’s experiences of birth may be mediated by a relational model of support, through the provision of caseload midwifery care.

  16. A Study Of Risk Factors For Low Birth Weight

    Directory of Open Access Journals (Sweden)

    Deswal B S

    1999-01-01

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

  17. Preterm birth research: from disillusion to the search for new mechanisms.

    Science.gov (United States)

    Buekens, P; Klebanoff, M

    2001-07-01

    No intervention has been shown to decrease the rate of preterm birth. There was thus a need for a new research agenda. The new emphasis is on social and biological mechanisms, including the impact on stress of racism and poverty, and gene-environment interactions. New markers are also under study, and pertain mostly to infection and inflammation. The impact on preterm birth of broad contextual factors, such as universal social protection, will need to be explored further. The recent trends toward increased rates of preterm births deserve much attention. New policies and interventions to decrease medically indicated preterm births should be urgently developed and evaluated. The failure to prevent preterm deliveries has been so disappointing that there is a risk that high rates of preterm births will be seen as unavoidable. The research programme launched by March of Dimes is a timely effort to foster new enthusiasm, to test new ideas and to generate new hypotheses.

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

    Science.gov (United States)

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

    2017-12-20

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

  19. 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.

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

    Science.gov (United States)

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

    2015-11-01

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

  1. The role of lifestyle in preventing low birth weight.

    Science.gov (United States)

    Chomitz, V R; Cheung, L W; Lieberman, E

    1995-01-01

    Lifestyle behaviors such as cigarette smoking, weight gain during pregnancy, and use of other drugs play an important role in determining fetal growth. The relationship between lifestyle risk factors and low birth weight is complex and is affected by psychosocial, economic, and biological factors. Cigarette smoking is the largest known risk factor for low birth weight. Approximately 20% of all low birth weight could be avoided if women did not smoke during pregnancy. Reducing heavy use of alcohol and other drugs during pregnancy could also reduce the rate of low birth weight births. Pregnancy and the prospect of pregnancy provide an important window of opportunity to improve women's health and the health of children. The adoption before or during pregnancy of more healthful lifestyle behaviors, such as ceasing to smoke, eating an adequate diet and gaining enough weight during pregnancy, and ceasing heavy drug use, can positively affect the long-term health of women and the health of their infants. Detrimental lifestyles can be modified, but successful modification will require large-scale societal changes. In the United States, these societal changes should include a focus on preventive health, family-centered workplace policies, and changes in social norms.

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

    Science.gov (United States)

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

  3. 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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

  6. 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.

  7. Reforming birth registration law in England and Wales?

    Directory of Open Access Journals (Sweden)

    Julie McCandless

    2017-06-01

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

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

    Science.gov (United States)

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

    2016-10-01

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

  9. 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.

  10. 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…

  11. 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 ...

  12. 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.

  13. Womenomics and Acrobatics: Why Japanese Feminists Remain Skeptical about Feminist State Policy

    Directory of Open Access Journals (Sweden)

    Ayako Kano

    2018-03-01

    Full Text Available Neoliberalism and conservative ideology have come together in Japan as ‘womenomics’, a state policy to boost women’s labour productivity as well as the nation’s birth rate. Feminists have responded with scepticism to this policy, proposed by the strongly conservative and nationalist Prime Minister, Shinzo Abe. The content of ‘womenomics’ includes a new law to promote the advancement of women to leadership positions, and reflects the government’s concern for Japan’s international standing. The demographic crisis of a rapidly aging society with a declining birth rate is another background to the policy. Policies to boost the birth rate have been hard to reconcile with policies to promote women in leadership positions in corporate life. The gendered division of labour and the structure of the labour market exacerbate problems as neoliberal reforms are introduced belatedly to Japan. The resistance to neoliberalism has come from conservatives, and thus feminists in Japan have had to perform complicated acrobatics. The long-term prospects depend on finding ways to promote equality in a potentially shrinking nation while continuing to resist the seductions of neoliberal state policies that purport to advance the interests of women.

  14. Association of US State Implementation of Newborn Screening Policies for Critical Congenital Heart Disease With Early Infant Cardiac Deaths.

    Science.gov (United States)

    Abouk, Rahi; Grosse, Scott D; Ailes, Elizabeth C; Oster, Matthew E

    2017-12-05

    In 2011, critical congenital heart disease was added to the US Recommended Uniform Screening Panel for newborns, but whether state implementation of screening policies has been associated with infant death rates is unknown. To assess whether there was an association between implementation of state newborn screening policies for critical congenital heart disease and infant death rates. Observational study with group-level analyses. A difference-in-differences analysis was conducted using the National Center for Health Statistics' period linked birth/infant death data set files for 2007-2013 for 26 546 503 US births through June 30, 2013, aggregated by month and state of birth. State policies were classified as mandatory or nonmandatory (including voluntary policies and mandates that were not yet implemented). As of June 1, 2013, 8 states had implemented mandatory screening policies, 5 states had voluntary screening policies, and 9 states had adopted but not yet implemented mandates. Numbers of early infant deaths (between 24 hours and 6 months of age) coded for critical congenital heart disease or other/unspecified congenital cardiac causes for each state-month birth cohort. Between 2007 and 2013, there were 2734 deaths due to critical congenital heart disease and 3967 deaths due to other/unspecified causes. Critical congenital heart disease death rates in states with mandatory screening policies were 8.0 (95% CI, 5.4-10.6) per 100 000 births (n = 37) in 2007 and 6.4 (95% CI, 2.9-9.9) per 100 000 births (n = 13) in 2013 (for births by the end of July); for other/unspecified cardiac causes, death rates were 11.7 (95% CI, 8.6-14.8) per 100 000 births in 2007 (n = 54) and 10.3 (95% CI, 5.9-14.8) per 100 000 births (n = 21) in 2013. Early infant deaths from critical congenital heart disease through December 31, 2013, decreased by 33.4% (95% CI, 10.6%-50.3%), with an absolute decline of 3.9 (95% CI, 3.6-4.1) deaths per 100 000 births after

  15. Where Do You Feel Safest?: Demographic Factors and Place of Birth

    Science.gov (United States)

    Sperlich, M.; Gabriel, C.; Seng, J.

    2016-01-01

    Introduction The vast majority of planned out-of-hospital births in the United States occur among white women; no study has addressed whether black women prefer out-of-hospital birth less or whether this racial disparity is due to other causes such as constrained access. This study sought to answer the question of whether white and black women feel safest giving birth in out-of-hospital settings at different rates, and whether this answer is associated with other socioeconomic indicators. Methods An interview of 634 nulliparous women during the third trimester of their pregnancy in Michigan provided data regarding where women felt safest giving birth. Feeling safest giving birth out-of-hospital was examined in relation to socioeconomic factors including race, age, household income, education, residence in a high-crime neighborhood, partnered status, and type of insurance. Results This study found that black and white women say they feel safest giving birth in out-of-hospital settings at similar rates (11.5% and 13.1% respectively). Logistic regression results showed that poverty and having education beyond high school were the only sociodemographic indicators significantly associated with feeling safest giving birth out-of-hospital. Discussion Disparities evident in planned homebirth and birth center rates cannot be explained by racial differences in feelings toward out-of-hospital birth and should be addressed more specifically in public policy and future studies. PMID:27623132

  16. 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.

  17. Birth defects in children with newborn encephalopathy

    NARCIS (Netherlands)

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

    2000-01-01

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

  18. 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

  19. 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.

  20. 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

  1. 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...

  2. Where Do You Feel Safest? Demographic Factors and Place of Birth.

    Science.gov (United States)

    Sperlich, Mickey; Gabriel, Cynthia; Seng, Julia

    2017-01-01

    The vast majority of planned out-of-hospital births in the United States occur among white women; no study has addressed whether black women prefer out-of-hospital birth less or whether this racial disparity is due to other causes such as constrained access. This study sought to answer the question of whether white and black women feel safest giving birth in out-of-hospital settings at different rates and whether this answer is associated with other socioeconomic indicators. An interview of 634 nulliparous women during the third trimester of their pregnancy in Michigan provided data regarding where women felt safest giving birth. Feeling safest giving birth out-of-hospital was examined in relation to socioeconomic factors including race, age, household income, education, residence in a high-crime neighborhood, partnered status, and type of insurance. This study found that black and white women say they feel safest giving birth in out-of-hospital settings at similar rates (11.5% and 13.1%, respectively). Logistic regression results showed that poverty and having education beyond high school were the only sociodemographic indicators significantly associated with feeling safest giving birth out-of-hospital. Disparities evident in planned home birth and birth center rates cannot be explained by racial differences in feelings toward out-of-hospital birth and should be addressed more specifically in public policy and future studies. © 2016 by the American College of Nurse-Midwives.

  3. Systemic sclerosis, birth order and parity.

    Science.gov (United States)

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

    2014-06-01

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

  4. Policies for care during the third stage of labour: a survey of maternity units in Syria

    Science.gov (United States)

    2010-01-01

    Background Care for women during the third stage aims to reduce the risk of major haemorrhage, but is very variable. The current World Health Organisation (WHO) recommendation is that care should include administration of a uterotonic (oxytocin, if it is available) soon after birth of the baby, delayed cord clamping, and delivery of the placenta by controlled cord traction. Methods To ascertain care policies used during the third stage of labour in maternity units in Syria, we conducted a survey of 69 maternity units in obstetric and general public hospitals. A brief questionnaire was administered by face to face interview or telephone with senior obstetricians and midwives. Outcome measures were the use of prophylactic uterotonic drugs, timing of cord clamping, use of controlled cord traction, and treatment for postpartum haemorrhage. Obstetricians were asked about both vaginal and caesarean births, midwives only about vaginal births. Results Responses were obtained for 66 (96%) hospitals: a midwife and an obstetrician were interviewed in 40; an obstetrician only in 20; a midwife only in 6. Responses were similar, although midwives were more likely to report that the umbilical cord was clamped after 1-3 minutes or after cessation of pulsation (2/40 obstetricians and 9/40 midwives). Responses have therefore been combined. One hospital reported never using a prophylactic uterotonic drug. The uterotonic was Syntometrine® (oxytocin and ergometrine) in two thirds of hospitals; given after delivery of the placenta in 60 (91%) for vaginal births, and in 47 (78%) for caesarean births. Cord clamping was within 20 seconds at 42 hospitals 64%) for vaginal births and 45 (75%) for caesarean births. Controlled cord traction was never used in a quarter (17/66) of hospitals for vaginal births and a half (32/60) for caesarean births. 68% of respondents (45/66) thought there was a need for more randomised trials of interventions during the third stage of labour. Conclusion Most

  5. Birth order and post-traumatic stress disorder.

    Science.gov (United States)

    Green, Ben; Griffiths, Emily C

    2014-01-01

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

  6. 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.

  7. Skin-to-skin contact: multicultural perspectives on birth fluids and birth ‘dirt’

    Science.gov (United States)

    Finigan, V; Long, T

    2014-01-01

    Aim To explore the experiences of women from three population groups of immediate skin-to-skin contact (SSC) with their newborn babies. Method A mixed methods approach was adopted in a phenomenological study to elicit the experiences of English, Pakistani and Bangladeshi women. Audiotaped diaries, semi-structured interviews, photographs and video recordings were employed. Concept mapping was central to data analysis. Results This paper reports novel findings that women contextualized and accepted secretions and bodily fluids from birth. This contradicts the beliefs of midwives that Asian women find bodily secretions abhorrent and culturally unacceptable. All participants reported positive experiences of SSC despite varying degrees of soiling from birth fluids. Limitations The study was conducted in a single setting, and participants may not have been representative of others in their cultural groups. Third-party translation may have added an unsought layer of interpretation. The imposition of cultural expectations by peers in the recruitment process excluded some potential participants. Conclusion Stereotypical assumptions about cultural background often characterize professional responses. When this stereotyping was put aside, women of all three cultures, whether breastfeeding or bottle-feeding, were able to enjoy SSC with their babies. Implications for Nursing and Health Policy The findings suggest that changes will be needed in professional practice to be more open to women's expressed preferences, in local policy to ensure that choices are made clear and are available, and in national strategic direction to ensure widespread adoption of positive practices for opportunities to increase breastfeeding, promote parent–child bonding and support patient choice to be realized. PMID:24712443

  8. 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)

  9. 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

  10. 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.

  11. 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.

  12. Eczema, birth order, and infection.

    Science.gov (United States)

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

    2008-05-15

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

  13. 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.

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

    Science.gov (United States)

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

    2013-04-01

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

  15. The BirthPlace collaborative practice model: results from the San Diego Birth Center Study.

    Science.gov (United States)

    Swartz; Jackson; Lang; Ecker; Ganiats; Dickinson; Nguyen

    1998-07-01

    Objective: The search for quality, cost-effective health care programs in the United States is now a major focus in the era of health care reform. New programs need to be evaluated as alternatives are developed in the health care system. The BirthPlace program provides comprehensive perinatal services with certified nurse-midwives and obstetricians working together in an integrated collaborative practice serving a primarily low-income population. Low-risk women are delivered by nurse-midwives in a freestanding birth center (The BirthPlace), which is one component of a larger integrated health network. All others are delivered by team obstetricians at the affiliated tertiary hospital. Wellness, preventive measures, early intervention, and family involvement are emphasized. The San Diego Birth Center Study is a 4-year research project funded by the U.S. Federal Agency for Health Care Policy and Research (#R01-HS07161) to evaluate this program. The National Birth Center Study (NEJM, 1989; 321(26): 1801-11) described the advantages and safety of freestanding birth centers. However, a prospective cohort study with a concurrent comparison group of comparable risk had not been conducted on a collaborative practice-freestanding birth center model to address questions of safety, cost, and patient satisfaction.Methods: The specific aims of this study are to compare this collaborative practice model to the traditional model of perinatal health care (physician providers and hospital delivery). A prospective cohort study comparing these two health care models was conducted with a final expected sample size of approximately 2,000 birth center and 1,350 traditional care subjects. Women were recruited from both the birth center and traditional care programs (private physicians offices and hospital based clinics) at the beginning of prenatal care and followed through the end of the perinatal period. Prenatal, intrapartum, postpartum and infant morbidity and mortality are being

  16. 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...

  17. Changing messages about place of birth in Mother and Baby magazine between 1956 and 1992.

    Science.gov (United States)

    McIntosh, Tania

    2017-11-01

    this paper explores changing messages about place of birth offered to women by Mother and Baby magazine, a UK publication aimed at a general readership DESIGN: the research uses an historical perspective to explore changing messages about place of birth in Mother and Baby magazine between 1956-1992. It analyses the content and medium of the magazine through a narrative and semiotic approach. the UK between the mid-1950s and 1990s. The period was a time of significant change in the maternity services, at both a philosophical and organisational level with a move towards hospital rather than home birth and a dominant discourse which privileged medical models of care over social ones. producers and consumers of Mother and Baby magazine FINDINGS: Mother and Baby moved from an assumption of home birth to a focus on hospital birth, reflecting national changes in policy. The magazine moved from a social to a risk focused medical view of birth, with an emphasis on the safety of the baby and the sacrifice of the mother. These changes can be traced through both the organisation and the language of content between 1956 and 1992. However, home birth was always offered to readers as a viable, if increasingly niche, option. This reflected the magazine's need to appeal to its readers as consumers; both in consumption of the magazine and of maternity care. the evidence suggests that Mother and Baby magazine mirrored elements of the prevailing policy discourse around place of birth. However, it always gave space to other narratives. In doing so it reminds us of the complexity about how messages about labour and birth are told and received. It gives insight into ways in which the media lead and reflect change and the impact this might have on decision making by women. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. 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

  19. 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.

  20. 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.

  1. Agricultural Compounds in Water and Birth Defects.

    Science.gov (United States)

    Brender, Jean D; Weyer, Peter J

    2016-06-01

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

  2. Delivering information: a descriptive study of Australian women's information needs for decision-making about birth facility.

    Science.gov (United States)

    Thompson, Rachel; Wojcieszek, Aleena M

    2012-06-18

    Little information is known about what information women want when choosing a birth facility. The objective of this study was to inform the development of a consumer decision support tool about birth facility by identifying the information needs of maternity care consumers in Queensland, Australia. Participants were 146 women residing in both urban and rural areas of Queensland, Australia who were pregnant and/or had recently given birth. A cross-sectional survey was administered in which participants were asked to rate the importance of 42 information items to their decision-making about birth facility. Participants could also provide up to ten additional information items of interest in an open-ended question. On average, participants rated 30 of the 42 information items as important to decision-making about birth facility. While the majority of information items were valued by most participants, those related to policies about support people, other women's recommendations about the facility, freedom to choose one's preferred position during labour and birth, the aesthetic quality of the facility, and access to on-site neonatal intensive care were particularly widely valued. Additional items of interest frequently focused on postnatal care and support, policies related to medical intervention, and access to water immersion. The women surveyed had significant and diverse information needs for decision-making about birth facility. These findings have immediate applications for the development of decision support tools about birth facility, and highlight the need for tools which provide a large volume of information in an accessible and user-friendly format. These findings may also be used to guide communication and information-sharing by care providers involved in counselling pregnant women and families about their options for birth facility or providing referrals to birth facilities.

  3. 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

  4. Methods for developing useful estimates of the costs associated with birth defects.

    Science.gov (United States)

    Case, Amy P; Canfield, Mark A

    2009-11-01

    Cost estimates for birth defects are useful to policy makers in deciding the best use of resources to prevent these conditions. Much of the effort in this area has focused on spina bifida, in part because cost savings can be estimated from folic acid-preventable cases. However, comprehensive cost-of-illness estimates for this condition may be too outdated, too general, or not applicable to individual states' environments. Using the live birth prevalence for spina bifida in Texas, we applied recent spina bifida cost estimates to approximate total lifetime medical and other costs for an average live birth cohort of spina bifida cases in Texas. In addition, we queried various government programs that provide services for persons with spina bifida to provide program-specific annual costs for this condition. Applying a recently published average lifetime medical cost of $635,000 per case of spina bifida to the average annual birth cohort of 120 Texas cases, an estimated $76 million in direct and indirect medical and other costs will be incurred in Texas over the life span of that cohort. Examples of estimated medical costs for one year are $5 million for infants using actual employer-paid insurance claims data and $6 million combined for children in two public sector programs. Stakeholders and state policy makers may look to state birth defects registries for useful cost data. Although comprehensive state-specific figures are not available, applying prevalence data to existing estimates and obtaining actual claims and program expenditures may help close this information gap.

  5. The Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Andersen, Anne-Marie Nybo; Olsen, Jørn

    2011-01-01

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

  6. Maternal characteristics and hospital policies as risk factors for nonreceipt of hepatitis B vaccine in the newborn nursery.

    Science.gov (United States)

    O'Leary, Sean T; Nelson, Christina; Duran, Julie

    2012-01-01

    A birth dose of hepatitis B vaccine (HBV) is a primary focus of the Advisory Committee on Immunization Practices' strategy to eliminate transmission of hepatitis B virus in the United States. We sought to assess the impact of maternal characteristics and hospital policy on the receipt of a birth dose of HBV. A retrospective cohort study was performed using data from the 2008 Colorado birth registry. Hospital policy was assessed by state health department personnel. Univariate and multivariate logistic regression analyses were used to examine the association of maternal characteristics and hospital policy with nonreceipt of HBV. A total of 64,425 infants were identified in the birth cohort, of whom 61.6% received a birth dose of HBV. Higher maternal education and income were associated with nonreceipt of HBV (master's degree vs. eighth grade or less: adjusted odds ratio [OR] = 1.66, 95% confidence interval [CI] = 1.49-1.85; >$75,000 vs. risk of perinatal hepatitis B transmission, hospitals should stipulate that all infants are offered HBV and ensure that these policies are implemented and followed.

  7. 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

  8. 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 ...

  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. 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. 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. 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

  13. 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...

  14. 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.

  15. 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.

  16. 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.

  17. 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

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

    Science.gov (United States)

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

    2015-07-01

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

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. Birth Weight in Type 1 Diabetic Pregnancy

    Directory of Open Access Journals (Sweden)

    Jacquemyn Yves

    2010-01-01

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

  4. 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

  5. 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...

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

    Science.gov (United States)

    Himes, Katherine P; Simhan, Hyagriv N

    2007-02-01

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

  7. 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 ...

  8. The Soviet Union and population: theory, problems, and population policy.

    Science.gov (United States)

    Di Maio, A J

    1980-04-01

    Until the important public dialog on 3rd World population issues began in the Soviet Uuion in 1965, ideological limitations and bureaucratic interests prevented policy makers from recognizing the existence of a world of national "population problem." Since then, freer discussions of the Soviet Union's surprising decline in birthrate and labor shortages have led to serious policy questions. Conflicting policy goals, however, have resulted in only modest pronatalist policies. The Soviet population problem is a result of interregional disparities in population growth rates between the highly urbanized Soviet European populations with low birth rates and the least urbanized Central Asians with dramatically higher birth rates. As a result, these essentially Muslim people will provide the only major increases in labor resources and an increasing percentage of Soviet armed forces recruits. Policy planners are thus faced with difficult options. Current policies stressing technological transfers from the west and greater labor productivity, however, are unlikely to solve further labor shortages and regional imbalances. Ultimately, nonEuropana regions will be in an improved bargaining position for more favorable nationwide economic policies and for a greater role in policy planning.

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

    Science.gov (United States)

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

    2013-01-01

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

  10. Transfer from planned home birth to hospital: improving interprofessional collaboration.

    Science.gov (United States)

    Vedam, Saraswathi; Leeman, Lawrence; Cheyney, Melissa; Fisher, Timothy J; Myers, Susan; Low, Lisa Kane; Ruhl, Catherine

    2014-01-01

    Women's heightened interest in choice of birthplace and increased rates of planned home birth in the United States have been well documented, yet there remains significant public and professional debate about the ethics of planned home birth in jurisdictions where care is not clearly integrated across birth settings. Simultaneously, the quality of interprofessional interactions is recognized as a predictor of health outcomes during obstetric events. When care is transferred across birth settings, confusion and conflict among providers with respect to roles and responsibilities can adversely affect both outcomes and the experience of care for women and newborns. This article reviews findings of recent North American studies that examine provider attitudes toward planned home birth, differing concepts of safety of birthplace as reported by women and providers, and sources of conflict among maternity care providers during transfer from home to hospital. Emerging evidence and clinical exemplars can inform the development of systems for seamless transfer of women and newborns from planned home births to hospital and improve experience and perceptions of safety among families and providers. Three successful models in the United States that have enhanced multidisciplinary cooperation and coordination of care across birth settings are described. Finally, best practice guidelines for roles, communication, and mutual accommodation among all participating providers when transfer occurs are introduced. Research, health professional education, and policy recommendations for incorporation of key components into existing health care systems in the United States are included. © 2014 by the American College of Nurse-Midwives.

  11. Season of birth and multiple sclerosis in Tunisia.

    Science.gov (United States)

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

    2015-11-01

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

  12. Delivering information: A descriptive study of Australian women’s information needs for decision-making about birth facility

    Directory of Open Access Journals (Sweden)

    Thompson Rachel

    2012-06-01

    Full Text Available Abstract Background Little information is known about what information women want when choosing a birth facility. The objective of this study was to inform the development of a consumer decision support tool about birth facility by identifying the information needs of maternity care consumers in Queensland, Australia. Methods Participants were 146 women residing in both urban and rural areas of Queensland, Australia who were pregnant and/or had recently given birth. A cross-sectional survey was administered in which participants were asked to rate the importance of 42 information items to their decision-making about birth facility. Participants could also provide up to ten additional information items of interest in an open-ended question. Results On average, participants rated 30 of the 42 information items as important to decision-making about birth facility. While the majority of information items were valued by most participants, those related to policies about support people, other women’s recommendations about the facility, freedom to choose one’s preferred position during labour and birth, the aesthetic quality of the facility, and access to on-site neonatal intensive care were particularly widely valued. Additional items of interest frequently focused on postnatal care and support, policies related to medical intervention, and access to water immersion. Conclusions The women surveyed had significant and diverse information needs for decision-making about birth facility. These findings have immediate applications for the development of decision support tools about birth facility, and highlight the need for tools which provide a large volume of information in an accessible and user-friendly format. These findings may also be used to guide communication and information-sharing by care providers involved in counselling pregnant women and families about their options for birth facility or providing referrals to birth facilities.

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. Did professional attendance at home births improve early neonatal survival in Indonesia?

    Science.gov (United States)

    Hatt, Laurel; Stanton, Cynthia; Ronsmans, Carine; Makowiecka, Krystyna; Adisasmita, Asri

    2009-07-01

    BACKGROUND Early neonatal mortality has been persistently high in developing countries. Indonesia, with its national policy of home-based, midwife-assisted birth, is an apt context for assessing the effect of home-based professional birth attendance on early neonatal survival. METHODS We pooled four Indonesian Demographic and Health Surveys and used multivariate logistic regression to analyse trends in first-day and early neonatal mortality. We measured the effect of the context of delivery, including place and type of provider, and tested for changes in trend when the 'Midwife in the Village' programme was initiated. RESULTS Reported first-day mortality did not decrease significantly between 1986 and 2002, whereas early neonatal mortality decreased by an average of 3.2% annually. The rate of the decline did not change over the time period, either in 1989 when the Midwife in the Village programme was initiated, or in any year following when uptake of professional care increased. In simple and multivariate analyses, there were no significant differences in first-day or early neonatal death rates comparing home-based births with or without a professional midwife. Early neonatal mortality was higher in public facilities, likely due to selection. Biological determinants (twin births, male sex, short birth interval, previous early neonatal loss) were important for both outcomes. CONCLUSIONS Decreasing newborn death rates in Indonesia are encouraging, but it is not clear that these decreases are associated with greater uptake of professional delivery care at home or in health facilities. This may suggest a need for improved training in immediate newborn care, strengthened emergency referral, and continued support for family planning policies.

  18. Living in violence: Neighborhood domestic violence and small for gestational age births.

    Science.gov (United States)

    Felker-Kantor, Erica; Wallace, Maeve; Theall, Katherine

    2017-07-01

    To determine the association between neighborhood domestic violence and small-for-gestational-age (SGA) birth and to examine if there is a differential impact of neighborhood domestic violence on SGA births by race in a high crime community. This analysis includes all birth records issued in New Orleans, Louisiana from 2011 to 2012 geocoded by census tract (N=177 census tracts, N=8322 women). Hierarchical modeling and ecologic spatial analysis were used to examine the area-effect of neighborhood domestic violence on SGA births, independent of individual-level predictors and accounting for the propensity to live in high domestic violence neighborhoods. Tests for spatial autocorrelation reveled area-level clustering and overlap of SGA and domestic violent rates. Pregnant women living in high domestic violence areas were more likely to give birth to an SGA infant compared to women in low-domestic violence areas (OR=1.04, 95%CI: 1.01, 1.08), net of the effects of individual-level factors and propensity scores. Neighborhood-level attributes including rates of domestic violence may increase women's risk for SGA birth, highlighting a policy-relevant and potentially amenable exposure. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ivorra Carmen

    2012-07-01

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

  1. Associations between birth health, maternal employment, and child care arrangement among a community sample of mothers with young children.

    Science.gov (United States)

    Chiao, Chi; Chyu, Laura; Ksobiech, Kate

    2014-01-01

    Although a large body of literature exists on how different types of child care arrangements affect a child's subsequent health and sociocognitive development, little is known about the relationship between birth health and subsequent decisions regarding type of nonparental child care as well as how this relationship might be influenced by maternal employment. This study used data from the Los Angeles Families and Neighborhoods Survey (L.A.FANS). Mothers of 864 children (ages 0-5) provided information regarding birth weight, maternal evaluation of a child's birth health, child's current health, maternal employment, type of child care arrangement chosen, and a variety of socioeconomic variables. Child care options included parental care, relative care, nonrelative care, and daycare center. Multivariate analyses found that birth weight and subjective rating of birth health had similar effects on child care arrangement. After controlling for a child's age and current health condition, multinomial logit analyses found that mothers with children with poorer birth health are more likely to use nonrelative and daycare centers than parental care when compared to mothers with children with better birth health. The magnitude of these relationships diminished when adjusting for maternal employment. Working mothers were significantly more likely to use nonparental child care than nonemployed mothers. Results suggest that a child's health early in life is significantly but indirectly related to subsequent decisions regarding child care arrangements, and this association is influenced by maternal employment. Development of social policy aimed at improving child care service should take maternal and family backgrounds into consideration.

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

    NARCIS (Netherlands)

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

    2017-01-01

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

  3. Risk Factors for premature birth in a hospital 1

    OpenAIRE

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

    2016-01-01

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

  4. 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 ...

  5. 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

  6. 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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

  9. 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.

  10. Maternal employment and birth outcomes

    DEFF Research Database (Denmark)

    Wüst, Miriam

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

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

    Directory of Open Access Journals (Sweden)

    Mirzarahimi M

    2012-01-01

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

  12. Policies for care during the third stage of labour: a survey of maternity units in Syria

    Directory of Open Access Journals (Sweden)

    Abdulsalam Asma

    2010-06-01

    Full Text Available Abstract Background Care for women during the third stage aims to reduce the risk of major haemorrhage, but is very variable. The current World Health Organisation (WHO recommendation is that care should include administration of a uterotonic (oxytocin, if it is available soon after birth of the baby, delayed cord clamping, and delivery of the placenta by controlled cord traction. Methods To ascertain care policies used during the third stage of labour in maternity units in Syria, we conducted a survey of 69 maternity units in obstetric and general public hospitals. A brief questionnaire was administered by face to face interview or telephone with senior obstetricians and midwives. Outcome measures were the use of prophylactic uterotonic drugs, timing of cord clamping, use of controlled cord traction, and treatment for postpartum haemorrhage. Obstetricians were asked about both vaginal and caesarean births, midwives only about vaginal births. Results Responses were obtained for 66 (96% hospitals: a midwife and an obstetrician were interviewed in 40; an obstetrician only in 20; a midwife only in 6. Responses were similar, although midwives were more likely to report that the umbilical cord was clamped after 1-3 minutes or after cessation of pulsation (2/40 obstetricians and 9/40 midwives. Responses have therefore been combined. One hospital reported never using a prophylactic uterotonic drug. The uterotonic was Syntometrine® (oxytocin and ergometrine in two thirds of hospitals; given after delivery of the placenta in 60 (91% for vaginal births, and in 47 (78% for caesarean births. Cord clamping was within 20 seconds at 42 hospitals 64% for vaginal births and 45 (75% for caesarean births. Controlled cord traction was never used in a quarter (17/66 of hospitals for vaginal births and a half (32/60 for caesarean births. 68% of respondents (45/66 thought there was a need for more randomised trials of interventions during the third stage of labour

  13. Implications of teen birth for overweight and obesity in adulthood.

    Science.gov (United States)

    Chang, Tammy; Choi, HwaJung; Richardson, Caroline R; Davis, Matthew M

    2013-08-01

    The objective of this study was to examine whether teen birth was independently associated with overweight and obesity in a US cohort. We examined whether teen birth is independently associated with overweight and obesity in a multiyear US cohort using the 2001-2010 National Health and Nutrition Examination Survey, a nationally representative cross-sectional survey of the US civilian, noninstitutionalized population. We performed multinomial logistic regression adjusting for survey cohort, age at survey, race, education, and parity. We included women 20-59 years old at the time of survey, with at least 1 live birth, not currently or recently pregnant (unweighted, n = 5220; weighted, n = 48.4 million). Our outcome measure was the effect of teen birth on subsequent overweight and obesity. In bivariate analyses, women with a teen birth were significantly more likely than women without a teen birth to be overweight (relative risk ratios [RRRs], 1.61; 95% confidence interval [CI], 1.37-1.90) or obese (RRR, 1.84; 95% CI, 1.56-2.16) at the time of the survey. In multivariate models, women with a teen birth remained significantly more likely to be overweight (adjusted RRR, 1.33; 95% CI, 1.10-1.62) or obese (adjusted RRR, 1.32; 95% CI, 1.09-1.61) than women without a teen birth. For women in the United States, giving birth as a teen is associated with subsequent overweight/obese status later in life. To inform clinical and policy interventions with the goal to improve the long-term health of teenage mothers, future studies must examine modifiable physiological and sociomedical reasons for early child-bearing and later risk of obesity. Copyright © 2013 Mosby, Inc. All rights reserved.

  14. 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

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

    Science.gov (United States)

    McAllister, Jan; Collier, Jacqueline

    2014-03-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  17. Eastern Europe: pronatalist policies and private behavior.

    Science.gov (United States)

    David, H P

    1982-02-01

    Fertility trends in the 9 Eastern European socialist countries (Albania, Bulgaria, Czechoslovakia, German Democratic Republic, Hungary, Poland, Romania, USSR, Yugoslavia) are reviewed. Official policy in all these countries but Yugoslavia is explicitly pronatalist to varying degrees. Attention is directed to the following areas: similarities and differences; fertility trends (historical trends, post World War 2 trends, and family size); abortion trends (abortion legislation history, current legislation, abortion data, impact on birth rates, abortion seekers, health risks, and psychological aftereffects); contraceptive availability and practice; pronatal economic incentives (impact on fertility); women's position; and marriage, divorce, and sexual attitudes. The fact that fertility was generally higher in the Eastern European socialist countries than in Western Europe in the mid-1970s is credited to pronatalist measures undertaken when fertility fell or threatened to fall below replacement level (2.1 births/woman) after abortion was liberalized in all countries but Albania, following the lead of the USSR in 1955. Fertility increased where access to abortion was again restricted (mildly in Bulgaria, Czechoslovakia, and Hungary at various times, and severely in Romania in 1966) and/or economic incentives such as birth grants, paid maternity leave, family and child care allowances, and low interest loans to newlyweds were substantially increased (Bulgaria, Czechoslovakia, Hungary, and Poland to some extent, in the late 1960s and early 1970s, and the German Democratic Republic in 1976). Subsequent declines in Bulgaria, Czechoslovakia, Hungary, and Romania suggest that policy induced increases in fertility are short-lived. Couples respond to abortion restrictions by practicing more efficient contraception or resorting to illegal abortion. It is evident that the region's low birth rate is realized mainly with abortion, for withdrawal remains the primary contraceptive

  18. 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

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

    Science.gov (United States)

    Kataoka, Yaeko; Eto, Hiromi; Iida, Mariko

    2013-08-01

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

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

    Science.gov (United States)

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

    2005-04-01

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

  1. Profile and birthing practices of Maranao traditional birth attendants

    Directory of Open Access Journals (Sweden)

    Maghuyop-Butalid R

    2015-10-01

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

  2. Agricultural pesticide use and adverse birth outcomes in the San Joaquin Valley of California.

    Science.gov (United States)

    Larsen, Ashley E; Gaines, Steven D; Deschênes, Olivier

    2017-08-29

    Virtually all agricultural communities worldwide are exposed to agricultural pesticides. Yet, the health consequences of such exposure are poorly understood, and the scientific literature remains ambiguous. Using individual birth and demographic characteristics for over 500 000 birth observations between 1997-2011 in the agriculturally dominated San Joaquin Valley, California, we statistically investigate if residential agricultural pesticide exposure during gestation, by trimester, and by toxicity influences birth weight, gestational length, or birth abnormalities. Overall, our analysis indicates that agricultural pesticide exposure increases adverse birth outcomes by 5-9%, but only among the population exposed to very high quantities of pesticides (e.g., top 5th percentile, i.e., ~4200 kg applied over gestation). Thus, policies and interventions targeting the extreme right tail of the pesticide distribution near human habitation could largely eliminate the adverse birth outcomes associated with agricultural pesticide exposure documented in this study.The health consequences of exposure to pesticides are uncertain and subject to much debate. Here, the effect of exposure during pregnancy is investigated in an agriculturally dominated residential area, showing that an increase in adverse birth outcomes is observed with very high levels of pesticide exposure.

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

    DEFF Research Database (Denmark)

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

    2009-01-01

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

  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. [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.

  6. 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

  7. 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.

  8. Population policy and the Five Year Plans.

    Science.gov (United States)

    Chandna, R C

    1989-01-01

    Population policy and the 5-year plans since 1951 in India are reivewed and evaluated in terms of limiting population growth. The family planning (FP) programs have not had a major impact on people's attitudes, practice of contraceptives, or the average fertility rate. Not enough attention has been paid to the interaction of demographic structure and economic and social development, and the implications for limiting population growth. Vital elements of a population policy are containing population growth, limiting births among the young and reproductive age groups, enhancing employment options for males and females, diversifying the economy, improving literacy and educational standards, improving urban/rural ratios, and balancing male/female ratios. Several approaches to FP programs are possible: long term measures to improve the social, economic, and demographic structure, and short term measures to immediately avert births. Long term approaches recognize the complexity of the problem. Rapid socioeconomic development is the best contraceptive for controlling India's population. A well conceived population education program can help, as will increasing the marriage age, preventing children from entering the labor market, increasing female education levels, providing old age pension and social security and other insurance, and providing maternity benefits for small families. Short term measures may provide temporary or permanent methods of averting births; i.e., contraceptives, sterilization, penalties and rewards for small families. However, it must not be a bureaucratic measure imposed from above. It must be a self generating process. The author suggests that simultaneous long and short term approaches are necessary. Research should be conducted to delineate which measures have the most impact on reducing fertility and policy be formulated in accordance with these answers. Compulsion is required, and government should not hesitate to step in. In rural areas

  9. Racial/ethnic variations in the prevalence of selected major birth defects, metropolitan Atlanta, 1994-2005.

    Science.gov (United States)

    Kucik, James E; Alverson, Clinton J; Gilboa, Suzanne M; Correa, Adolfo

    2012-01-01

    Birth defects are the leading cause of infant mortality and are responsible for substantial child and adult morbidity. Documenting the variation in prevalence of birth defects among racial/ethnic subpopulations is critical for assessing possible variations in diagnosis, case ascertainment, or risk factors among such groups. We used data from the Metropolitan Atlanta Congenital Defects Program, a population-based birth defects registry with active case ascertainment. We estimated the racial/ethnic variation in prevalence of 46 selected major birth defects among live births, stillbirths, and pregnancy terminations at >20 weeks gestation among mothers residing in the five central counties of metropolitan Atlanta between 1994 and 2005, adjusting for infant sex, maternal age, gravidity, and socioeconomic status (SES). We also explored SES as a potential effect measure modifier. Compared with births to non-Hispanic white women, births to non-Hispanic black women had a significantly higher prevalence of five birth defects and a significantly lower prevalence of 10 birth defects, while births to Hispanic women had a significantly higher prevalence of four birth defects and a significantly lower prevalence of six birth defects. The racial/ethnic disparities in the prevalence of some defects varied by SES, but no clear pattern emerged. Racial/ethnic disparities were suggested in 57% of included birth defects. Disparities in the prevalence of birth defects may result from different underlying genetic susceptibilities; exposure to risk factors; or variability in case diagnosis, ascertainment, or reporting among the subpopulations examined. Policies that improve early diagnosis of birth defects could reduce associated morbidity and mortality.

  10. 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.

  11. 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...

  12. Epigenetic signature of birth weight discordance in adult twins

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  13. 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.

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

    Science.gov (United States)

    Omar, Abeer

    2018-01-01

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

  15. The effects of family policies in the German Democratic Republic: a re-evaluation.

    Science.gov (United States)

    Monnier, A

    1990-01-01

    The author examines "the impact which various pro-natalist measures adopted since 1976 in the German Democratic Republic have had on women's birth cohorts....A period analysis of subsequent birth and fertility trends would seem to indicate that this policy was remarkably effective. The annual number of births...started to rise rapidly in 1976 and reached a peak of 245,132 births in 1980, an increase of 37%....Furthermore, comparison with the period fertility trend in the Federal Republic of Germany...shows that the gap between the two Germanys has widened since 1977...whereas the trends had been very similar in the two countries before that date....However...other factors should be taken into account: in particular, the number of marriages has fallen steeply during the last few years, and at the same time the number of births outside marriage has soared. These changes, which were in all probability prompted by the adoption of social legislation which favoured single mothers (or fathers)...must be taken into account when assessing the consequences of the new family policy." excerpt

  16. 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.

  17. 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.

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

    OpenAIRE

    Declercq, E R

    1984-01-01

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

  19. 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...

  20. 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.

  1. 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.

  2. 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.

  3. Reflections on the Unintended Consequences of the Promotion of Institutional Pregnancy and Birth Care in Burkina Faso.

    Directory of Open Access Journals (Sweden)

    Andrea Melberg

    Full Text Available The policy of institutional delivery has been the cornerstone of actions aimed at monitoring and achieving MDG 5. Efforts to increase institutional births have been implemented worldwide within different cultural and health systems settings. This paper explores how communities in rural Burkina Faso perceive the promotion and delivery of facility pregnancy and birth care, and how this promotion influences health-seeking behaviour. A qualitative study was conducted in South-Western Burkina Faso between September 2011 and January 2012. A total of 21 in-depth interviews and 8 focus group discussions with women who had given birth recently and community members were conducted. The data were analyzed using qualitative content analysis and interpreted through Merton's concept of unintended consequences of purposive social action. The study found that community members experienced a strong pressure to give birth in a health facility and perceived health workers to define institutional birth as the only acceptable option. Women and their families experienced verbal, economic and administrative sanctions if they did not attend services and adhered to health worker recommendations, and reported that they felt incapable of questioning health workers' knowledge and practices. Women who for social and economic reasons had limited access to health facilities found that the sanctions came with increased cost for health services, led to social stigma and acted as additional barriers to seek skilled care at birth. The study demonstrates how the global and national policy of skilled pregnancy and birth care can occur in unintentional ways in local settings. The promotion of institutional care during pregnancy and at birth in the study area compromised health system trust and equal access to care. The pressure to use facility care and the sanctions experienced by women not complying may further marginalize women with poor access to facility care and contribute to

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

    Science.gov (United States)

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

    2017-04-01

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

  5. The role of progesterone in prevention of preterm birth

    Directory of Open Access Journals (Sweden)

    Jodie M Dodd

    2009-07-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

  7. 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...

  8. 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.

  9. 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).

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

    Science.gov (United States)

    Chang, Jen Jen; Macones, George A

    2011-08-01

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

  11. The Sorting of Female Careers after First Birth

    DEFF Research Database (Denmark)

    Arntz, Melanie; Dlugosz, Stephan; Wilke, Ralf

    2017-01-01

    unprecedented insights into how women's skills, the quality of the previous job match, firm level characteristics, labour market conditions and leave legislation are related to the length of maternity duration. Expansionary leave policies, e.g. are found to be a key factor for the rising share of women who have......A number of contributions have found evidence that motherhood is a critical life event for women's employment careers. This study presents a detailed analysis for the duration of maternity leave in which young mothers can make a transition into different types of employment, unemployment as well...... as the next birth. We provide a comprehensive picture of the sorting mechanisms that lead to the differentiation of women's employment careers after birth. Our empirical evidence is derived from large-linked administrative individual labour market data from Germany for a period of three decades. We obtain...

  12. Cervical mucus properties stratify risk for preterm birth.

    Directory of Open Access Journals (Sweden)

    Agatha S Critchfield

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

  13. Towards universal access to skilled birth attendance: the process of transforming the role of traditional birth attendants in Rural China.

    Science.gov (United States)

    Jiang, Hong; Qian, Xu; Chen, Lili; Li, Jian; Escobar, Erin; Story, Mary; Tang, Shenglan

    2016-03-21

    Institution-based childbirth, with the ultimate goal of universal access to skilled birth attendance (SBA), has been selected as a key strategy to reduce the maternal mortality rate in many developing countries. However, the question of how to engage traditional birth attendants (TBAs) in the advocacy campaign for SBA poses a number of challenges. This paper aims to demonstrate how TBAs in rural regions of China have been integrated into the health system under a policy of institutional delivery. Research was conducted through literature and document reviews and individual in-depth interviews with stakeholders of the safe motherhood program in rural Guangxi Zhuang Autonomous Region, China. A total of 33 individual interviews were conducted with regional and local politicians, policy makers, health managers, health providers, civil society members, village cadres for women affairs, former TBAs, village maternal health workers, mothers and their mother-in-laws. Since 1998, TBA's traditional role of providing in-home care during childbirth has been restructured and their social role has been strengthened in rural Guangxi. TBAs were redesigned to function as the linkage between women and the health system. A new policy in 1999 shifted the role of TBAs to village maternal health workers whose responsibilities were mainly to promote perinatal care and institution-based delivery of pregnant women. This successful transformation involved engaging with government and other actors, training TBAs for their new role, and providing incentives and sanctions for human resources management. The China experience of transforming the role of TBAs in Guangxi rural area is an example of successfully engaging TBAs in promoting institution-based childbirth.

  14. 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.

  15. Are tuition-free primary education policies associated with lower infant and neonatal mortality in low- and middle-income countries?

    Science.gov (United States)

    Quamruzzaman, Amm; Mendoza Rodríguez, José M; Heymann, Jody; Kaufman, Jay S; Nandi, Arijit

    2014-11-01

    Robust evidence from low- and middle-income countries (LMICs) suggests that maternal education is associated with better child health outcomes. However, whether or not policies aimed at increasing access to education, including tuition-free education policies, contribute to lower infant and neonatal mortality has not been empirically tested. We joined country-level data on national education policies for 37 LMICs to information on live births to young mothers aged 15-21 years, who were surveyed as part of the population-based Demographic and Health Surveys. We used propensity scores to match births to mothers who were exposed to a tuition-free primary education policy with births to mothers who were not, based on individual-level, household, and country-level characteristics, including GDP per capita, urbanization, and health expenditures per capita. Multilevel logistic regression models, fitted using generalized estimating equations, were used to estimate the effect of exposure to tuition-free primary education policies on the risk of infant and neonatal mortality. We also tested whether this effect was modified by household socioeconomic status. The propensity score matched samples for analyses of infant and neonatal mortality comprised 24,396 and 36,030 births, respectively, from 23 countries. Multilevel regression analyses showed that, on average, exposure to a tuition-free education policy was associated with 15 (95% CI=-32, 1) fewer infant and 5 (95% CI=-13, 4) fewer neonatal deaths per 1000 live births. We found no strong evidence of heterogeneity of this effect by socioeconomic level. Copyright © 2014. Published by Elsevier Ltd.

  16. Navajo birth outcomes in the Shiprock uranium mining area

    International Nuclear Information System (INIS)

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

    1992-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Facilitating home birth.

    Science.gov (United States)

    Finigan, Valerie; Chadderton, Diane

    2015-06-01

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

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

    OpenAIRE

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

    2005-01-01

    To obtain the low birth weight (LBW) rate, the very low birth weight (VLBW) rate, and gestational age (GA)-specific birth weight distribution based on a large population in Korea, we collected and analyzed the birth data of 108,486 live births with GA greater than 23 weeks for 1 yr from 1 January to 31 December 2001, from 75 hospitals and clinics located in Korea. These data included birth weight, GA, gender of the infants, delivery type, maternal age, and the presence of multiple pregnancy. ...

  20. 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.

  1. 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.

  2. 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.

  3. 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

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

    Science.gov (United States)

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

    1993-04-01

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

  5. 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

  6. Obstetric History and Likelihood of Preterm Birth of Twins.

    Science.gov (United States)

    Easter, Sarah Rae; Little, Sarah E; Robinson, Julian N; Mendez-Figueroa, Hector; Chauhan, Suneet P

    2018-01-05

     The objective of this study was to investigate the relationship between preterm birth in a prior pregnancy and preterm birth in a twin pregnancy.  We performed a secondary analysis of a randomized controlled trial evaluating 17-α-hydroxyprogesterone caproate in twins. Women were classified as nulliparous, multiparous with a prior term birth, or multiparous with a prior preterm birth. We used logistic regression to examine the odds of spontaneous preterm birth of twins before 35 weeks according to past obstetric history.  Of the 653 women analyzed, 294 were nulliparas, 310 had a prior term birth, and 49 had a prior preterm birth. Prior preterm birth increased the likelihood of spontaneous delivery before 35 weeks (adjusted odds ratio [aOR]: 2.44, 95% confidence interval [CI]: 1.28-4.66), whereas prior term delivery decreased these odds (aOR: 0.55, 95% CI: 0.38-0.78) in the current twin pregnancy compared with the nulliparous reference group. This translated into a lower odds of composite neonatal morbidity (aOR: 0.38, 95% CI: 0.27-0.53) for women with a prior term delivery.  For women carrying twins, a history of preterm birth increases the odds of spontaneous preterm birth, whereas a prior term birth decreases odds of spontaneous preterm birth and neonatal morbidity for the current twin pregnancy. These results offer risk stratification and reassurance for clinicians. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. 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.

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

    Science.gov (United States)

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

    2018-01-01

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

  9. Cross-Country Individual Participant Analysis of 4.1 Million Singleton Births in 5 Countries with Very High Human Development Index Confirms Known Associations but Provides No Biologic Explanation for 2/3 of All Preterm Births.

    Science.gov (United States)

    Ferrero, David M; Larson, Jim; Jacobsson, Bo; Di Renzo, Gian Carlo; Norman, Jane E; Martin, James N; D'Alton, Mary; Castelazo, Ernesto; Howson, Chris P; Sengpiel, Verena; Bottai, Matteo; Mayo, Jonathan A; Shaw, Gary M; Verdenik, Ivan; Tul, Nataša; Velebil, Petr; Cairns-Smith, Sarah; Rushwan, Hamid; Arulkumaran, Sabaratnam; Howse, Jennifer L; Simpson, Joe Leigh

    2016-01-01

    Preterm birth is the most common single cause of perinatal and infant mortality, affecting 15 million infants worldwide each year with global rates increasing. Understanding of risk factors remains poor, and preventive interventions have only limited benefit. Large differences exist in preterm birth rates across high income countries. We hypothesized that understanding the basis for these wide variations could lead to interventions that reduce preterm birth incidence in countries with high rates. We thus sought to assess the contributions of known risk factors for both spontaneous and provider-initiated preterm birth in selected high income countries, estimating also the potential impact of successful interventions due to advances in research, policy and public health, or clinical practice. We analyzed individual patient-level data on 4.1 million singleton pregnancies from four countries with very high human development index (Czech Republic, New Zealand, Slovenia, Sweden) and one comparator U.S. state (California) to determine the specific contribution (adjusting for confounding effects) of 21 factors. Both individual and population-attributable preterm birth risks were determined, as were contributors to cross-country differences. We also assessed the ability to predict preterm birth given various sets of known risk factors. Previous preterm birth and preeclampsia were the strongest individual risk factors of preterm birth in all datasets, with odds ratios of 4.6-6.0 and 2.8-5.7, respectively, for individual women having those characteristics. In contrast, on a population basis, nulliparity and male sex were the two risk factors with the highest impact on preterm birth rates, accounting for 25-50% and 11-16% of excess population attributable risk, respectively (pbirth within each country lacks a plausible biologic explanation, and 63% of difference between countries cannot be explained with known factors; thus, research is necessary to elucidate the underlying

  10. 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

  11. Prevalence of abnormal birth weight and related factors in Northern region, Ghana.

    Science.gov (United States)

    Abubakari, Abdulai; Kynast-Wolf, Gisela; Jahn, Albrecht

    2015-12-15

    Birth weight is a crucial determinant of the development potential of the newborn. Abnormal newborn weights are associated with negative effects on the health and survival of the baby and the mother. Therefore, this study was designed to determine the prevalence of abnormal birth weight and related factors in Northern region, Ghana. The study was a facility-based cross-sectional survey in five hospitals in Northern region, Ghana. These hospitals were selected based on the different socio-economic backgrounds of their clients. The data on birth weight and other factors were derived from hospital records. It was observed that low birth weight is still highly prevalent (29.6%), while macrosomia (10.5%) is also increasingly becoming important. There were marginal differences in low birth weight observed across public hospitals but marked difference in low birth weight was observed in Cienfuegos Suglo Specialist Hospital (Private hospital) as compared to the public hospitals. The private hospital also had the highest prevalence of macrosomia (20.1%). Parity (0-1) (p malnutrition phenomenon, which is currently being experienced by developing and transition counties. Both low birth weight and macrosomia are risk factors, which could contribute considerably to the current and future burden of diseases. This may overstretch the already fragile health system in Ghana. Therefore, it is prudent to recommend that policies aiming at reducing diet related diseases should focus on addressing malnutrition during pregnancy and early life.

  12. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

    Science.gov (United States)

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2016-01-01

    A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3) for women of high obstetric risk. The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

  13. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services.

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Leal

    Full Text Available A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk.This is a sub-analysis of a national population-based survey of postpartum women entitled "Birth in Brazil", performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services.Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8% when compared to the ones receiving public services (rate of 2.4%, regardless of obstetric risk-adjusted OR of 2.3 (CI 1.5-3.6 for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1-2.3 for women of high obstetric risk.The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care.

  14. 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.

  15. Graduate course development : transportation policy and politics.

    Science.gov (United States)

    2009-08-01

    Transportation, public policy, and politics are inextricably linked and have been, in the United States, from : at least 1956, with the birth of the federal highway system and the Interstate Highway Act, if not earlier. : Much of the transportation s...

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

    African Journals Online (AJOL)

    raoul

    2011-02-23

    Feb 23, 2011 ... methylmalonic aciduria, and maple syrup urine disease (MSUD) had their diagnoses confirmed by enzyme assay. The diagnosis of all ... Personal information like date of birth, sex, area of residence, mother's age at birth, father's age, order of birth, birth weight, gestational age on birth, medical history and ...

  17. Birth Territory: a theory for midwifery practice.

    Science.gov (United States)

    Fahy, Kathleen M; Parratt, Jenny Anne

    2006-07-01

    The theory of Birth Territory describes, explains and predicts the relationships between the environment of the individual birth room, issues of power and control, and the way the woman experiences labour physiologically and emotionally. The theory was synthesised inductively from empirical data generated by the authors in their roles as midwives and researchers. It takes a critical post-structural feminist perspective and expands on some of the ideas of Michel Foucault. Theory synthesis was also informed by current research about the embodied self and the authors' scholarship in the fields of midwifery, human biology, sociology and psychology. In order to demonstrate the significance of the theory, it is applied to two clinical stories that both occur in hospital but are otherwise different. This analysis supports the central proposition that when midwives use 'midwifery guardianship' to create and maintain the ideal Birth Territory then the woman is most likely to give birth naturally, be satisfied with the experience and adapt with ease in the post-birth period. These benefits together with the reduction in medical interventions also benefit the baby. In addition, a positive Birth Territory is posited to have a broader impact on the woman's partner, family and society in general.

  18. Links between environmental geochemistry and rate of birth defects: Shanxi Province, China

    Energy Technology Data Exchange (ETDEWEB)

    Yu Haiying [State Key Laboratory of Earth Surface Processes and Resource Ecology, School of Geography, Beijing Normal University, Beijing 100875 (China); College of Resources and Environmental Sciences, Sichuan Agricultural University, Ya' an, Sichuan 625014 (China); Zhang Keli, E-mail: keli@bnu.edu.cn [State Key Laboratory of Earth Surface Processes and Resource Ecology, School of Geography, Beijing Normal University, Beijing 100875 (China)

    2011-01-01

    The rate of birth defects in Shanxi Province is among the highest worldwide. In order to identify the impacts of geochemical and environmental factors on birth defect risk, samples of soil, water and food were collected from an area with an unusually high rate of birth defects (study area) and an area with a low rate of birth defects (control area) in Shanxi Province, China. Element contents were determined by ICP-OES, and the results were analyzed using a non-parametric test and stepwise regression. Differences in the level and distribution of 14 geochemical elements, namely arsenic (As), selenium (Se), molybdenum (Mo), zinc (Zn), strontium (Sr), iron (Fe), tin (Sn), magnesium (Mg), vanadium (V), calcium (Ca), copper (Cu), aluminum (Al), potassium (K) and sulfur (S) were thus compared between the study and control areas. The results reveal that the geochemical element contents in soil, water and food show a significant difference between the study area and control area, and suggest that the study area was characterized by higher S and lower Sr and Al contents. These findings, based on statistical analysis, may be useful in directing further epidemiological investigations identifying the leading causes of birth defects. - Research Highlights: {yields} Environmental geochemistry has an significant impact on birth defects in the regions with an unusually high rate of birth defects. {yields} An excess of S and deficiency of Sr and Al are the distinctive environmental features associated with the high rate of birth defects in the Shanxi Province of China. {yields} Geochemical anomalies is a non-medical basis for effective prevention and cure of birth defects.

  19. Links between environmental geochemistry and rate of birth defects: Shanxi Province, China

    International Nuclear Information System (INIS)

    Yu Haiying; Zhang Keli

    2011-01-01

    The rate of birth defects in Shanxi Province is among the highest worldwide. In order to identify the impacts of geochemical and environmental factors on birth defect risk, samples of soil, water and food were collected from an area with an unusually high rate of birth defects (study area) and an area with a low rate of birth defects (control area) in Shanxi Province, China. Element contents were determined by ICP-OES, and the results were analyzed using a non-parametric test and stepwise regression. Differences in the level and distribution of 14 geochemical elements, namely arsenic (As), selenium (Se), molybdenum (Mo), zinc (Zn), strontium (Sr), iron (Fe), tin (Sn), magnesium (Mg), vanadium (V), calcium (Ca), copper (Cu), aluminum (Al), potassium (K) and sulfur (S) were thus compared between the study and control areas. The results reveal that the geochemical element contents in soil, water and food show a significant difference between the study area and control area, and suggest that the study area was characterized by higher S and lower Sr and Al contents. These findings, based on statistical analysis, may be useful in directing further epidemiological investigations identifying the leading causes of birth defects. - Research Highlights: → Environmental geochemistry has an significant impact on birth defects in the regions with an unusually high rate of birth defects. → An excess of S and deficiency of Sr and Al are the distinctive environmental features associated with the high rate of birth defects in the Shanxi Province of China. → Geochemical anomalies is a non-medical basis for effective prevention and cure of birth defects.

  20. 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.

  1. 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

  2. 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

  3. Birth characteristics and Wilms tumors in children in the Nordic countries

    DEFF Research Database (Denmark)

    Schüz, Joachim; Schmidt, Lisbeth Samsø; Kogner, Per

    2011-01-01

    Little is known about causes of Wilms tumor. Because of the young age at diagnosis, several studies have looked at various birth characteristics. We conducted a registry-based case-control study involving 690 cases of Wilms tumor aged 0-14 years, occurring in Denmark, Finland, Norway or Sweden...... during 1985-2006, individually matched to five controls drawn randomly from the Nordic childhood population. Information on birth characteristics was obtained from the population-based medical birth registries. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) using conditional logistic......-for-gestational age girls also had a higher risk (2.48, 1.51-4.05), whereas no effect was seen for boys (1.12, 0.60-2.07). An association was seen with Apgar score at 5 min birth order. In our large-scale, registry...

  4. Canada's evacuation policy for pregnant First Nations women: Resignation, resilience, and resistance.

    Science.gov (United States)

    Lawford, Karen M; Giles, Audrey R; Bourgeault, Ivy L

    2018-02-10

    Aboriginal peoples in Canada are comprised of First Nations, Métis, and Inuit. Health care services for First Nations who live on rural and remote reserves are mostly provided by the Government of Canada through the federal department, Health Canada. One Health Canada policy, the evacuation policy, requires all First Nations women living on rural and remote reserves to leave their communities between 36 and 38 weeks gestational age and travel to urban centres to await labour and birth. Although there are a few First Nations communities in Canada that have re-established community birthing and Aboriginal midwifery is growing, most First Nations communities are still reliant on the evacuation policy for labour and birthing services. In one Canadian province, Manitoba, First Nations women are evacuated to The Pas, Thompson, or Winnipeg but most - including all women with high-risk pregnancies - go to Winnipeg. To contribute scholarship that describes First Nations women's and community members' experiences and perspectives of Health Canada's evacuation policy in Manitoba. Applying intersectional theory to data collected through 12 semi-structured interviews with seven women and five community members (four females, one male) in Manitoba who had experienced the evacuation policy. The data were analyzed thematically, which revealed three themes: resignation, resilience, and resistance. The theme of resignation was epitomized by the quote, "Nobody has a choice." The ability to withstand and endure the evacuation policy despite poor or absent communication and loneliness informed of resilience. Resistance was demonstrated by women who questioned the necessity and requirement of evacuation for labour and birth. In one instance, resistance took the form of a planned homebirth with Aboriginal registered midwives. There is a pressing need to improve the maternity care services that First Nations women receive when they are evacuated out of their communities, particularly

  5. Parental bonding after preterm birth: child and parent perspectives in the Helsinki study of very low birth weight adults.

    Science.gov (United States)

    Pyhälä, Riikka; Räikkönen, Katri; Pesonen, Anu-Katriina; Heinonen, Kati; Lahti, Jari; Hovi, Petteri; Strang-Karlsson, Sonja; Andersson, Sture; Eriksson, Johan G; Järvenpää, Anna-Liisa; Kajantie, Eero

    2011-02-01

    To examine whether parenting behavior recalled by very low birth weight (VLBW) adults or their parents differs from that of term-born control subjects or their parents. A total of 164 VLBW and 172 control adults (mean age 22.5 years, SD 2.2) assessed retrospectively the parenting behavior of their parents by the Parental Bonding Instrument, which includes dimensions of care, protectiveness, and authoritarianism. A subgroup of 190 mothers and 154 fathers assessed their own parenting behavior by the Parent Behavior Inventory, which includes dimensions of supportive and hostile parenting. The VLBW women assessed their mothers as more protective and authoritarian than the control women. The VLBW and control men did not differ from each other. Both mothers and fathers of the VLBW adults assessed their own parenting as more supportive than those of the control subjects. Preterm birth at VLBW may promote a more protective, as well as more supportive, parenting style. Copyright © 2011 Mosby, Inc. All rights reserved.

  6. Randomized trial of BCG vaccination at birth to low-birth-weight children

    DEFF Research Database (Denmark)

    Aaby, Peter; Roth, Adam Anders Edvin; Ravn, Henrik

    2011-01-01

    Observational studies have suggested that BCG may have nonspecific beneficial effects on survival. Low-birth-weight (LBW) children are not given BCG at birth in Guinea-Bissau; we conducted a randomized trial of BCG at birth (early BCG) vs delayed BCG.......Observational studies have suggested that BCG may have nonspecific beneficial effects on survival. Low-birth-weight (LBW) children are not given BCG at birth in Guinea-Bissau; we conducted a randomized trial of BCG at birth (early BCG) vs delayed BCG....

  7. Small-for-gestational age and preterm birth across generations: a population-based study of Illinois births.

    Science.gov (United States)

    Castrillio, Stephanie M; Rankin, Kristin M; David, Richard J; Collins, James W

    2014-12-01

    Small for gestational age (weight for gestational age mothers (1956-1976) with appended US census income information. Former SGA White mothers (N = 8,993) had a twofold greater infant SGA frequency than former non-SGA White mothers (N = 101,312); 14.4 versus 6.9 %, RR = 2.1 (2.0-2.2). Former SGA African American (N = 4,861) mothers had a SGA birth frequency of 25.7 % compared to 16.1 % for former non-SGA mothers (N = 28,090); RR = 1.5 (1.5-1.6). The adjusted (controlling for maternal age, education, marital status, parity, prenatal care usage, cigarette smoking, and hypertension) RR (95 % CI) of infant SGA for former SGA (compared to non-SGA) White and African-American mothers equaled 2.0 (1.9-2.1 and 1.5 (1.5-1.6), respectively. The adjusted RR (95 % CI) of infant preterm birth for former preterm (compared to term) White and African-American mothers were 1.1 (1.0-1.2). The findings were minimally changed among mothers with a lifelong residence in impoverished or affluent neighborhoods. In both races, approximately 8 % of SGA births were attributable to maternal SGA. There is a transgenerational association of SGA but not preterm birth among non-Hispanic Whites and African-Americans. In both races, a similar proportion of SGA births are attributable to maternal SGA.

  8. 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.

  9. 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

  10. 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)

  11. Planned hospital birth versus planned home birth

    DEFF Research Database (Denmark)

    Olsen, O.; Clausen, J.A.

    2012-01-01

    Observational studies of increasingly better quality and in different settings suggest that planned home birth in many places can be as safe as planned hospital birth and with less intervention and fewer complications. This is an update of a Cochrane review first published in 1998....

  12. [Risk factors associated with preterm birth in a second level hospital].

    Science.gov (United States)

    Escobar-Padilla, Beatriz; Gordillo-Lara, Limberg Darinel; Martínez-Puon, Horacio

    2017-01-01

    Preterm birth is one of the biggest problems in obstetrics and gynecology, given that it has an incidence of 10-11%. The objective was to identify the risk factors associated with a preterm birth. A retrospective, observational, transversal and analytic case-control study was made. All premature birth incidences were determined as study objects and controls were integrated with term deliveries. A sample size of 344 patients with a control per case was calculated. A total of 688 patients were studied. Statistical analysis was descriptive, univariate and bivariate and we used the Pearson chi square test, with a p preclampsia, PROM, twin pregnancy, placenta praevia, cervicovaginitis, previous preterm delivery and UTI are risk factors with statistical significance associated with preterm delivery.

  13. 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....

  14. 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.

  15. Demographic Consequences of Gender Discrimination in China: Simulation Analysis of Policy Options.

    Science.gov (United States)

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

    2011-08-01

    The large number of missing females in China, a consequence of gender discrimination, is having and will continue to have a profound effect on the country's population development. In this paper, we analyze the causes of this gender discrimination in terms of institutions, culture and, economy, and suggest public policies that might help eliminate gender discrimination. Using a population simulation model, we study the effect of public policies on the sex ratio at birth and excess female child mortality, and the effect of gender discrimination on China's population development. We find that gender discrimination will decrease China's population size, number of births, and working age population, accelerate population aging and exacerbate the male marriage squeeze. These results provide theoretical support for suggesting that the government enact and implement public policies aimed at eliminating gender discrimination.

  16. Experiences of women who planned birth in a birth centre compared to alternative planned places of birth. Results of the Dutch Birth Centre Study

    NARCIS (Netherlands)

    Hitzert, M.; Hermes, M.A.; Scheerhagen, M.; Boesveld, L.C.; Wiegers, T.A.; Akker-van Marle, M.E.; Dommelen, P. van; Pal-de Bruin, K.M. de; Graaf, J.P. de

    2016-01-01

    Objective to assess the experiences with maternity care of women who planned birth in a birth centre and to compare them to alternative planned places of birth, by using the responsiveness concept of the World Health Organization. Design this study is a cross-sectional study using the ReproQ

  17. Experiences of women who planned birth in a birth centre compared to alternative planned places of birth. Results of the Dutch Birth Centre Study.

    NARCIS (Netherlands)

    Hitzert, M.; Hermus, M.; Scheerhagen, M.; Boesveld, I.C.; Wiegers, T.; Akker-van Marle, M.E. van den; Dommelen, P. van; Pal-de Bruin, K.M. van der; Graal, J. P. de

    2016-01-01

    Objective: to assess the experiences with maternity care of women who planned birth in a birth centre and to compare them to alternative planned places of birth, by using the responsiveness concept of the World Health Organization. Design: this study is a cross-sectional study using the ReproQ

  18. 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

  19. 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...

  20. Birth Rates of Ethnic Groups in Croatia from 1998 to 2008

    Directory of Open Access Journals (Sweden)

    Dario Pavić

    2013-04-01

    Full Text Available Belonging to an ethnic group can affect both socio-economic status and birth-rate (fertility of the individual. Thus women of minority ethnic groups usually have a relatively high birth-rate, and they are more often single mothers, have lower education and generally lower socio-economic status. Although numerous international researches confirmed the differences in birth rates between ethnic groups, the relationship between ethnicity and birth rates has almost not been investigated in Croatia. This research analyzed the fertility rates of ethnic groups in the Republic of Croatia as well as the relationship between mother's ethnicity and socio-economic variables: age at birth, education, economic activity, nuptiality and birth order. The birth data from DEM-1 forms were used for years 1998 to 2008 as well as the data from the 2001 Census. The links between the mother’s ethnicity and all of the socio-economic variables was established although the magnitude of this correlation was small. Also, there were significant differences in the fertility rates of ethnic groups. The women of Albanian, Bosniak, Romani and other ethnicities, and to some degree Serbian women as well, had lower socio-economic status while the Romani and Albanian women had high fertility. However, it is not possible to establish a clear relationship between ethnicity and fertility owing to methodological difficulties and the way of keeping vital statistics. The inclusion of the variable ethnicity and the presentation of socio-economic variables according to mother’s ethnicity in the official statistical publications would facilitate future research and enable to create a more efficient demographic and social policy.

  1. The incidence of histological chorioamnionitis in IVF/GIFT preterm births.

    Science.gov (United States)

    Williams, H; Jeffery, H

    1994-08-01

    A retrospective case control study was designed to investigate the role of subclinical infection as a risk factor for the high rate of preterm deliveries in IVF/GIFT pregnancies. The cases and the controls were identified from the records of consecutive livebirths of preclampsia and antepartum haemorrhage. As a marker of subclinical infection, the incidence of histological chorioamnionitis (HCA) in the 2 groups (as defined by the standardized, semiquantitative method of Benirschke) was compared. The matched variables did not differ significantly between the IVF/GIFT group and the control group. No significant difference in the incidence of HCA was detected between IVF/GIFT and control groups for singletons or twins. Overall 24% of IVF/GIFT and 30% of controls showed evidence of HCA, odds ratio (95% confidence intervals), 0.72 (0.40-1.31). This study showed no evidence that the incidence of HCA, is significantly increased in IVF/GIFT preterm births compared with other matched, preterm births. Therefore, we conclude that subclinical infection/inflammation cannot explain the 4-fold increase in preterm births in the IVF/GIFT population.

  2. 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

  3. 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.

  4. 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.

  5. [The development of population policies in Africa].

    Science.gov (United States)

    Sala-diakanda, D M

    1991-12-01

    Influencing demographic dynamics in order to improve the welfare of the population is the fundamental objective of a population policy. The efficacy of a population policy cannot be satisfactorily evaluated without referring to the objectives of the overall development strategy, of which the population policy is only one component. At the time of the 1974 World Population Conference in Bucharest, the positions of the developed and developing countries were polarized. The developing countries were accused of impeding their own socioeconomic development by their high fertility rates and rapid population growth, while the industrialized world was blamed for environmental degradation and exhaustion of nonrenewable resources due to overconsumption by households and industry. Despite the near total disagreement about what constituted the problem, a "World Population Plan of Action" was adopted almost unanimously, indicating agreement at least on the existence of a problem even if ther was no consensus on its content. The Plan affirmed that each nation has a sovereign right to formulate and implement its own population policies, that international cooperation is needed in population matters, and that population policies are components of social and economic development policies and not substitutes for them. Interest in African population dates back to the beginning of the colonial era, when the imperial powers wished to control population movements, estimate the taxable population, and control depopulation due to pathological infertility. Colonial population legislation was somewhat more liberal in English-speaking countries than in those under the sway of France because of the influence of Malthusianism in Great Britain and the movement for birth control that developed there. By the 1984 World Population Conference in Mexico, the governments of African countries had adopted the "Program of Action of Kilimanjaro Concerning the African Population and Autonomous Development

  6. 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.

  7. 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....

  8. 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.

  9. A blueprint for the prevention of preterm birth: vaginal progesterone in women with a short cervix

    Science.gov (United States)

    Romero, Roberto; Yeo, Lami; Miranda, Jezid; Hassan, Sonia; Conde-Agudelo, Agustin; Chaiworapongsa, Tinnakorn

    2014-01-01

    Preterm birth is the leading cause of perinatal morbidity and mortality worldwide, and is the most important challenge to modern obstetrics. A major obstacle has been that preterm birth is treated (implicitly or explicitly) as a single condition. Two-thirds of preterm births occur after the spontaneous onset of labor, and the remaining one-third after “indicated” preterm birth; however, the causes of spontaneous preterm labor and “indicated” preterm birth are different. Spontaneous preterm birth is a syndrome caused by multiple etiologies, one of which is a decline in progesterone action, which induces cervical ripening. A sonographic short cervix (identified in the midtrimester) is a powerful predictor of spontaneous preterm delivery. Randomized clinical trials and individual patient meta-analyses have shown that vaginal progesterone reduces the rate of preterm delivery at cervix, and therefore, the compound of choice is natural progesterone (not the synthetic progestin). Routine assessment of the risk of preterm birth with cervical ultrasound coupled with vaginal progesterone for women with a short cervix is cost-effective, and implementation of such a policy is urgently needed. Vaginal progesterone is as effective as cervical cerclage in reducing the rate of preterm delivery in women with a singleton gestation, history of preterm birth, and a short cervix (<25mm). PMID:23314512

  10. Vaginal birth after cesarean: neonatal outcomes and United States birth setting.

    Science.gov (United States)

    Tilden, Ellen L; Cheyney, Melissa; Guise, Jeanne-Marie; Emeis, Cathy; Lapidus, Jodi; Biel, Frances M; Wiedrick, Jack; Snowden, Jonathan M

    2017-04-01

    Women who seek vaginal birth after cesarean delivery may find limited in-hospital options. Increasing numbers of women in the United States are delivering by vaginal birth after cesarean delivery out-of-hospital. Little is known about neonatal outcomes among those who deliver by vaginal birth after cesarean delivery in- vs out-of-hospital. The purpose of this study was to compare neonatal outcomes between women who deliver via vaginal birth after cesarean delivery in-hospital vs out-of-hospital (home and freestanding birth center). We conducted a retrospective cohort study using 2007-2010 linked United States birth and death records to compare singleton, term, vertex, nonanomolous, and liveborn neonates who delivered by vaginal birth after cesarean delivery in- or out-of-hospital. Descriptive statistics and multivariate regression analyses were conducted to estimate unadjusted, absolute, and relative birth-setting risk differences. Analyses were stratified by parity and history of vaginal birth. Sensitivity analyses that involved 3 transfer status scenarios were conducted. Of women in the United States with a history of cesarean delivery (n=1,138,813), only a small proportion delivered by vaginal birth after cesarean delivery with the subsequent pregnancy (n=109,970; 9.65%). The proportion of home vaginal birth after cesarean delivery births increased from 1.78-2.45%. A pattern of increased neonatal morbidity was noted in unadjusted analysis (neonatal seizures, Apgar score birthing their second child by vaginal birth after cesarean delivery in out-of-hospital settings had higher odds of neonatal morbidity and death compared with women of higher parity. Women who had not birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery had higher odds of neonatal morbidity and mortality compared with women who had birthed vaginally prior to out-of-hospital vaginal birth after cesarean delivery. Sensitivity analyses generated distributions of plausible

  11. Gestational age, birth weight, and the risk of hyperkinetic disorder

    DEFF Research Database (Denmark)

    Linnet, Karen M; Wisborg, Kirsten; Agerbo, Esben

    2006-01-01

    AIMS: To study the association between gestational age and birth weight and the risk of clinically verified hyperkinetic disorder. METHODS: Nested case-control study of 834 cases and 20 100 controls with incidence density sampling. RESULTS: Compared with children born at term, children born...... with gestational ages of 34-36 completed weeks had a 70% increased risk of hyperkinetic disorder (rate ratio (RR) 1.7, 95% confidence interval (CI) 1.2 to 2.5). Children with gestational ages below 34 completed weeks had an almost threefold increased risk (RR 2.7, 95% CI 1.8 to 4.1). Children born at term...... with birth weights of 1500-2499 g had a 90% increased risk of hyperkinetic disorder (RR 1.9, 95% CI 1.2 to 2.9), and children with birth weights of 2500-2999 g had a 50% increased risk (RR 1.5, 95% CI 1.2 to 1.8) compared with children born at term with birth weights above 2999 g. The results were adjusted...

  12. Malaria has no effect on birth weight in Rwanda

    Directory of Open Access Journals (Sweden)

    Karema Corine

    2009-08-01

    Full Text Available Abstract Background Malaria has a negative effect on pregnancy outcome, causing low birth weight, premature birth and stillbirths, particularly in areas with high malaria transmission. In Rwanda, malaria transmission intensity ranges from high to nil, probably associated with variable altitudes. Overall, the incidence decreased over the last six years (2002–2007. Therefore, the impact of malaria on birth outcomes is also expected to vary over time and space. Methods Obstetric indicators (birth weight and pregnancy outcome and malaria incidence were compared and analyzed to their association over time (2002–2007 and space. Birth data from 12,526 deliveries were collected from maternity registers of 11 different primary health centers located in different malaria endemic areas. Malaria data for the same communities were collected from the National Malaria Control Programme. Associations were sought with mixed effects models and logistic regression. Results In all health centres, a significant increase of birth weight over the years was observed (p Conclusion In Rwanda, birth weight and pregnancy outcome are not directly influenced by malaria, which is in contrast to many other studied areas. Although malaria incidence overall has declined and mean birth weight increased over the studied period, no direct association was found between the two. Socio-economic factors and improved nutrition could be responsible for birth weight changes in recent years.

  13. Modern Russian Demographic Policy in the Field of Fertility: Results and Areas for Improvement

    Directory of Open Access Journals (Sweden)

    Larisa Alekseevna Popova

    2016-05-01

    Full Text Available During last years in Russia the active state demographic policy, directed on the support of second and subsequent births, is leading. The article describes its evolution, evaluates efficiency and recommends directions of its improvement. It was detected, that increment of measures of demographic policy by introduction in 2011 the regional maternity capitals to a third child in addition to the federal capital to a second child gave a perceptible positive results. It allowed continuing the positive trend of fertility already in the condition of the beginning deterioration the age structure of the women in the childbearing age; maximally realize the births, which were postponed by the older generations; to increase number of children on account of additional births; to enhance the family component of fertility. Despite of concerns, the growth of reproductive attitudes happened not only in the older cohorts of the population. Conducted in 2013 sociological research gives grounds to expect, that minorities generations 1990 years of birth, which will be determine prospects of fertility, will reach the level of slightly expanded reproduction of population. In the conditions of deterioration the age structure of fertile contingents the demographic policy must be elongated and improved. All components of economic demographic measures must be saved, including child allowances to needy families, but with increasing the horizon of its assignment to adulthood of child. The directions of maternity capitals realizations must be expanded. During the develop of new measures of demographic policy need to focus on psychological measures of formation the value orientations of the population in area of number of children, on improvement of qualitative structure of fertility and strengthening of the family institute. The economic measures need to redirect on the second births, which are more family. The general line of family demographic policy is the increasing of

  14. Maternal risk factors associated with low birth weight

    International Nuclear Information System (INIS)

    Khan, N.; Jamal, M.

    2003-01-01

    Objective: To determine the association of socio-demographic, maternal, medical and obstetric risk factors with low birth weight. Results: The mean weight of cases was 2.08 kg as compared to 3.1 in controls. Forty-sixty percent of cases were preterm. The factors like maternal malnutrition, young age of the mothers, poverty, close birth spacing, hypertension and antenatal per vagamin (p/v) bleeding during pregnancy have independent effect in causing low birth weight (LBW). Conclusion: Maternal bio social, medical and obstetric factors have strong association with LBW. To overcome this problem, special attention is required to strengthen the mother and child health care services in the community. (author)

  15. Planned and unplanned home births and hospital births in Calgary, Alberta, 1984-87.

    Science.gov (United States)

    Abernathy, T J; Lentjes, D M

    1989-01-01

    Information collected on all home births in Calgary (Canada) between the years 1984 and 1987, was examined and analyzed according to whether the home birth environment had been planned or unplanned. The two groups were compared to each other and to all hospital births according to demographic characteristics of mothers, indicators of prenatal care, and birth outcome. Mothers who had planned their home birth were more likely to be primiparous, attend prenatal classes, obtain regular prenatal care from a physician, and have babies with a higher birth weight than either the unplanned or hospital group. Of particular concern, however, were the subset of unplanned home births who were primiparous. These mothers attended prenatal classes less frequently than any other group, reported the lowest number of physician visits, were youngest, and least likely to be married. In addition their babies averaged the shortest gestational age and the lowest birth weight. Findings in general show that planned and unplanned home births must be considered as heterogeneous groups in any comparison of risk factors and of birth outcome between home and hospital births. Further, within the unplanned group, multiparous women differ from primiparous women. Given the limitations inherent in this and similar studies, the apparent better outcome in the planned home birth group, as measured by birth weight, must be viewed with caution.

  16. 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 “ ...

  17. Privatisation & marketisation of post-birth care: the hidden costs for new mothers

    Directory of Open Access Journals (Sweden)

    Benoit Cecilia

    2012-10-01

    Full Text Available Abstract Retrenchment of government services has occurred across a wide range of sectors and regions. Care services, in particular, have been clawed away in the wake of fiscal policies of cost containment and neoliberal policies centred on individual responsibility and market autonomy. Such policies have included the deinstitutionalisation of care from hospitals and clinics, and early discharge from hospital, both of which are predicated on the notion that care can be provided informally within families and communities. In this paper we examine the post-birth "care crisis" that new mothers face in one region of Canada. Method The data are drawn from a larger study of social determinants of pregnant and new mothers' health in Victoria, Canada. Mixed methods interviews were conducted among a purposive sample of women at three points in time. This paper reports data on sample characteristics, length of stay in hospital and health service gaps. This data is contextualised via a more in-depth analysis of qualitative responses from Wave 2 (4-6 weeks postpartum. Results Out results show a significant portion of participants desired services that were not publically available to them during the post-birth period. Among those who reported a gap in care, the two most common barriers were: cost and unavailability of home care supports. Participants' open-ended responses revealed many positive features of the public health care system but also gaps in services, and economic barriers to receiving the care they wanted. The implications of these findings are discussed in relation to recent neoliberal reforms. Discussion & conclusions While Canada may be praised for its public provision of maternity care, mothers' reports of gaps in care during the early postpartum period and increasing use of private doulas is a worrying trend. To the extent that individual mothers or families rely on the market for care provision, issues of equity and quality of care are

  18. The Study of Mothers’ Periodontal Status and Newborn’s Low Birth Weight

    Directory of Open Access Journals (Sweden)

    M. Shirinzad

    2006-10-01

    Full Text Available Introduction & Objective: Recent studies have presented evidence that periodontal disease in pregnant women may be a determining factor for newborn’s low birth weight. The present investigation was carried out to verify whether there is an association between maternal periodontal disease and low birth weight of newborns.Materials and Methods: This was a case-control study on 330 women, containing 110 mothers having live newborns with weight 2500 g (control group. The existence of an association between periodontal disease and newborn’s low birth weight was evaluated by means of analytic statistics that considered other risk factors for low weight. The two groups were compared with regard to urinary infection, preeclampsia, premature rupture of membrane, placenta previa, primiparous, smoking, age, height, socioeconomic status and periodontal disease.Results: There were no statistically significant differences between the case and control groups for any of the covariables (P>0.05, but there was significant differences for principal independent variable (periodontal disease P<0.05.Conclusion: Results indicated a positive association between periodontal disease and newborn’s low birth weight. Thus periodontal disease is a possible risk factor for low birth weight.

  19. Birth order and risk of non-hodgkin lymphoma--true association or bias?

    Science.gov (United States)

    Grulich, Andrew E; Vajdic, Claire M; Falster, Michael O; Kane, Eleanor; Smedby, Karin Ekstrom; Bracci, Paige M; de Sanjose, Silvia; Becker, Nikolaus; Turner, Jenny; Martinez-Maza, Otoniel; Melbye, Mads; Engels, Eric A; Vineis, Paolo; Costantini, Adele Seniori; Holly, Elizabeth A; Spinelli, John J; La Vecchia, Carlo; Zheng, Tongzhang; Chiu, Brian C H; Franceschi, Silvia; Cocco, Pierluigi; Maynadié, Marc; Foretova, Lenka; Staines, Anthony; Brennan, Paul; Davis, Scott; Severson, Richard K; Cerhan, James R; Breen, Elizabeth C; Birmann, Brenda; Cozen, Wendy

    2010-09-15

    There is inconsistent evidence that increasing birth order may be associated with risk of non-Hodgkin lymphoma (NHL). The authors examined the association between birth order and related variables and NHL risk in a pooled analysis (1983-2005) of 13,535 cases and 16,427 controls from 18 case-control studies within the International Lymphoma Epidemiology Consortium (InterLymph). Overall, the authors found no significant association between increasing birth order and risk of NHL (P-trend = 0.082) and significant heterogeneity. However, a significant association was present for a number of B- and T-cell NHL subtypes. There was considerable variation in the study-specific risks which was partly explained by study design and participant characteristics. In particular, a significant positive association was present in population-based studies, which had lower response rates in cases and controls, but not in hospital-based studies. A significant positive association was present in higher-socioeconomic-status (SES) participants only. Results were very similar for the related variable of sibship size. The known correlation of high birth order with low SES suggests that selection bias related to SES may be responsible for the association between birth order and NHL.

  20. Grand multiparae's evolving experiences of birthing and technology in U.S. hospitals.

    Science.gov (United States)

    Fleming, Susan E; Vandermause, Roxanne

    2011-01-01

    To explore the nature of birthing in United States (U.S.) hospitals from 1973-2007 and to explicate and interpret common, often overlooked, birthing experiences and nursing care. A Heideggerian phenomenological approach utilizing in-depth interviews. Participants' homes in Washington, Idaho, and Oregon. A purposive sample of grand multiparaes (N = 14). Data were collected via open conversational interviews of 60-90 minutes recorded on digital media and completion of a demographic and birth attribute form. Field notes and interpretive commentary were used as additional data sources and were analyzed using an established Heideggerian approach. The participants came from diverse religious and ethical backgrounds and experienced 116 births (8.29 births per woman, 79% unmedicated), a Cesarean rate of 6%, and a breastfeeding rate of 99% with a mean duration of 12 months. Two overarching patterns emerged: pursuing the "'good birth": a safe passage for baby and being in-and-out of control: body, technology, others. Each pattern subsumed several overlapping themes. The first pattern revealed that women often desire a good birth in the safety of a hospital by navigating their options prior to and during the birth. The second pattern revealed a common, yet often unachievable, desire by all of those involved in the process to control birth. Harmonizing an exchange of ideas in a technologically advanced environment prevalent in hospitals today can increase the quality of intrapartum care. Encouraging anchored companions and promoting normal physiological birth will make hospitals places where women can experience a good birth and feel safe. © 2011 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

  1. Probing Birth-Order Effects on Narrow Traits Using Specification-Curve Analysis.

    Science.gov (United States)

    Rohrer, Julia M; Egloff, Boris; Schmukle, Stefan C

    2017-12-01

    The idea that birth-order position has a lasting impact on personality has been discussed for the past 100 years. Recent large-scale studies have indicated that birth-order effects on the Big Five personality traits are negligible. In the current study, we examined a variety of more narrow personality traits in a large representative sample ( n = 6,500-10,500 in between-family analyses; n = 900-1,200 in within-family analyses). We used specification-curve analysis to assess evidence for birth-order effects across a range of models implementing defensible yet arbitrary analytical decisions (e.g., whether to control for age effects or to exclude participants on the basis of sibling spacing). Although specification-curve analysis clearly confirmed the previously reported birth-order effect on intellect, we found no meaningful effects on life satisfaction, locus of control, interpersonal trust, reciprocity, risk taking, patience, impulsivity, or political orientation. The lack of meaningful birth-order effects on self-reports of personality was not limited to broad traits but also held for more narrowly defined characteristics.

  2. Self-reported practices among traditional birth attendants surveyed in western Kenya: a descriptive study.

    Science.gov (United States)

    Bucher, Sherri; Konana, Olive; Liechty, Edward; Garces, Ana; Gisore, Peter; Marete, Irene; Tenge, Constance; Shipala, Evelyn; Wright, Linda; Esamai, Fabian

    2016-08-12

    The high rate of home deliveries conducted by unskilled birth attendants in resource-limited settings is an important global health issue because it is believed to be a significant contributing factor to maternal and newborn mortality. Given the large number of deliveries that are managed by unskilled or traditional birth attendants outside of health facilities, and the fact that there is on-going discussion regarding the role of traditional birth attendants in the maternal newborn health (MNH) service continuum, we sought to ascertain the practices of traditional birth attendants in our catchment area. The findings of this descriptive study might help inform conversations regarding the roles that traditional birth attendants can play in maternal-newborn health care. A structured questionnaire was used in a survey that included one hundred unskilled birth attendants in western Kenya. Descriptive statistics were employed. Inappropriate or outdated practices were reported in relation to some obstetric complications and newborn care. Encouraging results were reported with regard to positive relationships that traditional birth attendants have with their local health facilities. Furthermore, high rates of referral to health facilities was reported for many common obstetric emergencies and similar rates for reporting of pregnancy outcomes to village elders and chiefs. Potentially harmful or outdated practices with regard to maternal and newborn care among traditional birth attendants in western Kenya were revealed by this study. There were high rates of traditional birth attendant referrals of pregnant mothers with obstetric complications to health facilities. Policy makers may consider re-educating and re-defining the roles and responsibilities of traditional birth attendants in maternal and neonatal health care based on the findings of this survey.

  3. Using new satellite based exposure methods to study the association between pregnancy PM₂.₅ exposure, premature birth and birth weight in Massachusetts.

    Science.gov (United States)

    Kloog, Itai; Melly, Steven J; Ridgway, William L; Coull, Brent A; Schwartz, Joel

    2012-06-18

    Adverse birth outcomes such as low birth weight and premature birth have been previously linked with exposure to ambient air pollution. Most studies relied on a limited number of monitors in the region of interest, which can introduce exposure error or restrict the analysis to persons living near a monitor, which reduces sample size and generalizability and may create selection bias. We evaluated the relationship between premature birth and birth weight with exposure to ambient particulate matter (PM₂.₅) levels during pregnancy in Massachusetts for a 9-year period (2000-2008). Building on a novel method we developed for predicting daily PM₂.₅ at the spatial resolution of a 10x10 km grid across New-England, we estimated the average exposure during 30 and 90 days prior to birth as well as the full pregnancy period for each mother. We used linear and logistic mixed models to estimate the association between PM₂.₅ exposure and birth weight (among full term births) and PM₂.₅ exposure and preterm birth adjusting for infant sex, maternal age, maternal race, mean income, maternal education level, prenatal care, gestational age, maternal smoking, percent of open space near mothers residence, average traffic density and mothers health. Birth weight was negatively associated with PM₂.₅ across all tested periods. For example, a 10 μg/m³ increase of PM₂.₅ exposure during the entire pregnancy was significantly associated with a decrease of 13.80 g [95% confidence interval (CI) = -21.10, -6.05] in birth weight after controlling for other factors, including traffic exposure. The odds ratio for a premature birth was 1.06 (95% confidence interval (CI) = 1.01-1.13) for each 10 μg/m3 increase of PM₂.₅ exposure during the entire pregnancy period. The presented study suggests that exposure to PM₂.₅ during the last month of pregnancy contributes to risks for lower birth weight and preterm birth in infants.

  4. Relationship between birth order and birth weight of the pig

    OpenAIRE

    Charneca, Rui; Freitas, Amadeu; Nunes, José; Le Dividich, Jean

    2013-01-01

    The objective of this study was to determine whether birth weight of the pig is related to its birth order. The study involved 292 sows from 2 genotypes (Large White x Landrace crossbred (LL), n= 247 and Alentejano (AL), n=45) of mixed parity and their piglets. Most sows farrowed naturally. Each piglet was identified, weighed (± 1g) (mummies excepted) and its birth order (BO) recorded within 2 min of birth. A total of 3418 LL and 375 AL piglets were born of which 43 and 7 were mummified, a...

  5. Parental investments in child health - maternal health behaviours and birth outcomes

    DEFF Research Database (Denmark)

    Wüst, Miriam

    consumption, exercise and diet during pregnancy on birth outcomes and considers the problem of identifying the causal effect of these endogenous maternal health behaviours. The analysis controls for a wide range of covariates and exploits sibling variation in the Danish National Birth Cohort. The paper...... the ways in which child health is generated, and - for children of higher birth order - earlier children's outcomes will shape parental investments in child health....

  6. [Effects of the late marriage of Korean women on the first-birth interval].

    Science.gov (United States)

    Chung, Woojin; Lee, Kyoungae; Lee, Sunmi

    2006-05-01

    The purpose of this study was to examine the effect of women's late age of marriage on the interval between marriage and their first birth. Data from Year 2000 Korea National Fertility Survey was collected through direct interview questionings, and the data was analyzed based on randomly selected sampling. In particular, the married women (N=5,648) were analyzed for the factors that determined the first-birth interval by performing Cox's proportional hazard model survival analysis. Unlike previous findings, the woman whose age of marriage was 30 or more was more likely to delay the birth of her first baby than were the other women who married earlier. Further, a woman's age at marriage, a woman's residence before marriage, her husband's religion, her husband's level of education and the difference in age between the woman and her husband significantly influenced the first-birth interval. In contrast, for a married woman, her age, level of education, current residence and religion were not significant predictors of her first birth interval. Our study showed that women who married at the age of 30 years or more tend to postpone their first birth in Korea. When facing the increasing number of women who marry at a late age, the Korean government should implement population and social policies to encourage married women have their first child as early as possible.

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

    Science.gov (United States)

    Daw, Jamie R; Sommers, Benjamin D

    2018-02-13

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

  8. Planned home births: the need for additional contraindications.

    Science.gov (United States)

    Grünebaum, Amos; McCullough, Laurence B; Sapra, Katherine J; Arabin, Birgit; Chervenak, Frank A

    2017-04-01

    Planned home births in the United States are associated with fewer interventions but with increased adverse neonatal outcomes such as perinatal and neonatal deaths, neonatal seizures or serious neurologic dysfunction, and low 5-minute Apgar scores. The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice states that, to reduce perinatal death and to improve outcomes at planned home births, strict criteria are necessary to guide the selection of appropriate candidates for planned home birth. The committee lists 3 absolute contraindications for a planned home birth: fetal malpresentation, multiple gestations, and a history of cesarean delivery. The aim of this study was to evaluate whether there are risk factors that should be considered contraindications to planned home births in addition to the 3 that are listed by the American College of Obstetricians and Gynecologists. We conducted a population-based, retrospective cohort study of all term (≥37 weeks gestation), normal weight (≥2500 grams), singleton, nonanomalous births from 2009-2013 using the Centers for Disease Control and Prevention's period-linked birth-infant death files that allowed for identification of intended and unintended home births. We examined neonatal deaths (days 0-27 after birth) across 3 groups (hospital-attended births by certified nurse midwives, hospital-attended births by physicians, and planned home births) for 5 risk factors: 2 of the 3 absolute contraindications to home birth listed by the American College of Obstetricians and Gynecologists (breech presentation and previous cesarean delivery) and 3 additional risk factors (parity [nulliparous and multiparous], maternal age [women home births (12.1 neonatal death/10,000 deliveries; Pbirths by certified nurse midwives (3.08 neonatal death/10,000 deliveries) or physicians (5.09 neonatal death/10,000 deliveries). Neonatal mortality rates were increased significantly at planned home births, with the

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. Demographic Consequences of Gender Discrimination in China: Simulation Analysis of Policy Options

    Science.gov (United States)

    Quanbao, Jiang; Marcus W., Feldman

    2013-01-01

    The large number of missing females in China, a consequence of gender discrimination, is having and will continue to have a profound effect on the country's population development. In this paper, we analyze the causes of this gender discrimination in terms of institutions, culture and, economy, and suggest public policies that might help eliminate gender discrimination. Using a population simulation model, we study the effect of public policies on the sex ratio at birth and excess female child mortality, and the effect of gender discrimination on China's population development. We find that gender discrimination will decrease China's population size, number of births, and working age population, accelerate population aging and exacerbate the male marriage squeeze. These results provide theoretical support for suggesting that the government enact and implement public policies aimed at eliminating gender discrimination. PMID:24363477

  14. Maternal residential exposure to agricultural pesticides and birth defects in a 2003 to 2005 North Carolina birth cohort.

    Science.gov (United States)

    Rappazzo, Kristen M; Warren, Joshua L; Meyer, Robert E; Herring, Amy H; Sanders, Alison P; Brownstein, Naomi C; Luben, Thomas J

    2016-04-01

    Birth defects are responsible for a large proportion of disability and infant mortality. Exposure to a variety of pesticides have been linked to increased risk of birth defects. We conducted a case-control study to estimate the associations between a residence-based metric of agricultural pesticide exposure and birth defects. We linked singleton live birth records for 2003 to 2005 from the North Carolina (NC) State Center for Health Statistics to data from the NC Birth Defects Monitoring Program. Included women had residence at delivery inside NC and infants with gestational ages from 20 to 44 weeks (n = 304,906). Pesticide exposure was assigned using a previously constructed metric, estimating total chemical exposure (pounds of active ingredient) based on crops within 500 meters of maternal residence, specific dates of pregnancy, and chemical application dates based on the planting/harvesting dates of each crop. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals for four categories of exposure (90(th) percentiles) compared with unexposed. Models were adjusted for maternal race, age at delivery, education, marital status, and smoking status. We observed elevated ORs for congenital heart defects and certain structural defects affecting the gastrointestinal, genitourinary and musculoskeletal systems (e.g., OR [95% confidence interval] [highest exposure vs. unexposed] for tracheal esophageal fistula/esophageal atresia = 1.98 [0.69, 5.66], and OR for atrial septal defects: 1.70 [1.34, 2.14]). Our results provide some evidence of associations between residential exposure to agricultural pesticides and several birth defects phenotypes. Birth Defects Research (Part A) 106:240-249, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Midwife-assisted planned home birth: an essential component of improving the safety of childbirth in Sub-Saharan Africa.

    Science.gov (United States)

    Dayyabu, Aliyu Labaran; Murtala, Yusuf; Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Levene, Malcolm I; Brent, Robert L; Monni, Giovanni; Sen, Cihat; Makatsariya, Alexander; Chervenak, Frank A

    2018-05-29

    Hospital births, when compared to out-of-hospital births, have generally led to not only a significantly reduced maternal and perinatal mortality and morbidity but also an increase in certain interventions. A trend seems to be emerging, especially in the US where some women are requesting home births, which creates ethical challenges for obstetricians and the health care organizations and policy makers. In the developing world, a completely different reality exists. Home births constitute the majority of deliveries in the developing world. There are severe limitations in terms of facilities, health personnel and deeply entrenched cultural and socio-economic conditions militating against hospital births. As a consequence, maternal and perinatal mortality and morbidity remain the highest, especially in Sub-Saharan Africa (SSA). Midwife-assisted planned home birth therefore has a major role to play in increasing the safety of childbirth in SSA. The objective of this paper is to propose a model that can be used to improve the safety of childbirth in low resource countries and to outline why midwife assisted planned home birth with coordination of hospitals is the preferred alternative to unassisted or inadequately assisted planned home birth in SSA.

  16. From institutionalized birth to home birth

    Directory of Open Access Journals (Sweden)

    Clara Fróes de Oliveira Sanfelice

    2014-06-01

    Full Text Available The study aimed to describe the experiences of a group of nurse-midwives from the city of Campinas, SP, Brasil, regarding the transition process from attending institutionalized births to attending home births, in the period 2011 – 2013. The study is of the experience report type; the reflections, perceptions and challenges experienced in this process were collected using the technique of brainstorming. Content analysis, as proposed by Bardin, was used, which yielded four thematic categories: a the hospital experience; b living with obstetric violence; c returning home and d the challenges of home care. It is concluded that attending home births offers greater satisfaction to the nurses, even in the face of various obstacles, as it is possible to offer a care to the woman and new-born which covers both the concept of comprehensiveness and the current scientific recommendations.

  17. Mothers with alcoholic liver disease and the risk for preterm and small-for-gestational-age birth.

    Science.gov (United States)

    Stokkeland, Knut; Ebrahim, Fereshte; Hultcrantz, Rolf; Ekbom, Anders; Stephansson, Olof

    2013-01-01

    To study pregnancy outcome in women with alcoholic liver disease (ALD). Using the Swedish nation-wide Patient and Medical Birth Registers, we investigated risk of adverse pregnancy outcome in 720 women diagnosed with ALD before and 1720 diagnosed after birth and compared them with 24 460 population-based control births. Women with ALD diagnosed before or after birth were generally of higher age and body mass index, more likely to smoke cigarettes during pregnancy and to have a low socio-economic status compared with controls. Women diagnosed with ALD before birth had an increased risk of moderately and very preterm birth, adjusted odd ratio (OR) = 1.53 (95% confidence interval (CI): 1.37-1.72 and 1.15-2.06 95%), respectively. Infants of mothers with ALD before birth were more often small-for-gestational age, adjusted OR = 1.22 (95% CI: 1.05-1.43), and were at increased risk for low Apgar scores (<7) at 5 min, adjusted OR = 1.49 (95% CI: 1.15-1.92) compared with controls. Similar associations with slightly lower-risk estimates were found among women diagnosed with ALD after birth. ALD is associated with adverse-birth outcomes, highlighting the importance of screening women for alcohol dependence in antenatal care.

  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. 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.

  20. 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.

  1. [Birthing institutions and births in Norwegian counties in the early 1990s].

    Science.gov (United States)

    Bergsjø, P; Daltveit, A K

    1996-05-20

    Between 1972 and 1993 the number of hospitals and maternity homes providing obstetric help in Norway fell from 158 to 67. Most of the decline is explained by the closing down of maternity homes and obstetrical units in small hospitals, partly due to a reduction in number of births and partly to a deliberate drive towards giving birth in larger units. 16 of the 19 counties of Norway contained four or fewer obstetric institutions in 1993. Nevertheless, most of the 60,000 births took place in institutions with between 500 and 2,999 births annually. Births at home accounted for 0.3%, and births during transport for 0.2% of the total in 1990 and 1993.

  2. 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.

  3. The costs of home delivery of a birth dose of hepatitis B vaccine in a prefilled syringe in Indonesia.

    OpenAIRE

    Levin, Carol E.; Nelson, Carib M.; Widjaya, Anton; Moniaga, Vanda; Anwar, Chairiyah

    2005-01-01

    OBJECTIVE: To provide global policy-makers with decision-making information for developing strategies for immunization of infants with a birth dose of hepatitis B vaccine, this paper presents a retrospective cost analysis, conducted in Indonesia, of delivering this vaccine at birth using the Uniject prefill injection device. METHODS: Incremental costs or cost savings associated with changes in the hepatitis B immunization programme were calculated using sensitivity analysis to vary the estima...

  4. 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 ...

  5. Contact Between Birth and Adoptive Families During the First Year Post-Placement: Perspectives of Lesbian, Gay, and Heterosexual Parents.

    Science.gov (United States)

    Farr, Rachel H; Goldberg, Abbie E

    Despite growing visibility of lesbian- and gay-parent adoption, only one qualitative study has examined birth family contact among adoptive families with lesbian and gay parents (Goldberg, Kinkler, Richardson, & Downing, 2011). We studied adoptive parents' (34 lesbian, 32 gay, and 37 heterosexual; N = 103 families) perspectives of birth family contact across the first year post-placement. Using questionnaire and interview data, we found few differences in openness dynamics by parental sexual orientation. Most reported some birth mother contact, most had legally finalized their adoption, and few described plans to withhold information from children. We discuss implications for clinical practice, policy, and research.

  6. 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 ...

  7. 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.

  8. Examining the effects of birth order on personality.

    Science.gov (United States)

    Rohrer, Julia M; Egloff, Boris; Schmukle, Stefan C

    2015-11-17

    This study examined the long-standing question of whether a person's position among siblings has a lasting impact on that person's life course. Empirical research on the relation between birth order and intelligence has convincingly documented that performances on psychometric intelligence tests decline slightly from firstborns to later-borns. By contrast, the search for birth-order effects on personality has not yet resulted in conclusive findings. We used data from three large national panels from the United States (n = 5,240), Great Britain (n = 4,489), and Germany (n = 10,457) to resolve this open research question. This database allowed us to identify even very small effects of birth order on personality with sufficiently high statistical power and to investigate whether effects emerge across different samples. We furthermore used two different analytical strategies by comparing siblings with different birth-order positions (i) within the same family (within-family design) and (ii) between different families (between-family design). In our analyses, we confirmed the expected birth-order effect on intelligence. We also observed a significant decline of a 10th of a SD in self-reported intellect with increasing birth-order position, and this effect persisted after controlling for objectively measured intelligence. Most important, however, we consistently found no birth-order effects on extraversion, emotional stability, agreeableness, conscientiousness, or imagination. On the basis of the high statistical power and the consistent results across samples and analytical designs, we must conclude that birth order does not have a lasting effect on broad personality traits outside of the intellectual domain.

  9. 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.

  10. 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

  11. 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

  12. 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.

  13. 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

  14. Prenatal nitrate intake from drinking water and selected birth defects in offspring of participants in the national birth defects prevention study.

    Science.gov (United States)

    Brender, Jean D; Weyer, Peter J; Romitti, Paul A; Mohanty, Binayak P; Shinde, Mayura U; Vuong, Ann M; Sharkey, Joseph R; Dwivedi, Dipankar; Horel, Scott A; Kantamneni, Jiji; Huber, John C; Zheng, Qi; Werler, Martha M; Kelley, Katherine E; Griesenbeck, John S; Zhan, F Benjamin; Langlois, Peter H; Suarez, Lucina; Canfield, Mark A

    2013-09-01

    Previous studies of prenatal exposure to drinking-water nitrate and birth defects in offspring have not accounted for water consumption patterns or potential interaction with nitrosatable drugs. We examined the relation between prenatal exposure to drinking-water nitrate and selected birth defects, accounting for maternal water consumption patterns and nitrosatable drug exposure. With data from the National Birth Defects Prevention Study, we linked addresses of 3,300 case mothers and 1,121 control mothers from the Iowa and Texas sites to public water supplies and respective nitrate measurements. We assigned nitrate levels for bottled water from collection of representative samples and standard laboratory testing. Daily nitrate consumption was estimated from self-reported water consumption at home and work. With the lowest tertile of nitrate intake around conception as the referent group, mothers of babies with spina bifida were 2.0 times more likely (95% CI: 1.3, 3.2) to ingest ≥ 5 mg nitrate daily from drinking water (vs. nitrate daily (vs. water nitrate intake did not increase associations between prenatal nitrosatable drug use and birth defects. Higher water nitrate intake was associated with several birth defects in offspring, but did not strengthen associations between nitrosatable drugs and birth defects.

  15. The impact of postpartum contraception on reducing preterm birth: findings from California.

    Science.gov (United States)

    Rodriguez, Maria I; Chang, Richard; Thiel de Bocanegra, Heike

    2015-11-01

    Family planning is recommended as a strategy to prevent adverse birth outcomes. The potential contribution of postpartum contraceptive coverage to reducing rates of preterm birth is unknown. In this study, we examine the impact of contraceptive coverage and use within 18 months of a birth on preventing preterm birth in a Californian cohort. We identified records for second or higher-order births among women from California's 2011 Birth Statistical Master File and their prior births from earlier Birth Statistical Master Files. To identify women who received contraceptive services from publicly funded programs, we applied a probabilistic linking methodology to match birth files with enrollment records for women with Medi-Cal or Family Planning, Access, Care, and Treatment Program (PACT) claims. The length of contraceptive coverage was determined through applying an algorithm based on the specified method and the quantity dispensed. Preterm birth was defined as a birth occurring birth using subcategories defined by the World Health Organization: extremely preterm (birth and control for key covariates. The cohort consisted of 111,948 women who were seen at least once by a Medi-Cal or Family PACT provider within 18 months of delivery. Of the cohort, 9.75% had a preterm birth. Contraceptive coverage was found to be protective against preterm birth. For every month of contraceptive coverage, odds of a preterm birth confidence interval, 0.986-0.993). Improving postpartum contraceptive use has the potential to reduce preterm births. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. 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

  17. Impact of forced separation policy on incarcerated postpartum mothers.

    Science.gov (United States)

    Chambers, Angelina N

    2009-08-01

    The number of incarcerated women in the United States is steadily increasing with 9% giving birth while serving time. Mothers and babies are routinely separated immediately and during most of the postpartum period. This qualitative study examines the impact of this policy by exploring the nature and meaning of the mother-infant bonding experience when the mothers know separation is coming. Twelve incarcerated postpartum mothers were interviewed during the early postpartum period about their antepartum and postpartum relationships with their babies. Qualitative data analysis produced four relational themes: (a) "a love connection," (b) "everything was great until I birthed," (c) "feeling empty and missing a part of me," and (d) "I don't try to think too far in advance." Results of this qualitative study provide information to professionals exploring gender-sensitive prison policies for the growing female population.

  18. At the Crossroads: ICT Policy Making in East Africa | IDRC ...

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

    ) policymaking, e-strategies, or indeed e-government implementations have a recent history in Africa, not many countries have fully developed working policies ... Birth registration is the basis for advancing gender equality and children's rights.

  19. Relationship between periodontal disease and preterm low birth weight: systematic review.

    Science.gov (United States)

    Teshome, Amare; Yitayeh, Asmare

    2016-01-01

    Periodontal disease is a neglected bacterial infection that causes destruction of the periodontium in pregnant women. Yet its impact on the occurrence of adverse pregnancy outcomes has not systematically evaluated and there is no clear statement on the relationship between periodontal disease and preterm low birth weight. The objective of this study was to summarize the evidence on the impact of periodontal disease on preterm low birth weight. We searched the following data bases from January 2005 to December 2015: CINAHL (cumulative index to nursing and allied health literature), MEDLINE, AMED, EMBASE (excerpta medica database), Cochrane library and Google scholar. Only case-control studies with full text in English were eligible. Critical appraisal of the identified articles was done by two authors independently to provide the possible relevance of the papers for inclusion in the review process. The selected Case control studies were critically appraised with 12 items structured checklist adapted from national institute of health (NIH). Odds ratio (OR) or risk ratios (RR) were extracted from the selected studies. The two reviewers who selected the appropriate studies also extracted the data and evaluated the risk of bias. Of 229 articles, ten studies with a total of 2423 participants with a mean age ranged from 13 to 49 years were met the inclusion criteria. The studies focused on preterm birth, low birth weight and /or preterm low birth weight and periodontitis. Of the selected studies, 9 implied an association between periodontal disease and increased risk of preterm birth, low birth weight and /or preterm low birth weight outcome (ORs ranging from 2.04 to 4.19) and only one study found no evidence of association. Periodontal disease may be one of the possible risk factor for preterm low birth weight infant. However, more precise studies with randomized clinical trial with sufficient follow-up period must be done to confirm the association.

  20. Making birthing safe for Pakistan women: a cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Khan Muhammad

    2012-07-01

    Full Text Available Abstract Background Two out of three neonatal deaths occur in just 10 countries and Pakistan stands third among them. Maternal mortality is also high with most deaths occurring during labor, birth, and first few hours after birth. Enhanced access and utilization of skilled delivery and emergency obstetric care is the demonstrated strategy in reducing maternal and neonatal mortality. This trial aims to compare reduction in neonate mortality and utilization of available safe birthing and Emergency Obstetric and Neonatal Care services among pregnant mothers receiving ‘structured birth planning’, and/or ‘transport facilitation’ compared to routine care. Methods A pragmatic cluster randomized trial, with qualitative and economic studies, will be conducted in Jhang, Chiniot and Khanewal districts of Punjab, Pakistan, from February 2011 to May 2013. At least 29,295 pregnancies will be registered in the three arms, seven clusters per arm; 1 structured birth planning and travel facilitation, 2 structured birth planning, and 3 control arm. Trial will be conducted through the Lady Health Worker program. Main outcomes are difference in neonatal mortality and service utilization; maternal mortality being the secondary outcome. Cluster level analysis will be done according to intention-to-treat. Discussion A nationwide network of about 100,000 lady health workers is already involved in antenatal and postnatal care of pregnant women. They also act as “gatekeepers” for the child birthing services. This gate keeping role mainly includes counseling and referral for skill birth attendance and travel arrangements for emergency obstetric care (if required. The review of current arrangements and practices show that the care delivery process needs enhancement to include adequate information provision as well as informed “decision” making and planned “action” by the pregnant women. The proposed three-year research is to develop, through national

  1. 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...

  2. The Impact of Tobacco Control Policies on Smoking Among Socioeconomic Groups in Nine European Countries, 1990-2007.

    Science.gov (United States)

    Hu, Yannan; van Lenthe, Frank J; Platt, Stephen; Bosdriesz, Jizzo R; Lahelma, Eero; Menvielle, Gwenn; Regidor, Enrique; Santana, Paula; de Gelder, Rianne; Mackenbach, Johan P

    2017-11-07

    It is uncertain whether tobacco control policies have contributed to a narrowing or widening of socioeconomic inequalities in smoking in European countries during the past two decades. This paper aims to investigate the impact of price and non-price related population-wide tobacco control policies on smoking by socioeconomic group in nine European countries between 1990 and 2007. Individual-level education, occupation and smoking status were obtained from nationally representative surveys. Country-level price-related tobacco control policies were measured by the relative price of cheapest cigarettes and of cigarettes in the most popular price category. Country-level non-price policies were measured by a summary score covering four policy domains: smoking bans or restrictions in public places and workplaces, bans on advertising and promotion, health warning labels, and cessation services. The associations between policies and smoking were explored using logistic regressions, stratified by education and occupation, and adjusted for age, Gross Domestic Product, period and country fixed effects. The price of popular cigarettes and non-price policies were negatively associated with smoking among men. The price of the cheapest cigarettes was negatively associated with smoking among women. While these favorable effects were generally in the same direction for all socioeconomic groups, they were larger and statistically significant in lower socioeconomic groups only. Tobacco control policies as implemented in nine European countries, have probably helped to reduce the prevalence of smoking in the total population, particularly in lower socioeconomic groups. Widening inequalities in smoking may be explained by other factors. Policies with larger effects on lower socioeconomic groups are needed to reverse this trend. Socioeconomic inequalities in smoking widened between the 1990s and the 2000s in Europe. During the same period, there were intensified tobacco control policies

  3. Evaluation of factors affecting birth weight and preterm birth in southern Turkey

    International Nuclear Information System (INIS)

    Araz, N. C.

    2013-01-01

    Objective: To identify factors affecting birth weight and pre-term birth, and to find associations with electromagnetic devices such as television, computer and mobile phones. Methods: The study was conducted in Turkey at Gazintep University, Faculty of Medicine Outpatient Clinic at the Paediatric Ward. It comprised 500 patients who presented at the clinic from May to December 2009. All participants were administered a questionnaire regarding their pregnancy history. SPSS 13 was used for statistical analysis. Results: In the study, 90 (19%) patients had pre-term birth , and 64 (12.9%) had low birth weight rate Birth weight was positively correlated with maternal age and baseline maternal weight (r= 0.115, p= 0.010; r= 0.168, p=0.000, respectively). Pre-term birth and birth weight less than 2500g were more common in mothers with a history of disease during pregnancy (p=0.046 and p=0.008, respectively). The habit of watching television and using mobile phones and computer by mothers did not demonstrate any relationship with birth weight. Mothers who used mobile phones or computers during pregnancy had more deliveries before 37 weeks (p=0.018, p=0.034; respectively). Similarly, pregnancy duration was shorter in mothers who used either mobile phone or computers during pregnancy (p=0.005, p=0.048, respectively). Conclusion: Mobile phones and computers may have an effect on pre-term birth. (author)

  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. 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…

  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. 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)

  8. Efficacy of additional psychosocial intervention in reducing low birth weight and preterm birth in teenage pregnancy: A systematic review and meta-analysis.

    Science.gov (United States)

    Sukhato, Kanokporn; Wongrathanandha, Chathaya; Thakkinstian, Ammarin; Dellow, Alan; Horsuwansak, Pornpot; Anothaisintawee, Thunyarat

    2015-10-01

    This systematic review aimed to assess the efficacy of psychosocial interventions in reducing risk of low birth weight (LBW) and preterm birth (PTB) in teenage pregnancy. Relevant studies were identified from Medline, Scopus, CINAHL, and CENTRAL databases. Randomized controlled trials investigating effect of psychosocial interventions on risk of LBW and PTB, compared to routine antenatal care (ANC) were eligible. Relative risks (RR) of LBW and PTB were pooled using inverse variance method. Mean differences of birth weight (BW) between intervention and control groups were pooled using unstandardized mean difference (USMD). Five studies were included in the review. Compared with routine ANC, psychosocial interventions significantly reduced risk of LBW by 40% (95%CI: 8%,62%) but not for PTB (pooled RR = 0.67, 95%CI: 0.42,1.05). Mean BW of the intervention group was significantly higher than that of the control group with USMD of 200.63 g (95% CI: 21.02, 380.25). Results of our study suggest that psychosocial interventions significantly reduced risk of LBW in teenage pregnancy. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  9. 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

  10. 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.

  11. Epigenetic Consequences of Low Birth-Weight and Preterm Birth in Adult Twins

    DEFF Research Database (Denmark)

    Tan, Qihua

    2018-01-01

    could be detrimental to health later in life. Current epigenetic studies using genome-wide DNA methylation profiling have discovered molecular evidence confirming that, as important early life events, both low birth-weight and premature birth can result in long-lasting epigenetic consequences...... that impact health at adult ages. Results from our epigenome-wide association studies indicate that the two moderately correlated traits of adverse pregnancy outcome could be linked to increased susceptibility to different health problems with low birth-weight more relevant to metabolic disorders, while......Adverse birth outcomes including low birth-weight and preterm birth are associated with long-term morbidity and health consequences at adult ages. Molecular mechanisms including epigenetic modification may have been involved in the adaptation to the stressful condition in peridelivery period which...

  12. Ideology, Family Policy, Production, and (ReEducation: Literary Treatment of Abortion in the GDR of the Early 1980s

    Directory of Open Access Journals (Sweden)

    Heinz Bulmahn

    1997-06-01

    Full Text Available The decision by the Constitutional Court in Karlsruhe of placing restrictions on the right to an abortion will profoundly affect German women's right to choose. This decision is a culmination of efforts to errode the right to choose for West as well as East German women. In the former GDR, even though liberal abortion laws allowed women access to free abortions, for ideological reasons, the government devised policies that discouraged abortions as a means of birth control. This policy becomes particularly apparent in the early 1980s when the East German government, confronted with a declining birth rate, faced the dilemma of how to leave the existing liberal abortion law intact while discouraging women from aborting their fetuses. To accomplish this task officials persuaded writers to produce literary works that promoted a three-child family policy where abortion was relegated to an inappropriate option. The article analyzes several literary works written in the early 1980s within the context of this renewed effort to encourage women to produce more children at the expense of their personal choice, and concludes that, in spite of the liberal abortion rights in the former GDR, the conditions for exercising these rights proved to be far less favorable.

  13. Birth Order and Educational Achievement in Adolescence and Young Adulthood

    Science.gov (United States)

    Fergusson, David M.; Horwood, L. John; Boden, Joseph M.

    2006-01-01

    This paper examines the relationship between birth order and later educational outcomes in a birth cohort of more than 1,000 New Zealand young adults studied to the age of twenty-five. Being later born was associated with gaining fewer educational qualifications at secondary level and beyond. The use of nested models to control for the confounding…

  14. 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.

  15. What impact have tobacco control policies, cigarette price and tobacco control programme funding had on Australian adolescents' smoking? Findings over a 15-year period.

    Science.gov (United States)

    White, Victoria M; Warne, Charles D; Spittal, Matthew J; Durkin, Sarah; Purcell, Kate; Wakefield, Melanie A

    2011-08-01

    To assess the impact of tobacco control policies relating to youth access, clean indoor air and tobacco advertising at point-of-sale and outdoors, in addition to cigarette price and per capita tobacco control spending, on adolescent smoking prevalence. Repeated cross-sectional surveys. Logistic regression analyses examined association between policies and smoking prevalence. Australia, 1990-2005. A nationally representative sample of secondary students (aged 12-17 years) participating in a triennial survey (sample size per survey range: 20 560 to 27 480). Students' report of past-month smoking. In each jurisdiction, extent of implementation of the three policies for the year of the survey was determined. For each survey year, national per capita tobacco control spending was determined and jurisdiction-specific 12-month change in cigarette price obtained. Extent of implementation of the three policy areas varied between states and over the survey years. Multivariate analyses that adjusted for demographic factors, year and all tobacco control variables showed that 12-month cigarette price increases [odds ratio (OR): 0.98, 95% confidence interval (CI): 0.97-0.99], greater per capita tobacco control spending (OR: 0.99, 95% CI: 0.98-0.99) and stronger implementation of clean indoor air policies (OR: 0.93, 95% CI: 0.92-0.94) were associated with reduced smoking prevalence. Adult-directed, population-based tobacco control policies such as clean indoor air laws and increased prices of cigarettes, implemented as part of a well-funded comprehensive tobacco control programme are associated with lower adolescent smoking. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  16. The Effect of Local Smokefree Regulations on Birth Outcomes and Prenatal Smoking.

    Science.gov (United States)

    Bartholomew, Karla S; Abouk, Rahi

    2016-07-01

    Objectives We assessed the impact of varying levels of smokefree regulations on birth outcomes and prenatal smoking. Methods We exploited variations in timing and regulation restrictiveness of West Virginia's county smokefree regulations to assess their impact on birthweight, gestational age, low birthweight, very low birthweight, preterm birth, and prenatal smoking. We conducted regression analysis using state Vital Statistics individual-level data for singletons born to West Virginia residents between 1995-2010 (N = 293,715). Results Only more comprehensive smokefree regulations were associated with statistically significant favorable effects on birth outcomes in the full sample: Comprehensive (workplace/restaurant/bar ban) demonstrated increased birthweight (29 grams, p workplace/restaurant ban) demonstrated a small decrease in very low birthweight (-0.2 %, p workplace ban) was associated with a 23 g (p < 0.01) decrease in birthweight; Limited (partial ban) had no effect. Comprehensive's improvements extended to most maternal groups, and were broadest among mothers 21+ years, non-smokers, and unmarried mothers. Prenatal smoking declined slightly (-1.7 %, p < 0.01) only among married women with Comprehensive. Conclusions Regulation restrictiveness is a determining factor in the impact of smokefree regulations on birth outcomes, with comprehensive smokefree regulations showing promise in improving birth outcomes. Favorable effects on birth outcomes appear to stem from reduced secondhand smoke exposure rather than reduced prenatal smoking prevalence. This study is limited by an inability to measure secondhand smoke exposure and the paucity of data on policy implementation and enforcement.

  17. Birth Weight, Physical Morbidity, and Mortality: A Population-based Sibling-Comparison Study

    Science.gov (United States)

    Class, Quetzal A.; Rickert, Martin E.; Lichtenstein, Paul; D'Onofrio, Brian M.

    2014-01-01

    Associations between low birth weight (≤2,500 g) and increased risk of mortality and morbidity provided the foundation for the “developmental origins of health and disease” hypothesis. Previous between-family studies could not control for unmeasured confounders. Therefore, we compared differentially exposed siblings to estimate the extent to which the associations were due to uncontrolled factors. Our population cohort included 3,291,773 persons born in Sweden from 1973 to 2008. Analyses controlled for gestational age, among other covariates, and considered birth weight as both an ordinal and a continuous variable. Outcomes included mortality after 1 year, cardiac-related death, hypertension, ischemic heart disease, pulmonary circulation problems, stroke, and type 2 diabetes mellitus. We fitted fixed-effects models to compare siblings and conducted sensitivity analyses to test alternative explanations. Across the population, the lower the birth weight, the greater the risk of mortality (e.g., cardiac-related death (low birth weight hazard ratio = 2.69, 95% confidence interval: 2.05, 3.53)) and morbidity (e.g., type 2 diabetes mellitus (low birth weight hazard ratio = 1.79, 95% confidence interval: 1.50, 2.14)) outcomes in comparison with normal birth weight. All associations were independent of shared familial confounders and measured covariates. Results emphasize the importance of birth weight as a risk factor for subsequent mortality and morbidity. PMID:24355331

  18. Planned and unplanned home births and hospital births in Calgary, Alberta, 1984-87.

    OpenAIRE

    Abernathy, T J; Lentjes, D M

    1989-01-01

    Information collected on all home births in Calgary (Canada) between the years 1984 and 1987, was examined and analyzed according to whether the home birth environment had been planned or unplanned. The two groups were compared to each other and to all hospital births according to demographic characteristics of mothers, indicators of prenatal care, and birth outcome. Mothers who had planned their home birth were more likely to be primiparous, attend prenatal classes, obtain regular prenatal c...

  19. Periodontal treatment during pregnancy and birth outcomes: a meta-analysis of randomised trials.

    Science.gov (United States)

    George, Ajesh; Shamim, Simin; Johnson, Maree; Ajwani, Shilpi; Bhole, Sameer; Blinkhorn, Anthony; Ellis, Sharon; Andrews, Karen

    2011-06-01

    The objective of this review was to conduct a meta-analysis of all up-to-date randomised control trials to determine whether periodontal treatment during pregnancy has the potential of reducing preterm birth and low birth weight incidence. Bibliographic databases MEDLINE (1966-present), EMBASE (1980-present), CINAHL (1982-present) and the Cochrane library up to and including 2010 Issue 10 were searched. The reference list of included studies and reviews were also searched for additional literature. Eligible studies were, published and ongoing randomised control trials that compared pregnancy outcomes for pregnant women who received periodontal treatment during the prenatal period. Two of the investigators independently assessed the studies and then extracted and summarised data from eligible trials. Extracted data were entered into Review Manager software and analysed. A total of 5645 pregnant women participated in the 10 eligible trials. Meta-analysis found that periodontal treatment significantly lowered preterm birth (odd ratio 0.65; 95% confidence interval, 0.45-0.93; P = 0.02) and low birth weight (odd ratio 0.53; 95% confidence interval, 0.31-0.92; P = 0.02) rates while no significant difference was found for spontaneous abortion/stillbirth (odd ratio 0.71; 95% confidence interval, 0.43-1.16; P = 0.17). Moderate heterogeneity was observed among the studies for preterm birth and low birth weight. Subgroup analysis showed significant effect of periodontal treatment in pregnant women with low rate of previous preterm birth/low birth weight (odd ratio 0.35; 95% confidence interval, 017-0.70; P = 0.003) and less severe periodontal disease (odd ratio 0.49; confidence interval, 028-0.87; P = 0.01) as defined by probing depth. The cumulative evidence suggests that periodontal treatment during pregnancy may reduce preterm birth and low birth weight incidence. However, these findings need to be further validated through larger more targeted randomised control trials.

  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.